PC-VETGARD+™ - Vmed Technology, Inc.
Contents
1. Replacing battery Figure 13 Use tweezers or forceps to place the plug of the replacement battery over the battery socket and press into place by pressing down on top of the plug Place the battery into the compartment ensuring that wires are not pinched and replace the cover Cable Connectors CAUTION TAKE CARE NOT TO BEND THE PINS IN THE PLUG OR FORCE PLUG INTO RECEPTACLE PLUGS SHOULD BE INSERTED INTO THE VETGARD BY PUSHING THE PLUG STRAIGHT INTO THE RECEPTACLE DO NOT FORCE NOTE The Vined logo is on the top and the plug key is on the bottom 53 Troubleshooting Refer to the table below to trace common problem areas SITUATION Cannot make Bluetooth connection with computer Bluetooth connection has range lt 50ft POSSIBLE CAUSE S e Weak battery on VetGardt e Improper Bluetooth discovery Bluetooth not enabled Bluetooth USB adapter not plugged in Wrong type of Bluetooth used e Low Battery e Signal may pass through high attenuation barrier such as concrete floor walls or heavy metal objects e Using computer s built in Bluetooth CORRECTIVE ACTION Recharge the battery or use the module while plugged in to power Re initiate discovery procedure Verify that USB Bluetooth adapter is plugged in to computer Determine if the Windows XP Service Pack 2 method of Bluetooth should be used over Bluetooth drivers that came with Bluetooth adapter See Chapter 1 Recharge the battery or2. O If moving or handling the VetGard is often required use the monitor in its protective hanging pouch if possible 50 51 Cleaning Except for the SpO and IRMA gas sensors Refer to using the SpO and IRMA gas sensors in the appropriate sections of Chapter 3 of this manual clean the VetGard sensors and cables by wiping surfaces with any of the following solutions e Soap and water e Isopropyl or ethyl alcohol e Peroxide solution Salt based ECG gel or paste will corrode skin clips and loop electrodes over time These sensors should be cleaned after each use if salt based electrolytes are used Maintenance There are no field serviceable components inside the VetGard other than the rechargeable battery which should be replaced every 2 years Opening the housing other than the battery compartment voids the warranty Store the VetGard in the storage pouch when not in use Changing Batteries VetGard uses a rechargeable lithium ion battery that has a useful life of approximately two years When this battery no longer holds its charge or if battery power is suspected as a source of trouble the battery should be replaced MOTE Use only Vmed replacement batteries Order Vmed part ETRS2 4000 Removing battery Figure 12 Remove cover from the back of the device and remove the battery from its compartment Stretch the wires to their full length and pull the battery straight up to remove the battery plug 52
3. analyzer shows a flashing red light If applicable perform a tightness check on the patient circuit with the sampling line attached ISA LEAKAGE CHECK Whenever gas readings are questionable perform a leakage check according to the following instructions if Connect a new Nomoline sampling line with male Luer lock to the ISA gas inlet connector and check that the gas inlet connector shows a steady green light Connect a short segment of silicon tubing with an inner diameter of 3 32 2 4 mm to the Nomoline male Luer Exhale a long breath into the silicon tubing until the CO concentration is greater than 4 5 vol or 34 mmHg Quickly connect the silicon tubing tightly to the exhaust port Wait 1 minute until the CO concentration has stabilized Note the value Wait 1 minute and check that the CO concentration has not decreased more than 0 4 vol or 3 mmHg If it has decreased more there is a major leakage in the ISA unit or in the Nomoline Do not operate the ISA if there is a major leakage in the unit 47 3 Plug the Nomoline plug of the sampling line into the ISA module Zeroing the ISA device ISA sidestream gas analyzers perform zeroing automatically by switching the gas sampling from the respiratory circuit to ambient air Automatic zeroing is performed every 24 hours and takes less than 3 seconds for ISA CO gas analyzers and less than 10 seconds for ISA multi gas analyzers WARNI
4. Respiration One ECG chest probe with three build in metallic electrodes for ECG rhythm strips When placed over the heart accurate rate and rhythm information is derived One SpO lingual sensor with two clips One set of low force clip electrodes that when attached to the legs of the patient as described provide ECG Lead II information Note Since it is not always possible to obtain an adequate signal using the chest probe clip leads may be required when monitoring some patients Clip leads can also be used to continuously monitor the ECG signal during surgery or for short term critical care monitoring Three trans esophageal probes to monitor the ECG and temperature of anesthetized patients Each probe has three electrodes affixed to the flexible plastic tube that is inserted into the esophagus and positioned over the heart with the distal electrode positioned behind the left ventricle and the second electrode behind the left atrium The third electrode is reference A temperature sensor is fitted inside the tip of each probe to measure and display core body temperature One cable yoke and set of 3 leads with spring clips for use with pre gelled disposable electrodes One 3 mm rectal temperature probe with 5 foot cable VetGard Add On Modalities Non invasive blood pressure SunTech motion reduction electronics provides excellent oscillometric blood pressure detection on large and small animals including cats a
5. the adaptor window Do not use the large airway adaptor on animals weighing less than 6 pounds since this adaptor adds 6 ml dead space the patient circuit Do not use the small adaptor on animals weighing over 6 pounds since this will cause excessive flow resistance Do not place the airway adaptor in a gravity dependent position in order to prevent moisture draining into the adaptor Do not use the airway adaptor with nebulizer medications as this may affect light transmission through the blue window Do not sterilize or submerge the disposable airway adaptor in fluids other than distilled water Used airway adapters should be disposed of in accordance with local regulations for medical waste Do not apply tension to the sensor cable Do not operate at temperatures less than 50 For over 95 F The gas sensing IRMA probe is intended only as an adjunct in patient assessment It must be used in conjunction with other assessments of clinical signs and symptoms 35 Set up Airway gas monitoring is accomplished by use of an infrared measuring apparatus IRMA mainstream airway sensor and a semi disposable plastic airway adaptor The clear window on the adaptor is very important for accurate gas measurements the below images show a blue ring around this IR window CAUTION Under most conditions airway adaptors will remain reliable for 20 patients after which the adaptor should be replaced Should gas readings become questionabl
