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Vital Signs Monitor (New) - Frank`s Hospital Workshop

1. WelchAllyn Vital Signs Monitor O perator s Manual CAUTION United States Federal Law restricts this device to sale by or on the order of a licensed health care practitioner TABLE OF CONTENTS Section Introduction L ALOU TNS OPEENS EI 1 e TOTA OTEO E E E E E EEEE ph neon E A are ntaness 1 3 Indications Contraindications For Use cceccceeccccscccceccccssccccsccccssccescccsscccssccesceceesceees 2 e E e E E N E 2 De DUO PMCS AG COS SO IICS a A estou norenccurtct ots acto O E ot acres 3 5 Section Il Functions amp Specifications 1 Blood Press re Cette Mod s aot cecrse ress ttaticn cca cra voy stecen asa wsaeta Aa ii 7 8 a Max Min Blood Pressure and Pulse Ranges eee eeeeeceeeeeeeeeeeeeeeeeseeeenaees 7 b Blood Pressure Manual Mode eessessesseeeeerresessrrsrrsrersrrsresrersresrersersresreseeesresseeees 8 C Blood Pressure Awtomatic Mode siciricss garrecnco mn rere EA ante 8 aed 507 oles ye avn ag OPE Cel aioe ener aera cane re ene E ere eee a ore ere 9 10 a Max Min Temperature IRA CS ca cty coer aanniavssiesonncunpnteacoaeusar aun yesemsaesgunemeisionnaees 9 pD Temperature Normal ModE arenerrrnn nerenrre reeereer tres ernment crrenrre E 9 e lemperdiure Montor NIG e sar cacascare cesar tanntones scone tanatanetsseneutainatonnsieeneaapensune ness 10 2 OP era NO ast acatsea rns seo E E E E E E E E 10 11 a Mog Min Py RINGO eei a a a EDERE 11 De DPI MON OEM ore e e A E ee E E N 11 e e e e E
2. Do not allow the tip of the temperature probe to come into contact with a heat source i e hands or fingers prior to taking a temperature measurement If this occurs dis card the probe cover and start the temperature determination process again Normal Mode 10 second axillary temperatures are accurate only for children under the age of four Normal Mode axillary temperatures will not be accurate on older children or adults The Welch Allyn Vital Signs Monitor is intended for use with adult and pediatric patients age 3 and above 32 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL SECTION IV OPERATING PROCEDURES 1 Power On System Check Procedure 2 Choosing Operating Modes 3 Setting the Programmable Alarms O CON D O11 e 18 19 20 Blood Pressure High Systolic Limit Blood Pressure Low Systolic Limit Blood Pressure High Diastolic Limit Blood Pressure Low Diastolic Limit Pulse Rate High Limit Pulse Rate Low Limit g SpO Low Limit moan oD Temperature Measurement Range Indicators Alarm Indications and Interpretation Setting the Default Inflation Pressure Preset Level Blood Pressure Cuff Selection Criteria Positioning the Blood Pressure Cuff Manual Mode Blood Pressure 10 11 12 13 14 15 16 17 Automatic Mode Blood Pressure Reviewing Information from Prior Cycles Selecting the Temperature Scale Selecting Temperature Operation Mode Taking Oral Temperatu
3. Note Normal mode axillary temperatures are only accurate on children 4 years or younger Note The Welch Allyn Vital Signs Monitor is intended for use with adult and pediatric patients age 3 and above The default setting for the Monitor is Normal mode To change the operating mode for temperature determinations the user must enter the Monitor s internal configuration mode 1 While the Monitor is turned off press both the POWER and START buttons simulta neously Hold the START button down until all of the LED display segments are illuminated 2 The operator can now cycle through the Monitor s internal configuration menu by pressing the REVIEW button Pressing the REVIEW button three times will cycle to the temperature options and three dashes will appear in the TEMPERATURE display 3 Press the ADJUST button once to choose Monitor mode F or three times to choose Monitor mode C When the desired selections are made press the REVIEW but ton again and then turn the Monitor off These choices will be saved into memory Note If the temperature is in Normal mode the user may easily switch to Monitor mode without entering the Monitor s internal configuration mode To do this remove the probe from the probe holder attach a new probe cover and wait one minute do not place probe in patients mouth underarm or rectum at this time After one minute the Monitor will automatically switch to temperature Monitor mode and
4. Sensors placed on the extremities should be positioned at heart level When selecting a sensor site priority should be given to an extremity free from an arterial catheter blood pressure cuff or intravenous infusion line This will reduce challenges related to poor pulse signals at the sensor site Venous blood is usually considered nonpulsatile Under conditions of elevated venous pressure right sided heart failure tightly applied sensors use of additional tape on the sensor or presence of a tourniquet or restrictive dressing peripheral venous blood may become pulsatile and could result in inaccurate SpO5 values To avoid inaccurate readings resulting from venous pulsations sensors should be applied according to the directions for use It is possible that light from the light source may scatter throughout edematous tissue before reaching the photodetector which can result in inaccurate readings Care should be taken to position the sensor on nonedematous sites If extensive peripheral edema is present the R 15 nasal sensor RS 10 reflectance sensor or Dura Y sensor with ear clip may be an acceptable alternative To reduce the potential for motion artifact on an active patient apply the sensor or an appropriate alternative sensor to a less active recommended site e g the great toe or forehead of an adult Cover the sensor site with an opaque material in the presence of bright light sources such as direct sunlight surgical l
5. 10 C to 40 C 50 F to 104 F Exception Thermometry module will not maintain its performance characteristics below 60 F 16 C OPERATING ALTITUDE 170m to 4877m 557ft to 16 000ft Il 6 D TRANSPO RTATION STO RAGE CONDITIONS STORAGE TEMPERATURE 20 C to 50 C 4 F to 122 F RELATIVE HUMIDITY 15 to 90 non condensing WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL SECTION III SYSTEM INSTALLATION 1 Unpacking Checklist 2 Controls Indicators and Connections 3 Set Up Procedure a Blood Pressure Hose amp Cuff Connections b Temperature Probe Connection c SpO Sensor Connection d AC Power Connection e Charging the Battery f Setting Up the Printer g Changing the Time and Date Setting 4 Safety Warnings and Cautions Hl 1 UNPACKING CHECKLIST After you have unpacked the Welch Allyn Vital Signs Monitor and the components iden tify each item with the checklist that follows and inspect for missing items Retain the shipping materials in the event of shipping damage or for return if necessary to Welch Allyn Tycos for repair or warranty service All Welch Allyn Vital Signs Monitors include the following components A G A Welch Allyn Vital Signs Monitor This device is a portable light weight device designed to automatically measure and display blood pressure and pulse rate Options available include pulse oxime try temperature and integrated printer B Operator Manual This manual To
6. A red rectal probe is available separately K Temperature Probe Covers One box of 25 single use disposable probe covers for both oral and rectal tempera ture determinations Note Report any signs of shipping damage to the carrier If an item is missing or dam aged contact the Welch Allyn Service Center near you See section VI of this manual for more information WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL lll B CONTROLS INDICATORS AND CONNECTIONS Note In this section all drawing and text are representative of the Welch Allyn Vital signs Monitor with all available options i e Blood Pressure plus Pulse Oximetry SpO3 Temperature and Printer Your Monitor may not include all functions depending on the options purchased SYSTOLIC mmHg L DIASTOLIC mmHg PULSE BPm C FRONT PANEL FRONT PANEL FUNCTIONS A POWER Button amp Indicator Light This on off button controls the power to the Monitor The indicator light will glow when the unit is on Battery power will be used unless the M onitor is powered through the AC power transformer START Button Pressing this button initiates an on demand blood pressure cycle CANCEL Button If a blood pressure cycle is in progress pressing this button aborts the cycle and immediately releases the cuff pressure In STAT automatic blood pressure mode pressing the cancel button aborts the cycle in process and cancels the STAT mode as well When pressed fo
7. Max Min Blood Pressure and Pulse Ranges b Blood Pressure Manual Mode c Blood Pressure Auto Mode 2 Temperature Operating Modes a Max Muin Temperature Ranges b Temperature Normal Mode c Temperature Monitor Mode 3 SpOy Operating Mode a Max Min SpO Ranges b SpOy Monitor Mode 4 Pulse Rate Feature a Max Min Pulse Rate Ranges 5 Performance Specifications 6 Technical Specifications a Mechanical Specifications b Electrical Specifications c Environmental Specifications d Transportation Storage Conditions WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 1 BLOOD PRESSURE OPERATING MODES When a blood pressure measurement cycle is initiated the cuff will automatically inflate to the default pressure level The cuff will immediately begin to deflate in a stepped fashion and will determine systolic pressure and diastolic pressure from the pulses sensed by the cuff at various pressure lev els This is the oscillometric method of non invasive blood pressure monitoring Blood pressure measurements may be initiated manually or automatically at time inter vals determined by the user At the completion of a measurement cycle the systolic and diastolic pressures are dis played If the Monitor is in Automatic Mode the measured values are kept on display until the next BP measurement is initiated When not in Automatic Mode the measured values are displayed for two minutes after which time the display screen is bl
8. by pressing the SILENCE button This will silence the audible tone dis play will continue to flash while the practitioner attends to the patient and Monitor Silence mode resets automatically after 30 seconds or when the patient s condition returns to within the preset alarm parameters Note Certain alarms alert the operator to abnormal system conditions or internal sys tem failures Alarm conditions error codes and suggested operator action are reviewed in the Troubleshooting section Section V 1 of this manual 40 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 6 SETTING THE DEFAULT INFLATION PRESSURE PRESET LEVEL The default cuff inflation level for blood pressure measurements is set in the Monitor s internal configuration menu The factory default level is 160 mmHg If desired the default pressure preset can be changed by following these instructions e Turn the monitor off e Press both the POWER button and the START button simultaneously The Monitor will enter it s internal configuration mode e Press the REVIEW button 6 times PrP will appear in the systolic display and the default pressure preset level will appear in the diastolic display e Press the SET arrow up and arrow down buttons to cycle through the seven options available 120 140 160 180 200 240 and 280 mmHg e When the desired pressure preset level is illuminated press the REVIEW button once to save this change e Turn the Monit
9. e movement may cause inaccuracies from artifact Do not contact tubing during blood pressure cycle e movement may cause inaccuracies from artifact Check all connections Do not over tighten Replace probe Consult Technical Manual Notify Biomedical department or Welch Allyn Technical Support Wait for display window to read OrL before placing probe Place probe in most posterior sublingual pocket Notify Biomedical department or Welch Allyn Technical Support Replace probe in holder prior to taking another temperature Insert the patient s finger completely into sensor Ensure sensor cable is correctly plugged into monitor Ensure Sp05 is enabled check Configuration Mode Ensure that correct manufacturers sensor is in use e Nonin and Nellcor Puritan Bennett sensors are not interchangeable Consult Technical Manual Notify Biomedical department or Welch Allyn Technical Support Check connections between monitor and transformer and trans former and wall receptacle Unplug unit from wall receptacle and check for breaks in cord If connections secure check electrical outlet e Charging light will be on if connections are OK and the monitor is plugged into a working outlet Notify Biomedical Department or Welch Allyn Technical Support Check default Pressure Preset setting in Configuration Mode e Unless patient has underlying systolic hypertension set pressure preset at 160 mmHg If systolic blood pressure
10. s Manual for complete information on the Nurse Call interface VSM Monitor RS232 Cable t p a a E L LA oltiate RS232 D8 9 k Se Anis Nire Narma ONHAr Nurse Call Contacts 30VDC 1Amp or 240VAC 1Amp The Welch Allyn Vital Signs Monitor provides a switch closure output between two pins of the serial connector pins 7 and 8 The output is universal in that it is compatible with a wide vari ety of different systems with no polarity dependence The Nurse Call output is ohmically isolated from all circuitry The output is rated for 1 Amp at 240 VAC or 30VDC During an alarm condi tion the output is closed otherwise the output is open During a power off or power failure condi tion the output is open 98 Welch Allyn Vital Signs M onitor Serial N umber Date of Purchase Dealer Name Telephone Dealer Representative N ame Telephone Welch Allyn Sales Representative Welch Allyn Vital Signs Monitor O perator s M anual Copyright 1999 Welch Allyn Inc All rights reserved Printed in U S A WelchAllyn Welch Allyn Inc 4341 State Street Road P O Box 220 Skaneateles Falls NY 13153 0220 Tel 315 685 4100 or 1 800 535 6663 Fax 315 685 3361 Part 95P442E Rev A
11. 3 years All blood pressure pulse temperature and SpO gt s values are displayed on large easy to read displays and may be printed via an integrated thermal printer as desired The rechargeable battery and wide variety of mounting accessories make the Welch Allyn Vital Signs Monitor convenient for many locations The operator may choose any combi nation of simultaneous measurement modalities This flexibility combined with features such as programmable alarms and automatic blood pressure cycles makes the Welch Allyn Vital Signs Monitor ideal for a wide variety of patient monitoring needs The Welch Allyn Vital Signs Monitor is intended for use in a wide variety of health care settings This includes hospital departments as well as patient transport within the hospi tal environment The Welch Allyn Vital Signs Monitor is also intended for use in alternate care settings such as physician offices freestanding ambulatory care and surgery centers health clinics and nursing homes The Welch Allyn Vital Signs Monitor may also be used during patient transport within any of these alternate care environments The Welch Allyn Vital Signs Monitor is not intended for the monitoring of patients during transport external to the health care environment eg ambulance helicopter transport The Welch Allyn Vital Signs Monitor is not intended for use in environments which are not supervised by a health care practitioner WELCH ALLYN VITAL SIGNS MONITOR O
12. 40 bpm PULSE RATE ACCURACY SpO Module Heart Rate Nonin 3 0 SpO Module Heart Rate Nellcor Puritan Bennett 3 bpm Blood Pressure Algorithm Heart Rate 5 0 OVERPRESSURE CUTOFF 295 mmHg to 330 mmHg TEMPERATURE DETERMINATION Normal and Monitor Modes Maximum 108 0 F 42 2 C Minimum 84 0 F 28 9 C TEMPERATURE ACCURACY Temperature accuracy meets ASTM E112 86 Standard Specification for Electronic Thermometer for Intermittent Determination of Patient Temperature 13 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL TEMPERATURE DETERMINATION TIME ORAL Normal Mode ORAL 4 seconds typical 15 seconds maximum Monitor Mode ORAL 3 minutes OXYGEN SATURATION RANGE SpO5 40 99 oxygen saturation SpO ACCURACY Nonin Pulse Oximeter Module Saturation SpO gt 1 Standard Deviation 70 99 2 digits lt 70 unspecified Nellcor Puritan Bennett Pulse Oximeter Module Saturation SpO gt 1 Standard Deviation 70 99 3 digits lt 70 unspecified Standard Deviation is a statistical measure up to 32 of the readings may fall outside these limits BATTERY CHARGING To at least 90 capacity in 12 hours Unit will operate and charge battery simultaneously when connected to power source A fully charged battery will support 200 typical blood pressure determinations taken at 3 minute intervals Battery is 90 100 charged after 12 hours of charging The battery auto matically charges when
13. ANTI THEFT BLOCK onto tab on BASKET PLATE oriented as shown below Allow ANTI THEFT BLOCK to rest freely as shown Do not tighten SET SCREW 2 Attach monitor to BASKET PLATE 3 Slide ANTI THEFT BLOCK up until it seats against bottom of monitor With allen wrench provided tighten SET SCREW to secure ANTI THEFT BLOCK to tab 4 Retain allen wrench for future use BASKE CY ANTI THEFT BLOCK Instruction Sheet P N 95P375 3 14 97 ART9808 E 96 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL WelchAllyn Vital Signs Monitor Transformer Mounting Instructions Transformer Mounting Kit Model 5200 106 1 Position PLATE in basket as shown 2 Place TRANSFORMER in BRACKET With transformer oriented as shown secure bracket to plate using 2 6x 5 16 long pan head phillips screws Tighten screws to prevent transformer movement 3 Remove basket plate mounting screw indicated and replace with 8 32 x 1 2 long pan head phillips screw Tighten securely 4 Place STRAP over basket plate mounting screw in basket plate with hook and loop side towards basket Secure with 8 LOCKNUT 6 32 x 3 16 PAN HEAD PHILLIPS BASKET PLATE MOUNTING SCREW J LOCKNUT BASKET HOOK AND LOOP SIDE TRANSFORMER BRACKET Instruction Sheet P N 95P395 12 06 96 ART9859 97 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL APPENDIX D NURSE CALL INTERFACE WIRING DIAGRAM Note See Section V 19 A of the Operator
14. CENTERS For Service or Repair USA Customers CANADA Customers Welch Allyn Inc Welch Allyn Canada Limited Technical Service Center Technical Service Center 95 Old Shoals Road 160 Matheson Blvd East Arden NC 28704 9739 USA Mississauga Ontario L4Z 1V4 CANADA Phone 828 684 4895 Phone 416 890 0004 or 1 800 561 8797 Fax 828 687 1002 Fax 416 890 0008 INTERNATIONAL CUSTOMERS LATIN AMERICA CUSTOMERS Welch Allyn MDI International Speidel Keller GmbH Co Technical Service Center Technical Service Center 7324 S W 48th Street Suite A Zollerstrasse 2 4 Miami FL 33155 USA D 72417 Jungingen Phone 305 669 9591 GERMANY Fax 305 669 1971 Phone 49 7477927173 Fax 49 7477927193 Welch Allyn Australia Pty Ltd Welch Allyn Ltd Technical Service Center 21 09 Golden Mile Ground Floor 18 20 Orlon Road Beach Road Lane Cove NSW 2066 AUSTRALIA Singapore 199589 Phone 61 29 4183 155 REPUBLIC OF SINGAPORE Fax 61 29 4183 650 Phone 65 291 0882 Fax 65 291 5780 Welch Allyn UK Ltd Cublington Road Aston Abbotts Buckinghamshire HP224ND UNITED KINGDOM Phone 44 129 668 2140 Fax 44 129 668 2104 71 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Ce The CE Mark on this product indicates it has been tested to and conforms with the provisions noted with the 93 42 EEC Medical Device Directive European contact for regulatory compliance European Regulatory M anager Welch Allyn LTD Navan C
15. E sgeer cen neeeonen antes aeen eeteseentuceenerseae eareniee 12 a Max Min Pulse Rate Ranges eeeseserserereerrerrsrrsrrsrrsrrsresrrsresrrsresresresrrsresresreses 12 a TOPO RIGS Pece ON a E E R 13 14 Ga Tecna Pecica ON a E E E E E 14 15 ax Mechanical SPCC CA OIG sisiccprirrse oerien iein n ECESE Ero E Ena e Ea A EEEE 14 De Plecia lope ANS a E RE EESE E EEEE i C Environmental SpeciNcaHonS sarieun E 15 d Iransportalon Slorage CondiHoNS sissa ennea iE EEE 15 Section III System Installation E Uopackine CECS ene tT E E E EAE ee ee 16 17 2 Controls Indicators and Connections sseseenssseerseseerssseeressseresseeresseerssssersesseres 18 22 a Pon el a E E E ott 18 20 b Side amp Rear Panel Connections iicsscncsccsienssicccvensdecdovesectevensastdonssucuswensdescousneouss 21 22 a Se UPTE O O a E A E E E E 22 29 a Blood Pressure Hose amp Cuff Connections 0 ccceeeececccccccesesessssesccseseeeeeneees 22 23 D demperaire Prope Conneccion sirrinin nnen RE E EE 24 C DPOF ear C OECO orarin E O NEE E 2 Cl AG Power GE ONCE HOM semeresini eino E e i 26 e CNN E Da CN eea esse E uasiwssoomenuesavacessncneenenteaaee 26 Hg Cna UP E T r E EEE AA 27 28 2 Changing the Date and Mme Selg sossannirdrsekns oone EE EE 29 4 gatety Warnings and AU ONS cee se sacs ccsge ae nsaeceoescueacacaucoayinsersgesaansscevietareeseeeeeseaee 30 32 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Section IV Operating Procedures 1 Power On S
16. Only Nellcor Puritan Bennett SpO sensors and accessories may be used with this configuration of the Welch Allyn Vital Signs Monitor Inserting the sensor connector into the Monitor port 25 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL lll 3 D SET UP PROCEDURE AC POWER CONNECTION The Welch Allyn Vital Signs Monitor may be powered by either AC power or battery power after the battery has been charged To install the AC power transformer insert the round transformer connector into the power port on the side of the Monitor as shown Insert the connector into the port until it is fully seated Insert the line cord into the line connector on the transformer Inserting the AC power transformer connector into the Monitor port To power the Welch Allyn Vital Signs Monitor plug the line cord into the AC mains power source Ill 3 E SET UP PROCEDURE CHARGING THE BATTERY The Welch Allyn Vital Signs Monitor may be powered by either AC power or battery power after the battery has been charged UPON INITIALLY RECEIVING THE MONITOR CHARGE THE BATTERY FOR SIX TEEN 16 HOURS OR UNTIL THE CHARGING INDICATOR LIGHT NO LONGER FLASHES The battery is charged by attaching the AC power transformer to the Monitor and plugging the AC power transformer into the AC mains power source While charging the charging indicator will flash a yellow light When the Monitor is fully charged the flashing light will be replaced with a solid
