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VETSPECS USER`S MANUAL
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1. 36 1 Install the software on computer 36 2 Transfer data and organize files 37 3 View and print monitoring records 39 4 View and print ECG 44 4 6 Troubleshooting 2 0 2 0202 mnm 46 Maintenance 0 2 00 senna nenennnnne 49 Customer Support 02 22 nnn nnnnnnnnn ene 50 Limited Warranty 0 0 enennnnnnnnnn 51 Introduction VetSpecs VSM8 The VetSpecs VSM8 Vital Signs Monitor the flagship model of VetSpecs patient monitors is developed specifically for monitoring during anesthesia pre anesthetic ECG testing and clinical blood pressure measurements in cats dogs and other similar sized veterinary patients Featuring state of the art VetSpecs proprietary technologies the VSM8 offers the capability of comprehensive monitoring for patients under anesthesia It monitors patients ventilation with mainstream capnography circulation with noninvasive blood pressure oxygenation with pulse oximetry and ECG and core body temperature with an esophageal probe The VSM8 automatically saves monitoring records waveforms readings a
2. Decreased or abolished ETCO2 may be due to hyperventilation low cardiac output respiratory arrest or cardiac arrest Capnogram also provides vital information regarding the patient s airway potency A depressed or absent capnogram may be due to a dislodged misplaced or obstructed endotracheal tube or airway a leak around endotracheal tube cuff or disconnection of the endotracheal tube from the anesthetic machine The following are some examples of abnormal capnograms No ETCO2 recorded CO mmHg 50 Real Time Possible causes e Apnea e Accidental endotracheal tube disconnect e Esophageal intubation e Airway obstruction e Cardiac arrest e Respiratory arrest 15 A sudden drop of the ETCO2 to near zero followed by the absence of capnogram is potentially life threatening which could indicate malposition of the endotracheal tube disruption of airway integrity disruption of sampling lines or a sudden cardiac arrest Increasing ETCO2 hypoventilation CO mmHg 50 Real Time Possible causes e Decreased respiratory rate e Decreased tidal volume e Deep anesthesia e Interference with chest expansion e Increased metabolic rate In anesthetized patients ETCO2 higher than 50mmHg indicates hypoventilation Decreasing ETCO2 CO mmHg 50 Real Time Possible causes e Increased respiratory rate e Increased tidal volume e Reduced cardiac output e Leaks around the tube dilution e Dec
3. The normal range of ETCO2 for most mammals is 25 45 mmHg or 3 5 5 5 It is considered to be abnormal when the ETCO2 is higher than 50 mmHg or 6 5 or lower than 20 mmHg or 2 5 The diagram below shows the shape of a normal capnogram mm Hg Phase A near zero baseline Exhalation of CO2 free gas contained in dead space Phase Il Rapid sharp rise Exhalation of mixed dead space and alveolar gas Phase Ill Alveolar plateau Exhalation of mostly alveolar gas At the end of exhalation CO2 concentration reaches the peak end tidal CO2 value Phase 0 Rapid sharp down stroke Inhalation VetSpecs mainstream capnography provides real time CO2 waveforms an ETCO2 reading a RR and a digital respiratory sound Unlike side stream or micro stream capnography mainstream capnography performs CO2 measurements directly inside the airway withdrawing no gas away from the airway 14 2 Clinical implications Normal ETCO2 readings together with a normal capnogram indicate normal function of the patient s metabolism circulation and ventilation and of the anesthesia machine Increases in ETCO2 may be due to anesthetic induced respiratory depression increased metabolism or the addition of CO2 to the circulatory system as a result of re breathing CO2 Re breathing CO2 can be due to soda lime exhaustion or incompetent expiratory valve on the anesthesia machine allowing exhaled CO2 to be re inhaled
4. Since systole is normally shorter than diastole mean arterial pressure MAP is not simply the midpoint between systolic arterial pressure SAP and diastolic arterial pressure DAP but is estimated as MAP DAP SAP DAP 3 The VSM8 offers a breakthrough noninvasive blood pressure method called volume plethysmographic method which employs an inflatable cuff to occlude arterial flow and a sensor band to sense arterial pulsations The VSM8 registers SAP DAP and MAP and a real time pulse rate PR in each measurement and with push of a button provides the averaged readings for all the measurements 2 Choose an appropriately sized cuff The VSM8 comes with a set of different sized cuffs for use in cats and dogs of all sizes All cuffs are marked to aid in proper cuff selection When a cuff is wrapped around a site its index edge should be within the range indicated on the cuff The cuff is too small or too large if the index edge is outside the range The following should be used only as general guidelines for cuff selections because the circumference of the site not the size of the patient determines which cuff to use e The smallest cuff is for kittens and very small dogs e The second smallest cuff is for cats and small dogs e The third largest cuff is for medium dogs e The second largest cuff is for medium to large dogs e The largest cuff is for large dogs A cuff that is too narrow will produce artificially elevate
5. The ECG and pulse waveforms have three speeds 25 50 default and 100 mm s e Select SPEED 50 mm s and then push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the speed and then push it to set B NIBP With the NIBP module connected to the monitor e Turn the JOG DIAL to select PAGE 1 1 and then push the JOG DIAL The first page of stored BP readings will be displayed on the screen e Turn the JOG DIAL to change page numbers Push the JOG DIAL to return to waveforms display C TREND e Turn the JOG DIAL to select TREND 1h and then push the JOG DIAL The trends of the last one hour 1 hour trends will be displayed on the screen e Turn the JOG DIAL to change between the 1 hour trends and the 4 hour trends Push the JOG DIAL to return to waveforms display NIBP With the NIBP module connected to the monitor select NIBP and push the JOG DIAL to enter NIBP submenu as below 1 Interval 3min 2 Alarm OFF 3 SAP HI 180 LO 60 4 DAP HI 120 LO 40 5 MAP HI 150 LO 50 6 RETURN 7 ESC 31 A INTERVAL To change the interval setting for automatic BP measurements default 3 minutes e Select 3 min and then push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the setting and then push the JOG DIAL to set B ALARM The default setting for BP alarm is OFF To turn on BP alarm Select Alarm OFF and push the JOG DIAL to highlight in red Turn the JOG DIAL to change to ON a
6. 25 IV Operational Instructions Push the purple POWER button on the back of the monitor to turn on or off the power Sleep Mode To extend the life of the screen the monitor will automatically turn off the screen sleep mode after the monitor has been idle for more than 30 minutes In sleep mode the screen is turned off but the green power light at the lower left corner is flashing To exit sleep mode turn the screen back on simply push the yellow WAKE UP key on the front panel not push the POWER button on the back To exit sleep mode i e turn the screen back on push the yellow WAKE UP key not the POWER button If you mistakenly pushed up the POWER button when the monitor was in sleep mode you would need to wait at least 15 seconds with the POWER button staying at the UP position and then push down the POWER button to turn on the monitor 26 4 1 Control Panel WAKE UP Push this key to exit Sleep Mode to turn the screen back on see the previous page TREND Push this key to display stored BP readings and trends and go back to waveforms display TREND and WAKE UP share the same key yellow SAVE In monitoring mode push this key to make a screen capture saving the information on the screen to the flash drive This key has no function in ECG mode and BP mode vBEAT Push this key to turn off or on the heartbeats sound FREEZE Push this key to freeze a line of ECG on the screen Push it a