6. E eRe ta Selec Nadas alata ae 17 Chapter 2 Operating INStrictOnS scenic till aa lad tena eel ceed 18 Battery Life between Battery Charges ssscseseseececeeeseteseneseseseseaeneaeseseseseseseseneaeaeaeseseneseeenenenenenesees 18 Preparation sts dente sechactes serve te cteten Sed auaa ected a e ental cone castes ea i ae tor al ate dued wicca od atlad E N 18 USING L Eg CMDS cease esses eee cites fae nce a date aah aren Sones teach de aed eet ice SE ee Peer ea eee 23 Using Esophageal PTO ex arire naet naea aaa ate naaa Ta rana eaaa a ea a eaae aE eT EEEa deaet 24 Using Long term Monitoring Electrodes sssscscesssesesecesecesesesesssesesesesesesesesesesessessesenesesesesesessensanseeseeees 25 Rectal Temperature Probe iusan e e vats a aE A E ecu ie eeu es eee ses 25 Pulse Oximety SpOs nater a a a L E Ea 26 PRM GAO Sa i A A A a A A A AE yes Aa a A A a a ea 27 tet 02 2 9 a e a a E E E Seen mee 27 Cleaning eeann ei a adele acta celtic talented cin cola e a EE EE a E 29 Non Invasive Blood Pressure Monitoring scccecececeseseseseeeeeeeeeeeceeeeeeseseseseseseseaeeeeeaseeeeeeeeeeeeeeeeeeeeeaees 30 Mainstream Airway Gas Monitoring csscscsessseseeceeeeeeeseneseseseseseseseaeseseseseseseseneneaeaeseseseseseenssenenenesees 35 04S nolacoa lore Pea E E E E EE EE E E I ak ek i oh 42 CO Zero Reference Calibration ccccccccccsscsscsscesscsscessssecesseeeeesseessescesseessesseeseesseeseesseus
7. displayed vital sign parameter 10 Display trend graph Click to display the trend graph window Unless this window is pinned to the screen it will automatically disappear in 10 seconds Refer to Figure 7 below 11 DEMO PC etGard Patient ID Trend information x x Displayed trend plot ends at 0 01 35 40 0 J 0 01 35 40 35 40 after connection of med Remote Displaying real time trend Move bottom bar to the left to display past trend Figure 2 Trend graph screen Appears momentarily at preset time automatically or as selected on the upper tool bar icon NOTE Select preference in the PC Display default Settings window 11 Toggle ECG recording Click to begin recording of the ECG waveform into a patient episode file This will be saved according to the Patient ID recorded within the patient information window prior to saving the episode Click the button again to stop recording 12 Enter patient information Click on this button to open the Patient Information window Enter the patient s name or ID the client s name the patient s species breed age sex and weight These values will be included in the saved episode if a recording is made 13 Print report Click on this button to print the last 24 seconds of the ECG tracing and vital signs values to the default printer of the computer in use In addition to printing this report an individual episode of the same seconds of ECG tracing will be sa
8. exotics Esophageal ECG and temperature probe dogs and cats Esophageal ECG and temperature probe large breeds Cable yoke for 3 clip leads for disposable chest electrodes Clip leads for disposable long term electrodes set of 3 Extension cable SpO sensor A with connector Extension cable ECG 3 Rectal temperature probe with 8 cable and connector Nellcor SpO lingual sensor with 2 clips IRMA mainstream CO only sensor 8 cable IRMA mainstream CO and O 8 cable IRMA mainstream CO O and primary agent 8 cable IRMA mainstream CO O primary and secondary agent agent ID IRMA semi disposable airway adaptor with O port box of 12 IRMA semi disposable airway adaptor without O port box of 12 IRMA oxygen sensor box of 5 62 CATALOG DESCRIPTION BLOOD PRESSURE ACCESSORIES C100 C101 ETRS2 6000 OTHER BT USB BT2 USB ETRS2 4000 HC 110 HC 110B P5 P6 M3 W2 Small animal cuff set of 5 Feline cuff set of 5 Tubing blood pressure 8 Class I Bluetooth adaptor kit with hardware and software Class 1 Bluetooth adaptor kit for Windows XP and Vista Battery Rechargeable lithium ion 3 7 v Battery Charger Patient isolated 110v 220v A C power cord for charger Storage pouch Hanging pouch Protective Manual VetGard PC Display installation CD all monitors 63 Installation Setup and Operating nstructions PC VetGard Wireless Patient Monitor Vmed Technolo
9. of defects in materials and workmanship for two years from date of purchase by the original end user customer 11 Vet Dop Blood Pressure Monitor to be free of defects in materials and workmanship for one year from date of purchase by the original end user customer iii Cables lead wires and connectors ECG sensors and clips esophageal probes temperature probes blood pressure cuffs and blood pressure tubing sold with the VetGard Monitor the PC Vet Monitor the Vet Dop Monitor or purchased as an optional accessory for such monitors will be free of defects in materials and workmanship for six months from date of purchase by the original end user customer and iv all other supplies or disposable or single use instruments or products are warranted to be free of defects in materials and workmanship for the period that ends upon the earlier of initial use for their intended purpose or their expiration date Customers who feel an instrument is defective must return it to Vmed Technology for evaluation Such return must be made in accordance with both the Vmed Technology RMA procedures described below and prior to expiration of the warranty period Products found by Vmed Technology to be defective will either be repaired or replaced with the same or a comparable product at the discretion of Vmed Technology As described below repair or replacement at no charge for parts or labor is the Customer s sole and exclusive remedy The warranty on any V
10. patient in the event of a ground fault ECG noise may occur with some patients when operating VetGard with the battery charger plugged in If noise is present disconnect battery charger and operate on battery GENERAL PRECAUTIONS Do not plug VetGard sensors into any other equipment or into AC line receptacles Do not operate or mount the VetGard on its side Vertical mounting is OK VetGard is not registered with the FDA for human use Do not use in the presence of flammable anesthetics Do not immerse the VetGard sensors or cables in water or other fluids Avoid spilling fluids on the VetGard connection plate or accessories Do not autoclave the VetGard or sensors Do not disassemble the VetGard enclosure VetGard contains no operator serviceable components and opening enclosure voids the warranty with the exception of the battery door ECG electrical interference The wireless connection used in the VetGard minimizes electromagnetic or radio frequency interference RFI Noise may occasionally occur when operating with the AC charger plugged in or from the strong RFI generated by electro cautery diathermy and dental scaling equipment Distortion of ECG signal may occur with the use of these devices CAUTION Before using a defibrillator disconnect any ECG accessory of the VetGard from the patient Ensure that electrodes are connected only to the patient and do not touch any other conductive part or equ
11. F AIRWAY ADAPTORS Semi disposable small animal and exotic Dead space 7 ml RESPIRATION RATE 3 100 BPM FLAGS Apnea O low Replace O sensor Check adaptor Sensor over range Hardware errors OXYGEN Integrated ultra fast response galvanic oxygen sensor gt 62 500 O2 hours CALIBRATION No routine calibration required room air calibration performed automatically when changing airway adaptor time lt 5 sec WARM UP TIME 5 seconds full accuracy within 1 minute SAFETY Anesthesia monitors EN ISO 11196 1997 ASTM F 1452 92 Capnometers EN864 1996 ISO 9918 ASTM F 1456 92 Oxygen monitors EN12598 1999 ISO 7767 ASTM F 1462 93 Medical equipment safety EN60601 1 2 2001 ACCURACY SPECIFICATION DURING ALL CONDITONS GAS RANGE INACCURACY CO 0 10 0 5 ABS or 10 REL HAL ISO 0 15 ABS or 10 REL SEVO 0 8 0 15 ABS or 10 REL O 10 100 3 ABS Accuracy specification is valid for all specified environmental conditions and includes effects from interfering gases 58 BLOOD PRESSURE METHOD OF MEASUREMENT Oscillometric Diastolic values correspond to Phase 5 Korotkoff sounds BLOOD PRESSURE RANGE Systolic 40 265mmHeg MAP 27 222mmHeg Diastolic 20 200mmHeg PULSE RANGE 25 to 300 Beats per Minute CUFF DEFLATION RATE Deflation step size varies with heart rate cuff pressure and cuff volume INITIAL INFLATION PRESSURE Large Animal Mode 160 mmHg default Variable from 120 280 mmHg Small A