17. REVIEWING INFORMATION FROM PRIOR CYCLES The Welch Allyn Vital Signs Monitor will hold in memory the previous 99 sets of vital signs data which include blood pressure pulse rate and or temperature and or SpO gt The information is held in memory until the Monitor is turned off When memory capaci ty 99 sets of data has been reached the MEMORY indicator will blink After capacity is reached the oldest stored reading will be deleted to make room for the newest data set The following criteria are applied for saving data Blood Pressure Data will be saved for both MANUAL and AUTOMATIC cycles Predictive Temperature Data will always be saved Monitor Mode Temperature Data will be saved only if concurrent with a blood pressure cycle SpO Data will be saved if concurrent with a blood pressure cycle or a predictive tem perature measurement Will be saved if the START button is pressed while the BP mode is inactive Will also be saved one data set per minute if a patient alarm condition occurs Pulse Rate Data will be saved with every blood pressure and SpO gt data set To review data from prior vital signs measurements press the REVIEW button The most recently obtained data will appear in the appropriate displays and the CYCLE display will show the total number of data sets currently in memory Also the MEMORY indica tor will be illuminated indicating that stored data is being displayed Each subsequent press of the REVIEW but
18. a more secure fit on active patients than the Durasensor finger clip sensor Sterility Adhesive Oxisensor II and OxiCliq sensors are sterile in their unopened packages They offer an infection control advantage for patients with suspected or confirmed infections and for those at greater risk for infection such as neonates or immunosuppressed patients Reusable sensors are nonsterile and require cleaning between patients with 70 alcohol or 1 10 bleach Monitoring Compatibility Only Nellcor Puritan Bennett brand SpO gt sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nellcor Puritan Bennett pulse oximetry option This sensor is for use only with Nellcor Puritan Bennett instruments and with instruments that contain Nellcor Puritan Bennett oximetry or are licensed to use Nellcor Puritan Bennett sensors Consult individual manufacturers for compatibility of particular instru ments and sensor models Each instrument manufacturer is responsible for determining whether its instruments are compatible for safe and effective use with each Nellcor Puritan Bennett sensor model Because most monitoring systems manufacturers offer Nellcor Puritan Bennett sensor compatibility many hospitals now apply an Oxisensor II sensor to each monitored patient The sensor can travel with the patient from department to department throughout the hospital stay Latex Content The adhesive coating of the bandage on th
19. achieve satisfactory results the operator should read this manual thoroughly before attempting to use the monitor Save this manual for helpful product refer ence C Instrument Warranty Card Fill this out today and return to Welch Allyn This card validates your warranty 16 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL D Large Adult Size Cuff Assembly Includes cuff bladder and pneumatic tubing with connector Note A full range of cuff sizes are available as accessory items however the Large Adult cuff will fit the majority of adults and give the most accurate blood pressure measurement E Coiled Pressure Hose With connector connects a variety of blood pressure cuffs to the monitor F Power Transformer and Cord Assembly Operates the monitor and charges the internal battery G Cuff Clip Attaches to the rear of the monitor to hold the blood pressure cuff Not used if mobile stand pole mount or wall mount accessories are purchased Certain Welch Allyn Vital Signs Monitors will include the following items based on the options purchased PRINTER OPTION H Box of Printer Paper Six 6 rolls of thermal printer paper One additional roll will be pre loaded into the printer PU LSE O XIM ETRY SpO 2 OPTION I Finger Clip SpO Sensor and Cord Other sensors are available separately TEM PERATURE OPTION J Oral Temperature Probe The blue oral probe is used for both oral and axillary temperature determinations
20. adjunct to the blood pressure measurement and the SpO measurement The pulse rate in beats per minute will be determined primarily from the SpO measure ment methodology In the case where SpO is not available or is disabled the pulse rate display will be driven by data from the blood pressure measurement method There are two operator selectable alarm limits for the pulse rate They are PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT Pulse rates which activate alarm limits are indicated by a flashing display and a repetitive audible tone Should a pulse rate alarm occur when the pulse rate measurement is derived from the blood pressure measurement no subsequent blood pressure or pulse rate measurements may be made until the alarm is reset The alarm may be reset by pressing any button on the Monitor s display Should a pulse rate alarm occur when the pulse rate measurement is derived from the SpO gt measurement the monitor will indicate an alarm condition flashing amp beeping while continuing to monitor and display the patient s current SpO 7 and pulse rate The alarm will automatically reset when the patient s condition returns to within the preset alarm parameters Should a patient alarm condition for pulse rate occur during SpO monitoring the oper ator may invoke Silence Mode by pressing the SILENCE button This will silence the audible tone display will continue to flash while the practitioner attends to the patien
21. and a repetitive audi ble tone If an alarm limit is violated subsequent blood presssure determinations may be made only after the alarm condition is reset by pressing any button on the Monitor s dis play ll 1 C BLOOD PRESSURE AUTOMATIC MODE The Automatic Blood Pressure Mode is entered by pressing the AUTO button Pressing the AUTO button displays a choice of 11 cycle interval times as follows St STAT mode 1 minute 3 minutes 4 minutes 5 minutes 10 minutes 15 minutes 30 minutes 45 min utes 60 minutes and 90 minutes These choices represent the time interval from the beginning of one cycle to the beginning of the next automatic cycle STAT mode allows the monitor to take continuous blood pressure measurements for 15 minutes In addition the operator may choose to disable the Auto Mode by choosing two dashes Note In the 1 minute automatic cycle mode the Welch Allyn Vital Signs Monitor will automatically take blood pressure measurements in 1 minute intervals for up to 15 minutes A measurement cycle may be cancelled at any time by pressing the CANCEL button This action immediately initiates a rapid cuff deflation The blood pressure measurement data will appear on the display immediately following the measurement and will remain displayed until the next measurement cycle is initiated In Blood Pressure Auto Mode the following alarm limits may be activated SYSTOLIC HIGH LIMIT SYSTOLIC LOW LIMIT DIASTOLIC HIGH
22. another temperature measurement When in Normal mode the current temperature is displayed for one minute after the probe is replaced in the holder after which time the display will go blank The most recent temperature can be recalled by pressing the REVIEW button once Note If a probe position error occurs during the temperature determination the tempera ture display will alternate between the final predicted temperature and the letter P in the display IV 16 TAKING A RECTAL TEM PERATURE To take a rectal temperature in either Normal or Monitor mode follow this procedure 1 Insure that the rectal probe is connected to the unit The rectal probe has a RED tip Accurate rectal temperatures can only be obtained by using the red temperature probe Remove the probe from the probe holder A short self test mode will be initiated where every LED segment on the TEMPERATURE display is illuminated briefly Following this self test the display will show rEC rEC Rectal Probe indicating that the rectal probe is in use The Monitor s display must show rEC prior to the initiation of a temperature measurement Load a probe cover onto the probe by holding the probe collar with the thumb and forefinger being careful not to press the ejection button See illustration below Loading the probe cover 52 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 4 Separate the buttocks with one hand Apply a thin coat of wa
23. be obtained in this loca tion Temperatures in other mouth locations can vary by as much as 2 F or 1 C Location of the sublingual pockets The probe should be held by the clinician during the entire temperature measure ment process to insure the probe tip maintains tissue contact During the temperature measurement cycle the TEMPERATURE display will show a series of LED segments in a box shaped formation This indicates that the tempera ture measurement is in process When the final temperature has been reached a tone will sound and the temperature will be displayed on the Monitor After the temperature measurement is complete remove the probe from the patient s mouth and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover Insert the probe into the probe holder before attempting to take another temperature measurement The current temperature is displayed for one minute after the probe is replaced in the holder after which time the display will go blank The most recent temperature can be recalled by pressing the REVIEW button once Note If a probe position error occurs during the temperature determination the tempera ture display will alternate between the final predicted temperature and the letter P in the display 90 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 15 TAKING AN AXILLARY TEM PERATU RE Note Normal mode axillary tempera
24. greater than pressure preset monitor will automatically increase an additional 40 mmHg Determine cuff size with the cuff markings or refer to chart in Operator s Manual for determining cuff size e If cuff continues to pop off notify Biomedical Department or Welch Allyn Technical Support Re apply cuff e Make sure Welch Allyn label is facing away from arm WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Symptom Possible Cause Explanations and Corrective Action 10 CUFF DEFLATING Normal operation o time to take a reading is 20 to 45 seconds 165 seconds is the maximum TOO SLOWLY Pressure Preset too high Check default Pressure Preset setting in Configuration Mode Patient movement Have patient sit still Do not have arm tight against chest wall as respirations may affect speed and accuracy of blood pressure measurement Small leak in pneumatic system Check cuff and tubing for leaks QUICK GUIDE TO TAKING A MANUAL AUSCULTATORY BLOOD PRESSURE Action EXPLANATION 1 Collect appropriate equipment Many sphygmomanometers are inaccurate Low quality stetho Use a certified accurate sphygmomanometer and quality scopes do not transmit sound well enough for blood pressure stethoscope sounds to be heard accurately A cuff that is either too large or too small will produce an inaccurate reading Select a blood pressure cuff of a suitable size Use a blood pressure cuff of the largest appropriate size for patient see
25. markings on inside of cuff Have the patient assume a comfortable position with the 3 If the arm is not at the proper level inaccurate readings will result upper arm relaxed at heart level and the lower arm passively supported Expose the area of the brachial artery by removing clothing Clothing over the artery hinders the ability to hear and may cause or move a sleeve if not too tight above the area where the inaccurate readings Tight clothing may cause vessel congestion and cuff will be placed inaccurate readings Center the cuff bladder so that the lower edge is at least 1 This places the cuff in the best position for occluding the blood flow inch 2 5cm above the bend of inner arm of the elbow through the brachial artery Palpate the brachial or radial pulse 3 Determines the most accurate location for assessment and approxi mation of systolic pressure Inflate the cuff until the pulsation disappears Then continue Facilitates identification of Phase One of Korotkoff sounds to inflate until the pressure reads 30 mmHg above the point where the pulse disappeared Listen carefully with stethoscope over brachial artery while One of the major sources of error in auscultatory blood pressure controlling the release of air at a rate of 3 mmHg per second measurement is deflating the cuff too quickly It is a normal opera tion of the Welch Allyn Vital Signs Monitor to deflate at the American Heart As
26. monitor or in the U S contact Nellcor Puritan Bennett s Technical Services Department Outside the U S contact your local Nellcor Puritan Bennett representative For the accuracy specification range when used with a monitor other than those manufactured by Nellcor Puritan Bennett consult the information provided by the manufacturer of that instrument Note Refer to the instrument operator s manual for complete instructions for use of the sensor with that monitor CAUTION Federal law U S restricts this device to sale by or on the order of a physician This sensor is sold under the following U S Patents and foreign equivalents 4 621 643 4 685 464 and 4 700 708 Oxisensor 11 and Durasensor are trademarks of Nellcor Puritan Bennett Inc 91 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL APPENDIX C WELCH ALLYN VITAL SIGNS MONITOR MOUNTING ACCESSORIES amp ASSEMBLY INSTRUCTIONS THE WELCH ALLYN VITAL SIGNS MONITOR BASKET The mobile stand IV pole mount and wall mount systems use the same basket Attaching the Monitor onto the Basket Assembly Locate the two keyhole slots on the rear of the Monitor and the two circular lugs on the basket assembly just above the basket Insert the lugs into the large openings in the key hole slots and slide the Monitor down until it is secured Removing the Monitor from the Mobile Stand Locate the metal tab underneath and toward the back of the Monitor With one hand in the ha
27. non functional the user must enter the Monitor s config uration mode This may be accomplished by following these instructions e Turn the Monitor off e Press both the POWER button and the START button simultaneously The Monitor will enter it s internal configuration mode e Press the REVIEW button 9 times ON will appear in both the Systolic and SpO5 displays e Press the SET arrow up and arrow down buttons to cycle through the three options available Systolic Display SpO2 Display Monitor Functionality On On Both blood pressure and pulse oximetry modes are operational This is the factory default mode OFF On Blood pressure mode is disabled Pulse oximetry mode is operational On OF Blood pressure mode is operational Pulse oximetry mode is disabled e When the desired functionality is displayed press the REVIEW button once to save this selection e Turn the Monitor off e When the Monitor is turned on the new functionality setting will be established as the default level The Monitor will always revert to this setting on power up 34 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 3 SETTING THE PROGRAMMABLE ALARMS The Welch Allyn Vital Signs Monitor has the ability to generate a visual and audible alarm when certain patient conditions are detected by the monitor The following chart outlines the conditions ranges programming intervals and default values for the alarm function Warning It is the o
28. of the tape Press the sensor into the foam with the windows out and apply to the patient Use additional tape to secure the lead wire to the patient to avoid pulling or tipping the sensor Caution The reflectance sensor is not recommended for pediatric patients because the accuracy has not been established for pediatric use 5 NONIN ADULT AND PEDIATRIC FINGER FLEXI FORM SENSOR These sensors are designed for monitoring adult and pediatric patients as a single patient use sensor and are intended for use where moderate patient movement is expected or cross contamination is possible The preferred application site is the index finger However other fingers or toes may be used where the tissue thickness is between 5 and 21 millimeters Other sites may not give acceptable results because of inadequate perfusion or inadequate light transmission The application of these sensors is the same for either the adult or the pediatric patient The difference is in the size of the sensor For best results secure the cable independently from the sensor Make sure that the tape securing the cable does not restrict the blood flow Caution Do not stretch the tape while applying the sensor This may cause inaccurate readings or skin blisters NOTE These sensors may be sterilized using ethylene oxide EtO cold cycle after removal from the plastic shipping bag 76 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL a Grip the tab on the sensor s botto
29. over the light source and photo detector to restore adhesive quality and extend the life of the sensor e In cases of poor perfusion adhesive sensors may obtain more reliable readings than reusable sensors The R 15 nasal sensor or RS 10 reflectance sensor may provide read ings when peripheral pulse signals are poor e The Oxisensor II D 25 and D 20 sensors have an 18 inch cable while the I 20 N 25 and D 25L come with a 36 inch cable to accommodate application in a variety of situations The OxiCliq sensor cable OC 3 is a 36 inch cable linking the OxiClig sensor to the pulse oximeter 83 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Reusable Sensors e Check sensor site and circulation distal to the sensor and move the sensor to another site at least every four hours or as specified in the directions for use e Avoid applying additional tape to minimize the risk of impaired perfusion and tissue injury However applying tape over the cable may help prevent the sensor from becoming dislodged e Clean sensor by wiping with 70 alcohol or a 1 10 bleach solution e Carefully remove the adhesive wrap from the D YS OXI P I OXI A N and RS 10 to avoid damage to the patient s skin and the sensor e Secure the RS 10 reflectance sensor with the headband provided Avoid use on patients in Trendelenburg supine or lateral positions and with patients on mechanical ventila tors e Apply Do not throw away labels to cables of reusab
30. sensor clicks into place in the cable connector and is easy to detach when monitoring is interrupted This two part system is less expensive than other adhesive sensors Nellcor Puritan Bennett offers OxiCliq models to fit different patient sizes 78 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Reusable Sensors Nellcor Puritan Bennett also offers a broad line of reusable sensors designed to monitor various sizes of relatively immobile patients particularly when cross contamination is less of an issue When short term or intermittent monitoring is necessary these reusable non sterile sensors are an effective monitoring alternative Nellcor Puritan Bennett offers the following models of reusable sensors and accessories e Durasensor finger clip sensor e Dura Y multisite sensor which can be applied with disposable wraps an ear clip for adults or a pediatric spot check clip depending on patient size e Oxiband sensors applied with disposable wraps e RS 10 adhesive reflectance sensor CHOOSING A SENSOR BASIC PRINCIPLES The following considerations should be evaluated when choosing a sensor for your patients Weight All sensors contain a light source and photodetector which are the essential optical com ponents necessary to determine arterial oxygen saturation by pulse oximetry SpO gt 5 All Nellcor Puritan Bennett sensors are designed so that the light source and photodetector are positioned a certain distance
31. the AUTO button and note two dashes in the CYCLE display This is the default setting for AUTO mode and indicates that no time interval cycles have been selected Select one of the ten pre programmed cycle interval times by pressing the AUTO but ton until the desired interval time in minutes is displayed The operator may choose from the following time interval selections 1 3 4 5 10 15 30 45 60 or 90 minutes Note These intervals represent the time from the beginning of one cycle to the beginning of the next cycle Note In 1 minute automatic cycle mode the Monitor will automatically take BP measurements in 1 minute intervals for up to 15 minutes The operator may also choose St STAT mode In STAT mode the Monitor takes blood pressure readings repeatedly for up to 15 minutes A new measurement cycle will be initiated when the cuff pressure from the previous cycle drops below 10mmHg When the desired interval is displayed the operator may select the interval by press ing any other button or by refraining from pushing the AUTO button for 10 seconds When the interval is stored the AUTO indicator light will glow green The unit will take its first automatic blood pressure determination 10 seconds after the time interval is selected Subsequent readings will be taken according to the time interval selected For the first automatic blood pressure determination the Monitor will inflate the cuff to the default pressure preset