7. The VetSpecs program is compatible with all computers using Windows XP operating system Insert the software CD into your computer and then open up the CD Double click the J VetSpecs exe file named VetSpecs exe The window below pops up Click Yes button Registry Editor 2 j re you sure you want to add the information in c SMiY SMwin reg to the registry The window below pops up Click OK button Registry Editor It is highly recommended to copy the VetSpecs exe program to your computer in case that the original software CD is misplaced 36 2 Transfer data and organize files 1 Create a master folder on the hard drive It is highly recommended to establish a new folder on the hard drive of your computer to be the master folder for storing all patient data recorded by the VSM8 monitor before you ever start to transfer data to your computer You can give any name to the master folder For example you can name it My VetSpecs Data a My YetSpecs Data 2 Create a patient folder inside the master folder Each patient should have a separate folder inside the master folder You can literally create thousands of folders inside the master folder if necessary Before you transfer any data of a new patient you should crease a new folder inside the master folder for the new patient You should name all your patient folders in a way which allows you to identify them easily For example you may name a p
8. back of the monitor The monitor displays DISK None at the bottom of the screen when the flash drive is not plugged in and DISK Ready when the flash drive is plugged in 8 Power Cord Connect the included power cord to the black power port at the back of the unit and to a standard 3 line power outlet ll Clinical Instructions 3 1 Monitoring in Anesthetized Patients The VSM8 features three work modes monitoring mode ECG mode and blood pressure mode The VSMB8 automatically switches to monitoring mode when an esophageal probe is inserted into the patient i e a temperature is registered or the CO2 sensor is connected to the Module In monitoring mode the VSM8 displays cascaded two lines of ECG green one line of pulse waveforms red and one line of CO2 waveforms yellow GAIN AUTO a 2 SPEED S50Omm s READY 419 0 843 95 PR T2 ALARM f C02 fe BEAT 0 DISK None PRN None NAME Monitoring mode 4 1 ECG and Core body Temperature The VSMB8 registers ECG heart rate HR and core body temperature in anesthetized patients with an esophageal probe 1 The esophageal probes Generally speaking the esophageal probe labeled for Dogs is for use in dogs while the esophageal probe labeled for Cats is for use in cats and some small dogs An esophageal probe for small kittens rodents and lizards is also available as optional In order for the esophageal probe to register ECG all th
9. in main menu and then push the JOG DIAL to enter as below 1 Units F 2 HI 105 0 3 LO 95 0 4 Alarm ON 5 RETURN 6 ESC SETUP Select SETUP in main menu and push JOG DIAL to enter as below 1 Date m d y 2 Time h m s 3 RETURN 4 ESC 33 4 3 Recall Data 1 Recall BP readings The monitor stores in its internal memory registered BP readings for up to 58 measurements Push TREND key to display the BP readings Turn the JOG DIAL to change pages The monitor automatically calculates averages of the registered BP readings and displays them at the top of the BP readings table Turning off the monitor or disconnecting the NIBP module from the monitor will erase all BP readings stored in the internal memory However the data already saved in the flash drive will not be deleted 2 Recall trends The monitor stores in its internal memory up to four hours of trends HR SpO2 Temp RR and CO2 and can display these trends in one hour or four hour formats Push TREND key to display the trends Turn the JOG DIAL to switch between displaying the trends of the last one hour and displaying the trends of the last four hours 34 4 4 Save Information The monitor can not save information without the flash drive The monitor displays DISK None when no flash drive is plugged in After connecting a USB flash drive to the monitor DISK Ready is displayed A new folder will automatically be created o
10. old In the absence of clinical findings of hypertension cats with a systolic pressure between 160 190 mmHg should have measurements repeated many times over the course of a day In general dogs with a systolic pressure over 180 mmHg are considered hypertensive Care has to be taken in diagnosing hypertension as marked breed differences occur These are not absolute limits just a guideline for each individual case Repeated measurement helps clarify whether the elevation in pressure is sustained or stress induced Results always need to be interpreted carefully in light of the animal s condition and measurement environment If the same patient is to be measured at different times cuff size and position should be matched as close as possible 3 BP measurements in hypotensive patients In order for the sensor band to pick up valid arterial pulsations in hypotensive patients place the sensor band at a site with better circulation position the sensor band right above a main artery and wrap the sensor band firmly but not excessively tight If the sensor band cannot pick up valid arterial pulsations try another location Generally speaking the base of the tail has a stronger blood flow than the distal legs The sensor band may not be able to pick up valid arterial pulsations when the circulation underneath is too weak Failure to pick up arterial pulsations by the sensor band at multiple locations is a clear indication of hypotension
11. verify if the cuff can occlude the arterial flow properly when inflated see page 13 for more instructions e Place the cuff and the sensor band between the elbow and the carpus see sketch 6 Lay the patient in lateral recumbence to minimize the effect of gravity Conscious cats usually do not tolerate well the foreleg placement If a site is too small to allow the sensor band to be wrapped properly tight try another site with a larger circumference In order for the cuff to occlude the arterial flow when inflated the cuff must be placed at an appropriate site Do not place the cuff on the hock or elbow If the cuff is placed on a joint or too high on a limb it may not be able to completely occlude the arterial flow when inflated producing erroneous readings 10 Sketch 5 Place the cuff at the base of the tail and the sensor band half of an inch below the cuff Position the sensor band over the median coccygeal artery Pull the Velcro strip to wrap the sensor band tight Wrap the strip around the sensor site until it is completely wrapped up Do not leave the strip unwrapped Sketch 6 Place the cuff and the sensor band between the elbow and the carpus with the sensor band half of an inch to one inch distal to the cuff Pull the Velcro strip to wrap the sensor band tight Wrap the strip around the sensor site until it is completely wrapped up Do not leave the strip unwrapped Lay the patient in lateral recumbence to minimiz