12. NG Since a successful zeroing requires the presence of ambient air 21 O and 0 CO in the gas analyzer place the ISA in a well ventilated area Avoid breathing near the ISA before or during the zeroing procedure Connection for Use 1 Place the ISA sensor in a convenient place You might attach to the monitor with tape Velcro or rubber bands as shown below 2 Position the airway adapter in the patient airway circuit with the port pointed up The device will be used in this position 6 Turn on the VetGard monitor and connect to your Computer 48 49 7 Confirm that the green light is displayed on the ISA device Chapter WARNING To ensure accuracy replace the Nomoline after each use If accuracy can be confirmed the Nomline can be used a maximum of 10 times and should be replaced after 10 uses in any case Chapter3 Service and Maintenance Service and Support If you purchased directly from Vmed Phone 800 926 9622 FAX 425 585 0231 Email info vmedtech com WEB www vmedtech com If you purchased from DVM Solutions Phone 866 373 9627 FAX 830 438 7041 WEB www dvmsolutions com Cleaning and Maintenance Precautions Do not immerse or soak the monitor or cable connectors in any fluid Do not use bleach bleach solution or ketones on plastic parts Do not steam autoclave or gas sterilize the VetGard or cable connectors Do not use petroleum based solvents on any parts O O
13. PC VETGARD WIRELESS MULTI PARAMETER PATIENT MONITOR USB Adapter 100 Meter CEET ler pepa B t aab Lartri wet ae Last Updated 10 5 2015 Installation Setup and Operating nstructions STANDARD ACCESSORIES AND COMPONENTS Check packaging to ensure the following items are included lea lea lea lea lea Bluetooth adaptor Battery charger unit Nellcor V Sat SpO2 sensor with two tongue clips IRMA gas sensor with 2 airway adaptors Optional Storage pouch containing ea ea ea ea ea ea 3 ea ea VetGard in hanging pouch ECG chest probe Set of 3 low force ECG skin clips ECG Yoke cable Set of three disposable ECG electrode clips Packet of 3 ECG disposable electrodes Esophageal ECG and temperature probes Rectal temperature probe Inner box containing ea ea ea ea Instruction manual Installation CD Set of 5 blood pressure cuffs Optional 8 ft Blood pressure air hose Optional Quick Start instructions NOTE COMPLETE MANUALS FOR VETGARD AND PC DISPLAY SOFTWARE ARE AVAILABLE ON THE INSTALL CD FROM THE HELP MENU AND CAN BE DOWNLOADED FROM www vmedtech com customers GENERAL PRECAUTIONS CAUTION Use only the patient isolated battery charger provided by Vmed Laptop charging plugs may appear identical but their use with the VetGard may damage electronics and voids the warranty WARNING Non isolated chargers do not protect
14. Prepuce Tongue Preparation Open the clip by pressing with the thumb and forefinger as shown A Slide one of the sensors alignment buttons along the clip slot until the sensor is fully engaged in the clip B Slide the second sensor button along the slot in the other side of the clip until fully engaged as in step 3 C NOTE Be sure the optical components face each other 27 Otherwise PC Display will take this information from SpO However you may manually The sensor is now ready to be applied to the animal The preferred application site for select SpO as the source of the heart rate and beat tone even ifa good ECG signal is canine feline and equine patients is on the tongue with the sensor positioned at the present by clicking on the Tools menu and then on the item marked HR from SPO2 center of the tongue as shown D Alternatively the sensor may be applied to the Alternatively you may use the shortcut key Alt H to do the same This feature may animals lip toe ear prepuce or vulva be toggled off by way of the same procedure Cleaning Wipe inside of sensor with isopropyl or ethyl alcohol and dry Clean cable and clips the O fne J o same way Hold the connector and rub toward sensor NOTE Do not pull cable while tor p 4 AR holding sensor or Xa NOTE If the sensor does not track the pulse reliably it may be incorrectly positioned or the sensor site may be too thick
15. ace O sensor Service required At least one parameter is out of range Accuracy of current gas readings can not be guaranteed Room air calibration of O measurement required 1 Leave gas probe connected to VetGard Remove airway adapter from the gas probe Wait for LED on gas probe to start blinking red Put the airway adapter back in the gas probe O Se W N Wait for LED on gas probe to turn green 6 Exit PC Display and reconnect to VetGard remote Cleaning IRMA Sensor and Airway Adaptor Clean the gas probe with a cloth moistened not wet with maximum of 70 isopropyl alcohol or ethanol Remove the disposable airway adapter prior to cleaning of the gas probe NOTE Do not attempt to directly clean the airway adaptor as this may affect light transmission through the transmission window If it is to be used more than once then it can be rinsed with distilled water and allowed to drip dry DO NOT INSERT OBJECTS OF ANY KIND INTO THE ADAPTER CAUTION lt is important to keep the gas probe from getting wet since this may cause irreparable damage to the sensor Such damage will void the warranty of the sensor CAUTION To avoid damage to the IRMA gas sensor aggressive Chlorine disinfectant and Chlorine cleaners should be avoided Under no circumstances should Chlorine be used with the IRMA gas sensor If Chlorine solutions cleaners are used in the operating procedure room the IRMA gas sensor should be remov
16. and LED Indications In addition to a descriptive alarm appearing on the VetGard computer display the following LED indications will appear on the IRMA gas sensor itself Steady Blue Light Anesthetic Agent Present Blinking Red Light Check Adaptor Contamination of the light transmission window may have occurred Remove contamination by rinsing with distilled water or replace the adaptor IRMA Sensor Computer Display Pop up Messages The PC Display program will advise or warn the user when certain conditions occur associated with the IRMA gas sensor Gas Probe Messages PC Display checks the status of the gas probe every five seconds after initial connection of the remote When abnormal status is detected a message box typical of the one below is shown Gas Probe Message Please check airway adaptor No airway adapter detected Please connect adapter IR signal high There are many possible messages that can be shown in this box including 40 Replace airway adapter IR signal low This message will appear when the airway adaptor is extremely worn or dirty The adaptor should be replaced every 20 patient uses in any case No airway adapter detected Please connect adapter IR signal high Airway adaptor O port failure clogged or plugged O port No airway adapter detected Please connect adaptor IR signal high QO sensor has low sensitivity and will soon need to be replaced Please repl
