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Operation Manual - Artemis Medical

1. each time NOTE AQBUCQDEE are only codes for drugs instead of their real names The units for these five drugs are fixed The operator may select the appropriate units according to the convention of using these drugs The rules for expressing the units are mg series units are fixedly used for drug A B and C g mg mcg unit series units are fixedly used for drug D unit k unit m unit mEq is fixedly used for drug E 9 2 Patient Monitor user s manual V 2 2 Patient weight Drug Calculation and Titration Table After accessing the DRUG CALC window the operator should enter the patient weight into the first or the second item The entered weight will be used as the independent data only for the calculation of drug concentration A Note A This drug calculation function acts only as a calculator That means the patient weight in Drug Calculation menu and the patient weight in Patient Information menu are independent from each other Therefore if the Weight in Drug Calculation changes the Weight in Patient Information does not change In this way we can say the Drug Calculation menu is independent from other menus in the system Any change of it will not affect other information about the patient being currently monitored 9 2 Titration Table Access titration table Select TITRATION item
2. CO2REVERSE FLOW CO2 FORWARD FLOW CO2 MALNUFUNC TION CO2 BAROMETRIC HIGH CO2 BAROMETRIC LOW CO2 modules has failure Contact the manufacturer for repair Patient Monitor user s manual V 2 2 5 System Alarm Prompt CO2 ERROR WATCHDOG CO2 INT COMM ERR SYSTEM ROM ERR CO2 FLASH CRC ERR CO2 EXT RAM ERR CO2 INT RAM ERR FLASH CHECK ERR CO2 STACK OVER CO2 SENSOR FAULT CO2 SENSOR TEMP HIGH CO2 SENSOR TEMP LOW When the system displays Re set up the system time It is better to set up the time just after a 2000 1 1 the system gives the start up and prior to Ne SE this prompt reminding the monitoring the patient After user that the current system modifying the time the user had time is not right better re start up the monitor to avoid storing error time The system has no cell REAL CLOCK NOT Install or replace the EXIST Ge rechargeable battery run out of the capacity SYSTEM WD FAILURE SYSTEM SOFTWARE ERR SYSTEM CMOS FULL SYSTEM CMOS ERR SYSTEM EPGA FAILURE SYSTEM FAILURE2 SYSTEM FAILURE3 SYSTEM FAILURE4 SYSTEM FAILURES SYSTEM FAILURE6 SYSTEM FAILURE SYSTEM FAILURE8 SYSTEM FAILURES SYSTEM FAILURE10 SYSTEM FAILURE11 SYSTEM FAILURE
3. EtO2 LOW The measured EtCO value is below the setup lower alarm limit User selectable FiIN2O HIGH The measured PINO value exceeds the setup upper alarm limit User selectable FiN20 LOW The measured FiN2O value is below the setup lower alarm limit User selectable EtN20 HIGH The measured ENZ value exceeds the setup upper alarm limit User selectable EtN20 LOW FiDES HIGH The measured EtN2O value is below the setup lower alarm limit The measured FiDES value exceeds the setup upper alarm limit User selectable User selectable FiDES LOW The measured FiIDES value is below the setup lower alarm limit User selectable EtDES HIGH The measured EtDES value exceeds the setup upper alarm limit User selectable EtDES LOW The measured EtDES value is below the setup lower alarm limit User selectable FIHAL HIGH The measured FiHAL value exceeds the setup upper alarm limit User selectable FIHAL LOW The measured FIHAL value is below the setup lower alarm limit User selectable EtHAL HIGH EtHAL LOW The measured EtHAL value exceeds the setup upper alarm limit The measured EtHAL value is below the setup lower alarm limit User selectable User selectable FiISO HIGH The measured FilSO value exceeds the setup upper alarm limit User selectable FilSO LOW The measured FilSO value is below the setup lower alar
4. 4 4 Face Select Trend graph is located to the right of the corresponding waveform in the Waveform area Its color is the same as that of the corresponding parameter H Trend length Dynamic trend length is 2 hours On the trend graph the scale of the right end of the X axis is 0 hour while the left end is 2 hour m Select trend parameter If multiple parameters are located at the same position on the trend graph by selecting the corresponding hot key of a parameter on the trend graph you can have the trend graph of this parameter displayed on the screen For example in ECG trend graph you can select hot keys such as HR ST or PVCs then the system will display their corresponding trend graphs respectively H Close trend screen In the FACE SELECT menu select options of other operating screens to close the Trend Screen oxyCRG Screen m Enter oxyCRG screen In the FACE SELECT menu select the oxyCRG SCREEN to enter the oxyCRG Screen BED No 1 ADU D nn Zhangshan M oxyGRG KIE RESP WAVE Figure 4 4 oxyCRG SCREEN m Trend graph of oxyCRG screen Located at the lower part of the screen oxyCRG screen consists of three trends HR Patient Monitor user s manual V 2 2 4 3 Face Select Trend SpO2 Trend and RR Trend or Compressed Resp Waveform H Select OxyCRG trend length Three are three hot keys at the bottom part of the oxyCRG Screen which are 4MIN 2MIN 1MIN RR RESP WAVE a
5. Airway Adapter S Figure 18 2 Sidestream Connectio Figure 18 3 Mainstram Connection 1 Do not use the supplied CO2 Water trap set for side stream including water trap and sample line and cannula and Air adapter for main stream if the packaging or the sensor is damaged and return them to the vendor 2 CO2 WARM UP or CO2 SENSOR START UP displayed on the screen indicates that the sensor is in warm up or starting up After the information disappears from the screen the standard measurement can then be generated 3 For MainStream if the sensor is not connected it will display CO2 SENSOR OFF on the screen If connect the sensor the information will disappear and the information CO2 WARM UP will be on the screen For SideStream if water trap is not inserted CO2 WaterTrap Off is displayed on the screen If connect water trap the information will disappear 4 Monitor has water trap beside it which is used to prevent the moisture or water drops produced by patient s respiration from entering the module The sample line and the water trap are one off consumables that can not be repeatedly used by different patients A Warning A For mainstream measurement the sensor and the airway connector must be braced to avoid oppressing the endotracheal sleeve 18 4 Patient Monitor user s manual V 2 2 CO2 Measuring 18 4 CO2 Menu 18 4 1 Parameter Setup and Adjustment There are two ways to access
6. SpO is a non invasive measurement of the functional oxygen saturation The measurement is taken by placing a sensor on a patient usually on the fingertip for adults and the hand or foot for neonates The sensor is connected to the patient monitor with pulse oximetry measurement module Masimo Set which is called MS 7 The monitor displays the calculated data from MS 7 in three ways 1 as a percent value for arterial oxygen saturation SpOz 2 as a pulse rate PR and 3 as a plethysmographic waveform on the screen Principles of Operation This MS 7 is based on three principles H Oxyhemoglobin and deoxyhemoglobin differ in their absorption of red and infrared light spectrophotometry m The volume of arterial blood in tissue and the light absorbed by the blood changes during the pulse plethysmography H Arterio venous shunting is highly variable and that fluctuating absorbance by venous blood is a major component of noise during the pulse This MS 7 determines SpO2 by passing red and infrared light into a capillary bed and measuring changes in light absorption during the pulsatile cycle Red and infrared light emitting diodes LEDs in oximetry sensors serve as the light sources a photodiode serves as the photodetector Traditional pulse oximeter assumes that all pulsations in the light absorbance signal are caused by oscillations in the arterial blood volume This assumes that the blood flow in the region of the sensor passe
7. the system will turn off the on line help function Scan type The system can display all waveforms about monitored patient on the screen either in Refresh or Scroll way The method is Select SELECTION item in SYSTEM MENU to access SELECTION sub menu in which there is the item SCAN TYPE The user may decide the way to display the waveform by choosing either REFRESH or SCROLL Alarm Limits The system can display the alarm limits You can choose this function as per your need The method is Patient Monitor user s manual V 2 2 3 11 System Menu Select the SELECTION in the SYSTEM MENU to call up the SELECTION menu You can set the ALM LIMIT switch to ON or OFF Night Mode You can use the NIGHT item to set On Off of night mode When ON is picked the monitor will silence the beep and pulse volume in order to ensure comfortable environment for the patient Select the SELECTION item in SYSTEM SETUP MENU SELECT menu pops up in which the user may set up the NIGHT to ON or OFF When it is ON the system automatically adjusts the screen brightness to the DARK level when the system has brightness adjustment function and turns off the volume of heart beat and pulse to help patient sleep When the system is alarming the user can not select NIGHT mode If any parameter alarm is triggered
8. window Pick REC button to print out the CO value and measurement curve Access the MEASURE button on the CO module to call up the WINDOWS FOR CO MEASUREMENT window Pick the EDIT button in the window to call up the WINDOWS FOR C O EDIT window in which pick the HEMO CALCULATE button to access the HEMOD WINDOW window Then pick the REC button to print out the calculated result Access the ENTER MAINTAIN PASSWORD menu from the MAINTAIN menu Then pick the STATUS button to access the STATUS window Pick REC button to print out the status monitor information currently displayed in the window Access the DRUG CALC menu from the SYSTEM MENU menu Pick the TITRATION button in the menu to access the TITRATION window Pick the REC button to print out the titration currently displayed in the window In oxyCRG screen pick the REC button to print out the oxyCRG currently displayed in the window You can press REC STOP button on the recorder module to stop the current recording process Access the RECORD menu from the SYSTEM SETUP menu Then pick the CLEAR REC TASK button to stop all recording tasks 7 4 Recorder Operations and Status Messages Record Paper Requirement Only standard 50 0 1 mm thermosensitive record paper can be used otherwise the recorder may not function the recording quality may be poor
9. 2 The monitor beeps in its corresponding alarm class and volume 3 Alarm lamp flashes 4 Store all parameter values during the alarm and 4 8 or 16 second waveform prior to and after alarm 5 If alarm recording is on the recorder starts alarm recording For further information on alarm recording please refer to Chapter Recording 5 6 When an Alarm Occurs A Note A When an alarm occurs you should always check the patient s condition first The alarm message appears at the top of the screen on the right side It is needed to identify the alarm and act appropriately according to the cause of the alarm Check the patient s condition Identify the module in alarm Identify the cause of the alarm Silence the alarm if necessary Hi a ir When cause of alarm has been over check that the alarm is working properly You will find the alarm messages for the individual parameter in Chapter 12 19 of this manual 5 6 Patient Monitor user s manual V 2 2 Chapter6 Freeze 6 1 6 2 E General m Freeze amp Unfreeze m Review amp Record Frozen Waveforms General When monitoring a patient you may freeze the waveforms of interest so as to view them carefully Generally you can review maximally 40 seconds of a frozen waveform If required you may also use recorder to print out a frozen waveform The Freeze function of this monitor has following features Freeze status can be activated on any operating screen A
10. 60 dip user of the monitor requires voltage variation in Uy for 5 cycle continued operation during on power supply 70 Ur 30 dip power mains interruptions it is input lines in Ur for 25 70 Ur 30 dip recommended that the monitor IEC 61000 4 11 cycle in U7 for 25 cycle be powered from an uninterruptible power supply or lt 5 Ur gt 95 lt 5 Us gt 95 dip a battery dip in U for 5 in U7 for 5 sec sec Power frequency magnetic eae Geier fields should be at levels 3 A m 3 A m characteristic of a typical magnetic field IEC 61000 4 8 location in a typical commercial of hospital environment NOTE Uzis the a c mains voltage prior to application of the test level TABLE 3 Guidance and manufacturer s declaration electromagnetic immunity Portable and mobile RF communications equipment should be used no closer to any part of the monitor including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people The monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an en
11. ALM LEV MED DEF POINT gt gt ALM REC OFF Perform the ST analysis only when switch is On EXIT Figure 12 12 ST ANALYSIS menu ST analysis alarm setting v ST ANAL the switch for ST analysis Set it to ON to activate the ST analysis or OFF to disable the ST analysis v ST ALM pick ON to enable prompt message and data record during the ST analysis alarm pick OFF to disable the alarm function and there will be a 2 beside ST ST alarm is activated when the result exceeds set ST HI value or falls below ST LO value v ALM LEV used to set up the ST alarm level There are three selections HIGH MED and LOW v ALM REC pick ON to enable report printing upon ST analysis alarm v ALM HI used to set up the upper limit of ST alarm The max higher limit is 2 0 The minimum higher limit is 0 2 larger than the set lower limit v ALM LOW used to set up the lower limit of ST alarm The minimum lower limit is 2 0 The max lower limit is 0 2 lower than the set higher limit ST analysis alarm limits Max ST HI Min ST LO Step ST 2 0 mv 2 0 mv 0 1 m DEF POINT pick this item to access the DEF POINT window in which the position of ISO and ST point can be set up o ISO Base point Default is 78 ms OST Measurement point 12 16 Patient Monitor user s manual V 2 2 ECG RESP Monitoring DEF POINT ISO ST Back to the upper menu Figure 12 13 DEF POINT window The operator can adjust the position of both
12. Message Cause Alami Level AG NO WATERTRAP The l AG watertrap falls off from the Medi ri monitor CHANGE AG WATERTRAP Replace the AG watertrap Medium AG WATERTRAP TYPE The type of the AG watertrap being Medium WRONG used is not suitable AG INIT FAIL AG module has failure High AG COMM STOP s module failure or communication High ailure The actual PUMP rate of the AG AG OCCLUSION module is lt 20ml min which exceeds 1 High second AG COMM ERROR AG module has communication failure High AG HARDWARE ERROR AG module has hardware failure High AG DATA LIMIT ERROR AG module failure High AG USA ERROR AG module failure High AG ZREF FAIL AG module fails to zero High AG CAL FAIL AG module fails to calibrate High FiCO2 ALM LMT ERR Functional safety failure High EtCO2 ALM LMT ERR Functional safety failure High FiO2 ALM LMT ERR Functional safety failure High EtO2 ALM LMT ERR Functional safety failure High 19 14 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement FiN20 ALM LMT ERR Functional safety failure EtN20 ALM LMT ERR Functional safety failure FiAA ALM LMT ERR Functional safety failure EtAA ALM LMT ERR Functional safety failure AwRR ALM LMT ERR Functional safety failure High Prompt Alarm Message Cause level AG IS STARTING Loading the AG module No alarm AG WARM UP AG module is operating in the Warm up Neier status The AG module is operating in the AG STANDBY Standby status No al
13. patient pulse is too Low Use other method to measure blood pressure weak Reset NIBP module if failure RANGE Measuring range persists stop using measuring EXCEEDED exceeds the specified HIGH function of NIBP module notify upper limit biomedical engineer or Mindray service staff Affected by arm EXCESSIVE motion signal noise is LOW Make sure that the patient under MOTION too large or pulse rate monitoring is motionless is not regular Pressure has Measure again if failure persists exceeded the stop using measuring function of OVER PRESSURE specified upper safety HIGH NIBP module and notify biomedical limit engineer or Mindray service staff SIGNAL Ex ive motion LOW Stop th tient from movin STURATED cessive motio op the patient fro oving During pneumatic Check and replace the leaking parts PNEUMATIC LEAK LOW if required notify biomedical test leak is detected engineer or Mindray service staff Operation of blood Stop using measuring function of EE pressure pump HIGH NIBP module notify biomedical system is failed engineer or Mindray service staff Cuff type does not CUFF TYPE ERR comply with the LOW Select appropriate cuff type patient type Measuring time has exceeded 120 Measure again or use other MEE MEO seconds adult or 90 SEN measuring method seconds neonatal NIBP ILLEGALLY Abnormal module RESET reset HIGH Reset again Problem happens when measuring the curve The system Check the cuff M
14. AN Warning A If the protective grounding protective earth system is doubtful the monitor must be supplied by inner power only Condensation Make sure that during operation the instrument is free of condensation Condensation can form when equipment is moved from one building to another thus being exposed to moisture and differences in temperature A Warning A Possible explosion hazard if used in the presence of flammable anesthetics Explanation of Symbols in the Monitor e This symbol means BE CAREFUL Refer to the manual 10 2 Patient Monitor user s manual V 2 2 Y Patient Safety This symbol indicates that the instrument is IEC60601 1 Type CF equipment The unit displaying this symbol contains an F Type isolated floating patient applied part providing a high degree of protection against shock and is suitable for use during defibrillation Protective earth ground l Power on Power off LE Equipotential grounding system This item is compliant with Medical Device Directive 93 42 EEC of 14 June 1993 a directive of the European Economic Community Patient Monitor user s manual V 2 2 Chapter 11 Care Cleaning 11 1 System Check Before using the monitor do the following WH check if there is any mechanical damage WH check al the outer cables inserted modules and accessories WH check al the functions of the monitor to make sure that the monitor is in good condition
15. CELL BAT TOO LOW is not installed or the manufacturer connection is loose Execute Clear Record Task RECORDER SELFTEST ERR During the selftest the system fails connecting with the recorder module function in the recorder setup menu to re connect the host and the recorder If the failure still exists contact the manufacturer for repair RECORDER VLT HIGH RECORDER VLT LOW The recorder module has voltage failure Contact the manufacturer for repair RECORDER HEAD HOT REC HEAD IN WRONG POSITION The continuous recording time may be too long The handle for pressing the paper is not pressed down After the recorder becomes cool use the recorder for output again If the failure still exists contact the manufacturer for repair Press down the recorder handle for pressing the paper RECORDER OUT OF PAPER No paper is in the recorder Place the paper into the recorder RECORDER PAPER The paper in the recorder is Place the recorder correctly and JAM jammed try again ERR recorder setup menu execute RECORDER S COMM ERR The communication of the recorder is abnormal the function of clearing record task The function can make the host and the recorder connect again If the failure still exists contact the manufacturer for repair RECORDER W P PAPER REC NOT AVAILABLE The paper roll of the recorder is not placed in th
16. IBP PRESSURE ZERO Being Prepared press ZERO key CH1 ZERO 00 00 0000 00 00 00 CH2 ZERO 00 00 0000 00 00 00 Back to the upper menu ep Figure 16 6 IBP PRESSURE ZERO Patient Monitor user s manual V 2 2 16 7 IBP Monitoring AY Note A User should ensure that the transducer has been zeroed before measurement otherwise the device does not have valid zero value which may result in inaccurate measuring data Zero Transducer Select CH1 ZERO IBP1 is zeroed Select CH2 ZERO IBP2 is zeroed Cautions Close the transducer stopcock to the patient before zeroing WR Open the venting stopcock to atmosphere m The transducer should be placed at the same level of the patient s heart approximately mid axillary line H Zero procedure should be performed before starting the monitoring or at least once a day or each time after connecting disconnecting the cable Information related to zero For this example CH1 is used m SUCCESSFUL ZERO Indicate the zero procedure has finished open the transducer stopcock to the patient and close the venting stopcock to atmosphere SENSOR OFF FAIL Verify that the transducer for CH1 does not fall off then execute zeroing If problem still exists contact the serviceman IN DEMO FAIL Ensure that the monitor is not in DEMO mode Contact the serviceman if necessary PRESSURE OVER RANGE FALL Ensure that the venting stopcock is opened to
17. If you find any damage on the monitor stop using the monitor on patient and contact the biomedical engineer of the hospital or Mindray Customer Service immediately The overall check of the monitor including the safety check should be performed only by qualified personnel once every 6 to 12 month and each time after fix up You should check the synchronism of the defibrillator in the frequency described in the hospital regulations At least every 3 months it should be checked by a qualified customer service technician All the checks that need to open the monitor should be performed by qualified customer service technician The safety and maintenance check can be conducted by persons from Mindray You can obtain the material about the customer service contract from the local Mindray office A Warning A If the hospital or agency that is responding to using the monitor does not follow a satisfactory maintenance schedule the monitor may become invalid and the human health may be endangered A Note A To ensure maximum battery life it is recommended that at least once a month the monitor be run on battery until it turns itself off and then recharged A Warning A Refer the battery replacement only to Mindray service technician 11 2 General Cleaning A Warning A Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line Patient Monitor user s manual V
18. NS ALM LMT ERR fai HIGH NIBP module and notify biomedical ailure engineer or Mindray service staff Functional safety Stop using alarming functions of NM ALM LMT ERR fai HIGH NIBP module and notify biomedical ailure engineer or Mindray service staff Functional safety Stop using alarming functions of ND ALM LMT ERR fai HIGH NIBP module and notify biomedical ailure engineer or Mindray service staff Technical alarms 2 display in the area below the NIBP value Message Cause aan Remedy Sensor or other Stop using measuring function of NIBP SELE TEST hardware of NIBP HIGH NIBP module notify biomedical module is incorrect engineer or Mindray service staff If failure persists stop using Communication with measuring function of NIBP module NEE COMMERH NIBP module is failed SEN notify biomedical engineer or Mindray service staff Cuff is no properly LOOSE CUFF wrapped or no cuff LOW Properly wrap the cuff exists Cuff hose or Check and replace the leaking parts AIR LEAK connector is LOW if required notify biomedical damaged engineer or Mindray service staff Stable pressure value Check if the hoses are tangled if ARPRESSURE is not available e g LOW failure persists notify biomedical ERROR hoses are tangled engineer or Mindray service staff Patient Monitor user s manual V 2 2 14 11 NIBP Monitoring Cuff is too loose or WEAK SIGNAL
19. The name of the waveform is displayed on the upper left part of the waveform The user may 1 8 Patient Monitor user s manual V 2 2 Instruction choose ECG lead based on the requirements The gain of the channel and the filter way are also displayed on each ECG waveform A 1mV scale bar is also displayed to the right side of ECG waveform The IBP waveform scale can also be selected according to the actual requirement Its range is described in the part IBP MONITORING In the IBP waveform area the waveform scale is displayed The three dotted lines for each IBP waveform form up to down represent respectively the upper limit scale reference scale and lower limit scale The values of these three scales can be set The specific method is given in the part IBP MONITORING When menu is wanted during screen operation the menu always occupies the fixed position in the middle part of the waveform area therefore part of waveform can not be viewed temporarily After exiting the menu the system will restores the original screen The user may set up the rate to refresh the waveform The method to adjust the refreshing rate of each waveform is discussed in the setup description of each parameter Parameter area The parameter area lies to the right side of the waveform area whose position basically corresponds to the waveform The parameters displayed in the parameter area include ECG heart rate or pulse rate un
20. When the operator is entering the patient name the name is displayed in this position When the operator does not enter the patient name the position displays blank Patient sex displayed to the right side of the patient name Other information displayed in the information area appears or disappears together with the status being reported which is divided into following parts based on the contents Patient Monitor user s manual V 2 2 1 7 Introduction RW Monitor Prompt Information informing the status of monitor or sensor which always appears to the right side of the time When this information appears it will cover the patient sex and name EI flag for alarm PAUSE Press SILENCE button once less than 1 second to mute all alarm sounds are muted for the time being and the flag appears at the same time Press the button again to terminate the PAUSE status The duration for PAUSE status can be 1 minute 2 minutes or 3 minutes A flag for alarm SILENCE Press SILENCE button once more than 1 second to manually mute the alarm sound and this flag appears at the same time The SILENCE status terminates when you discharge the status or new alarm occurs ra lag flag for Alarm Volume Off It appears indicating that you have closed the alarm sound permanently This status terminates when you discharges the status A Note A If EJ symbol appears the system will no longer give audible alarm sound You
21. means that the CO2 module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair O0 SETUP the button used to set up the related items of CO2 Press SETUP button the CO2 SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel O0 STANDBY START Standby Measure button A socket for CO2 watertrap Before monitoring the patient the user should first safely insert the watertrap into this socket C A means BE CAREFUL Refer to the attached document this manual of the monitor C A means that the CO2 module is IEC 60601 1 Type CF equipment AN Note A When not using the CO2 module to monitor the patient the user may unload the 18 2 Patient Monitor user s manual V 2 2 CO2 Measuring module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected 18 3 Monitoring Procedure Principle of CO2 measurement is primarily based on the fact that CO2 molecule can absorb 4 3um infrared ray Absorption intensity is proportional to CO2 concentration of patient sample the CO2 concentration will compute from the detecting CO2 absorption intensity of patient sample The relation between partial pressure and percentage of CO2 concentration is given
22. must be very careful in using this function Two ways can be used to discharge this status One is set the alarm volume to an option other than OFF in the USER MAINTAIN menu The other method is to press SILENCE button to make the flag turn to 4 And then press SILENCE again and the system will restore the normal alarm status m Patient parameter alarm information this information is fixedly displayed in the extreme right side of the screen E When the waveform on the screen is frozen the corresponding prompt FROZEN window appears on the lower part of the screen E There is a status bar on the bottom of the screen Some status information will be displayed in it For example Loading XX module Module unloaded The recorder does not exit and the information such as the lead system detected by the hardware is different from the current user setup Waveform menu area The waveform area can maximally display 8 waveforms The displaying order of the waveforms on the screen can be adjusted For the maximum configuration the waveforms provided by the system for selection are 2 ECG waveforms SpO2 waveform 4 IBP waveforms RESP waveform CO2 waveform O2 waveform and anaesthetic gas waveform All the waveforms in the system are listed out inthe TRACE SETUP menu The user may select the waveform to be displayed and adjust their displaying positions The specific method is illustrated in the part SYSTEM MENU
23. the EtN20 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E FiN20 ALM HI used to adjust the upper alarm limit of FIN20 When the measured value is larger than FiN2O upper alarm limit the FIN2O0 HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E FiN2O ALM LO used to adjust the lower alarm limit of FiN20 When the measured value is smaller than FiN2O lower alarm limit the FiN20 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E EtAA ALM HI used to adjust the upper alarm limit of EtAA When the measured value is larger than EtAA upper alarm limit the EtAA HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit RAA ALM LO used to adjust the lower alarm limit of EtAA When the measured value is smaller than EtAA lower alarm limit the EtAA LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E FIAA ALM HI used to adjust the upper alarm limit of FiAA When the measured value Patient Monitor user s manual V 2 2 19 9 Anesthetic Gas Measurement is larger tha
24. the FREEZE status press this button again to discharge the FREEZE status For detailed information refer to related chapter Freeze MENU Press this button to call up the SYSTEM MENU in which the user may set up system information and perform review operation For detailed information refer to related chapter System Menu and related chapter Trend and Event Rotary knob Patient Monitor user s manual V 2 2 1 11 Introduction The user may use the rotary knob to select the menu item and modify the setup It can be rotated clockwise or counter clockwise and pressed like other buttons The user may use the knob to realize the operations on the screen and in the system menu and parameter menu Method to use the knob to operate on the screen The rectangular mark on the screen that moves with the rotation of the knob is called cursor Operation can be performed at any position at which the cursor can stay When the cursor is in the waveform area the user may immediately modify the current setup When the cursor is in the parameter area the user may open the setup menu of the corresponding parameter module so as to set up the menu items of the module Operating method RW Move the cursor to the item where the operation is wanted m Press the knob E One of the following four situations may appear 10 The cursor with background color may become into the frame without background color which implies that the content in the frame ca
25. you cannot open the setup menu of system time If the Central Station has no this function you can skip over this paragraph 3 4 3 Recorder setup Select the RECORD in the SYSTEM SETUP menu to call up the following menu RECORD REC WAVE1 SP02 X7 REC WAVEZ IBP1 S RT REC TIME DS 4 TIMING REC TIME OFF REC RATE 25 0 4 REC GRID ON S CLEAR REC TASK Back to the upper menu Figure 3 10 Record Setup In this menu the user can set up to output two waveforms The waveforms that can be selected include ECG1 The first to the seventh ECG waveform on the screen there are seven ECG SE waveforms in full leads display If no ECG waveform is currently displayed on the screen this item cannot be picked SPO2 SpO2 Plethysmogram IBP1 Displayed waveform of Generated by IBP 1 2 module on the screen If no IBP e waveform is currently displayed on the screen this item cannot be picked GE Displayed waveform of Generated by IBP 3 4 module on the screen If no IBP waveform is currently displayed on the screen this item cannot be picked Patient Monitor user s manual V 2 2 3 7 System Menu RESP RESP waveform If no RESP waveform is currently displayed on the screen this item cannot be picked CO2 Displayed waveform either of anesthetic gas or generated by CO2 module N20 Displayed waveform of anesthetic gas O02 Displayed waveform of anesthetic gas AA Refers to displayed waveform anestheti
26. 19 17 Chapter 20 Accessories and Ordering Information ccsscsseeeeeseeeseseeeeseeeeeeeeeneas 20 1 ell ECGIHACCESSONGS sahil atid Seege adie dana Gah geet aert 20 1 20 2 SPOZACCESSOMOS ech sales sees srt ccedatdenechh inc cyotesiaha a AA aa od aaa aiako hata 20 2 EE ee TE 20 2 20 4 TEMP ACCOSSONOS i ccszecisiectccienthcvvetitcacecianenscatentacuveditaad Ah ege ed deed Ah Eege 20 3 20 5 IBP ee eege dead Beech aed Avda Bie al eden Aad eee daaa 20 3 20 6 CO Accessorie S ie seier Sege ee ee enge Gi ee ee Nees Nasa Dees 20 4 20 7 CO2 ACCESSONES sit dee ote avn eine ahi oat 20 4 20 BAG ACCESSONGS EE 20 4 Appendix I EC Declaration Of Conformance ccsccseeceseeeeeeeeeseseseseeeeneeeeseeesesnaeenseeeeeeneess 1 Appendix II Product Specification cccccssccsseeeeeseeeseeeeesneeenseeeeseeeseseaesesneeenseeeseeeseneaneeeenees 1 Appendix Ul EM Ca eegeg sce esd cette EES 1 Appendix IV System Alarm Prompt cccsccccseceseeeeeeeeeseeeeesneeenseeeeseaesesaeseseeeeneeeesseeseseeeeenenees 1 Patient Monitor user s manual V 2 2 Chapter 1 Instruction H For the overall information about the monitor refer to General For the knowledge about the various displayed information on the screen refer to Screen Display For the operating method refer to Button Function and Basic Operation For the position of the various interface refer to External Interface For the specifications of the monitor refer to Specifications For sa
27. 30 12263 P N 0010 30 12264 P N 0010 30 12265 P N 0010 30 12266 P N 0010 30 12267 P N 0010 30 12268 P N 0010 30 12269 P N 0010 10 12080 P N 0010 10 12304 P N 0509 10 00094 P N 900E 10 04879 P N 900E 10 04880 P N 0010 10 12274 P N 0010 10 12101 P N 6200 30 11692 P N 9000 10 05161 P N 9000 10 07308 P N 9000 10 07336 P N 512B 30 90134 P N 512D 30 90200 P N 518A 30 90226 P N 0010 21 11957 20 2 Patient Monitor user s manual V 2 2 Accessories and Ordering Information Patient Type Limb perimeter PN Factory PN Infant 10 19 cm 0010 30 12157 CM1201 Child 18 26 cm 0010 30 12158 CM1202 Adult 25 35 cm 0010 30 12159 CM1203 Large Adult 33 47 cm 0010 30 12160 CM1204 Thigh 46 66 cm 0010 30 12161 CM1205 Adult 25 35 cm 0010 30 12059 W A BAUM Child 18 26 cm 0010 30 12060 W A BAUM Infant 10 19 cm 0010 30 12061 W A BAUM Pediatric 6 11 cm 0010 30 12067 W A BAUM Adult 25 35 cm 509B 30 08845 CM1203 1 H Disposable cuff Size No Limb perimeter PN Factory PN 1 3 1 5 7 cm 900E 10 04876 Pediatric PHILIPS M1866A 2 4 3 8 0cm 900E 10 04875 Pediatric PHILIPS M1868A 3 5 8 10 9cm 900E 10 04874 Pediatric PHILIPS M1870A 4 7 1 13 1cm 900E 10 04873 Pediatric PHILIPS M1872A 20 4 TEMP Accessories LN TI Application temperature measurements temperature measurements Adult give surface temperature readings Pediatric give surface tempera
28. ALM REC pick ON to enable report printing upon ECG alarm e ALM HI used to set up the upper limit of ECG alarm e ALM LO used to set up the lower limit of ECG alarm ECG alarm is activated when the heart beat exceeds set ALM HI value or falls below ALM LO value ECG alarm limits Max ALM HI Min ALM LO Step HR ADU 300 15 1 HR PED 350 15 1 HR NEO 350 15 1 A Note A Please set the alarm limits according to clinical condition of individual patient The upper limit shall not exceed 20 beat min higher than the patient s heart rate E HR FROM ECG SpO2 AUTO and BOTH may detect heart rate AUTO distinguishes heart rate source according to the quality of signal By picking ECG the monitor prompts HR and activates HR beep By picking SpO2 the monitor prompts PULSE and activates pulse beep BOTH mode displays HR and PR simultaneously when this item is picked PR 12 10 Patient Monitor user s manual V 2 2 ECG RESP Monitoring parameter is displayed to the right side of SpO As for the sound of HR or PR in BOTH mode HR is given the priority i e if HR is available whose sound will be sent out but if HR is not available then the sound will be for PR HR CHANNEL CH1 to count the heart rate by CH 1 waveform CH2 to count the heart rate by CH 2 waveform AUTO the monitor selects a channel automatically LEAD TYPE used to select either 5 LEADS or 3 LEADS SWEEP Available options for ECG SWEEP are 12 5 25 0
29. CONFIG Back to the upper menu SSS Figure 19 10 AG DEFAULT CONFIG FACTORY DEFAULT CONFIG use the factory default configuration to initialize menu items USER DEFAULT CONFIG use the user default configuration to initialize menu items EXIT used to exit this menu Alarm information and prompts When the alarm record switch in a related menu is on those physiological alarms caused by the parameter value exceeding the alarm limits will trigger the recorder to automatically output this parameter value and its related measured waveforms Physiological and technical alarms and prompts that may appear during AG monitoring are listed in following tables Physiological alarms Message Cause Alarm level The measured FCO value FiCO2 HIGH exceeds the setup upper alarm User selectable limit FiCO2 LOW The measured FiCO value is below User selectable the setup lower alarm limit The measured EtCO value EtCO2 HIGH exceeds the setup upper alarm User selectable limit The measured EtCO value is Coo below the setup lower alarm limit ASET ORARIE The measured FiO value exceeds FiO2 HIGH the setup upper alarm limit User selectable The measured FiO value is below ene the setup lower alarm limit Liserecleciable The measured EtCO value EtO2 HIGH exceeds the setup upper alarm User selectable limit 19 12 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement
30. Cleaning 13 24 Chapter 14 NIBP MOnitoring cccccesccesseeeeeeeeeeeeeeseeeeensneeeeeeeeseaesaseeenseeesesesaneenenseeeees 14 1 E Miel Te Le EE 14 1 14 2 ET 14 2 14 3 NIBP MOnitoring 0 0 ccccececceceeeeceeeeeeeeeeeeeeeceeeeecaaeeseeeesaeessaaeseeaaesseeeeseaeeeeeaaessinees 14 3 14 4 NIBP SETUP menu 14 7 14 5 NIBP Alarm Message eesneesseesseesseesressnnesrnesnrnstnnrrnnetnnesnnetnnstnnsennnennnennsnnnnnns 14 11 14 6 Maintenance and Ceamimg 14 13 Chapter 15 TEMP Monitoring ccccscccsseeeeeeeeeeeneeseaeeenseeeeeeeeesnaeseseeeenseeesseessaseanenseeeees 15 1 ISA TEMP MON ItOninG Aere eelere ee eet ge eege egen 15 1 15 2 TEMP Module cit sat acpi iii EE eee nia ce hie nia 15 2 15 3 TEMP SETUP Meed thao hi tn eon a lee 15 3 15 4 TEMP Alarm message 15 4 15 5 Care and Cleaning 0 ccecceceeceeeeeeeeeeeeeeceeeeceaeeeeaaeeeeeeeseaeeesaaeeeseeeeseaeeesaeeesaeeeenees 15 5 Chapter 16 IBP Monitoring cccseeecesceesseeeeseeeeeeeeeeseeeensneeeeeeeesnaeseseeenseaesseaesaseenenseeeees 16 1 VG eege eebe tech a eege Daer eeben Edel E er die 16 1 EE le 16 1 16 3 Precautions during IBP Monitortmg 16 2 16 4 Monitoring Procedure A 16 3 16 5 IBP MenU states A E sat aes E 16 4 16 6 Alarm Information and Prompts 16 12 16 7 Maintenance and Ceamimg 16 14 16 8 ICP Transducer ICT B Optional Accessory ceecceeeeeeeeeeeeeeeeeeeeaeeeeneeeeaees 16 15 Chapter 17 CO Measurinng ccsscccssessseesseeeeseeeee
31. Configuration including ECG RESP Temp NIBP SpO2 Options Thermal Recorder 4 channel IBP Cardiac Output EtCO2 Sidestream EtCO2 Mainstream Anaesthetic Gases oa A Go N Classification MDD Annex IX IIb We herewith declare that the above mentioned products meet the provisions of the following EC Council Directives and Standards All supporting documentations are retained under the premises of the manufacturer and the notified body Patient Monitor user s manual V 2 2 1 EC Declaration of Conformance DIRECTIVES General applicable directives Medical Device Directive COUNCIL DIRECTIVE 93 42 EEC of 14 June 1993 concerning medical devices MDD 93 42 EEC Standards Harmonized Standards published in the Official Journal of the European Communities applicable to this product are 1ISO14971 2000 A1 2003 EN1041 1998 EN980 2003 IEC60878 2003 ISO1000 1992 A1 1998 ISO10993 1 2003 1ISO3744 1994 EN540 1993 EN60601 1 1990 A1 1993 A2 1995 A13 1996 EN60601 1 1 2001 EN60601 1 2 2001 EN60601 1 4 2000 EN60601 2 27 1994 EN60601 2 30 2000 EN60601 2 34 2000 EN475 1995 EN865 1997 EN864 1996 EN12470 4 2000 EN1060 1 1995 EN1060 3 1997 IEC60601 2 49 2001 ANSI AAMI SP 10 1996 Notified Body T V Product Service GmbH Ridlerstrasse 65 D 80339 M nich Germany 2 Patient Monitor user s manual V 2 2 Appendix Il Product Specification 1 Classification Anti electroshock ty
32. D Ensure the correct label name has been selected Refer to the next section for details D Zero the transducer Refer to the next section for details oO oO SD Normal Sal JE if y Normal Saline d J z Ge ep pm ii d Pressure j l k transducer L f H L j d A G G e G Gi 7 VW See HE 2 WW i Stopcok E lt S Drip Distal End A hamber lo Putient PM6000 IBE s MODULE J Transducer Interface Cable Pressure line ELA en o See L A Hie dr A Au n e rr Sch F Mhe Figure 16 2 IBP Monitoring 16 5 IBP Menu There are two ways to access the IBP 1 2 SETUP menu Pick the SETUP button on the IBP module to call up the IBP 1 2 SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the IBP hot key in the parameter area and then press the knob to directly access the IBP 1 2 SELECT menu And then pick the IBP SETUP button to access the IBP 1 2 SETUP menu 16 4 Patient Monitor user s manual V 2 2 IBP Monitoring IBP 1 2 SETUP ALM ON FILTER NO FILTER ALM LEV MED v ALM LIMIT SETUP gt gt ALM REC OFF x SCALE ADJUST gt gt AMP ADJUST MANUAL EXPAND PRESSURE gt gt SWEEP 25 0 v SETUP TRANSFER gt gt UNIT mmHg v DEFAULT gt gt Transfer all the setups in the menu into the module EXIT Figure 16 3 IBP SETUP Menu Options that could be set up are m ALM Selec
33. ERR HIGH CO2 SYSTEM ROM ERR HIGH CO2 FLASH CRC ERR HIGH CO2 INT RAM ERR HIGH CO2 FLASH CHECK ERR HIGH CO2 EXT RAM ERR HIGH CO2 STACK OVER HIGH CO2 PUMP FAULT HIGH CO2 REVERSE FLOW HIGH CO2 FORWARD FLOW HIGH CO2 MALFUNCTION HIGH CO2 BAROMETRIC HIGH HIGH CO2 BAROMETRIC LOW HIGH Stop using measuring function of CO2 CO2 COMM ERR CO2 module communication HIGH module notify failure biomedical engineer or Mindray service staff CO2 module is not properly Stop using measuring PEANT ERR connected or failed aN function of CO2 module notify CO2 COMM STOP Measuring module failure or HIGH biomedical engineer communication failure or Mindray service staff CO2 ALM LMT ERR Functional safety failure HIGH top using measuring function of CO2 INS ALM LMT ERR Functional safety failure HIGH module notify biomedical engineer AWRR ALMLMTERR Functional safety failure HIGH oF Mindray service staff Prompt message Patient Monitor user s manual V 2 2 18 11 CO2 Measuring Message Cause Alarm Level Turn from measuring mode to CO2 STANDBY STATUS standby mode making the module No alarm in energy saving status CO2 WARM UP Shows that the sensor is in Noalarm warming up stage CO2 SENSOR START UP Shows that the sensor has just Noalarm entering start up stage 18 6 Maintenance and Cleaning H Care and Maintenance Sample line is for one off use in SideStream module Do not sterilize or cl
34. ERR4 IBP 1 2 INIT ERR5S IBP 1 2 INIT ERR6 IBP 1 2 INIT ERR7 IBP 1 2 INIT ERR8 amp IBP module notify biomedical engineer or Mindray service staff IBP 1 2 module l l IBP 1 2 COMM failure or Stop using ALARM function of IBP ass Ce HIGH module notify biomedical engineer STOP communication i or Our service staff failure IBP 1 2 Stop using ALARM function of IBP IBP 1 2 COMM ERR Swine z HIGH module notify biomedical engineer communication error d or Our service staff Stop using ALARM function of IBP1 ALM LMT ERR A safety HIGH IBP module notify biomedical ailure engineer or Our service staff ional Stop using ALARM function of IBP2 ALM LMT ERR Functiona safety HIGH IBP module notify biomedical failure engineer or Our service staff Prompt message Message Cause Alari Level IBP1 SYS EXCEED Systolic value of channel 1 is beyond HIGH measurement range IBP1 DIA EXCEED Diastolic measuring value of channel 1 is HIGH beyond measurement range IBP1 MEAN EXCEED Mean measuring value of channel 1 is HIGH beyond measurement range Systolic value of channel 2 is beyond IBP2 SYS EXCEED measurement range HIGH IBP2 DIA EXCEED Diastolic measuring value of channel 2 is HIGH beyond measurement range IBP2 MEAN EXCEED Mean measuring value of channel 2 is HIGH beyond measurement range IBP1 NEED ZERO CAL IBP channel 1 has not been
35. Minimum alveolar concentration Waveforms of four anesthetic gases including CO2 N20 02 AA System Construction This Monitor has three independent parts Display 12 1 color LCD or CRT DW Module Box allows horizontal or vertical placement RW Module includes parameter module and function module The display can be placed independently as a separate system or placed together with the module box forming a compact system R z Sep Ee CR g O Q 1 rT Figure 1 1 System Construction The visible LED are CLASS 1 LED PRODUCT according EN 60825 1 A11 Oct 1996 The power switch POWER of the monitor lies at the right side of the module box The three lamps on the right side of the module box are used to indicate the power situation After powering on the monitor these three lamps light on When the monitor is in function and there is alarm occurring both the alarm lamp on the screen and the ALARM lamp on the button module light on or flash in a specific way The socket for each sensor is on the front panel of corresponding module The output end of the recorder is on the front panel of the recorder module IL The battery door is on the rear panel of the monitor The analog interface VGA interface TFT interface are all on the right side of the rear panel of the monitor The power socket is on the left side of the rear panel refer to 1 4 Rear Panel Display WH The system may use either th