12. DY is again displayed To abort a measurement push START STOP key The bar graph should stop pulsating immediately after the cuff inflation indicating the occlusion of the arterial flow If the bar graph keeps pulsating immediately after the cuff inflation indicating a failure to occlude the arterial flow no BP readings will be registered and OCCLUSION FAILED will be flashing on the screen If OCCLUSION FAILED is displayed verify the cuff placement and size Make sure that 1 the cuff is applied correctly 2 the cuff is placed at an appropriate site and 3 the cuff size is appropriate for the site The monitor will keep flashing OCCLUSION FAILED _ until READY is displayed again It is highly recommended to manually start the first measurement and watch the entire measurement process closely Set the monitor to automatically perform BP measurements only after you have confirmed that the cuff can successfully occlude the arterial flow 13 4 Mainstream Capnography 1 The concept Capnography is measurement and waveform display of CO2 concentration at the patient s airway It monitors various components of patient and anesthesia circuit equipment as well as the critical connection between the two A capnogram is the graphical waveform depicting CO2 concentration throughout respiration End tidal CO2 ETCO2 which can be expressed as mmHg or percentage refers to the measurement of CO2 concentration at the end of exhalation
13. FF goes away when all three leads are applied onto the patient 4 SpO2 Sensor The VSM8 comes with a SpO2 lingual sensor gray clip Connect the SpO2 sensor to the RED port of the Module PROBE OFF goes away when the SpO2 sensor is connected to the Module 5 Mainstream CO2 Sensor The VSM8 comes with a mainstream CO2 sensor Connect the CO2 sensor to the YELLOW port of the Module The monitor displays MODULE OFF in the CO2 area yellow when the CO2 sensor is not connected to the Module Upon connecting the CO2 sensor to the Module the monitor displays CAL and CO2 CALIBRATION 6 NIBP Module and Accessories The noninvasive blood pressure NIBP capability of the VSM8 consists of a NIBP module a pulse sensor band with a long black Velcro strip and a set of five cuffs Connect the NIBP module to the BP port Gray on the right side of the monitor The monitor displays MODULE OFF in the NIBP area blue when the NIBP module is not connected to the monitor Upon connecting the NIBP module to the monitor MODULE OFF goes away The pulse sensor band is to be connected to the NIBP module Upon connecting the pulse sensor band a blue bar graph appears in the NIBP area When the pulse sensor band is not applied to the patient the monitor may flash BP SENSOR OFF The cuffs are to be connected to the tube on the NIBP module 7 USB Flash Drive The VSM8 includes a USB flash drive Connect the flash drive to the USB port on the
14. IBRATION and CAL go away In order for the CO2 sensor to be calibrated correctly attach the airway adapter onto the CO2 sensor as shown above before the sensor is connected to the Module Connect the CO2 sensor to the endotracheal tube after the calibration process has been completed 20 B CO2 monitoring The CO2 waveforms indicate the real time airflow in and out the patient If the CO2 waveforms are erratic or just a flat line verify the patient s respiration status and the endotracheal tube placement and if necessary bag the patient to have its breathing going again It is important to bag the patient when the CO2 waveforms are a flat line If the patient has stopped breathing for longer than the apnea time set by the user default setting 30 seconds an alarm will be sounded The audible alarm will automatically be suspended after 30 seconds If you want to stop the alarm right away push the ALARM key After a monitoring disconnect the CO2 sensor from both the endotracheal tube and the breathing circuit 4 Digital respiratory sound VetSpecs mainstream capnography provides a digital respiratory sound which allows you to continuously assess the patient s respiratory status without constantly watching the screen The respiratory sound can be set ON or OFF in the menu and the setting will be saved as default The sound volume can be adjusted with the VOLUME Dial 5 The airway adapter The airway adapter
15. VETSPEcs VSM8 VITAL SIGNS MONITOR USER S MANUAL The VSM8 is for veterinary use only VETSPECS INC www vetspecs com Vi Contents Introduction 222 22 nn nnn 1 Installation 00 02nnnn nnn nenennnnne 2 Clinical Instructions 4 3 1 Monitoring in Anesthetized Patients 4 1 ECG and Core body Temperature 5 2 Pulse Oximetry 6 3 Blood Pressure Monitoring 9 4 Mainstream Capnography 14 3 2 ECG Testing 0 2 22 0nnnen nnn nnnnnnn nen nnnn 22 3 3 BP Measurement 202 n2n nnn nnennnnnennnnns 24 Operational Instructions 26 4 1 Control Panel 27 4 2 Menu System 22 20 02 2nnn nanan n 28 4 3 Recall Data 2 202 0200 02nensenenennnnenesnenneenennennn 34 4 4 Save Information 35 4 5 Review Saved Information
16. ace the sensor at the center of the tonque with the light emitting side on top of the tongue not at the edge of the tonque For a thin tongue such as the tonque of cats and some small dogs it is highly recommended to put two pieces of dry gauze on the tongue one on each side and then clip the lingual sensor on the gauze 2 SpO2 Leg toe Sensor optional Use the leg toe sensor blue clip only when the lingual sensor is not suitable for the procedure for example in dentistry For cats place the leg toe sensor at one of these sites e On the distal leg between the carpal pad and the metacarpal pad see Sketch 1 If the sensor site is covered with dark hair clip the hair on both sides of the leg e On the paw with the light emitting side on top of the paw and the other side of the sensor on top of the metacarpal pad see Sketch 2 For dogs place the leg toe sensor at one of these sites e On the Achilles tendon see Sketch 3 e On a toe side to side see Sketch 4 If possible apply the sensor to a toe with light skin For a toe covered with dark hair clip the hair on both sides e On the distal leg between the carpal pad and metacarpal pad see Sketch 1 e On askin fold at the lower belly the prepuce or the vulva if appropriate Do not place the leg toe sensor on the tongue except for equine patients Applying the leg toe sensor on the tongue of cats or dogs may cause vasoconstriction a6 Sketch 1 The Leg toe sensor
17. atient s folder with the patient s name and ID number as below me 100001 Champ CJ 100002 Max 3 Copy data files to your computer Remove the flash drive from the monitor and insert it to a USB port on your computer The flash drive should be recognized by the computer automatically and indicated as Removable Disk under My Computer If you can not find the flash drive under My Computer window try another USB port on the computer If all USB ports are not working try another computer The USB flash drive is universally compatible with all computers with functional USB port s It is suggested that you copy all folders on the flash drive to your computer as soon as possible and then delete all folders on the flash drive Or you may get confused 297e 4 Rename data files Immediately after these data folders are copied to the computer you should move them into the folders of each patient involved and then rename these data folders in a wa that they can be identified easily For example the data folder of a surgical monitoring on July 1 2005 may be named as SM 07 01 05 the data folder of an ECG testing on July 1 2005 may be named as ECG 07 01 05 and the data folder of a BP screening on July 1 2005 may be named as BP 07 01 05 as shown below CJ SM 07 01 05 CJ ECG 07 01 05 J BP 07 01 05 5 Organize patient files All files for the same patient should be placed inside the patient s folder For exampl