17. arge Animal Mode The Large Animal Mode has been designed for animals requiring a 4 cuff or larger This typically is dogs weighing more than 8kg 17 5 lb and horses Equine blood pressure should be obtained from the base of the tail Ifa patient is using a 3 cuff in this mode and problems arise then try a larger cuff For cats and dogs the preferred position for all NIBP measurements is either left or right lateral recumbence for both sedated and awake conditions This will position the limbs fairly close to heart level and makes it easier to hold an awake animal Cuff Selection amp Placement It is important to select the cuff size that is appropriate to the diameter of the patient s limb or tail Use the Range Lines on the outside of the cuff to determine the correct size cuff or insure that the cuff width is approximately 40 of the limb circumference It is better to use a cuff that is slightly too large than one that is slightly too small The cuff should never extend over a joint Wrap the cuff around the limb making sure that the Artery Marker is directly above or reasonably close to the artery It may become necessary to shave excess hair or fur if there is trouble obtaining BP measurements The cuff should fit snug to the patient s limb for maximum oscillometric signal quality Ensure that the air hose from the monitor to the cuff is not compressed crimped or damaged The cuff should be at heart level for proper measu
18. be performed when e An offset in gas readings is discovered or if GAS CONC OUT OF RANGE alarms appear when measuring room air e Whenever PC Display message states CO outside specified accuracy range or Negative gas concentrations calculated Zero reference calibration may be required 42 e for IRMA OR and AX sensors only Every time that an airway adapter is changed The following procedure will guide you through the steps to perform a Zero Reference Calibration on the IRMA gas probe using your VetGard and PC Display version 2 5 0 or later Note not following these instructions exactly may cause a miscalibrated CO sensor which will result in incorrect measurements 1 Insure you have PC Display version 2 5 0 or later installed If not go to Help gt Check for Updates to download latest update 2 Insure your VetGard remote module is either plugged into AC power or has enough battery charge for this 15 minute procedure 3 Insure the IRMA gas probe is plugged into your VetGard remote module and is not connected to a patient Open to still ambient air 4 Make sure that a brand new airway adapter has been inserted into the IRMA gas probe 5 Connect your VetGard remote module to computer via Bluetooth link 6 After connecting via Bluetooth wait about 2 minutes if the serial number of your IRMA gas probe is greater than 200000 otherwise wait 15 minutes Then click the Zero op
19. cable SpO sensor with 36 cable System Specifications ECG GAIN SENSITIVITY 5 10 20 30 and 40 mm mV COMMON MODE REJECION 70dBV CMRL SAFETY STANDARDS IEC 601 AAMI EC 11 INPUT IMPEDANCE 1 M Ohm INPUT DYNAMIC RANGE 15 mV DC OFFSET CORRECTION 0 5 Hz A D SAMPLING RATE 400 Hz SAMPLE RESOLUTION 12 bit ECG SWEEP SPEED SELECTABLE 25 50 100 mm sec Default 50 mm sec QRS DETECTION RANGE gt 0 2 mV FILTERS PERMANENT Pass Band High pass 70 Hz Low pass 40 Hz USER SELECTABLE Notch AC line noise rejection 50 60 Hz ALARMS HEART RATE SPO RESPIRATION APNEA CO O AGENT TEMPERATURE and BLOOD PRESSURE systolic diastolic and MAP High Low selectable limits FEATURES ALARMS ENABLE DISABLE TONE ON OFF GRID ON OFF ALARM AUDIO ON OFF R WAVE DETECTOR ON OFF 57 SILENCE ALARMS USER ACTIVATED WIRELESS Bluetooth Class I radio RANGE 100 meters line of sight FREQUENCY 2 4 2 4835 GHz WITH FREQUENCY HOPPING OUTPUT POWER 4 to 20 dBm PHYSICAL INTERFERANCE USB UHCI OHCI 1 1 compliant IRMA GAS SENSORS TYPE Extremely fast compact infrared mainstream multi gas sensor with integrated ultra fast galvanic oxygen sensor When installed Self calibrating and self compensating for atmospheric pressure temperature and full spectral interference for any gas mixture DIMENSIONS W x D x H 1 45 x 1 1 x 0 9 CABLE 8 3 WEIGHT lt 30 g without cable OPERATING TEMPERATURE 50 F 95
20. d to identify animal legs pressing the Print switch on the keypad LEAD BIPOLAR LEAD amp REFERENCE COLOR RF Right Front Negative Electrode RH Right Hind Reference Electrode LH Left Hind Positive Electrode ioe NOTE Reference electrode may also be attached left front LF leg For an accurate Lead IT reading each pair of legs must be parallel to one another but not touching Use standing or right lateral recumbent position Plug the clip lead cable into the VetGard receptacle Place animal in the right lateral recumbent or standing position Saturate the area where clips attach with alcohol or electrolyte A CW N e Connect leg clips to the appropriate limb Connect two clips to the hind legs Red to left hind and Green to right hind on the posterior aspect of the stifle just proximal to or distal to the point of the knee Connect the remaining White clip to the right front leg on the anterior aspect of the leg just proximal to or distal to the elbow 22 23 Using Esophageal Probe Vmed esophageal probes have sensors for monitoring ECG and temperature Choose the appropriate probe for the size animal If the baseline tends to wonder or deviate from a straight line the electrode spacing is too large and a probe with a shorter spacing should be used If the ECG signal is intermittent usually with respiration or double counting occurs the electrode diameter is too small for the animal and a probe with larger diamete
21. e at any time during the monitoring period try replacing the adaptor Figure 9 IRMA sensors with O sensor cell Airway adaptors and O sensor cell Use the standard airway adaptor for animals over 15 pounds and for animals 6 15 pounds if a rebreathing circuit is used Use the small airway adaptor for all animals less than 6 pounds and for animals between 6 and 15 pounds if a non rebreathing circuit is used If inaccuracies are suspected with the standard adaptor change to the small adaptor CAUTION Do not use the small adaptor with rebreathing circuits due to the higher flow resistance of this adaptor Figure 10 Standard and Small Animal Airway Adaptors Standard airway adaptor for Small animal airway adaptor for animals weighing gt 15 pounds animals weighing lt 6 pounds and up Re breathing circuits OK to 15 pounds Do not use with re Order catalog C106221 without breathing circuits Order catalog 0 CatalogC 106211 with 0 C106260 without 0 36 1 Plug the gas sensor into the VetGard receptacle marked CO O GAS 2 Snap the IRMA gas sensor head into the disposable airway adaptor It will click into place when properly seated 3 The green LED indicator lamp will light when ready for use 4 Connect the airway adaptor 15 mm male end to the breathing circuit 37 5 Connect the airway adaptor 15 mm female end to the patient s endotracheal tube 8 To keep patient secretions from pooling on the b