32. the accessory pack The accessory pack will release from the basket 92 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Attaching and Removing the Accessory Pack from the Monitor Use the preceeding instructions for attaching and removing the accessory pack from the basket Inserting the Box of Temperature Probe Covers Open the box of 25 probe covers as directed Insert the box into the rectangular opening beside the pocket on the Accessory Pack The box will be tilted slightly to allow probe covers to be readily accessible when the Accessory Pack is mounted either on the basket or the Monitor THE MOBILE STAND The mobile stand is designed to be rugged and durable An integrated handle allows the stand to be easily wheeled wherever it is needed Two of the five wheels on the mobile stand are equipped with a brake These wheels can be identified by a lever on the outside of the wheel The brake is engaged by pushing on one end of the lever The brake may be released by pushing on the opposite end For best results use both brakes to insure that the mobile stand remains stationary THE IV POLE MOUNT The IV Pole Mount kit allows the Welch Allyn Vital Signs Monitor to be attached to an IV pole with a diameter range of 0 75 inches to 1 25 inches It is recommended that the Monitor be detached from the mounting hardware before attempting to attach or detach the pole mount to the pole When attaching the pole mounting hardware to the pole i
33. the green Monitor Mode dis play will be illuminated on the temperature display The operator may now proceed to take the patient s temperature After the probe is replaced in the holder the Monitor will revert back to Normal temperature mode 48 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 14 TAKING AN ORAL TEMPERATURE To take an oral temperature in either Normal or Monitor mode follow this procedure 1 Insure that the oral probe is connected to the unit The oral probe has a BLUE tip Accurate oral temperatures can only be obtained by using the blue temperature probe Remove the probe from the probe holder A short self test mode will be initiated where every LED segment on the TEMPERATURE display is illuminated briefly Following this self test the display will show OrL OrL Oral Probe indicating that the oral probe is in use The Monitor s display must show OrL prior to the initiation of a temperature measurement Load a probe cover onto the probe by holding the probe collar with the thumb and forefinger being careful not to hold or press the ejection button See illustration below Loading the probe cover 49 10 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Insert the probe tip gently into the patient s slightly opened mouth Carefully slide the probe under the tongue on either side of the mouth to reach the sublingual pock et see illustration below Accurate temperatures can only
34. the monitor is powered through the AC power transformer The battery will charge faster when the instrument is not in operation Ii 6 A TECHNICAL SPECIFICATIONS MECHANICAL SPECIFICATIO NS DIMENSIONS Height 6 5 inches 16 5cm Length 8 6 inches 21 8cm Depth 5 0 inches 12 7cm WEIGHT Approximately 6 pounds 2 8Kg COLOR Oral Axillary Temperature Probe Blue Rectal Temperature Probe Red 14 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL MOUNTING Self Supporting on rubber feet IV Pole Mountable Custom Mobile Stand Wall Mountable Attaches to Bed Rail PORTABILITY May be hand carried when held by the recessed handle When attached to an IV pole or mounted on its custom mobile stand the monitor and accessories can be wheeled from patient to patient When attached to the bed rail may be transported with the patient within the hospital environment OPERATOR INSTRUCTIONS ALARM INTERPRETATION Comprehensive Operator Manual available Quick reference operator instruction card available Il 6 B ELECTRICAL SPECIFICATIONS POWER REQUIREMENTS Patient Rated isolation transformer is connected to AC mains power source North American Version 120VAC 60 Hz 0 20A Input Source 8Vdc 0 75A Output Source International Versions 230VAC or 240VAC 50Hz 0 20A Input Source 8Vdc 0 75A Output Source BATTERY Lead acid with external recharge capability Il 6 C ENVIRONMENTAL SPECIFICATIONS OPERATING TEMPERATURE
35. yellow indicator light 26 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Ill 3 F SET UP PROCEDURE SETTING UP THE PRINTER A fully integrated thermal printer is available as an option to the Welch Allyn Vital Signs Monitor To load paper into the printer follow these steps 1 Grasp the printer cover as shown and slide the cover off of the Monitor by sliding the cover towards you Sliding off the printer cover 2 Holding a new roll of paper as shown feed approximately 1 inch of paper into the slot at the bottom of the paper holder Release the paper roll so that it sits in the bot tom of the paper holder Feeding the paper into the slot 2 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 3 Press the paper FEED button to advance the paper 3 to 4 inches above the top paper slot Advancing the paper 4 Thread the paper through the paper slot on the printer cover Slide the cover on to the Monitor and press down until it clicks into place as shown The excess paper may be torn off if desired Replacing the printer cover Note The operator will notice a red stripe along the edge of the printer paper when the paper roll is almost at the end Replace the printer paper with a new roll when the red stripe is observed 28 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL ll 3 G SET UP PROCEDURE CHANGING THE TIME DATE SET 1 Initiate the Monitor s internal configuration settings menu by pow
36. 5 D 25L oea C E QUANTITY Case of 24 Case of 24 niio Case of 24 Case of 24 Pediatric c cou Infant OxiClig adhesive sensors sterile single patient use CHARACTERISTICS e For patients who weigh more than 30 kg Preferred application site is index finger Alternative sites are thumb smaller finger great or second toe e D 25 has an 18 inch cable e D 25L has a 36 inch cable e Check at least every 8 hours e For patients who weigh between 10 and 50 kg Preferred application site is index finger Alternative sites are thumb smaller finger great or second toe e Check at least every 8 hours e For infants who weigh between 3 and 20 kg Preferred application site is great toe with cable running along sole of foot Alternative site is thumb or other digit e Use enclosed tape strip to secure cable to patient s foot or hand e Check at least every 8 hours e For patients who weigh more than 50 kg Only application site is bridge of nose e For use in no motion environments e Check at least every 8 hours Case of 24 OC 3 cable sold separately e For patients who weigh more than 30 kg Preferred application site is index finger Alternative sites are thumb smaller finger great toe e Must be used with OxiCliq OC 3 sensor cable e Check site at least every 8 hours YOLINOWSNOIS IVLIA NATIV HOTAM IVANVW Yd OLVdsd O OPERATOR MANUAL WELCH ALLY
37. ITOR MODE The SpO monitor performs most accurately with the fingerclip sensor which may be used on all fingers except the thumb The finger clip sensor is recommended for spot checks or short term continuous monitoring The device determines arterial oxyhemoglobin saturation SpO by measuring the absorption of red and infrared light passed through the tissue Oxygen saturation and pulse rate are displayed on the LED digital display On each detected pulse the pulse sig nal bar graph flashes The intensity of this signal is a simple visual indicator of waveform signal strength and can identify situations where the pulsatile nature of the tissue may not be adequate for an accurate SpO reading The update interval of the bar graph should correspond to the patient s pulse rate This is an indication of the quality of the SpO signal All Welch Allyn Vital Signs Monitors with pulse oximetry capability are equipped with a pulse tone This audible tone beeps in synchronization with each beat of the patient s heart In addition the frequency of the tone will vary based on the patient s oxygen satu ration value The higher the tone s frequency the higher the patient s oxygen saturation value The user may change the pulse tone volume or turn this feature off as necessary 11 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 4 PULSE RATE FEATU RE The Welch Allyn Vital Signs Monitor is capable of determining pulse rate as an
38. LIMIT DIASTOLIC LOW LIMIT PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT Blood pressure deter minations which activate alarms are indicated by flashing displays and a repetitive audi ble tone Any alarm limit violation must be reset to continue automatically timed blood pressure determinations The alarm may be reset by pressing any button on the Monitor s display WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 2 TEMPERATURE OPERATING MODES Thermometry measurements are made with the integrated Welch Allyn SureTemp ther mometer Oral and rectal probes utilize single use disposable probe covers which limit cross contamination Oral axillary or rectal temperatures are taken using Normal or Monitor operating modes Axillary temperatures are taken using the oral probe In Normal Mode the thermometer s microprocessor predicts body temperature in about 4 seconds for oral temperatures about 10 seconds for axillary temperatures and in about 15 seconds for rectal temperatures The Monitor Mode displays the patient s actual tem perature after 3 minutes and will continue to display an updated temperature as long as the probe remains in place Note Normal mode axillary temperatures 10 seconds are accurate only for children under the age of four Note The Welch Allyn Vital Signs Monitor is intended for use with adult and pediatric patients age 3 and above Temperature readings may be displayed in Fahrenheit or Celsius scale
39. Model SRC2 for Monitors incorporating the Nellcor Puritan Bennett brand pulse oximetry module Follow the manufacturer s instructions for performing a pulse oximetry calibration check 68 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL SECTION VI WARRANTY AND SERVICE INFORMATION 1 Warranty Information 2 Service Information a Service Policy b Technical Assistance Service Centers c Service Manual Spare Parts d Service Loaners 69 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL VI 1 WARRANTY INFORMATION Welch Allyn warrants the Welch Allyn Vital Signs Monitor when new to be free of defects in material and workmanship and to perform in accordance with manufacturer s specifica tions for a period of two years from the date of purchase from Welch Allyn or its autho rized distributors or agents Pulse oximetry sensors and temperature probes are warran teed for one year Welch Allyn will either repair or replace any components found to be defective or at variance from manufacturer s specifications within this time at no cost to the customer It shall be the purchaser s responsibility to return the instrument to Welch Allyn or an authorized distributor agent or service representative This warranty does not include breakage or failure due to tampering misuse neglect accidents modification or shipping This warranty is also void if the instrument is not used in accordance with manufacturer s recommendations or if repai
40. N VITAL SIGNS MONITOR QUICK GUIDE FOR NELLCOR PURITAN BENNETT SENSORS MODEL QUANTITY APPLICATION Case of 24 Pediatric OC 3 cable sold separately 1D YS and Multisite zen 7 Tl m i T gi a z i pen g m a x Es 40 wraps F Ear clip for use with D YS sensor CHARACTERISTICS e For patients who weigh between 10 and 50 kg Preferred application site is index finger Alternative sites are thumb smaller finger great toe e Must be used with OxiCliq OC 3 sensor cable e Check site at least every 8 hours e Adults gt 40 kg Preferred application site is index finger with cable running along top of hand Alternative sites are thumb other small finger or great toe with cable running along sole of foot When using the D YSE alternate sites are the ear lobe and ear pinna with the cable running down the side of the patient s face and body Change site at least every 4 hours e Pediatrics 15 40 kg Preferred application site is index finger with cable running along top of hand Alternative sites are thumb other small finger or great toe with cable running along sole of foot For patients who weigh 30 kg or more alternate sites are the ear lobe and ear pinna when using the D YSE with the cable running down the side of the patient s face and body Change site at least every 4 hours e Infants 3 15 kg Preferred application site is great toe with cabl
41. ON TEM PERATU RE CALIBRATION CHECK The accuracy of the Welch Allyn Vital Signs Monitor temperature determinations can be verified using the Temperature Calibration Key The calibration check is a simple yet valuable test to determine that the unit is measuring temperature accurately 1 Turn the Monitor on by pressing the POWER button Note The temperature function will automatically go into Monitor Mode as part of this procedure 2 Remove the temperature probe completely from the holder and detach the connector then insert the temperature calibration key 3 Insert then remove the probe from the probe holder to reset the thermometer 4 Wait for the temperture display test to be complete Observe and record the temper ture noted on the temperature display 5 The recorded temperature should be 97 3 F 0 2 F 36 3 C 0 1 C if the Monitor is properly calibrated If the temperature displayed is out of this range call your Welch Allyn technical service center for assistance V 4 C CALIBRATION SpO gt CALIBRATION CHECK The accuracy of the Welch Allyn Vital Signs Monitor s SpO determinations can be veri fied using an SpOs simulator The calibration check is a simple yet valuable test to deter mine that the unit is measuring SpO gt accurately Welch Allyn recommends the use of the following simulators NONIN Model 8000S for Monitors incorporating the Nonin brand pulse oximetry module NELLCOR PURITAN BENNETT
42. PERATOR MANUAL 1 3 INDICATIONS CONTRAINDICATIONS FOR USE The Welch Allyn Vital Signs Monitor is intended for monitoring of blood pressure pulse rate temperature and oxygen saturation SpO gt of adult and pediatric patients age 3 and above The device is not designed sold or intended for use except as indicated The monitor is not designed for use with neonates infants or children under the age of 3 years The monitor should not be used on patients who are linked to heart lung machines 1 4 SPECIAL FEATURES The following special features enhance the use of the Welch Allyn Vital Signs Monitor Choice of Measurement Modalities Non invasive blood pressure temperature and SpO5 measurements may be made inde pendently or simultaneously Operator Selectable BP Measurement Intervals Automatically takes BP measurements at intervals from 1 to 90 minutes Special STAT mode allows continuous blood pressure measurements for up to 15 minutes Programmable Alarms Both visual and audible alarms indicate readings outside of operator programmable high low limits and also indicate system hardware software problems Non Invasive Oscillometric BP Eliminates the risks associated with invasive monitoring with no need for microphones or external transducers Prior Data Recall Measurement data from up to 99 previous determinations is available at the touch of a button Operator Friendly Results Large easy to read LED displays
43. VITAL SIGNS MONITOR OPERATOR MANUAL III 3 C SET UP PRO CEDURE SpO gt SENSOR CONNECTION The Welch Allyn Vital Signs Monitor is available with a wide variety of SpO sensors The reusable finger clip sensor is shipped with the Monitor All other sensors may be ordered separately as accessory items For Welch Allyn Vital Signs Monitor with the Nonin Pulse Oximetry Option To install the Nonin SpO sensor insert the connector end of the sensor into the SpO con nector port on the side of the Monitor as shown The SpO gt connector port on the Monitor is clearly labeled SpO gt 5 The sensor connector can only be inserted one way matching the shape and pin configuration of the connector to the port Push the connector in until it is fully seated on the port Note only Nonin SpO gt sensors and accessories may be used with this configuration of the Welch Allyn Vital Signs Monitor For Welch Allyn Vital Signs Monitor with the Nellcor Puritan Bennett Pulse Oximetry Option Attach the Nellcor Puritan Bennett SpO sensor to the pulse oximetry extension cable Then insert the connector end of the extension cable into the SpO gt connector port on the side of the Monitor as shown The SpO gt connector port on the Monitor is clearly labeled SpO The extension cable can only be inserted one way matching the shape and pin configuration of the connector to the port Push the connector in until it is fully seated on the port Note
44. age of each section outlines the contents so you can readily find the information you need The information included in this manual is inclusive of all options available with the Welch Allyn Vital Signs Monitor ie SpO9 Temperature and Printer The applicability of some sections of this operator manual will depend on the configuration of your particular unit The first two sections INTRODUCTION and FUNCTIONS amp SPECIFICATIONS introduce you to the product its applications and its capabilities The next two sections SYSTEM INSTALLATION and OPERATING PROCEDURES takes you step by step through the installation and functional operation of the monitor in a logical sequence The final two sections TROUBLESHOOTING MAINTENANCE CALIBRATION and WARRANTY AND SERVICE INFORMATION are resources to offer troubleshooting or other special help as needed This information is intended as a comprehensive guide to the operation of the Welch Allyn Vital Signs Monitor To achieve satisfactory results the operator should read this manual thoroughly before attempting to use the monitor A quick reference operator s guide is provided on the side of the monitor as a convenient reference for experienced operators I 2 PRODUCT OVERVIEW The Welch Allyn Vital Signs Monitor is designed to non invasively and automatically measure systolic and diastolic blood pressure pulse rate temperature and oxygen satura tion SpO5 for adult and pediatric patients over the age of
45. amps infrared warming lamps and phototherapy lights This will minimize the potential for ambient light interference which can create unreliable readings If peripheral perfusion makes reliable pulse signal detection difficult consider Oxisensor II sensors the RS 10 reflectance sensor or the R 15 nasal sensor as well as alternative sensor sites 81 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL e Check the sensor site and circulation distal to the sensor site as specified in the direc tions for use e Exercise care when removing sensors to avoid damaging the skin e In cases of poor perfusion local rewarming of sensor sites as permitted by hospital policy may restore adequate signal quality Covering the sensor site with a noncon stricting bootie or glove placing the site under a warming device and or correcting the cause of poor perfusion can improve blood flow to the area e Repositioning the patient to correct compromised blood flow may restore signal quality when readings cannot be obtained e Nellcor Puritan Bennett oximetry sensors should not be used during MRI scanning because the sensors could affect the MRI image or the MRI could affect the accuracy of the oximetry measurements Adhesive Sensors e Apply to clean dry sites e Avoid applying additional tape over the sensor bandage This will reduce the risk of venous pulsation and inaccurate saturation measurements as well as the potential for pressure dama
46. anked The most recent BP measurement may be recalled by pressing the REVIEW button When in Automatic Mode if the unit is unable to determine the systolic or diastolic value the measurement will be automatically repeated once Il 1 A MAX MIN BLOOD PRESSURE RANGES The maximum and minimum ranges of blood pressure are detailed below Measurement Maximum Minimum Systolic Pressure 250 mmHg 60 mmHg Diastolic Pressure 160 mmHg 30 mmHg WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 1 B BLOOD PRESSURE MANUAL MODE In the Manual Mode a single blood pressure determination is made only when the START button is pushed The manual mode is the default mode of operation for blood pressure determinations A measurement cycle may be cancelled at any time by pressing the CANCEL button This action immediately initiates a rapid cuff deflation The blood pressure measurement data will appear on the display immediately following the measurement The display will blank after two minutes If the display is blanked pressing the REVIEW button on the front panel will recall the measurement Up to 99 prior measurements are available for review or printing In Blood Pressure Manual Mode the following alarm limits may be activated SYSTOLIC HIGH LIMIT SYSTOLIC LOW LIMIT DIASTOLIC HIGH LIMIT DIASTOLIC LOW LIMIT PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT Blood pressure deter minations which activate alarms are indicated by flashing displays
47. are complemented by an integrated thermal printer AC or Self Contained Battery Power The Welch Allyn Vital Signs Monitor is conveniently available in many locations for a variety of monitoring needs including interdepartmental transport within the facility WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL l 5 SUPPLIES AND ACCESSORIES BLOOD PRESSURE ACCESSORIES AND SUPPLIES LATEX FREE 5200 01 5200 02 5200 03 5200 10 5082 59 5082 61 5082 63 5082 64 5200 04 5200 05 5200 06 5200 11 5200 07 5200 12 5200 08 Cuff Assembly Adult cuff bladder and connector Cuff Assembly Large Adult cuff bladder and connector Cuff Assembly Small cuff bladder and connector Cuff Assembly Extra Large Adult cuff bladder and connector Cuff Adult Cuff Large Adult Cuff Small Cuff Extra Large Adult Bladder Adult includes connector Bladder Large Adult includes connector Bladder Small includes connector Bladder Extra Large Adult includes connector Coiled Pressure Hose 8ft 2 4M Note One additional hose may be connected to provide extended length All appropriate connectors are included Straight Pressure Hose 8ft 2 4M Calibration T Connector TEM PERATU RE ACCESSO RIES AND SUPPLIES 5200 20 5200 22 05031 101 06137 000 01800 210 Oral Probe 9ft 2 7M Rectal Probe 9ft 2 7M Disposable Probe Covers 1000 covers packaged 25 box Temperature Calibration Key Model 9600 Te