18. ause vasoconstriction in the tissue When using the leg toe sensor always place the sensor at a site with light skin if possible To apply to a site with pigmented tissue the hair on both sides must be clipped Watch the waveforms If the waveforms are a flat line or pulsating intermittently the bar graph is barely moving the site is too pigmented to permit adequate light transmission Try another site When both the SpO2 channel and the ECG channel are working properly the pulse waveforms and the ECG are in synch with each other If they are not in synch with each other a red flashing question mark will appear near the heart rate indicating one or both channels are not working properly Verify the patient status and sensor placement If necessary adjust the placement of the SpO2 sensor or the esophageal probe The red flashing question mark 7 will stay on the screen until the pulse waveforms and the ECG are in synch with each other again 3 Blood Pressure Monitoring 1 The technology Blood pressure BP is the lateral force per unit area exerted on a vessel wall The pressure generated is pulsatile and creates a wave of vascular distention This forward moving pressure wave has maximum systolic arterial pressure and minimum diastolic arterial pressure values oscillating around a mean value mean arterial pressure which is the average pressure throughout the cardiac cycle that pushes blood through the vascular network
19. ay need to be replaced When the NIBP module registers no signals the VSM8 will flash BP SENSOR OFF indicating one of the three situations 1 the sensor band is not connected to the NIBP module 2 the sensor band is not applied to the patient or 3 the sensor band was worn out If the monitor flashes BP SENSOR OFF while the sensor band is applied on the patient tap the sensor band with your finger If BP SENSOR OFF does not go away the sensor band needs to be replaced 12 5 Start a measurement BP measurements can be started manually or automatically at a user set interval To manually start a measurement push START STOP key while READY is displayed The VSM8 rapidly inflates the cuff to around 280 mmHg and then deflates gradually The real time cuff pressure count down is displayed in the NIBP area The deflation process takes only a few seconds The bar graph will resume pulsating when the pressure inside the cuff equals the systolic arterial pressure indicating the return of arterial flow Upon completing the measurement systolic diastolic and mean arterial pressure readings are displayed The time at which the measurement was completed is also displayed Between measurements if motions are induced to the patient the monitor may display WAIT until the sensor band is again picking up valid arterial pulsations If pushing START STOP key while WAIT is still displayed a measurement will not be started until REA
20. click Petlnfo button at the upper left corner of the window k VetSpecs File A30 BPtable Trend X Wavell ysm The Petlnformation window pops up as shown below Type in patient information and or comments and click Save button You can make changes at any time z z Petinformation Joe Smith Pet s Name champ Breed Lhasa Apso h Weight a5 lb Age A When printing the patient information will be printed at the top of each printout To print the diagnostic comments click the PRINT button 43 4 View and print ECG To view saved ECG directly go to the data folder and then open it Double click any one of the screen captures to open it up as shown below A BP_DATA VSM VetSpecs Record File KB WAVEOO VSM eo VetSpecs Record File SKB ty WAVEO2 VSM es VetSpecs Record File SKB 1s VetSpecs VSM7 Fie PetInfo BPtable Trend 9 KB 5 KB SKB b TREND VSM etSpecs Record File WAVEOL VSM etSpecs F WAVEO3 VSM etSpecs ecord File Record File Wavell vs Total Page 4 Current Page Four file display format 44 1 Gain 10mm 1mV HR 72 Speed 50mm s NIBP mmHg SAP DAP MAP PR Time Date Print DRAFT BOLD PRINT 23 08 50 06 24 2007 Open PgUp X Mode To display only one screen capture in the window place the cursor in its waveform area and then double click the left key o
21. d readings while a cuff that is too wide will produce spuriously low values 9 3 Apply the cuff and the sensor band Apply the cuff and the sensor band to the same limb or the tail of the patient The sensor band must be placed below distal to the cuff about half of an inch away from the cuff Place the sensor band over a main artery with the side labeled SENSOR BAND facing out It is not necessary to clip the hair anywhere Place the long Velcro strip though the metal buckle on the sensor band pull the strip back to wrap the sensor band tight and then wrap the strip completely around the sensor site Do not leave a portion of the strip unwrapped because motions may be induced to the sensor through the unwrapped strip disrupting the measurements The sensor band may not work effectively if it is not wrapped and positioned correctly The recommended cuff and sensor placements are listed below e Place the cuff at the base of the tail and the sensor band half of an inch below the cuff Position the sensor band over the median coccygeal artery see sketch 5 The tail placement_is recommended for patients with short legs and for conscious patients especially cats Cats tolerate much better the tail placement e For cats or dogs with long hind legs the cuff may be placed below the hock and the sensor band half of an inch distal to the cuff If the cuff is placed on the Achilles tendon and the sensor band below the hock you need to
22. ds to be replaced frequently in order to ensure a normal performance of the CO2 sensor 49 Modules and accessories Never modify any modules or accessories or use them on any other monitors Never use any cables leads probes sensors or cuffs on the VSM8 monitor which are not provided by VetSpecs Never have the monitor or its modules and accessories serviced by any unauthorized person Warranty for the monitor and its modules and accessories are voided if any of the above occurred VI Customer Support For technical support during the clinical trial period please call 1 800 705 0113 678 493 3555 For customer support after purchasing or to order accessories please call 1 800 599 2566 To return the VSM6B or its accessories for testing and services please ship to VetSpecs Inc 111 Mountain Brook Drive Canton GA 30115 USA 50 Limited Warranty VetSpecs Inc VetSpecs warrants The Main Unit of The VetSpecs VSMB8 Vital Signs Monitor the VSM8 to be free from defects in materials and workmanship when stored under appropriate conditions and given normal proper and intended usage for two 2 years from the date of delivery of the VSM8 to the original end user purchaser Buyer VetSpecs agrees during the applicable warranty period to repair or replace a defective VSM8 without cost to Buyer VetSpecs shall not have any obligation under this Limited Warranty to make replacements which result in wh