36. RIGHT ZOOM CURSOR REC Select the name of the parameter whose trend is to be selected EXIT Figure 8 1 TREND GRAPH Menu The uppermost part is the name of the parameter in which y axis stands for value and x axis time 4 Indicates the value of the parameter which it points to is below the x axis with corresponding time displayed beyond the trend graph Other trends except NIBP trend are displayed as continuous curves In NIBP trend graph o indicates systolic value t indicates diastolic value and indicates mean value To select trend graph of a specific parameter Pick PARA SELECT item the first selection of the upper line and select a requested parameter name by turning the knob To select 1 hour or 72 hour trend graph Pick RESOLUTION item the latter selection of the upper line choose 1 or 5 sec for 1 hour trend graph and 1 5 or 10 min for 72 hour trend graph Patient Monitor user s manual V 2 2 8 1 Trend and Event To view other trend curves When appears on the right part of the screen pick L RIGHT the button at the extreme left of the lower line turn the knob clockwise to view later trend curves When appears on the left part of the screen pick the same item turn the knob counterclockwise to view earlier trend curve To change the display scale Pick the ZOOM button in the lower line to adjust the y axis scale and thus change the trend curve in proportion The value beyon
37. SA aE T AE ee AARE SAA 12 3 12 5 EC GiScreensHot KOy O aaa a a aa a aaa a aa aaa a a aa aaa ar Maebbine ada ereeets 12 8 120 ECG Men i disni dee i ee AE e Wend 12 9 12 7 ECG Alarm Information and Prompt 12 14 12 8 ST Segment Monitoring optional 12 15 12 9 Arr Monitoring optional 12 19 1210 Measuring RESP i ciacuendavd lente aaedlae didi a a eet 12 24 12 11 Maintenance and Cleamimg 12 28 Chapter 13 SpO2 Monitoring cccccescccsseeeeeeeeeeeeeeseneeenseeeeeeneeseaeseseeeenseaesseessesnenenseeeees 13 1 13 1 PART 1 MASIMO SpO2 board configuration cccccceeeeeeeeeeeteeeseeeeeneeteeeeees 13 1 TS AST dee 13 3 13 1 2 Monitoring Procedure siraan sianrie onr SE EE EA TS 13 5 13 1 3 Sensors and Accessories ccccceeeeceeeee cent eeeesaeeeeeeeceaeeesaaeseeaaeseeeeeesaeeseaaeeeenees 13 9 13 1 4 Alarm Description and Prompt A 13 12 13 1 5 Masimo Intormaiion 13 14 13 2 PART 2 MINDRAY SpO2 board configuration c ccceeceeeseeeeeeeseeeeeeseeeeeaes 13 15 EC Ee E 13 15 2 Patient Monitor user s manual V 2 2 Content 13 2 2 Precautions during SpO2 Pulse Monitoring sssssseeesseeesrsesrssrssrrssrresresrns 13 17 13 2 3 Monitoring Procedure A 13 18 13 2 4 Limitations for Measurement ssesesesssssirrssrrssrrssrnssrnssinnsinssrnssrnssrnssrnssrnnnnnns 13 20 TJ pt Men geheier ead decedent A lee 13 20 13 2 6 Alarm Description and Prompt AA 13 22 13 2 7 Maintenance and
38. TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user DEFAULT pick this item to access the IBP 1 2 DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation EXIT used to exit the menu and return to the main screen AY Warning AN Before setting the alarm limits confirm to choose the correct label Patient Monitor user s manual V 2 2 IBP Monitoring IBP ALM LIMIT SETUP SYS MEAN DIA CH1 ART ALM HI 160 4 110 30 gt CH1 ART ALM LO 90 70 gt 50 Ka CH2 CUP ALM HI 5 10 st CH2 CUP ALM LO 9 dr ee Set upper limit of IBP systolic pressure If above upper limit alarms occurs EXIT Figure 16 5 IBP ALM LIMIT SETUP When the value exceeds the alarm limits an alarm will occur IBP alarm limits Pressure Label A ela BS kn ART 300 0 1 PA 120 6 1 CVP 40 10 1 RAP 40 10 1 LAP 40 10 1 ICP 40 10 1 P1 300 50 1 P2 300 50 1 IBP Zeroing m Press the ZERO button on the IBP module to call up IBP PRESSURE ZERO menu as shown below
39. When this switch is OFF the system will not trigger alarm Instead it will display d beside GAS in the Parameter area m ALM LEV there are three options HIGH MED and LOW HIGH refers to the most serious alarm followed by MED and LOW in the order of descending seriousness The default alarm level is MED m ALM REC if it is ON when anesthetic gas parameter has alarm the recorder will output the alarm information The default is OFF m EtCO2 ALM HI used to adjust the upper alarm limit of EtCO2 When the measured value is larger than EtCO2 upper alarm limit the EtCO2 HIGH message is Patient Monitor user s manual V 2 2 19 7 Anesthetic Gas Measurement displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E EtCO2 ALM LO used to adjust the lower alarm limit of EtCO2 When the measured value is smaller than EtCO2 lower alarm limit the EtCO2 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E FiCO2 ALM HI used to adjust the upper alarm limit of FiCO2 When the measured value is larger than FiCO2 upper alarm limit the FiCO2 HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E FiCO2 ALM LO used to a
40. additional measures may be necessary such as reorienting or relocating the monitor Over the frequency range 150kHz to 80 MHz field strengths should be less than 3V m TABLE 4 Recommended separation distances between portable and mobile RF communications equipment and the monitor The monitor is intended for user in an electromagnetic environment in which radiated RF disturbance are controlled The customer or the user of the monitor can help prevent electromagnetic interference by maintain a minimum distance between portable and mobile RF communication equipment transmitters and the monitor as recommended below according to the maximum output power of the communication equipment Rated maximum output Separation distance according to frequency of transmitter power of transmitter m Ww 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 d 1 2x P d 1 2x P GHz d 2 3x VP 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 For transmitters rated at a maximum output power not listed above the recommended separation distanced d in meters m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2 These guid
41. and 50 0 mm s ST ANALYSIS Pick this item to access ST ANALYSIS menu the detailed information about the menu is to be discussed in the following section ARR ANALYSIS Pick this item to access ARR ANALYSIS menu the detailed information about the menu is to be discussed in the following section OTHER SETUP Pick this item to access ECG SETUP menu as shown below ECG SETUP ECG DISPLAY NORMAL DISPLAY BEAT VOL ADJUST WAVE POS gt gt PACE OFF SETUP TRANSFER gt gt CASCADE OFF DEFAULT gt gt ECG CAL Select the sound volume of the heart beat EXIT Figure 12 9 ECG SETUP menu In the sub menu following functions are available ECG DISPLAY Select NORMAL DISPLAY to display 2 ECG waveforms for 5 lead for 3 lead only 1 ECG waveform is displayed Select MULTI LEADS DISPLAY the waveform area on the screen displays 6 ECG waveforms Select HALF SCAN MULTI LEADS there are 4 ECG waveforms are displayed on the screen Note If 3 LEADS is selected in the ECG SETUP menu only NORMAL DISPLAY can be selected for ECG DISPLAY item in the sub menu BEAT VOL Four selections are available OFF LOW MED HIGH HIGH indicates maximum volume OFF indicates no sound PACE Patient Monitor user s manual V 2 2 12 11 ECG RESP Monitoring ON detected signal will be marked by a above the ECG waveform OFF for non pacemaking patient A Note A If monitoring a patient with the pacemaker set PACE to On I
42. and alarm review are discussed in Chapter Trend and Event 3 1 Patient Information Setup AY Note A To clear current patient data refer to New Patient for details Pick the PATIENT SETUP item in the SYSTEM MENU to call up the following menu Patient Monitor user s manual V 2 2 3 1 System Menu PATIENT SETUP DEPT ADMIT 20014 8 e 104 PAT NO 888 BIRTH 19514 8 e 104 BED NO 3 HEIGHT 175 0 cm DOCTOR CHEN WEIGHT 70 0 om NAME zg BLOOD A SEX M NEW PATIENT PAT TYPE ADU ABCDEFGHIJKLMNOPQRSTU VUXxYZ0123456789 DEL OK Enter max 12 characters DEL delete the current character OK confirm the entered information EXIT Figure 3 2 PATIENT SETUP You can setup following patient information DEPT PAT NO BED NO DOCTOR NAME SEX PAT TYPE ADMIT BIRTH HT cm inch WT kg lb BLOOD NEW PATIENT Department in which the patient receives treatment Patient No Patient bed number Range 1 100 Name of the doctor Patient name Valid characters A Z 0 9 and space bar Max length 12 characters Patient gender Available options F for Female M for Male Patient type Available options ADU PED and NEO Hospitalization starting date format year month day Patient date of birth format year month day Patient height turning the knob with the increase decrease of 0 5 cm inch each time The other HT unit in the other menus accord with the unit which you cho
43. and the thermosensitive printhead may be damaged Patient Monitor user s manual V 2 2 7 5 Recording Function Properly m When the recorder is working the record paper goes out steadily Do not pull the paper or the recorder will be damaged m Do not operate the recorder without record paper Paper Out When RECORDER OUT OF PAPER alarm is displayed the recorder cannot start Please insert record paper properly Inserting Paper WH Open the recorder catch Pull down the switch on the left axis of the recorder WH Insert a new roll of paper into the paper cassette printing side facing the thermosensitive printhead m When the paper can be seen from the other side pull it out Ensure proper position and tidy margin m Pull back the switch on the left axis of the recorder RW Give out the paper from the recorder outlet mM Close the recorder catch AN Note AY Be careful when inserting paper Avoid damaging the thermosensitive printhead Unless when inserting paper or shooting troubles do not leave the recorder catch open Removing Paper Jam When the recorder functions or sounds improperly open the recorder catch to check for a paper jam Removing the paper jam in the following way Cut the record paper from the feeding edge Pull up the switch on the left axis of the recorder Pull the paper from below Re insert the paper Recorder Status Message Technical Alarms Mes
44. any type The power cord and plug must be intact and undamaged If there is any doubt about the integrity of the protective earth conductor arrangement operate the oximeter on internal battery power until the AC power supply protective conductor is fully functional 1 2 Patient Monitor user s manual V 2 2 Instruction A Note A The software was developed per IEC601 1 4 The possibility of hazards arising from errors in the software program is minimized A Caution A At the end of its service life the product described in this manual as well as its accessories must be disposed of in compliance with the guidelines regulation the disposal of such products If you have questions concerning disposal of the product please contact MINDRAY or its representatives AN Caution A If you have any doubt to the grounding layout and its performance you must use the built in battery to power the monitor 1 1 General PM 6000 is a modular multi parameter patient monitor that has abundant monitoring functions and is used for the clinical monitoring of adult pediatric and neonate The user may increase the parameter and functional module at any time according to different requirements In addition the system also supports the module exchange between inside and outside of the hospital and the transmission of parameter alarm setup PM 6000 can be connected to the central monitoring system via the Mindray network so as to form a network mo
45. are displayed at the same time plus MAC Minimal Alveolar Concentration or BAL Balance gas and AwRR Definitions of parameter CO carbon dioxide N O nitrous oxide O2 oxygen AwRR air way respiration rate respiring time per minute Halothame HAL Isoflurane ISO Enflurane ENF Sevoflurane SEV Desflurane DES Patient Monitor user s manual V 2 2 19 1 Anesthetic Gas Measurement AG value Figure A Note A a 70 hier 108 Nena 19 1 AG measurement display The system can only display the waveform and value of one anesthetic agent at one time 19 2 AG Module 19 2 1 AG module The outlook of AG module is as shown in the figure below MULTI GASES 9 Figure 19 2 AG module Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement O Indicator used to indicate the working status of the module It lights on when the module is operating AN Note A When AG module is being loaded this indicator should always light on indicating that the module is communicating with the master system If the indicator flashes it indicates that either the AG module or the communication port has failure In this situation you should load the module once again If the failure persists you should contact Mindray service engineer O SETUP used to set up anesthetic related items Press SETUP key to call out the popup AG SETUP menu O0 MEASURE STANDBY press t
46. atmosphere then execute zeroing If the problem still exists replace the transducer and contact the serviceman PULSATILE PRESSURE FALL Ensure that the transducer is not opened to the patient and the stopcock is vented to atmosphere Then execute zeroing If the problem still exists contact the serviceman IBP Calibration Pick IBP PRESSURE CALIBRATE in the IBP 1 2 SELECT menu to popup IBP PRESSURE CALIBRATE menu as shown below Patient Monitor user s manual V 2 2 IBP Monitoring IBP PRESSURE CALIBRATE CH1 CAL VALUE 200 CALIBRATE 200 200 08 10 2001 00 07 00 CH2 CAL VALUE 200 CALIBRATE 200 144 68 10 2001 00 00 00 Back to the upper menu Figure 16 7 IBP Calibration Menu Calibrate the transducer Turn the knob to select the item CH1 CAL VALUE press and turn the knob to select the pressure value to be calibrated for channel 1 Then turn the knob to select CALIBRATE to start calibrating channel 1 Turn the knob to select the item CH2 CAL VALUE press and turn the knob to select the pressure value to be calibrated for channel 2 Then turn the knob to select CALIBRATE to start calibrating channel 2 The pressure calibration of PM 6000 Pressure Transducer Ka T type Stopcock Pressure T type Transducer connector Interface cable Ki Hydrargyrum Pressure meter MOHITOR Figure 16 8 IBP Calibration Caution H Mercury calibration should be performed by the biomedical engineering dep
47. be made at a heart rate of less than 40 bpm and greater than 240 bpm Fatty patient The thick fat layer around the extremity may prevent the oscillation in the artery from coming to the cuff which therefore leads to decreased accuracy 14 3 2 NIBP monitoring screen NIBP measurement result and corresponding message are displayed as follows 14 6 Patient Monitor user s manual V 2 2 NIBP NIBP Monitoring Time of measurement 16 50 mmHg gt BPunit Measurement value 108 84 70 gt NS Alarm limit Measurement mode gt MANUAL gt Current cuff pressure Message gt Manual measure CUFF 100 14 4 NIBP SETUP menu There are two ways for the users to access the NIBP SETUP menu Pick the SETUP button on the NIBP module to access the NIBP SETUP menu as shown below Turn the rotary knob on the control panel to move the curse on the screen to the NIBP hot key in the parameter area and then press the rotary knob to directly access the NIBP NIBP SETUP SETUP menu ALM ALM LEV ALM REC SYS ALM HI SYS ALM LO MEAN ALM HI MEAN ALM LO DIA ALM HI DIA ALM LO DISPLAY WAY 1 GROUP MED UNIT mmHg z OFF INTERVAL MANUAL 160 RESET 30 CONTINUAL 110 CALIBRATE 60 PNEUMATIC g9 SETUP TRANSFER gt gt 50 DEFAULT gt gt Open or close the NIBP alarm Figure 14 3 v NIBP alarm setting EXIT NIBP SETUP Menu e ALM pick ON to enable prompt message and
48. carefully stripped at least 2cm under the skull and 180 in arc Patient Monitor user s manual V 2 2 16 19 IBP Monitoring before insertion Failure to do this will result in wedging of the pressure sensor and inaccurate readings Protect the catheter Use thick sutures and put tape around the catheter before suturing Remove all bone chips Use bone wax Use of a tunnel is recommended A short length of a large bore catheter can be passed first to act as a guide for the sensor tip Remove the guide from the burr hole end after the ICT B has been passed to the burr hole from the tunnel entrance Note that both edges are smoothed This will help to prevent damage to the catheter Sage se Gel EE e ott EE EE EE Strip the dura at least 2 cm under the inner table of the skull Strip in an arc of at least 180 Figure 16 12 ICT B application Reseat the transducer tip after a few days since the dura may rapidly tighten and change its physical characteristics If possible round the bone at the point where the catheter makes its first bend into the burr hole and round the bone where the catheter makes the second bend under the cranium This will help to prevent tearing the catheter or tip during insertion or removal A tear will require the device to be returned for repair an inconvenience that may be avoided by smoothing areas of bone in contact with the catheter transducer The catheter is led
49. case Patient Monitor user s manual V 2 2 12 19 ECG RESP Monitoring m ALM REC pick ON to enable report printing upon PVCs alarm e PVCs alarm is activated when the PVCs exceeds set PVCs ALM HI value PVCs alarm upper limits Max Min Step PVCs 10 1 1 PVCs alarm and prompt message Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during pycs measurement Esser alarms Message Cause Alarm Level PVCs TOO HIGH PVCs measuring value is above upper alarm User selectable limit Technical alarms Message Cause Alarm Level Remedy Stop using PVCs alarming PVCs ALM LMT ERR Functional safety HIGH function notify biomedical failure engineer or Mindray service staff mM ARRRELEARN Pick this item to start a learning procedure E ARRALARM Pick this item to access the ARR ALARM dialog box to set arrhythmia alarm parameters Set ALM to ON OFF to enable disable the alarm function Set REC to ON OFF to enable disable alarm record function turn the knob under LEV column to set alarm level to HIGH MED or LOW 12 20 Patient Monitor user s manual
50. cases it is better to place the two RESP electrodes laterally in the right axillary and left lateral chest areas at the maximum point of breathing movement to optimize the respiratory waveform A Note A The RESP monitoring is not recommended to be used on patients who are very active as this can cause false alarms Checklist for RESP Monitoring 1 Prepare the patient s skin prior to placing the electrodes 2 Attach snap or clip to the electrodes and attach the electrodes to the patient as described below 3 Switch on the monitor 12 24 Patient Monitor user s manual V 2 2 ECG RESP Monitoring 12 10 3 Installing electrode for RESP measurement Placing the Electrodes for Respiratory Monitoring Figure 12 19 Electrodes placement 5 lead AN Note A Place the red and green electrodes diagonally to optimize the respiration waveform Avoid the liver area and the ventricles of the heart in the line between the RESP electrodes so as to avoid cardiac overlay or artifacts from pulsating blood flow This is particularly important for neonates 12 10 4 RESP menu RESP SETUP Menu There are two ways for the user to access the RESP SETUP menu Pick the SETUP button on the ECG TEMP module to call up the ECG RESP TEMP SETUP menu Then pick the RESP SETUP item to call up the following menu Turn the rotary knob on the control panel to move the cursor on the screen to the RESP hot key in the parameter area and then press the
51. could not stop automatically Use this button to stop the measurement and display the C O C I calculation result CANCEL Cancel the processing measurement or cancel the result after measurement REC Print out the curve Scale Y Change the scale Y temperature value Three modes are available 0 0 5 C 0 1 0 C and 0 2 0 C Adjust the scale by the temperature differences A smaller scale results in a larger curve Scale X Change the scale X time value Two modes are available 0 30s and 0 60s If you start measurement in the 0 30s mode it will be switched to 0 60s mode automatically if the measurement can not finish within 30 seconds After the switch no further adjustment can be made to the Scale X EDIT Enter the WINDOW FOR CO EDIT EXIT Press to exit the WINDOWS FOR CO MEASUREMENT H Measuring CO Measurement should be taken when the message Ready for new measurement appears on the screen _ in the Figure 17 3 Press the START button and then start injection The thermodilution curve current blood temperature and the injectate temperature are displayed during the measurement Curve drawing will stop automatically when the measurement completes and then the C O Cardiac output and the C I Cardiac Index TI and in the Figure 17 3 will be calculated and displayed on the screen The monitor will also display the CO in the Parameter Area as well as the remaining t
52. effect The host may choose to disable this compensation when performing dry gas meaasurements in which the gas does not contain water vapor Dry gas procedures may include steady state measurements and calibration procedures Steady state measurements are performed only when background CO2 or CO2 present in the immediate environment is measured An example of a steady state measurement is measuring the CO2 content inside an incubator Calibration procedures use calibrated gas which is free of water vapor or dry as well The water vapor compensation is ON by default and may be enabled or disabled via a host system command BTPS The end user may want choose whether to correct values for gas that is at body temperature ambient pressure and is saturated with water vapor BTPS or has that is at Patient Monitor user s manual V 2 2 CO2 Measuring ambient temperature and pressure and is dry ATPD BTPS compensation Body Temperature and Pressure Saturated is a user selectable compensation that accounts for the differences between the airway sample and deep lung CO2 Since the intent is to report deep lung CO2 where the sample is at 37 C and fully saturated BTPS compensates for the variance of water vapor content due to temperature The BTPS compensation of CO2 module is on by default A Note A 1 If Compensate item is not correctly set as per the operation conditions the result will be far from the actual v
53. gives detailed description to PM 6000 Modular Patient Monitor concerning its performance operation and other safety information Reading through this manual is the first step for the user to get familiar with the equipment and make the best out of it Following symbols indicates some important facts that you have to pay special attention to AN Warning AN Points to be noted to avoid injury to the patient and the operator A Caution A Points to be noted to avoid damage to the equipment A Note A Points to be noted This manual is intended for persons who are trained in the use of this field and have adequate experience in operation of monitoring equipment Patient Monitor user s manual V 2 2 V Content Content Chapter 1 Iptrogduetton Nee 1 1 1 1 General Information 1 3 1 2 Screen Display ci sne Fy nd Paka eee nates tide ain de cae aaa 1 7 LS BUTLON FUNCHONS E E AE ATE E E eebe A 1 10 E Interni ler 1 13 E Ee EE 1 14 Chapter 2 Getting Startech E 2 1 2 1 Open the Package and Check 2 1 2 2 Connect the Power Cales 2 1 2 3 Power on the Monitor ssssssssnsssssesssrsnnsnssrertntnnntssnesttnnnnnnsttettnnnnnnnannennnnnnnanennn annene 2 2 2 4 Connect Patient Gensors siirius anita ran urranik unanini iaraa niniku pawi aea iiia ear 2 2 2 5 Check the eeler eetetoeetefg eet i gee kra vadetacaeve theca aA EAE ESERE KERERE ERT EKRE INER 2 2 Chapter 3 System MenU sssasssnsssnssennnennneunneunnnunnnunnnnnnnnnnnnnnnnnnnn
54. host system triumphantly If the indicator is still flashing it means that the CO module or the slot has failure In this case the Patient Monitor user s manual V 2 2 17 1 CO Measuring operator should re load the module If the failure still exists please contact the Mindray service engineer for repair SETUP the button used to set up the related items of CO Press SETUP button the CO SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel MEASURE press the MEASURE button to activate CO measuring program A socket for CO sensor Used to connect CO sensor Before monitoring the patient the user should first safely insert the CO sensor cable into this socket i AN means BE CAREFUL Refer to the attached document this manual of the monitor means that the CO module is IEC 60601 1 Type CF equipment AN Note AN When not using the CO module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected 17 3 Monitoring Procedure 17 3 1 C O Measurement Procedure 1 Plug the C O interface cable into the C O socket on the CO module 2 Attach the injectate probe connector and catheter thermistor connector to the appropriate parts of the cardiac output interface c
55. in DRUG CALC menu to enter titration table display Titration table display for drug is as following TITRATION Drug A VOLUME INF RATE 93 75 AMOUNT 400 00 mg DOSE hr 150 00 mg WEIGHT 70 0 kg DOSE 250 00 ml ml hr DRIP RATE 31 25 GTT min DOSE INF RATE INF RATE H 1 2 3 4 5 6 7 8 9 O O oo H bb ge UP DOWN Use one item as input calculate the other one 16 11 12 13 14 15 16 17 18 19 BASIC DOSE x STEP 1 DOSE TYPE DOSE hr Figure 9 2 H Method to operate the titration table 25 88 50 EXIT 20 21 22 23 24 25 26 27 28 29 TITRATION REC 12 13 13 14 15 15 16 16 17 18 50 13 75 38 Bo 63 25 88 50 13 va 1 In the TITRATION table turn the knob to pick BASIC item Press and turn the knob to select either FLOW RATE or DOSE or DROP RATE 2 Then turn the knob to pick STEP item Press and turn the knob to select step 1 10 are available for selection with the increment being 1 Patient Monitor user s manual V 2 2 Drug Calculation and Titration Table 3 Turn the knob to pick DOSE TYPE item Press and turn the knob to select the unit in the pull down list Use UP DOWN item in the table to view the data in previous or following pages Turn the knob to pick REC item After pressing the knob the recorder prints out the data displayed in the current titration table 6 Tur
56. into this socket O A socket for ECG 0 A means BE CAREFUL Refer to the attached document this manual of the monitor g 1 means that the ECG TEMP module is IEC 60601 1 Type CF equipment A Note A When not using the ECG TEMP module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected 15 3 TEMP SETUP Menu There are two ways to access the TEMP SETUP menu Press the SETUP button on the ECG TEMP module to access the ECG RESP TEMP SETUP menu Pick the TEMP SETUP to call up the TEMP SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the TEMP hot key in the parameter area and then press the knob to directly access the TEMP SETUP menu TEMP SETUP ALM ON T2 ALM LO 36 0 ah E ALM LEV MED TD ALM HI 2 0 ah ALM REC OFF 4 TEMP UNIT Z T1 ALM HI 39 0 SETUP TRANSFER gt gt d T1 ALM LO 36 0 DEFAULT gt gt d T2 ALM HI 39 0 Open or close the TEMP alarn EXIT Figure 15 2 TEMP SETUP Menu TEMP alarm setting e ALM pick ON to enable prompt message and data record during the TEMP alarm pick OFF to disable the alarm function and prompt the symbol beside TEMP numeric Patient Monitor user s manual V 2 2 15 3 TEMP Monitoring e ALMLEV used to set up the alarm level selectable f
57. is larger than AWRR upper alarm limit the AwRR HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E AwRR ALM LO used to adjust the lower alarm limit of AWRR When the measured value is smaller than AWRR lower alarm limit the AwRR LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E OTHER SETUP gt gt used to enter the other ALARM SETUP menus E EXIT used to close this ALARM SETUP menu 19 8 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement After selecting OTHER SETUP gt gt item in the ALARM SETUP menu the following ALARM SETUP menu pops up ALARM SETUP EtN20 ALM HI 55 EtAA ALN LO 0 0 EtN20 ALN LO o FiAA ALM HI 6 0 FiN20 ALM HI 53 FifAA ALM LO 0 0 FiN20 ALM LO o APNEA ALM 205 EtAA ALM HI 8 0 Back to the upper menu DT Figure 19 7 ALARM SETUP menu for other parameters E EtN2O ALM HI used to adjust the upper alarm limit of EtN20 When the measured value is larger than EtN2O upper alarm limit the EtN20 HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E EtN20 ALM LO used to adjust the lower alarm limit of EtN2O When the measured value is smaller than EtN2O lower alarm limit
58. key of Select Bed Number is the Parameter area in which parameters Patient Monitor user s manual V 2 2 4 5 Face Select of all monitors being viewed are displayed H Waveform area of Viewbed Screen Under the hot key of Select Waveform is the Waveform area The Sweep manner refreshing or scrolling of the waveform is identical with that of this monitor The feature description of the displayed waveform is given above the waveform Sweep speed is also identical with that set up for the same waveform on this monitor H Technical Information area Technical Information area is to the right of patient name in Viewbed Screen This area displays related technical information to Viewbed such as due to network failure or network too busy Viewbed is disabled m Close Viewbed Screen In the FACE SELECT menu select options of other operating screens to close the Viewbed Screen m Rules for automatically selecting monitor to be viewed and waveform When you turn on the monitor or enter Viewbed Screen the system will automatically select a networked bedside monitor and a waveform of this monitor for you to view If the monitor being currently viewed is disconnected the viewed monitor will automatically close clear displays of all alarms parameters and waveforms However in this situation the Viewbed Screen still displays If you want to view another monitor you must select again through using hot keys If a measure module of the v
59. knob to directly access the RESP SETUP menu Patient Monitor user s manual V 2 2 12 25 ECG RESP Monitoring ALM WAVE AMP 1 ALM LEV MED v HOLD TYPE AUTO 7 ALM REC DFF X HOLD HI ALM HI 30 Ka HOLD LO ALM LO 8 SETUP TRANSFER gt gt APNEA ALM 20S id DEFAULT gt gt SWEEP Sns EXIT Figure 12 20 RESP SETUP Menu RESP alarm setting e ALM pick ON to enable prompt message and data record during the RESP alarm pick OFF to disable the alarm function and there will be a 4 amp beside RESP e ALM REC pick ON to enable report printing upon RESP alarm e ALM LEV selectable from HIGH MED and LOW Level HIGH represents the most serious case e ALM HI used to set up the upper alarm limit e ALM LO used to set up the lower alarm limit RESP alarm is activated when the respiration rate exceeds set ALM HI value or falls below ALM LO value RESP alarm limits Max RR HI Min RR LO Step RESP ADU 120 0 1 RESP NEO PED 150 0 1 e APNEA ALM to set the standard of judging an apnea case It ranges from 10 to 40 seconds increases decreases by 5 e SWEEP Available options for RESP SWEEP are 6 25 12 5 and 25 0 mm s e WAVE AMP The user may set up the displaying amplitude of the RESP waveform The selections are 0 25 0 5 1 2 3 4 5 e HOLD TYPE AUTO MANUAL adjustable When it is AUTO mode HOLD HI and HOLD LO menus cannot be used and the monitor automatically calculates the RESP RATE When it is MA
60. mainstream mode from 25 C ambient 5W supplied to sensor heater Mainstream sensor temperature controlled to 42 C 100 msec 10 to 90 240 msec 10 to 90 1 12 seconds maximum with 7 feet long sampling line and ID 0 055 inch Sample rate is 175 ml min Mainstream Response Time Sidestream Rise Time Sidestream Delay Time Alarm range CO 0 99 mmHg Ins COs 0 99 mmHg AwRR 0 150 rpm Patient Monitor user s manual V 2 2 7 Product Specification Suffocation Alarm Delay AwRR 10 40 Sec 2 15 AG Method Infrared Absorption Technique Measuring mode Side stream Warm up time 30 Sec Iso accuracy mode 10 Min Full accuracy mode Side stream mode sampling gas flow rate Adult 1200 1500 250 ml min option Neonate 700 900 120 ml min option Gas Sort COs N20 O Option Des Iso Enf Sev Hal Measuring range CO 0 10 0 76 mmHg N O 0 100 Des 0 18 Sev 0 8 Enf Iso Hal 0 5 O2 0 100 Option awRR 2 100 rpm Resolution CO 1 mmHg awRR 1 rpm Accuracy Accuracy range COs 0 1 0 1 0 2 1 5 0 3 5 7 0 4 7 10 Unspecified gt 10 N O 2 0 20 3 20 100 Des 0 15 0 1 0 2 1 5 0 4 5 10 0 6 10 18 Unspecified gt 18 Sev 0 15 0 1 0 2 1 5 0 4 5 8 Unspecified gt 8 Enf Iso Hal 0 15 0 1 Patient Monitor user s manual V 2 2 O Option awRR Alarm range CO awRR Suffocation Alarm Delay awRR U
61. may become temporarily distorted However the monitor will work normally after defibrillation with the operation mode and user configuration being not affected AN Warning AN Inspect the transducer cable is in normal condition before monitoring Unplug the transducer of the channel 1 the monitor should display the error message IBP SENSOR 1 OFF and trigger audible alarm The other channel should act the same AY Note A Periodically calibrate the transducer either new or used according to the Hospital Regulation A Warning A If any kind of liquid other than the solution to be infused in the pressure line or transducer is splashed on the equipment or its accessories especially enters the transducer or the monitor contact the Service Center of the Hospital immediately 16 4 Monitoring Procedure Preparation before IBP measurement 10 Plug the pressure cable into corresponding socket and check that the monitor is switched on 2 Any entrapped air should be removed from the pressure system pressure line and transducer by filling with normal saline Patient Monitor user s manual V 2 2 16 3 IBP Monitoring 30 Connect the arterial catheter to the pressure line ensure any entrapped air removed AY Warning AY If any entrapped air in pressure system re fill system with normal saline AT Position the transducer at the same level of the patient s heart approximately mid axillary line
62. measuring value returns to the normal one the information disappears CO2 ALM LO to adjust the lower alarm limit of EtCO2 If the measuring value is smaller than CO2 lower alarm limit CO2 TOO LOW appears on the screen After the measuring value returns to the normal one the information disappears Patient Monitor user s manual V 2 2 18 5 CO2 Measuring m INS ALM HI to adjust the upper alarm limit of InsCO2 If the measuring value is larger than InsCO2 upper alarm limit INS TOO HIGH appears on the screen After the measuring value returns to the normal one the information disappears H AWRR ALM HI to adjust the upper alarm limit of AwRR If the measuring value is larger than the upper alarm limit of AWRR AWRR TOO HIGH appears on the screen After the measuring value returns to the normal one the information disappears m AWRR ALM LO to adjust the lower alarm limit of AWRR If the measuring value is smaller than the lower alarm limit of AWRR AWRR TOO LOW appears on the screen After the measuring value returns to the normal one the information disappears m UNIT to change the display units of CO2 and InsCO2 parameters mmHg and kPa are available for selection H APNEA ALM After selecting the alarm time for APNEA alarm having 7 options which are 10S 15S 20S 25S 30S 35S and 40S the CO2 APNEA information will appear on the screen after the corresponding selected time The alarm
63. module is IEC 60601 1 Type CF equipment life cycle of the module will be unfavorably affected Patient Monitor user s manual V 2 2 NIBP Monitoring 14 3 NIBP Monitoring 14 3 1 NIBP Measuring AY Warning A Before starting a measurement verify that you have selected a setting appropriate for your patient adult pediatric or neonate Do not apply the cuff to a limb that has an intravenous infusion or catheter in place This could cause tissue damage around the catheter when infusion is slowed or blocked during cuff inflation A Warning A Make sure that the air conduit connecting the blood pressure cuff and the monitor is neither blocked nor tangled Plug in the air hose and switch on the system 2 Apply the blood pressure cuff to the patient s arm or leg following the instructions below Figure 14 2 WH Ensure that the cuff is completely deflated Apply the appropriate size cuff to the patient and make sure that the symbol is over the appropriate artery Ensure that the cuff is not wrapped too tightly around the limb Excessive tightness may cause discoloration and eventual ischemia of the extremities A D EK SE e k KM S _ Figure 14 2 Applying Cuff AN Note A The width of the cuff should be either 40 of the limb circumference 50 for neonates or 2 3 of the upper arm length The inflatable part of the cuff should be long enough to encircle 50 80 of the limb The wrong siz
64. monitor Socket in Figure 1 7 Connect the other end of the power line to a grounded 3 phase power output A Note A Connect the power line to the jack special for hospital usage A Note A Mindray does not provide MULTIPLE PORTABLE SOCKET OUTLETS IF use it please do not place it on the floor Mindray advises that every one monitor uses one MULTIPLE PORTABLE SOCKET OUTLETS Connect to the ground line if necessary Refer to Chapter Patient Safety for details Patient Monitor user s manual V 2 2 2 1 Getting Started 2 3 Power on the Monitor Press POWER _ in Figure 1 1 to power on the monitor Then a beep will be heard and at the same time the indicator will flash twice in yellow and red After 10 seconds or so the system will enter monitoring screen after self test and you can perform normal monitoring now During self test the software version will display A Warning A If any sign of damage is detected or the monitor displays some error messages do not use it on any patient Contact biomedical engineer in the hospital or Mindray Customer Service Center immediately A Note A If the monitor finds any fatal error during self test it will alarm A Note A Check all the functions that may be used to monitor and make sure that the monitor is in good status A Note A The battery must be recharged to the full electricity after each use to ensure adequate electricity reserve A
65. or any operation is executed under the NIGHT mode night mode will be automatically shut off Brightness You can user the BRIGHTNESS item to select the screen brightness There are totally 8 options to select 3 6 Monitor Version Select the VERSION item in the SYSTEM MENU to know the software version of the monitor VERSION Version 05 08 00 07 31 2001 Copyright c Mindray Co Ltd Compile Time Apr 16 2003 DEVICE CONFIG LIST gt gt Back to the upper menu Figure 3 16 Monitor Version Select the DEVICE CONFIG LIST to know the configuration of the monitor 3 12 Patient Monitor user s manual V 2 2 System Menu DEVICE CONFIG LIST DYNAMIC TREND MODULE oxyCRG ECG VIEWBED RESP v WAVE SCROLL DISPLAY TEMP PARA ALARM LIMIT DISPLAY SP02 v DRUG CALC amp TITRATION NIBP ARR amp ST ANALYSIS IBP v ECG LEAD TYPE 5 LEADS v CO ECG MULTI LEADS DISPLAY C02 NIBP LIST DISPLAY GAS POWER OFF DATA STORAGE RECORDER Back to the upper menu Figure 3 17 Device Configuration List 3 7 Drug Calculation You can use the drug calculation and titration table function of PM 6000 to calculate the concentration of 15 kinds of drugs Refer to Chapter Drug Calculation and Titration Table for detailed information 3 8 Maintenance Select the MAINTAIN item in the SYSTEM MENU to call up the ENTER MAINTAIN PASSWORD dialog box as shown below in which you can e
66. or with poor skin integrity LNOP DCI REUSABLE Adults and Pediatrics gt 30 kg LNOP DCIP REUSABLE Pediatrics gt 10 kg and lt 50 kg LNOP DCSC REUSABLE Adult and Pediatrics gt 30 kg for spot check applications LNOP Ear sensor REUSABLE Adult Pediatric gt 30 kg LNOP YI Multi site REUSABLE Adult Pediatric Infant Neonatal gt 1 kg Cleaning and reuse of Masimo LNOP sensors Reusable sensors can be cleaned per the following procedure H Remove the sensor from the patient m Disconnect the sensor from the monitor m Wipe the entire sensor clean with a 70 isopropy alcohol pad H Allow the sensor to air dry before returning it to operation Reattachment of single use adhesive sensors m LNOP single use sensors may be reapplied to the same patient if the emitter and 13 10 Patient Monitor user s manual V 2 2 GpO Monitoring detector windows are clear and the adhesive still adheres to the skin m The adhesive can be partially rejuvenated by wiping with a 70 isopropyl alcohol wipe and allowing the sensor to thoroughly air dry prior to replacement on the patient AY Warning AY To avoid cross contamination only use Masimo LNOP single use sensors on the same patient A Note A If the sensor fails to track the pulse consistently the sensors may be incorrectly positioned Reposition the sensor or choose a different monitoring site AN Caution AN Do not reprocess any LNOP single use sensors m MASIMO SET PATIENT CABLES Reu
67. practices SpO gt alarm setting e ALM pick ON to enable prompt message and data record during the SpO alarm pick OFF to disable the alarm function and there will be a 2 beside SpO e ALM REC pick ON to enable report printing upon SpO gt alarm e ALM LEV used to set up alarm level selectable from HIGH MED and LOW HIGH represents the most serious case e SpO alarm is activated when the result exceeds set SPO2 ALM HI value or falls below SPO2 ALM LO value Use the knob to pick the SPO2 ALM HI or SPO2 ALM LOW item and turn the knob to select the desired alarm limit e PR alarm is activated when the pulse rate exceeds set PR ALM HI value or falls below PR ALM LO value Use the knob to pick the PR ALM HI or PR ALM LOW item and turn the knob to select the desired alarm limit SpO2 and PR alarm limits Max Upper Limit Min Lower Limit Step SpO2 100 0 1 PR 254 0 1 m SWEEP Available options for SPO2 SWEEP are 12 5 25 0 mm s Patient Monitor user s manual V 2 2 13 21 SpO2 Monitoring PR SOUND Pulse beep volume Options are OFF HIGH MED LOW AVG TIME 4S 8S 16S represent times that SpO average value is counted SETUP TRANSFER Pick this item to access SPO2 SETUP TRANSFER dialog box SP02 SETUP TRANSFER RT TRANSFER OFF SAVE SETUP INTO MODULE LOAD MODULE SETUP Back to the upper menu Sa Figure 13 8 SPO2 SETUP Transfer menu Whose functions are RT TRANSFER Refers to real time
68. shown below will pop up System time is in the format of year month day hour minute and second Use cursor to highlight the item that you want to modify and turn the knob to select time Then select EXIT A Note A You shall set up the system time upon turning on the monitor if you need to set up the system time otherwise when you review the content with time information the system may not display the correct time TIME SETUP YEAR z001 4 MONTH 12 DAY 1 HOUR 1 MINUTE 58 SECOND 17 EXIT Figure 3 9 System Time Setup When this monitor is linked to the Central Station its system time will keep consistent with 3 6 Patient Monitor user s manual V 2 2 System Menu that of the Central Station Method to adjust time Once link is successfully established the Central Station will send its current time to the monitor The monitor will automatically adjust its system time accordingly Besides the Central Station will keep on sending its current time to the monitor once per hour to maintain consistent time between them However the monitor will not adjust its time if it is different from the Central Station only in second Please note that if you are setting up the system time when link is just established successfully the monitor will immediately close the setup menu of system time The setup button of system time in the system setup menu is disabled when the monitor is linked to the Central Station That means
69. that the alarm record switch in the related menu is On Tables below describe respectively the possible various alarms those may occur during the measurement Physiological alarms Message Cause Alarm level ECG LOST No ECG signal of the patient is detected HIGH HR TOO HIGH HR measuring value is above the upper alarm limit User selectable HR TOO LOW HR measuring value is below the lower alarm limit User selectable Technical alarms Message Cause ECG LEAD OFF ECG V LEAD OFF or ECG C LEAD OFF ECG EP LES DIORE of ECG electrodes fall off se x Geck mi Be ECG F LEAD OFF the skin or ECG cables fall patient cables off the monitor als ECG LALEAD OFF or properly connected ECG L LEAD OFF ECG RALEAD OFF or ECG R LEAD OFF ECG INIT ERR ECG module failure Stop using measuring function provided by EC GUMT ERRI ECG module notifies ECG INIT ERR2 biomedical engineer 12 14 Patient Monitor user s manual V 2 2 ECG RESP Monitoring or Mindray service ene INIT ERR3 staff nes INIT ERR4 epes INIT ERR5 ene INIT ERR6 GE INIT ERR ECGINITERRS INIT ERR8 If failure persists Occasional communication notify biomedical failure engineer or Mindray service staff ECG COMM STOP If failure persists ECG COMM ERR Occasional communication notify biomedical failure engineer or Mindray service staff Stop using HR alarm function notify HR ALM LMT ERR Functional safety failure biomedical engin
70. the alarm parameter Arrhythmia Report XXX Arrhythmia type Freeze Wave Report Trend Graph Trend Table Para Alarm Review NIBP Test Review CO Test Curve HEMOCAL PARAMETERS Patient Monitor user s manual V 2 2 7 3 Recording Status Report Titration Table Alarm parameters alarm time and freeze time Patient bed number name sex height weight date of birth admission date Parameter name and value Recording time Waveform name Waveform scale for ECG waveform ECG lead scale filter mode if having ECG waveforms it will be printed out within the first second or when changing the lead gain and filter mode during real time recording IBP scale the first second of IBP waveform CO2 scale the first second of CO2 waveform Date and time Company name 7 3 Recording Startup You can start the recording in the following ways Continuous real time recording Press REC STOP to start stop the recording 8 second real time recording Press REC STOP to start recording It will automatically stop in 8 seconds Auto recording Record the two waveforms selected in RECORD menu according to the setup time interval in RECORD menu Alarm recording When alarm recording is set ON it automatically starts when alarm occurs Frozen waveform recording After accessing FREEZE menu use knob to select two waveforms to be output Then press REC button in the menu to print out the waveforms FROZEN WAVE 1 ECG1 v WA