48. be verified on an annual basis Equipment needed 1 Accurate office sphygmomanometer with inflation system Z Calibration T connector 3 Any rigid cylinder that approximates arm size such as a one pound coffee can Disconnect the coiled tubing from the cuff Attach the calibration T connector to the coiled tubing end Connect the male taper connector extending from the tubing of the office sphygmomanometer into the large open end of the T connector Then connect the female taper connector extending from the office sphygmomanometer cuff to the other side of the T connector Wrap the arm cuff around the rigid cylinder Check that all con nections are tight Initiate the Monitor s internal configuration settings menu by powering up the unit while the START button is depressed Hold the START button down until all the LED display segments go off The first message displayed is the revision level of the internal software This will be displayed in the systolic and diastolic displays Press the REVIEW button to advance to the calibration check menu Once in the calibration check menu the display will read CAL in the systolic display and the pressure will be shown in the diastolic and pulse rate displays Press the START button to close the Monitor s internal valve Inflate the cuff manually to a pressure of about 250 mmHg by squeezing the manometer bulb If the cuff won t inflate insure that the valve on the bulb is fully closed and that you
49. ck monitoring of arterial oxyhemoglobin saturation SpOj The finger clip sensor may also be used for continuous monitoring where patient move ment is not expected and the patient s finger is large enough for the sensor to fit securely The Nonin finger clip sensor 5200 40 5200 54 may be used for continuous monitoring less than 30 minutes The Nellcor Puritan Bennett finger clip sensor DS LOOA may be used for continuous monitoring less than 4 hours To use the finger clip sensor insert the patient s finger preferably the left or right index finger completely into the sensor as shown The thumb is specifically not recommended for use with the finger clip sensor The Nonin Finger Clip Sensor The Nellcor Puritan Bennett Finger Clip Sensor 5200 40 5200 54 DS 100A Warning If blood pressure monitoring is occuring simultaneously insure that the finger clip SpO gt sensor is attached to the limb opposite the limb with the blood pressure cuff Note Sensor sites must be checked periodically to determine circulation sensor position ing and skin sensitivity 54 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 17 B OTHER SENSORS A wide variety of reusable and disposable pulse oximetry sensors are available for use with the Welch Allyn Vital Signs Monitor These sensors expand the utility of the pulse oximetry component of the monitor For a detailed description of the use and application of these sensors see App
50. cossavaisasete E E E N 67 68 a Blood Pressure Calibration Check cccccccceccccccccssssscccccesesscscsseseesesseseeenees 67 68 D Temperature albrahon ChCK sist mesesoseacgeashexgenasiytivasionncerseeaed ances ytavesanees 68 Se DOO a AUOMCIECK E 68 Section VI Warranty and Service Information L Warranty Mormaers mtr terrae i Eiei eerere renee em tr ere eer renee etree Serre 70 2 Service Lie OUI Oi sees cece esa detec ees ctete Td enrera EEEE A EEEE EEEE i Ees 70 72 e OGY E T E E onaeiinss speaostovasyerserousatceensnee 70 b Technical Assistance Service Cente rs cccccccsesccccscccccscccccsecccectscccnccecuseecs 71 72 ovie Manual Spare PariS eeerasnriira in donesesesioons donsenteannenncte 7 d Service TAIN 1S necne anana sae EEEE E 2 Appendix A Nonin Brand SpO 9 Sensors Appendix B Nellcor Puritan Bennett Brand SpO gt Sensors Appendix C Mounting Accessories amp Assembly Instructions Appendix D Nurse Call Interface Wiring Diagram WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL OTe WN FR SECTION INTRODUCTION About the Operator Manual Product Overview Indications Contraindications For Use Special Features Supplies and Accessories WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL I 1 ABOUT THE OPERATOR MANUAL The operator manual is designed to help you understand the capabilities and operation of your Welch Allyn Vital Signs Monitor The manual has six tabbed sections and the first p
51. d deter gent solution Do not immerse hoses The temperature probe should periodically be cleaned by wiping with an alcohol damp ened cloth or wipe warm water or properly diluted non staining disinfectant Do not immerse the probes The Nonin reusable finger clip SpO sensor may be cleaned with isopropyl alcohol solution and may be sterilized using ethylene oxide EtO cold cycle Do not immerse the sensor The Nellcor Puritan Bennett reusable finger clip SpO gt sensor may be cleaned with 70 alcohol or 1 10 bleach V 3 B MAINTENANCE STORAGE Whenever possible the Welch Allyn Vital Signs Monitor should be stored at room temper ature in a dry environment If it is necessary to store the monitor for an extended period of time the unit should be packed in its original shipping carton Note Insure that the printer is loaded with paper prior to storage Storage specifications are as follows Temperature 20 C to 50 C 4 F to 122 F Relative Humidity 15 95 non condensing 65 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL V 3 C MAINTENANCE BATTERY REMO VAL amp REPLACEMENT Occasionally it may be necessary for the internal battery to be replaced When the battery will no longer take a charge remove it and replace it as outlined below with a battery of the same part number 1 Insure that the AC power transformer cord is disconnected from the Monitor and that the Monitor is turned off U
52. e case of 24 OC 3 OXI A N OXI P I RS 10 SRC 2 OXICLIO Sensor Cable OXIBAND Adult Neonatal Oxygen Transducer 1 sensor 50 wraps OXIBAND Pediatric Infant Oxygen Transducer 1 sensor 50 wraps Reflectance Oxygen Transducer 6 sensors 6 headbands Portable Oximetry Tester MOUNTING ACCESSORIES AND SUPPLIES 5200 60 5200 61 5200 62 5200 63 COMPLETE MOBILE STAND UNIT includes Accessory Pack Large Basket Pole and Base Assembly Transformer Mounting Kit Recommended for Models 52STP 52STO 52OTP 52O0TO 52NTP 52NTO MODIFIED MOBILE STAND UNIT includes Large Basket Pole and Base Assembly Transformer Mounting Kit Recommended for Models 52000 5200P 52SO0O 52SOP 52NOO 52NOP COMPLETE WALL MOUNT UNIT includes Accessory Pack Large Basket Wall Mount Bracket Transformer Mounting Kit Recommended for Models 52STP 52STO 52OTP 520TO 52NTP 52NTO MODIFIED WALL MOUNT UNIT includes Large Basket Wall Mount Bracket Transformer Mounting Kit Recommended for Models 52000 5200P 52SO0O 52SOP 52NOO 52NOP WELCH ALLYN VITAL SIGNS MONITOR 5200 64 5200 65 5200 66 5200 67 5200 68 5200 69 5200 70 OPERATOR MANUAL COMPLETE IV POLE MOUNT UNIT includes Accessory Pack Large Basket IV Pole Mount Bracket Transformer Mounting Kit Recommended for Models 52STP 52STO 52OTP 520TO 52NTP 52NTO MODIFIED IV POLE MOUNT UNIT includes Large Basket IV Pole Mount Bracket Tra
53. e running along sole of foot Change site at least every 4 hours e Neonates 1 3 kg Preferred application site is ball of foot Alternative site is palm of hand below the fingers with cable running along palm e Adhesive wraps are disposable e Change site at least every 4 hours 86 QUICK GUIDE FOR NELLCOR PURITAN BENNETT SENSORS MODEL QUANTITY APPLICATION CHARACTERISTICS PediCheck pediatric spot check clip D YSPD 1D YSPD Pediatric for use with e For patients who weigh between 3 and 40 kg Er D YS sensor Preferred application site is index finger or a smaller finger if it offers a better fit ee ee e For attended spot check monitoring not to exceed 20 minutes of continuous application i J z Sh a i _ Oxiband reusable sensors OXI A N 1 OXI A N and e Adults gt 40 kg Ga pin 50 adhesive Preferred application site is index finger with cable il a wraps P h ay running along top of finger ae ete Alternative sites are thumb other small finger or great toe with cable running along sole of foot e Neonates lt 3 kg Preferred application site is ball of foot Alternative site is palm of hand below the fingers with cable running along palm e Adhesives are disposable e Recommend changing site at least every 4 hours e For short term use only If long term monitoring is required consider using an Oxisensor II D 25 or OxiClig A sensor for adults and an Oxisensor II N 25 or O
54. e Oxisensor II sensor models I 20 I 20R N 25 and N 25R OxiClig N OxiCliq I and the ADH A N disposable wraps may contain a minute amount of natural latex Please note that this material is the same type used in commercial adhesive bandages With respect to the RS 10 reflectance oxygen transducer the patient contact surface and the double sided adhesive tabs contain no natural latex However natural latex is a com ponent in the adhesive used to bond the layers within the sensor These layers are above the patient contact surface The adhesive materials used in these sensors have been tested using the Latex ELISA Antigenic Protein LEAP Assay of Biomedical Extract testing at a nationally recognized independent testing laboratory No latex antigen was detected in this test The ELISA test has a lower detection threshold of 0 03 micrograms milliliter 80 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL TIPS FOR OPTIMAL SENSOR USE The following considerations may facilitate reliable and cost effective use of Nellcor Puritan Bennett sensors All Sensors Choose your sensor according to patient size duration of use level of activity and infection control concerns Read directions for use before using sensors Many sensors have both preferred and alternative application sites offering a broader range of placement options Observe alignment marks to ensure proper position of the light source and photodetec tor for each sensor
55. e sensors with an isopropyl alcohol wipe Allow enough time for the sensor to dry thoroughly before reusing The reusable sensors may also be sterilized using ethyl ene oxide EtO cold cycle 73 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL COMPATIBILITY Caution Use only the sensors provided by Welch Allyn These sensors are manufactured to meet the calibration requirements for the Welch Allyn Vital Signs Monitor Caution Each sensor is designed for a specific clinical application Optimal performance can only be attained by using each sensor appropriately Factors that can degrade performance excessive ambient light excessive motion electrosurgical interference arterial catheters blood pressure infusion lines etc moisture in the sensor improperly attached sensor incorrect sensor for patient poor patient perfusion venous pulsations anemia or low hemoglobin concentrations cardiovascular dyes sensor not at heart level Caution Use of double backed adhesive strips or the Hydrogel tape strips should be dis continued if the patient exhibits allergic reactions to the adhesive material Caution Sensor sites must be checked periodically to determine circulation sensor posi tioning and skin sensitivity Apply the appropriate oximeter sensor per the instructions below Warning Only Nonin brand SpO sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nonin p
56. e temperature in degrees Fahrenheit or Celsius The temperature scale F or C will be shown by a green indicator Also temperature monitor mode is indicated by a green indicator Q CYCLE Display This red LED display shows the time in minutes between automatically initiated blood pressure measurements or St for STAT mode continuous blood pressure measurements for up to 15 minutes Additionally this display identifies the high and low alarm limits for the various parameters during alarm select mode and the cycle number during review mode R CHARGING Indicator This flashing yellow indicator will signify that the internal battery is being charged when the Monitor is powered through the AC power transformer When the Monitor is fully charged the flashing will be replaced with a solid yellow indicator light S LOW BATTERY Indicator This yellow indicator light will remain on continuously as a visual indicator when the battery charge is weak The indicator will flash as a visual indicator that the bat tery charge is critically low T MEMORY Indicator This green indicator will flash when the unit has reached its maximum capacity of 99 data sets in storage Also it will remain on continuously when the operator is reviewing stored data sets 20 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL B SIDE amp REAR PANEL CONNECTIONS 1 SpOs Sensor Connection Nine pin connector for the SpO sensor 2 Temperature Probe Con
57. ear here in this summary Conforms to a ae Attention Consult e A i Accompanying Document alda CAN CSA C22 2 No 601 1 Approved to Australia AS 3200 1 Appendix Z Class II Equipment z Battery O perated Device See Section 111 2 B for Location T See Section 111 3 E for Charging Instructions Defibrillator proof See Section V 3 C for Replacement 4 E Type BF Applied Part GENERAL WARNINGS The Welch Allyn Vital Signs Monitor is designed for use by medical clinicians Although this manual may illustrate medical monitoring techniques this system should only be used by a trained clinician who knows how to take and interpret a patient s vital signs The information in this operator s manual is a comprehensive guide to the operation of the Welch Allyn Vital Signs Monitor To achieve satisfactory results the operator should read the manual thoroughly before attempting to use the Monitor To insure patient safety use only accessories and supplies i e cuffs hoses tempera ture probes SpO sensors etc recommended or supplied by Welch Allyn for the Welch Allyn Vital Signs Monitor Do not operate the Welch Allyn Vital Signs Monitor in the presence of flammable anesthetics or other explosive atmosphere An explosion may result It is the operator s responsibility to set alarm limits as appropriate for each individual patient Avoid compression of the pneumatic tubing of the Welch Allyn Vital Signs Monitor Compression of the tub
58. ection IV 3 for complete information The interface between the Monitor and the Nurse Call system will always be active whenev er an alarm condition occurs Canceling or resetting an alarm on the Monitor itself will also cancel the alarm signal to the Nurse Call System Note that while the alarm sound will flash on and off during an alarm condition the Nurse Call output will be continuously ON until the alarm condition is removed Reference Appendix D of the Operator s Manual for the wiring diagram for the Nurse Call interface IV 20 MEAN ARTERIAL PRESSU RE MAP DATA SEND MODE DATA STREAM MODE The operator has the ability to activate the SET Arrow Up button to perform additional functions These functions are mutually exclusive and include The oe to display the Mean Arterial Pressure MAP when the SET Arrow Up button is pressed The ability to send patient data to the Monitor s serial port when the SET Arrow Up but ton is pressed The ability to stream patient data to the Monitor s serial port whenever patient data is stored into the Monitor s memory To activate the additional functionality of the SET Arrow Up press both the START button and the POWER button simultaneously This activates the Monitor s internal configuration mode After the current software versions are displayed on the Monitor press the REVIEW button 7 times The current functionality of the SET Arrow Up button will appear in the sys t
59. ed within one minute of a prior BP measurement the Monitor will inflate to a level which is 40 mmHg above the previous systolic reading 3 The systolic display will show the pressure in the cuff as the blood pressure determi nation is being made 4 When the measurement cycle is complete an audible tone will sound and the systolic diastolic and pulse rate display will show the values of the reading 5 The reading will be displayed for two minutes and then this display will be blanked The reading may be recalled at any time prior to the next BP determination by press ing the REVIEW button 6 Pressing CANCEL at any time during a blood pressure determination will cause the determination to be aborted and the cuff to rapidly deflate 43 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Pulse rate as determined from the blood pressure measurement method will be displayed with the BP reading only if SpO gt option is absent or disabled If the SpO function is opera tional all pulse rate determinations will come as a result of the SpO gt 5 measurement method IV 10 AUTOMATIC MODE BLOOD PRESSU RE Blood pressure measurements may be automatically initiated at operator programmed time intervals To operate the blood pressure monitor in automatic Auto mode follow this procedure 1 Insure that the blood pressure cuff is properly sized and wrapped around the patient s upper arm or alternate site as necessary Press
60. endix A of this manual for Nonin sensors Appendix B for Nellcor Puritan Bennett sensors Warning Use only Nonin brand SpO gt sensors and accessories with Welch Allyn Vital Signs Monitors configured with Nonin pulse oximetry module Use only Nellcor Puritan Bennett brand SpO sensors and accessories with Welch Allyn Vital Signs Monitors configured with the Nellcor Puritan Bennett pulse oximetry module IV 17 C TAKING AN SpO 9 MEASUREMENT Prior to taking an SpO measurement insure that the SpO mode of the Welch Allyn Vital Signs Monitor is functional See section IV 2 Choosing Operating Modes The operator should follow this procedure for taking an SpO gt measurement 1 Properly attach the appropriate sensor to the patient 2 The pulse signal bar graph will illuminate indicating the relative strength and quali ty of the patient s pulses at the sensor site The sensor takes approximately 10 sec onds to determine the initial SpO7 value and pulse rate When the initial values are determined they will be shown in the SpO display and the Pulse Rate display respectively 3 The SpOQ5 and pulse rate are updated approximately every second 4 Removing the SpO sensor from the patient ends the monitoring period and immedi ately blanks the pulse signal bar graph The SpO display will flash 2 dashes and a repetitive audible alarm will sound To reset the sensor removal alarm press the SILENCE button
61. ensor does not track the pulse reliably it may be incorrectly positioned or the sensor site may be too thick thin or deeply pigmented to permit appropriate light transmission If any of these situations occurs reposition the sensor or choose an alternate Nellcor Puritan Bennett sensor CLEANING The DS 1OO0A may be surface cleaned by wiping it with a solution such as 70 isopropyl alcohol If low level disinfection is required use a 1 10 bleach solution Do not use undiluted bleach 5 5 25 sodium hypochlorite or any cleaning solution other than those recommended here because permanent damage to the sensor could occur To clean or disinfect the sensor 1 Saturate a clean dry gauze pad with the cleaning solution Wipe all surfaces of the sensor and cable with this gauze pad 2 Saturate another clean dry gauze pad with sterile or distilled water Wipe all surfaces of the sen sor and cable with this gauze pad 3 Dry the sensor and cable by wiping all surfaces with a clean dry gauze pad Caution Do not sterilize by irradiation steam or ethylene oxide WARNINGS 1 Failure to apply the DS 10OOA properly may cause incorrect measurements 2 Using the DS 1OOA in the presence of bright lights may result in inaccurate measurements In such cases cover the sensor site with an opaque material 3 Reusable sensors must be moved to a new site at least every 4 hours Because individual skin condition affects the ability of the skin
62. ering up the unit while the START button is depressed Hold the START button down until all the LED display segments go off The first message displayed is the revision level of the internal software This will be displayed in the systolic and diastolic displays Press the review button four 4 times to advance to the Date Set Screen The year month and day will appear in the systolic diastolic and heart rate displays respec tively Use the SELECT ALARM button to select the date item to be changed When select ed the date item will flash Use the SET buttons arrow up or arrow down to change the selected date item After making all the desired date changes press the REVIEW button to save the changes and advance to the Time Set Screen When in the Time Set Screen the hour in 24 hour format and minutes will appear in the systolic and diastolic displays respectively Use the SELECT ALARM and SET buttons to set the time in the same manner as described above When the time is set as desired press the REVIEW button to save the time and advance to the next screen Press the POWER button to turn the Monitor off 29 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Ill 4 SAFETY WARNINGS amp CAUTIONS All operating personnel should be familiarized with the general safety information in this summary Specific warnings and cautions will also be found throughout the operator s manual Such specific warnings and cautions may not app
63. essssessssesssesrsessesessesessesessesesseseeseseeseses 46 d Pae Da PACIO e scot poset caonsespctsaateteesaancceanateayusesnen septa 46 12 Selecting ihe lemperature CAS eiiis ienien a aaa REE iE Raa 47 13 Selecting Temperature Operation Mode sssini 48 Tk Tea Oral Tempera UE eassa e e EEEE EN 49 50 ela A lll Feng K og 9 2 go E neem AEA EA E EE 51 52 To TKD Recai TEn oT cs a cae be anaa nen err ser eer OEE 929 EF ADe Ee E E to shot cnpaesiesatenisesesicatatanas 53 56 w Ue TE e E E O a E tr treet ae te eieerre arte terre 54 D CSG O O eE E T E E E OE 55 G TAKS Alp IVC AS UCI SINE a E EE E EE A P D9 Cetin E Pa PISS E ga E EER 56 Prineet OP era Only OS saepe e E E E R sates 97 a Printing Options Batch Print or Streaming Print Mode eee 58 19 Using the R5232 Computer ali cs acs el aere remeron ee terre een eee en eeee ree ee repre rere oaa 58 Bigs NT Ti ae setae A ET 58 20 Mean Arterial Pressure MAP Data Send Mode Data Stream Mode 006 59 Section V Troubleshooting M aintenance Calibration 1 Troubleshooting Error Indications and Interpretation cece cece eee 60 62 2 Troubleshooting General Guide to Problems and Corrective Actions 62 64 Oe NA NCO e EE rane saganse sees A panaesoueiays 65 66 i CAI sac aoe sae sat nein E E E ots E 65 D COME 2 scocase E N NN 65 Battery Removal and Replacement ssassn 66 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Ay CO ALOU ipses aco nnaeets