23. e for patient Max with a patient ID number of 100002 all its files should be placed inside the folder 100002 Max as shown below CJ 100002 Max 2 8 BW BS B p SM 07 01 05 ECG 07 01 05 BP 07 01 05 ECG 07 01 06 BP 07 01 06 ECG 07 01 07 BP 07 01 07 38 3 View and print monitoring records To view saved monitoring records directly go to the data folder and then open it In the folder you will see a number of files WAVE00 VSM WAVE01 VSM WAVE02 VSM WAVEO03 VSM which are the screen captures TREND VSM is the trends page and BP_DATA VSM is the BP readings page You can open any of these files by double clicking on the file m BP ae sal Po TRT SM rd File cord File WAVEOO SM VetSpecs Record File WAVEOL VSM etSpecs Record Fil SKB WAVEO2 VSM WAVEOS VSM VetSpe s Record File etSpecs Recor KB 5 KB t s VetSpecs VSM7 File PetInfo BPtable Trend Wavelll vsm Wavell vsm Gain 10mm 1mV wu 6 Speed 50mm s NIBP mmHg sae 120 Dae 80 mar 92 PR 76 co2 s 41 19 F crc Time 08 56 26 Date 02 01 2001 Print Mode Open BOLD PgUp Total Page 2 Current Page 1 PRINT Four file display format 39 Four screen captures are opened up in one window Click inside a screen capture to select it see cursor in the picture on the previous page The readings displayed at the right side correspond to the selected screen capture To delete a screen capture select it and t
24. e JOG DIAL to select NAME and then e Push the JOG DIAL again to generate a red cursor rotate the JOG DIAL to input the first letter A to Z or digit 0 9 and then push the JOG DIAL to enter 28 e Rotate the JOG DIAL to input the second letter or digit and then push the JOG DIAL to enter A total of eight letters and or digits can be entered e After entering the name push the JOG DIAL until the red cursor disappears The patient s name is displayed at the bottom of the screen and a new folder under this name has been created on the flash drive Upon entering a new name BP readings and trends data already stored in the internal memory of the monitor will be erased making the monitor ready for the new patient The information already saved on the flash drive will not be deleted No new folder will be created on the flash drive until a new name is entered If a folder of the same name has already existed on the flash drive the monitor will briefly flash EXISTED Enter a different name or go to a computer to delete the folder with the same name from the flash drive If you do not want to save any information for a procedure just do not enter a name CO2 amp Resp e In main menu select CO2 amp Resp and then push the JOG DIAL to enter 1 Sound OFF 2 Speed Slow 3 Apnea 30s 4 ETCO2 Units mmHg HI 50 LO 20 Alarm ON 5 RETURN 6 ESC The respiratory sound can be set OFF or ON as default To turn on
25. e the effect of gravity 11 4 Watch the bar graph The VSM8 displays a systolic arterial pressure S diastolic arterial pressure D mean arterial pressure M and a real time pulse rate PR Measurement interval INT is also displayed on the screen The arterial pulsations registered by the sensor band are displayed as a pulsating bar graph blue After applying the cuff and the sensor band watch the bar graph The bar graph pulsates in synch with the heartbeats when the sensor band is picking up valid arterial pulsations If the bar graph is jumping erratically the sensor band is picking up motions In order to perform BP measurements a valid PR has to be registered first When the sensor band is picking up valid arterial pulsations a PR will be registered in seconds and at the same time the monitor will display READY indicating it is ready for BP measurements The monitor will be displaying WAIT until a valid PR is registered No BP measurements can be started before READY is displayed If the bar graph is erratic not in synch with the heartbeats there are repetitive motions being induced to the patient or the sensor band is not working properly Test the sensor band on your finger by wrapping it on your index or middle finger If the bar graph pulsates vigorously and in synch with your heartbeats the sensor band is good Try it again on the patient If the bar graph is erratic on your finger the sensor band m
26. er as instructed on page 12 BP SENSOR OFF does not go away after the sensor band is applied to the patient The sensor band may be worn out Tap on the sensor band If BP SENSOR OFF does not go away the sensor band needs to be replaced The bar graph is barely moving and BP SENSOR OFF is displayed intermittently 1 The perfusion at the sensor site is too weak 2 The sensor band is not placed correctly 3 The sensor band is not working normally 1 Check the patient status 2 Place the sensor band above a main artery and wrap it firmly 3 Test the sensor band on your finger MODULE OFF does not go away after the NIBP module is connected to the monitor The NIBP module is malfunctioning The NIBP module needs to be returned to manufacturer for testing 47 4 Pulse Oximetry Problems Possible Causes Recommended Actions PROBE OFF does not go away when a SpO2 sensor is connected to the Module Wires inside the SpO2 sensor were damaged Use another SpO2 sensor After applying the leg toe sensor to the patient the pulse waveforms are erratic or just a flat line No adequate light transmission due to dark hair pigmented skin and or thick tissue 1 Clip the hair on both sides 2 Apply the sensor to a site with light skin After applying the lingual sensor the pulse waveforms are erratic 1 Low perfusion at the sen
27. gain to release the line START STOP Push this key to manually start a BP measurement Push it again before a measurement has completed aborts the measurement ALARM Push this key to turn on or off an audible alarm JOG DIAL Push the JOG DIAL to display main menu Turn the JOG DIAL to select items in main menu or submenus and change settings VOLUME Turn this dial to increase or decrease the volume of the speaker 27 4 2 Menu System Main menu Push the JOG DIAL to display main menu as shown below Turn the JOG DIAL to select a submenu and then push the JOG DIAL to enter To exit from main menu select ESC and push the JOG DIAL 1 NAME CO2 amp Resp SCREEN NIBP ECG SPO2 Temp SETUP ESC OMNAA AWD NAME The monitor will prompt you to enter a patient name upon connecting the Module and or the NIBP module to the monitor The monitor will beep for 10 seconds and keep flashing NAME until a name is entered You can enter a name only when DISK Ready is displayed and NAME is flashing The patient name entered will be deleted each time the monitor switches work modes for example from ECG mode to monitoring mode For surgical monitoring you should first have the monitor enter into the monitoring mode by connecting the CO2 sensor or a respiration sensor to the Module and then enter the patient s name Or you enter the patient s name after a temperature is registered To enter a patient name push th
28. gs under the water If LEAD OFF does not go away the probe needs to be replaced After inserting a probe no temperature is registered or the registered temperature stays 113 F Wires in the esophageal probe are damaged Try another probe When using the ECG leads with flat clips ECG is erratic or having a lot of interference Good electrode to tissue contacts are not established Make sure all three clips are applied to the patient properly and all three contact sites are soaked with saline or alcohol LEAD OFF does not go away after applying all three leads on the patient A lead wire inside was damaged Use another set of leads 46 3 NIBP Problems Possible Causes Recommended Actions The NIBP module keeps inflating the cuff 1 There is a leakage on the cuff 2 There is a leakage on the tubing 3 There is a leakage inside the module 1 Try different cuffs The cuffs are semi disposable and need to be replaced after using for a period of time 2 Check the tubing 3 If all cuffs have the same problem and there is no crack on the tube the module needs to be returned for service The bar graph is erratic and no PR is registered 1 There are repetitive motions 2 The sensor band is not working properly 1 Calm down the patient or eliminate motions being induced to the patient 2 Test the sensor band on your fing