71. the alarm will also be recorded 3 Arrhythmia Alarm The monitor records 2 channel ECG waveforms 4 seconds prior to and after the alarm totally 7 2 Patient Monitor user s manual V 2 2 Recording 8 seconds All measurement results during the alarm will also be recorded Freeze Waveform Recording The monitor prints out the selected waveforms under the FREEZE mode In this way you can snap the abnormal waveforms on the screen and record it Trend Graph Table Recording The monitor can print out the trend graph and table in the current TREND GRAPH or TREND TABLE window Arrhythmia Review Recording The monitor can print out the alarm Arrhythmia event in the current ARR RECALL window Alarm Review Recording The monitor can print out the alarm events include waves and parameters in the current ALARM RECALL window NIBP Review Recording The monitor can print out all the NIBP review events in NIBP RECALL window CO Measurement Curve Recording The monitor can print out CO Measurement curve in WINDOWS FOR CO MEASUREMENT Hemodynamic Calculation result recording The monitor can print out parameters and results in HEMOD WINDOWS Monitor Information The monitor can print out messages in the current STATUS window Titration Table The monitor can print out the messages in the current TITRATION window Notes on Recording m Recording texts Real time Report Periodic Report Para Alarm Report XXX name of
72. the belt and fit one of its sides with V edge into the V groove on the corresponding side of the sheath Appropriately elongate the belt about 20mm and fit the V edge of the other side of the belt into the V groove of the other side of the sheath and then loosen the belt After the V edges of the two sides of the belt fit well into the V grooves on the two sides of the sheath put the belt into the first lock bar to fasten the belt See figure 13 5 If the belt is too much long you may put it into the second lock bar You must position the SpO2 sensor in this way so as to make the photoelectric component face the correct position In the mean time note not to elongate the belt too much which may cause venous pulsation and therefore result in inaccurate measurement and also blocking the blood circulation severely Figure 13 6 mounting of the neonate sensor A Note A If the sensor can not be positioned accurately to the part to be measured it may result in inaccurate SpO2 reading or even that the SpO2 cannot be measured because no pulse is detected If this is true you must position the sensor again The excessive patient movement may result in inaccurate reading In this situation you must keep the patient quiet or change the part for monitoring to reduce the adverse influence of excessive movement AN Warning A In the process of extended and continuous monitoring you should check the Patient Mo
73. the three scales can be set according to the instruction given below WH IBP label Selectable from ART PA CVP RAP LAP ICP P1 P2 WH HI IBP value of Higher scale the range of which is the measurable range of current pressure AY Note AY The HI value must be higher than the LO value m LO IBP value of Lower scale the range of which is the measurable range of current pressure A Note A The LO value must be lower than the HI value m VAL IBP value of Reference scale between HI and LO AY Note AY HI scale LO scale Reference scale and IBP waveform are displayed simultaneously on the screen user could obviously view the change of the waveform after the scale has been adjusted Patient Monitor user s manual V 2 2 16 11 IBP Monitoring 16 6 Alarm Information and Prompts Alarm Messages Physiological alarm caused by the parameter value exceeds the limits will activate the recorder to automatically outputting the parameters and related measuring waveforms once the alarm occur while ALARM REC in related menu switch ON Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during IBP measurement Physiological alarms Message Cause Alarm Level IS1 TOO HIGH SYS measuring value of channel 1 is WEE BE above upper alarm limit IS1 TOO LOW SYS measuring value of channel 1 is ebe below lower alarm limit ID1 TOO HIGH D
74. the two waveforms displayed on the screen EXPAND PRESSURE Access the sub menu of IBP EXPAND PRESSURE user could select the pressure type to be represented by P1 and P2 SETUP TRANSFER used to access the sub menu of IBP 1 2 SETUP TRANSFER as shown below DEFAULT Access the IBP DEFAULT CONFIG dialog in which user could select Patient Monitor user s manual V 2 2 16 5 IBP Monitoring FACTORY DEFAULT CONFIG or USER DEFAULT CONFIG After selecting an option and exiting the dialog the system will pop up a dialog asking for confirmation WH EXIT Exit the menu and return to the upper menu IBP 1 2 SETUP TRANSFER RT TRANSFER OFF 7 SAVE SETUP INTO MODULE LOAD MODULE SETUP Back to the upper menu Figure 16 4 IBP 1 2 SETUP TRANSFER in which the user may set up following information RT TRANSFER Refers to real time transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the IBP module into the IBP module 2 ON when choose the ON selection the system first saves all the setups into the IBP module and then saves the modifications to the module into the IBP module immediately For the newly loaded IBP module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT
75. the watertrap into this socket AN means BE CAREFUL Refer to the attached document this manual of the monitor A means that the SpO2 module is IEC 60601 1 Type CF equipment A Note A When not using the SpO2 module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the 13 6 Patient Monitor user s manual V 2 2 GpO Monitoring life cycle of the module will be unfavorably affected A Note A This monitor with MS 7 is intended for continuous noninvasive monitoring of functional oxygen saturation of arterial hemoglobin SpO2 and pulse rate measured by an SpO2 sensor for adult pediatric and neonatal patients in a hospital and mobile environment Limitations for Measurement If the accuracy of any measurement does not seem reasonable first check the patient s vital signs by alternate means and the check the instrument for proper functioning Inaccurate measurements may be caused by incorrect sensor application or use significant levels of dysfunctional hemoglobins e g carboxyhemoglobin or methemoglobin intravascular 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 direct sunlight exposure to excessive illumi
76. transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the SpO module into the SpO2 module 2 ON when choose the ON selection the system first saves all the setups into the SpO2 module and then saves the modifications to the module into the SoO2 module immediately For the newly loaded SpO module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user m DEFAULT pick this item to access the SPO2 DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation 13 2 6 Alarm Description and Prompt SpO2 Alarm Message Among physiological alarms those belonging to the type that the parameter has exceeded 13 22 Patient Monitor user s manual V 2 2 GpO M
77. you to further select an option on the module and system buttons of MAIN and MENU Plug in out the module m Execute any operation that may trigger the adjustment of the screen or display of anew menu After exiting the Freeze status the system will discharge the Freeze status clear screen waveforms and resume to display real time waveforms In the Screen Refresh mode the system begins scanning waveforms from the extreme left one In the Screen Scroll mode the system begins displaying and scrolling waveforms from the extreme right one 6 3 FROZEN Menu Press the FREEZE button on the button module the FROZEN menu will appear on the bottom part of the screen At the same time the system enters the Freeze status FROZEN WAVE 1 ECG1 WAVE 2 ECGZ RECALL REC EXIT Figure 6 1 FROZEN menu m WAVE III used to select the first frozen waveform to record The pull down list of this item gives you the names of all frozen waveforms displayed on the screen m WAVE 2 used to select the second frozen waveform to record The pull down list of this item gives you the names of all waveforms displayed on the screen H RECALL used to review frozen waveforms m REC after selected the system begins recording the frozen waveforms selected in WAVE 1 and WAVE 2 H EXIT after pressed the system closes the FROZEN menu and exits the Freeze status A Note A Pressing the FREEZE button repeatedly in short time period m
78. zeroed LOW IBP2 NEED ZERO CAL IBP channel 2 has not been zeroed LOW Patient Monitor user s manual V 2 2 16 13 IBP Monitoring 16 7 Maintenance and Cleaning 16 7 1 Care and cleaning AN Warning A Before cleaning the monitor or the transducer turn off the power and disconnect from power line Cleaning of IBP Transducer Reusable After the IBP monitoring operation is completed remove the tubing and the dome from the transducer and wipe the transducer diaphragm with water To clean the transducer and the cable soak or wipe them by using soap or the detergents listed below Cetylcide Wavicide 01 Wescodyne Cidex Lysol Vesphene Do not immerse the connector in any liquid After cleaning dry the transducer thoroughly before storing Slight discoloration or temporary increase of surface stickiness of the cable should not be considered abnormal If adhesive tape residue must be removed from the transducer cable double seal tape remover is effective and will cause a minimum of damage to the cable if used sparingly Acetone Alcohol Ammonia and Chloroform or other strong solvents are not recommended because over time the vinyl cabling will be damaged by these agents A Note A The disposable transducers or domes must not be re sterilized or re used A Note A For protecting environment the disposable transducers or domes must be reclaimed or disposed properly Sterilization H Chemical solution Sterilization Remo
79. 12 The system has serious error Re start up the system If the failure still exists contact the manufacturer KEYBOARD NOT AVAILABLE KEYBOARD COMM ERR KEBOARD ERROR KEYBOARD ERR1 KEYBOARD ERR2 The keys on the keyboard cannot be used The keyboard has failure which cannot be used Check the keys to see whether it is pressed manually or by other object If the key is not pressed abnormally contact the manufacturer for repair Contact the manufacturer for repair Patient Monitor user s manual V 2 2 System Alarm Prompt NET INIT ERR NET INIT ERR g NET INIT ERR Mii G Ram NET INIT ERR Re M NET INIT ERR Loop NET ERR Run1 NET ERR Run2 NET ERR Run3 The network part in the system has failure The system cannot be linked to the net Contact the manufacturer for repair 5V TOO HIGH 5V TOO LOW POWER ERR3 POWER ERR4 12V TOO HIGH 12V TOO LOW POWER ERR7 POWER ERR8 3 3V TOO HIGH 3 3V TOO LOW The power part of the system has failure If the prompt appears repeatedly contact the manufacturer Tor repair CELL BAT TOO HIGH Cell battery has problem The cell battery has low Replace the battery If the failure n u capacity or the cell battery still exists contact the
80. 120 DEFAULT gt gt Open or close the Sp02 alarm EXIT ah Figure 13 3 SpO2 SETUP menu A Warning A Setting the SpO upper alarm limit to 100 is equivalent to switching off the alarm on upper limit High oxygen levels may predispose a premature infant to retrolental fibroplasia Therefore the upper alarm limit for oxygen saturation must be carefully selected in accordance with commonly accepted clinical practices SpO z alarm setting e ALM pick ON to enable prompt message and data record during the SpO alarm pick OFF to disable the alarm function and there will be a 2 beside SpO e ALM REC pick ON to enable report printing upon SpO gt alarm e ALM LEV used to set up alarm level selectable from HIGH MED and LOW HIGH represents the most serious case 13 8 Patient Monitor user s manual V 2 2 GpO Monitoring e SpO2 ALM HI and SpO2 ALM LO SpO2 alarm is activated when the result exceeds set SpO2 ALM HI value or falls below SpO2 ALM LO value Use the knob to pick the SpO2 ALM HI or SpO2 ALM LO item and turn the knob to select the desired alarm limit e PR ALM HI and PR ALM LO PR alarm is activated when the pulse rate exceeds set PR ALM HI value or falls below PR ALM LO value Use the knob to pick the PR ALM HI or PR ALM LO item and turn the knob to select the desired alarm limit A Warning A Check alarm limits each time the monitor is used to ensure that they are appropriate for the patient being m
81. 2 2 11 1 Care Cleaning The PM 6000 Modular Monitor must be kept dust free Regular cleaning of the monitor shell and the screen is strongly recommended Use only non caustic detergents such as soap and water to clean the monitor shell A Note A Please pay special attention to the following items 1 Avoid using ammonia based or acetone based cleaners such as acetone 2 Most cleaning agents must be diluted before use Follow the manufacturer s directions carefully to avoid damaging the monitor 3 Don t use the grinding material such as steel wool etc 4 Don t let the cleaning agent enter into the chassis of the system 5 Don t leave the cleaning agents at any part of the equipment 11 3 Cleaning Agents Examples of disinfectants that can be used on the instrument casing are listed below E Diluted Ammonia Water RW Diluted Sodium Hyoichlo Bleaching agent A Note A The diluted sodium hyoichlo from 500ppm 1 100 diluted bleaching agent to 5000ppm 1 10 bleaching agents is very effective The concentration of the diluted sodium hyocihlo depends on how many organisms blood mucus on the surface of the chassis to be cleaned Diluted Formaldehyde 35 37 Hydrogen Peroxide 3 Alcohol isopropanol A Note A PM 6000 monitor and sensor surface can be cleaned with hospital grade ethanol and dried in air or with crisp and clean cloth A Note A Mindray has no responsibility for the effectiveness of controlling i
82. 40S Default 20S Work Mode MainStream Standby Measurement SideStream Standby Measurement Default Measurement Compensate Method MainStream General O2 N20 DES ALL SideStream General O2 N20 DES ALL Default Methods General Pump Rate 100 200 ml min Default 100 ml min Unit mmHg kPa Default mmHg Waveform Sweep 25 0 12 5 6 25 mm s Patient Monitor user s manual V 2 2 18 9 CO2 Measuring Default 25 0 mm s Waveform Scale LOW HIGH Default LOW Besides for alarm function of CO2 module refer to Chapter Alarm for its recording function refer to Chapter Recording and for information about alarm event review graphic and tabular trend of CO2 parameters refer to Chapter Trend and Event 18 5 Alarm Information and Prompt Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during CO2 measurement Physiological alarms Message Cause Alarm Level EtCO2 measuring value is above upper F CO2 TOO HIGH alarm limit User selectable EtCO2 measuring value is below lower CO2 TOO LOW alarm limit User selectable INS TOO HIGH KE measuring value is abov
83. 5 x0 5 x1 x2 auto 15 300 bpm 15 350 bpm 1 or 1bpm use the greater 1 bpm gt 200 uV P P gt 5 Mohm gt 105 dB gt 105 dB gt 90 dB 300mV lt 10 uA lt 3 S After Defi 8 mV p p 1 15 Hz Patient Monitor user s manual V 2 2 3 Product Specification Monitor Diagnostic Calibration Signal ST Segment Monitoring Range Measure and Alarm ARR Detecting Type Alarm Review 2 8 RESPARATION Method Differential input Impedance Measuring Impedance Range Base line Impedance Range Bandwidth Resp Rate Measuring and Alarm Range Adult Neo Ped Resolution Accuracy Apean Alarm 2 9 NIBP Method Mode 0 5 35 Hz 0 05 100 Hz 1 mV p p 5 Accuracy 2 0 2 0 mV ASYSTOLE VFIB VTAC COUPLET BIGEMINY TRIGEMINY R ON T VT gt 2 PVC TACHY BRADY MISSED BEATS PNP PNC Available Available Impedance between RA LL gt 2 5 MOhm 0 3 5 00 200 25000 use 1kQ of ECG cable 0 2 2 Hz 3db 0 120 rpm 0 150 rpm 1 rpm 2 rpm 10 40 s Oscillometric Manual Auto STAT Measuring Interval in AUTO Mode 1 2 3 4 5 10 15 30 60 90 120 180 240 480 min Measuring Period in STAT Mode 5 Min Pulse Rate Range 40 240 bpm Alarm Type SYS DIA MEAN Measuring and alarm range Adult Mode SYS 40 270 mmHg DIA 10 215 mmHg MEAN 20 230 mmHg Pediatric Mode 4 Patient Monitor user s manual V 2 2 Pro
84. AN Warning A Do not use ultrasonic cleaning A Warning A Do not use chlorinated hydrocarbons A Warning AY Patient Monitor user s manual V 2 2 16 21 IBP Monitoring Do not use toluene A Warning AY Do not use sodium hypochlorite solution A Note AY The ICT B is supplied non sterile It must be cleaned and sterilised before each use Inspect for cuts or damage to silicone coating before immersing in any liquid Be careful not to get liquid on the connector pins or inside the connector via the luer fitting Wash the catheter with soap solution being careful not to poke the sensing area Do not use synthetic detergents or oil based soaps as this may result in a foreign body reaction Transducers may be cleaned gently with alcohol wipes Do not soak in alcohol Sterilisation is by means of cold aqueous solutions of detergicide e g Cidex formalin or by ethylene oxide gas A Warning A Do not use the sterilizing cap during ETO gas sterilizing AY Note AY Immediately after removal of the catheter from the patient Checking for cuts in the silicone rubber Use a 1ml syringe to inject 0 5cc of air into the luer and immerse the catheter in water If small bubbles are seen from any part of the catheter or tip wipe dry and sterilize Return to Manufactory for repair A Note AY It is recommended that each institution establish the efficacy of its sterilization procedure by a method which includes the sterilization of an i
85. CALCULATE gt gt 0 DU AM CICl min m 2 3 3 Back to the upper menu Figure 17 4 CO Edit Windows Contents displayed in the window O Six curves of the six measurements and C O value O Average value of cardiac output D Average value of cardiac index O Function button in the edit window Editing operation Values of selected measurements can be averaged and stored in the CO item in the HEMOD menu as the basis for Hemodynamic calculations When first enter the EDIT Window curves and CO values of valid measurements are highlighted indicating these values are to be averaged You can move the cursor to the curve of questionable measurements and press the rotary knob dis highlighted waveforms and CO values will be excluded from the averaging calculation 17 6 Patient Monitor user s manual V 2 2 CO Measuring AY Note A Dis highlighted curves can be picked and included into the averaging calculation 17 3 3 Blood Temperature Monitoring H Blood temperature monitoring can function when C O measurement is not taken The blood temperature is measured by the thermistor situated in the distal end of the flotation catheter in the pulmonary artery See the Figure 17 5 m The blood temperature alarm function will not work during the C O measurement When the measurement ends the function will automatically resume m The current blood temperature is displayed in the CO Parameter Area Thermodilutio Cathete
86. DALL P N 0010 30 12248 P N 0010 30 12249 P N 0010 30 12250 P N 0010 30 12251 P N 0010 30 12252 P N 0010 30 12253 P N 0010 30 12254 P N 0010 30 12255 P N 0010 30 12258 P N 0010 30 12259 P N 0010 30 12260 P N 0010 30 12261 P N 9000 10 07445 P N 9000 30 07338 P N 9000 30 07470 Patient Monitor user s manual V 2 2 Accessories and Ordering Information 5 lead separable ECG lead wire AHA PINCH Mindray 3 lead separable ECG lead wire AHA PINCH Mindray 5 lead separable ECG lead wire IEC PINCH Mindray 3 lead separable ECG lead wire IEC PINCH Mindray 5 lead separable ECG lead wire AHA SNAP Mindray 3 lead separable ECG lead wire AHA SNAP Mindray 5 lead separable ECG lead wire IEC SNAP Mindray 3 lead separable ECG lead wire IEC SNAP Mindray m Electrodes ECG electrode Medi Trace 230 ECG electrode Medi Trace 210 KENDALL ECG electrode 2249 3M Pediatric ECG electrode 2248 3M Pediatric electrode 2258 3 3M 20 2 SpOz Accessories H MASIMO ACCESSORIES 1269 LNOP DCI ADULT SENSOR KIT 1269 LNOP DCI ADULT REUSABLE SENSOR 12PIN SPO2 cable m NELLCO ACCESSORIES DS 100A finger sensor OXI P I pediatric sensor NELLCO Adult Neonate wrapping SPO2 sensor OXI A N HR MINDRAY ACCESSORIES 512B finger SPO2 sensor Finger SPO2 sensor 518A multi function SPO2 sensor 12PIN SPO2 sensor trunk cable ver E 20 3 NIBP Accessories m Reusable cuff P N 0010 30 12262 P N 0010
87. ECG SETUP TEMP SETUP Access RESP Setup Menu EXIT Figure 12 2 ECG RESP TEMP SETUP menu 12 2 Patient Monitor user s manual V 2 2 ECG RESP Monitoring 12 3 Precautions during ECG Monitoring AN Warning A Do not touch the patient table nearby or the equipment during defibrillation A Warning A Use only the original PM 6000 ECG cable for monitoring A Warning A When connecting the cables and electrodes make sure no conductive part is in contact with the ground Verify that all ECG electrodes including neutral electrodes are securely attached to the patient A Warning A When apply the ECG cable with no resistances to Mindray patient monitor or other patient monitors which themselves with no current limit resistance it can t be applied to defibrillation A Note A Interference from a non grounded instrument near the patient and ESU interference can cause inaccuracy of the waveform 12 4 Monitoring Procedure 12 4 1 Preparation 1 Prepare the patient s skin prior to placing the electrodes The skin is a poor conductor of electricity therefore preparation of the patient s skin is important to facilitate good electrode contact to skin Shave hair from sites if necessary RW Wash sites thoroughly with soap and water Never use ether or pure alcohol because this increases skin impedance m Rub the skin briskly to increase capillary blood flow in the tissues and remove skin scurf and grease Atta
88. ETUP Back to the upper menu Figure 12 11 ECG SETUP TRANSFER Refers to real time transfer two selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the ECG TEMP module into the ECG TEMP module 2 ON when choose the ON selection the system first saves all the setups into the ECG TEMP module and then saves the modifications to the module into the ECG TEMP module immediately For the newly loaded ECG TEMP module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user DEFAULT pick this item to access the ECG DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation A Warning A For pacemaker patient the pacing impulse analysis function must be switched on otherwise th
89. ETUP gt gt RECORD gt gt MARK EVENT gt gt Back to the upper menu EE Figure 3 6 System setup In the System setup menu users can setup the following items 3 4 1 Face select Select FACE SELECT item in SYSTEM SETUP menu to access FACE SELECT dialog box as shown below in which four selections are available STANDARD SCREEN TREND SCREEN oxyCRG SCREEN and VIEWBED SCREEN Only one selection can be chosen for each time FACE SELECT STANDARD SCREEN TREND SCREEN oxyCRG SCREEN YIEWBED SCREEN Conventional monitor screen EXIT Figure 3 7 FACE SELECT 3 4 2 Alarm setup The system provides three levels of alarm volume You can select any of them as per the clinical requirement The procedures are Select the ALARM SETUP item in the SYSTEM SETUP sub menu of the SYSTEM SETUP menu The menu as shown below will pop up in which you can set up the alarm volume and other alarm information For detailed information refer to Chapter Alarm Patient Monitor user s manual V 2 2 3 5 System Menu ALM SEL common ALM SETUP M ALARM VOL MED z ALM REC TIME S ALM PAUSE TIME iMIN z PARA ALM TYPE UNLATCH Back to the upper menu Figure 3 8 Alarm Setup You can highlight the ALARM VOL item and then turn the knob to set up the alarm volume There are three options LOW MED and HIGH 3 4 3 Time Setup Select the TIME SETUP item in the SYSTEM SETUP menu The menu as
90. GpO Monitoring SpO2 l Make sure that the monitor UNRECOGNIZED ee not LOW and the patient are in correct SENSOR H i connection with the cables Sp02 This message is REES displayed when the LOW Make sure that the monitor SENSOR masimo sensor is finding use incompatible sensor incompatible sensor SpO02 Outside signal or energy SC INTERFERENCE preventing reading LOW Remove outside interference If values are not displayed within 30 seconds bac disconnect and reconnect PR a nae jor te LOW sensor If pulse search H puse continues remove sensor and replace on a better perfused site SpO2 LOW Move sensor to better PERFUSION SSES LOW perfused site Too much light on SpO2 TOO AE S Remove or reduce lighting Inadequate tissue LOW Ges Se from light covering sensor eposi lon sensor MUCH LIGHT detector SpO2 LOW Ensure proper sensor Low signal quality LOW application Mover sensor to SIGNAL IQ a better perfused site Spo2 This message appears Kee module BOARD FAULT Beane Ma SmE E notify biomedical engineer or board malfunctions o seivice stafi This message is displayed when the front SpO2 end module is having Ee ee COMMUNICATION problems communicating HIGH notif DEN engineer ar ERROR ie framing errors or bad ae Ce staff H checksums with the Masimo board This message is SpO2 displayed when the host p using the Measuring function of SpO2 module COMMUNICATION can not receive the data HIG
91. H notify biomedical CERN STOP from Masimo board for 5 E ff H SE our service staff This message is Stop using the measuring Sp02 INIT ERR displayed when the SpO2 HIGH function of SpO2 module module initialization error happened notify biomedical engineer or our service staff Patient Monitor user s manual V 2 2 13 13 SpO2 Monitoring Prompt message include general alerts Message Cause Alarm Level SpO2 EXCEED SpO2 measuring value exceeds the range HIGH PR EXCEED PR measuring value exceeds the range HIGH 13 1 5 Masimo Information The MASIMO SET Product Yaso El Masimo Patents This device is covered under one or more the following U S Patents 5 482 036 5 490 505 5 632 272 5 685 299 5 758 644 5 769 785 6 002 952 6 036 642 6 067 462 6 206 830 6 157 850 and international equivalents U S A and international patents pending No Implied License 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 13 14 Patient Monitor user s manual V 2 2 GpO Monitoring 13 2 PART 2 MINDRAY SpO2 board configuration What is SpO2 Monitoring SpO Plethysmogram measurement is employed to determine the oxygen saturation of hemoglobin in the arterial blood If for example 97 hemoglobin
92. HR ALM on off of the alarm switch ALM LEV alarm level ALM REC alarm recording switch ALM HI higher limit of HR alarm ALM LO lower limit of HR alarm When use the knob to select each item and press the knob a pull down list appears for the user to choose his desired selection The method for setting the alarm information of other parameters is the same as HR 5 2 Alarm verification during power on During the monitor power on audible and visual alarm capability will be tested by the system Every time when the monitor powers on alarm beeps DANG and the LED indicator on button module or on the display device flashes yellow and red once If no beeps heard or no alarm indicator flashing viewed do not use this device to monitor any patient and notify Customer Service Center A Warning A Always verify the audible and visual alarms when the monitor powers on 5 3 Alarm Cause Alarm occurs when 1 Physiological alarm is evoked 2 Alarm for error of the system technical alarm is evoked 3 General alert occurs Conditions that activate the parameter alarms When the measurement value exceeds the alarm limit and the alarm is set ON Alarm will not activate if the alarm is set OFF Conditions that activate the system alarms technical alarm Upon the system error the monitor prompts alarm immediately and proceeds corresponding remedy stops all monitoring and eliminates the final results in order to a
93. IA measuring value of channel 1 is User selectable above upper alarm limit ID1 TOO LOW DIA measuring value of channel 1 is User selectable below lower alarm limit IM1 TOO HIGH MAP measuring value of channel 1 is sersel ctable above upper alarm limit IM1 TOO LOW MAP measuring value of channel 1 is User selectable below lower alarm limit IS2 TOO HIGH SYS measuring value of channel 2 is User selectable above upper alarm limit IS2 TOO LOW SYS measuring value of channel 2 is Userselect bie below lower alarm limit ID2 TOO HIGH DIA measuring value of channel 2 is User selectable above upper alarm limit DIA measuring value of channel 2 is ID2 TOO LOW SC User selectable below lower alarm limit IM2 TOO HIGH MAP measuring value of channel 2 is User selectable above upper alarm limit IM2 TOO LOW MAP measuring value of channel 2 is User selectable below lower alarm limit Technical alarms Alarm Message Cause Level Remedy IBP cable of channel IBP1 SENSOR OFF 1 fals off from Low Make sure that cable is properly connected monitor IBP cable of channel IBP2 SENSOR OFF 2 falls off trom Low Make sure that cable e properly connected monitor IBP 1 2 INIT ERR IBP module failure HIGH Stop using measuring function of 16 12 Patient Monitor user s manual V 2 2 IBP Monitoring IBP 1 2 INIT ERR1 IBP 1 2 INIT ERR2 IBP 1 2 INIT ERR3 IBP 1 2 INIT
94. ISO and ST measurement points The reference point is the position where the peak of R wave locates see Figure 12 14 R Wave I 109 ms Figure 12 14 DEF Point The ST measurement for each beat complex is the vertical difference between the two measurement points A Note A the ST measurement point should be adjusted if the patient s HR or ECG morphology changes significantly Patient Monitor user s manual V 2 2 12 17 ECG RESP Monitoring o Adjusting ISO ST These two points can be adjusted turning the knob When adjusting ST measurement point the system will show the ST Measurement Point Window The QRS complex template displays in the window lf the template is not established a horizontal line will display If the channel is not at ON position a horizontal line will also display It is adjustable of the highlight bar in the window You may select ISO or ST then switch the knob left or right to move the cursor line When the cursor is at the required position you may select the base point or the measurement point A Note A Abnormal QRS complex is not considered in ST segment analysis ST Alarm Message Note The alarm limits for two ST measurements are identical No setting of alarm limits can be made only for one channel Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measu
95. NUAL mode the user can adjust the two dashed lines in the RESP WAVEFORM area respectively by using HOLD HI and HOLD LO menus The position of the dashed lines will be used to calculate the upper and lower limits of RESP RATE by the monitor e HOLD HI and HOLD LO When the HOLD TYPE is MANUAL the user can use the knob to pick either HOLD HI or HOLD LO and turn the knob to adjust the two dashed lines in the RESP WAVEFORM area respectively The positions of the dashed lines will be used to 12 26 Patient Monitor user s manual V 2 2 ECG RESP Monitoring calculate the upper and lower limits of RESP RATE by the monitor e SETUP TRANSFER used to access the sub menu of ECG SETUP TRANSFER in which the user may set up following information A RT TRANSFER Refers to real time transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the ECG TEMP module 2 ON when choose the ON selection the system first saves all the setups into the ECG TEMP module and then saves the modifications to the ECG TEMP module into the ECG TEMP module immediately For the newly loaded ECG TEMP module default is OFF A SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module A LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unneces
96. Note A The interval between twice press of POWER should be more than 1 minute 2 4 Connect Patient Sensors Connect all the necessary patient sensors between the monitor and the patient A Note A For information on correct connection refer to Chapter 12 19 2 5 Check the Recorder If your monitor is equipped with a recorder open the recorder door to check if paper is properly installed in the output slot If no paper present refer to Chapter Recording for details 2 2 Patient Monitor user s manual V 2 2 Chapter 3 System Menu New patient enrolment Recording Trend Graph Table and Alarm Review System Setup Drug Calculation Maintenance The Patient Monitor features flexible configurations You can configure various aspects of the monitor including the parameters to be monitored sweeping speed of the waveforms audio signal volume and printout text Press the MENU button on the Button Module or the display panel to call up SYSTEM MENU The configuration is realized through operations on the SYSTEM MENU as shown SYSTEM MENU PATIENT SETUP gt gt SYSTEM SETUP gt gt below DEFAULT gt gt SELECTION gt gt TREND GRAPH gt gt VERSION gt gt TREND TABLE gt gt DRUG CALC gt gt NIBP RECALL gt gt MAINTAIN gt gt ALARM RECALL gt gt DEMO gt gt Provide the DEMO data and display the DEMO waveform EXIT Figure 3 1 SYSTEM MENU Trend graph table review NIBP review
97. OF SHENZHEN MINDRAY BIO MEDICAL ELECTRONICS CO LTD ALL RIGHTS RESERVED Responsibility on the manufacturer party Mindray is responsible for safety reliability and performance of this equipment only in the condition that e all installation expansion change modification and repair of this equipment are conducted by Mindray qualified personnel and e applied electrical appliance is in compliance with relevant National Standards and e the monitor is operated under strict observance of this manual Patient Monitor user s manual V 2 2 l A Note A This equipment is not intended for family usage A warning Failure to follow this message may result in death or serious injury to the patient or operator or may cause damage to the equipment A warning To use this equipment safely the user must observe all special application instructions or precautions in this operation manual However these special instructions or precautions cannot replace the medical procedures executed presently Do not solely rely on the audible alarming system to monitor a patient Setting a very low volume or completely turning off the volume may cause catastrophe to the patient The most reliable method to monitor the patient is to at the same time of using the monitoring equipment the physician should himself closely observe the situation of the patient This equipment is designed to be used only by trained health care personnel i
98. P RANSFER item to pop up the AG SETUP TRANSFER menu AG SETUP TRANSFER RT TRANSFER OFF SAVE SETUP INTO MODULE LOAD MODULE SETUP Back to the upper menu SSS Figure 19 9 AG SETUP TRANSFER menu m Refers to RT TRANSFER there are two selections are available OFF when choose the OFF selection the system will not automatically save the modifications to the AG module into the AG module ON when choose the ON selection the system first saves all the setups into the AG module and then saves the modifications to the module into the AG module immediately For the newly loaded AG module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu items will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user 19 4 5 DEFAULT menu In the AG SETUP menu select the DEFAULT item to pop up the AG DEFAULT CONFIG menu as shown in the figure below Patient Monitor user s manual V 2 2 19 11 Anesthetic Gas Measurement 19 5 AG DEFAULT CONFIG FACTORY DEFAULT CONFIG USER DEFAULT
99. PM 6000 Portable Multi parameter Patient Monitor Operation Manual Copyright SHENZHEN MINDRAY BIO MEDICAL ELECTRONICS CO LTD 2002 Version 2 2 Issued date 2004 08 08 Serial No PM 6000 Statement SHENZHEN MINDRAY BIO MEDICAL ELECTRONICS CO LTD hereinafter called Mindray owns all rights to this unpublished work and intends to maintain this work as confidential Mindray may also seek to maintain this work as an unpublished copyright This publication is to be used solely for the purposes of reference operation maintenance or repair of Mindray equipment No part of this can be disseminated for other purposes In the event of inadvertent or deliberate publication Mindray intends to enforce its rights to this work under copyright laws as a published work Those having access to this work may not copy use or disclose the information in this work unless expressly authorized by Mindray to do so Mindray shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing performance or use of this material This publication may refer to information and protected by copyrights or patents and does not convey any license under the patent rights of Mindray nor the rights of others Mindray does not assume any liability arising out of any infringements of patents or other rights of third parties Content of this manual is subject to changes without prior notice PROPERTY
100. RYON P N 000 91060 E DRYLINE Water Trap Adult ARTEMA P N 60 13100 00 m DRYLINE Water Trap Neonate ARTEMA P N 60 13200 00 a DRYLINE Sample Line Adult 1 5m ARTEMA P N 60 15100 00 E DRYLINE Sample Line Adult 2 5m ARTEMA P N 60 15200 00 E DRYLINE Sample Line Neonate 2 5m ARTEMA P N 60 15300 00 19 8 Maintenance and cleaning E AG module For detailed cleaning information about AG Module refer to the chapter of Maintenance and Cleaning in this operation manual el Bacteria filter The bacteria filter is one off type i e one bacteria filter can only be used by one patient E Sample line The sample line is one off type el Gas exhaust outlet The gas exhaust outlet is reusable You need to replace it only when it is damaged or becomes loosely connected This tube can be cleaned and disinfected Cleaning use cloth moistened with warm soap water to clean the tube Do not immerse the tube into the liquid Disinfection use cloth moistened with cool chemical disinfector ramification mainly containing aldehyde ethanol or ramification mainly containing ethanol to clean the tube Do not immerse the tube into the liquid After cleaning use wet cloth to wipe off the disinfector and then use dry cloth to wipe the tube E Watertrap Replace the watertrap periodically every month or when prompt message appears requiring the maintenance E Occlusion handling If the AG module passage is occluded the screen will display the m
101. TER TRAP NEONATER 60 13200 00 MAINSTREAM SENSOR II P N 000 59000 AIRWAY ADAPTER ADULT BOX OF 10 P N 000 91060 AIRWAY ADAPTER LDS BOX OF 10 P N 000 91070 20 8 Anesthetic Gas Accessories DRYLINE Airway Adapter Straight P N 60 14100 00 DRYLINE Airway Adapter Elbow P N 60 14200 00 Aion DRYLINE Water Trap Adult purchase No 60 13100 00 P N 6000 10 02079 P N 6000 10 02080 P N 6000 10 02081 P N 6200 30 09744 P N 0010 10 12082 P N 0010 10 12083 P N 0010 10 12084 P N 0010 10 12085 P N 0010 10 12086 P N 0010 10 12087 P N 0010 10 12088 P N 0010 10 12089 P N 0010 10 12090 P N 0010 10 12091 P N 0010 10 12092 P N 0010 10 12093 P N 9200 10 10555 P N 9000 10 07297 P N 9200 10 10593 P N 9200 10 10574 P N 9000 10 07299 P N 9000 10 07301 P N 9000 10 07302 P N 9000 10 07486 P N 9000 10 07487 P N 9200 10 10530 20 4 Patient Monitor user s manual V 2 2 Accessories and Ordering Information Sampling Line Adult 2 5m Adult purchase No 60 15200 00 P N 9200 10 10533 Patient Monitor user s manual V 2 2 20 5 Manufacturer Address European Representative Product Model Code Appendix EC Declaration of Conformance Shenzhen Mindray Bio Medical Electronics Co Ltd Mindray Building Keji 12 Road South Hi tech Industrial Park Nanshan Shenzhen 518057 P R China Shanghai International Holding Corp GmbH Europe Eiffestrasse 80 D 20537 Hamburg Germany Patient Monitor PM 6000 Standard
102. U m1 SUI m1 m 2 SUR DS cm 5 SURI DSem 2 em 5 PUR DS em 5 PURI D n Zeen Bi LCW kg m LCWI kg m m 2 LUSU g m LUSWI g m7m 2 RCW Ckg m ye RCWI Ckg m m 2 e RUSU g m Gelee RUSU I g m m 2 BSA m 2 1 811 INPUT VALUE WD ep 4 PAUP mmHg 8 AP MAP mmHg 93 CUP mmHg 12 PA MAP mmHg CO lvmin HTCem 175 0 HR 60 UT Kg 70 0 CALCULATE REC EXIT Figure 17 7 HEMOD Windows Turn the rotary knob you can change the value of the selected parameter Pick CALCULATE after all parameter values being input the calculation results will be displayed in the window Pick REC can print out all the calculation results Input parameter value H PAWP Pulmonary Artery Wedge Pressure m CVP Central Venous Pressure m CO Cardiac Output m HR Heart Rate m AP MAP Mean Artery Pressure m LVD Left Ventricular Diameter m PAMAP Mean Pulmonary Artery Pressure E HT Height H WT Weight 17 6 Alarm Information and Prompt CO Alarm Message Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during co measurem
103. V 2 2 ECG RESP Monitoring Figure 12 5 ECG lead AN Note A If a ECG waveform is not accurate while the electrodes are tightly attached try to change the lead A Note A Interference from a non grounded instrument near the patient and ESU interference can cause inaccuracy of the waveform Normal QRS complex should be O O O O O Tall and narrow with no notches With tall R wave completely above or below the baseline With pacer spike no higher than R wave height With T wave less than one third of the R wave height With P wave much smaller than the T wave For getting 1 mv calibrated ECG wave choose ECG CAL button in ECG SETUP gt OTHER SETUP menu A message when CAL can t monitor prompts on the screen Figure 12 6 Standard ECG Waveform Patient Monitor user s manual V 2 2 12 7 ECG RESP Monitoring A Warning A Do not touch the patient table nearby or the equipment during defibrillation 12 5 ECG Screen Hot Keys Figure 12 7 the hot key for ECG Leads of channel 1 10 The selectable leads are Il II aVR aVL aVF V 20 When the ECG is 5 lead the selectable leads are Il III aVR aVL aVF V when ECG is 3 lead the selectable leads are I HO I 30 Leads on the ECG wave must not have the same name Otherwise the system will automatically change the ECG waveform name that has the same name as the waveform being curre
104. V 2 2 ECG RESP Monitoring ARR ALARM ALM LEV REC ASYSTOLE ON v HIGH OFF UFIB VTAC ON HIGH OFF R ON T ON MED OFF ALL ALM ON UT gt Z ON MED OFF COUPLET DN MED OFF v ALL ALM OFF PUC ON e MED OFF BIGEMINY ON MED OFF _ ALL REC ON TRIGEMINY ON MED OFF TACHY ON MED OFF v ALL REC OFF BRADY ON e MED OFF PNC ON MED OFF We PNP oo ome oor bs MISSED BEATS ON MED OFF Open or close the ASYSTOLE alarm EXIT Figure 12 16 ARR ALARM Menu You can pick ALL ALM ON to enable alarm function of all arrhythmia types and pick ALL ALM OFF to disable this function Likewise you can pick ALL REC ON to enable recording function for all arrhythmia types and pick ALL REC OFF to disable this function Changing the ALM LEV can reset alarm level of all arrhythmia types to the same value E ARR RECALL Pick this item to review and edit the ARR analysis result ARR RECALL 171 PUC 12 01 2001 BIGEMINY 12 01 2001 UFIB UTAC 12 61 2661 ASYSTOLE 12 61 2661 BIGEMINY 12 01 2001 UFIB UTAC 12 61 2661 MISSED BEATS 12 61 2661 MISSED BEATS 12 01 2001 PUC 12 01 2001 TACHY 12 01 2001 UP DOWN CURSOR WAVE gt gt DELETE RENAME Back to the upper menu eS Figure 12 17 ARR RECALL Menu The latest arrhythmia events up to 60 are displayed D UP DOWN Observe other event lists of other page Oo CURSOR Select the Arr event whose name is displayed in a protruding frame Pa
105. VE 2 Ec amp 2 RECALL REC EXIT If two waveforms are off the measure parameters in frozen are printed out only Trend graph recording Pick REC button in the TREND GRAPH menu when viewing the trend graph to print out the currently displayed trend graph Trend table recording Pick REC button in the TREND TABLE menu when viewing the trend table to printout the currently displayed trend table Arrhythmia review recording Access ARR RECALL window from ARR ANALYSIS of ECG SETUP menu and Pick WAVE button to access ARR WAVE RECALL menu Then press REC button to output 7 4 Patient Monitor user s manual V 2 2 Alarm review recording NIBP review recording CO measurement curve record Hemodynamic Calculation result recording Monitor information recording Titration table recording OxyCRG recording A Note A Recording the Arr waveform and related information currently displayed on the screen Access the ALARM RECALL window from ALARM RECALL CONDITION menu from SYSTEM MENU and pick REC button to print out the alarm review waveform and related information currently displayed in the ALARM RECALL window Access the NIBP RECALL window from SYSTEM MENU and pick REC button to print out the NIBP information currently displayed in the window Press the MEASURE button on the CO module to call up the WINDOWS FOR CO MEASUREMENT
106. a short time We read negative ICP but get good waveforms on the monitor Not proper zeroing The ICT B cannot read negative pressure Rezero the monitor transducer combination Make sure that you are not plugging the female luer during readings The waveform on the monitor makes large cyclical swings If you are using a respirator or some device that applies pressure even indirectly it may affect ICP The transducer is responding normally by showing this accurately Patient Monitor user s manual V 2 2 16 25 Chapter 17 CO Measuring 17 1 General m The Cardiac Output CO measurement is performed by using the rmodilution method H The PM 6000 Modular Patient Monitor can determine blood temperature measure cardiac output and perform hemodynamic calculations m You can have iced injectate using either the flow through system or individual syringes of injectate m You can perform up to six measurements before editing the average cardiac output C O and cardiac index C I m Prompt message on the screen will tell you when to inject 17 2 CO Module o T e CO 0 SETUP MEASURE 0 8 0 D L Figure 17 1 CO module Indicator the indicator that indicates the working status of the module When the module is working this indicator is on A Note A When loading the module this indicator is on at all times indicating that the module communicates with the
107. able Figure 17 2 3 Pick C O SELECT Menu and if necessary change the computation constant to the one appropriate to the catheter and volume of fluid used AN Note A If to replace the Catheter thermistor please enter the catheter computation coefficient into the CO CONST item according to the instruction 4 Pick the MEASURE button on the CO module to access the WINDOW FOR CO MEASUREMENT AN Note AY You should appropriately set the injectate switch because the CO calculation will be according to the ON or OFF of the injectate switch at the completion of measurement No change shall be made after the switch is set off 17 2 Patient Monitor user s manual V 2 2 CO Measuring WONTTOR CO MODULE Injectate Cardiac Output ep Cable a Tam eh wi j a gt Delivery amp SZ Housing D x E System Tray Thermodi lution ANS Catheter V WM M y WW V WH Wi Al hal E x k WS A AN intine injectate Temperature probe Figure 17 2 CO sensor connection 5 You can perform more than one measurement as required After completion of the measurement s access the WINDOW FOR CO EDIT window to edit measured data The procedure in detail is described in the following pages A Warning AN Make sure that the computational constant for the measurement is appropriate to the catheter used Patient Monitor user s manual V 2 2 17 3 CO Measuring AN Note A The blood te