22. ed during the cleaning process 41 Oxygen Monitoring Room Air Calibration for O Sensor If your sensor is equipped to monitor inspired and expired oxygen remove the plastic cap on top of the IRMA sensor open the sealed O sensor package and insert and screw in the O sensor into the IRMA sensor Room air calibration of the O sensor will be performed automatically at regular intervals whenever the sensor head is disconnected from the airway adaptor If the gas sensor is kept in operation for a long time without being disconnected from the airway adaptor or if the operating temperature for the O sensor changes significantly the gas sensor will indicate that a new room air calibration is required and a warning indication will appear on the VetGard computer display Use the following procedure to perform a room air calibration of the O sensor 1 Disconnect the disposable airway adapter from the IRMA gas sensor 2 Wait for the LED on the sensor to blink red 3 Snap the airway adapter back into the IRMA gas sensor 4 Check that the LED light turns green 5 Check that after a few seconds the O reading on the VetGard computer display reads at or near 21 Oxygen Sensor Replacement Replace the O sensor every four months when indicated by the VetGard computer display or whenever O readings are questionable CO Zero Reference Calibration A zero reference calibration of the CO or agent gas sensor measurements should
23. eesceusnseessensenaeenees 42 Sidestream Airway Gas MORMOMMG cs sc5 icc cetecesteeeraszieeseeteh atest el ee ae ee ae pint eietabies 44 Chapter3 Service and Maintenance cccccccccececeeeeceeeceeeseeessueeseeeseeeeaneees 51 Senice ANG SUP MOM a e Ak a A eA ehhh ie Ee ase ee a 51 Cleaning and IV AIVAS NA CS sech esc e eet Sas eaecd t ot ecee cetacean 51 TiO UMD SSI OCU NG a a E rae acd come ees a a Aaa et ad a aea a a nR 54 Appendix A Computer Requirements and Specifications ccccccceseceeeeeees 56 Computer Minimum Requirements sssscccscsssssssssscscsssscscssecscsssscscececsssesseseesscassesecesecacseseeeceseusesesneseetanes 56 Physical Specifications i e cs ha cla a ee a chi a alee a aee E ai 56 Syst m SPCC MCAS isien aesir aneen ree daan ad aea eE A ener crete ae eee 57 Appendix B Limited Waran y asesu a E E E E 60 Appendix C Accessories and Replacement Parts cccccecececeseeeeeeeeeeeeeees 62 Chapter 1 Monitor Description Hardware The PC VetGard is a battery operated Bluetooth enabled wireless multi parameter patient monitor providing as a minimum ECG SpO respiration and temperature and selectively NIBP and airway gas monitoring of CO CO O and CO anesthesia agents Digital information real time waveforms and trending are displayed through a wireless link to a Windows based computer Each VetGard includes the following sensors Basic unit with ECG SpO2 Temperature
24. ettings Bluetooth transmissions are omni directional operate at low power and travel through walls and around corners to a radius of up to 100 yards line of sight It is not necessary to aim the VetGard at the computer or printer to initiate commands The computer and or printer can be in another room if desired The print report can be printed from any printer connected to the computer being used with the VetGard or on a wireless network All functions not requiring keyboard input can be controlled from the VetGard control panel or the Windows display toolbar Commands are only active if a wireless connection between the VetGard and the computer is established Power is supplied by a rechargeable lithium ion battery or through the patient isolated power supply charger provided Power is always available from the A C mains even with a missing fully discharged or defective battery When fully discharged the battery can be fully recharged within 4 hours and provides up to 6 hours of use with all modalities operating VETGARD KEYPAD CONTROLS MASTER POWER Press and immediately release button to turn ON press and hold down to turn OFF VetGard will shut off automatically if a computer wireless connection is not established within three minutes and the power is not plugged in BLOOD PRESSURE POWER SWITCH Press and release to turn ON the blood pressure measurement sequence press and release again to turn OFF the blood
25. gy 2006 2015 914 164th St SE Mill Creek WA 98012 USA Customer service phone 800 926 9622 Email info vmedtech com Web site www vmedtech com Last Updated 10 5 2015
26. hat all three electrodes make good contact with the chest wall Figure 3 Correct position of the chest probe over heart on left chest oriented Right Front to Left Rear legs Apply alcohol liberally for good signal 3 Rotate the probe until the R amplitude is at its highest and a good tracing appears on the screen Ifa good tracing is not obtained re saturate the chest wall and reposition the chest probe In some rare cases excess hair should be clipped NOTE Orientation of the chest probe is important to approximate Lead IT information however the chest probe is accurate for rate and rhythm only Record the ECG until at least three good lines of tracing are obtained NOTE The ECG sweep windows stacked vertically on the display represent a continuous Lead II sweep with the earliest information being replaced by the current sweep At the default chart speed of 50 mm sec the three panels represent 12 seconds of data 21 5 Depress the Start Stop button on the chest probe to freeze the trace on the Using Leg Clips screen Depress the Print button on the keypad to print the display this The three lead clips are color coded according to American Heart Association AHA automatically saves about 24 seconds of the waveform up to that point to a standards The following table provides the list of AHA color codes for Lead II connections patient episode file You may also print directly from the moving trace by modifie
27. he VetGard can be used in the hanging pouch or placed on a secure flat Only surface without the hanging pouch The VetGard may be mounted horizontally or vertically CAUTION Do not mount or operate the VetGard NOTE A magenta ECG sweep represents a leads off condition and may occur on its side since this position restricts lubrication to the blood pressure pump even if a waveform is present however the computer will not recognize a valid ECG and the digital heart rate display will not appear You should in this case reposition the sensor or clip leads and add alcohol to the clip locations 3 Turn on the VetGard by briefly depressing and releasing the red power key on until a green sweep appears the keypad Do not hold the power switch down The CONNECTION light will turn red and then amber 2 Plug the sensor of choice into the appropriate VetGard receptacle 18 19 Important comments about ECG The VetGard obtains two types of clinical ECG information 1 rate and rhythm and 2 PQRST waveform characteristics For surgical and long term monitoring generally rate and rhythm only is needed to monitor patient status since changes in heart rate or significant variation of the periodic interval of the beating heart may be indications of patient compromise Accurate Rate and rhythm can be obtained by any of the available ECG sensors provided with the VetGard leg clips and the internal positioned esophageal probe being the most of
28. his button if you are using a gas probe that has the capability to measure anesthetic agents This button will allow you to select which agent you want to be displayed as the primary agent and in some cases which to be displayed as the secondary agent Remote Selection Menu 1 Turn on the VetGard and establish connection to the computer lh a 2 Press the SELECT key on the VetGard keypad and the following menu appears on the computer screen 13 _ REMOTEMENU SPECIES NEW PATIENT GRID SWEEP RATE ECG GAIN R WAVE MARKER R WAVE TONE SPO2 WAVEFORM RR WAVEFORM ALARMS ALARM TONE RECORD ECG ee 3 Use the UP DOWN arrows D V on the VetGard keypad to select the desired function and then press the SELECT switch again to choose the option Repeat the process for each function 4 These functions may also be selected from the icons on the PC Display toolbar NOTE Most of these functions may also be selected trom the icons on the PC Display toolbar and many are also available in iconic form on the VetGardt keypad SELECT OPTIONS DEFAULT Silence Alarms Press to silence audio alarm Keypad amp Toolbar Species Canine Gain 1 Feline Gain 1 Equine Gain 1 Other Gain 1 Sweep Rate 25 mm sec 25 mm sec 50 mm sec 100 mm sec 200 mm sec 14 Gain 0 5 55 mm mV 1 0 10 mm mV 1 0 10 mm mV 2 0 20 mm mV 3 0 30 mm mV 4 0 40 mm mV R Wave Marker ON ON OFF OFF Grid ON OFF OFF Beat Tone ON ON OFF Rec