29. he actual purchase price paid by Buyer for the VSMB8 In no event shall VetSpecs be liable to Buyer or any other person or entity for special incidental or consequential damages including but not limited to loss of profits damages to properties and injuries to the patient and or the user arising out of the manufacture sale supplying or use of the VSM8 The foregoing Limited Warranty extends to Buyer only and shall not be applicable to any other person or entity including without limitation customers of Buyer 51
30. hen click the right key on the mouse To display only one screen capture place the cursor in the screen capture and then double click the left key The selected screen capture is displayed in the whole window as shown below To go back to the four file display format place the cursor in the waveform area and then double click the left key t s VetSpecs VSM7 Single file display format To change pages click PgDn or PgUp button at the lower right corner of the window To print a screen capture select it and then click PRINT button The screen capture will be printed through the default printer of the computer 40 To view trends in a screen capture window click Trend button at the upper left corner of the window as shown below k i VetSpecs Fie PetInfo BPtable BUET 02 01 2001 To print the trends page click PRINT button as shown above a fee To view BP readings table in a screen capture window click BPtable button at the upper left corner of the window The BPTable window pops up as shown below AVERAGE 126 04 43 04 44 04 45 131 98 04 45 128 95 04 126 94 04 47 128 04 94 04 04 5 95 04 5 86 04 5 95 97 04 55 04 5 04 57 04 04 04 59 04 59 05 00 05 01 05 01 05 02 05 02 05 03 05 04 To print the BP readings table click PRINT button as shown above 42 To input patient information
31. ioning of the endotracheal tube at or beyond the carina so that one side of the lung has impaired emptying This makes the retained gas higher in CO2 and later to empty than from the normal lung The spike can occur anywhere in the plateau phase e Any functional blockage of a major airway below the carina foreign body mucous compressed airway etc Cardiogenic oscillations mm Hg 40 19 Cardiogenic oscillations are ripples superimposed on the expiratory plateau and the descending limb of the capnogram which are caused by small gas movements inside the airway Although cardiogenic oscillations can occur in any animal where the pulsations of the aorta and heart cause areas of lungs to be compressed and thereby emptied and filled they are typically seen in large dogs with a slow RR The guide to the fact that this is happening is that the oscillations are in synch with the heartbeats The displayed respiratory rate can be much higher than the actual respiratory rate when cardiogenic oscillations occur 3 Operational instructions A Apply the CO2 sensor Attach the airway adapter onto the CO2 sensor as shown below and then connect the CO2 sensor to the yellow port of the Module Airway adapter The CO2 sensor will automatically start to calibrate upon connecting to the Module The monitor displays CO2 CALIBRATION and CAL The calibration process takes two minutes Upon completing the calibration CO2 CAL
32. is a semi deposable item After using for a period of time it must be replaced due to the residuals accumulated inside the airway adapter which will block the infrared light Do not try to clean the airway adapter as it may damage the special optical film on the two circular windows To ensure accurate readings the airway adapter must be replaced at least one a month 21 3 2 ECG Testing The VSMB8 comes with a set of ECG leads with flat clips designed specifically for ECG testing in veterinary patients The VSM8 automatically enters into ECG mode when the ECG leads are applied to the patient and no CO2 sensor or respiration sensor is connected to the Module In ECG mode the VSM8 displays cascaded four lines of ECG on one screen GAIN AUTO 120 ECG mode Attach the foreleg lead s to the appropriate foreleg just above the elbow and the rear leg lead s to the appropriate rear leg immediately proximal to the stifle It is not necessary to clip hair Wet all three contact sites thoroughly with conductive agent such as saline In order to register interference free ECG adequate amount of conductive agent must be applied to all three contact sites 29 With the ECG leads with flat clips the monitor can register Lead l Lead ll or Lead lll ECG but one Lead at a time Lead ll is the Lead of choice for ECG testing in veterinary patients because Lead ll offers the largest ECG tracings Placements of leads flat c
33. lips for registering different Leads of ECG are listed below LEAD II ECG GREEN lead attaches to RIGHT REAR LEG RED lead attaches to LEFT REAR LEG WHITE lead attaches to RIGHT FORELEG LEAD I ECG GREEN lead attaches to RIGHT REAR LEG RED lead attaches to LEFT FORELEG WHITE lead attaches to RIGHT FORELEG LEAD III ECG GREEN lead attaches to RIGHT REAR LEG RED lead attaches to LEFT REAR LEG WHITE lead attaches to LEFT FORELEG The patient should be laid on its side usually on a towel or rubber mat and relaxed Trembling and panting may produce motion artifacts on ECG For more instructions on ECG testing refer to pages 35 44 and 45 23 3 3 BP Measurements For more instructions on BP measurements refer to pages 9 13 34 35 and 42 The monitor automatically enters into BP mode when only the NIBP module is connected to the monitor In BP mode the monitor displays cascaded four lines of pulse waveforms blue registered by the sensor band 1 Screening for hypertension Screening for hypertension must be performed in a quiet environment under a stress free condition If possible have two people to perform the procedure One holds and calms the patient while the other person places the cuff and the sensor band and then performs the measurements For cats it is highly recommended to place the cuff and sensor band on the tail see sketch 5 on page 11 as cats usually tolerate better the tail placement A
34. n the flash drive upon entering a new patient name The monitor will not save information on the flash drive until a name is entered 1 Save information in monitoring mode In monitoring mode the monitor will save the information on the screen i e make a screen capture along with registered trends and BP readings automatically every five minutes or each time you push the SAVE key For example for a one hour monitoring at least 12 screen captures along with a trends page and a BP readings page will be saved in the folder of the patient on the flash drive The number of saved screen captures is displayed at the bottom of the screen 2 Save information in ECG mode In ECG mode the monitor automatically and continuously saves ECG on the flash drive The monitor will automatically start saving ECG screen captures upon registering valid ECG and automatically stop saving when ECG is no longer registered Up to 99 screen captures can be saved continuously The number of saved screen captures is displayed at the bottom of the screen 3 Save information in BP mode In BP mode the monitor automatically saves on the flash drive readings registered in each measurement Readings for up to 58 measurements along with the averages of these readings will automatically be saved in the folder of the patient on the flash drive 35 4 5 Review Saved Information 1 Install the software on computer The VSM8 comes with a software CD