108. action according to the prompt message After calibration disconnect the tube of sohygmomanometer and the T type connector then connect the transducer to the patient by following specified steps Related information to calibration for this example CH1 is used SUCCESSFUL CALIBRATION CH1 work properly User could perform IBP monitoring via CH1 SENSOR OFF FALL Check the connection of CH1 transducer Ensure no SENSOR OFF FALL message prompts and Execute calibration If problem still exists contact serviceman IN DEMO FAIL Ensure that the monitor is not in DEMO mode Execute calibration If problem still exists contact serviceman PRESSURE OVER RANGE FAIL Make sure that you have selected transducer value in IBP CAL then proceed calibration PULSATILE PRESSURE FALL 16 10 Patient Monitor user s manual V 2 2 IBP Monitoring Ensure that the pressure value of the sphygmomanometer is constant Execute calibration If problem still exists contact serviceman Changing the Label E IBP SCALE ADJUST submenu IBP SCALE ADJUST LO VAL HI CH1 ART 6 75 CH2 CVUP 40 0 20 Ad just the value of the upper scale the upper dotted line EXIT ah gt Figure 16 9 IBP SCALE ADJUST Menu The waveform and corresponding scale appears in the IBP Waveform Area with 3 dotted lines representing Higher Scale Reference Scale and Lower Scale from the top to the bottom Values of
109. ake sure that the MEASURE FAIL cannot perform HIGH patient under monitoring is measurement motionless Measure again analysis or calculation Prompt message display in the prompt area below NIBP value Message Cause Alarm Level Manual measure During manual measuring mode No alarm Cont measuring During continuous measuring mode Auto measuring During automatic measuring mode Please start After selecting interval between measurements in MENU Press START STOP key during Measurement over measuring to stop measurement Calibrating Calibration over During calibrating Calibration over Pneum testing During pneumatic test Pneum test over pneumatic test over 14 12 Patient Monitor user s manual V 2 2 NIBP Monitoring Resetting NIBP module in resetting Reset failed NIBP module reset failed 14 6 Maintenance and Cleaning A Warning A E Do not squeeze the rubber tube on the cuff Do not allow liquid to enter the connector socket at the front of the monitor Do not wipe the inner part of the connector socket when cleaning the monitor When the reusable cuff is not connected with the monitor or being cleaned always place the cover on the rubber tube to avoid liquid permeation Reusable Blood Pressure Cuff The cuff can be sterilized by means of conventional autoclaving gas or ra
110. al engineer or error Mindray service staff Stop using the measuring function of Functional safet SpO2 module notify SPO2 ALM LMT ERR failure x HIGH biomedical engineer or Mindray service staff PR ALM LMT ERR Functional safety HIGH Stop using the Patient Monitor user s manual V 2 2 13 23 SpO2 Monitoring failure measuring function of SpO2 module notify biomedical engineer or Mindray service staff Prompt message include general alerts Message Cause Alarm Level SPO2 EXCEED SpO measuring value exceeds the range HIGH PR EXCEED PR measuring value exceeds the range HIGH SEARCH PULSE SpO 2 module is searching for pulse No alarm SpO2 module cannot detect SpO signal for a NO PULSE long time HIGH 13 2 7 Maintenance and Cleaning Care and Cleaning A Warning A Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line A Warning A Do not subject the sensor to autoclaving Do not immerse the sensor into any liquid Do not use any sensor or cable that may be damaged or deteriorated For cleaning m Use a cotton ball or a soft mull moistened with hospital grade ethanol to wipe the surface of the sensor and then dry it with a cloth This cleaning method can also be applied to the luminotron and receiving unit m The cable can be cleaned with 3 hydrogen dioxide 70 isopropanol or other active reag
111. alue thus leading to severe misdiagnosis 2 The default of Water Vapor Compensate is on Turn it off when measuring dry gas such as when performing regular maintenance or measurement validation by using dry calibrated gas 3 The default of BTPS is on Turn it on when measuring the VA saturated damp gas under the body temperature and ambient pressure and turn it off when measuring the dry gas under the ambient temperature and pressure 4 Operate by strictly observing the Compensate operation method m SETUP TRANSFER lUused to access the sub menu of CO2 SETUP TRANSFER in which the user may set up following information RT TRANSFER Refers to real time transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the CO2 module into the CO2 module 2 ON when choose the ON selection the system first saves all the setups into the CO2 module and then saves the modifications to the module into the CO2 module immediately For the newly loaded CO2 module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu ite
112. ared rays Therefore we have to measure oxygen concentration by taking advantage of its paramagnetic characteristic Inside the sensor of the oxygen module there are two glass balls filled up with Nitrogen These two glass balls are suspended into symmetric non uniform magnetic field pointing into the direction away from the most intensive part of the field This device is surrounded by oxygen having paramagnetic characteristic By this means this device is actually further pushed out of the field by the oxygen having relatively more intensive paramagnetic characteristic The force moment acted on this device is proportional to the paramagnetic intensity of the surrounding gas and therefore also proportional to oxygen concentration Aqua knot I Water Trap AG Mondule Patient sample line Airway Adapter La Exhaust line to Scavenging System lt Endotracheal Tube Figure 19 4connection diagram for measuring AG gas A warningA Ensure tight connection when installing the filter Any leakage in the system will result in incorrect reading because this leakage will make the surrounding environmental air mix up with patient gas A warningA To protect the module against contamination always use bacteria filter because without it bacteria and liquid may directly enter the AG module and lead to system contamination clog or incorrect reading In order to prevent clog dispose the filter each time after it is used on a patient Do n
113. arm 19 6 Technical specifications Method infrared absorption characteristic Patient mode Adult Pediatric Neonate Flow rate Adult Pediatric High 200 ml min Medium 150 ml min Low 120 ml min Neonate High 120 ml min Medium 90 ml min Low 70 ml min Measure range CO 0 76 mmHg O2 0 100 N O 0 100 AwRR 0 100 rmp Halothame 0 5 Isoflurane 0 5 Enflurane 0 5 Sevoflurane 0 8 Desflurane 0 18 Patient Monitor user s manual V 2 2 19 15 Anesthetic Gas Measurement Gas Concentration reL Inaccuracy asgs 0 1 0 1 1 5 0 2 CO 5 7 0 3 7 10 0 5 gt 10 Unspecified 0 20 2 N O 20 100 3 0 25 1 O 25 80 2 80 100 3 HAL EN ES 0 15 F 1 5 0 2 ISO gt 5 Unspecified 0 1 0 15 1 5 0 2 SEV 5 8 0 4 gt 8 Unspecified 0 1 0 15 1 5 0 2 5 10 0 4 DES 10 15 0 6 15 18 1 gt 18 Unspecified Updating frequency once per second Start time lt 40 seconds Calibrate Test gas measurement once per year Refer to the Service Manual for the method Responding time lt 350ms 10 90 Delay time Sampling rate is 200ml min for adult pediatric and 120ml min for neonate When using Artema watertrap and sampling tube the delay time is lt 4 seconds 19 16 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement 19 7 Anesthetic Gas Accessories a Sampling elbow PRYON P N 000 91400 a Airway adapter for Adult P
114. arning A If the user does not load unload the module as per the method illustrated above when the top rake of the device is large the module may slide out from the slot In this case the user may be injured and the module may be damaged 1 6 Patient Monitor user s manual V 2 2 Instruction 1 2 Screen Display The display of PM 6000 modular multi parameter monitor is a color LCD which can display the collected patient parameters waveforms alarm information as well as bed number time and monitor status etc The operating screen of the PM 6000 is the standard monitoring screen Main system screen WR Standard monitoring screen 0 Ben No 1 ADU 8209 Zhang shan M Figure 1 4 standard monitoring screen In the standard monitoring screen the screen has three areas information area waveform menu area and parameter area lt Information area Information area lies on the top part of the screen which is used to display the current status of the monitor and the patient The information area contains following data Bed No used to indicate the bed number of the patient being monitored This information is displayed all the time Adult used to indicate the patient type This information is displayed all the time 2000 01 01 used to indicate the date 210 090 12 is the time This information is displayed all the time Patient name displayed to the right side of the data
115. artment either whenever a new transducer is used or as periodically as requested by your Patient Monitor user s manual V 2 2 16 9 IBP Monitoring Hospital regulation The purpose of the calibration is to ensure that the system gives you accurate measurements Before starting a mercury calibration a zero procedure must be performed If you need to perform this procedure yourself you will need the following pieces of equipment Standard sohygmomanometer 3 way stopcock Tubing approximately 25 cm long The Calibration Procedure SEE Figure 16 8 A Warning A You must never perform this procedure while patient is being monitored Disconnect transducer with patient when patient is monitored By using of tube one end of T type connector links to 3 way stopcock of transducer another end links to inflation orb and the third end links to sohygmomanometer Vent the stopcock of transducer to atmosphere and run zeroing procedure Open the stopcock to the sohygmomanometer side after successful zeroing Select the calibrated channel in IBP calibration menu and preset the calibration pressure of this channel Inflate spohygmomanometer and obtain the value of pressure to preset value in menu Repeatedly adjust the calibrating pressure value in the menu or the pressure value of sphygmomanometer until they are equal Push CALIBRATION button the monitor starts calibrating process Wait for the result of calibration determine the
116. ay service staff PR ALM LMT ERR Functional safety failure Stop using the measuring function of SpO module notify biomedical engineer or Mindray service staff MASIMO Alarm information SpO2 NO SENSOR Sensor not fully inserted into the connector May be an incorrect sensor or a defective sensor or cable Insert sensor into the connector Disconnect and reconnect sensor Refer to the instructions for the sensor being used Sensor inserted upside Disconnect and reconnect he down sensor with the logos matching SpO2 SENSOR SpO2 sensor may be Disconnect and reconnect the disconnected from the Sensor OFF patient or the monitor Reattach sensor Stop using the measuring SpO2 SENSOR This message appears function of SpO2 module notify FAULT when the sensor is faulty biomedical engineer or our service staff SpO2 Make sure that the monitor and UNRECOGNIZED E not the patient are in correct SENSOR g i connection with the cables SpO2 This message is displayed INCOMPATIBLE when the masimo sensor is Make sure that the monitor use SENSOR finding incompatible sensor p SpO2 Outside signal or energy KAN INTERFERENCE preventing reading DEENS SpO2 PULSE Unit is searching for the ER EE SEARCH patients pulse f reconnect sensor H pulse search Patient Monitor user s manual V 2 2 3 System Alarm Prompt continues remove sensor and replace
117. ay the user should buy the button module to realize the functions of the monitor The monitor supports the use of both hard buttons on the screen and the button module All the operations of the system can be realized through the combined operation of the buttons and the rotary knob 1 4 Rear panel Pmt Sen Ta r CE m ee ne enn beet e Se memg eas E 8 Figure 1 6 rear panel U FUSE Standard T 3 0A Power supply 100 250 VAC 50 60 Hz Analog output used to output the analog signals able to be connected to oscillometer and pen recorder VGA MONITOR able to be connected to the external VGA monitor LVDS MONITOR able to be connected to the display provided by Mindray Patient Monitor user s manual V 2 2 1 13 Introduction Network interface connected to the Mindray Hypervisor III via a standard RJ45 Socket EXTEND used to connect to an external device Equipotential grounding terminal able to be connected to the hospital s grounding system This symbol means BE CAREFUL Refer to the manual this manual A Note A Monitor must be connected with specific network equipment such as Harb during using net function A Warning A Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards e g IEC 60950 for data processing equipment and IEC 60601 1 for medical equ
118. ay result in discontinuous waveforms on the screen 6 2 Patient Monitor user s manual V 2 2 6 4 6 5 Freeze Reviewing Frozen Waveform By moving the waveform you may review a waveform of 40 seconds before the moment when it is frozen For a waveform less than 40 seconds the remaining part is displayed as a straight line Use the rotary snob on the button module to move the cursor to the RECALL option on the FROZEN menu Press the knob the option displays L RIGHT By turning the knob left or right frozen waveforms on the screen will move left or right correspondingly There is an arrow indicating upward under the right side of the last waveform There is also a time scale beside the arrow OS is used to mark the moment when waveforms are frozen With waveforms moving right this time mark will in turn change into 1S 2S 3S These time marks are applied to all waveforms on the screen Recording Frozen Waveform In the Freeze status you may output displayed frozen waveforms via the recorder Maximum 2 waveforms can be output at one time On the FROZEN menu the pull down lists of both WAVE 1 and WAVE 2 give you all names of frozen waveforms on the screen from which you may select two Select the REC option on the FROZEN menu to output parameters generated upon the freezing moment and the two selected frozen waveforms If one of the two selected waveforms is closed or not available only parame
119. b CO Met Hb or dye dilution chemicals SpO2 Pulse Monitoring A Warning A ES Electrosurgery equipment wire and SpO2 cable must not be tangled up 13 16 Patient Monitor user s manual V 2 2 GpO Monitoring A Warning A Do not put the sensor on extremities with arterial catheter or venous syringe A Note A Do not perform SpO measuring and NIBP measuring in same arm at one time because obstruction of blood flow during NIBP measuring may adversely affect the reading of SpO value 13 2 2 Precautions during SpO2 Pulse Monitoring A Note A Make sure the nail covers the light window The wire should be on the backside of the hand A Note A SpO value always displays at the same position Pulse Rate will display when HR FROM is set at SPO2 BOTH in the ECG SETUP menu A Note A SpO waveform is not proportional to the pulse volume A Warning A Verify sensor cable fault detection before beginning of monitoring phase Unplug the SpO sensor cable from the socket the screen will display the error message SENSOR OFF and the audible alarm is activated A Warning A Do not use the sterile supplied SpO sensors if the packaging or the sensor is damaged and return them to the vendor A Warning A Prolonged and continuous monitoring may increase jeopardy of unexpected change of dermal condition such as abnormal sensitivity rubescence vesicle repressive putrescence and so on It is especial
120. below P mmHg Percentage Pamp ambient pressure Of CO2 MainStream and CO2 SideStream modules whichever is selected by the user Autorun measuring mode is adopted Rate for waveform sampling is 31 msec time The operating series for the two modules are respectively MainStream work sequence After the system is powered on CO2 module automatically begins warming up for about 45S to 90S Then the sensor motor is activated After 5S to 10S the light source of infrared ray is opened After 10S the system enters the normal measuring status SideStream work sequence Except the procedures that after being powered on the system needs not warming up and the air pump should be activated other procedures are the same as those in MainStream sequence CO2 measurement setups 1 Verify the type of the configured CO2 module MainStream or SideStream 2 For MainStream connect the sensor to the receptacle of CO2 module For SideStream plug the water trap onto its fixing chassis Add a permanently used nafion tube between the sampling line and the watertrap to further remove the influence of water vapor 3 After CO2 module is activated and enters the normal status for MainStream MAIN is displayed following CO2 waveform identifier and for SideStream SIDE is displayed following the identifier of CO2 waveform Patient Monitor user s manual V 2 2 18 3 CO2 Measuring Watertrap Nafion tube Mainstream Sensor
121. by COMMON ALM SETUP and the alarm setup of each parameter ALARM SETUP ALM SEL COMMON ALM SETUP z ALARM VOL MED X ALM REC TIME 8 amp 3 Z ALM PAUSE TIME 2MIN ki PARA ALM TYPE UNLATCH Back to the upper menu Figure 5 1 ALARM SETUP 4 COMMON ALM SETUP Select COMMON ALM SETUP selection in ALM SEL item This operation may call up the dialog box as the default one ALARM VOL which has three selections OFF LOW MED and HIGH ALM REC TIME which has three selections 8S 16S 32S ALM STOP TIME refers to the alarm suspension time span which has three selections 1MIN 2MIN 3MIN PARA ALM TYPE which has two selections LATCH UNLATCH LATCH refers to the situation once alarm occurs the system will alarm always until the intervention of the operator press PAUSE or SILENCE on the button module UNLATCH refers to the situation that once the alarm condition is discharged the alarm will disappear automatically Alarm setup of each parameter Patient Monitor user s manual V 2 2 5 3 Alarm In ALARM SETUP menu select ALM SEL item to set up the alarm information of following parameters They are HR ST PVC SPO2 NIBP IBP 1 2 RESP TEMP For example Method to set up alarm information of HR Step 1 Select HR ALM SETUP in ALM SEL item to call up the dialog box ALARM SETUP for HR only Step 2 Five items are available for the user to set up which are
122. c agent OFF No display for this waveform RT REC TIME this item has two options CONTINUAL and 8s CONTINUAL means once pushing the REC STOP button on the recorder panel or the monitor panel the recorder will continuously print out the waveform or parameter until this button is pushed again TIMING REC TIME OFF used to set up the time interval between two recordings 10 selections are available OFF 10min 20min 30min 40min 50min 1hour 2hours 3hours and 4hours The system will start the recording process according to the selected time interval The recording time is always 8 seconds AN Note AN RT REC TIME takes priority over TIMING REC TIME OFF REC RATE this item has two options 25 0 and 50 0 mm s REC GRID used to decide output format OFF is without grid and ON is with grid CLEAR REC TASK used to clear the alarm event that has been generated and is waiting for recording out AN Note A H two same waveforms are selected the system will automatically change one of the waveform to a different one 3 4 4 Module Setup Select the MODULE SETUP item in the SYSTEM SETUP menu to call up the following menu 3 8 Patient Monitor user s manual V 2 2 System Menu MODULE SETUP v ECG v IBP 1 2 RESP v c02 TEMP v CO v SP02 NIBP Back to the upper menu Figure 3 11 Module Setup You can choose the parameters to be monitored in this menu This can avoid the interferenc
123. cator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the ECG TEMP module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair O SETUP the button used to set up the related items of ECG REST TEMP Press SETUP button the ECG RESP TEMP SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel O Blank Button O Two sockets for TEMP sensor Before monitoring the patient the user should first safely insert the TEMP sensor cable into this socket O A socket for ECG Befor monitoring the patient the user should first safely insert the ECG lead cable into this socket 0 A means BE CAREFUL Refer to the attached document this manual of the monitor 0 means that the ECG TEMP module is IEC 60601 1 Type CF equipment A Note A When not using the ECG TEMP module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected Press SETUP button the ECG RESP TEMP SETUP appears on the screen Then the user may access the setup menu respectively for ECG RESP or TEMP through using the rotary knob on the control panel ECG RESP TEMP SETUP
124. ch clip or snap to electrodes prior to placement Put the electrodes on the patient Before attaching apply some conductive jelly on the electrodes if the electrodes are not electrolyte self supplied Connect the electrode lead to the patient s cable Make sure the monitor is ready with power supply AN Warning A Patient Monitor user s manual V 2 2 12 3 ECG RESP Monitoring Check everyday whether there is skin irritation resulted from the ECG electrodes If so replace electrodes every 24 hours or change their sites A Note A For protecting environment the electrodes must be recycled or disposed of properly A Warning A Verify lead fault detection prior to the start of monitoring phase Unplug the ECG cable from the socket the screen will display the error message ECG LEAD OFF and the audible alarm is activated 12 4 2 Installing ECG lead Placing the Electrodes for ECG Monitoring Electrode placement for 5 lead set Figure 12 3 Red R electrode Be placed near the right shoulder directly below the clavicle Yellow L electrode Be placed near the left shoulder directly below the clavicle Black N electrode Be placed on the right hypogastrium Green F electrode Be placed on the left hypogastrium White C electrode Be placed on the chest as illustrated in the F Figure 12 4 Note the following table gives the corresponding lead names used in Europe and America respectively Lead names are r
125. ck anemia low temperature and the use of vasoconstrictive drug can cause the blood flow in the artery to reduce to a value exceeding the measurement range Measurement is also dependent on the properties of HbO2 and deoxyhemoglobin to absorb lights of special wavelengths If there are materials that can absorb the lights of the same wavelengths false or low SpO2 value may be resulted These materials include COHb MetHb indigo carmine etc 13 2 5 SpO2 Menu SPO2 SETUP Menu There are two ways to access the SPO2 SETUP menu Pick the SETUP button on the SpO module to access the SPO2 SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the SPO2 hot key in the parameter area and then press the knob to directly access the SPO2 13 20 Patient Monitor user s manual V 2 2 GpO Monitoring SETUP menu ALM ON PR ALM LO 50 ALM LEV MED SWEEP 25 0 ALM REC OFF PR SOUND MED SPOZ ALM HI 100 AVG TIME 4S z SP02 ALM LO 90 SETUP TRANSFER gt gt PR ALM HI 120 DEFAULT gt gt Open or close the Sp02 alarm EXIT Figure 13 7 SPO2 SETUP menu A Warning A Setting the GpO upper alarm limit to 100 is equivalent to switching off the alarm on upper limit High oxygen levels may predispose a premature infant to retrolental fibroplasia Therefore the upper alarm limit for oxygen saturation must be carefully selected in accordance with commonly accepted clinical
126. ck the zero or baseline must not exceed 0 5ml or the membrane over the sensor may be ruptured 16 16 Patient Monitor user s manual V 2 2 IBP Monitoring AN Warning AN Do not press with thumb and forefinger on the tip of the ICT B Enormous pressures will be generated this way and the device will be subject to possible damage To see if the ICT B is operating gently touch the sensor tip A Note A Carefully check for cuts on the silicone of the catheter and sensor tip before use PLACING THE ICT B Ax Note A Burr hole edges must be rounded where the catheter makes an S bend into the epidural space Evacuate all bone chips A Note A The catheter should be protected by suitable means where sutures are placed This will prevent damage to the catheter when pulling sutures tight A Warning A Do not use haemostats or forceps as these will damage the device A Note A When removing the catheter care should be taken not to nick the device while cutting sutures Pull slowly on the catheter to remove the ICT B 16 8 3 Connection to the pressure monitor Ax Note A Although the catheter tip pressure transducer sensor is electrically isolated from the patient it is recommended that pressure monitors with patient isolation be used for safety Consult the manufacturer of the monitoring equipment for questions relating to monitor safety Calibration The ICT B is supplied with minimal zero offset and the sensitivit
127. ctors are not waterproof Do not sterilize by irradiation steam or ethylene oxide AN Caution AN Do not use damaged patient cables Do not immerse the patient cables in water solvents or cleaning solutions the sensors and connectors are not waterproof Do not sterilize by irradiation steam or ethylene oxide H Selecting a Masimo sensor When selecting a sensor consider the patient s weight the adequacy of perfusion the available sensor sites and the duration of monitoring For more information refer to the following table or contact Masimo Use only Masimo sensors and sensor cables Select an appropriate sensor apply it as directed and observe all warnings and cautions presented in the directions for use accompanying the sensor High ambient light sources such as surgical lights especially those with a xenon light source bilirubin lamps fluorescent lights infrared heating lamps and direct sunlight can interfere with the performance of an SpO2 sensor To prevent interference from ambient light ensure that the sensor is properly applied and cover the sensor site with opaque material if required Failure to take this precaution in high ambient light conditions may result in inaccurate measurements SENSOR USAGE PATIENT WEIGHT LNOP ADT SINGLE USE ADULTS gt 30 kg LNOP PDT SINGLE USE Adults gt 10 kg and lt 50 kg LNOP NEO SINGLE USE Neonate lt 10 kg LNOP NEO PT SINGLE USE Neonate lt 1 kg
128. d NIBP measuring in same arm at one time because obstruction of blood flow during NIBP measuring may adversely affect the reading of SpO value A Note A Make sure the nail covers the light window The wire should be on the backside of the hand A Note A SpO value always displays at the same position Pulse Rate will display when HR FROM is set at SpO2 BOTH in the ECG SETUP menu A Note A SpO waveform is not proportional to the pulse volume 13 1 2 Monitoring Procedure SpO2 Module Patient Monitor user s manual V 2 2 13 5 SpO2 Monitoring Figure 13 1 SPO2 module Indicator the indicator that indicates the working status of the module When the module is working this indicator is on AN Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the SpO2 module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair SETUP the button used to set up the related items of SpO2 Press SETUP button the SPO2 SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel Blank Button A socket for SpO2 sensor Before monitoring the patient the user should first safely insert
129. d maximum value will be represented by the maximum value To obtain trend data of a specific time The time to which the cursor points will change as the knob is turned Parameter at this time is displayed below the x axis When gt appears on the right part of the screen the trend graph pages down for later trend curve as the cursor moves here When appears on the left part of the screen the trend graph pages up for earlier trend curve as the cursor moves here To print out the trend curve Press REC button to print out the trend curve of current selected parameter Mark event If an event is marked A B C or D then the corresponding event type will display on the axis time of the trend graph The event sign A B C or D is displayed in a frame Operation example To view the NIBP trend graph of the last 1 hour Press the MENU button on the button module Pick TREND GRAPH item Pick the first item and switch to NIBP by turning the knob Adjust the second item to be 1 or 5 sec Pick the ZOOM button and turn the knob to view changes of the trend graph time and trend curve H Stop at requested trend time section for careful review Pick the ZOOM button to adjust the display scale if necessary m For measurement result of a specific time pick CURSOR to move the cursor to the point corresponding time and value will display on above and below respectively WR For printout of trend graph pick REC to start report printi
130. data record during the NIBP alarm pick OFF to disable the alarm function and there will be a 28 beside NIBP e ALM LEV selectable from HIGH MED to LOW HIGH represents the most serious case e ALM REC pick ON to enable report printing upon NIBP alarm e SYS ALM HI SYS ALM LOW MEAN ALM HI MEAN ALM LO DIA ALM HI DIA ALM LO are for the user to set up the alarm limit for each type of pressure NIBP alarm is activated when the pressure exceeds set upper alarm limits or falls below lower alarm limits Patient Monitor user s manual V 2 2 14 7 NIBP Monitoring NIBP alarm limits Adult Mode SYS 40 270 mmHg DIA 10 215 mmHg Mean 20 230 mmHg Pediatric Mode SYS 40 200 mmHg DIA 10 150 mmHg Mean 20 165 mmHg Neonatal Mode SYS 40 135 mmHg DIA 10 100 mmHg Mean 20 105 mmHg m RESET Restore measurement status Pick this item to restore initial settings of the pressure pump When the pressure does not work properly and the system fails to give message for the problem pick this item to activate self test procedure thus restore the system from abnormal performance m CONTINUAL Start continuous measuring When this item is picked the menu will disappear automatically m INTERVAL Interval time for automatic measuring Available selections 1 2 3 4 5 1 0 15 30 60 90 120 180 240 480 minutes Press START STOP button on the NIBP module to start the first auto measuring Pick MANUAL selection in INTERVAL item to set
131. designed for measuring intracranial pressure by the epidural method There are many advantages of catheter tip measurement including simplicity of use and excellent frequency response without artefacts The ICT B has an atmospheric reference pressure channel that connects the back of the sensing area to the ambient air pressure via the luer fitting on the connector All measurements are differential with respect to ambient air pressure Reference channel to Luer fitting for i ae ambient air pressure Measured Calibration zero check by Extension pressure sleeve balloon inflation Y Transducer drive IH sensor Temperature compensation and Output signal bridge balance network Figure 16 10 ICT B transducer A significant feature of the ICT B is the ability to check the zero drift of the ICT B and pressure Patient Monitor user s manual V 2 2 16 15 IBP Monitoring monitor in vivo Not only does this allow for accurate measurements but also allow moving the patient with the ICT B in the epidural space and reconnection to another monitor quickly and easily There is a flat silicone rubber membrane or balloon covering the pressure sensing diaphragm Two internal tubes connect the two sides of the diaphragm to a female luer fitting on the connector shell By introducing approximately 0 2 to 0 3ml of air from a 1ml syringe the pressure in these tubes will be greater than the ICP being measured The exact amount of air is no
132. diation sterilization in hot air ovens or disinfected by immersion in decontamination solutions but remember to remove the rubber bag if you use this method The cuff should not be dry cleaned The cuff can also be machine washed or hand washed the latter method may prolong the service life of the cuff Before washing remove the latex rubber bag and for machine washing close the Velcro fastening Allow the cuff to dry thoroughly after washing then reinsert the rubber bag BU E i Ss Orel IZIS UO 9V8 NOILVIANI X3LV1 AAND MOT muer 19 omouemneg Figure 14 7 Replace Rubber Bag in Cuff Patient Monitor user s manual V 2 2 14 13 NIBP Monitoring To replace the rubber bag in the cuff first place the bag on top of the cuff so that the rubber tubes line up with the large opening on the long side of the cuff Now roll the bag lengthwise and insert it into the opening on the long side of the cuff Hold the tubes and the cuff and shake the complete cuff until the bag is in position Thread the rubber tubes from inside the cuff and out through the small hole under the internal flap Disposable Blood Pressure Cuffs Disposable cuffs are intended for one patient use only Do not use the same cuff on any other patient Do not sterilize or use autoclave on disposable cuffs Disposable cuffs can be cleaned using soap solution to prevent infection A Note A For protecting environment the disposable blo
133. djust the lower alarm limit of FiCO2 When the measured value is smaller than FiCO2 lower alarm limit the FiCO2 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E EtO2 ALM HI used to adjust the upper alarm limit of EtO2 When the measured value is larger than EtO2 upper alarm limit the EtO2 HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit m EtO2 ALM LO used to adjust the lower alarm limit of EtO2 When the measured value is smaller than EtO2 lower alarm limit the EtO2 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit E FiO2 ALM HI used to adjust the upper alarm limit of FiO2 When the measured value is larger than FiO2 upper alarm limit the FiO2 HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E FiCO2 ALM LO used to adjust the lower alarm limit of FiO2 When the measured value is smaller than EiO2 lower alarm limit the FiO2 LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit AwRR ALM HI used to adjust the upper alarm limit of AWRR When the measured value
134. duct Specification SYS 40 200 mmHg DIA 10 150 mmHg MEAN 20 165 mmHg Neonatal Mode SYS 40 135 mmHg DIA 10 100 mmHg MEAN 20 105 mmHg Resolution Pressure 1mmHg Cuff pressure accuracy 3mmHg Accuracy Pressure Maximum Mean error 5mmHg Maximum Standard deviation 8mmHg Overpressure Protection dult Mode 29743 mmHg Pediatric Mode 240 3 mmHg Neonatal Mode 147 3 mmHg 2 10 SPO Measuring Range 0 100 Alarm Range 0 100 Resolution 1 Accuracy 70 100 2 0 69 unspecified Actualization interval about 1 Sec Alarm Delay 10 Sec Pulse Rate Measuring and Alarm Range 0 254bpm Resolution 1bpm Accuracy 2bpm or 2 use the greater MASIMO Specification Range Saturation SpOz 1 100 Pulse Rate bmp 25 240 Accuracy Saturation SpOz During No Motion Conditions Adults pediatric 70 100 2 O 69 unspecified Neonates 70 100 3 Patient Monitor user s manual V 2 2 5 Product Specification O 69 unspecified Saturation SpOz During Motion Conditions Adults pediatric Neonates 70 1000 3 0 69 unspecified Pulse bpm During No Motion Condition 25 to 240 3BPM Pulse bpm During Motion Condition 25 to 240 5BPM Resolution Saturation SpOz Pulse Rate bpm 2 11 TEMPERATURE Channel Measuring and Alarm Range Resolution Accuracy Actualization
135. e correction position Cannot communicate with the recorder Place the paper roll in the correct position Re load the module or in the recorder setup menu execute the function of clearing record task The function can make the host and the recorder connect Patient Monitor user s manual V 2 2 7 System Alarm Prompt again If the failure still exists contact the manufacturer for repair NIBP INIT ERR NIBP SELFTEST ERR NIBP initialization error Execute the reset program in the NIBP menu If the failure still exists contact the manufacturer for repair NIBP RESET ILLEGALLY During NIBP measurement illegal reset occurs Check the airway of NIBP to see if there are clogs Then measure again if the failure still exists contact the manufacturer Tor repair NIBP COMM ERR The NIBP communication part has problem Execute the reset program in the NIBP menu If the failure still exists contact the manufacturer for repair LOOSE CUFF The NIBP cuff is not Re connect the NIBP cuff connected correctly S Check the connection of each D n THES AMBE EE ol part or replace with a new cuff If AIR LEAK connected correctly or there he fail ill exi h are leaks in the airway the failure sti exists contact the manufacturer for repair e dee Wich Check the connection of each AIR PRESSURE GE KS E part or replace with a new cuff If ERROR y per the failur
136. e from the parameters that need not attention 3 4 5 Analog output setup The monitor can output an analog waveform whose time delay is less than 30ms The output terminal is on the rear panel Select ANALOG item in SYSTEM SETUP menu to call up the ANALOG menu The first item is for setting up On Off of the switch of the analog output The second item is for selecting the waveform name to be output Select EXIT item to return to the previous menu ANALOG OUT ANALOG WAVE ECGi Open close analog output On outputing analog wave EXIT Figure 3 12 Analog 3 4 6 Tracing Waveforms Selection Select the TRACE SETUP in the SYSTEM SETUP menu to call up the following menu Patient Monitor user s manual V 2 2 3 9 System Menu TRACE SETUP v ECG1 v L v ECGZ N20 v SP02 02 v IBP1 AA v IBP2 v RESP WAVE SEQUENCE gt gt Back to the upper menu Figure 3 13 Tracing Waveforms Selection You can choose the waveform to be displayed in this menu 3 4 7 Event Setup The monitor has four types of events You can specify their representations by yourself Select the MARK EVENT item in the SYSTEM SETUP to call up the following menu MARK EVENT EVENT B EVENT C EVENT D operator def ined events EXIT Figure 3 14 MARK EVENT Menu How to mark the event Use the rotary knob to select one from event A B C and D The symbol will appear in the frame of the event being selected O
137. e 12 1 color LCD provided by Mindray or the ordinary purchased display WH The color LCD provided by Mindray has 6 system buttons and a rotary knob used for 1 4 Patient Monitor user s manual V 2 2 Instruction direct operation performed by the user WH The display provided by the Mindray possesses the device used for visual and audio alarm WH The ordinary purchased display does not have system buttons and alarm device Therefore the user should buy the button module to realize the direct operation by the user and visual and audio alarm function Module box WH The module box can maximally hold 8 standard modules at the same time The module box can be placed either horizontally or vertically Modules The modules currently provided by the system include d 2 g O module 1 module 2 module 3 module 4 module 5 module 6 module 7 module 8 module 9 module 11 module IBP 3 4 channel blank module used for decoration standard module button alarm module standard module ECG RESP TEMPJ 2 channel standard module SPO2 module standard module NIBP module standard module IBP 1 2 channel module standard module CO module standard module EtCO2 module standard module Anaesthetic gas module occupies a space of three slots Recorder module occupies a space of two slots module standard module SpOz NIBP seTuP START stor 1 module 2
138. e alarm User selectable AwRR measuring value is above upper AWRR TOO HIGH User selectable LEAK alarm limit AWRR TOO LOW ae measuring value is below lower alarm User selectable In specific time interval no RESP can be GORANE detected using CO2 module MaR Technical alarms Alarm Message Cause Level Remedy Mainstream sensor is not Make sure that CO2 SENSOR OFF properly connected or has LOW mainstream sensor is fallen off properly connected CO2 NO Sidestream water trap is not Make sure that WATERTRAP properly connected or has LOW sidestream water trap fallen off is soundly connected CO2WATERTRAP Sidestream water trap is jow AN Seed uer tat OCCLUDE occluded sidestream water trap i functions smoothly CO2 SIGNAL LOW Measuring module technical LOW If necessary re start failure the monitor If failure CO2 SIGNAL TOO LOW persists stop using LOW measuring function of CO2 BAROMTRC MED CO2 module notify TOO LARGE biomedical engineer CO2 PNEUMATIC MED or Mindray service staff 18 10 Patient Monitor user s manual V 2 2 CO2 Measuring CO2 SIGNAL NOISY Low _ Staff CO2 SIGNAL SATURATE SC CO2 CALCULATION ERR HIGH CO2 SENSOR FAULT HIGH CO2 SENSOR TEMP HIGH nee CO2 SENSOR TEMP LOW HIGH CO2 WATCHDOG TIMEOUT SE CO2 INT COMM
139. e of cuff can cause erroneous readings H the cuff size is in question then use a larger cuff Patient Monitor user s manual V 2 2 14 3 NIBP Monitoring Size of reusable cuff for neonate children adult Patient Type Limb perimeter Cuff width Hose Infant 10 19 cm 8 cm Child 18 26 cm 10 6 cm 1 5m Adult 25 35 cm 14 cm or Large Adult 33 47 cm 17 cm 3m Thigh 46 66 cm 21cm Size of disposable cuff for neonate children adult Size No Limb perimeter Cuff width Hose 1 3 1 5 7 cm 2 5 cm 1 5m 2 4 3 8 0 cm 3 2 cm or 3 5 8 10 9 cm 4 3 cm 3m 4 7 1 13 1 cm 5 1 cm Make sure that the cuff edge falls within the range of mark lt gt If it does not use a larger or smaller cuff that fits better 3 Connect the cuff to the air hose The limb chosen for taking the measurement should be placed at the same level as the patient s heart If this is not possible you should apply the following corrections to the measured values WH Ifthe cuff is placed higher than the heart level add 0 75 mmHg 0 10 kPa for each cm of difference WH f itis placed lower than the heart level deduct 0 75 mmHg 0 10 kPa for each cm of difference 4 Check whether the patient mode is appropriately selected Access PATIENT SETUP menu from SYSTEM MENU and pick PAT TYPE item and turn the knob to select the required patient type 5 Press the SETUP button on the NIBP module to ca
140. e pacing impulse may be counted as normal QRS complex which results in failure of ECG LOST error detection For monitor with ST segment amp Arrhythmia analysis software refer to ST Segment Monitoring and Arrhythmia Analysis for details AN Note A When Pacer Switch is On the Arrhythmia events related to PVCs will not be monitored Patient Monitor user s manual V 2 2 12 13 ECG RESP Monitoring At the same time the ST analysis will not be performed either 12 7 ECG Alarm Information and Prompt Alarm Message Alarms occurring in the process of ECG measurement contain two types physiological alarm and technical alarm Prompt message may also appear in the mean time For the audio and visual features during the appearance of these alarms and prompt messages in the process of ECG measurement please refer to the related description in Chapter Alarm In the screen physiological alarm messages and the prompt messages able to trigger alarms general alerts all displayed in the alarm area of the monitor while technical alarms and prompt messages unable to trigger alarms are then displayed in the information area of the monitor This section does not describe the content about Arr and ST analysis Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition
141. e reading accuracy of the AG module must be performed by trained and qualified personnel 19 18 Patient Monitor user s manual V 2 2 Chapter 20 Accessories and Ordering Information This chapter lists the recommendation accessories used in this device A Warning A The accessories list below are specified to be used in this device of Shenzhen Mindray Bio Medical Electronics Co Ltd The device will be possibly damaged or lead some harm if any other accessories are used 20 1 ECG Accessories m Cables 12PIN 5 lead ECG cable and lead wires assembly AHA Mindray 12PIN 5 lead ECG cable and lead wires assembly IEC Mindray 12PIN 3 lead ECG cable and lead wires assembly AHA Mindray 12PIN 3 lead ECG cable and lead wires assembly IEC Mindray 12PIN 5 lead ECG cable and lead wires assembly Deffibrilation AHA Mindray 12PIN 5 lead ECG cable and lead wires assembly Deffibrilation IEC Mindray 12PIN 3 lead ECG cable and lead wires assembly Deffibrilation AHA Mindray 12PIN 3 lead ECG cable and lead wires assembly Deffibrilation IEC Mindray 12PIN separable ECG trunk cable assembly white Mindray 12PIN separable ECG trunk cable assembly green Mindray 12PIN separable ECG trunk cable assembly Deffibrilation white Mindray 12PIN separable ECG trunk cable assembly Deffibrilation green Mindray m Lead wires 3 lead ECG lead wire LL 22363 EURO 5 lead ECG lead wire KENDALL 3 lead ECG lead wire EURO KEN
142. e still exists contact the Measurement sarialysis Et manufacturer for repair calculation Check if the setup of patient type E deer WE is correct Check the connection WEAK SIGNAL system cannot perform ofeach part OF replace witha measurement analysis or calculation new cuff If the failure still exists contact repair the manufacturer for RANGE EXCEEDED Problem happens when measuring the curve The system cannot perform measurement analysis or calculation Check the connection of each part or replace with a new cuff If the failure still exists contact the manufacturer for repair EXCESSIVE MOTION The patient arm moves Check the connection of each part and the patient situation Measure again if the failure still exists contact the manufacturer for repair OVER PRESSURE Perhaps folds exist in the airway Check for the smoothness in the airway and patient situation Measure again if the failure still exists contact the manufacturer for repair Problem happens when Check the connection of each measuring the curve The part and the patient situation SIGNAL SATURATED system cannot perform Measure again if the failure still measurement analysis or exists contact the manufacturer calculation for repair Problem happens when Check the connection of each measuring the curve The part and the patient situation NIBP TIME OUT system canno
143. ean for reuse on a another patient 2 Airway adapter is for one off use in MainStream module Do not sterilize or clean for reuse on another patient 3 When the sample system of Sidestream module occurring occlusion first check kinks for sampling line If no kinks are found then check water trap after disconnecting sample line from the Watertrap If the occlusion message on the screen disappears the sampling line must be replaced If the occlusion message on the screen remains the Watertrap must be replaced 4 No routine calibration required in both Mainstream and Sidestream CO2 module 18 12 Patient Monitor user s manual V 2 2 Chapter 19 Anesthetic Gas Measurement 19 1 General AG module is used to measure respiratory and anesthetic gases of a patient during anesthesia This module provides et end tidal values and inspired values of various gases listed below kb CO here it represents the measured EtCO2 value maximum expired gas value maximum expired gas value tested during expiring period e N O nitrous oxide J Oz optional function e AwRR respiring time per minute The system can simultaneously display the waveforms of 4 anesthetic gases COs N20 O2 and an anesthetic waveform The default is to display CO waveform Parameters that can be displayed simultaneously are CO N O Oz and AA it refers to anesthetic DES ISO ENF SEV HAL In addition inspired and expired values