64. from one another to provide for proper fit over various sizes of tissue Sensors should be chosen according to the patient s body weight to ensure the optical components are properly aligned when applied to the recommended area With the excep tion of the reflectance RS 10 and nasal R 15 sensors all sensors must be positioned so that the light source and photodetector are directly opposed to one another across an arte riolar bed Figure 1 ligt sources vascular bed p photogetector Figure 1 Duration of Use While adhesive sensors can be used for short or long term monitoring reusable sensors are generally indicated for spot check measurements or for short term monitoring of less than four hours Adhesive sensor sites should be checked for skin integrity and distal cir culation at least once every eight hours and changed as appropriate Reusable sensor sites must be checked and changed at least every four hours or as specified in the directions for use 19 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Patient Activity Adhesive sensors provide a stable second skin fit that maintains secure positioning of the sensor s optical components and allows the sensor to move with the patient With active patients these sensors provide greater monitoring reliability Reusable sensors gen erally are less secure on active patients Since the Dura Y and the Oxiband sensors are held in place with an adhesive wrap they provide
65. ge at the site However applying tape over the cable may help prevent the sensor from becoming dislodged Figure 2 Figure 2 e Check sensor site and circulation distal to the sensor at least every eight hours and change the sensor site as appropriate e Carefully remove the sensor from the patient for reapplication to another site e Oxisensor II and OxiCliq sensors may be reused on the same patient if the adhesive tape attaches without slipping Replace the sensor when its adhesive quality is depleted e With Oxisensor II sensors if intermittent readings are required leave the sensor on the patient secure the cable and protect the site as much as possible when not monitoring 82 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL e With OxiCliq sensors if intermittent readings are required leave the sensor on the patient and either disconnect the OxiClig sensor cable OC 3 from the sensor Figure 3 or secure the cable with tape Protect the site as much as possible when not monitoring Figure 3 e If the sensor is removed between readings store the sensor on a clean dry surface such as the original sensor liner and label with the patient s name Figure 4 Figure 4 e Keep sensors with the patient s belongings until discharge and notify others that the patient has a dedicated sensor e The Oxisensor II I 20 and N 25 and OxiCliq N and I sensors have six clear double sided adhesive dots that can be applied
66. ger being careful not to hold or press the ejection button 5 Lift the patient s arm so that the entire axilla is easily visualized Place the probe as high as possible in the axilla Do not allow the probe tip to come into contact with the patient until it is deliberately placed in the measurement site Any tissue contact before this time will activate the probe position error message and may cause inaccu rate tempurature readings 6 Be sure that the probe tip will be completely surrounded by axillary tissue Clothing or other material touching the probe tip may cause inaccurate readings 7 Place the arm snugly at the patient s side Hold the arm in this position without movement of the arm or probe during the measurement cycle Movement of the arm may cause inaccurate readings 8 In Normal Mode the Monitor will produce an audible tone and display the tempera ture reading when a final temperature has been reached This generally takes about 10 seconds In Monitor Mode the operator must allow the temperature readout to stabilize for 5 minutes to accurately display a final temperature reading 51 10 11 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL After the temperature measurement is complete remove the probe from the patient s axilla and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover Insert the probe into the probe holder before attempting to take
67. h Allyn Vital Signs Monitor by Welch Allyn Blood pressure measurements may not be accurate for patients experiencing moder ate to severe arrhythmias When monitoring over an extended period of time or at frequent intervals it is recommended to check the cuff site and cuffed extremity regularly for possible ischemia purpura and or neuropathy SpO 2 WARNINGS The operation of the SpO gt sensor in MRI environments is specifically not recom mended Use only SpO sensors and accessories which are compatible with the SpO2 configu ration purchased Welch Allyn Vital Signs Monitor with the Nonin pulse oximetry option may only be used with Nonin brand SpO sensors and accessories Welch Allyn Vital Signs Monitor with Nellcor Puritan Bennett pulse oximetry option may only be used with Nellcor Puritan Bennett brand sensors and accessories TEM PERATURE WARNINGS Single use disposable probe covers available from Welch Allyn will limit patient cross contamination The use of any other probe cover or the failure to use a probe cover may produce temperature errors and is specifically not indicated Oral probes blue are to be used for taking oral and axillary temperatures only Rectal probes red are to be used for taking rectal temperatures only The use of the wrong probe may produce temperature errors 31 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL GENERAL CAUTIONS If the accuracy of any measurement is in questio
68. have pressed the START button to close the Monitor s internal valve Now slowly deflate the cuff and stop at 30mmHg increments to compare the pressure reading on the manometer with the pres sure reading displayed on the Monitor display The Monitor displays the pressure in mmHg units down to the 01 mmHg resolution This should compare closely with the manometer reading within 3 mmHg Inherent inac curacies of 3mmHg in office sphygmomanometers could result in an observed and acceptable Monitor error of 6mmHg Compare several readings taken at pressures ranging from 250 to 50 mmHg This checks the Monitor within the range of typical blood pressure readings If the Monitor does not agree closely with the manometer that is within 3 mmHg call the Welch Allyn technical service center 67 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL WARNING Internal safety features of the Monitor will automatically open the valve and sound an alarm if the pressure is detected to be above 15 mmHg for longer than 165 seconds In the event that this happens pressing either the SILENCE or CANCEL button will reset the alarm condition Pressing the START button will then close the valve after which the check can be continued Upon completion of the calibration check the Monitor can be powered down and pow ered back up to bring the device to its normal state of operation Meets O E M product specifications and at minimum 2mmHg V 4 B CALIBRATI
69. he Monitor mode Operator selectable patient alarm limits are not available in temperature monitor mode However temperatures which are outside of the normal operating range of the device will be noted on the temperature display Il 3 SpO 2 OPERATING MODE The Welch Allyn Vital Signs Monitor incorporates either the Nonin or Nellcor Puritan Bennett pulse oximetry module which determines arterial oxyhemoglobin saturation SpO 7 by measuring the absorption of red and infrared light passed through the tissues Changes in absorption caused by pulsation of blood in the vascular bed are used to deter mine arterial saturation and pulse rate Oxygen saturation percent is calculated with each pulse detected and thus the monitor display is continually updated The pulse signal bar graph is an indicator of the strength and quality of the detected pulses When SpO is measured the patient s pulse rate is also measured and displayed A pulse rate measurement from the SpO5 determination overrides a pulse rate measurement derived from a blood pressure measurement When measuring SpO gt the user may enable the SpO Pulse Tone feature A short audible tone is emitted with every patient heartbeat The frequency of the tone is based on the patient s SpO gt level The lower the frequency of the tone the lower the patients SpO gt level In SpO monitoring mode operator selectable alarm limits for low SpO may be acti vated A condition wh
70. hed to a patient press the VOLUME button With each press of the button a sample pulse tone will sound and the SpO gt Pulse Signal Bar Graph will provide a visual indicator of the volume setting Subsequent presses of the VOLUME button will cycle the unit through each of the five volume settings until the Off setting is reached Alternatively the user can press the SET arrow up and arrow down buttons to cycle through the volume choices When the desired volume setting is reached refrain from pressing the button for three seconds and the setting will be saved In all settings except volume off the pulse tone indicator light will be illuminated 56 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 18 PRINTER O PERATION SYMBOLS The Welch Allyn Vital Signs Monitor may be configured with an optional integrated ther mal printer The operator may control the printer using the two buttons FEED PRINT located on the top rear face of the Monitor Pressing the FEED button advances the paper The PRINT button will generate the printout of all the stored blood pressure temperature pulse rate and SpO data in the Monitor The unit will store and print a maximum of 99 data sets The following criteria are applied for saving and printing measurement data Blood Pressure Data will be saved for both MANUAL and AUTOMATIC cycles Predictive Temperature Data will always be saved Monitor Mode Temperature Data will be saved on
71. icates the low SpO alarm setting The SpO display will show the current alarm limit for the SpO2 or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 1 intervals The operator may choose the low SpOQ9 limit within the range of 98 70 or the alarm may be turned off by choosing When the desired alarm limit is displayed pressing SELECT ALARM again saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode 38 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 4 TEM PERATU RE MEASU REMENT RANGE INDICATORS The high and low measurement ranges of the temperature module are as follows HIGH MEASUREMENT RANGE 108 0 F 42 2 C LOW MEASUREMENT RANGE 84 0 F 269 C IMPORTANT No audible tone will indicate that the temperature is outside of the measurement range of the Monitor This is a visual indicator only Temperatures which are outside of the measurement range of the Monitor will cause the following to be displayed Note the symbol shown in the tenths position of the display CONDITION TEMPERATURE DISPLAY Temperature is outside of Fahrenheit high measurement range of the Monitor Celsius Temperature is outside of Fahrenheit low measurement range of
72. ich violates the SpO low limit alarm is indicated by a flashing dis play and repetitive audible tone Should a patient alarm condition for SpO or pulse rate occur the Monitor will indicate an alarm condition flashing amp beeping while continuing to monitor and display the patient s current SpO 7 The alarm will automatically reset when the patient s condition returns to within the preset alarm parameters Should a patient alarm condition for SpO gt or pulse rate occur the operator may invoke Silence Mode by pressing the SILENCE button This will silence the audible tone dis play will continue to flash while the practitioner attends to the patient and the monitor Silence mode resets automatically after 30 seconds or when the patient s condition returns to within the preset alarm parameters 10 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Removal of the SpO sensor from the patient will initiate an alarm unless the SpO5 and pulse rate alarms are turned off To reset the sensor alarm press any button on the Monitor s display SpO gt is generally measured via pulses detected using a finger sensor However for cer tain situations SpO gt may be measured at alternate sites including the earlobe forehead and toes Special sensors must be employed in these situations Il 3 A MAX MIN SpO gt RANGES The SpO sensor is designed to detect oxygen saturation as follows Maximum Minimum SpO 99 40 Il 3 B S0 MON
73. indicate that streaming data mode is operational To turn streaming data mode off press the SET Arrow Up button again Str Off in the systolic and diastolic displays indicates that streaming data mode is no longer operational 99 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL SECTION V TRO U BLESHO OTING MAIN TENANCE CALIBRATION 1 Troubleshooting Error Indications and Interpretation 2 Troubleshooting General Guide to Problems and Corrective Actions 3 Maintenance a Cleaning b Storage c Battery Removal and Replacement 4 Calibration a Blood Pressure Calibration Check b Temperature Calibration Check c SpO Calibration Check 60 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL V 1 TROUBLESHOOTING ERROR INDICATIONS AND INTERPRETATION The following table of alarm conditions and error codes is intended to provide the opera tor with a quick reference to the descriptions and probable causes of the error codes For service level troubleshooting refer to the service manual When responding to a Monitor alarm always CHECK THE PATIENT FIRST and then proceed to check the Monitor Press CANCEL to reset patient alarm conditions ERROR MEASUREMENT DESCRIPTION CORRECTIVE CODE MODE ACTION Blood Pressure Measurement cycle was cancelled by operator Blood Pressure Autozero Failure Check for air obstruction limit patient movement C01 C02 C03 Blood Pressure Inflation too rapid Check for kinked hose or air
74. ing may cause system errors to occur in the Monitor The Welch Allyn Vital Signs Monitor is safe to use in the presence of high frequency surgical equipment Care should be taken to prevent water or other fluid from entering any connectors on the Monitor Should this occur the connectors should be dried with warm air All monitoring functions should then be checked for proper operation 30 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Any Monitor which has been dropped or damaged should be checked by qualified service personnel to insure proper operation prior to use Cords should periodically be checked for fraying or other damage and replaced as necessary There are no user serviceable parts inside the Monitor other than paper replacement and battery replacement This Monitor is not designed for use with neonates infants or children under the age of 3 years This Monitor should not be used on patients who are linked to heart lung machines This Monitor will not operate effectively on patients who are experiencing convul sions or tremors This device complies with current required standards for electromagnetic interference and should not present problems to other equipment or be affected by other devices As a precaution avoid using this device in close proximity to other equipment BLOOD PRESSURE WARNINGS Blood pressure measurements may be inaccurate if cuffs and or hoses are used other than those provided for the Welc
75. is ideal for nearly every application These sensors include the Flex Sensor the Fingerclip Sensor the Ear Clip the Reflectance Sensor and two sizes of Flexi Form single patient use sensors Each sensor is designed for a specific site application and specific patient size and weight range When selecting sensors for a particular application consider the following 1 The best performing sensor for most patients is an appropriately sized adhesive style sensor either reusable or single patient use located on the finger or toe 2 The fingerclip sensor is recommended for spot checks or short term continuous moni toring The fingerclip sensor performs best for most patients when used on fingers other than the thumb The finger clip sensor is not recommended where motion is expected or for relatively long term monitoring e g greater than 30 minutes 3 The reflectance and ear clip sensors generally do not perform as well as sensors locat ed on the finger or toe They are not recommended for applications where the best possible SpO gt accuracy is important Use the reflectance and ear clip sensors when fingers and toes are not suitable as with peripheral shut down or when monitoring central body perfusion for timing response reasons They may also be useful in high motion environments such as stress testing Clear Tape Strips or Hydrogel Tape Strips are recommended to provide additional secur ing for the reusable flex sensors Clean reusabl
76. is the upper arm The arm must be relaxed and motion free during measurement s Warning Do not place the cuff on any extremity being used for intravenous infusions or any area where circulation is or may be compromised Warning Do not place the cuff on any extremity being used for SPO monitoring Cuff inflation during an SpO gt measurement will cause inaccurate SpO gt results Wrap the cuff snugly with room between the cuff and the arm for two fingers Excessive tightness may cause venous congestion and discoloration of the limb If the cuff is wrapped too loosely it cannot be inflated properly and the measured values may be in error It is best to place the cuff on a bare arm Clothing may interfere with measurement accuracy When wrapping the cuff observe the mark on the cuff which must be placed over the artery Insure that the hose is not twisted kinked or compressed as this may cause mea surement errors IV 9 MANUAL MODE BLOOD PRESSURE Blood pressure measurement may be initiated on demand by the operator This is the manual mode of operation To operate the blood pressure monitor in manual mode follow this procedure 1 Insure that the blood pressure cuff is properly sized and wrapped around the patient s upper arm or alternate site as necessary 2 With the Monitor powered up press the START button The Monitor will inflate the cuff to the default pressure preset level Note If a BP measurement is initiat
77. is turned off press both the POWER and START buttons simulta neously Hold the START button down until all of the LED display segments are illu minated The operator can now cycle through the Monitor s internal configuration menu by pressing the REVIEW button Pressing the REVIEW button three times will cycle to the temperature options and three dashes will appear in the TEMPERATURE display The first option illuminated on the TEMPERATURE display is F Pressing the ADJUST button twice will illuminate C When the desired temperature scale is selected press the REVIEW button again and then turn the Monitor off By follow ing this procedure the selected temperature scale will be saved into memory 47 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 13 SELECTING TEMPERATURE OPERATION MODE When configured with the temperature option the Welch Allyn Vital Signs Monitor has the capability of taking a temperature in either Normal or Monitor mode In the Normal mode the thermometer s microprocessor predicts body temperature in about 4 seconds for oral temperatures about 10 seconds for axillary temperatures and in about 15 seconds for rectal temperatures Monitor mode is normally used for longer term monitoring and when difficult situations prevent accurate temperature from being taken in the Normal mode In Monitor mode the probe must be in contact with tissue for at least 3 minutes for accurate temperature measurement
78. isensor II oxygen transducer model D 25 or D 25L INSTRUCTIONS FOR USE Reusable sensors may be used on the same site for a maximum of 4 hours provided the site is inspected routinely to ensure skin integrity and correct positioning Because individual skin condi tion affects the ability of the skin to tolerate sensor placement it may be necessary to change the sensor site more frequently with some patients TO APPLY THE DS 100A 1 Place an index finger over the sensor window of the DS 1OOA with the finger tip against the stop fig A 2 If the fingernail is long the nail tip will extend over the finger stop fig B 3 Spread open the rear tabs of the sensor to provide even force over the length of the pads fig C Check the position of the sensor If an index finger cannot be positioned correctly or is not available a smaller finger can be used or use an Oxisensor IT oxygen transducer Do not use the DS 1OOA on a thumb or toe or across a child s hand or foot Note When selecting a sensor site priority should be given to an extremity free of an arterial catheter blood pressure cuff or intravascular infusion line 4 The sensor should be oriented in such a way that the cable is positioned along the top of the hand fig D 89 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 5 Plug the DS IOOA into the oximeter and verify proper operation as described in the oximeter opera tor s manual Note If the s