29. ious menus available with the SELECT switch Press the SELECT after scrolling to the desired selection OPEN MENU SELECT Displays keypad menu selections and selects the highlighted option in this menu SCROLL DOWN MENU Scroll through the various menus available with the SELECT switch Press the SELECT after scrolling to the desired selection Software PC Display Software The Vmed Windows application programs installed on your computer for the processing and display of real time patient information for all Vmed wireless monitors PC Display software can be installed on multiple computers without limit and simultaneous instances of the program can be run subject to computer capability See the PC Display User Manual for more details Reviewer Software The Vmed Reviewer program is used to open and review patient files saved from PC Display The Reviewer program is compatible with Vmed wireless monitors Refer to the PC Display Manual for a complete description of this program Interpreter Software The Vmed Interpreter is optional ECG interpretation software compatible with all Vmed wireless monitors This program has restricted use and requires registration All functions available in the Reviewer program are also available in the Interpreter program Bluetooth Software This software is only used if your computer is NOT operating with Windows XP Service Pack 2 or 3 Windows Vista or Windows 7 operating system
30. ipment to prevent possible shock to patient from leakage current from other equipment Avoid cable and connector damage by grasping the plug not the cable and pulling straight out and pushing straight in Take care not to bend the pins in the plug WARNING Do not use electro surgery or electrocautery devices near metal ECG electrodes especially esophageal probes Electric arcing may cause tissue burns CAUTION Use only the patient isolated battery charger provided by Vmed Laptop charging plugs may appear identical but their use with the VetGard may damage electronics and voids the warranty WARNING Non isolated chargers do not protect patient in the event of a ground fault Table of Contents Chapter 1 Monitor Description casctmsssttctce te ctucstesxerucrnashs teat ee edsadeareaceanetasienhdabidadaes 5 ETEO NI AD cf Nh a NG a el E Olga gala ececea i ah tea eect chara E ted eas haat 5 SOT WES sess s carat cag teen ate deca scien at ste ath cel e a a acral A aaar e E N cesta ieee ad cuaeatemtueinoes 9 Computer DiS AV a a a a a a a e aa ar e Nai 10 PC Display Toolbar See PC Display manual for details c ssssssssscsssccsessesesseseesessesescesesceseeseseeneecesessens 10 Remote Selection Men sos cere cas onc eke ae ee ol eee ek ee ee ed pee 13 Remote BP Measurement Selection cccscscscscsseseseseseceseceseseseseseseseseseeesesesesseaseseseseseeesesesesssasaseeeeeeees 15 NCCE SOMOS scan E ace Seat tats dated Soa adh ect
31. ir of non conforming or defective goods or the replacement of non conforming or defective goods with conforming or comparable goods THE REMEDIES OF THE CUSTOMER SET FORTH IN THESE CONDITIONS OF SALE ARE EXCLUSIVE VMED TECHNOLOGY SHALL NOT BE LIABLE FOR SPECIAL 60 INCIDENTAL PUNITIVE OR CONSEQUENTIAL DAMAGES ARISING FROM BREACH OF WARRANTY BREACH OF CONTRACT TORT PERSONAL INJURY PRODUCT LIABILITY NEGLIGENCE STRICT LIABILITY INDEMNITY OR ANY OTHER LEGAL THEORY EVEN IF VMED TECHNOLOGY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES OR THE REMEDY PROVIDED HEREUNDER FAILS OF ITS ESSENTIAL PURPOSE SUCH EXCLUDED DAMAGES INCLUDE BUT ARE NOT LIMITED TO LOSS OF PROFITS OR REVENUES LOST INCOME CANCELLED PATIENT FEES OR PROCEDURES STEMMING FROM ANY PRODUCT ON BACKORDER LOSS OF USE OF THE GOODS OR INSTRUMENTS COSTS OF CAPITAL COST OF SUBSTITUTE GOODS FACILITIES OR SERVICES OR CLAIMS OF CUSTOMERS OR PATIENTS CLIENTS OF THE CUSTOMER FOR SUCH DAMAGES SOME STATES MAY NOT ALLOW EXCLUSION OR LIMITATION OF LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES AND THEREFORE THE ABOVE LIMITATIONS MAY NOT APPLY TO YOU IF SUCH STATE S LAWS ARE FOUND TO BE APPLICABLE TO YOU WARRANTY RETURN POLICY Return of Product for Breach of Warranty In order to make a claim for breach of warranty or to return a product for warranty or non warranty repair Customer must obtain a Return Merchandise Authorization RMA number from Vmed Technology custome
32. lectrodes may also be placed on the chest over the heart and oriented to the Lead II axis White on right chest toward right front leg Green in the middle and Red on left chest toward the left hind leg NOTE It is suggested that a protective bandage be applied over the electrodes to prevent the animal from dislodging or chewing off the electrode or lead Accurate Lead II information is only available if electrodes or clips are attached to the patients legs 6 Smooth down the electrodes with a circular motion Avoid pressing on center of electrode Rectal Temperature Probe Plug the rectal probe into the receptacle at the front of the VetGard Use a disposable thermometer sheath if available to minimize contamination Insert the tip into the rectum to a safe depth Wrap the Velcro strap around the base of the tail to stabilize and secure the rectal probe MOTE The rectal probe is not needed if an esophageal probe is used since esophageal probes are fitted with a temperature sensor 25 Pulse Oximetry SpO Each SpO reusable sensor comes with two clips that are used to apply the sensor to different sized animals and to different sites The sensor and clips are indicated for use when continuous non invasive monitoring of arterial oxygen saturation is desired for canine feline and equine animals Reusable sensors may be used on the same site for a maximum of 4 hours provided that the site is inspected routinely to ensure skin integrit
33. lue windows position the airway adaptor with the IR windows in a vertical position only Pre Use Check 1 If you are using the O feature before connecting the airway adaptor to the breathing circuit verify the O calibration by checking that the O reading on the monitor is correct at 21 normal ambient reading Refer to section below on how to perform room air calibration 2 Perform the tightness check of the patient circuit with the sensor head snapped into the airway adaptor 3 Verify that there has not been any accumulation of gas between the gas sensor head and the IR window on the adaptor by checking that the CO and Agent readings on the monitor are correct before connecting the patient to the breathing circuit 4 Check that the connections have been made correctly by verifying the actual patient CO waveform on the computer display per Fig 10 below 7 Do not place the IRMA gas sensor and airway adaptor between the ET tube and an elbow This may allow patient secretions to block the adaptor IR windows The normal capnogram is a waveform which represents the varying CO level throughout the breath cycle Waveform Characteristics B Baseline C Expiratory Upstroke D Expiratory Plateau End Tidal Concentration E Inspiration Begins DUUNOWY Figure 11 Normal CO display 38 39 NOTE See Monitoring Parameters in the HELP menu for CO2 waveform analysis IRMA Sensor Operating Alarms