35. n the mouse eu VetSpecs VSM x File PetInfo BPtable Trend Wavell vs Gain 10mm 1mV m 72 Speed 50mm s NIBP mmHg SAP DAP MAP PR Time 23 08 50 Date 06 24 2007 Print Mode Open DRAFT MSE BOLD Pgup s Total Page 16 Current Page 1 PRINT Single file display format To view ECG screen by screen click PgDn or PgUp button as shown above To display four screen captures in one window double click the left key on the mouse To print ECG click PRINT button at the lower right corner of the window 45 4 6 Troubleshooting 1 The Module Problems Possible Causes Recommended Actions MODULE OFF in the HR area SpO2 area or RR area does not go away after connecting the Module to the monitor The Module is malfunctioning The Module needs to be returned to manufacturer for service 2 ECG and Core body Temperature Problems Possible Causes Recommended Actions After inserting an esophageal probe the ECG is erratic Not all the three rings have established a good contact with the esophagus The probe is inserted too shallow or deep 1 To use an appropriately sized probe 2 Adjust the position depth of the probe After inserting an esophageal probe LEAD OFF does not go away Wires in the esophageal probe are damaged Test the probe by inserting it in a cup of water with all three metal rin
36. nd then push the JOG DIAL to set C CHANGE BP ALARM LIMITS Select the item to be changed push the JOG DIAL to highlight in red Turn the JOG DIAL to change the number and push the JOG DIAL to set ECG Select ECG in main menu and push the JOG DIAL to enter ECG submenu as below 1 HI 400 2 LO 50 3 Gain AUTO 4 Alarm ON 5 RETURN 6 ESC A CHANGE HR ALARM LIMITS e Select the item to be changed push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the number and push the JOG DIAL to set e The new setting will be saved as default B GAIN AUTO The ECG amplifier features automatic sensitivity adjustment GAIN AUTO indicates that the ECG amplifier will automatically adjust its sensitivities gain among five levels X 2 X1 X2 X4 and X8 to display ECG in an optimal size as large as possible 32 without saturation The red bar 10 mm high displayed in the ECG channel provides a scale mV for measuring the amplitude of the ECG on the screen To suspend the automatic sensitivity adjustment change GAIN AUTO to GAIN CAL the gain of the ECG amplifier will be fixed at X1 SPO2 Select SPO2 in main menu and then push the JOG DIAL to enter as below 1 HI 100 2 LO 90 3 Alarm ON 4 RETURN 5 ESC To change SpO2 alarm limits e Select the item to be changed push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the number and push the JOG DIAL to set Temp Select Temp
37. nd trends ECG tracings and blood pressure readings on a USB flash drive for easy transfer of data to computers You can then review the saved information print reports through your office laser or ink jet printers on 8 5 X11 plain papers The VSM8 exemplifies VetSpecs devotion to developing effective easy to use and reliable products to support veterinarians efforts in providing excellent care while building successful practices Il Installation 1 The Module The VSM8 comes with a multi parameter module hereinafter the Module Connect the Module to the light gray port on the right side of the monitor The monitor displays MODULE OFF in the HR area green SpO2 area red and RR area yellow when the Module is not connected to the monitor Upon connecting the Module to the monitor MODULE OFF in all three areas go away 2 Esophageal Probes The VSM8 comes with a set of two esophageal probes The one labeled Esophageal Probe for Cats is for use in cats and some small dogs The one labeled Esophageal Probe for Dogs is for use in dogs For monitoring ECG and temperature in anesthetized patients connect an esophageal probe to the GREEN port of the Module LEAD OFF goes away when the probe is inserted into the patient 3 ECG Leads with Flat Clips The VSM8 comes with a set of ECG leads with flat clips green red and white For ECG testing connect the ECG leads to the GREEN port of the Module LEAD O
38. ole or in part from catastrophe fault or negligence of Buyer or anyone claiming through or on behalf of Buyer or from improper use of the VSM8 or use of the VSM8 in a manner for which it was not designed or by cause external to the VSM8 The Module NIBP module and CO2 sensor are covered by a 12 month limited warranty The esophageal probes ECG leads with flat clips SpO2 sensors pulse sensor band and USB flash drive are covered by a 6 month limited warranty The cuffs and airway adapter are semi disposable items and have no warranty Buyer shall notify VetSpecs of any product which it believes to be defective during the warranty period Such product shall be returned by Buyer transportation and insurance prepaid to VetSpecs for examination and testing VetSpecs shall repair or replace any such product found to be so defective and return such product to Buyer transportation and insurance prepaid The provisions of the foregoing Limited Warranty are exclusive and are expressly in lieu of any other warranty whether express or implied written or oral VetSpecs neither assumes nor authorizes any employee agent distributor or other person or entity to assume for it any other liability in connection with the manufacture sale supplying or use of the VSM8 VetSpecs liability arising out of the manufacture sale or supplying of the VSMB8 or its use or disposition whether based upon warranty contract tort or otherwise shall not exceed t
39. on the distal leg of cats or small dogs Ny J g93adSLIAO i D Sketch 2 The leg toe sensor on a paw of cats Sketch 3 The leg toe sensor on the Achilles tendon of dogs Sketch 4 The leg toe sensor on a toe of dogs Bay ge 3 Watch the waveforms Each time when the sensor is applied onto the patient the monitor will automatically start to calibrate the sensor The calibration process takes about 15 20 seconds After the calibration a line of pulse waveforms red and a red pulsating bar graph are displayed The waveforms and the bar graph pulsate in synch with the heartbeats when the sensor is picking up valid arterial pulsations The SpO2 reading is accurate only when the waveforms and the bar graph are pulsating in synch with the heartbeats After applying the lingual sensor if the waveforms are erratic or a flat line the tissue underneath may be in a low perfusion condition Some anesthetic agents produce low perfusion on the tongue For cats and small dogs it is recommended to place two pieces of dry gauze on the tonque one on each side and then clip the sensor on the gauze This may improve perfusion in the tissue by reducing the pressure build up If the waveforms become erratic during the monitoring verify the patient status and move the sensor to another spot on the tongue After the sensor has been placed on one spot for an extended period of time the effect of the pressure could build up to c
40. or off the respiratory sound 29 e Select SOUND OFF and push the JOG DIAL to highlight in red e Turn the JOG DIAL to change to ON and then push the JOG DIAL to set The CO2 waveforms have two speeds Fast and Slow To change waveform speeds e Select Speed Slow and push the JOG DIAL to highlight in red e Turn the JOG DIAL to change to Fast and then push the JOG DIAL to set If the patient has stopped breathing for longer than the apnea time set by the user an alarm will be sounded The default apnea time is 30s To change it highlight in red and then turn the JOG DIAL The end tidal CO2 can be expressed as mmHg or percentage The user can select one of the two units and set it as default To change the unit e Select units mmHg and push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the unit and then push the JOG DIAL to set To change end tidal CO2 alarm limits e Select the item to be changed push the JOG DIAL to highlight in red e Turn the JOG DIAL to change the number and push the JOG DIAL to set The default alarm setting for end tidal CO2 is ON To change the alarm setting to OFF e Select Alarm ON and push the JOG DIAL to highlight in red e Turn the JOG DIAL to change to OFF and then push the JOG DIAL to set SCREEN e Select SCREEN and push the JOG DIAL to enter SCREEN submenu as below 1 WAVE SPEED 50 mm s 2 NIBP PAGE 1 1 3 TREND 1h 4 RETURN 5 ESC 30 A WAVE