144. ed ECG Lead Placement for Surgical Patients A Warning A When using Electrosurgery equipment leads should be placed in a position in equal distance from Electrosurgery electrotome and the grounding plate to avoid cautery Electrosurgery equipment wire and ECG cable must not be tangled up The placing of the ECG leads will depend on the type of surgery that is being performed For example with open chest surgery the electrodes may be placed laterally on the chest or on the back In the operating room artifacts can sometimes affect the ECG waveform due to the use of ES Electrosurgery equipment To help reduce this you can place the electrodes on the right and left shoulders the right and left sides near the stomach and the chest lead on the left side at mid chest Avoid placing the electrodes on the upper arms otherwise the ECG waveform will be too small AY Warning A When using Electrosurgery equipment never place an electrode near the grounding plate of the Electrosurgery device otherwise there will be a great deal of interference with the ECG signal m Using 5 lead ECG set The default setting is ECG CH1 corresponding to Channel Il and ECG CH2 to Channel you can modify the setting to meet your needs You can set them to correspond to any two from I Il Ill AVR AVL AVF and V If you set both to the same value one of them will be adjusted to another option automatically Figure 12 5 12 6 Patient Monitor user s manual
145. ed chapter 1 3 Button Function and Basic Operation This section discusses the following information E Button functions of PM 6000 E The method to use the rotary knob to realize the operation on the screen E Index for basic operation Button function of PM 6000 Two types of buttons are available on PM 6000 hard buttons and soft buttons Hard buttons include system button panel and module button panel The system button panel is on the screen or on the button module The module button is on each module Soft buttons are on the screen which have to be selected by the operator through using the rotary knob Figure 1 5 module button panel and screen button panel System buttons SILENCE Push this button to suspend alarm for maximum 3 minutes with 1 minute 2 minutes and 3 minutes selectable In Alarm PAUSE status a 4 symbol appears in the Message Area Push this button to mute all kinds of sounds including alarm sound heart beat pulse tone key sound At the same time a EZ symbol appears in the Message Area Push this button again to restore all kinds of sounds and the 1 10 Patient Monitor user s manual V 2 2 Instruction EZ symbol disappears from the screen A Note A If new alarm occurs in Alarm Pause Silence status the system will discharge Pause Silence status automatically For specific rules see Chapter Alarm A Note A The system will begin to give alarm information again once there exist alarm trig
146. ed document this manual of the monitor A means that the SpO2 module is IEC 60601 1 Type CF equipment A Note A When not using the SpO2 module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected How the SpO2 PLETH Parameter Works WH Arterial oxygen saturation is measured by a method called pulse oximetry It is a continuous non invasive method based on the different absorption spectra of reduced hemoglobin and oxyhemoglobin It measures how much light sent from light sources on one side of the sensor is transmitted through patient tissue such as a finger or an ear to a receiver on the other side The sensor measurement wavelengths are nominally 660nm for the Red LED and 940nm for Infrared LED Maximum optical power output for LED is 4 mW WH The amount of light transmitted depends on many factors most of which are constant However one of these factors the blood flow in the arteries varies with time because it is pulsating By measuring the light absorption during a pulsation it is possible to derive the oxygen saturation of the arterial blood Detecting the pulsation gives a PLETH waveform and pulse rate signal mM The SpO value and the PLETH waveform can be displayed on the main screen A Warning A Pulse oximetry can overestimate the GpO value in the presence of H
147. eds set alarm high limit or falls below alarm low limit TB alarm limits Max Alarm High Min Alarm Low Step TB 43 C 23 C 0 1 C CO CONST It represents the computation constant related to the catheter and injectate volume After replacing the catheter you should adjust this constant according to the instruction AY Warning AN Make sure that the computational constant for the measurement is appropriate to the catheter used H INT TIME s It refers to the minimum time interval between two measurements It is in second unit The adjustment range is 5 to 300 seconds with the increment being 5 17 8 Patient Monitor user s manual V 2 2 CO Measuring seconds INJ TEMP FROM Pick ON or OFF to select from two ways of obtaining the injectate temperature ON the system obtains the injectate temperature through sampling OFF directly display the injectate temperature obtains from the INJ TEMP item INJ TEMP When the INJ TEMP FROM is OFF the user can set the injectate temperature between 0 27 C with the increment being 0 1 C TEMP UNIT C for Celsius degree F for Fahrenheit degree SETUP TRANSFER used to access the sub menu of CO SETUP TRANSFER in which the user may set up following information RT TRANSFER Refers to real time transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the CO module i
148. eer or Mindray service staff Make sure the patient is quiet the ECG NOISE ECG measuring signal is electrodes are greatly interfered properly connected and AC power system is well grounded Prompt messages include general alerts Message Cause Alarm Level HR measuring value exceeds the measurement range HR EXCEED HIGH 12 8 ST Segment Monitoring optional ST Segment Monitoring Optional mM ST segment monitoring function is shutoff by default You can switch it to ON when necessary NOTE When setting ST ANALYSIS on the monitor will automatically switch to DIAGNOSTIC mode You can set it to MONITOR mode or OPERATE mode as required However at this time ST value has been severely distorted Hilt is available to measure the variance of ST segment with ST analysis at the waveform tracks for selected lead The corresponding ST measurement result displays numerically at ST1 and ST2 in the Parameter Area The trend can be viewed with table or graphic form mM Measurement unit of ST segment mv m Measurement symbol of ST segment elevating depressing Patient Monitor user s manual V 2 2 12 15 ECG RESP Monitoring m Measurement range of ST segment 2 0 mv 2 0 mv Pick the ST ANALYSIS item in the ECG SETUP menu to access the ST ANALYSIS sub menu as shown below ST ANALYSIS menu ST ANALYSIS ST ANAL OFF M ALM HI 0 20 ST ALM OFF ALM LO 0 20
149. elines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Patient Monitor user s manual V 2 2 3 Appendix IV System Alarm Prompt PROMPT CAUSE MEASURE SLOT x LOADING Already load another Do not load more than one MODULE CONFLICT module of the same type module of the same parameter X represents the numerical code of 1 8 slots o a XX value exceeds the AA TORIO higher alarm limit Check if the alarm limits are appropriate and the current XX TOO LOW XX value is below the lower situation of the patient alarm limit XX represents the value of parameter such as HR ST1 ST2 RR SpO2 IBP NIBP etc in the system ECG WEAK SIGNAL The ECG signal of the patient is too small so that the system can not perform ECG analysis Check if the electrodes and lead wires are connected correctly and the current situation of the patient NO PULSE The pulse signal of the patient is too small so that the system can not perform pulse analysis Check the connection of the sensor and the current situation of the patient RESP APNEA The respiration signal of the patient is too small so that the system cannot perform RESP analysis Check the connection of the linking wire and the current situation of the patient CO2 APNEA The respiration signal of the patient is too small
150. ent 17 10 Patient Monitor user s manual V 2 2 Physiological alarms CO Measuring Message Cause Alarm Level TB TOO HIGH eee value is above upper alarm W E TB TOO LOW TB measuring value is below lower alarm User selectable limit Technical alarms Alarm Message Cause Level Remedy TB SENSOR OFF TB measuring cable LOW Make sure that cable is properly falls off the monitor connected CO INIT ERR CO INIT ERR1 CO INIT ERR2 CO INIT ERR3 Stop using measuring function of CO INIT ERR4 CO module failure HIGH CO module notify biomedical engineer or Mindray service staff CO INIT ERR5 CO INIT ERR6 CO INIT ERR7 CO INIT ERR8 CO module failure or Stop using measuring function of CO COMM STOP communication HIGH CO module notify biomedical failure engineer or Mindray service staff CO module failure or Stop using measuring function of CO COMM ERR communication HIGH CO module notify biomedical failure engineer or Mindray service staff Functi nal safet Stop using TB alarming function TB ALM LMT ERR i Y HIGH notify biomedical engineer or failure i Mindray service staff Prompt message general alerts Message Cause Alarm Level TB EXCEED TB measuring value is HIGH beyond measuring range 17 7 Maintenance and Cleaning Care and Maintenance A Warning A Before cleaning the monitor or the transducer make sure that the equipment i
151. ent However connector of the sensor shall not be subjected to such solution 13 24 Patient Monitor user s manual V 2 2 Chapter 14 NIBP Monitoring 14 1 Introduction m Reference to the European standard EN 1060 1 Specification for Non invasive sphygmomanometers Part 1 General requirements The Non invasive Blood Pressure NIBP module measures the blood pressure using the oscillometric method Itis applicable for adult pediatric and neonatal usage mM There are three modes of measurement available manual automatic and continuous Each mode displays the diastolic systolic and mean blood pressure O Inthe MANUAL mode only one measurement is conducted for each time O In the AUTO mode the measurement is cycled you can set the interval time to 1 2 3 4 5 1 0 15 30 60 90 1 20 1 80 240 480 minutes O In the continuous mode the monitor measures the blood pressure as many times as possible in five minutes A Warning A 1 You must not perform NIBP measurements on patients with sickle cell disease or under any condition which the skin is damaged or expected to be damaged 2 For a thrombasthemia patient it is important to determine whether measurement of the blood pressure shall be done automatically The determination should be based on the clinical evaluation 3 Ensure that the correct setting is selected when performing measurements on children It may be dangerous for the children to use an over pressure
152. epresented by R L N F and C respectively in Europe whose corresponding lead names in America are RA LA RL LL and V America Euro Lead names color Lead names color RA White R Red LA Black L Yellow LL Red F Green RL Green N Black V brown C White 12 4 Patient Monitor user s manual V 2 2 A Note A ECG RESP Monitoring LA Black RA White V Brown LL RL Red Green Figure 12 3 Electrode placement for 5 lead set To ensure patient safety all leads must be attached to the patient For 12 lead set attach the C electrode to one of the indicated positions as below Figure 12 4 m vi m V2 E V3 mg V4 m V5 m ve m V3R V7R m VE E vi E V7R On the 4th intercostal space at the right sterna margin On the 4th intercostal space at the left sterna margin Midway between V2 and V4 electrodes On the 5th intercostal space at the left clavicular line On the left anterior axillary line horizontal with V4 electrode On the left middle axillary line horizontal with V4 electrode On the right side of the chest in positions corresponding to those on the left Over the xiphoid position On the 5th intercostal space at the left posterior axillary line of back On the 5th intercostal space at the right posterior axillary line of back Patient Monitor user s manual V 2 2 12 5 ECG RESP Monitoring Figure 12 4 C electrode placement for 5 lead set Recommend
153. es User selectable PNP A pacemaker of the average R R interval only considering patients with pacemaker When pacing pulse is available no PNC With QRS exists during the period 1 75 times s rselectable pacemaker of the average RR interval only considering patients with pacemaker Patient type All patients refers to perform Arr analysis on patients either with pacemakers or without pacemakers Without pacemaker refers to perform Arr Analysis only on the patients without pacemakers With pacemaker refers to perform Arr Analysis only on the patients with pacemakers Prompt message Message Cause Alarm Level The QRS template building ARR LEARNING required for Arr Analysis is in No alarm process Patient Monitor user s manual V 2 2 12 23 ECG RESP Monitoring A Note A Arrhythmia name displays in the Alarm Message Area 12 10 Measuring RESP 12 10 1 How to measure RESP The monitor measures respiration from the amount of thoracic impedance between two ECG electrodes The change of impedance between the two electrodes due to the thoracic movement produces a respiratory waveform on the screen 12 10 2 Setting Up RESP measurement For RESP monitoring it is not necessary for additional electrodes however the placing of electrodes is important Some patients due to their clinical condition expand their chest laterally causing a negative intrathoracic pressure In these
154. essage AG OCCLUSION Following are a few examples of occlusion which you may remove one by one until this message disappears Patient Monitor user s manual V 2 2 19 17 Anesthetic Gas Measurement Entrance Occlusion If the part at the entrance such as filter sample line or airway connector is occluded by condensed water the screen will display the message telling that the airway is occluded The optimal method to remove clogs of this kind is check for clogs in entrance parts a replace the bacteria filter at the entrance b check the sample pipe for clogs and or entangle If necessary replace it c Check the airway connector for water If necessary drain off the water and install the connector again Internal Occlusion If the interior of the AG module is contaminated by condensed water the screen will also display the message telling that the airway is occluded The optimal method to remove clogs of this kind is Step 1 as usual check the entrance or the exit for clogs and remove them Step 2 if occlusion still persist after step 1 you should consider the existence of interior occlusion In this situation contact Mindray service engineer Calibrate the reading accuracy Check the module once per year and confirm if it is necessary to calibrate the reading accuracy Please consult the biomedical engineer in your hospital or Mindray service engineer for related information A Note A Calibration of th
155. estable lower alarm limit Difference between two channels is TD TOO HIGH larger than upp r limit User selectable Technical alarms Alarm Message Cause fe Remedy Temperature T1 SENSOR OFF oe Ge E LOW Make sure that the cable is disconnected properly connected from the monitor 15 4 Patient Monitor user s manual V 2 2 TEMP Monitoring Temperature cable of channel 2 may be ow Make sure that the cable is disconnected from properly connected the monitor T2 SENSOR OFF Stop using alarming function Functional safety Gi of TEMP module notify failure biomedical engineer or Mindray service staff T1 ALM LMT ERR Stop using alarming function Functional safety Hig of TEMP module notify failure biomedical engineer or Mindray service staff T2 ALM LMT ERR Stop using alarming function TDALMLMTERR Functional safety ueu of TEMP module notify failure biomedical engineer or Mindray service staff Prompt message Message Cause Alarm Level T1 EXCEED Measuring value of channel 1 is beyond HIGH measuring range T2 EXCEED Measuring value of channel 2 is beyond HIGH measuring range 15 5 Care and Cleaning A Warning A Before cleaning the monitor or the probe make sure that the equipment is switched off and disconnected from the power line Reusable TEMP Probes 1 The TEMP probe should n
156. f began injecting water into the luer but we caught it just as a little went into the ICT B Is the device ruined Probably not Return to Manufactory for repair Why will the ICT B be damaged if we ETO sterilize it with the luer plugged When you plug the luer you are sealing the internal lumens at normal atmospheric pressure Part of the ETO cycle is a partial vacuum Thus the trapped air at atmospheric pressure will expand and rupture the balloon 16 8 8 TROUBLE SHOOTING TROUBLE CAUSE REMEDY You inject air to check the zero and cal but the baseline reappears with the waveform The catheter or tip is cut and cannot hold zero long enough Readings cannot be trusted Remove the ICT B and use a spare The waveforms will be accurate if that is all you need showing The monitor Either the tip is wedged or the If the tip is wedged pull back a few indicates tip sensor was overpressured millimeters to free it This will allow damaged gauge or over range and if you inject air or not you cannot see the waveform Everything was alright for several hours and then the against the dura during insertion Therefore the monitor is seeing a transducer that has a very high initial zero and finds this zero out of its range Although overpressured or wedged the sensor zero must have been just within the range the monitor to be zeroed If this does not help t
157. f monitoring a patient without pacemaker set PACE to Off If PACE is on the system will not perform some types of ARR analysis For detailed information please refer to the section ARR ALARM In the table the ARR type marked by All types applies to the analysis in all situations marked by Non paced applies only to the analysis in the situation when the patient does not use pacemaker CASCADE switch for ECG cascade CASCADE wave of each channel is displayed in two lines This function effects only when NORMAL DISPLAY is selected for ECG DISPLAY ECG CAL pick this item to start calibrating ECG The method to end CAL re select the CAL key in the menu or re select the lead name on the screen ADJUST WAVE POS used to adjust the position of the waveform on the screen Pick to access ADJUST WAVE POS dialog box The user may use CH NAME item to select the channel to be adjusted UP DOWN to adjust the position of the selected channel on the screen BACK TO DEFAULT to let the wave go back to the default position on the screen CH NAME CH1 UP DOUN BACK TO DEFAULT Select the wave channel to be adjusted EXIT Figure 12 10 ADJUST WAVE POS menu SETUP TRANSFER used to access the sub menu of ECG SETUP TRANSFER in which the user may set up following information 12 12 Patient Monitor user s manual V 2 2 ECG RESP Monitoring ECG SETUP TRANSFER RT TRANSFER OFF S SAVE SETUP INTO MODULE LOAD MODULE S
158. fety precautions of the monitor please refer to Patient Safety A Warning A PM 6200 is intended for clinical monitoring application with operation only granted to appropriate medical staff A Warning A Monitor can only monitoring one patient at a time A Warning A There could be hazard of electrical shock by opening the monitor casing All servicing and future upgrading to this equipment must be carried out by personnel trained and authorized by Mindray A Warning A Possible explosion hazard if used in the presence of flammable anesthetics or other flammable substance in combination with air oxygen enriched environments or nitrous oxide A Warning A You must verify if the device and accessories can function safely and normally before use A Warning A You must customize the alarm setups according to individual patient situation and make sure that alarm sound can be activated when alarm occurs A Warning A Do not use cellular phone in the vicinity of this device High level electromagnetic radiation emitted from such devices may greatly affect the monitor performance A Warning A Patient Monitor user s manual V 2 2 1 1 Introduction Do not touch the patient table or the device during defibrillation A Warning Ax Devices connected to the monitor shall form an equipotential system protectively earthed A Warning A When used with Electro surgery equipment you doctor or nurse must give top pri
159. flashes signal appears on the kK DEI screen indicating the occurrence of alarm Red indicates high level alarm yellow DEI indicates medium level alarm and yellow indicates low level alarm Technical alarm will not ow prompts signal Lamp light The high medium low level alarms are indicated by the system in following different visual ways Alarm level Visual prompt High Alarm indicator flashes in red with high frequency Medium Alarm indicator flashes in yellow with low frequency Low Alarm indicator lights on in yellow Alarm Sound The high medium low level alarms are indicated by the system in following different audio 5 2 Patient Monitor user s manual V 2 2 Alarm ways Alarm level Audio prompt High Mode is DO DO DO DO DO DO DO DO DO DO which is triggered once every 8 seconds Medium Mode is DO DO DO which is triggered once every 24 seconds Low Mode is DO which is triggered once every 24 seconds A Note A When alarms of different levels occur at the same time the monitor prompts the one of the highest level 5 1 3 Alarm Setup The setup of the alarms can be realized in the alarm menu Press the ALARM SETUP button on the button module to call up ALARM SETUP menu default menu as shown below In the ALM SEL item the user may set up the information about common alarm setup represented
160. gering event Nevertheless remember pushing SILENCE button can permanently shut off audible alarm sound of ECG LEAD OFF and SPO2 SENSOR OFF alarms PAUSE Press this button the system accesses the Alarm Pause status All the alarm sounds are muted However other sounds such as heart beat button sound and pulse sound will still exist At this time the ALARM PAUSE xx s appears in the parameter alarm information area Press this button again or when the pause time runs out the system terminates the alarm pause status and returns to the normal monitoring status then the alarm sound resumes and the prompt ALARM PAUSE xx s disappears from the screen AN Note A After the end of Alarm Pause status whether the alarm sound is restored depends on whether the alarm exists However the technical alarms such as lead off will not be restored That is to say the user may also close the technical alarms such as lead off through accessing and then exiting the Alarm Pause status ALARM SETUP Press this button to let the system rapidly access the sub menu of ALARM SETUP In this menu the user may set up all the information about the alarms MAIN Whatever level of menu the system is in press the button and the system will always return to the main screen FREEZE Press this button and the system will access the FREEZE status In this status the user may review the waveform of 40 seconds Also the frozen waveform can be printed out In
161. he above equations are combined and a noise reference N is determined N S 660 S 940 x R If there is no noise N 0 then S 660 S 940 x R which is the same relationship for the traditional pulse oximeter The equation for the noise reference is based on the value of R the value being seeked to determine the oC This instrument s software sweeps through possible values of R that correspond to SpO values between 1 and 100 and generates an N value for each of these R values The S 660 and S 940 signals are processed with each possible N noise reference through an adaptive correlation canceler ACC which yields an output power for each possible value of R i e each possible SpO2 from 1 to 100 The result is a Discrete Saturation Transform DST plot of relative output power versus possible SpO value as shown in the following figure where R corresponds to SpOz 97 13 2 Patient Monitor user s manual V 2 2 GpO Monitoring Discrete Saturation Transform _ DST Ei b S C O C Ss s5 DO 6 o 2 Zw r H MIN Ill cc oil Una iii 65 95 97 100 SpO The DST plot has two peaks the peak corresponding to the higher saturation is selected as the SpO gt 2 value This entire sequence is repeated once every two seconds on the most recent four seconds of raw data The SpOz value therefore corresponds to a running average of arterial hemoglobin saturation that i
162. he latest to the earliest Pick UP DOWN button and turn the knob to view later or earlier events Recording Pick REC to print our all data and waveform of this event 8 5 Power off data storage optional PM 6000 has the function to store the data after power off Once power off accident happens the PM 6000 can save the 72 hour trend data the latest 400 NIBP data the latest 60 alarm events and latest 60 Arr events That means even power off accident takes place these data can be safely saved And after the monitor is turned on next time the user can view all saved data via menus including Trend Graph Trend Table NIBP Recall Alarm Recall and Arr Recall etc A Note A If the user executes New Patient operation all measured data and trends will be cleared A Warning AN When monitoring a new patient the new measured data will be saved together with the measured data of the previous patient To save appropriate data please execute New Patient operation Patient Monitor user s manual V 2 2 8 7 Chapter 9 Drug Calculation and Titration Table PM 6000 Modular Patient Monitor provides Drug calculation and titration table display functions for fifteen drugs and outputs the content of titration table on the recorder 9 1 Drug Calculation The drug calculations that can be performed by the system are AMINOPHYLLINE DOBUTAMINE DOPAMINE EPINEPHRINE HEPARIN ISUPREL LIDOCAINE NIPRIDE NITROGLYCERIN and PITOCIN Be
163. he transducer has been strained and must come out and be returned for repair Sometimes raising the scale on the monitor will allow it to manage a transducer with a high zero offset Try raising the pressure scale to 90 120 or 300mmHg and then setting zero If this works the only thing that you will sacrifice is the waveform resolution Return the catheter for repair when the measurement is finished Try raising the pressure scale to 90 120 or 300mmHg and then setting 16 24 Patient Monitor user s manual V 2 2 IBP Monitoring damaged gauge of the monitor As conditions zero or over range changed the total pressure light came on zero amount ICP pushed the monitor beyond its capabilities The transducer The sensor face must be flat It is important that the transducer can be zeroed and planar against the dura If its face be placed against an intact we have good facing the inner table of the section of dura pressure waves skull for example then you will if reouired usea coniralateral burt but the ICP reads get pressure waves and be able GE constantly near to zero it but not obtain actual i zero mmHg ICP readings If indeed placed properly the brain may have moved away from the skull substantially enough so that there is poor contact between the skull transducer and the dura This may happen soon after the transducer is placed but may correct itself in
164. his key to make the module either access the standby status or start a measurement O Watertrap socket prior to monitoring a patient you should first of all safely plug the watertrap into this socket O0 EXHAUST OUTLET Exhaust Line to Scavenging System 0 A ATTENTION consult accompanying documents this operation manual When not using this AG module you may plug out it and preserve it in a clean and dry place so as to ensure its intended life cycle 19 2 2 Plug in out AG module This AG module has relatively big volume and heavy weight It occupies a space of three slots The method of plugging in out the AG module is different from that of plugging in out other modules The detailed procedures are ER O 40 Figure 19 3 Plug in out AG module Patient Monitor user s manual V 2 2 19 3 Anesthetic Gas Measurement H Unload AG module according to figure 1 2 and 3 Use one hand to hold the AG module and another hand to press down the press plates at the left and right sides of the bottom of the module And then press down the press plate on the middle bottom of the module After the module comes out use two hands to safely hold the module and put it out gently E Load AG module place the AG module into empty slots totally three slots push the module into slots in the way as shown in figure 4 You should push the module for consecutive two times The sound of Ka Ka indicates the completion of loadi
165. ia algorithm can monitor paced and non paced patients Qualified personnel can use arrhythmia analysis to evaluate patient s condition such as heart rate PVCs frequency rhythm and ectopic beat and decide the treatment Besides detecting changing of ECG arrhythmia algorithm can also monitor patients and give proper alarm for arrhythmia The arrhythmia monitoring is shutoff by default You can enable it when necessary This function can call up the doctor s attention to the patient s heart rate by measuring and classifying the arrhythmia and abnormal heart beat and triggering the alarm The monitor can conduct up to 13 different arrhythmia analyses The monitor can store the latest 60 alarm events when taking arrhythmia analysis to a peculiar buffer The operator can edit these arrhythmia events through the menu below Pick the item ARR ANALYSIS in ECG SETUP menu to access the ARR ANALYSIS sub menu ARR ANALYSIS Menu ARR ANAL OFF ALM HI 10 PUCs ALM OFF ARR RELEARN ALM LEY MED ARR ALARM gt gt ALM REC OFF ARR RECALL gt gt Perform Arr analysis only when the switch is On EXIT Figure 12 15 ARR ANALYSIS Menu ARR ANAL Pick ON during monitoring Default set is OFF PVCs ALM pick ON to enable prompt message and data record when alarm occurs pick OFF to disable the alarm function and there will be a beside PVCs ALM LEV selectable from HIGH MED LOW Level HIGH represents the most serious
166. ient into or out of the hospital This device can not be used at home The operating environment must satisfy following conditions Surrounding temperature 0 C 40 C Humidity 15 85 Altitude 500 4600 meters WH Conditions for transportation and storage Without specific description the transportation and storage of PM 6000 must satisfy following conditions Surrounding temperature 20 C 60 C Humidity 10 93 relative humidity Altitude 500 13100 meters Patient Monitor user s manual V 2 2 1 15 Chapter 2 Getting Started Open the package and check Connect the power cables Power on the monitor Connect patient sensors Check the recorder A Note A To ensure that the monitor works properly please read Chapter Patient safety and follow the steps before using the monitor 2 1 Open the Package and Check Open the package and take out the monitor and accessories carefully Keep the package for possible future transportation or storage Check the components according to the packing list mM Check for any mechanical damage WH Check all the cables modules and accessories If there is any problem contact the distributor immediately 2 2 Connect the Power Cables Connection procedure of the AC power line H Make sure the AC power supply complies with following specification 100 250 VAC 50 60 Hz m Apply the power line provided with the monitor Plug the power line to INPUT interface of the
167. iewed monitor is plugged out or closed its corresponding waveform will disappear and the waveform in the Waveform area will not be refreshed Instead this Waveform area will display empty At this time if you want to view other waveforms of this monitor you need to select again Patient Monitor user s manual V 2 2 Chapter 5 Alarm This chapter gives general information about the alarm and corresponding remedies Alarm setup and prompt messages are provided in respective parameter setup sections A warning A When the monitor is powered on the system may verify the audio and visual alarm function Upon turning on the monitor a Dang will be heard and at the same time the indicator will flash twice in yellow and red This is used to verify the audio and visual alarm function of the system Therefore the user should be carefully observe the status If the audio and visual alarm function is not normal it indicates that the monitor cannot be used to monitor a patient Please contact Mindray company or service center 5 1 Alarm Modes 5 1 1 Alarm Level Each alarm either technical or physiological has its own level For alarm of higher level when it occurs the system will give prompt in a more alert way Some alarm s level can be set by the user via software Others can not by changed once defined by the system Alarms in The monitor are divided into three levels that is high medium and low High level alarm indicate
168. ime to the next measurement O in the Figure 17 3 To ensure the accuracy of the measurement it is suggested that a reasonable interval should take place between two consecutive measurements The length of the interval can be set in the CO SETUP menu Time unit second The interval time counter Q in the Figure 17 3 is displayed on the screen The next measurement can not be performed until the time reduces to zero and a prompt message Ready for new measurement appears A Note A It is strongly recommended that the user must push the injector within four seconds after pressing the START button Patient Monitor user s manual V 2 2 17 5 CO Measuring AN Note A It is strongly recommended that you wait at least 1 minute or longer depending on the patient s clinical condition before starting the next measurement Continue to repeat this procedure until you have completed the measurements you want to perform You can perform a maximum of 6 measurements before editing If you perform additional measurements the oldest measurement each time will be deleted If any of the curves in the editing window is not selected for calculation excluded from the averaging calculations the place will be taken by the new measurement Editing the CO measurement Pick EDIT to access the WINDOW FOR C O EDIT window WINDOW FOR CU EDIT H v 2 49 w 2 49 ER EE 8 AVERAGE CC l min 2 49 HEMO
169. interval Average Time Constant 2 12 IBP Channel Label Measuring and alarm range ART PA CVP RAP LAP ICP P1 P2 Press Sensor Sensitivity Impedance Resolution Accuracy Actualization interval 2 13 CO Method Measuring range CO TB TI 2 0 50 C 0 1 C 0 1 C 0 C about 1 Sec lt 10 Sec 50 C exclusive of probe errors 2 ART PA CVP RAP LAP ICP P1 P2 0 300 mmHg 6 120 mmHg 10 40 mmHg 50 300 mmHg 5 uV V mmHg 300 3000 Ohm 1 mmHg 2 or 1mmHg use the greater about 1 Sec Thermodilution Technique 0 1 20 L min 23 43 C 0 27 C 6 Patient Monitor user s manual V 2 2 Product Specification Resolution CO 0 1 L min TB 0 01 C TI 0 1 C Accuracy CO 2 or 0 1L min TB 0 1 C TI 0 1 C Calculation CO Hemodynamic Calculation Alarm Range 23 43 C 2 14 CO Method Infra red Absorbation Technique Measuring mode Sidestream or Mainstream optional Side stream mode sampling gas flow rate Measuring range 100 150 200 ml min option COs 0 99 mmHg INS CO 0 99 mmHg AwRR 0 150 bpm Resolution CO 1 mmHg INS CO 1mmHg AwRR 1 rpm Accuracy COs 2 mmHg 0 40 mmHg 5 of reading 41 76 mmHg 10 of reading 77 99 mmHg AwRR 2 rom Actualization interval Start up Time about 1 Sec lt 30 sec typical in sidestream mode lt 80 seconds in
170. ipment Furthermore all configurations shall comply with the valid version of the system standard IEC 60601 1 1 Everybody who connects additional equipment to the signal input part or signal output part configures a medical system and is therefore responsible that the system complies with the requirements of the valid version of the system standard IEC 60601 1 1 If in doubt consult the technical service department or your local representative 1 5 Specifications 1 5 1 Products classification m Anti electroshock type Class equipment m EMC type Class A m Anti electroshock degree ECG RESP SpO2 NIBP IBP TEMP CO CO2 CF H Harmful liquid proof degree Ordinary equipment sealed equipment without liquid proof WR Working system Continuous running equipment 1 5 2 Specifications M Applicable patient type Adult pediatric and neonate m Parameters monitored by PM 6000 ECG RESP NIBP SpO PR pulse rate Dual TEMP 4 IBP CO TB blood temperature CO2 ANAESTHETIC GAS etc m Display 1 14 Patient Monitor user s manual V 2 2 Instruction 12 1 TFT WH Analog output 1 channel signal amplitude 1V mV amplitude error lt 5 output impedance 100ohm signal delay lt 20ms Mm Power supply Operate on AC power AC power 100 250VAC 50 60Hz Pmax 110VA 1 5 3 Environmental requirements RW Working environment PM 6000 can only be used in the hospital or by the trained physician during transporting the pat
171. ired you can select different operating screens for necessary information Let s probe into these four operating screens one by one Select Operating Screen In the SYSTEM MENU select the FACE SELECT option in the SYSTEM SETUP menu to call up the dialog box as shown in the figure below There are four options in this dialog which are STANDARD SCREEN TREND SCREEN oxyCRG SCREEN and VIEWBED SCREEN Only one item can be selected at one time FACE SELECT STANDARD SCREEN TREND SCREEN oxyCRG SCREEN VIEWBED SCREEN Conventional monitor screen EXIT Figure 4 1 FACE SELECT 4 2 Standard Screen In the FACE SELECT menu Select the STANDARD SCREEN option to enter the Standard Screen The Standard Screen displays to us the parameters in the Parameter area and the waveforms being monitored This screen is the basic operating screen of the monitor Patient Monitor user s manual V 2 2 4 1 Face Select BED No 1 ADU Ann Zhang shan M lt sep TOO HIGH oucnostic POCE OF Ne Lu Lul 100 53 NIBP mals m 4 L Lul 12070 98 Figure 4 2 STANDARD SCREEN 4 3 Trend Screen m Enter TREND SCREEN In the FACE SELECT menu select the TREND SCREEN option to enter the Trend Screen BED No 1 ADU Ann Zhang shan M 21 sep TOO HIGH DIAGNOSTIC Figure 4 3 TREND SCREEN H Position of trend graph 4 2 Patient Monitor user s manual V 2 2
172. ires Check the current situation of the BRADY Pateni Sugis SEN patient Check the connection of BRADY the electrodes and lead wires Check the current situation of the VT gt 2 Rallent SUNETE romani g patient Check the connection of VT gt 2 the electrodes and lead wires MISSED BEATS Patient suffers from Arr of MISSED BEATS Check the current situation of the patient Check the connection of the electrodes and lead wires Check the connection of the pacemaker PNP The pacemaker is not Check the connection of paced electrodes and lead wires Check the current situation of the patient Check the connection of the pacemaker PNC No pacemaker signal is Check the connection of captured electrodes and lead wires Check the current situation of the patient ECG LEAD OFF ECG lead is not connected correctly Check the connection of ECG lead wire ECG V LEAD OFF The V lead wire of ECG is not connected correctly Check the connection of V lead wire ECG LL LEAD OFF The LL lead wire of ECG is not connected correctly Check the connection of LL lead wire ECG LA LEAD OFF The LA lead wire of ECG is not connected correctly Check the connection of LA lead wire ECG RA LEAD OFF The RA lead wire of ECG is not connected correctly Check the connection of RA lead wire ECG C LEAD OFF The C lead wire of ECG is
173. is larger than 60 and O2 is not being monitored turn on this switch m SWEEP used to select the speed to scan the screen waveforms m WORK MODE to monitor the anesthetic gas select the MEASURE option Otherwise select the STANDBY option 19 6 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement E ALARM SETUP gt gt used to enter the ALARM SETUP submenu E CALIBRATE gt gt used to enter the CALIBRATE submenu E O2 calibrate gt gt used to enter the O2 CALIBRATE submenu m ADJUST WAVE AMP gt gt used to enter the ADJUST WAVE AMP submenu in which you may select the appropriate waveform amplitude for display E SETUP TRANSFER gt gt used to enter the AG SETUP TRANSFER submenu E DEFAULT gt gt used to enter the AG DEFAULT CONFIG submenu You can use the information in this submenu to initialize all menus 19 4 2 ALARM SETUP menu In the ALARM SETUP menu select the ALARM item to pop up the ALARM SETUP menu ALARM SETUP ALM ON vy EZ ALM HI 684 ALM LEV MED EZ ALM LO 76 ALM REC OFF Fi02 ALM HI 669 EtcO2 ALM HI 50 Fi02 ALM LO 76 EtcO2 ALM LO 15 AWRR ALM HI 30 FicO2 ALM HI 4 AURR ALN LO 8 gt FicO2 ALM LO o gt OTHER SETUP gt gt Back to the upper menu EES Figure 19 6 ALARM SETUP menu E ALM when this switch is ON if anesthetic gas has alarm the system will give alarm prompt and save the alarm information
174. it beats minute The ST analyzing result of channel 1 and 2 ST1 ST2 unit mV PVCs j unit times minute NIBP From left to right there are Systolic pressure Mean pressure and Diastolic pressure unit mmHg or kPa SpO gt 2 SpO unit Pulse Rate unit beats minute When BOTH item is selected CO CO unit liter minute TBQ unit C or F IBP The blood pressure of channel 1 2 3 and 4 From left to right there are Systolic pressure Mean pressure and Diastolic pressure unit mmHg or kPa RESP Respiration Rate unit times minute CO EtCO2 unit mmHg or kPa INS CO2 unit mmHg or kPa AwRR times minute TEMP Temperature of channel 1 and 2 T1 T2 and the difference between them TD unit C or F AG Patient Monitor user s manual V 2 2 1 9 Introduction AwRR times minute MAC Alarm lamp and alarm status In normal status the alarm lamp is not on When alarm exists the alarm lamp flashes or lights on The color of the lamp corresponds to the alarm level Refer to related chapter Alarm For the details of alarm information and prompt information refer to the related content of each parameter in relat
175. item will change into STOP PENUM which if picked the system will stop air leakage test A warning This pneumatic test other than being specified in the EN 1060 1 standard is to be used by the user to simply determine whether there are air leaks in the NIBP airway If at the end of the test the system gives the prompt that the NIBP airway has air leaks please contact the manufacturer for repair Procedure of the air leakage test 1 Connect the cuff securely with the socket for NIBP air hole 2 Wrap the cuff around the cylinder of an appropriate size 3 Access the NIBP SETUP menu 4 Turn the knob to the PNEUMATIC item and press the knob Then the prompt Pneum testing will appear on the bottom of the NIBP parameter area indicating that the system has started performing pneumatic test 5 Inflate the pneumatic system to about 180mmHg automatically 6 After 20 seconds or so the system will automatically open the deflating valve which marks the completion of a pneumatic measurement 7 no prompt appears on the bottom of the NIBP parameter area it indicates that the airway is in good situation and no air leaks exist However if the prompt PNEUMATIC LEAK appears in the place it indicates that the airway may have air leaks In this case the user should check for loose connection After confirming secure connections the Patient Monitor user s manual V 2 2 14 9 NIBP Monitoring user should re perform the pne
176. itor or re plug XX COMM STOP with the host XX COMM ERR XX cannot communicate normally with the host in out the module If the error still exists contact the manufacturer XX represents all the paramete r modules in the system such as ECG NIBP SpO2 IBP CO module etc XX ALM LMT ERR The alarm limit of XX parameter is modified by chance Contact the manufacturer for repair XX RANGE EXCEEDED The measured value of XX parameter has exceeded the measuring range of the system Contact the manufacturer for repair XX represents the parameter name in the system such as HR ST1 ST2 RR SpO2 IBP NIBP etc CO2 NO WATERTRAP CO2 watertrap connected correctly is not Check the connection of CO2 watertrap CO2 OCCLUDE WATERTRAP CO2 watertrap is clogged Replace the filter net or CO2 air hose Check if the water in the CO2 watertrap is too much CO2 SIGNAL LOW CO2 signals are poor CO2 SIGNAL TOO LOW CO2 signals are too poor Check for leaks in the airway Check if the airway is clogged Check if the watertrap is too old After excluding the above problems replace another CO2 air hose or watertrap If it still cannot work normally contact the manufacturer for repair CO2 BAROMETRIC TOO LARGE CO2 PNEUMATIC LEAK CO2 SIGNAL NOISY CO2 SIGNAL SATURATE CO2 CALCULATION ERR CO2 PUMP FAULT
177. kinds of CO2 measuring methods as per the requirements of users which are MainStream and SideStream This module can be applied in operation room monitor units etc it can measure the CO2 partial pressure or concentration of patient Air Way obtain EtCO2 Inspired Maximum CO2 InsCO2 Air Way Respiration Rate AwRR and display CO2 concentration waveforms The parameter symbols displayed on the screen are defined as following CO2 ECO INS InsCOs AWRR Air Way Respiration AwWRR Resp times MIN A Warning A Do not perform CO2 sidestream measurement in the presence of flammable anaesthetic agent Do not measure CO2 in the presence of foggy drug Use the specified gas sampling tube Mindray Company shall not be responsible for any damage caused by other than specified sampling tube The device can only be operated by personnel having taken professional training and familiar with this manual A Warning A CO2 module shall be avoided from crash and vibration Patient Monitor user s manual V 2 2 18 1 CO2 Measuring 18 2 CO2 Module i 8 A ze 0 Figure 18 1 CO2 module O Indicator the indicator that indicates the working status of the module When the module is working this indicator is on A Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it