79. isplay shows LO This indicates the low diastolic alarm setting The diastolic display will show the current alarm limit for low diastolic blood pressure in mmHg or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 mmHg intervals The operator may choose the low diastolic blood pressure limit within the range of 35mmHg through the current high diastolic limit The alarm may be turned off by choosing When the desired alarm limit is displayed pressing SELECT ALARM gain saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode IV 3 E SETTING THE PROGRAMMABLE ALARMS PULSE RATE HIGH LIMIT Press the SELECT ALARM button until the PULSE display is illuminated and the CYCLE display shows HI This indicates the high pulse rate alarm setting The pulse display will show the current alarm limit for high pulse rate in bpm or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 bpm intervals The operator may choose the high pulse rate limit within the range of the current low pulse rate limit through 195bpm The alarm may be turned off by choosing When the desired alarm limit is displayed p
80. ital fossa bend in the elbow on many people but because the Monitor uses oscillometric technology not aus cultation this will NOT result in an inaccurate blood pressure Careful sizing of the cuff is important to the accuracy of blood pressure readings If the cuff is too small the readings could be falsely high 41 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL There are two simple methods for determining the correct cuff size for the patient Use either method A or B below A DETERMINING CUFF SIZE WITH THE CUFF MARKINGS One way to insure proper cuff size is to wrap the cuff around the patient s upper arm and visually check it The cuff is marked with a distinct white edge and two divi sions that indicate range When the cuff is properly fit the edge will meet the cuff at some point within the range See illustration below B CHART FOR DETERMINING CUFF SIZE You can also determine cuff size by measuring the patient s arm circumference mid way between the elbow and shoulder and then use the chart below to select the cor rect cuff See oeetoOTe ee Oe e ARESE RIRES RS aa CUFF SIZE ARM CIRCUMFERENCE INCHES CENTIMETERS Small 4 7 8 3 12 0 21 0 Medium 7 1 12 6 18 0 32 0 Large 8 3 15 4 ZA oo Extra Large 11 8 18 5 30 48 0 42 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 8 POSITIONING THE BLOOD PRESSURE CU FF The preferred blood pressure measurement site for adults and children
81. l lock ACCESSORY PACK onto BASKET I V Pole Kit Model 5200 64 amp 5200 65 Refer to figure 2 for the following instructions 1 Attach BASKET PLATE to V BRACKET by inserting 4 8 X 1 4 long flat head phillips screws through four countersunk holes designated D into four threaded holes in bracket Securely tighten screws la V BRACKET BASKET ACCESSORY 2 Assemble BASKET to BASKET PLATE by inserting 4 8 X 3 16 long phillips screws through basket holes marked A and into four threaded holes in BASKET PLATE PACK Securely tighten screws 3 For Model 5200 64 only attach ACCESSORY PACK by im 4 a FLAT HEAD Wa orienting as shown in figure 2 and inserting onto side plate of im 4 8 PAN HEAD B PROBE BASKET and pushing up This will lock ACCESSORY PACK SCREW 3 16 LONGI COVERS onto BASKET Figure 2 i MONT TOR Bedrail Kit ae Model 5200 66 amp 5200 67 Refer to figure 3 for the following instructions 1 Remove top two housing screws on one side of MONITOR only 2 Orient BEDRAIL as shown and attach using 2 4 x 1 1 8 long screws supplied Securely tighten screws 3 Repeat steps 1 amp 2 on other side of MONITOR Figure 3 Instruction Sheet P N 95P374 3 14 97 ART9807 E 95 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL WelchAllyn Vital Signs Monitor Anti theft Kit Installation Instructions Anti theft Kit Model 5200 70 1 With monitor detached assemble
82. le sensors to prevent inadvertent disposal e If the cable is gray don t throw it away Nellcor Puritan Bennett manufactures Durasensor Oxiband and Dura Y sensors and the EC 4 EC 8 and OC 3 cables with gray components to identify them as reusable rather than disposable items SENSOR ASSISTANCE FROM NELLCOR PURITAN BENNETT Please contact the individual company representatives for specific information on the compatibility of particular instrument models with particular Nellcor Puritan Bennett sen sor models Contact your Nellcor Puritan Bennett Regional Oximetry Specialist Account Manager or Clinical Consultant at 1 800 NELLCOR for information and assistance with all Nellcor Puritan Bennett sensor products They will gladly assist you your department and your hospital with educational presentations and any questions regarding sensors In addition Nellcor Puritan Bennett s Technical Services Department provides telephone support for any questions related to sensors or other Nellcor Puritan Bennett products Contact the Technical Services Department at 1 800 NELLCOR between 6 AM and 5 PM PST Oxisensor Oxisensor II OxiCliq Durasensor Dura Y Oxiband Oxismart PediCheck C Lock and the Nellcor Puritan Bennett knob configu ration are trademarks of Nellcor Puritan Bennett Inc 84 G8 QUICK GUIDE FOR NELLCOR PURITAN BENNETT SENSORS Oxisensor II adhesive sensors sterile single patient use APPLICATION MODEL D 2
83. level For all subsequent blood pressure determina tions the Monitor will inflate the cuff to a pressure 40 mmHg above the prior systolic reading The systolic display will show the pressure in the cuff as the blood pressure determi nation is being made Exception In STAT mode the systolic and diastolic displays will show the most current completed BP measurement Ag WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 8 When the measurement cycle is complete an audible tone will sound and the systolic diastolic and pulse rate displays will show the values of the reading 9 The measurement will be displayed until the next measurement cycle is initiated 10 Pressing CANCEL at any time during a blood pressure determination will cause the determination to be aborted and the cuff to deflate In STAT mode pressing CAN CEL will also terminate the STAT mode of operation 11 To end an AUTO blood pressure session press the AUTO button until two dashes appear in the CYCLE display Auto mode will then be terminated STAT mode may be terminated in this manner or by pressing the CANCEL button Pulse rate as determined from the blood pressure measurement method will be dis played with the BP reading only if the SpO gt option is absent or disabled If the SpO5 function is operational all pulse determinations will come as a result of the SpO gt 5 measure ment method 45 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 11
84. ly if concurrent with a blood pressure cycle SpO Data will be saved only if concurrent with a blood pressure cycle or a predictive temperature measurement Will be saved if the START button is pressed and the BP mode has been disabled Will also be saved one data set per minute if a patient alarm condi tion occurs Pulse Rate Data will be saved with every blood pressure and SpO gt data set Note If no data is stored in the Monitor pressing the PRINT button will cause only the printout header to be printed Note The printer uses thermal paper which has a tendancy to fade over time especially when exposed to heat and light For more permanent records it is recommended that the printout be photocopied Feed O Print 57 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 18 A PRINTING OPTIONS BATCH PRINT OR STREAMING PRINT MODE The operator may choose to print all stored data in either batch print mode all stored data printed simultaneously or streaming a mode data printed automatically at the time it is stored Batch print mode is the default setting for the Welch Allyn Vital Signs Monitor To change the print mode press both the START button and the POWER button simultane ously This activates the Monitor s internal configuration mode After all of the current soft ware versions are displayed on the Monitor press the REVIEW button 8 times The current print mode will appear in the systolic and diastolic di
85. m adhesive cover and peel the adhesive cover off b Place the patient s finger or toe into the sensor nail side up with the tip of the finger or toe centered against the center line mark in the curved area as illustrated Reference the line that indicates the center of the curved area on the tape This will assure vertical alignment between the emitter and detector Wrap the tape around the finger The fingernail should not be covered with tape during this step Attaching the Flexi Form Sensor c Grip the sensor top adhesive cover and peel it off d Fold the sensor s top over the top of the finger Ensure that the detector and emitter are vertically aligned as illustrated by the dotted axis line Aligning the detector and emitter 11 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL APPENDIX B NELLCOR PURITAN BENNETT PULSE O XIM ETRY SENSORS Warning Only Nellcor Puritan Bennett brand SpO gt sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nellcor Puritan Bennett pulse oximetry option Nellcor Puritan Bennett the leading manufacturer of pulse oximeters offers a broad line of adhesive and reusable oximetry sensors for all monitoring requirements This appendix contains information about selecting and applying adhesive and reusable sensors and pro vides tips for the optimal cost effective use of sensors Please consult the directions for use packaged with Nellcor Puri
86. mperature Calibration Kit 110v NONIN PULSE O XIM ETRY ACCESSO RIES AND SUPPLIES 5200 40 5200 54 5200 41 5200 42 5200 44 5200 45 5200 46 5200 47 5200 50 5200 51 5200 52 5200 53 5200 55 Finger Clip Sensor with 9ft 2 7M cable Finger Clip Sensor with 3ft 0 9M cable Ear Clip Sensor Flex Sensor Reflectance Sensor Reflectance Sensor Holder 10 SpO Adult Finger Flexiform Sensors 10 SpO gt Pediatric Finger Flexiform Sensors 10 SpO gt Sensor Attachment Tape SpO Hydrogel Tape Strips SpO gt Extension Cable 3ft 0 9m SpO Finger Phantom Calibration Kit SpO gt Extension Cable 9ft 2 7m 3 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL NELLCOR PURITAN BENNETT PULSE O XIM ETRY ACCESSORIES AND SUPPLIES DS IOOA EC 8 D YS D YSE D YSPD D 25 D 25L D 20 I 20 R 15 DURASENSOR Adult Oxygen Transducer Extension Cable 8 ft DURA Y Oxygen Transducer 1 sensor 40 wraps Ear Clip use with Dura Y sensor PediCheck Pediatric Spot Check use with Dura Y sensor OXISENSOR II Adult Digit Oxygen Transducer case of 24 OXISENSOR II Adult Digit Oxygen Transducer long cable case of 24 OXISENSOR II Pediatric Oxygen Transducer case of 24 OXISENSOR II Infant Digit Oxygen Transducer case of 24 OXISENSOR Adult Nasal Oxygen Transducer case of 24 OXICLIQ A Adult Oxygen Transducer use with OC 3 cable case of 24 OXICLIQ P Pediatric Oxygen Transducer use with OC 3 cabl
87. n check the patient s vital sign s by an alternate method and then check the Monitor for proper functioning Insure the Monitor is placed on a secure surface or use one of the optional mounting accessories Do not place fluids on the Monitor BLOOD PRESSURE CAUTIONS Extremity and cuff motion should be minimized during blood pressure determina tions If the blood pressure cuff is not at heart level the difference in reading due to the hydrostatic effect should be noted The value of 1 80 mmHg must be added to the displayed reading for every inch 2 5cm above heart level The value of 1 80 mmHg must be subtracted from the displayed reading for every inch 2 5cm below heart level Proper blood pressure cuff size and placement is essential to the accuracy of the BP determination See Section IV 7 for cuff sizing information p0 2 CAUTIONS The pulse oximeter is calibrated to determine the percentage of arterial oxygen satu ration of functional hemoglobin Significant levels of dysfunctional hemoglobins such as carboxyhemoglobin or methemoglobin may affect the accuracy of the mea surement Some intravascular dyes depending on the concentration may affect the accuracy of the SpO5 measurement Some sensors may not be appropriate for a particular patient If at least 10 seconds of perfusion pulses cannot be observed for a given sensor change sensor location or sensor type until this condition is achieved TEM PERATURE CAUTIONS
88. n the user has the ability to upload stored data from the Monitor to a computer network or Nurse Call system Also any user programmable options may be programmed via the computer For more detailed information on using the RS232 computer interface contact Welch Allyn Customer Service IV 19 A NURSE CALL INTERFACE All configurations of the Welch Allyn Vital Signs Monitor are capable of interfacing to a Nurse Call system via two pins on the RS232 communications port This allows alarm cond tions to be recognized at a central monitoring location as well as at the Monitor itself Both patient alarm conditions and system alarm conditions are communicated to the Nurse Call System See section IV 5 of the Operator Manual for information on patient alarm conditions and interpretation See section V I of the Operator Manual for information on alarms which alert the operator to abnormal system conditions or internal system failures Warning It is the user s responsibility to implement the interface between the Nurse Call system and the Welch Allyn Vital Signs Monitor It is also the user s responsibility to ade quately test the interface between the Monitor and the Nurse Call system to ensure that e desired functionality is operational 58 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Warning It is the operator s responsibility to set the Monitor s programmable alarm lim its as appropriate for each individual patient See s
89. ndle on top of the Monitor push on the metal tab and pull up on the Monitor Using the Wall Transformer Cord Wrap On the side of the basket are two hooks which allow the operator to manage the trans former cord To use the cord wrap plug the transformer into the Monitor after installing the Monitor onto the basket assembly Wrap the cord around the two hooks in a counter clockwise motion until there is just enough cord remaining to allow the transformer plug to rest within the basket THE ACCESSO RY PACK The accessory pack has the ability to be attached to the mobile stand the wall mount the IV pole mount or on the rear of the Welch Allyn Vital Signs Monitor The accessory pack is easily exchangable from one mounting accessory to another using the quick release fea ture The accessory pack is designed to hold one box of temperature probe covers a spare temperature probe or SpO gt sensor The accessory pack has an integrated cuff clip which can secure any of the cuffs used with the Monitor Attaching the Accessory Pack to the Basket Locate the two keyhole slots on the plate on the side of the basket assembly and the two circular lugs on the back of the accessory pack Insert the lugs into the large openings in the keyhole slots and slide the accessory pack UP until it is secured Removing the Accessory Pack for the Basket Locate the metal tab on the bottom of the accessory pack Push the metal tab away from the basket and pull down on
90. nector Connector for either oral axillary blue or rectal red probe 3 Temperature Probe Holder Active temperature probe is inserted here when not in use Removing and replacing the probe turns the temperature on and off respectively 4 RS232 Data Interface Connector Port for the connection of a cable to an external computer network or nurse call system 5 Transformer Power Connector AC power transformer connector 6 Pressure Hose Connector Connector for black coiled pressure hose 7 Printer Compartment and paper feed area for integrated thermal printer 8 Print Button Pressing this button initiates a print operation 9 Printer Feed Button Pressing this button advances the paper in the printer 21 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 10 Mounting Keyholes Mounting accessories are attached via these keyholes 11 Battery Compartment Contains the internal battery Removal of 4 screws allows changing battery without affecting other internal parts Ill 3 A SET UP PRO CEDURE BLOOD PRESSURE HOSE amp CUFF CONNECTIONS Identify and have available each of the following items The Welch Allyn Vital Signs Monitor Cuff and bladder assembly Black coiled pressure hose Using the illustrations below for reference perform the following set up procedures 1 Inspect the black coiled pressure hose and note that one end has a connector fitting and the other end does not Attach the end without the con
91. nector to the pressure hose connector on the monitor by fitting the pressure hose on to the connector as shown Be sure that the pressure hose is completely inserted over the connector and into the recess and that the fit is snug Attaching pressure hose to connector on monitor 22 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 2 Join the other end of the black coiled pressure hose to the pneumatic tubing which is attached to the cuff Twist the black plastic connectors together until finger tight DO NOT OVER TIGHTEN 23 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 3 B SET UP PROCEDURE TEM PERATU RE PROBE CONNECTION The Welch Allyn Vital Signs Monitor is available with two probes one for oral axillary temperatures blue and one for rectal temperatures red The rectal probe is an accesso ry item and must be ordered separately To install the temperature probe press down on the tab on top of the connector and insert the connector into the temperature probe connector port on the side of the Monitor until the connector clicks into place The temperature connector port on the Monitor is clearly labeled TEMP The probe connector can only be inserted one way with the tab on top The temperature probe should be inserted into the probe holder on the side of the Monitor Should removal of the tempera ture probe be necessary press down on the connector tab and slide the connector out 24 WELCH ALLYN
92. nsformer Mounting Kit Recommended for Models 52000 5200P 52SO0O 52SOP 52NOO 52NOP COMPLETE BED RAIL MOUNTING UNIT includes Accessory Pack 2 Bed Rail Brackets Recommended for Models 52STP 52STO 52OTP 520TO 52NTP 52NTO MODIFIED BED RAIL MOUNTING UNIT includes 2 Bed Rail Brackets Recommended for Models 52000 5200P 52SO0O 52SOP 52NOO 52NOP Cuff Clip Accessory Pack Anti Theft Kit for Mounting Devices MISCELLANEOUS SUPPLIES 7052 25 5200 84 5200 85E 5200 86E 5200 88 5200 100 5200 101 5200 102 5200 103 5200 106 5200 110 5200 111 5200 112 5200 113 5200 114 5200 115 Printer Paper 6 rolls box Lead acid Battery Operator Manual Service Manual Plastic Monitor Covers pack of 5 Welch Allyn Vital Signs Monitor Carrying Case AC Power Transformer desktop transformer line cord not included North AmericanVersion AC Power Transformer desktop transformer line cord not included European Version AC Power Transformer desktop transformer line cord not included United Kingdom Version Transformer Mounting Kit for use with the desktop transformer Line Cord United States Canada Japan version Line Cord European version Line Cord United Kingdom version Line Cord Australian version Line Cord Swiss version Line Cord South American version WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL SECTION II FUNCTIONS AND SPECIFICATIONS 1 Blood Pressure Operating Modes a
93. nsure that the hardware is securely fastened to the pole before attaching the Monitor 93 WELCH ALLYN VITAL SIGNS MONITOR WelchAllyn Vital Signs Monitor OPERATOR MANUAL Mounting Accessories Assembl Instructions Mobile Stand Kit Model 5200 60 amp 5200 61 Refer to figure 1 for the following instructions 1 Lay BASE on floor with wheels down Assemble POLE into BASE by inserting tapered end into hole in center of BASE Stabilize BASE Push down and twist on POLE until POLE is tight and two holes in the top of POLE are aligned between two adjacent legs in the BASE Check to be sure POLE is secure Tighten if it is not 2 Loosen HANDLE BRACKET screws tool provided and slide HANDLE over pole as shown BASKET PLATE BASKET POLE CAP Position approximately 10 from top of POLE Lightly tighten screws i 3 Insert POLE CAP into the top of the POLE PROBE 4 Assemble BASKET to BASKET PLATE by COVERS inserting 4 8 X 3 16 long phillips screws through four holes designated A Securely neal tighten screws HANDLE 5 Assemble BASKET PLATE to POLE CAP BRACKET using 1 8 x 1 2 long phillips flat head screw SCREWS inserted through top hole B in BASKET PLATE and into top threaded hole in POLE CAP Do not POLE securely tighten screw 6 Align two C holes in BASKET with corresponding holes in POLE and insert 2 8 x 1 2 long phillips screws Securely tighten these screw
94. o Meath Republic of Ireland Phone 353 46 79060 Fax 353 46 27128 VI 2 C SERVICE INFORMATION SERVICE MANUAL SPARE PARTS A service manual is available by request to qualified electronics personnel The service manual is a comprehensive guide to troubleshooting service and repair of the Welch Allyn Vital Signs Monitor Also included with the service manual is a complete spare parts price list Spare parts may be ordered from your local Welch Allyn Service Center VI 2 D SERVICE INFORMATION SERVICE LO AN ERS Service loaners are provided on request when repair service is provided by a Welch Allyn Service Center Loaners for products repaired while under the original warranty or while under extended warranty or service contract are provided free of charge and are shipped within 48 hours of notification of need Shipment charges to the user are paid by Welch Allyn For service repairs outside of warranty or contract loaners will be available for a nominal daily charge and will be shipped subject to availability Loaners will be shipped pre paid however this charge will be added to the service charges 12 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL APPENDIX A NONIN PULSE O XIM ETRY SENSORS Warning Only Nonin brand SpO sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nonin pulse oximetry option The Welch Allyn Vital Signs Monitor features a sensor which