41. pply the cuff and the sensor band and then calm down the patient After the patient is calmed down connect the cuff and the sensor band to the NIBP module which should be placed close to the patient on the same table The patient must be calmed down before starting a measurement Do not start a measurement when the patient is constantly struggling panting trembling or shivering No technologies can measure BP effectively when there are repetitive motions on the patient Furthermore it makes no sense to measure BP when the patient is obviously under stress Watch the bar graph If the bar graph is pulsating erratically i e it is not in synch with the heartbeats the patient is not relaxed Even when there are no visible body motions the muscles underneath the sensor band may still be too tense producing minute muscle movements Continue to calm the patient After the patient is calmed down the bar graph will pulsate in synch with the heartbeats As soon as READY is displayed you can push the START STOP key to start a measurement For better control it is suggested to manually start each measurement for BP screening 24 2 Systemic hypertension The diagnosis of systemic hypertension may be made in a cat of any age with a systolic pressure over 190 mmHg Cats with clinical findings compatible with hypertension and systolic pressures between 160 190 mmHg should also be considered hypertensive particular in cats lt 14 years
42. reased metabolic rate e g hypothermia 16 Gradual reductions in ETCO2 often reflect decreases in PaCOz that occur following increases in minute ventilation or a reduction of the metabolic rate Baseline does not return to zero CO mmHg 50 Real Time At the same time the ETCO2 value will also start to rise Possible causes e Incompetent or absent unidirectional dome valves e Insufficient fresh gas in non rebreathing circuit e Exhausted soda lime in rebreathing circuit e Absorber canister bypassed e Leak in Bain circuit inner hose e Excessive dead space in anesthetic circuit Abnormal Upstroke Shark Fins CO mmHg 50 Real Time Possible causes e Kinked or occluded endotracheal tube e Upper airway obstruction e Obstruction on expiratory side of anesthesia machine e Bronchospasm 17 Abnormal Down Stroke CO mmHg 50 Real Time Possible causes e Leak around endotracheal tube cuff e Artificial airway is too small for the patient Abrupt fall in ETCO2 level mm Hg 40 Possible causes e Pulmonary artery compression e Pulmonary artery embolism e Sudden hemorrhage e Acute cardiac tamponade e Cardiac compression Abrupt decreases in the ETCO2 are often associated with an altered cardiopulmonary status embolism or hypoperfusion 18 Differential emptying mm Hg 40 mm Hg CO 40 The above capnograms can result from the following e Posit
43. ree metal rings must establish good and stable contacts with the esophagus If the metal rings are too small to do so the esophageal probe may produce erratic ECG tracings and inaccurate HR Thus the probe for Cats should not be used in medium or large dogs 2 Apply the esophageal probe After the patient has been anesthetized and intubated estimate how deep to insert by laying the probe on the patient The distal ring and middle ring should be positioned across the heart after inserted Mark the probe at the mouth level with your hand and then slide the probe into the esophagus to the estimated depth Watch the screen If ECG is erratic adjust the depth of the probe until stable ECG tracings are registered Motions induced to the patient and or the probe may produce motion artifacts on the ECG tracings Tie the probe to the endotracheal tube to minimize motions if necessary When using the esophageal probes in electrosurgery the patient must be properly grounded as instructed in the User s Manual for the electrosurgical unit being used Never insert a probe into a patient which is not anesthetized Do not use a probe which is damaged externally 2 Pulse Oximetry The VSM8 comes standard with a SpO2 lingual sensor gray clip A SpO2 leg toe sensor and a SpO2 rectal probe are also available as optional 1 SpO2 Lingual Sensor The lingual sensor is intended for use on the tongue only not at any other places on the patient Pl
44. sor site 2 The sensor is malfunctioning 1 Check the patient status 2 Try the sensor on your finger If the sensor works normally try it again by placing at a different spot of the tongue 5 Mainstream Capnography Problems Possible Causes Recommended Actions MODULE OFF does not go away after connecting the CO2 sensor to the Module The CO2 sensor is malfunctioning The CO2 sensor needs to be returned to manufacturer for testing After the CO2 sensor is connected to the endotracheal tube there are no CO2 waveforms stay a flat line 1 The airflow in the airway is too weak to be registered 2 The CO2 sensor is malfunctioning or not calibrated properly Verify the patient s respiration status If necessary bag the patient to make it breath again If there are still no waveforms when bagging the patient disconnect the CO2 sensor from the Module and then re connect it to the Module to re calibrate the CO2 sensor After the sensor has been calibrated test it on yourself by breathing through the sensor If it is still a flat line the CO2 sensor needs to be returned to manufacturer for testing 48 V Maintenance The monitor Keep the monitor away from heat sources liquid flammable or corrosive materials and direct sunshine Avoid dusty humid or wet places Always place the monitor on a stable and secure place Do not block its ventila
45. tion vent Esophageal probes and ECG leads Disconnect them from the Module prior to cleaning Clean the esophageal probes and ECG leads with a paper towel wet with alcohol after each use Do not wash the esophageal probes and ECG leads or submerge them in liquid SpO2 sensors Disconnect the sensor from the Module prior to cleaning Clean the sensor with a paper towel damped with liquid detergent Do not wash the sensor or submerge it in liquid Pulse sensor band and cuffs Disconnect the sensor bands and cuffs from the NIBP module prior to cleaning Remove the hairs from the pulse sensor band with a tooth brush or a sticky roller Always keep the pulse sensor band dry Do not excessively bend twist or stretch the pulse sensor band Do not exert excessive forces to the pulse sensor band and its wire Clean the cuffs with a paper towel wet with liquid detergent Do not wash the pulse sensor band and cuffs or submerge them in liquid The cuffs are semi disposable items CO2 sensor and its airway adapter Disconnect the sensor from the Module prior to cleaning After each use wipe the sensor and airway adapter dry with a towel Do not detach the airway adapter from the sensor for cleaning Never use alcohol or any detergent to clean the sensor and the airway adapter as it may damage the special optical film Do not wash the sensor and the airway adapter or submerge them in liquid The airway adapter is semi disposable which nee
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