178. king status of the module When the module is working this indicator is on A Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the IBP module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair Patient Monitor user s manual V 2 2 16 1 IBP Monitoring SETUP the button used to set up the related items of IBP Press SETUP button the IBP 1 2 SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel ZERO used to zero the IBP module CAL used to calibrate the IBP module Two sockets for IBP socket for IBP sensor Before monitoring the patient the user should first safely insert the IBP sensor cable into this socket A means BE CAREFUL Refer to the attached document this manual of the monitor A means that the IBP module is IEC 601 1 Type CF equipment AN Note A When not using the IBP module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the life cycle of the module will be unfavorably affected PM 6000 Modular Patient Monitor measures direct blood p
179. l pigmentation may cause erroneous readings A Warning A Do not use this instrument and the sensors during magnetic resonance imaging MRI scanning Induced current could potentially cause burns The monitor may affect the MRI image and the MRI unit may affect the accuracy of the oximetry measurements A Warning A Pulse oximetry can overestimate the SpO2 value in the presence of Hb CO Met Hb or dye dilution chemicals A Warning A Verify sensor cable fault detection before beginning of monitoring phase Unplug the SpO sensor cable from the socket the screen will display the error message SpO2 SENSOR OFF and the audible alarm is activated A Warning A Do not use the sterile supplied SpO sensors if the packaging or the sensor is 13 4 Patient Monitor user s manual V 2 2 GpO Monitoring damaged and return them to the vendor A Warning A Prolonged and continuous monitoring may increase jeopardy of unexpected change of dermal condition such as abnormal sensitivity rubescence vesicle repressive putrescence and so on It is especially important to check the sensor placement of neonate and patient of poor perfusion or immature dermogram by light collimation and proper attaching strictly according to changes of the skin Check per 2 3 hours the sensor placement and move it when the skin deteriorates More frequent examinations may be required for different patients A Note A Do not perform SpO measuring an
180. le thus decreases the power consumption and extends the life cycles of IR source and the whole CO2 module A Note A When not using CO2 monitoring function it is suggested not to connect MainStream sensor or SideStream water trap and to adjust to STANDBY mode COMPENSATE to perform different compensate operations as per the selection of the user The selections are GENERAL O2 N2O DESand ALL Work conditions for calculating compensate are shown in following table Here is the operation method First select the gas compensates to be used including general compensate O2 compensate Desf compensate and full compensates Then determine whether to make VA compensate and BTPS compensate Work Conditions for CO Calculation Compensate Calculation Compensate Method O2 Modification N2O Desflurane Modification Work Conditions General OFF OFF 02 ON OFF O2 lt 60 no N20 O2 gt 50 no N20 Desflurance OFF ON O2 lt 60 amp N20 Desflurane 12 Full ON ON O2 gt 60 amp N20 WATERVAPOR determine whether to make watervapor compensate Water vapor compensation accounts for the effect of water vapor on the CO2 IR Infra Red absorption characteristics It is used in both mainstream and sidestream measurement modes The user may disable this compensation under certain situations During normal sidestream operation CO2 measurements are adjusted mathematically to compensation for this
181. le plug may be used to do this This plug must be removed during normal use and ETO sterilization 1 Rinse and cold soak the catheter transducer in a solution of glutaraldehyde such as Cidex following the chemical manufacturer s instructions Note that disinfecting does not equal sterilisation and the strength of the glutaraldehyde must be confirmed by the chemical manufacturer s instructions 2 After sterilisation of the catheter and just before use rinse the device with pyrogen free sterile distilled water or saline solution as recommended by the manufacturer of the sterilising agent kl Care of the ICT B The metal sensor is very robust and can withstand severe shocks and vibrations It can be irreversibly damaged by contact with sharp objects or overpressure for instance by squeezing the tip between finger and thumb The silicone coating on the sensing area allows a small amount of water absorption During this process which may take an hour or more the baseline may drift a few mmHg The device should be allowed to stabilize in water or saline before use for a few hours Liquids entering the back of the sensor will cause damage to the sensor Cuts to the outer coating should be avoided and repaired immediately if any are found Return to manufactory or apply a temporary repair using a suitable silicone sealant to the damage The most common reason for failure of the ICT B pressure transducer is physical damage to the device s silic
182. levant room does not comply with NFPA 70 National Electric Code or NFPA 99 Standard for Health Care Facilities Outside the United States the relevant room must comply with all electrical installation regulations mandated by the local and regional bodies of government Patient Monitor user s manual V 2 2 II Return Policy Return Procedure In the event that it becomes necessary to return a unit to Mindray the following procedure should be followed 1 Obtain return authorization Contact the Mindray Service Department and obtain a Customer Service Authorization Mindray number The Mindray number must appear on the outside of the shipping container Return shipments will not be accepted if the Mindray number is not clearly visible Please provide the model number serial number and a brief description of the reason for return 2 Freight policy The customer is responsible for freight charges when equipment is shipped to Mindray for service this includes customs charges Company Contact Address Mindray Building Keji 12th Road South Hi tech Industrial Park Nanshan Shenzhen P R China 518057 Phone 86 755 2658 2888 Fax 86 755 2658 2680 Free hot line 86 800 830 3312 EC Representative Name Shanghai International Holding Corp GmbH Europe Address Eiffestrasse 80 D 20537 Hamburg Germany Phone 49 40 2513174 Fax 49 40 255726 IV Patient Monitor user s manual V 2 2 Preface This manual
183. level Patient Monitor user s manual V 2 2 14 1 NIBP Monitoring 14 2 NIBP Module O SETUP START STOP O i 0 Figure 14 1 NIBP module Indicator the indicator that indicates the working status of the module When the module is working this indicator is on A Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the NIBP module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair SETUP the button used to set up the related items of NIBP Press SETUP button the NIBP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel START STOP the button is used to start stop the NIBP measurement A socket for NIBP a socket for NIBP air hose Before monitoring the patient the user should first safely insert the NIBP air hose into this socket monitor A Note A When not using the NIBP module to monitor the patient the user may unload the module which however must be stored in a clean and dry environment otherwise the A means BE CAREFUL Refer to the attached document this manual of the means that the NIBP
184. level is HIGH E SWEEP to adjust the display rate of CO2 waveforms with 6 25 mm s 12 5 mm s or 25 0 mm s selectable m Exit to close CO2 SETUP menu A Note A APNEA ALM cannot be closed When various alarms occur simultaneously the alarm information of highest level will be displayed on the screen m OTHER SETUP pick this item in the menu to call up CO2 more setup sub menu WAVE SCALE LOW M WATERVAPOR ON SS WORK MODE STANDBY BTPS ON PUMP RATE 100ml min vy DEFAULT gt gt COMPENSATE GENERAL Select the displaying amplitude of the COZ wave EXIT Figure 18 5 CO2 More Setups Menu Now we introduce you to the functions of each item in CO2 SETUP submenu m WAVE SCALE to adjust full scale size of CO2 waveform display area with LOW or HIGH selectable The default value is LOW m PUMP RATE to adjust the pump rate of the air pump of CO2 module with 100ml min 18 6 Patient Monitor user s manual V 2 2 CO2 Measuring 150ml min or 200ml min selectable The default value is 100ml min This item only functions to SideStream WORK MODE to change the work mode of CO2 with MEASURE mode or STANDBY mode selectable The default is STANDBY mode When it is required to monitor CO2 select MEASURE mode STANDBY mode disables the air pump in SideStream module the sensor and the IR infrared ray source in MainStream modu
185. ll up the NIBP SETUP menu 6 Press the START STOP button on the NIBP module to start a measurement Operation Hints 1 To start auto measuring Access NIBP SETUP menu and pick the INTERVAL item in which the user may choose the selections other than MANUAL to set up the time interval for auto measurement After that press START STOP button on the NIBP module to start the auto measuring according to the selected time interval A Warning A Prolonged non invasive blood pressure measurements in Auto mode may be 14 4 Patient Monitor user s manual V 2 2 NIBP Monitoring associated with purport ischemia and neuropathy in the limb wearing the cuff When monitoring a patient examine the extremities of the limb frequently for normal color warmth and sensitivity If any abnormality is observed stop the blood pressure measurements 2 To stop auto measuring During auto measuring press START STOP button on the NIBP module at any time to stop auto measurement 3 To start a manual measuring H Access NIBP SETUP menu and pick the INTERVAL item Select the MANUAL selection Then press the START STOP button on the NIBP module to start a manual measurement m During the idle period of auto measuring process press the START STOP button on the NIBP module at any time to start a manual measurement Then press the START STOP button on the NIBP module to stop manual measurement and the system continues executes auto measuring program acc
186. log box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation 14 10 Patient Monitor user s manual V 2 2 NIBP Monitoring 14 5 NIBP Alarm Message Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during NIBP measurement Physiological alarms Message Cause Alarm Level NS TOO HIGH MIBE SYS measuring walle is above User selectable upper alarm limit NS TOO LOW NIBP SYS measuring value is below VE lower alarm limit N tt teg EE ER User selectable upper alarm limit NIBP DIA measuring value is below ND TOO LOW lowest alarm limit User selectable NNCTOOHIGN CUBR MAE Tmaasuring value Es User selectable upper alarm limit NM TOO LOW NIBP MAP measuring value is below User selectable lower alarm limit Technical alarms 1 display in information area Alarm Message Cause Level Remedy Functional safety Stop using alarming functions of
187. ly free from vibration dust corrosive or explosive gases extremes of temperature humidity and so on For a cabinet mounted installation allow sufficient room at the front for operation and sufficient room at the rear for servicing with the cabinet access door open The PM 6000 Modular Patient Monitor operates within specifications at ambient temperatures between 0 C and 40 C approximately 15 minutes after switch on Ambient temperatures that exceed these limits could affect the accuracy of the instrument and cause damage to the modules and circuits Allow at least 2 inches 5cms clearance around the instrument for proper air circulation Power Source Requirements Refer to Appendix I Production Specification Grounding the PM 6000 Modular Patient Monitor To protect the patient and hospital personnel the cabinet of the PM 6000 Modular Patient Monitor must be grounded Accordingly the PM 6000 Modular Patient Monitor is equipped with a detachable 3 wire cable which grounds the instrument to the power line ground protective earth when plugged into an appropriate 3 wire receptacle If a 3 wire receptacle is not available consult the hospital electrician If completeness of the protective grounding wire Patient Monitor user s manual V 2 2 10 1 Patient Safety is in doubt the equipment must be operated with internal power supply A Warning A Do not use a 3 wire to 2 wire adapter with this instrument Connect the grounding
188. ly important to check the sensor placement of neonate and patient of poor perfusion or immature dermogram by light collimation and proper attaching strictly according to changes of the skin Check per 2 3 hours the Patient Monitor user s manual V 2 2 13 17 SpO2 Monitoring sensor placement and move it when the skin deteriorates More frequent examinations may be required for different patients 13 2 3 Monitoring Procedure H Adult SpO plethysmogram measurement 4 Switch on the monitor 5 Attach the sensor to the appropriate site of the patient finger 6 Plug the connector of the sensor extension cable into the SpO socket on the SpO2 module Figure 13 3 mounting of the adult sensor H Neonate SpOz plethysmogram measurement The process of neonate SpO plethysmogram measurement is the same as for adult The neonate SpO gt z sensor and install method will be introduced 1 Neonate SpO sensor Neonate SpO2 sensor consists of Y form SpO2 sensor and its sheath Insert the LED and PD ends of the Y form SpO2 sensor respectively into the upper and lower grooves on the sheath figure 13 3 Figure 13 4 shows us the neonate SpO2 sensor after insertion Y form SpO2 sensor SEB Figure 13 4 Neonate SpO2 sensor 1 13 18 Patient Monitor user s manual V 2 2 GpO Monitoring Figure 13 5 neonate SpO2 sensor 2 2 Mounting of the neonate SpO2 sensor Wind the SpO2 sensor around a hand or foot Hold the sensor pull
189. m limit User selectable EtISO HIGH The measured EtlSO value exceeds the setup upper alarm limit User selectable EtISO LOW The measured EtISO value is below the setup lower alarm limit User selectable FISEV HIGH The measured FiSEV value exceeds the setup upper alarm limit User selectable FISEV LOW The measured FiSEV value is below the setup lower alarm limit User selectable EtSEV HIGH The measured EISEN value exceeds the setup upper alarm limit User selectable Patient Monitor user s manual V 2 2 19 13 Anesthetic Gas Measurement EtSEV LOW The measured EtSEV value is below the setup lower alarm limit User selectable FIENF HIGH The measured FiENF value exceeds the setup upper alarm limit User selectable FIENF LOW The measured FiENF value is below the setup lower alarm limit User selectable EtENF HIGH The measured EtENF value exceeds the setup upper alarm limit User selectable EtENF LOW AwRR HIGH The measured EtENF value is below the setup lower alarm limit The measured AwRR value exceeds the setup upper alarm limit User selectable User selectable AwRR LOW The measured AwRR value is below the setup lower alarm limit User selectable GAS APNEA ALM Respiration cannot be detected during specified time interval HIGH Technical alarms
190. m will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user m DEFAULT pick this item to access the CO2 DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation EtCO2 upper alarm limit when parameter value exceeds this limit there will be alarm for exceeding the upper limit 18 8 Patient Monitor user s manual V 2 2 CO2 Measuring Default Adult 50 mmHg Pediatric 50 mmHg Neonatal 45 mmHg EtCO2 lower alarm limit when parameter value is smaller than the lower limit there will be alarm for exceeding lower limit Default Adult 15 mmHg Pediatric 20 mmHg Neonatal 30 mmHg InsCO2 upper alarm limit when parameter value exceeds this limit there will be alarm for exceeding upper limit Default Adult 4 mmHg Pediatric 4 mmHg Neonatal 4 mmHg AwRR upper alarm limit when parameter value exceeds this limit there will be alarm for exceeding upper limit Default Adult 30 rpm Pediatric 30 rpm Neonatal 100 rpm AwRR lower alarm limit when parameter value is smaller than the limit there will be alarm for exceeding lower limit Default Adult 8 rpm Pediatric 8 rpm Neonatal 30 rpm APNEA Time Selections are 10S to
191. module 3 module 4 module m GC a H _ IN wes 35 CO Kee SET MEASURE Ke gt Ke o e 5 TuP ZER CAL 8P Bez A Ka 5 module 9 module 7 module 6 module Figure 1 2 module Patient Monitor user s manual V 2 2 Introduction These modules are independent from each other hence easy for the expansion of the new parameter module A Note A The manufacturer will not inform each customer of the appearance of the new module Method to load unload the module 3 Step 3 unload the module 4 load the module Figure 1 3 methods to load unload the module m Unload the module as per the Figure 1 3 1 3 first use one hand to hold the module to be unloaded then use the other hand to press down the plate under the module and finally take out the module carefully E Load the module Align the module to be loaded with the empty slot and then push the module into the slot as per the method shown in the Figure 1 3 4 When the sound click is heard it indicates the module has been successfully loaded A Note A You can load unload a module when the monitor is operating After loading unloading a module the system will refresh the screen and display parameters and waveforms according to the module newly loaded For a module that has been unloaded its measured data will be still stored in the system You can view these data by using Trend Graph Trend Table and NIBP Recall menus A W
192. molecules in the red blood cells of the arterial blood combine with oxygen then the blood has a SpOz oxygen saturation of 97 The Go numeric on the monitor will read 97 he Go numeric shows the percentage of hemoglobin molecules which have combined with oxygen molecules to form oxyhemoglobin The SpO PLETH parameter can also provide a pulse rate signal and a plethysmogram wave 13 2 1 SpO2 Module Figure 13 2 SPO2 module Indicator the indicator that indicates the working status of the module When the module is working this indicator is on A Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the SpO2 module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair SETUP the button used to set up the related items of SpO2 Press SETUP button the Patient Monitor user s manual V 2 2 13 15 SpO2 Monitoring SPO2 SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel Blank Button A socket for SpO2 sensor Before monitoring the patient the user should first safely insert the watertrap into this socket AN means BE CAREFUL Refer to the attach
193. mperature alarm will not function during CO measurement It will resume automatically when the measurement is over 17 3 2 CO Measuring A Warning A Make sure that appurtenance applied is in conformity with relevant Medical Device Safety Requirements A Warning A Appurtenance should be avoided from contact with conductive metal body when being connected or applied CO Measurement Window Press the MEASURE button on the CO module to access WINDOWS FOR CO MEASUREMENT window If CO transducer is not connected the monitor will prompt No Sensor unable to measure CO in the window WINDOW FOR CO MEASUREMENT 2 0 C COCl min H o 2 49 Cl Lonincg 21 0 3 3 BSA m 2 0 0 743 TB C 37 0 TICC 2 0 E EI EI Feady for new measurement T EE E R START STOP CANCEL REC 00 00 Scale X Scale Y EDIT gt gt L Back to the upper menu a d Figure 17 3 Contents in CO Measurement Window H Contents displayed in the CO Window Measurement curve Prompt message Start time of the measurement CO Cardiac Output Cl Cardiac Index BSA Body Surface Area E ET EI ET Ea E 17 4 Patient Monitor user s manual V 2 2 CO Measuring TB Blood Temperature Tl Injectate Temperature If necessary change can be performed in the SETUP menu Function keys START Start a measurement STOP If the blood temperature cannot resume in a considerably long time the measurement
194. n health care institution To reduce the risk of electrical shock do not open any casing of the equipment Service can be performed only by qualified personnel This equipment may interfere with the ultrasound imaging system If there is interference interference signals may appear on the screen of the ultrasound imaging system To eliminate the interference the distance between this equipment and the ultrasound imaging system should be as far as possible It is dangerous to subject the electric contact and the connector to normal saline other liquid or conductive adhesive The electric contact and the connector such as cable connector power and parameter module plug in connector and frame connector must be kept clean and dry Once being wetted they must be thoroughly dried before use If to decontaminate the electric contact or the connector please contact biomedical department or Mindray company Ay Warning A This monitor is not a device for treatment purpose It is important for the hospital or organization that employs this equipment to carry out a reasonable maintenance schedule Neglect of this may result in machine breakdown or injury of human health Patient Monitor user s manual V 2 2 Warranty Workmanship amp Materials Mindray guarantees new equipment other than accessories to be free from defects in workmanship and materials for a period of 18 months six months for multi site probes and SpO2 sensor f
195. n FiAA upper alarm limit the FiAA HIGH message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is below the upper alarm limit E FiAA ALM LO used to adjust the lower alarm limit of FAA When the measured value is smaller than FiAA lower alarm limit the FiAA LOW message is displayed on the screen In the UNLATCH mode this message disappears when the measured value is above the lower alarm limit m APNEA ALM used to set up the apnea alarm time A Note A Never turn off APNEA alarm When various alarms happen together the screen only displays the alarm message of the highest alarm level 19 4 3 ADJUST WAVE AMP menu In the AG SETUP menu select the ADJUST WAVE AMP gt gt item to pop up the ADJUST WAVE AMP menu as shown in the figure below ADJUST WAVE AMP C02 WAVE AMP 2 v N20 WAVE AMP 2 v 02 WAVE AMP 2 AA WAVE AMP 2 Back to the upper menu Figure 19 8 ADJUST WAVE AMP menu m CO2 WAVE AMP used to adjust the display amplitude of CO2 waveform m N20 WAVE AMP used to adjust the display amplitude of N2O waveform m O2 WAVE AMP used to adjust the display amplitude of O2 waveform m AA WAVE AMP used to adjust the display amplitude of anesthetic waveform E EXIT used to exit this menu 19 10 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement 19 4 4 SETUP TRANSFER menu In the AG SETUP menu select the TSETU
196. n change with the rotation of the knob 20 Menu or measuring window may appear on the screen or the original menu is replaced by the new menu 30 A check mark Vv appears at the position indicating that the item is confirmed AT The system immediately executes a certain function Module buttons ECG module SETUP setup button of ECG RESP TEMP blank button SPO2 module SETUP SPO2setup button blank button NIBP module SETUP NIBP setup button START STOP button to start stop measurement IBPQ 1 2 module SETUP IBP setup button ZERO IBP zero button CAL IBP calibrate button CO module SETUP CO setup button MEASURE button used to access the CO MEASURMENT window 1 12 Patient Monitor user s manual V 2 2 Instruction CO2 module SETUP CO2 setup button STANDBY START Standby Measure button Recorder module REC STOP button to start stop recording IBPO 3 40 module SETUP IBP setup button ZERO IBP zero button CAL IBP calibrate button A Note A When using the color LCD provided by Mindray the system buttons and alarm function are integrated on the screen The user may operate the buttons on the display directly to realize the functions of the monitor When using the ordinary purchased displ
197. n the knob to pick EXIT to return to DRUG CALC menu Total amount dose volume flow rate drop rate and patient weight and drug name are displayed on the top of the titration table Meaning of each English identifier is AMOUNT drug amount VOLUMEQ liquid volume DOSE min drug dose FLOW RATE flow rate DROP RATE drop rate WEIGHT patient weight 9 4 Patient Monitor user s manual V 2 2 Chapter 10 Patient Safety The PM 6000 Modular Patient Monitor is designed to comply with the International National Safety requirements for medical electrical equipment This device has floating inputs and is protected against the effects of defibrillation and electrosurgery If the correct electrodes are used and applied in accordance with the manufacturer instructions the screen display will recover within 10 seconds after defibrillation Y This symbol indicates that the instrument is IEC60601 1 Type CF equipment The unit displaying this symbol contains an F Type isolated floating patient applied part providing a high degree of protection against shock and is suitable for use during defibrillation A Warning A Do not touch the patient bed or instrument during defibrillation Environment Follow the instructions below to ensure a completely safe electrical installation The environment where the PM 6000 Modular Patient Monitor will be used should be reasonab
198. nation can be corrected by covering the sensor with a dark or opaque material excessive patient movement venous pulsations placement of a sensor on an extremity with a blood pressure cuff arterial catheter or intravascular line the monitor can be used during defibrillation but the readings may be inaccurate for a short time Loss of pulse signal can occur in any of the following situation the sensor is too tight there is excessive illumination from light sources such as a surgical lamp a bilirubin lamp or sunlight a blood pressure cuff is inflated on the same extremity as the one with a SpO2 sensor attached the patient has hypotension severe vasoconstriction severe anemia or hypothermia there is arterial occlusion proximal to the sensor the patient is in cardiac arrest or is in shock SpO gt 2 plethysmogram measurement MASIMO SET ONLY 1 Switch on the monitor 2 Attach the sensor to the appropriate site of the patient finger 3 Plug the connector of the sensor extension cable into the SpO2 socket on the PM 9000 Patient Monitor user s manual V 2 2 13 7 SpO2 Monitoring Figure 13 2 mounting of the sensor SpO2 SETUP Menu Pick the SpO2 hot key on the screen to call up the SoO2 SETUP menu as shown below MASIMO SPO2 SETUP ALM ON gt PR ALM LO 59 s ALM LEV MED SWEEP 25 0 ALM REC OFF PR SOUND MED SPOZ ALM HI 100 AVG TIME 8S z 4 SP02 ALM LO 90 SENSITIVITY MODE NORMAL PR ALM HI
199. nce making a wrong selection you can push the knob on the event again to give up the selection Select EXIT to exit the menu and consequently the selection will come into effect Event function has following significance To classify the records into different categories such as those having influence on patients 3 10 Patient Monitor user s manual V 2 2 System Menu and those having influence on parameter monitoring including dose taking injection therapy status Event will be displayed on the trend graph table in order to assist the analysis on the patient parameters when the event happens 3 5 Selection Setup Select the SELECTION item in the SYSTEM SETUP to call up the following menu SELECTION KEY VOL MED x HELP ON S SCAN TYPE REFRESH 4 ALM LIMIT OFF NIGHT OFF e BRIGHTNESS 5 volume EXIT Figure 3 15 Selection Setup Key Volume Select the KEY VOL item in the SELECTION menu Turn the knob to select the volume There are four selections available which are OFF LOW MED HIGH Help Function The system provides On line Help to menu operations You can choose any help information as per your need The method is Select the SELECTION item in the SYSTEM MENU to access the SELECTION sub menu in which you can highlight the HELP item and turn the knob to select ON or OFF When it is ON you can browse the on line help information When it is OFF
200. nd REC By using hot keys for trend time you may select to display trend graphs of three different lengths i e 1 min 2 min and 4 min H Select RR trend or Compressed Resp Waveform By using the hot keys for RR RESP WAVE you may select either RR trend graph or compressed Resp Wave They occupy the same position Therefore if select RR the position displays the dynamic trend of RR If select RESP WAVE the position displays the compressed Resp Wave H Record Select the REC hot key in the OxyCRG Screen you may use the recorder to output the three waveforms in the oxyCRG at the same time H Close OxyCRG In the FACE SELECT menu select options of other operating screens to close the OxyCRG Screen 4 5 Viewbed Screen If another monitor is connected on the same LAN of this monitor you can use this monitor to view any measured waveform and information about all measured parameters from another monitor m Enter Viewbed Screen Select the VIEWBED SCREEN option in the FACE SELECT menu Viewbed Screen window occupies the space of the bottom four waveforms 4 4 Patient Monitor user s manual V 2 2 Face Select BED No 1 ADU G 2p ang shan M WIEWBED NIBP mmHg 1 wo macuostic Figure 4 5 VIEWBED SCREEN H Hot key of Viewbed There are two hot keys in the Viewbed Screen Select Bed Number and Select Waveform The hot key of Select Bed Number displays the bed numbers and patie
201. nfectious disease using these chemical agents Please contact infectious disease experts in your hospital for details 11 2 Patient Monitor user s manual V 2 2 Care Cleaning 11 4 Sterilization To avoid extended damage to the equipment sterilization is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Sterilization facilities should be cleaned first Recommended sterilization material Ethylate and Acetaldehyde Appropriate sterilization materials for ECG lead blood pressure cuff are introduced in Chapter ECG RESP Monitoring Chapter NIBP Monitoring respectively AN Caution A E Follow the manufacturer s instruction to dilute the solution or adopt the lowest possible density Do not let liquid enter the monitor No part of this monitor can be subjected to immersion in liquid Do not pour liquid onto the monitor during sterilization Use a moistened cloth to wipe up any agent remained on the monitor 11 5 Disinfection To avoid extended damage to the equipment disinfection is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Disinfection facilities should be cleaned first Appropriate disinfection materials for ECG lead SpO2 sensor blood pressure cuff TEMP probe IBP sensor and CO cable are introduced in Chapters 12 17 respectively A Caution A Do not use EtO gas or formaldehyde to disinfect the monitor Patient Monitor user s man
202. ng of NIBP trend of this hour m Pick EXIT to return to trend graph display 8 2 Patient Monitor user s manual V 2 2 8 2 Trend Table Trend and Event The latest 72 trend table data can be displayed at every 1 5 10 30 or 60 minutes Pick TREND TABLE in the SYSTEM MENU to call up the following menu TREND TABLE HR RR PUC gt TINE EVENT BPM RPM Gmin 01 15 48 53 20 01 15 47 6 20 01 15 46 6 mm 01 15 45 6 20 01 15 44 6 20 01 15 43 6 2 01 15 42 01 15 41 01 15 40 01 15 39 01 15 38 01 15 37 RESOLUTION UP DOWN L RIGHT REC Select the time interval used to view the trend data of the parameter Figure 8 2 EXIT TREND_TABLE Menu Time in response to each group of trend data is displayed at the leftmost list with date in bracket Marked event corresponds to marking time Trend data of each parameter is divided into 9 groups HR RR PVC ST1 ST2 TEMP1 TEMP2 TEMPD SPO2 PR NIBP NS ND NM IBP1 S D M IBP2 S D M IBP3 S D M IBP4 S D M CO2 INS AWRR TB NIBP trend data presents different specificity A certain NIBP measuring time is displayed below the TEST AT item as well as the measurement value For more than one measurement in one time it can display only one group and mark a on the MORE to indicate two and above measurement results To choose trend table
203. ng the AG module A Note A When loading AG module if CO2 module works normally the system will automatically unload CO2 module When loading CO2 module if AG module works normally the system will automatically unload AG module AG module and CO module cannot work at the same time 19 3 Measuring principle and operating process Principle for measuring anesthetic gas Anesthetic gas can absorb infrared ray By using this principle we can measure the concentration of anesthetic gas Gases that can be measured using AG module are all able to absorb infrared ray Besides each gas has it own absorption characteristic First the gas to be measured is driven into a sample cell Then optic infrared filter selects the infrared ray with special wavelength to penetrate this gas For a given volume the higher the gas concentration is the more infrared rays are absorbed This means that the higher the concentration of the absorbed infrared is the fewer infrared rays there are to have penetrated the gas We may first measure the quantity of the infrared rays that have penetrated the gas and then calculate the gas concentration via specialized formula If you desire to measure multiple gases you should install various infrared filters in the AG module 19 4 Patient Monitor user s manual V 2 2 Anesthetic Gas Measurement Principle for measuring oxygen Within the range of wavelengths mentioned above oxygen does not absorb infr
204. nitor user s manual V 2 2 13 19 SpO2 Monitoring peripheral circulation and the skin every 2 hours If any unfavorable changes take place you should change the measured position in time In the process of extended and continuous monitoring you should periodically check the position of the sensor In case that the position of the sensor moves during monitoring the measurement accuracy may be affected 13 2 4 Limitations for Measurement Measurement Limitations In operation the accuracy of oximetry readings can be affected by High frequency electrical noise including noise created by the host system or noise from external sources such as electrosurgical apparatus which is admitted by the host system Do not use oximeters and oximetry sensors during magnetic resonance imaging MRI scanning Induced current could potentially cause burns Intravascular dye injections Excessive patient movement Improper sensor application Sensor temperature maintain between 28 C and 42 C for best operation Placement of the sensor on an extremity that has a blood pressure cuff arterial catheter or intravascular line Significant concentrations of dysfunctional hemoglobin such as carboxyhemoglobin and methemoglobin External illumination more than 5 000 lumens square meter typical office lighting Venous pulsations Itis recommended to use SpO sensors described in chapter Accessories and Ordering Information Sho
205. nitoring system PM 6000 Modular Patient Monitor is year 2000 compliant The Patient Monitor Figure 1 1 can monitor vital physiological signals as ECG Respiratory Rate SpO2 NIBP Dual TEMP fourfold IBP CO CO2 and AG Heart Rate HR ECG 2 channel ECG waveforms Arrhythmia and S T segment analysis optional Pace Respiratory Rate RR Ree Respiration Waveform SpO2 Oxygen Saturation SpO2 Pulse Rate PR SpO2 Plethysmogram NIBP Systolic Pressure NS Diastolic Pressure ND Mean Pressure NM TEMP Channel 1 Temperature T1 Channel 2 Temperature T2 Temperature Difference between two channels TD Channel 1 SYS DIA MAP Channel 2 SYS DIA MAP IBP Channel 3 SYS DIA MAP Channel 4 SYS DIA MAP fourfold IBP waveforms Blood Temperature TB ed Cardiac Output CO End Tidal CO2 EtCO2 cCoO2 Inspired Minimum CO2 InsCO2 Air Way Respiration Rate AwRR AG Inhale and exhale CO2 FiCO2 EtCO2 Patient Monitor user s manual V 2 2 1 3 Introduction Inhale and exhale N2O FiN2O EtN20 Inhale and Exhale O2 FiO2 EtO2 Inhale and exhale anesthetic agent FIAA ETAA Note AA refers to one of anesthetic agents listed below HAL Halothance ISO Isoflurance ENF Enflurance SEV Sevoflurance DES Desflurance Airway Respiration Rate respiratory times per minute unit rpm AwRR MAC
206. nnnnnnnnnnnn annunin nunnan ennen 3 1 3 1 Patient Information Getup 3 1 3 2 Detault Set Ps EE 3 3 CPER PLEATA AA EA EE AE E E E E ETN 3 4 3 4 System Setup EE 3 4 E en SOLU EE 3 11 8 6 Monitor NVerSiOM eroaren testes Wee Janae cea ean tesa ce te eara da eee 3 12 3 DrugiGalCulation E 3 13 SCHO lee 3 13 29 DEMO FUnGIOM eeror E Seen she boudad da ecadia cas ETO 3 16 Chapter d Face Seleta e EE EENEG 4 1 4 1 Select Operating Screen ENEE 4 1 4 2 Standard Screen TTT 4 1 4 3 Trend Green 4 2 Wee EE TEE 4 3 45 Viewbed SChee ET 4 4 Ch pt t e El EE 5 1 ed AlArM le te 5 1 5 2 Alarm verification during power on 5 4 5 3 Alarm Cause cic ege ee eege D eg ed E ee 5 4 5 4 SILENCE and PAUSE anere ena Wanna Daa 5 5 D D Parameter E EE 5 6 5 6 When an Alan ee 5 6 Chapter6 FreeZes iicccctciec ccc encedeticecg ae r aa chess EE 6 1 DT GON CPA as eet A E EN EEN NEEN ee 6 1 6 2 Enter Exit Freeze Gtaius ccccccccccsccecessecceeecseeceeescneeeeeesseeeeesseeeeeeesensaeesssnsaeesseeeaees 6 1 6 3 Frozen Men sechettececesesee deed adaa enee eegen 6 2 Patient Monitor user s manual V 2 2 1 Content 6 4 Reviewing Frozen Waveform cccceceeeceeceeeeeeeeeeeeeeeceaeeecaaeeesaaeeeeneeseaeeeseaeeneneeeeaees 6 3 6 5 Recording Frozen Waveiomm 6 3 Chapter 7 Recording ME 7 1 7 1 General Information on Recording e sesseessesseeesiesiesrissrissristrintsrrnsrinsrnesrnnsnesnnte 7 1 Te ROCOPGING D 7 1 TS Recording Sta
207. not connected correctly Check the connection of C lead wire ECG F LEAD OFF The F lead wire of ECG is not connected correctly Check the connection of F lead wire ECG L LEAD OFF The L lead wire of ECG is not connected correctly Check the connection of L lead wire ECG R LEAD OFF The R lead wire of ECG is not connected correctly Check the connection of R lead wire SPO2 SENSOR OFF SPO2 INIT ERR SPO2 INIT ERR 1 SPO2 INIT ERR 2 SPO2 INIT ERR 3 SpO2 sensor may be disconnected from the patient or the monitor SpO module failure Make sure that the monitor and the patient are in correct connection with the cables Stop using the measuring function of SpO2 module notify biomedical engineer or Mindray service staff Patient Monitor user s manual V 2 2 System Alarm Prompt SPO2 INIT ERR 4 SPO2 INIT ERR 5 SPO2 INIT ERR 6 SPO2 INIT ERR 7 SPO2 INIT ERR 8 SPO2 COMM STOP SpO2 module failure or communication error Stop using the measuring function of SpO2 module notify biomedical engineer or Mindray service staff SPO2 COMM ERR SpO2 module failure or communication error Stop using the measuring function of SpO 2 module notify biomedical engineer or Mindray service staff SPO2 ALM LMT ERR Functional safety failure Stop using the measuring function of SpO module notify biomedical engineer or Mindr
208. not suitable Check if the watertrap type is correct Check the connection of each part or replace with a new watertrap If the failure still exists contact the manufacturer for repair AG INIT FAIL AG module has failure Check the connection of each part and the patient situation Measure AG COMM STOP AG module failure or again if the failure still exists communication failure contact the manufacturer for repair The actual PUMP rate of Refer to the chapter of the AG module _ is Maintenance and Cleaning of the AGOCCLUSION lt 20ml min which Anesthetic Gas RE in exceeds 1 second this operation manual AG module has AG COMM ERROR communication failure AG HARDWARE ERROR AG module has hardware failure AG DATA LIMIT ERROR AG module failure AG USA ERROR AG module failure AG ZREF FAIL AG module fails to zero AG CAL FAIL AG module fails to calibrate FiCO2 ALM LMT ERR Functional safety failure EtCO2 ALM LMT ERR Functional safety failure FiO2 ALM LMT ERR Functional safety failure EtO2 ALM LMT ERR Functional safety failure FIN2O ALM LMT ERR Functional safety failure EtN2O ALM LMT ERR Functional safety failure FiAA ALM LMT ERR Functional safety failure EtAA ALM LMT ERR Functional safety failure AwRR ALM LMT ERR Functional safety failure Check the connection of each part and the patient situati
209. nt names of other monitors currently connected on the LAN You can select a monitor to be monitored according to the patient name and bed number If at this time no other monitors are connected on the same LAN of this monitor the hot key of Bed Number will therefore display N A After you use this hot key to select a monitor to be viewed the system will toggle to the display of the selected monitor for your view The selected waveform is one of those listed in the hot key of Select Waveform The hot key of Select Waveform is used to select a waveform generated by the monitor being viewed If the hot key of Select Waveform displays N A it indicates that the bedside monitor being viewed has no waveforms You can use this hot key to select and therefore view different waveforms of the monitor being viewed E Alarm indicator of Viewbed On the upper right side of the Viewbed Screen there is an Alarm Indicator used to tell the alarm status of the monitor being viewed The activity of this alarm indicator is identical with that of the alarm lamp on the panel of the monitor being viewed That is to say if the monitor being viewed occurs medium low level alarm this alarm indicator illuminates yellow if it occurs high level alarm this alarm indicator illuminates red If the monitor being viewed has no alarm or the alarm is screened the icon for this alarm indicator will not be displayed E Parameter area of Viewbed Screen Under the hot
210. ntentionally contaminated product AY Note A There are only two chemical sterilization techniques recognized by the U S Department of Agriculture as effective and truly sporicidal gas sterilization by ethylene oxide and liquid sterilization by a glutaraldehyde J Ethylene oxide ETO Procedure Unplug the female luer on the proximal connector before the ETO sterilization cycle Failure to do this will result in damage to the ICT B and render it unusable The luer must be open to allow free passage of ETO gas both internally and externally E Package the ICT B in a coil in disposable ETO packaging Include an approved 16 22 Patient Monitor user s manual V 2 2 IBP Monitoring sterilization indicator E Sterilize Normal Cycle in an accepted commercially available hospital sterilizer Follow the manufacturer s instructions for the sterilizer Use the following as a guide only In an actual hospital sterilization facility the following parameters were found to provide acceptable sterilization via ETO Sterilizer make and model AMSCO Eagle 2000 Prevacuum 15 minutes 24 inches Hg Relative humidity 40 Temperature 140 F ETO mix 12 88 Gas pressure 8 psi Exposure time 1 hour 45 minutes Post Vacuum 15 minutes 24 inches Hg Aeration Cycle 12 hours Calculated ETO Concentration 600 mg l e Liquid Sterilization Procedure Prevent liquids from entering the female luer on the electrical connector A ma
211. nter password and then customize maintenance settings You cannot execute factory maintenance function which is only available for the service engineers of MINDRAY company ENTER MAINTAIN PASSWORD USER KEY FACTORY KEY CONF IRM CONF IRM STATUS gt gt ABCDEFGHIJKLMNOPQRSTU VUXYZ01234567869 DEL OK EXIT Figure 3 18 Enter Maintain Password Patient Monitor user s manual V 2 2 3 13 System Menu Input the password into the ENTER MAINTAIN PASSWORD box and press CONFIRM the USER MAINTAIN menu will pop up in which you can set up following items USER MAINTAIN LANGUAGE LEAD NANING AHA zs ALM SOUND ON Z NET TYPE HYPER TIT 7 LOCAL NET NO 1 SYSTEM KEY SETUP gt gt COLOR SELF DEFINE gt gt Select device language EXIT Figure 3 19 User Maintain For the LANGUAGE language you can set the screen language to Chinese or English For the LEAD NAMING item you can select AHA or EURO To know the difference between these two styles refer to Chapter ECG RESP Monitoring For the ALM SOUND item you can set the alarm volume to ON or OFF For the NET TYPE item two selections are available HYPER III and CMS For the LOCAL NET NO item it refers to the net No SYSTEM KEY SETUP press this item to access SYSTEM KEY SETUP submenu in which the user may define the functions of the six extension keys F1 F6 on the external keyboard The user can define that
212. ntly adjusted to another name O Waveform gain of channel 1 used to adjust the size of ECG waveforms Select gain value for each channel from x 0 25 x 0 5 x 1 x 2 and auto Under auto mode the monitor chooses an appropriate level automatically A 1mv scale displays on each ECG channel s right side The height of 1mV bar is directly proportional to the waveform amplitude A Note A When the input signals are too large the peak of the waveform may be not able to be displayed In this case the user may manually change the setup method of ECG waveform according to the actual waveform so as to avoid the occurrence of the unfavorable phenomena O Filter method used for displaying clearer and more detailed waveform There are three filter modes for selection DIAGNOSTI MONITOR and SURGERY modes may reduce perturbance and interference from Electrosurgery equipment The filter method is 12 8 Patient Monitor user s manual V 2 2 ECG RESP Monitoring the item applicable for both channels which is always displayed at the waveform place of the channel 1 ECG waveform A Note A Only in Diagnosis mode the system can provide non processed real signals In Monitor or Sugery mode ECG waveforms may have distortion of different extent In either of the latter two modes the system can only show the basic ECG and the results of ST analysis may also be greatly affected In Surgery mode results of ARR analysis may be somewhat affected Therefore i
213. nto the CO moduel 2 ON when choose the ON selection the system first saves all the setups into the CO module and then saves the modifications to the module into the CO module immediately For the newly loaded CO module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module is loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user DEFAULT pick this item to access the CO DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation EXIT used to exit the menu and return to the main screen 17 5 Hemodynamic Calculation Hemocalculation Pick HEMO CALCULATE item in the WINDOWS FOR CO EDIT to call up the HEMOD WINDOWS that displays input parameter value and lists calculation results Patient Monitor user s manual V 2 2 17 9 CO Measuring HEMOD WINDOW RESULT C1Q1 minsm 2 EF S