95. obstruction Blood Pressure Excessive inflation time Check for air leaks C06 E10 C20 21 C05 Blood Pressure Excessive noise Check patient condition cuff placement limit patient movement Blood Pressure Measurement was outside Check patient condition of Monitor s measurement range O moo Blood Pressure Cuff overpressure condition Check patient condition C Temperature Probe not ready Replace probe in holder wait 15 seconds retry P Temperature Loss of tissue contact Insure proper probe positioning 61 WELCH ALLYN VITAL SIGNS MONITOR MEASUREMENT DESCRIPTION a B SpO Internal Malfunction Battery failure Use wall transformer of range Internal safety violation Ambient temperature out O PERATOR MANUAL CORRECTIVE ACTION Check patient condition sensor position and connection Contact customer service Check patient contact customer service Adjust temperature or monitor location V 2 TRO U BLESHO OTING GENERAL GUIDE TO PROBLEMS AND CORRECTIVE ACTIONS Symptom 1 INACCURATE BLOOD PRESSURE READINGS Please note Differences of up to 10mmHg should be considered normal and will occur for a number 7 reasons including intrapatient BP variability observer hearing differences and auscultatory deflation rate Possible Cause Incorrect cuff size Note Use Welch Allyn approved cuffs only Patient s arm position Arm movement during blood pressure cycle Blood pressure taken o
96. olic and diastolic displays Use the SEI Arrow Up button to toggle through the four choices When the desired functionality is displayed press the REVIEW button then turn the Monitor off To turn the Monitor on press the POWER button The desired functionality of the SET Arrow Up button will now be operational I TAP MAP Mean Arterial Pressure indicates that pressing the SET Arrow Up button will cause the Mean Arterial Pressure in mmHg to be displayed and printed while a valid blood pressure measurement is displayed Mean Arterial Pressure data cannot be sent to the serial port This is the default mode of the Welch Allyn Vital Signs Monitor nO Op no operation indicates that the SET Arrow Up button has no additional functionality SEn dAt Send data indicates that pressing the SET Arrow Up button sends patient data to the Monitor s serial port In normal mode the most recent data set is sent to the serial port when the SET Arrow Up button is pressed In REVIEW mode the currently displayed data set is sent to the serial port when the SET Arrow Up button is pressed Str dAt Stream data indicates that streaming data mode is functional This mode allows patient data to be sent to the serial port automatically whenever such data is stored into the Monitor s memory To initiate streaming data mode during normal operation press the SET Arrow Up button Str On in the systolic and diastolic displays
97. on the Monitor s display Note If the programmable alarms for low SpO2 high pulse rate and low pulse rate are turned off no sensor removal alarm will occur when the SpO gt sensor is removed from the patient 55 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 17 D USING THE SpO gt PULSE TONE All Welch Allyn Vital Signs Monitors with pulse oximetry capability are equipped with a pulse tone This audible tone beeps in synchronization with each beat of the patient s heart In addition the frequency of the tone will vary based on the patient s oxygen satu ration value The higher the tone s frequency the higher the patient s oxygen saturation value The volume of the pulse tone may be adjusted to any of 5 volume settings as well as a volume off setting To change the volume of the SpO gt pulse tone follow these proce dures When the SpOs sensor is attached to a patient press the VOLUME button With each sub sequent press of the button the volume of the pulse tone will increase until the Off set ting is reached Subsequent presses of the VOLUME button will again cycle through the five volume settings When the desired volume setting is reached refrain from pressing the button for three seconds and the setting will be saved In all settings except volume off the pulse tone indicator light will be illuminated There is no visual indicator of the volume level When the SpO gt sensor is NOT attac
98. or off e When the Monitor is turned on the new pressure preset will be established as the default level The Monitor will always revert to this pressure preset level except in the circumstances noted below Note In Manual Blood Pressure Operating Mode the Monitor will inflate to the default pressure preset level However if a BP measurement is initiated within one minute of a prior BP measurement the Monitor will inflate to a level which is 40 mmHg above the previous systolic reading In Automatic Blood Pressure Operating Mode the Monitor will inflate to default pressure preset level for the initial BP determination only After the initial measurement the Monitor will inflate to a level which is 40 mmHg above the previous systolic reading IV 7 BLOOD PRESSU RE CUFF SELECTION CRITERIA Note A large Adult size cuff is included with your Vital Signs Monitor A full range of cuff sizes are available as accessory items however the Large Adult cuff will fit the majority of adults and give the most accurate blood pressure measurement Research has shown that an undersized cuff will overestimate the true blood pressure by as much as 10 to 30 mmHg Please refer to the reference markings located inside the cuff for correct cuff sizing When there is an area of overlap whereby you could use a smaller or larger cuff it is strongly recommended that you use the larger size cuff You may find that the bottom of the cuff extends to the antecub
99. or three dashes if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 mmHg intervals The operator may choose the high systolic blood pressure limit within the range of 245mmHg through the current low systolic alarm limit The alarm may be turned off by choosing When the desired alarm limit is displayed pressing SELECT ALARM again saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode 35 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 3 B SETTING THE PROGRAMMABLE ALARMS BLOOD PRESSURE LOW SYSTOLIC LIMIT Press the SELECT ALARM button until the SYSTOLIC display is illuminated and the CYCLE display shows LO This indicates the low systolic alarm setting The Systolic display will show the current alarm limit for low systolic blood pressure in mmHg or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 mmHg intervals The operator may choose the low systolic blood pressure limit within the range of the current high systolic alarm limit through 65mmH g The alarm may be turned off by choosing When the desired alarm limit is displayed pressing SELECT ALARM again saves the dis
100. per second Only use a sphygmomanometer that is known to be in calibration e Blood pressure taken with an un calibrated sphygmomanometer may be very inaccurate Check blood pressure immediately prior to Welch Allyn Vital Signs Monitor Reading Use higher quality stethoscope Have a different observer check patient s blood pressure WELCH ALLYN VITAL SIGNS MONITOR Symptom 2 CUFF INFLATION amp DEFLATION WITH NO BLOOD PRESSURE READING DISPLAYED or error code in display 3 NO CUFF INFLATION 4 TEMPERATURE MALFUNCTION 5 SpO5 MALFUNCTION e Sensor in Place but No Sp05 on Display e Inaccurate Sp0 gt Reading 6 PRINTER MALFUNCTION 7 MONITOR WILL NOT TURN ON 8 CUFF TOO TIGHT Over inflation 9 CUFF POPPING OFF Possible Cause Leak in pneumatic system Arm movement during cycle Tubing movement artifact Connections from monitor to cuff loose Broken probe Improper probe placement Probe not replaced Improperly attached sensor Cable incorrectly plugged into monitor Sp05 disabled Incorrect Sensor Paper will not advance Low battery Monitor not powering up Pressure Preset too high Inappropriate size cuff Cuff applied inside out 63 OPERATOR MANUAL Explanations and Corrective Action Ensure all cuff attachments are tight Carefully check for tubing leaks in blood pressure cuff and tubing attachment to monitor Keep arm still during blood pressure cycle
101. perator s responsibility to set alarm limits as appropriate for each individual patient Programmable Alarm Programmable Factory Alarm Ranges Intervals Default Values BP High Systolic 245 65 mmHg 200 mmHg BP Low Systolic 245 65 mmHg 70 mmHg BP High Diastolic 35 155 mmHg 155 mmHg BP Low Diastolic 35 155 mmHg 50 mmHg Pulse Rate High 45 195 bpm 140 bpm Pulse Rate Low 45 195 bpm 45 bpm SpO9 Low 98 70 O5 85 Note Temperature default alarms are 108 F 42 2 C high and 84 0 F 28 9 C low The temperature alarms are not programmable they indicate that the patient s temperature has exceeded the functional range of the thermometer The unit will default to these factory settings only until the operator selects a different alarm limit When a new alarm limit is selected the Monitor will retain this new limit set ting in memory even if the Monitor is turned off Alarm limits may be reviewed or changed by using the SELECT ALARM and SET arrow up and arrow down buttons and viewing the CYCLE display and the display of the parameters being changed IV 3 A SETTING THE PROGRAMMABLE ALARMS BLOOD PRESSURE HIGH SYSTOLIC LIMIT Press the SELECT ALARM button until the SYSTOLIC display is illuminated and the CYCLE display shows HI This indicates the high systolic alarm setting The systolic display will show the current alarm limit for high systolic blood pressure in mmHg
102. played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode IV 3 C SETTING THE PROGRAMMABLE ALARMS BLOOD PRESSURE HIGH DIASTOLIC LIMIT Press the SELECT ALARM button until the DIASTOLIC display is illuminated and the CYCLE display shows HI This indicates the high diastolic alarm setting The diastolic display will show the current alarm limit for high diastolic blood pressure in mmHg or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 mmHg intervals The operator may choose the high diastolic blood pressure limit within the range of the current low diastolic limit through 155mmHg The alarm may be turned off my choosing When the desired alarm limit is displayed pressing SELECT ALARM again saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode 36 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 3 D SETTING THE PROGRAMMABLE ALARMS BLOOD PRESSURE LOW DIASTOLIC LIMIT Press the SELECT ALARM button until the DIASTOLIC display is illuminated and the CYCLE d
103. r 3 seconds the cancel button erases all stored data in the Welch Allyn Vital Signs Monitor 18 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL D REVIEW Button Pressing this button will display the most current set of stored data including BP amp pulse rate and or SpO gt and or temperature Subsequent presses will display the next most recent data sets E AUTO Button amp Indicator Pressing this button allows the operator to scroll through the automatic blood pres sure interval options Time intervals are displayed in minutes on the CYCLE display see Q below Choosing any time interval except will cause the Auto indicator light to glow and blood pressure determinations to be made according to the dis played time interval F SILENCE Button amp Indicator During SpO monitoring should an SpO gt or Pulse Rate alarm condition occur press ing the Silence button invokes Silence Mode This will silence the audible tone dis play will continue to flash while the practitioner attends to the patient and Monitor Silence mode resets automatically after 30 seconds or when the patient s condition returns to within the preset alarm parameters In Silence Mode the silence indicator light will glow G SELECT ALARM Button Pressing this button allows the operator to select a specific parameter for which an alarm threshold will be set The HIGH HI or LOW LO indicator will show in the CYCLE display and the current val
104. r and emitter por tions of the sensor over the tissue Attach the sensor using 3M Micropore tape or equiv alent by wrapping the tape or wrap over the sensor assembly Wrap the sensor snug but not so tight as to restrict the blood flow See illustration below Attaching the Flex Sensor 15 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL NOTE For optimum light transmission attach the sensor on the finger or toe For best results secure the cable independently from the sensor Make sure that the tape securing the cable does not restrict the blood flow Micropore is a registered trademark of the 3M Company 3 NONIN EAR CLIP SENSOR This sensor is designed for adults where finger tip monitoring is impractical Rub the ear lobe vigorously for 5 seconds and then apply the ear clip to the lobe of the ear Make sure the ear clip is positioned so that the LED emitters and the detector are completely covered by the earlobe This ensures no stray light bypasses the earlobe which can lead to SpO inaccuracies 4 NONIN REFLECTANCE SENSOR The reflectance sensor is for use on well vascularized skin surfaces For adults this will usually be the center of the forehead slightly above and between the eyebrows The Reflectance Sensor Holder provides the precise pressure this sensor needs against the skin Remove the backing from one side of the double back tape and apply to the flange of the holder Then remove the back from the other side
105. r incorporates either the Nonin pulse oximetry mod ule or the Nellcor Puritan Bennett pulse oximetry module The pulse oximeter deter mines arterial oxyhemoglobin saturation SpOQ5 by measuring the absorption of red and infrared light passed through the tissues Changes in absorption caused by pulsation of blood in the vascular bed are used to determine arterial saturation and pulse rate Oxygen saturation percent is calculated with each pulse detected and thus the Monitor display is continually updated The pulse signal bar graph is an indicator of the strength and quality of the detected pulses SpO gt is generally measured via pulses detected using a finger clip sensor However for certain situations SpO5 may be measured at alternate sites including the earlobe forehead and toes Special sensors must be employed in these situations See Appendix A for Nonin sensors Appendix B for Nellcor Puritan Bennett sensors 53 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 17 A USING THE FINGER CLIP SENSOR Warning Only Nonin brand SpO sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nonin pulse oximetry option Only Nellcor Puritan Bennett brand SpO gt sensors and accessories should be used with Welch Allyn Vital Signs Monitors configured with the Nellcor Puritan Bennett pulse oximetry option The reusable finger clip pulse oximeter sensor is designed for spot che
106. re Taking Axillary Temperature Taking Rectal Temperature SpO Operation Mode a Using the Finger Clip Sensor b Other Sensors c Taking an SpO Measurement d Using the SpO gt Pulse Tone Printer Operation Symbols a Printing Options Batch Print or Streaming Print Mode Using the RS232 Computer Interface a Nurse Call Interface Mean Arterial Pressure MAP Data Send Mode Data Stream Mode 33 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 1 POWER ON OFF AND SYSTEM CHECK PROCEDURE Each time the Welch Allyn Vital Signs Monitor is turned on the unit performs an internal self diagnostic check To turn the unit on press the POWER button Upon power up note that all of the LED segments in each display turn on briefly An audible tone should also sound If the internal self check is successful the displays will assume their normal functions and the monitor is ready for operation If the self check fails an error code will be shown in the displays To turn the unit off press POWER button Note that turning the unit off will erase all stored blood pressure temperature SpO7 and pulse rate data IV 2 CHOOSING OPERATING MODES For all Welch Allyn Vital Signs Monitors which are configured with blood pressure and pulse oximetry capability the operator may choose to make either parameter non func tional Having both blood pressure and pulse oximetry operational is the default operat ing mode To make either mode
107. red by other than Welch Allyn or an autho rized agent Purchase date determines warranty requirements No other express warran ty is given RETURN THE INSTRUMENT REGISTRATION CARD IMPORTANT Remember to submit the instrument registration card for warranty validation Complete the information and mail the pre addressed card to Welch Allyn VI 2 A SERVICE INFORMATION SERVICE POLICY All repairs on products under warranty must be performed or approved by a Welch Allyn Service Center Unauthorized repairs will void the warranty Products out of warranty should be repaired by qualified electronics personnel or a Welch Allyn Service Center 70 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL VI 2 B SERVICE INFORMATION TECHNICAL ASSISTANCE If you have an equipment problem that you cannot resolve call the Welch Allyn Service Center nearest you for assistance Technical service support is available to you by tele phone on normal business days at the phone numbers listed below If you are advised to return a product to Welch Allyn for service or repair schedule the repair with the service center nearest you Before returning a product for repair you must obtain authorization from Welch Allyn An RGA Return Goods Authorization number will be given to you by our service per sonnel Be sure to note this number on the outside of your shipping box Returns without an RGA number will not be accepted for delivery WELCH ALLYN SERVICE
108. ressing SELECT ALARM again saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode 3 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 3 F SETTING THE PROGRAMMABLE ALARMS PULSE RATE LOW LIMIT Press the SELECT ALARM button until the PULSE display is illuminated and the CYCLE display shows LO This indicates the low pulse rate alarm setting The pulse display will show the current alarm limit for low pulse rate in bpm or if the alarm is turned off Pressing the SET arrow up and arrow down buttons will cycle through the options in 5 bpm intervals The operator may choose the low pulse rate limit within the range of 45bpm through the current high pulse rate alarm limit The alarm may be turned off by choosing When the desired alarm limit is displayed pressing SELECT ALARM again saves the dis played alarm limit and changes the alarm parameter Alternatively pressing no buttons for approximately 10 seconds will cause the displayed value to be set as the alarm limit and the Monitor will automatically revert to the current operating mode IV 3 G SETTING THE PROGRAMMABLE ALARMS SpO gt LOW LIMIT Press the SELECT ALARM button until the SpO5 display is illuminated and the CYCLE display shows LO This ind
109. s Il 2 A MAX MIN TEMPERATURE RANGES Measurement Maximum Minimum Temperature F 108 0 F 84 0 F Temperature C 42 2 C 28 9 C Il 2 B TEMPERATURE NORMAL MODE In Normal Mode the device will measure temperature at discrete intervals and then cal culate the rate of change according to a proven algorithm This allows the thermometer to predict the end point that the thermistor would reach if it were left in the mouth until it reached mouth temperature This predictive feature allows the thermometer to arrive at an accurate oral temperature reading in approximately 4 seconds Normal mode is the default operating mode for temperature determinations Operator selectable patient alarm limits are not available in Temperature Normal Mode However temperatures which are outside of the operating range of the device will be noted on the temperature display WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL II 2 C TEMPERATURE MONITOR MODE Continuous Monitor Mode operation is normally used for longer term monitoring and when difficult situations prevent accurate temperatures from being taken in the normal mode The probe must be in contact with tissue for at least three 3 minutes for accurate temperature measurement Monitor mode temperatures may not be identical to predicted Normal temperatures because of ambient temperature influence and other factors The trend in temperature is the important standard to be observed when in t
110. s and screw assembled in step 5 SCREW 172 LONG 7 Loosen HANDLE BRACKET screws again and slide HANDLE up under basket to desired m 2 8 PAN HEAD height and location Securely tighten screws SCREW 17 2 LONG 8 For Model 5200 60 only attach ACCESSORY PACK by orienting as shown in figure 1 and inserting onto side plate of BASKET and pushing up This will lock ACCESSORY PACK onto BASKET HARDWARE INCLUDED mp 1 8 FLAT HEAD im 4 8 PAN HEAD SCREW 3 16 LONG Figure 1 94 BASE WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Wall Mount Kit Model 5200 62 amp 5200 63 Refer to figure 2 for the following instructions 1 Attach BASKET PLATE to wall by inserting 5 8 flat head screws not provided through BASKET PLATE in four D holes and one B hole Securely tighten screws NOTE Mounting hardware should be selected according to the wall surface that monitor is being attached to Welch Allyn is NOT responsible for the integrity of the mounting means If there is any indecision or uncertainty on what hardware to use contact a professional service for installation 2 Assemble BASKET to BASKET PLATE by inserting 4 8 X 3 16 long phillips screws through basket holes marked A and into four threaded holes in BASKET PLATE Securely tighten screws 3 For Model 5200 62 only attach ACCESSORY PACK by orienting as shown in figure 2 and inserting onto side plate of BASKET and pushing up This wil
111. se a Phillips head screwdriver to remove the four 4 screws holding in the battery door Remove the battery door exposing the battery Tip the Monitor and slide the battery out Disconnect each of the 2 connectors and discard the old battery per local regulations Attach the battery connectors to the new battery as shown below Attaching connectors to the new battery Slide the new battery into the battery compartment as far as it will go Replace the battery door tightening each of the 4 screws Connect the AC power transformer to the monitor and allow the new battery to charge for approximately 16 hours The Monitor may be used during this charging period While charging the charging indicator will flash a yellow light When the Monitor is fully charged the flashing light will be replaced with a solid yellow light The battery is a non spillable lead acid battery In the USA call 1 800 SAV LEAD for instructions on how to recycle For International users contact your local authorities on recycling 66 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL V 4 A CALIBRATION BLOOD PRESSURE CALIBRATION CHECK The accuracy of the Welch Allyn Vital Signs Monitor s pressure measurement can be veri fied with an accurate office mercurial or aneroid sphygmomanometer The calibration check is a simple yet valuable test to determine that the unit is sensing pressure accurately Welch Allyn recommends that blood pressure calibration