34. med Technology product is voided if the product is repaired by anyone other than Vmed Technology Shipping charges are not covered by this warranty Warranties do not cover general maintenance or cleaning needs that result from normal use Damage to an instrument or product caused by accident abuse alteration misuse improper care cleaning chemicals loss or theft are not covered by this warranty OPENING THE PC VET OR VETGARD HOUSING OR THE HOUSING OF ANY OTHER VMED TECHNOLOGY PRODUCT WILL VOID THE WARRANTY Disclaimer of all other Warranties VMED TECHNOLOGY HEREBY DISCLAIMS ANY AND ALL OTHER WARRANTIES WHATSOEVER INCLUDING WITHOUT LIMITATION THE IMPLIED WARRANTIES OF MERCHANTABILITY FITNESS FOR PARTICULAR PURPOSE TITLE OR NON INFRINGEMENT OF THIRD PARTY RIGHTS The agents and representatives of Vmed Technology are not authorized to make modifications to these warranties or to make additional warranties Any additional statements whether oral or written do not constitute warranties and should not be relied upon by the Customer Exclusive Remedies of Customer Limitation of Liability Vmed Technology s liability and Customer s remedy for damages incurred as a result of any breach of warranty or related to the goods and products provided to Customer or use of those products by Customer or others is expressly limited to return of the non conforming or defective goods to Vmed Technology and at Vmed Technology s option either the repa
35. moline configuration on animals weighing more than 10 pounds Use on should use ISA devices and components lighter animals may add dead space to the patient circuit ALARMS 6 Do not use the ISA device with metered flow dose inhalers or nebulized medications as this may clog the bacterial filter Indication Status 7 Check that the gas sample flow is not too high for the patient size Steady green light System OK 8 Replace the sampling line if the sampling line input connector flashes red or a Blinking green light Zeroing in progress Nomoline occlusion message is displayed on your computer Steady blue light Anesthetic agent present 9 Vmed monitors and the ISA device are not designed for MRI environments Steady red light Sensor error 10 Operating high frequency electrosurgical equipment in the vicinity of the monitor or the ISA can produce interference and may cause inaccurate readings Blinking red light Check sampling line connections 11 Too strong positive or negative pressure on the patient circuit may cause inaccurate readings and internal damage to the ASA CLEANING 12 Strong scavenging suction pressure might cause incorrect readings and internal damage Clean the ISA analyzer with a cloth moistened with ethanol or isopropyl alcohol 13 Do not place the Vmed monitor or ISA device in any position that might cause it to CAUTION Clean with the Nomoline connected to prevent liquid contamination fall on the pa
36. ms This is useful for a quick waveform measurement reference Click it once more to turn it off 2 Sweep rate Click to toggle through 25 50 100 and 200 millimeters per second sweep speed for ECG and SpO waveforms CO sweep rate may be different as controlled from the configuration window 3 ECG gain Click to toggle through 1 2 3 4 and 0 5 times the gain vertical scale factor of the ECG waveform 4 Toggle R wave markers Click to turn off or on the white triangular R wave markers for each ECG beat 5 Toggle beat audio tone Click to turn off or on the beat tone that is sounded for each beat whether from ECG or from SpO 6 Select waveforms Clicking on this button will open a small window where you may select which waveforms you wish to have displayed besides ECG ECG will always be selected 7 Change current settings Clicking on this button will open the Current Configuration window where you may make configuration changes that will only affect the current session These changes will revert to the default configuration upon disconnection of the wireless remote See the Setup PC Display Defaults section of Chapter 1 for more information 8 Toggle alarm audio Click to enable or disable the audio alarm tone that sounds when a vital sign parameter exceeds its preset limit Video representation of alarm will remain 9 Toggle all alarms Click to enable or disable all the alarms for every
37. nd is validated for veterinary use The NIBP module includes an 8 foot long 4mm diameter air hose with fittings and a set of 5 animal cuffs including size L x W in cm 2 2 5 x 11 3 3 x 13 4 5 x 21 7 6 x 25 and 8 7 x 30 Airway gas sensors PhaseIn IRMA mainstream automatic gas sensors are self contained self calibrating inline infrared sensors that detect inspired and expired CO O and Anesthesia agent airway gases in any mixture o CO sensor includes 8 foot cable with connector and two semi disposable airway adaptors Airway adaptors should be changed after 20 patient uses when prompted on the computer display o CO O sensor includes 8 foot cable with connector two semi disposable airway adaptors with O vent and a rapid response galvanic oxygen sensor The O sensor should be replaced every four months or whenever the oxygen readings are questionable o CO Agents sensor includes 8 foot cable with connector and two airway adaptors The O sensor may also be fitted to this probe The VetGard is equipped with an internal wireless Bluetooth radio transmitter Bluetooth enables the wireless transmission of real time monitoring information between the VetGard and a Bluetooth enabled Windows based computer Bluetooth operates at approximately 2 4 GHz and steps up and down frequency constantly making the VetGard free of interference including the radio frequency interference common in hospital and clinic s
38. nimal Mode 160 mmHg default Variable from 60 280 mmHg CLINICAL ACCURACY Animal algorithm is based upon the human algorithm that meets accuracy requirements of ANSI AAMI SP10 1992 and 2002 PRESSURE TRANSDUCER ACCURACY 3mmHg between 0 mmHg and 300 mmHg for operating conditions between 0 C and 50 C Possible slight reduction in accuracy for temperatures above 50 C up to 60 C RECOMMENDED FREQUENCY OF TRANSDUCER CALIBRATION Verify annually OPERATING CONDITIONS 0 C to 50 C 15 to 95 non condensing humidity STORAGE CONDITIONS 20 C to 65 C 15 to 95 non condensing humidity ALTITUDE Measurement accuracy is not affected by altitude PATIENT SAFETY Internal operating software ensures that Maximum cuff inflation time limited to 75 seconds Duration of blood pressure reading is limited to 130 seconds non MT mode 120 seconds Motion Tolerant mode Additional redundant safety circuitry oversees normal operation and will override to abort a reading if cuff pressure exceeds 300 mmHg at any time or if the cuff has been inflated for gt 180 seconds 59 Appendix B Appendix B Limited Warranty All Vmed Technology products carry the limited warranties described below All warranty claims must be received by Vmed Technology in written form within the warranty periods specified below or they will lapse Limited Warranty Vmed Technology warrants 1 the PC Vet ECG monitor VetGard monitor and IRMA gas sensors to be free