214. od pressure cuffs must be recycled or disposed of properly 14 14 Patient Monitor user s manual V 2 2 Chapter 15 TEMP Monitoring 15 1 TEMP Monitoring TEMP monitoring setup m f you are using disposable TEMP probes you need to plug the TEMP cable into the monitor and then connect the probe to the cable With a reusable TEMP probe you can plug the probe directly into the monitor H Apply the TEMP probe s securely to the patient WR Switch on the system A Warning AN Verify probe cables fault detection before beginning of monitoring phase Unplug the temperature probe cable of the channel 1 from the socket the screen will display the error message T1 SENSOR OFF and the audible alarm is activated The other channel is the same A warningA Handle the TEMP probes with due care The probe and cable should be rolled up to a loose loop when not in use Over straining will result in mechanical damage of the probes A warningA The calibration of the temperature measurement is necessary for every two years or as frequently as dictated by your Hospital Procedures Policy When you need calibrate the temperature measurement contact the manufacture please A warningA If use two TEMP probes them must be made by the same manufacture AN Note A Disposable TEMP probe can only be used once for one patient AN Note A Patient Monitor user s manual V 2 2 15 1 TEMP Monitoring Disposable TEMP probe can onl
215. of different resolution Pick the leftmost item and change the time interval of trend data Patient Monitor user s manual V 2 2 8 3 Trend and Event To view other trend data When A appears on the upper part of the screen pick UP DOWN button and turn the knob clockwise to view later trend data When A appears on the lower part of the screen pick the same item and turn the knob counterclockwise to view earlier trend data To obtain trend data of different parameter Pick L RIGHT to select one from the 9 groups of parameters A gt by the rightmost item indicates following page available And lt by the leftmost item indicated previous page available To print out the trend data Pick REC to print out the trend data of current displayed parameter Mark event If an event is marked A B C or D the corresponding event type will display on the axis time of the trend table Operation example To view a NIBP trend table m Press MENU button on the button module to access SYSTEM MENU m Pick TREND TABLE Pick L RIGHT and switch to NIBP by turning the knob Pick the first item from the left and select requested time interval Pick UP DOWN and turn the knob to view NIBP trend data of different time For printout of trend table pick REC to start report printing of all trend data including NIBP of this time span m Pick EXIT to return to SYSTEM MENU 8 3 NIBP Recall The monitor can review the latest 400 NIBP meas
216. off the real time record will print out measure parameters only A Note A If certain recording is in process and another parameter demands alarm recording it will only be executed after the earlier recording is finished Auto recording The monitor starts the recorder for 8 seconds according to interval time set in the TIMING REC TIME of the RECORDER SETUP menu Refer to Charter Recorder Setup for details Alarm Recording 1 Parameter Alarm The monitor records waveforms 4 8 or 16 seconds prior to and after the alarm totally 8 16 or 32 seconds which can be selected in System Menu All parameter values during the alarm will also be recorded When parameter alarm occurs two recorded waveforms can be printed out In order to avoid repeated printout of alarm waveforms Milf more than two parameter alarms are switched on and triggered simultaneously the recorder will print out those of the highest level If of the same alarm level the latest alarm will be printed out Milf an alarm occurs during the alarm of another parameter it will be printed out after the current recording is finished Milf many alarms occur at the same time some of waveforms will be stored for printout in turn 2 ST Segment Alarm The monitor records 2 channel ECG waveforms 4 8 or 16 seconds prior to and after the alarm totally 8 16 or 32 seconds which can be selected in the ECG SETUP menu All parameter values during
217. om zero reset the zero control to zero value on the meter Remove the syringe and the monitor will immediately begin to measure intracranial pressure A Warning A The total volume of air injected from a 1ml syringe to check the zero must not exceed 0 5ml or the membrane over the sensor may be ruptured H Connecting to a new monitor when the ICT B is in the Epidural Space v Set correct pressure range on monitor v Inject 0 3cc of air from a 1ml syringe v Adjust the monitor for zero reading v With the air still injected set the calibration number on the monitor if applicable 16 18 Patient Monitor user s manual V 2 2 IBP Monitoring v Remove the syringe and the ICP will be displayed immediately A Note A Always leave the luer fitting open to ambient pressure during measurement A Warning AN Disconnect the catheter from the monitor before defibrillation or electrosurgery 16 8 4 Practicing with the ICT B It is a good idea to obtain experience using the ICT B and monitor combination before actually using the device with a patient Set up the monitor and the ICT B as already described Use either a water column or the calibration tube to apply a known pressure of from 10 to 25mmHg to the ICT B Recall that 13 6cm of water is about equal to 10mmHg With the known pressure applied to the ICT B inject approximately 0 3cc of air into the female luer using a 1ml syringe and note that the monitor does indeed immediately go
218. on Measure again if the failure still exists contact the manufacturer for repair Patient Monitor user s manual V 2 2 9 P N 6200 20 09733
219. on a better perfused site SpO2 LOW Signal t ll Move sensor to better perfused PERFUSTION INARO Sman site Too much light on Remove or reduce lighting Cover SpO2 TOO patient sensor Inadequate sensor from light SS MUCH LIGHT tissue covering sensor detector Reposition sensor Ensure proper sensor SE Low signal quality application Mover sensor to a better perfused site Stop using the measuring SpO2 This message appears function of SpO2 module notify BOARD FAULT when the Masimo Set biomedical engineer or our board malfunctions service staff This message is displayed when the front end module Stop using _the measuring SpO2 COMMUNICATION is having problems function of SpO2 module notify ERROR communicating ie framing biomedical engineer or our errors or bad checksums Service staff with the Masimo board This message is displayed Sto usin the measurin SpO2 COMMUNICATION when the host can not Sech of Zeg module oti STOP receive the data from biomedical engineer or our Masimo board for 5 g service staff seconds Stop using the measuring This message is displayed function of SpO2 module notify when the SpO2 module k i SpO2 INIT ERR initialization error biomedical engineer or our happened service staff TEMP1 SENSOR OFF TEMP1 sensor is not Check the connection of TEMP1 connected correctly sensor TEMP2 SENSOR OFF TEMP2 sensor is not Check the connecti
220. on of TEMP2 connected correctly sensor IBP1 LEAD OFF IBP1 sensor is not Check the connection of IBP1 connected correctly sensor IBP2 LEAD OFF IBP2 sensor is not Check the connection of IBP2 connected correctly sensor IBP3 LEAD OFF IBP3 sensor is not Check the connection of IBP3 connected correctly sensor IBP4 LEAD OFF IBP4 sensor is not Check the connection of IBP4 connected correctly sensor Zero calibrating must be IBP1 NEED ZERO CAL done before measuring in Do zero calibrating for IBP1 IBP1 Zero calibrating must be IBP2 NEED ZERO CAL done before measuring in Do zero calibrating for IBP2 IBP2 Zero calibrating must be IBP3 NEED ZERO CAL done before measuring in Do zero calibrating for IBP3 IBP3 IBP4 NEED ZERO CAL 12810 calibrating must be Geo zero calibrating for IBP4 done before measuring in Patient Monitor user s manual V 2 2 System Alarm Prompt IBP4 TB SENSOR OFF TB sensor is not connected Check the connection of TB correctly sensor CO2 SENSOR OFF CO2 sensor is not Check the connection of CO2 connected correctly sensor Check the connection of ECG iy Rather large interference lead wire Check the current ECG NOISE signals appear in the EGG situation of the patient Check if signals the patient moves a lot XX INIT ERR X AA Mas DOr EEN initialization XX cannot communicate Re start up the mon
221. one catheter and or tip The cuts are usually caused by sharp bone segments and are not always visible to the naked eye If such damage remains undetected fluids may enter the device and damage the sensing element Check for damage as described in the Cleaning section of this manual Patient Monitor user s manual V 2 2 16 23 IBP Monitoring 16 8 7 SOME COMMONLY ASKED QUESTIONS QUESTION ANSWER Is the ICT B a single use device No it is designed to be reused many times If it is damaged what shall we do Sterilize first Then obtain a purchase order for repair and send it back to Manufactory for repair Does the air used for checking the zero get into the patient No Air used for checking the zero stays in the fine lumens and tip of the ICT B until the syringe is removed What happens if we autoclave the ICT B It will have to be returned to Manufactory for repair We inject air to check the zero but the baseline on the scope always returns to ICP even if we leave the syringe attached What is wrong There is a leak in the catheter or sensor tip Remove wipe clean with alcohol and then sterilize Return the device to Manufactory for repair Readings were taken with the syringe left attached until we noticed it Can we rely on these readings No They are incorrect All pressure readings must be made with the proximal female luer open to atmosphere Someone new on the staf
222. onitor user s manual V 2 2 ECG RESP Monitoring Fibrillatory wave for consecutive 4 seconds or Without The number of continuous Vent beats is VFIB VTAC pacemaker larger than the upper limit of cluster User selectable Vent beats gt 5 The RR interval is less than 600ms VT gt 2 Without 3 lt the number of cluster PVCs lt 5 sers isct bie pacemaker COUPLET Without 2 consecutive PVCs serselsctable pacemaker Vent Bigeminy BIGEMINY Without User selectable pacemaker TRIGEMINY _ Without EE User selectable pacemaker A type of single PVC under the condition that HR lt 100 R R interval is Without less than 1 3 the average interval RON T pacemaker followed by a compensating pause of User selectable 1 25X the average R R interval the next R wave advances onto the previous T wave Without Single PVCs not belonging to the type PVC pacemaker of above mentioned PVCs User selectable i 5 consecutive QRS complex RR TACHY All patients interval is less than 500ms User selectable BRADY All patients consordivo ARS comple RR User selectable interval is longer than 1 5s When HR is less than 100 beats min no heart beat is tested during the MISSED Without period 1 75 times of the average RR User selectable BEATS pacemaker interval or When HR is larger than 100 beats min no beat is tested with 1 second No QRS complex and pacing pulse are With availabe during the period 1 75 tim
223. onitored SpO and PR alarm limits Max Upper Limit Min Lower Limit Step SpO2 100 0 1 PR 254 0 1 m SWEEP Available options are 12 5 25 0 mm s m PRSOUND Pulse beep volume Options are OFF HIGH MED LOW E AVG TIME 2 4S 4 6S 8S 10S 12S 14S 16S represent times that SpO average value is counted mM SENSITIVITY MODE Available options are normal and high m DEFAULT Pick this item to access the SoO2 DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation 13 1 3 Sensors and Accessories Before use carefully read the LNOP sensor Directions for Use Use only Masimo oximetry sensors for SoO2 measurements Other oxygen transducers or sensors may cause improper Radical Pulse Oximeter performance Tissue damage can be caused by incorrect application or use of an LNOP sensor for example by wrapping the sensor too tightly Inspect the sensor site as directed in he sensor Directions for Use to ensure skin integrity and correct positioning and adhesion of he sensor A Caution A Do not use the damaged sensors Do not use a sensor with exposed optical Patient Monitor user s manual V 2 2 13 9 SpO2 Monitoring components Do not immerse the sensor in water solvents or cleaning solutions the sensors and conne
224. onitoring the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On TABLES BELOW DESCRIBE THE POSSIBLE PHYSIOLOGICAL ALARMS TECHNICAL ALARMS AND PROMPT MESSAGES OCCURRING DURING SPO MEASUREMENT Physiological alarm Message SPO2 TOO HIGH Cause SpO2 measuring value is above upper alarm limit Alarm Level User selectable SpO2 TOO LOW SpO2 measuring value is below lower alarm limit User selectable PR TOO HIGH PR measuring value is above upper alarm limit User selectable PR TOO LOW PR measuring value is below lower alarm limit User selectable Technical alarmsMessage Cause Alarm Level Remedy SpO2 sensor may be disconnected Make sure that the monitor and the patient SPOR SENSOR OEP from the patient or LOW are in correct connection the monitor with the cables Stop using the measuring function of SpO2 module SpO2 module notify SPO2 INIT ERR Se HIGH biomedical engineer or Mindray service staff Stop using the SpO2 module measuring function of failure or SpO2 module notify SPO2 COMM STOP communication HIGH biomedical engineer or error Mindray service staff Stop using the SpO2 module measuring function of failure or SpO2 module notify SPO2 COMM ERR communication HIGH biomedic
225. or must first of all enter the patient weight and drug name The system first gives a group of random initial values which cannot be used by the operator as the calculation reference Instead he should enter a new group of values at the doctor s instruction As Note A Each drug has its fixed unit or unit series Operator must select the proper unit at the doctor s instruction If the result exceeds the system defined range it will display A Note AY After entering a value a conspicuous prompt will appear in the menu warning the Operator to confirm the correctness of the entered value The correct value is the guaraniee for the reliability and safety of the calculated results AN Note A In neonate mode Drip Rate and Drop Size items are disabled A Note A For each entered value the system will always give a dialog box asking for the user s confirmation You must be careful when answering each box The calculated result is reliable only after the entered value is confirmed to be correct Select the drug name Turn the knob to pick the DRUG NAME item in DRUG CALC menu The user may select the drug name in the pull down list including AMINOPHYLLINE DOBUTAMINE DOPAMINE EPINEPHRINE HEPARINGISUPREL GLIDOCAINE NIPRIDEQNITROGLYCERIN JPITOCIN Drug AQ Drug BO Drug CT Drug D and Drug E Calculation for only one type can be generated
226. or use in all establishments Harmonic other than domestic and those directly connected to Emissions IEC the public low voltage power supply network that Voltage supplies buildings used for domestic purposes Fluctuations Flicker Class A Emissions IEC 61000 3 3 TABLE 2 Guidance and manufacturer s declaration electromagnetic immunity The monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an environment Immunity test IEC 60601 Compliance level Electromagnetic Test level environment guidance Patient Monitor user s manual V 2 2 1 EMC 7 SEN 2KV 4KV Floors should be ace contac concrete or ceramic tile a ES ev contact floors are covered with ENEE EE x pte mata te clave D fe 7 6KV 8KV air 30 air WW Electrical fast Mains power quality should be Transient burst Se Gg power okV that of a typical commercial or IEC 61000 4 4 SUPP nes hospital environment Surge Seen PE 1kV Mains power quality should be EC E 2 kV that of a typical commercial or Seng hospital environment mode Voltage dips Short lt 5 Ur gt 95 dip in Ur for 0 5 cycle 40 Ur 60 dip lt 5 Ur gt 95 dip in Ur for 0 5 cycle Mains power quality should be that of a typical commercial or hospital environment If the interruptions and in Uy for 5 cycle 40 Ur
227. ording to selected time interval 4 To start a manual measuring during the AUTO mode Press START STOP button on the NIBP module 5 To stop a manual measuring Repress the START STOP button on the NIBP module again 6 To perform continuous measuring Access NIBP SETUP menu and pick the CONTINUAL item to start the continuous measurement The monitor will measure as many times of NIBP as possible within 5 minutes A Warning A Prolonged non invasive blood pressure measurements in continual mode may be associated with purport ischemia and neuropathy in the limb wearing the cuff When monitoring a patient examine the extremities of the limb frequently for normal color warmth and sensitivity If any abnormality is observed stop the blood pressure measurements 7 To stop continuous measuring During continuous measuring press START STOP button on the NIBP module at any time to stop continuous measurement A Note A If you are in doubt about the accuracy of any reading s check the patient s vital signs by an alternative method before checking the functioning of the monitor A Warning A Patient Monitor user s manual V 2 2 14 5 NIBP Monitoring If liquid is inadvertently splashed on the equipment or its accessories or may enter the conduit or inside the monitor contact local Customer Service Center Measurement Limitations To different patient conditions the oscillometric measurement has certain limitations The meas
228. ority to the patient safety A Warning A Do not place the monitor or external power supply in any position that might cause it to fall on the patient Do not lift the monitor by the power supply cord or patient cable use only the handle on the monitor A Warning A Consult IEC 601 1 1 for system interconnection guidance The specific requirements for system interconnection are dependent upon the device connected to the monitor and the relative locations of each device from the patient and the relative location of the connected device to the medically used room containing the monitor In all circumstance the monitor must be connected to a grounded AC power supply The monitor is referred to as an IEC 601 F device in the summary of situations table contained in IEC 601 1 1 A Warning A Dispose of the packaging material observing the applicable waste control regulations and keeping it out of children s reach A Warning A This equipment is accord with the standard CISPR11 EN55011 class A A Warning A Grounding Connect the oximeter only to a three wire grounded hospital grade receptacle The three conductor plug must be inserted into a properly wired three wire receptacle if a three wire receptacle is not available a qualified electrician must install one in accordance with the governing electrical code Do not under any circumstances remove the grounding conductor from the power plug Do not use extension cords or adapters of
229. osed here Patient weight turning the knob with the increase decrease of 0 5 kg Ib each time The other WT unit in the other menus accord with the unit which you choosed here Patient blood type Pick A B O AB or N N represents unknown blood type Admission of new patient Also in this menu you may select the NEW PATIENT item to access the CONFIRM TO 3 2 Patient Monitor user s manual V 2 2 System Menu UPDATE PATIENT dialog box as shown below in which you can decide whether to monitor a new patient CONFIRM TO UPDATE PATIENT All data of currently monitored patient will be deleted Yes Figure 3 3 Confirm To Update Patient Menu Pick YES to delete all information of the patient being currently monitored and exit the menu Pick NO to give up updating the patient and the system will keep the information of the current patient and exit the menu A Note A If you select YES the system will delete all information of the patient being currently monitored 3 2 Default Setup A Note A After selecting any item in this sub menu the selected item will replace the current setup of the system and accordingly become the system default configuration DEFAULT FACTORY DEFAULT ADU CONFIG FACTORY DEFAULT PED CONFIG FACTORY DEFAULT NEO CONFIG USER DEFAULT ADU CONFIG USER DEFAULT PED CONFIG USER DEFAULT NEO CONFIG SAVE CURRENT AS USER CONFIG Back to the upper menu Figure 3 4 DEFAULT Men
230. ot be heated above 100 C 212 F It should only be subjected briefly to temperatures between 80 C 176 F and 100 C 212 F The probe must not be sterilized in steam Only detergents containing no alcohol can be used for disaffection The rectal probes should be used if possible in conjunction with a protective rubber cover To clean the probe hold the tip with one hand and with the other hand rubbing the probe down in the direction of the connector using a moist lint free cloth A Note A Disposable TEMP probe must not be re sterilized or reused A Note A Patient Monitor user s manual V 2 2 15 5 TEMP Monitoring For protecting environment the disposable TEMP probe must be recycled or disposed of properly 15 6 Patient Monitor user s manual V 2 2 Chapter 16 IBP Monitoring 16 1 General This chapter introduces IBP measurement maintenance and cleaning of relevant accessories This chapter mainly describes the information about IBP module including the specifications of the module the method to use the module to measure some indexes of invasive blood pressure Also information about how to maintain and clean the module is briefed in the chapter Using the PM 6000 the user may simultaneously monitor maximum 4 channel IBP of 2 modules i e one module has IBP1 and IBP2 the other module has IBP3 and IBP4 16 2 IBP Module Figure 16 1 IBP module O Indicator the indicator that indicates the wor
231. ot try to disinfect or clean a used filter Only use the sample line recommended especially for the system Using other sample line may reduce the performance and reliability of the AG module If the sample line is tangled up do not use it because the line in this condition may have clog or leakage Patient Monitor user s manual V 2 2 19 5 Anesthetic Gas Measurement 19 4 Menus 19 4 1 AG SETUP menu There are two ways to enter the AG SETUP menu 1 Use the rotary knob to select the GAS hot key in the Parameter area to call out the AG SETUP menu 2 Press the SETUP button on the AG module to call out the AG SETUP menu AG SETUP AGENT v O02 COMPEN OFF S c02 UNIT mmHg SWEEP dee 02 UNIT mmHg WORK MODE STANDBY N20 UNIT z 4 ALARM SETUP gt gt AA UNIT z 4 ADJUST WAVE AMP gt gt PUMP RATE LOW DEFAULT gt gt Use the default configuration to initialize all the menus EXIT Figure 19 5 AG SETUP menu Detailed information about each item in the AG SETUP menu is m AGENT used to select the name of the anesthetic to be monitored m CO2 UNIT used to select the display unit of CO2 m O2 UNIT used to select the display unit of O2 m N20 UNIT used to select the display unit of N2O m AA UNIT used to select the display unit of anesthetic m PUMP RATE used to select the appropriate pump rate m O2 COMPEN O2 compensation switch When the O2 concentration
232. out through the wound in the manner of a drain It may make sharp bends without disturbing the operation of the ICT B Care should be taken though not to pinch the catheter by bending onto itself at acute angles for this will seal and possibly damage the internal lumens required for proper operation The catheter should be restrained from moving once the tip is in place It may be fixed to the scalp by encircling sutures or with a silicone rubber suture collar available from manufacturers of such items as peritoneal shunt systems The latter method is preferred as it will help prevent damage to the catheter by sutures or during removal of sutures Another method is by first approaching the burr hole through a tunnel under the skin entering the tunnel from a point distal to the burr hole by making a small incision in the skin The ICT B can be guided in the tunnel by using a disposable tube removable from the burr hole side This latter method is to be preferred from both a mechanical stability point of view and from 16 20 Patient Monitor user s manual V 2 2 IBP Monitoring the reported low incidence of infection The catheter can then be led out in the manner of a drain and the burr hole incision sutured The physician is urged to examine the ICT B for physical damage to the silicone rubber covering anywhere on the tip or catheter before use If damage is suspected do not use the catheter and return it to Manufactory for repair P
233. pdating frequency AG calibrate stability Descending time Delay time Product Specification 0 2 1 5 Unspecified gt 5 1 0 25 2 25 80 3 80 100 1 rpm 0 10 0 76 mmHg 2 100 rpm 20 40 Sec once per second no specified calibrate regulations after being used for consecutive 12 months the deviation from precision is lt 1 240ms 10 90 1 12 seconds maximum with 7 feet long sampling line and ID 0 055 inch Sample rate is 175 ml min Patient Monitor user s manual V 2 2 9 Appendix Ill EMC The monitor meets the requirements of EN 60601 1 2 2001 A Note A The monitor needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided below A Note A Portable and mobile RF communications equipment can affect this monitor See tables 1 2 3 and 4 below TABLE 1 Guidance and manufacturer s declaration electromagnetic emmissions The monitor is intended for use in the electromagnetic environment specified below The customer or the user of the monitor should assure that it is used in such an environment Emissions test Electromagnetic environment guidance The MONITOR uses RF energy only for its internal RF emissions Group function Therefore its RF emissions are very low and CISPR 11 H are not likely to cause any interference in nearby electronic equipment RF emissions The MONITOR is suitable f
234. pe Anti electroshock degree EMC Harmful liquid proof degree Disinfection sterilizing method Working system 2 Specifications 2 1 Size and Weight Size Main box Single module Weight Main box 2 2 Environment Temperature Working Class equipment with internal power supply ECG RESP SpOz NIBP IBP TEMP CO CO CF AG BF Class A Ordinary equipment sealed equipment without liquid proof Refer to Operation manual for details Continuous running equipment 340 x 120 x 250 mm D W H D 40 x 100 x 155 mm D W H D 7 3 kg 0 40 C Welch Allyn Sidestream CO2 5 C 35 C Welch Allyn Mainstream COs 10 C 40 C Artema AION Anesthesia Gases 10 C 40 C Storage Humidiity Working Storage 20 60 C 15 85 noncondensing 10 93 noncondensing Patient Monitor user s manual V 2 2 1 Product Specification Altitude Working Transport and Storage Power Supply 2 3 Display Device Messages 2 4 Signal Interface External Display ECG Output Amplitude Accuracy Impedance Signal Delay 2 5 Recorder Record Width Paper Speed Trace Recording types 500 to 4 600m 500 to 13 100m 100 250 V AC 50 60 Hz Pmax 110VA FUSE T1 6A 12 1 in Color TFT 800 x 600 Resolution 3 LED 8 Waveforms Maximum 1 Alarm LED Yellow Red 1 Power LED G
235. physiological alarm and enter the PAUSE status The countdown of PAUSE status is displayed in the Physiological Alarm area in which area the x symbol is also displayed The time duration of the PAUSE status can be set to 1min 2min or 3min You can select in the ALM PAUSE TIME item in the SYSTEM MENU MAINTAIN After pushing the PAUSE button again the system will restore the normal status Besides the occurrence of any new technical alarm will also terminate the PAUSE status and let the system restore the normal status The 4 symbol disappears too AN Note A After the system goes back to the normal status the existence of alarm depends on whether the alarm condition is complied with After pushing the SILENCE button the system will permanently shut off the alarm sound for LEAD OFF SENSOR OFF alarm 5 5 Parameter Alarm The setup for parameter alarms is in their menus In the menu for a specific parameter you can check and set the alarm limit alarm status The setup is isolated from each other When a parameter alarm is off a symbol S displays near the parameter If the alarms Patient Monitor user s manual V 2 2 5 5 Alarm are turned off individually they must be turned on individually For the parameters whose alarm is set to ON the alarm will be triggered when at least one of them exceeds alarm limit The following actions take place 1 Alarm message displays on the screen as described in alarm mode
236. prompt is given by the button module or TFT display device the speaker on the module or on the display device and the alarm indicator Description is displayed on the screen Physiological alarm is displayed in the Physiological Alarm area Most of technical alarms are displayed in the Technical Alarm area Technical alarms related to NIBP measurement are displayed in the NIBP Technical Alarm area at the bottom of NIBP parameter area AN Note A The Physiological Alarm area is on the upper right part of the screen The Technical Alarm area is to the left side of the Physiological Alarm area A Note A If the monitor is connected to the external alarm prompt system e g the alarm speaker and indicator connected onto the rear panel of the monitor when alarm occurs the external alarm prompt system responds in the same way as the button module of the monitor A Note A The concrete presentation of each alarm prompt is related to the alarm level Alarm prompt of the parameter exceeding the alarm limit When physiological alarm of the monitored parameter exceeds the alarm limit besides using the above mentioned three ways to give the alarm prompt the monitor also gives alarm by making the monitored parameter flash in the frequency of 1Hz If at this time the upper and lower limits of the parameter are displayed they will flash in the same frequency 1Hz Screen Display DEI When an alarm occurs the parameter triggering the alarm
237. red waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages during ST measurement Physiological alarms Message Cause Alarm Level ST measuring value of channel 1 is ST1 TOO HIGH TA above the upper alarm limit User selectable ST measuring value of channel 1 is STI TOO LOW Below the lower alarm limit User seleclable ST2 TOO HIGH ST measuring value of channel 2 is Ve above the upper alarm limit ST2 TOO LOW ST measuring value of channel 2 is GE E EE below the lower alarm limit Technical alarms Stop using ST alarming function notify biomedical engineer or Mindray service staff ST ALM LMT ERR Functional safety failure HIGH Prompt messages include general alerts Message Cause Alarm Level 12 18 Patient Monitor user s manual V 2 2 ECG RESP Monitoring ST1 EXCEED ST measuring value of channel 1 exceeds the HIGH measurement range ST2 EXCEED ST measuring value of channel 2 exceeds the HIGH measurement range 12 9 Arr Monitoring optional Arrhythmia Analysis The arrhythmia algorithm is used to monitor ECG of neonate and adult patient in clinical detect the changing of heart rate and ventricular rhythm and also save arrhythmia events and generate alarming information Arrhythm
238. reen 3 Sound Mode corresponding Alarm Mode Standard VGA BNC 1 V mV lt 5 100 ohm lt 20 ms 48 mm 25 50 mm s 2 Continuous real time recording 8 second real time recording Auto 8 second recording Parameter alarm recording Waveform freeze recording Trend graph table recording ARR events review recording Alarm event review recording NIBP review recording CO Measurement review recording 2 Patient Monitor user s manual V 2 2 2 6 Recall Trend Recall Short Long Alarm Event Recall NIBP Measurement Recall 2 7ECG Lead Mode Lead selection Waveform Lead mode Lead selection Waveform Gain HR and Alarm Range Adult Neo Ped Accuracy Resolution Sensitivity Differential Input Impedance CMRR Monitor Surgery Diagnostic Electrode offset potential Leakage Current Baseline Recovery ECG Signal Range Bandwidth Surgery Product Specification AG Measurement review recording CO Measurement curve recording Hemodynamic Calculation result recording Drug Calculation and titration table recording Monitor information recording OxyCRG review recording 1 hour 1 second or 5 second Resolution 72 hrs 1 min 5min or 10 min Resolution 60 alarm events of all parameters and 8 16 or 32 seconds of corresponding waveform 400 NIBP measurement data 5 Leads R L F N C or RA LA LL RL V I Il I avR avL avF V CAL 2ch 3 Leads R L F or RA LA LL I Ul Hl CAL 1ch x0 2
239. ressure SYS DIA and MAP of one selected blood vessel through two channels and displays two BP waveforms The available pressure labels are Label Definition ART Arterial Blood Pressure PA Pulmonary Arterial Pressure CVP Center Venous Pressure RAP Right Atrial Pressure LAP Left Atrial Pressure ICP Intracranial Pressure ICT B Transducer information Refer to 16 8 P1 P4 Expand Pressure 16 3 Precautions during IBP Monitoring A Warning A Parts and accessories used must meet the safety requirements of the medical electrical equipment standards A Warning A Do not contact the metal part connected to the electrical appliance when connecting or using the accessory 16 2 Patient Monitor user s manual V 2 2 IBP Monitoring A Warning A When the monitor is used with HF surgical equipment do not let the transducer and cable contact the HF surgical equipment to prevent the patient from burning caused by leakage current A Warning AN Disposable IBP transducer or domes should not be reused A Note A Use only the pressure transducer specified in this operation manual The specified transducef except for ICT B transducer has the function of protecting against the electric shock especially the leakage current and the influence of cardiac defibrillator It can be used in surgical operation When the patient is in the defibrillation the pressure waveform
240. ring Stop using RESP alarming function HIGH notify biomedical engineer or Mindray service staff RESP ALM LMT Functional safety ERR failure Prompt message general alerts Message Cause Alarm Level RR measuring value exceeds RR EXCEED the measure range HIGH 12 11 Maintenance and Cleaning Care and Cleaning A Warning A Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line If there is any sign that the ECG cable may be damaged or deteriorated replace it with a new one instead of continuing its application on the patient mM Cleaning Use fine hair cloth moistened in mild soap liquid or cleaning agent containing 70 ethanol to clean the equipment Sterilization To avoid extended damage to the equipment sterilization is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Sterilization facilities should be cleaned first Recommended sterilization material e Ethylate 70 alcohol 70 isopropanol e Acetaldehyde RW Disinfection To avoid extended damage to the equipment disinfection is only recommended when stipulated as necessary in the Hospital Maintenance Schedule Disinfection facilities should be cleaned first 12 28 Patient Monitor user s manual V 2 2 Chapter 13 SpO2 Monitoring 13 1 PART 1 MASIMO SpO2 board configuration Oger General description
241. rms Output with grid selectable English Chinese printout The real time recording time and waveform are user configurable Auto recording interval is set by the user the waveform is in accordance with the real time recording H The alarm recording waveform is automatically selected by the monitor 7 2 Recording Type The monitor provides several stripe recording types Continuous real time recording 8 second real time recording Auto 8 second recording Alarm recording Waveform freeze recording Trend graph table recording ARR events review recording Alarm event recording NIBP review recording COs Measurement review recording AG Measurement review recording CO Measurement curve recording Hemodynamic Calculation result recording Drug Calculation and titration table recording Monitor information recording Patient Monitor user s manual V 2 2 7 1 Recording OxyCRG review recording Real time Recording Real time recording starts as you press the REC STOP button on the recorder module The waveforms for continuous real time recording and continuous 8 second recording are automatically set by the monitor usually the first two waveforms displayed on the screen You can also configure it through the menu Refer to related section for details In RECORD menu the user can choose two waveforms to be printed out The User can setup one waveform off Thus the real time record will print out one waveform If two waveforms are
242. rn Se Pulmonary Artery Balloon e SS Thermister Right Atrium d Right Ventricle Figure 17 5 Thermodilutio Cathetern Site 17 4 CO SETUP Menu H CO Setup and Adjustment There are two ways for the user to access the CO SETUP menu Pick the SETUP button on the CO module to call up the CO SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the CO hot key in the parameter area and then press the knob to call up the C O SELECT menu pick the C O SETUP button to access the C O SETUP menu Patient Monitor user s manual V 2 2 17 7 CO Measuring GU SETUP ALM ON INJ TEMP FROM ON a ALM LEU MED _ INJ TEMP 2 0 ALM REC OFF TEMP UNIT z TB ALM HI 39 0 INT TIME s 30 TB ALM LO 36 0 SETUP TRANSFER gt gt CO CONST 0 542 DEFAULT gt gt EXIT Figure 17 6 CO Setup Menu H TBAlarm setup ALM Select ON to enable alarm prompt and data storage during TB alarm Select OFF to disable audio alarm and prompt the 4 symbol beside TB numeric A Warning AN During the cardiac output measurement procedure the blood temperature alarms will be inactive ALM REC Select ON to enable recording during the TB alarm ALM LEV selectable from level HIGH level MED to level LOW Level HIGH represents the most serious case TBALM HI and TB ALM LO used to set up the upper and lower alarm limit for TB Alarm occurs when the measured TB exce
243. rom HIGH MED or LOW ALM REC used to start stop recording TEMP alarms Pick ON to enable report printing upon TEMP alarm Alarm for T1 T2 and TD occurs when the measured temperature exceeds set alarm high limit or falls below alarm low limit T1 is Channel 1 temperature T2 is Channel 2 temperature TD is the temperature difference between the above two TEMP alarm limits Max TEMP HI Min TEMP LO Step T1 T2 50 0 0 1 TD 50 0 0 1 E UNIT To set temperature unit C or F mM SETUP TRANSFER see chapter ECG RESP Monitoring for ECG SETUP TRANSFER m DEFAULT see chapter ECG RESP Monitoring for ECG DEFAULT CONFIG 15 4 TEMP Alarm message Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during TEMP measurement Physiological alarms Message Cause Alarm Level Measuring value of channel 1 is above T1 TOO HIGH upper alarm limit User selectable Measuring value of channel 1 is below TI TOO LOW lower alarm limit User selectable Measuring value of channel 2 is above T2 TOO HIGH upper alarm limit User selectable T2 TOO LOW Measuring value of channel 2 is below Usanesi
244. rom date of shipment under normal use and service Mindray s obligation under this warranty is limited to repairing at Mindray s option any part which upon Mindray s examination proves defective THIS WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER WARRANTIES EXPRESSED OR IMPLIED INCLUDING WARRANTIES OF MERCHANT ABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE Exemptions Mindray s obligation or liability under this warranty does not include any transportation or other charges or liability for direct indirect or consequential damages or delay resulting from the improper use or application of the product or the substitution upon it of parts or accessories not approved by Mindray or repaired by anyone other than a Mindray authorized representative This warranty shall not extend to any instrument which has been subjected to misuse negligence or accident any instrument from which Mindray s original serial number tag or product identification markings have been altered or removed or any product of any other manufacturer Safety Reliability and Performance Mindray is not responsible for the effects on safety reliability and performance of the PM 6000 Modular Patient Monitor if HM assembly operations extensions re adjusts modifications or repairs are carried out by persons other than those authorized by Mindray mM the Patient Monitor is not used in accordance with the instructions for use or the electrical installation of the re
245. roper function before insertion into the epidural space should be confirmed by gently touching the tip of the transducer and observing a deflection on the operating room pressure monitor Once the ICT B has been inserted into the epidural space the physician should check the proper function again by injecting 0 3cc of air to check the zero of the ICT B The monitor should respond correctly as previously described J Review of techniques to prevent damage to the catheter 1 In preparing the burr hole it is imperative that the hole be rounded at the edges where the catheter makes an S bend into the epidural space 2 Evacuate all bone chips 3 A small pledgelet of woven bandage should be placed around the catheter where sutures will be placed This will prevent damage to the catheter when pulling sutures tight Otherwise you may cut the catheter 4 Use some bone wax on the edges of bone where the catheter and tip make contact with bone 5 When removing the catheter care should be taken not to cut the device while cutting sutures Remove the ICT B by pulling slowly on the catheter 6 The dura mater should be stripped sufficiently so that the tip of the sensor is not forced or wedged into place 7 Do not use haemostats or forceps they will damage the device Do not squeeze the sensor between thumb and forefinger 16 8 6 Cleaning and sterilization A Warning A Do not autoclave A Warning A Do not use radiation sterilization
246. rtup masii seek a ai A ae leone ath Ad Ge 7 4 7 4 Recorder Operations and Status Messages eseeieeseeseesreesriesriesretrresrresne 7 5 Chapter 8 Trend and Event See eseu et a a 8 1 831 Trend Graphite eet th ei ee tis EE 8 1 8 2 Tr nd WE LTE 8 3 ARCANI E ea p eTe i E E E A A A AA E A E E 8 4 8 4 Alarm Event Recall goe ireira rannani a natant seni aeaa i Aada genes ai 8 5 8 5 Power off data storage Optional cccceeeceecseeeeeneececeeeecaeeeeaaeseeeeeseaeeesaeeeeeeteeeees 8 7 Chapter9 Drug Calculation and Titration Table cccssessseesseeeeseeeesseeseseeeenseeeenees 9 1 9 1 Drug Caleulatio EE 9 1 9 Titration Tab eG eea ecite E Go adie thee iigndait pied netted 9 3 Chapter 10 Patient Safety cccseccessecesseeenseeeeeeeeseeeeseeeeneeeessaeseseeeseeeneeseaesaseaeenseeeseas 10 1 Chapter 11 Carre Cle anitng sccsssecceseeessseeenseeeeeeneeseaeseneeeenseeesssaeseseeeenseeesseeseseaeenseanenss 11 1 Tlic yStem CHECK i cectaths ee ege ee Ee 11 1 RE e ne WEE 11 1 Re E lee e EE 11 2 11 4 Sterilization eae cea aise ian We eee Ada ane devia Ae 11 3 RRE ele EE 11 3 Chapter 12 ECG RESP Monitoring csseccceseeesseeeeseeeeeeeeesneeseseeeeeseeeseeeseseeeeenseeeeeas 12 1 12 1 What Is ECG Monttoring irni atirei aaneen aeae aaa iaaea a iaa aiaa 12 1 122 EGG RESP Mod le 1 riitainen iaado ida aint de iii ia iii 12 1 12 3 Precautions during ECG Monitoring 12 3 12 4 Monitoring ProCedure aesae araa a eraa
247. s Patient Monitor user s manual V 2 2 17 11 CO Measuring switched off and disconnected from the power line CO Cable Cleaning 1 H adhesive tape residue must be removed from the transducer cable double seal tape remover is effective and will cause a minimum of damage to the cable if used sparingly Acetone Alcohol Ammonia Chloroform or other strong solvents are not recommended because they will eventually damage the vinyl cabling 2 Sponge the cable with warm water and soap or another suitable cleaning solution and dry Do not immerse them in water 3 Check each cable for corrosion cracks and deterioration Gas Sterilization For more complete asepsis use gas sterilization O Remove obvious contamination by using the cleaning procedure described previously To inhibit the formation of ethylene glycol when ethylene oxide gas is used as the disinfectant the transducer should be completely dry o Follow the operating instructions provided by the manufacturer of the gas disinfectant A Warning A Do not autoclave the cable or heat it above 75 C 167 F The cable should be stored in an environmental temperature between 20 C to 75 C 68 F to 167 F It should be hung up or laid flat to prevent damage to the cable 17 12 Patient Monitor user s manual V 2 2 Chapter 18 CO2 Measuring 18 1 General This chapter offers some relevant data concerning CO2 monitoring PM 6000 provides two
248. s entirely through the capillary bed rather than through any arterio venous shunts The traditional pulse oximeter calculates the ratio of pulsatile absorbance AC to the mean absorbance DC at each of two wavelengths 660 nm and 940 nm S 660 AC 660 DC 660 Patient Monitor user s manual V 2 2 13 1 SpO2 Monitoring S 940 AC 940 DC 940 This traditional instrument then calculates the ratio of these two arterial pulse added absorbance signals R S 660 S 940 This value of R is used to find the saturation SpOz in a look up table built into the instrument s software The values in the look up table are based upon human blood studies against a laboratory co oximeter on healthy adult volunteers in induced hypoxia studies This MS 7 assumes that arterio venous shunting is highly variable and that fluctuating absorbance by venous blood is the major component of noise during the pulse The MS 7 decomposes S 660 and S 940 into an arterial signal plus a noise component and calculates the ratio of the arterial signals without the noise S 660 S1 N1 S 940 S2 N2 R S1 S2 Again R is the ratio of two arterial pulse added absorbance signals and its value is used to find the saturation SpOz in an empirically derived equation into the software The values in the empirically derived equation are based upon human blood studies against a laboratory co oximeter on healthy adult volunteers in induced hypoxia studies T
249. s the patient s life is in danger or the monitor under using has serious problem in technical respect It is the most serious alarm Medium level alarm means serious warning Low level alarm is a general warning Alarms are classified into three categories which are physiological alarm technical alarm and general alarm Physiological alarm refer to those alarms triggered by patient s physiological situation which could be considered dangerous to his or her life such as heart rate HR exceeding alarm limit parameter alarms Technical alarm refer to system failure which can make certain monitoring process technically impossible or make monitoring result unbelievable Technical alarm is also called System Error Message General alarm belongs to those situations that can not be categorized into these two cases but still need to pay some attention The monitor has preset the alarm level for the parameters You can also modify the alarm level using the method described in this chapter Alarm level of the System Error Message technical alarm is pre set in the system All technical alarm level and general alarm level some of the physiological alarm level are pre set in the system and can not be changed by user Patient Monitor user s manual V 2 2 5 1 Alarm 5 1 2 Alarm Modes When alarm occurs The monitor may raise the user s attention in at least three ways which are audio prompt visual prompt and description Audio and visual