112. sociation recommended 3 mmHg per second Systolic is determined by reading the manometer gauge 3 Follows AHA recommended standards when the first faint but clear tapping sound is heard with the stethoscope Diastole in adults is determined by reading the manometer 2 Follows AHA recommended standards gauge to the closest even number when the last sound is Diastolic blood pressure in children is the point at which the sound heard becomes muffled Release the air quickly after at least 10 to 20 mmHg of silence 64 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL V 3 A MAINTENANCE CLEANING The Welch Allyn Vital Signs Monitor may be wiped clean with a cloth slightly dampened with warm water and a mild detergent solution Never immerse the monitor in any type of fluid Occasionally as necessary the unit may be cleaned with appropriately diluted non stain ing disinfectant solution Note Care should be taken to prevent water or other fluids from entering any connectors Should this occur the connectors should be dried with warm air All monitoring functions should then be checked for proper operation The reusable blood pressure cuff should be cleaned by sponging with a damp cloth If washing is necessary the bladder should be removed and the cuff washed with soap or detergent disinfectant After washing the cuff should be air dried Cabling and the pressure hose can be wiped with a damp cloth moistened in a mil
113. splays as either bAt Pr batch print mode or Str Pr s streaming print mode Press the SET arrow up and arrow down but tons to toggle between the two print mode choices When the desired print mode is dis played press the REVIEW button again then turn the Monitor off Turn the Monitor on by pressing the POWER button The desired printing mode will now be operational If batch print mode is chosen all data in the Monitor s memory will be printed whenever the PRINT button is pressed If streaming print mode is chosen the printer must be activated after the Monitor is turned on Press the PRINT button and Pr Str On will appear in the systolic diastolic and pulse rate displays as the print header is printed Patient information will now automatical M print whenever data is stored into the memory of the Monitor To turn the streaming print func tion off press the PRINT button again Pr Str Off will appear in the systolic diastolic and pulse rate displays A batch printout may be initiated while in streaming print mode First turn the streaming print function off by pressing the PRINT button Pr Str Off will appear in the systolic diastolic and pulse rate displays Next press and hold the PRINT button for 3 seconds A batch printout will be printed IV 19 USING THE RS232 COMPUTER INTERFACE The Welch Allyn Vital Signs Monitor includes an external RS5232 Computer Data Interface Connector With this optio
114. t and Monitor Silence mode resets automatically after 30 seconds or when the patient s condition returns to within the preset alarm parameters If an alarm limit is violated sub sequent determinations of any type may only be made after the alarm condition is reset Il 4 A MAX MIN PULSE RATE RANGES The maximum and minimum pulse rate ranges are as follows Maximum Minimum Pulse Rate 200 bpm 40 bpm 12 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL Il 5 PERFORMANCE SPECIFICATIONS The performance specifications of the Welch Allyn Vital Signs Monitor are as follows CUFF PRESSURE RANGE 0 mmHg 300mmHe INITIAL CUFF INFLATION Default cuff inflation pressure is 160 mmHg Operator may change this default in configuration mode Options are 120 140 160 180 200 240 and 280 mmHg SYSTOLIC DETERMINATION Maximum 250 mmHg Minimum 60 mmHg DIASTOLIC DETERMINATION Maximum 160 mmHg Minimum 30 mmHg BLOOD PRESSURE ACCURACY Blood pressure accuracy meets or exceeds SP10 1992 AAMI standards for non invasive blood pressure accuracy AAMI standard 5 mmHg mean error 8 mmHg standard deviation Blood pressure accuracy is validated for pressure measurement using the upper arm only with the patient in a seated position Blood pressure is validated against manual auscultatory readings BLOOD PRESSURE DETERMINATION TIME 20 seconds to 45 seconds typical 165 seconds maximum PULSE RATE DETERMINATION Maximum 200 bpm Minimum
115. tan Bennett sensors for additional information THE NELLCOR PURITAN BENNETT SENSOR FAMILY While all pulse oximeters operate on similar principles much of the reliability of pulse oximetry readings can be attributed to proper sensor application and fit Nellcor Puritan Bennett offers a broad family of sensors designed to provide accurate readings on a vari ety of patients under a wide range of monitoring conditions Adhesive Sensors Nellcor Puritan Bennett s adhesive sensors are designed to enable the sensor s light source and photodetector to be securely and properly positioned on the patient The adhesive stabilizes these important optical components and provides a comfortable second skin fit Adhesive sensors are patient dedicated and can travel with your patients Single patient use sensors do not present the risk of cross contamination caused by products that are reused from patient to patient Nellcor Puritan Bennett s sterile adhesive Oxisensor II sensors are the ideal choice when environmental electronic noise levels are high and the patient s pulse is weak because special shielding in both the bandage and the cable helps protect the pulse oximetry sig nal Nellcor Puritan Bennett offers Oxisensor II models to fit different patient sizes Nellcor Puritan Bennett offers another cost effective option in its adhesive sensor line The OxiClig system combines a reusable cable with a patient dedicated adhesive sensor The
116. ter based lubricant when necessary Using the other hand gently insert the probe ONLY 1cm 3 8 inch ONLY inside the rectal sphincter Extreme caution should be used to avoid risk of bowel perforation in children 5 Tilt the probe to insure good tissue contact and continue to keep the buttocks sepa rated while the measurement is in process 6 During the temperature measurement cycle the TEMPERATURE display will show a series of LED segments in a box shaped formation This indicates that the tempera ture measurement is in process 7 When the final temperature has been reached a tone will sound and the temperature will be displayed on the Monitor 8 After the temperature measurement is complete remove the probe from the patient s rectum and eject the probe cover by firmly pressing the ejection button on the probe Properly dispose of the used probe cover 9 Insert the probe into the probe holder before attempting to take another temperature measurement 10 The current temperature is displayed for one minute after the probe is replaced in the holder after which time the display will go blank The most recent temperature can be recalled by pressing the REVIEW button once Note If a probe position error occurs during the temperature determination the tempera ture display will alternate between the final predicted temperature and the letter P in the display IV 17 SpO gt OPERATION MODE The Welch Allyn Vital Signs Monito
117. the Monitor Celsius 39 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 5 ALARM INDICATIONS AND INTERPRETATION Patient alarms will be activated when the patient s systolic pressure diastolic pressure pulse rate or SpO 9 exceed the alarm limits programmed by the operator Patient alarm conditions are visually indicated by flashing LED displays for the parameter in question accompanied by a repetitive audible alarm tone The Welch Allyn Vital Signs Monitor handles patient alarms in the following manner NOTE Pulse rate measurements from the SpO gt determination override pulse rate mea surements from the blood pressure determination DURING BLOOD PRESSURE MEASUREMENT Should a blood pressure or pulse rate patient alarm condition occur no additional mea surements may be initiated until the alarm is reset Check the patient condition first and then reset the patient alarm by pressing the SILENCE button on the Monitor s display Measurements may now be resumed DURING SpO5 MEASUREMENT Should a patient alarm condition for SpO or pulse rate occur the Monitor will indicate an alarm condition flashing amp beeping while continuing to monitor and display the patient s current SpO5 The alarm will automatically reset when the patient s condition returns to within the preset alarm parameters DURING SpOy MEASUREMENT Should a patient alarm condition for SpO gt or pulse rate occur the operator may invoke Silence Mode
118. the hairline Alternative site is the temple e Recommend changing site at least every 4 hours e Use headband in brightly lit or high motion environment e Not for use with ventilator patients or those in Trendelenburg supine or lateral positions e Limited reuse 88 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL DS 100A DU RASENSOR ADULT OXYGEN TRANSDUCER Nonsterile Reusable Directions for Use INDICATIONS CONTRAINDICATIONS The Nellcor Puritan Bennett Durasensor adult oxygen transducer model DS 1OOA is indicated for use when continuous noninvasive arterial oxygen saturation and pulse rate monitoring are required for patients weighing greater than 40 kg This sensor is for use only with Nellcor Puritan Bennett instruments and with instruments that con tain Nellcor Puritan Bennett oximetry or are licensed to use Nellcor Puritan Bennett sensors Consult individual manufacturers for compatibility of particular instruments and sensor models Each instrument manufacturer is responsible for determining whether its instruments are compati ble for safe and effective use with each Nellcor Puritan Bennett sensor model The DS 1OOA is contraindicated for use on active patients or for prolonged use It is not designed for long term monitoring It must be moved every 4 hours or more often if indicated by circulato ry status and or skin integrity and reapplied to a different site If long term monitoring 1s required use an Ox
119. to tolerate sensor placement it may be necessary to change the sensor site more frequently with some patients If skin integrity changes move the sensor to another site 4 Intravascular dyes may lead to inaccurate measurements 5 The performance of the DS 1OOA is compromised by motion use of this sensor is contraind1 cated for active patients 6 Do not apply tape to secure the sensor in place or to tape it shut venous pulsations may lead to inaccurate saturation measurements 7 As with all medical equipment carefully route cables to reduce the possibility of patient entan glement or strangulation 8 Do not use the DS IOOA or other oximetry sensors during MRI scanning Conducted current may cause burns Also the DS IOOA may affect the MRI image and the MRI unit may affect the accuracy of oximetry measurements 9 Do not alter or modify the DS IOOA Alterations or modifications may affect performance or accuracy 90 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL If you have questions regarding any of this information contact the Technical Services Department or your local Nellcor representative WARRANTY To obtain information about a warranty if any for this product contact Nellcor Puritan Bennett Technical Services or your local Nellcor Puritan Bennett representative ACCURACY SPECIFICATIONS For the accuracy specification range when used with Nellcor Puritan Bennett monitors refer to information provided with the
120. ton will display the next most recent data set After the earliest data set has been displayed CYCLE display 1 the next press of the REVIEW button will return the display to the most recent set of measurements At any time during REVIEW the operator may return to normal operating mode by pressing any other button or by refraining from pressing the REVIEW button for 10 seconds IV 11 A ERASE DATA FUNCTION The CANCEL button may be used to erase all stored blood pressure pulse rate oxygen saturation and temperature data without turning the Monitor off To erase all stored data in the Welch Allyn Vital Signs Monitor press and hold the CAN CEL button for three 3 seconds until a confirmatory beep is heard This beep indicates that all data stored in the Monitor has been erased Data is also erased each time the Welch Allyn Vital Signs Monitor is turned off 46 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL IV 12 SELECTING THE TEMPERATURE SCALE The temperature module option of the Welch Allyn Vital Signs Monitor is capable of dis playing temperature in either degrees Fahrenheit F or degrees Celsius C To determine the current temperature scale remove the temperature probe from its holder and view the TEMPERATURE display A small green display will illuminate showing either F or C To change the temperature scale the user must enter the Monitor s internal configuration mode 1 While the Monitor
121. tures are accurate only for children under the age of four In Normal mode the Monitor cannot take accurate axillary temperatures for older children or adults If an axillary reading is desired for a patient age four and older the oral probe must be used in Monitor mode Note The Welch Allyn Vital Signs Monitor is intended for use with adult and pediatric patients age 3 and above To take a axillary temperature in either Normal or Monitor mode follow this procedure 1 Insure that the oral probe is connected to the Monitor The oral probe has a BLUE tip Accurate axillary temperatures can only be obtained by using the blue tipped tem perature probe 2 Remove the probe from the probe holder A short self test mode will be initiated where every LED segment on the TEMPERATURE display is illuminated briefly Following this self test the display will show OrL OrL Oral Probe indicating that the oral probe is in use 3 Press the SET Arrow Up button once The display will now show ALY indicating that the Monitor is ready to take an axillary temperature reading Note that subse quent presses of the SET Arrow Up button allows the Monitor to toggle between the oral and axillary modes of operation The Monitor s display must show ALY prior to the initiation of a temperature measurement 4 With the TEMPERATURE display showing ALY load a probe cover onto the probe by holding the probe collar with the thumb and forefin
122. ue will appear in the respective display H SET Buttons Arrow Up or Arrow Down These buttons increment or decrement the currently displayed alarm threshold The SET Arrow Up button has additional functionality See section IV 19 I PULSE TONE Indicator This indicator will be lit when the pulse tone function is enabled J PULSE TONE Button Pressing this button allows the operator to control the volume of the SpO pulse tone K SYSTOLIC Display This red LED display shows the systolic blood pressure Additionally this display can show systolic alarm limits see G and H above L DIASTOLIC Display This red LED display shows the diastolic blood pressure Additionally this display can show diastolic alarm limits see G and H above M SpQ Display This red LED display shows the percent saturation of arterial hemoglobin SpO5 Additionally this display can show SpO gt low saturation alarm limits see G and H above WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL N PULSE SIGNAL BAR GRAPH This bar graph gives a visual indication of the strength and quality of the pulses detected by the SpO sensor Additionally this bar graph can indicate the volume level of the SpO gt pulse tone see I and J above O PULSE Display This yellow LED display shows the pulse rate Additionally this display can show pulse rate alarm limits see G and H above P TEMPERATURE Display and Indicator The red LED display shows th
123. ulse oximetry option 74 WELCH ALLYN VITAL SIGNS MONITOR OPERATOR MANUAL 1 NONIN FINGERCLIP SENSORS The fingerclip sensor is designed for spot check monitoring of pediatric and adult patients or continuous monitoring less than 30 minutes where patient movement is not expected and the patient s finger is large enough for the sensor to be attached securely NOTE If patient movement is occurring or the finger size is inappropriate select a differ ent sensor that is appropriate for the patient and the monitoring environment Insert finger preferably left or right index finger completely into the sensor See illustra tion below The thumb is specifically not recommended for use with the fingerclip sensor U sing the Finger Clip Sensor NOTE For the best results secure the sensor cable independently from the sensor prefer ably around the base of the finger Make sure that the tape securing the cable does not restrict the blood flow 2 NONIN FLEX SENSORS The flex sensor is designed for monitoring of pediatric and adult patients in which moder ate patient movement is expected and or long term monitoring is required Apply the double stick tape to the smooth side of the sensor Position the Sensor on the top and bottom of the end of the finger or toe Place the light emitter portion on the finger toe nail side and the detector on the side opposite of the nail In all sensor placement applications align the windows detecto
124. ver clothing Arrhythmia Incorrect reference Change in blood pressure from ausculta tory reading to Welch Allyn Vital Signs Monitor reading Poor auscultatory sound recognition by observer 62 Explanations and Corrective Action Determine correct cuff size e Use reference markings on cuff e Measure patient s arm circumference midway between elbow and shoulder see page 42 of Operator s Manual to select correct cuff size Ensure patient s arm is at heart level Keep arm still during blood pressure cycle e Movement may cause inaccuracies from artifact Blood pressure should be taken on a bare arm Check for regularity of heart rate palpate pulse or check monitor e Moderate to severe heart rate irregularities may make blood pressure difficult to measure Use the correct Korotkoff sound to determine diastolic blood pressure e Many listeners incorrectly equate diastolic blood pressure with the disappearance of sound only phase 5 The Welch Allyn Vital Signs Monitor was developed using the American Heart Association recom mendations which state that phase 5 be used unless sound continues to 0 mmHg in which case the change in the quality of sound phase 4 is to be used Deflate cuff no faster than 3 mmHg per second e One of the major sources of error in auscultatory blood pressure measurement is deflating the cuff too quickly The American Heart Association recommends deflation no faster than 3 mmHg
125. xiCliq N sensor for neonates OXI P I 1 OXI P I and e Pediatrics 15 40 kg 50 adhesive Preferred application site is index finger with cable fol To wraps et running along top of finger ias an Alternative sites are thumb or other small finger e Infants 3 15 kg Preferred application site is great toe with cable running along sole of foot e Adhesive wraps are disposable e Recommend changing site at least every 4 hours e For short term use only If long term monitoring is required consider using an Oxisensor II D 20 or OxiCliq P sensor for pediatrics and an Oxisensor I 20 or OxiCliq I sensor for infants YOLINOWSNOIS IVLIA NATIV HOTAM IVANVW Yd OLVdsd O OPERATOR MANUAL WELCH ALLYN VITAL SIGNS MONITOR ee F a QUICK GUIDE FOR NELLCOR PURITAN BENNETT SENSORS MODEL QUANTITY APPLICATION Durasensor reusable sensor DS 100 1 per package RS 10 reflectance sensor RS 10 Case of 6 sensors Adult reflectance with 6 headbands CHARACTERISTICS e For patients who weigh more than 40 kg Preferred application site is index finger Alternative site is smaller finger e Do not use on thumb or toe e Recommend changing site at least every 4 hours e For short term use only If long term monitoring is required consider using an Oxisensor II D 25 or an OxiClig A sensor e For patients who weigh more than 40 kg Preferred application site is forehead above the brow or below
126. ystem Check Procedure isesisisnrisiisereieiriarnseeni iret eni e Eeken rsr 34 2 Choosing Operating MOd S erases tenets esate spencers ene iaia 34 3 Setting the Programmable Alarms sessessessesserserseresererssresreseesresreseesreseeseesreseeseeseesee 35 38 Blood Pressure High Systolic LI asausssiisaiianin 35 bD Blood Pressure Low Systolic LIMIT sacorcseacserssrsonenstessnoonvnpenutencssnemnessaenrtioae 36 c Blood Pressure High Diastolic Limit essessessessereseesesereerereseeseeseeseereeseeseeseeses 36 d Blood Pressure Low Diastoue DITUT gg cies res yeastoseensiae aes RRT 37 e Pube kie EN sei AE 37 fe Pe nate Vr LAA E E 38 i yO AUN testa caser cena E E E A estan 38 4 Temperature Measurement Range Indicators ce eee ee eee eseeseeeseesseeseesseeeseeeseeees 29 De Alarm ndcatonsand Met Ot SLO a acscescee tive asecsaneeansenee qiutseneeeneonenciecnienrysgeenqeutoeaneasn 40 6 Setting the Default Inflation Pressure Preset Lev elisa cesscsutcsusssesesseeaueveusesauessseaacennsnaseds 41 7 Blood Pressure Cuff Selection Criteria seeseesseseseeseerssrsesrreesresresrrsrsresresreresresresreeeses 42 8 Positioning the Blood Pressure Cuff essesessessereseereersrrsrrsrrsrsresresresrsresresresrsresresreseseens 43 9 Mannal Mode Blood Presse groiriei iri roepa NE EE e NEEE 43 10 A tomalie Mode Blood Press re sssisieiipsscesinoiecoisiiiini ngen EET ERNE eri 44 45 11 Reviewing Information from Prior Cycles sessss

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