250. s updated every two seconds 13 1 1 Precautions A Warning A This pulse wave from M 7 should NOT be used as an apnea monitoring A Warning A This monitor with M 7 should be considered an early warning device for SpO2 As a trend towards patient deoxygenation is indicated blood samples should be analyzed by a laboratory co oximeter to completely understand the patient s condition AN Warning A If an alarm condition other than exceptions listed herein occurs while the alarm silence period is set to off the only alarm indications will be visual displays and symbols related to the alarm condition A Warning A Patient Monitor user s manual V 2 2 13 3 SpO2 Monitoring Measure the monitor s leakage current whenever an external device is connected to the serial port Leakage current must not exceed 100 microamperes A Warning AN To ensure patient electrical isolation connect only to other equipment with electronically isolated circuits AN Warning A Do not connect to an electrical outlet controlled by a wall switch or dimmer A Warning A As with all medical equipment carefully route patient cabling to reduce the possibility of patient entanglement or strangulation A Warning A Interfering Substances Carboxyhemoglobin may erroneously increase readings The level of increase is approximately equal to the amount of carboxyhemoglobin present Dyes or any substance containing dyes that change usual arteria
251. sable patient cables of various lengths are available All cables that display the Masimo SET logo are designed to work with any Masimo LNOP sensor and with any pulse oximeter or multiparameter instrument displaying the Masimo SET logo Only use Masimo oximetry patient cables for SoO2 measurements Other patient cables may cause improper Radical pulse oximeter performance AN Caution Carefully route patient cables to reduce the possibility of patient entanglement or strangulation A CautionA Do not soak or immerse patient cables in any liquid solution Do not sterilize patient cables by irradiation steam or ethylene oxide see the cleaning instructions in the directions for use for reusable Masimo patient cables m Maintenance A Warning A Before cleaning the monitor or the sensor make sure that the equipment is switched off and disconnected from the power line For cleaning Use a cotton ball or a soft mull moistened with hospital grade ethanol to wipe the Patient Monitor user s manual V 2 2 13 11 SpO2 Monitoring surface of the sensor and then dry it with a cloth This cleaning method can also be applied to the luminotron and receiving unit The cable can be cleaned with 3 hydrogen dioxide 7 isopropanol or other active reagent However connector of the sensor shall not be subjected to such solution 13 1 4 Alarm Description and Prompt SpO2 Alarm Message Among physiological alarms those belonging to the t
252. sage Cause Alarm Remedy Level RECORDER HEAD The thermal terminal is Stop operation HOT too hot ow The thermal head is not Push down the switch on E in recording place low the left axis of the f recorder RECORDER OUT OF Record paper runs out ioi Insert a new roll of PAPER record paper 7 6 Patient Monitor user s manual V 2 2 RECORDER COMM Operating status error Recording Reset the recorder ERR ew RECORDER PAPER Recording continuously for law Re insert paper JAM more than 30m RECORDER The recorder is in iow Wait for the completion INITIALIZING initialization process of initialization TOO MANY REC Too many alarm events Low Send recording order TASKS take place simultaneously after a while RECORDER PAPER The paper is in wrong ous Insert the record paper W P position again In the status of printing out Wait for the completion RECORDER BUSY low of printing out Recorder stops working Gives recording order after the recorder REC NOT AVAILABLE Low restores to the normal status or the failure is removed The voltage of the Stop recording until the Pee REE ACT recorder is too high Low recorder restores normal HIGH status The voltage of the Stop recording until the RECORDER VLT LOW recorder is too low Low recorder restores normal status RECORDER S COMM Unrecoverable serial port L Shut down the monitor NEE ow ERR communication error and re
253. sary the setups in the module are loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user e DEFAULT pick this item to access the RESP DEFAULT CONFIG dialog box in which the user may select whether the FACTORY DEFAULT CONFIG or the USER DEFAULT CONFIG is to be used After selecting any of the items and exiting the dialog box the system will pop up the dialog box asking for the user s confirmation RESP Alarm Message Among physiological alarms those belonging to the type that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On Tables below describe the possible physiological alarms technical alarms and prompt messages occurring during RESP measurement Physiological alarms Message Cause Alarm Level RR TOO HIGH RESP measuring value is above upper alarm limit User selectable RESP measuring value is below lower alarm limit RR TOO LOW User selectable RESP APNEA RESP can not be measured within specific time HIGH interval Technical alarms Message Cause Alarm Level Remedy Patient Monitor user s manual V 2 2 12 27 ECG RESP Monito
254. seeeesneeensneeeneneescaesaseeeenseeeessaesaseenenseaeees 17 1 RRE E EE 17 1 172 GO EE 17 1 17 3 Monitoring ProCedure AA 17 3 17ACO SETUP Mente Access etiut dda sa e Eed leet 17 7 17 5 Hemodynamic Calceulaton eene eene enn teenntrnrttnnntnnttnntttnntnnstnnsennnennnnt 17 9 17 6 Alarm Information and Promi 17 10 17 7 Maintenance and Ceamimg 17 11 Chapter 18 CO2 Measuring cccscccesccesseeeeseeeeeeeseseeeseseeeeseeesesneeeaseeeeneeessnaeseseenenseaeeeas 18 1 18 1 General er ie teed ah scan a taa aiaa acd Aosta ate fase ee enn 18 1 Elei rainn n treteermrrerecrere ctr E aa ter cece reer corer 18 2 18 3 Monitoring Procedure cee eeeeaeeeeeeee cage eesaaeseeeeeseeeesaeeeeeeseeeeees 18 3 TEA CO Men tiie tas evan hero ee a fee a te a bate alae 18 5 18 5 Alarm Information and Promi 18 10 18 6 Maintenance and Ceamimg 18 12 Chapter 19 AG Measuring cccsceceseesseeeeeeeeeeeeeeeseeeensneeeneeeeseaeseseeeeeneneeseaesaseenenseeeees 19 1 Patient Monitor user s manual V 2 2 3 Content E DEE 19 1 192 AQ Ne 19 2 19 3 Measuring principle and operating Drorcess n 19 4 ER AE 19 6 19 5 Alarm information and prompts sesssesesisesesiiessrirsreirinnteirntntiinnentnnrneitnnenet 19 12 19 6 Technical Specifications ek 19 15 19 7 Anesthetic Gas Accessories ccecceeeeceeceeeeeeeeeneeeeeeeeeeeesenaaeeeeeeeeeeeeeaaas 19 17 19 8 Maintenance and cleaning cee eeeeeeeeeeeeeeceeeeeeeeeeaeeaeeeeeeaeeeeeeesenenaeeaeeeeeeatens
255. sides DRUG A DRUG B DRUG C DRUG D and DRUG E are also provided to flexibly replace any of the drugs Select DRUG CALC in SYSTEM MENU the following DRUG CALC display appears DRUG CALC ADULT DRUG NAME Drug A INF RATE 93 75 nml hr WEIGHT 70 0 4 kg DRIP RATE 31 25 GTTvmin AMOUNT 400 00 mg DROP SIZE 20 00 GTT ml VOLUME 250 00 ml DURATION 2 67 CONCENTRAT 1 60 hr ah ah gt ng ml DOSE min 2500 00 mcg Please carefully verify DOSE hr 150 00 mg the input information DOSE kg min 35 71 mcg DOSE kg hr 2142 86 mcg TITRATION gt gt Patient weight in Kg EXIT Figure 9 1 DRUG CALC The following formulas are applied for dose calculation Concentrat Amount Volume INF Rate DOSE Concentrat Duration Amount Dose Dose Rate x Concentrat Operating method In the Drug Calculation window the operator should first select the name of the drug to be Patient Monitor user s manual V 2 2 9 1 Drug Calculation and Titration Table calculated and then confirm the patient weight Afterwards the operator should also enter other known values Turn the knob to select the value of the item to be calculated Turn the knob to change the value When it is the required value press the knob to view the calculation result Each item has its calculation range If the result exceeds the range display AN Note A For the drug calculation the prerequisite is that the operat
256. so that the system cannot perform RESP analysis Check the connection of CO2 sensor and the current situation of the patient ASYSTOLE Patient suffers from Arr Of ASYSTOLE Check the current situation of the patient Check the connection of the electrodes and lead wires VFIB VTAC Patient suffers from Arr of VFIB VTAC Check the current situation of the patient Check the connection of the electrodes and lead wires COUPLET Patient suffers from Arr of COUPLET Check the current situation of the patient Check the connection of the electrodes and lead wires BIGEMINY Patient suffers from Arr Of BIGEMINY Check the current situation of the patient Check the connection of the electrodes and lead wires TRIGEMINY Patient suffers from Arr of TRIGEMINY Check the current situation of the patient Check the connection of the electrodes and lead wires RON T Patient suffers from Arr of RONT Check the current situation of the patient Check the connection of Patient Monitor user s manual V 2 2 1 System Alarm Prompt the electrodes and lead wires Patient suffers from Arr of Check the current situation of the PVC patient Check the connection of PVC the electrodes and lead wires Check the current situation of the TACHY Patient suffers from TACHY patient Check the connection of the electrodes and lead w
257. start it again RECORDER Possibly caused by the i Reset the recorder SELFTEST ERR RAM ROM CPU or OW WATCHDOG Error occurs during Shutdown and re start RECORDER INIT ERR initialization low RECORDER INIT Error occurs during low Shutdown and re start ERR1 initialization RECORDER INIT Error occurs during iw Shutdown and re start ERR2 initialization RECORDER INIT Error occurs during bw Shutdown and re start ERR3 initialization RECORDER INIT Error occurs during ee Shutdown and re start ERR4 initialization RECORDER INIT Error occurs during iow Shutdown and re start ERR7 initialization RECORDER INIT Error occurs during law Shutdown and re start ERR8 initialization If after shutdown and re start error still exists contact out service engineers Patient Monitor user s manual V 2 2 7 7 Chapter 8 Trend and Event The monitor provides 72 hour trend data of all parameters storage of 400 NIBP measurement results and 60 alarm events This chapter gives detailed instruction for review of all data 8 1 Trend Graph WH The latest 1 hour trend is displayed every 1 or 5 seconds WH The latest 72 hour trend is displayed every 1 5 or 10 minutes Pick TREND GRAPH in the SYSTEM MENU to call up the following menu TREND GRAPH BPM p 2001 12 01 15 48 11 o 15 42 11 15 44 11 15 46 11 15 48 11 HS HR Ti Tai SP02 NS RR T2 T2 PR ND PUC TD NM PARA SELECT HR RESOLUTION 18 D L
258. t ON to enable alarm and data storage during IBP alarm Select OFF to disable physiological alarm and display the symbol beside IBP numeric ALM LEV Set up the alarm level Three levels are available HIGH MED LOW ALM REC Select ON to enable recording once IBP alarm occurs Select OFF to disable recording function AMP ADJUST adjust waveform amplitude Two selections are available MANUAL AUTO Set it to AUTO the pressure names of IBP become P1 and P2 and the IBP scale is adjusted by system automatically Set it to MANUAL the pressure names of IBP can choose one of ART PA CVP RAP LAP ICP P1 P2 and the IBP scale is adjusted by the user via SCALE ADJUST item SWEEP Select the scanning speed of the IBP wave Two selections are available 12 5 mm s or 25 mm s UNIT Select the pressure unit mmHg or kPa FILTER Select filtering mode of system Three selections are available NORMAL filter the waveform at the frequency of 16Hz SMOOTH filter the waveform at the frequency of 8Hz and NO FILTER display the original waveform The default is NO FILTER ALM LIMIT SETUP Access the sub menu of IBP ALM LIMIT SETUP in which user may set up the upper and lower alarm limit of systolic pressure diastolic pressure and mean pressure respectively for channel 1 and channel 2 SCALE ADJUST Access the sub menu of IBP SCALE ADJUST in which user may adjust the position of the high reference and low scales for
259. t critical subject to the permitted maximum When this air is injected the pressure will cause the balloon to be lifted from the surface of the sensor and the same pressure will be applied to the back of the sensor The strain gauge senses equal pressure above and below which is equivalent to having zero pressure applied Thus by injecting a small volume of air one undeflects the pressure sensor and checks the zero of the transducer and amplifier 16 8 2 Cautions A Note A Gaeltec catheter tip pressure transducers are designed for use by trained physicians practicing a specialized branch of medicine Use of the transducers should be restricted to those trained to perform the procedures A Note A All pressure transducers must be used with patient monitors which meet the current safety standards for the country in which they are used and which are intended for use with strain gauge pressure transducers The PATIENT MONITOR must provide electrical isolation between the transducer and any mains powered equipment to which the monitor is connected A Warning A Disconnect the catheter from the monitor before defibrillation or electrosurgery A Warning A Do not plug the female luer on the proximal end of the catheter during ethylene oxide sterilization or damage to the transducer may result AN Warning AN Do not immerse or soak the electrical connector end in any kind of fluid or liquid A Warning A The total volume of air injected to che
260. t is suggested that in the environment having relative small interference you d better monitor a patient in Diagnosis mode Leads of channel 2 refer to for detailed information O Waveform gain of channel 2 refer to for detailed information A Note A Pacemaking signal detected is marked by a above the ECG waveform 12 6 ECG Menu ECG SETUP Menu There are two ways for the user to access the ECG SETUP menu Pick the SETUP button on the ECG TEMP module to call up the ECG RESP TEMP SETUP menu Then select ECG SETUP item to access the ECG SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the ECG hot key in the parameter area and then press the knob to directly access the ECG SETUP menu Patient Monitor user s manual V 2 2 12 9 ECG RESP Monitoring ECG SETUP HR ALM ON v HR CHANNEL CH1 a ALM LEV MED v LEAD TYPE 5 LEADS ALM REC OFF v SWEEP 25 0 ALM HI 120 Ka ST ANALYSIS gt gt ALM LU 50 gt ARR ANALYSIS gt gt HR FROM ECG Z OTHER SETUP gt gt Access the sub menu in which more items can be set EXIT Figure 12 8 ECG SETUP menu ECG alarm setting e HR ALM pick ON to enable prompt message and data record during the ECG alarm pick OFF to disable the alarm function and there will be a 2 beside ECG e ALM LEV selectable from HIGH MED LOW Level HIGH represents the most serious case e
261. t perform Measure again if the failure still measurement analysis or exists contact the manufacturer calculation for repair 8 Patient Monitor user s manual V 2 2 System Alarm Prompt CUFF TYPE ERR Perhaps the used cuff does not fit the setup patient type Check if the patient type is set up correctly Check the connection of each part or replace with a new cuff If the failure still exists contact the manufacturer Tor repair PNEUMATIC LEAK NIBP airway has leaks Check the connection of each part or replace with a new cuff If the failure still exists contact the manufacturer for repair MEASURE FAIL Problem happens when measuring the curve The system cannot perform measurement analysis or calculation Check the connection of each part and the patient situation Measure again if the failure still exists contact the manufacturer for repair NIBP SYSTEM FAILURE Problem happens when measuring the curve The system cannot perform measurement analysis or calculation Check the connection of each part and the patient situation Measure again if the failure still exists contact the manufacturer for repair AG NO WATERTRAP The AG watertrap falls off from the monitor Check the connection of AG watertrap sensor CHANGE WATERTRAP AG Replace the AG watertrap AG WATERTRAP_ TYPE WRONG The type of the AG watertrap being used is
262. t the same time of entering the Freeze status the system exits all other operating menus Besides the system freezes all waveforms in the Waveform area of the Basic Screen or Full lead ECG waveforms and the extra waveform if available on the Full lead ECG screen Nevertheless the Parameter area refreshes normally In the Freeze status it does not affect the display and refresh of the Trend Graph area on the trend screen the display and refresh of oxyCRG on the Dynamic Refresh screen or the display and refresh of the Viewbed window on the Viewbed screen The frozen waveforms can be reviewed or recorded Enter Exit Freeze Status Enter Freeze Status In the Non Freeze status press the FREEZE button on the button module of the monitor to let the system exit the Menu being currently displayed if available then enter the Freeze status and display the popup FROZEN menu In the Freeze status except Viewbed waveforms all other waveforms are frozen In other words the system will no longer refresh all other waveforms Exit Freeze Status In the Freeze status executing any of the following operations will command the system to exit the Freeze status m Select the EXIT option on the FROZEN menu m Press the FREEZE button on the button module again Patient Monitor user s manual V 2 2 6 1 Freeze m Press the non immediate to execute button such as a button once pressed a menu will pop up for
263. tem is turned on COLOR SELF DEFINE is used by the user to define the color of the waveform displayed on the screen Five colors can be chosen from green cyan red yellow and white Patient Monitor user s manual V 2 2 3 15 System Menu COLOR SELF DEF INE ECG WAVE amp PARA GREEN 7 SP02 WAVE amp PARA CYAN IBP WAVE amp PARA RED v COZ WAVE amp PARA YELLOW 4 4 RESP WAVE amp PARA YELLOW 4 AG WAVE amp PARA YELLOW 4 OTHER PARA WHITE Back to the upper menu Figure 3 21 Color Self define 3 9 DEMO function Select the DEMO item in the SYSTEM MENU to call up the ENTER DEMO PASSWORD After entering the password the system enters DEMO status The purpose of waveform demonstration is only to demonstrate the machine performance and for training purpose In clinical application this function is not forbidden because the DEMO will mislead the medical staff to treat the DEMO waveform and parameter as the actual data of the patient which may result in the delay of treatment or mistreatment Therefore before entering this menu you shall enter password INPUT DEMO KEY KEY 2080 4 Back to the upper menu aaa Figure 3 22 Input Demo Key 3 16 Patient Monitor user s manual V 2 2 Chapter A Face Select 4 1 This monitor has four different operating screens which are Standard Screen Trend Screen oxyCRG Screen and Viewbed Screen When requ
264. ters and the other waveform are recorded If these two selected waveforms are all closed or not available only parameters are recorded As for the function of recording frozen waveforms you can only record the waveforms displayed upon the freezing moment The recording time length is the same as the length of the waveform displayed on the screen For example if the speed of a waveform is relatively fast then it needs shorter time to record it When recording frozen waveforms the system is still in the Freeze status After completion of recording if required you may select once more the waveform to be output and select REC option again to record the whole selected waveforms You may also record frozen waveforms by pressing the REC STOP button on the recorder module If the recorder does not exist selecting the REC option can only call out the prompt Recorder does not exist in the STATUS bar For more detailed information about recording please refer to the chapter of Recording Patient Monitor user s manual V 2 2 6 3 Chapter 7 Recording WR General information on recording H Instructions for configuring and recording m Recording messages 7 1 General Information on Recording A thermal dot matrices recorder with 48mm wide printout paper is used for PM 6000 Modular Patient Monitor Performance of the Recorder Waveform record is printed out at a rate of 25 or 50 mm s It can record up to 2 wavefo
265. the CO2 SETUP menu Pick the SETUP button on the CO2 module to call up the CO2 SETUP menu as shown below Turn the rotary knob on the control panel to move the cursor on the screen to the CO2 hot key in the parameter area and then press the knob to directly access the CO2 SETUP menu c02 SETUP ALM ON AWRR ALM HI 30 Ka ALM LEV MED AURR ALM LO 8 gt ALM REC OFF APNEA ALM 20S c02 ALM HI 50 SWEEP fie c02 ALM LO 15 UNIT mmHg v INS ALM HI 4 OTHER SETUP gt gt Open or close the COZ alarm EXIT Figure 18 4 COs Setup Menu Following functions can be realized via CO2 SETUP menu ALM select ON to enable and store alarm prompt when CO2 parameters have alarms Select OFF to disable alarm and display amp beside CO2 The default is ON ALM REC select ON to generate output from the recorder ever since CO2 parameter alarm occurs The default is OFF ALM LEV select from HIGH MED and LOW Level HIGH represents the most serious alarm followed by Level MED and Level LOW with a decrease of seriousness Change in ALM LEV can only affect the physiological alarm levels of CO2 parameters including EtCO2 upper limit EtCO2 lower limit InsCO2 upper limit AwRR upper limit and AwRR lower limit The default alarm level is MED CO2 ALM HI to adjust the upper alarm limit of EtCO2 If the measuring value is larger than CO2 upper alarm limit CO2 TOO HIGH appears on the screen After the
266. the extension key has the same function as the button on any of the modules including the button module except rotary knob Pressing this extension is the same as pressing the corresponding button on the module All the buttons on all the modules not including rotary knob on the button module are given as the selections for the extension function which are not related to whether the corresponding module is loaded or not 3 14 Patient Monitor user s manual V 2 2 System Menu SYSTEM KEY SETUP F1 OFF F2 OFF M F3 OFF F4 OFF M F5 OFF S F6 OFF M EXIT Figure 3 20 SYSTEM KEY SETUP AN Warning A When the alarm volume is set to OFF you will not hear the alarm sound if new alarm occurs Therefore you must be very careful in using this selection If setting the alarm volume to OFF when the system is in Silence or Pause status the system will automatically discharge Silence or Pause status If you select Silence or Pause when the alarm volume is set to OFF the system will restore the alarm volume before the alarm volume is set to OFF and enter Silence or Pause status AN Note A After the alarm volume is set to OFF a ol symbol will appear in the Technical Alarm Area AN Note AY Setting Alarm Volume to OFF is valid only when the monitor is turned on for this time After turning on the monitor next time this setup will restore its value of the previous time when the sys
267. tient Monitor user s manual V 2 2 12 21 ECG RESP Monitoring DELETE Delete the selected Arr event O RENAME Rename the selected Arr event whose name is displayed in a sunken frame Switch the knob until the name you want appears D WAVE To display the Arrhythmia waveform time and parameter value o UP DOWN To observe waveforms of other Arrhythmia events oO L_RIGHT To observe 8 second waveform of Arrhythmia events o REC To print out displayed Arrhythmia event oO EXIT To return to ARR RECALL menu of Arrhythmia event ARR WAVE RECALL BIGEMINY 12 01 2001 17 02 1712 ECG SP02 IBPA IBPB NIBP 76 SP02 CH1 CH2 CH1 CH2 SYS S s s MEAN PR Select previous or next Arr waveform EXIT Figure 12 18 ARR WAVE RECALL Menu A Note A If there are more than 60 Arrhythmia events the latest will be retained For a monitor having the function of power off data storage the system can save the latest 60 Arr Events once power off accident happens ARR ALARM The alarm is triggered when an Arrhythmia occurs If the ALM is ON the alarm sounds and the alarm indicator flashes If the REC is ON the alarm record will be printed out 4 seconds prior to and after the alarm with the ECG waveforms of analysis channel Physiological alarms Applicable P Ss Prompt Patient Type Occurring Condition Alarm Level All patient No QRS is detected for 4 consecutive ASYSTOLE ES e User selectable 12 22 Patient M
268. to zero Also note that if the ICT B is moved rapidly up and down in a column of water pressure waves of high fidelity are seen The ICT B has a very high frequency response and you will observe excellent pressure waves in actual practice It can also be confirmed that the exact amount of air injected to check the zero is not important 16 8 5 Note to the neurosuregeon The ICT B is intended for the measurement of epidural pressures Use of the transducer for the measurement of intraventricular pressures is not recommended The ICT B is designed for the measurement of positive pressures only AY Note A Catheter Tip Pressure Transducers must be used under the supervision of a suitably qualified Physician Method of Application of the ICT B The application of the ICT B may be accomplished through a variety of surgical techniques Therefore the surgeon is best advised to use the method which his own practice and discretion dictate to be best for the patient The following are some general guidelines The ICT B may be inserted during surgery or through a burr hole When in place the catheter tip transducer should have its pressure sensing surface facing against the dura under the cranium There are 2 5cm marks on the back of the catheter and these are visible when the sensor is facing in the proper direction The site of placement should be away from any craniotomy flap preferably via a contralateral burr hole The dura mater should be
269. ture readings 20 5 IBP Accessories ICP encephalic pressure transducer ICT B GADTEC P N 0010 10 12151 12PIN ICP cable assembly P N 0010 21 12206 12PIN IBP cable assembly PX1800 896019021EDWARDS ver A P N 0010 21 12180 Disposable IBP transducer DT 4812 OHMEDA or BD P N 6000 10 02107 Reusable IBP transducer P23XL OHMEDA P N 900E 10 04882 Disposable IBP pressure transducer PX260 EDWARDS P N 0010 10 12176 Edwards two disposable IBP pressure transducer PX2X2 P N 0010 10 12208 Patient Monitor user s manual V 2 2 20 3 Accessories and Ordering Information 20 6 CO Accessories IT sensor OHMEDA P N SP4042 BD IT sensor cap OHMEDA P N SP5045 BD anti pressure three circles injector 12CC 12PIN CO cable assembly 20 7 CO2 Accessories 008 0781 00 EtCO2 DryerSample Line with TEE HH 008 0784 00 EtCO2 DryerSample Line HH No TEE 008 0780 00 EtCO2 DryerSample Line with TEE LH 008 0782 00 EtCO2 Dryer 008 0789 00 Adult Nasal Sampling Line soft 008 0786 00 Adult O2 Delivery Sampling Line 008 0790 00 Pediatric Nasal Sampling Line Soft 008 0785 00 Pediatric O2 Deliver Nasal SampleLine 008 0788 00 Infant EtCO2 Nasal Sampling Line Soft 008 0783 00 Infant O2 Deliver Nasal SampleLine 2 5mm 008 0766 00 InfantConnecter with Sideport 008 0779 00 Adult Pediatric Sampling TEE Sampling LineNeonate2 5m purchase Nol 60 15300 00 Sampling ELBOW BOX OF 50 P N 000 91167 Sampling SATRAIGHT CTEE connector DRYLINE WA
270. u Patient Monitor user s manual V 2 2 3 3 System Menu In this sub menu you can select both the factory default and the user defined default Also in this sub menu you can save the current system configuration as the user defined default configuration But at this time the system will automatically save all the setups in the parameter menu ECG gain and filter way as the user defined default configuration according to the patient type Also the dialog box as shown below will pop up CONFIRM SAVE DEFAULT CONFIG Old user defined config for this patient type will covered Yes Figure 3 5 CONFIRM DEFAULT CONFIG A Note A After selecting any item in the DEFAULT menu and exiting the box the CONFIRM DEFAULT CONFIG Dialog box will pop up in which you can select YES to confirm your selection or NO to give up your selection AN warning All configurations in the system will be replaced by default configurations 3 3 Trend Review Measurement Review and Alarm Event Review In the SYSTEM MENU there are TREND GRAPH TREND TABLE NIBP RECALL and ALARM RECALL items Please refer to Chapter 7 Trend and Event for detailed information 3 4 System Setup Select the system setup item in the system menu 3 4 Patient Monitor user s manual V 2 2 System Menu SYSTEM SETUP FACE SELECT gt gt ANALOG gt gt ALARM SETUP gt gt MODULE SETUP gt gt TIME SETUP gt gt TRACE S
271. ual V 2 2 11 3 Chapter 12 ECG RESP Monitoring 12 1 What Is ECG Monitoring Monitoring the ECG produces a continuous waveform of the patient s cardiac electric activity to enable an accurate assessment of his current physiological state Only proper connection of the ECG cables can ensure satisfactory measurement On the Normal Display PM 6000 provides display of 2 channel ECG waveforms The patient cable consists of 2 parts The cable that connects to the monitor The lead set that connects to the patient m Using a 5 lead set the ECG can derive up to two waveforms from two different leads For requested lead you may choose from the left side of ECG waveform WR The monitor displays the Heart Rate HR ST segment and Arrhythmia analysis Allof the parameters above can be set as alarm parameters AN Note A In the default settings of PM 6000 the ECG waveforms are the first two waveforms from top in the Waveform Area 12 2 ECG TEMP Module ECG TEMP module is a standard module incorporating functions of ECG RESP and TEMP monitoring For TEMP monitoring refer to Chapter 15 Figure 12 1 ECG TEMP module Patient Monitor user s manual V 2 2 12 1 ECG RESP Monitoring O Indicator the indicator that indicates the working status of the module When the module is working this indicator is on A Note A When loading the module this indi
272. umatic test If the failure prompt still appears please contact the manufacturer for repair Patient Monitor cylinder Cuff Figure 14 5 Diagram of NIBP air leakage test m SETUP TRANSFER Pick this item to access NIBP SETUP TRANSFER dialog box NIBP SETUP TRANSFER RT TRANSFER OFF Z SAVE SETUP INTO MODULE LOAD MODULE SETUP Back to the upper menu E Figure 14 6 NIBP SETUP menu Whose functions are RT TRANSFER Refers to real time transfer Three selections are available 1 OFF when choose the OFF selection the system will not automatically save the modifications to the NIBP module into the NIBP module 2 ON when choose the ON selection the system first saves all the setups into the NIBP module and then saves the modifications to the module into the NIBP module immediately For the newly loaded NIBP module default is OFF SAVE SETUP INTO MODULE means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the system are transferred into the module LOAD MODULE SETUP means that when the RT TRANSFER is off when it is ON this function is unnecessary the setups in the module are loaded into the system When using this function the warning Menu item will adopt the value from the module Yes will be appearing on the screen And the system will execute the operation after the confirmation of the user m DEFAULT pick this item to access the NIBP DEFAULT CONFIG dia
273. up the measuring mode to MANUAL E UNIT Pick this item to set measurement unit Option mmHg or kPa m CALIBRATE Calibrate the cuff pressure reading with a calibrated reference manometer Pick the CALIBRATE item to start the calibration and the item will change into STOP CAL which if picked the system will stop calibration A warning A The calibration of the NIBP measurement is necessary for every two years or as frequently as dictated by your Hospital Procedures Policy The performance should be checked according to the following details Procedure of the Pressure Transducer Calibration Replace the cuff of the device with a rigid metal vessel with a capacity of 500 ml 5 14 8 Patient Monitor user s manual V 2 2 NIBP Monitoring Connect a calibrated reference manometer with an error less than 0 8 mmHg and a ball pump by means of a T piece connector and hoses to the pneumatic system Set the monitor in CALIBRATE mode Inflate the pneumatic system to 0 50 and 200 mmHg by ball pump separately The difference between the indicated pressure of the reference manometer and the indicated pressure of the monitor will not exceed 3 mmHg Otherwise please contact our customer service Patient Monitor Reference Manometer Ball Pump i Metal Vessel Figure 14 4 Diagram of NIBP calibration m PNEUMATIC This item is used for air leakage test Turn the knob to pick the item to start the air leakage test Then the
274. urement data Pick NIBP RECALL in the SYSTEM MENU to invoke the result and time of the latest 10 measurements as shown in the figure below 8 4 Patient Monitor user s manual V 2 2 Trend and Event NIBP RECALL NS NM ND TIME 1 108 84 70 12 01 2001 15 13 58 NUM 1 UNIT UP DOWN REC Select the unit of the NIBP measured result EXIT Figure 8 3 NIBP RECALL Data is listed chronologically from the latest to the earliest 10 measurements can be displayed in one screen Pick UP DOWN to view other trend curve up to 400 results Pick REC to print out all measurement data of NIBP RECALL 8 4 Alarm Event Recall PM 6000 can display the latest 60 alarm events m Select ALARM RECALL in the SYSTEM MENU to access ALARM RECALL CONDITION menu as shown below ALARM RECALL CONDITION ALARM RECALL TIME START 2001 j 12 1 15 4 4 END CURRENT TIME SELF DEF INE ALARM RECALL EVENT ALL ALARM RECALL gt gt Select the beginning time of the alarm concerned EXIT Figure 8 4 ALARM RECALL CONDITION Menu In this menu the user may select the conditions for alarm review including Patient Monitor user s manual V 2 2 8 5 Trend and Event Oooo oO Start and End time of review The user may select the start time of review in the item of START Then the user may select the end time of review Two selections are available current time and the user defined time For user defined end time the
275. urement is in search of regular arterial pressure pulse In those circumstances when the patient s condition makes it difficult to detect the measurement becomes unreliable and measuring time increases The user should be aware that the following conditions could interfere with the measurement making the measurement unreliable or longer to derive In some cases the patient s condition will make a measurement impossible Patient Movement Measurements will be unreliable or may not be possible if the patient is moving shivering or having convulsions These motions may interfere with the detection of the arterial pressure pulses In addition the measurement time will be prolonged Cardiac Arrhythmia s Measurements will be unreliable and may not be possible if the patient s cardiac arrhythmia has caused an irregular heartbeat The measuring time thus will be prolonged Heart lung Machine Measurements will not be possible if the patient is connected to a heart lung machine Pressure Changes Measurements will be unreliable and may not be possible if the patient s blood pressure is changing rapidly over the period of time during which the arterial pressure pulses are being analyzed to obtain the measurement Severe Shock If the patient is in severe shock or hypothermia measurements will be unreliable since reduced blood flow to the peripheries will cause reduced pulsation of the arteries Heart Rate Extremes Measurements can not
276. user can use the knob to select ALARM RECALL EVENT In the pull down list of ALARM RECALL EVENT the user can select the parameter whose alarm events he wants to review The selections include ALL alarm events of all parameters ECG REST SPO2 NIBP IBP TEMP CO2 CO HR_H gt 180 the value of HR is higher than the upper alarm limit HR_L lt 60 the value of HR is below the lower alarm limit SPO2 lt 90 IBP_H gt 200mmHg IBP_L lt 40mmHg RR_H gt 40 RR_L lt 10 TEMP_H gt 40 C TEMP_L lt 34 C After setting up all the review conditions press the ALARM RECALL button to access ALARM RECALL window ALARM RECALL The ALARM RECALL window is as shown below in which following data are displayed Time span Format month day year hour minute month day year hour minute Event type Serial number Format NO xx of XX The value at the time of alarm NIBP result is with time Two 8 16 32 second waveforms ALARM RECALL g TIME SPAN 12 01 2001 15 04 CURRENT TIME EVENT TYPE ALL 0 ims 2 CmmHg S SP02 98 IBP CH1 ART Page up down to view the previous or the following alarm event EXIT Figure 8 5 ALARM RECALL Menu To view all waveforms during the alarming process Pick L RIGHT and turn the knob to view all 8 16 32 second waveforms stored 8 6 Patient Monitor user s manual V 2 2 Trend and Event To view other alarm events Events of up to 60 are listed chronologically from t
277. ve obvious contamination by using the cleaning procedure described previously Select a sterilant that has been found effective to your hospital or institution for chemical solution sterilization of operating room equipment Buffered glutaraldehyde e g Cidex or Hospisept has been found to be effective Do not use quaternary cationic detergents 16 14 Patient Monitor user s manual V 2 2 IBP Monitoring such as zephiran chloride If the whole unit is to be sterilized immerse the transducer but not the electrical connector into the sterilant for the recommended sterilizing period Ensure that the dome has been removed Then rinse all transducer parts except the electrical connector with sterilized water or saline The transducer must be thoroughly dried before storing WH Gas Sterilization For more complete asepsis use gas sterilization Remove obvious contamination by using the cleaning procedure described previously To inhibit the formation of ethylene glycol when ethylene oxide gas is used as the disinfectant the transducer should be completely dry Follow the operating instructions provided by the manufacturer of the gas disinfectant A Warning A The sterilize temperature must not exceed 70 C 158 F Plastics in the pressure transducer may deform or melt above this temperature 16 8 ICP Transducer ICT B Optional Accessory 16 8 1 Introduction The ICT B is one of catheter tip transducers manufactured by Gaeltec It is
278. vironment e IEC 60601 Compliance Electromagnetic environment munity test Test level level guidance Conducted RF 3 Vrms 150kHz 3 Vrms Recommended separation distance IEC 61000 4 6 to 80MHz d 1 2x p 2 Patient Monitor user s manual V 2 2 EMC Recommended separation distance d 1 2xJP 80MHz to 800MHz d 2 3x p 800MHz to 2 5GHz 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 Radiated RF 3 V m 80MHz 3 V m m IEC 61000 4 3 to 2 5 GHz Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range H Interference may occur in the vicinity of equipment marked with the following symbol Bei a 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 monitor is used exceeds the applicable RF compliance level above the monitor should be observed to verify normal operation If abnormal performance is observed
279. void faulted treatment If more than one error occur they will be displayed by turns m General alert In some circumstances alerts will behave as physiological alarm but in normal sense we don t regard them as real patient health related items 5 4 Patient Monitor user s manual V 2 2 Alarm 5 4 SILENCE and PAUSE m SILENCE CLOSE Push the SILENCE button on the panel for more than 1 second the system will shut off all sounds Push the SILENCE button again the system can exit the SILENCE status and accordingly suspend the alarm as per the previously defined time duration When the system is in the SILENCE status any new alarm will terminate the SILENCE status and make the system restore the normal alarm status A Note A When the lg symbol appears indicating the alarm sound is shut off and accordingly the system will not give alarm sound Therefore you must be very careful in using this function There are two methods to terminate this status One is to set the alarm volume to ON in the MAINTAIN menu The second method is to push the PAUSE button shortly to make the Jee symbol become 2 push the PAUSE button again and the system will restore the normal alarm status again The third method is to twice push the PAUSE button the system will restore the normal alarm status again m PAUSE Push the PAUSE button on the panel shortly the system will shut off all alarm sound and visual prompt as well as description of
280. wire to the equipotential grounding terminal on the main system If it is not evident from the instrument specifications whether a particular instrument combination is hazardous or not for example due to summation of leakage currents the user should consult the manufacturers concerned or else an expert in the field to ensure that the necessary safety of all instruments concerned will not be impaired by the proposed combination Equipotential Grounding Protection class 1 instruments are already included in the protective grounding protective earth system of the room by way of grounding contacts in the power plug For internal examinations on the heart or the brain the PM 6000 Modular Patient Monitor must have a separate connection to the equipotential grounding system One end of the equipotential grounding cable potential equalization conductor is connected to the equipotential grounding terminal on the instrument rear panel and the other end to one point of the equipotential grounding system The equipotential grounding system assumes the safety function of the protective grounding conductor if ever there is a break in the protective grounding system Examinations in or on the heart or brain should only be carried out in medically used rooms incorporating an equipotential grounding system Check each time before use that the instrument is in perfect working order The cable connecting the patient to the instrument must be free of electrolyte
281. y be used once for one patient The self test of the temperature measurement is performed automatically once per hour during the monitoring The test procedure lasts about 2 seconds and does not affect the normal measurement of the temperature monitoring 15 2 TEMP Module TEMP module refers also to the ECG TEMP module It is a standard module incorporating functions of ECG RESP and TEMP monitoring For ECG RESP monitoring refer to Chapter 12 Figure 15 1 TEMP module Indicator the indicator that indicates the working status of the module When the module is working this indicator is on AN Note A When loading the module this indicator is on at all times indicating that the module communicates with the host system triumphantly If the indicator is still flashing it means that the ECG TEMP module or the slot has failure In this case the operator should re load the module If the failure still exists please contact the Mindray service engineer for repair SETUP the button used to set up the related items of ECG REST TEMP Press SETUP button the ECG RESP TEMP SETUP menu appears on the screen The user may modify any item in the menu through using the rotary knob on the control panel 15 2 Patient Monitor user s manual V 2 2 TEMP Monitoring O Blank Button O Two sockets for TEMP sensor Before monitoring the patient the user should first safely insert the TEMP sensor cable
282. y is set at 5 uV V mmHg In order to set up the amplifier and recorder accurately the controls should be zeroed at ambient pressure and then a known pressure applied for instance using the calibration tube syringe and manometer or immersion to a known depth in a water column The gain of the system is Patient Monitor user s manual V 2 2 16 17 IBP Monitoring then set to the required level The procedure should be repeated to check that the zero baseline has not changed due to the change in gain Manometer and syringe to apphy ak nown pressure Patient Monitor Use a imlsyringe to inflate the balloon for zero check Luer fitting must be open to ambient pressure during normal operation Calibration tube Figure 16 11 ICT B calibration Tightening the collet on calibration tube over the sliding calibration sleeve will seal around the ICT B catheter Using the male luer fitting a connection can be made to a reference pressure such as a syringe and manometer The output of the transducer and amplifier system can be reliably and quickly confirmed Zeroing H Checking the Zero when the ICT B is in the Epidural Space Using a 1ml syringe inject approximately 0 3cc of air into the female luer connector on the proximal end of the ICT B Leave the syringe attached and note the value on the pressure monitor or scope The ICP will decrease to zero or a value very close to it If the monitor transducer combination has drifted fr
283. ype that the parameter has exceeded the limits may activate the recorder to automatically output the parameters and related measured waveforms when the alarms occur on the condition that the alarm record switch in the related menu is On TABLES BELOW DESCRIBE THE POSSIBLE PHYSIOLOGICAL ALARMS TECHNICAL ALARMS AND PROMPT MESSAGES OCCURRING DURING SPO2 MEASUREMENT Physiological alarm Message Cause Alarm Level SPO TOO HIGH SpO2 measuring value is above upper alarm limit User selectable SpO2 TOO LOW SpO2 measuring value is below lower alarm limit User selectable PR TOO HIGH PR measuring value is above upper alarm limit User selectable PR TOO LOW PR measuring value is below lower alarm limit User selectable Technical alarms Message Possible Cause s PA Recommendation May be an incorrect sensor or a defective sensor or cable Insert sensor into the SE EE LOW connector Disconnect and SpO2 NO i reconnect sensor Refer to the instructions for the sensor SENSOR being used Disconnect and reconnect he Sensor deeg LOW sensor with the logos upside down matching Disconnect and reconnect SpO2 SENSOR SpO2 sensor may be 5 disconnected from the LOW the sensor OFF patient or the monitor Reatta h See So Stop using the measuring De This message appears HIGH function of SpO2 module FAULT when the sensor is faulty notify biomedical engineer or our service staff 13 12 Patient Monitor user s manual V 2 2

Operation Manual - Artemis Medical

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