39. ord ECG Press for continuous recording Keypad amp Toolbar Alarms ON ON OFF Blood Pressure ON OFF OFF Table 1 Select key options and factory default values Remote BP Measurement Selection 1 Turn on the VetGard and establish wireless connection to the computer 2 Press the D key on the VetGard keypad and the following menu appears CUFEMENU NEONATE 1 NEONATE 2 a NEONATE 3 NEONATE 4 NEONATE 5 7 SMALL ADULT OR NEONATE 8 ADULT EXIT 15 3 Use the UP DOWN arrows appropriate cuff size and then press the SELECT Ee on the VetGard keypad to select the Wi button again to accept this choice The measurement will begin immediately 4 This measurement functionality may also be selected from the D icon on the PC Display toolbar 16 Accessories ECG Long term monitoring leads 4 ECG Leads and Adaptors ECG Loop Electrodes Rectal and Esophageal ECG and Temperature Temperature Probe Esophageal Probes ECG Skin Clips ECG Chest Probe a P Nellcor SpO Sensor CO Airway Adaptors Mainstream CO Probes F 7 Side Stream CO2 Side Stream CO Side Stream CO Sensor Airline NOMOline Airway T Adapter USB Adapter Vmed Class 1 Bluetooth 17 Chapter 4 Double click the PC Display icon on your desktop to start the program This will open a window to select the particular device and initiate the search p
40. pressure measurement sequence RECORD STOP START SWITCH Press to manually begin recording and saving the ECG to file Press again to stop recording completing the save function OPEN ECG FOR REVIEW Provided an ECG trace has been completely recorded and saved this switch opens the ECG Reviewer or Interpreter program in a second window while PC Display continues to monitor the current trace Analyses can be carried out only on the portion of the ECG that was recorded and saved to file G SILENCE ALARM S Turns off the audio alarm tones during an alarm event Pil f E DISPLAY TREND GRAPH Manually displays trend graph of all parameters being monitored Select the switch again to remove the trend graph The trend graph will also display automatically at the desired interval and period set in the default configuration window The trend graph is displayed in a second window super imposed over the real time patient display START STOP TRACE Stops and starts moving sweep information for evaluation of waveforms i e freeze or unfreeze This will not affect the recording functionality SELECT ECG GAIN Sequentially changes ECG gain vertical scale factor settings from 0 5 to 4 0 PRINT COMMAND Sends information on the screen to the printer that is connected to the computer and automatically saves up to a 30 second recording of the ECG trace as a patient episode file SCROLL UP MENU Scroll through the var
41. r electrodes should be used NOTE Do not try to evaluate ECG traces using the esophageal probe Sweep is accurate for rate and rhythm only Use the ECG clips for a Lead IT ECG 1 Lay the probe on the animal simulating it being in the esophagus 2 Place end of probe one finger width from the last rib Figure 4 Position of esophageal probe on and in patient 3 Note the distance marked on the probe in centimeters at the nose 4 Lubricate probe with lubricating jelly and slide it into the esophagus until the distance marked at the animal s nose is at the mouth Reference centimeter depth marks 5 Move the probe cranial and caudal and rotate as necessary until the best ECG signal is obtained 24 Using Long term Monitoring Electrodes The clip leads provided with this optional sensor connect to the metal tabs on disposable infant pre gelled electrodes Disposable chest electrodes are best for long term critical care situations when the animal is under or recovering from anesthesia It may be necessary to shave excess hair l P the three clip leads into the corresponding colored receptacle on the yoke cable 2 Connect a plastic clip from each lead to each of three electrodes 3 Prepare the electrode site by clipping excess hair 4 Wet area with alcohol and wipe dry 5 Remove electrode from the liner and place on the leg indicated by the color code on the cable preferably above the hock and elbow E
42. r service at 800 926 9622 An itemized list of returned products must accompany all returns The RMA number and explanation of why the product is being returned must be included Returned goods MUST be packaged in a shipping container equivalent to that in which it was received Returned goods MUST be shipped pre paid at Customer s expense by FedEX or UPS or other service that provides package tracking and must be insured for the purchase price of the contents Returned goods received by Vmed Technology in any form less than that described above will be refused by Vmed Technology and return shipped to the Customer Vmed Technology will pay the return freight on products repaired or replaced under watranty 61 Appendix C Appendix C Accessories and Replacement Parts SEE www vmedtech com accessories FOR PHOTOS AND DESCRIPTION CATALOG SENSORS ECGN18 ECG 10 ECG id2 2070 2248 3 CEI CHIB EQ1 PET4 PET6 PET8 CY1 CE2 DEC4 XTN3 TRIB VAL 200101 200201 200301 200401 106211 106221 100230 DESCRIPTION Needle electrodes 28 ga set of 3 18 lead Loop electrodes Set of 3 18 lead Loop electrode exotic set of 3 18 lead Electrodes Monitoring 3M large Animal Box of 50 Electrodes Monitoring 3M small animal Box of 20 3ea Clip leads 3 wires low force clips with connector ECG Small animal chest probe with start stop button ECG large animal chest probe Esophageal ECG and temperature probe kittens and
43. rement accuracy When the cuff is below heart level measurement results may be higher and when the cuff is above heart level measurement results may be lower than comparative results obtained at the level of the heart Please remember that using a cuff that is the wrong size may give false and misleading results 32 Cuff Considerations on Cats amp Dogs For the awake animal the cuff should be placed on a front limb instead of a hind limb This is because when the cuff inflates many animals instinctively retract their hind limbs which can alter the blood flow For sedated cats and dogs this is not a concern It is important to choose a limb that does not have a med line or pulse oximeter probe attached For all applications the artery marker should be over the artery regardless of which limb is chosen Cuff Considerations on Horses The preferred cuff location is at the base of the tail The artery marker should be on the underside of the tail base Measurement Advice Animals are often anxious during medical examinations and procedures Calm the animal down as much as possible before attempting to measure blood pressure on awake animals It is beneficial to have the owner help with the procedure Several measurements should be taken and It is common practice to eliminate the first reading because of elevated results or excessive motion artifact due to the anxiousness of the animal Default Values After po
44. rocess 5 Wait for the CONNECTION light to turn from amber to blinking green The process may take as long as 30 seconds to complete the first time after initial discovery NOTE When the VetGard connection status light blinks green the notation in the STATUS box on the screen will change to Connected and the notation at the lower right corner of the screen will change to VetGard Remote Chapter 2 Operating Instructions Connected on a green background To preserve battery life the VetGard will shut off automatically if connection to your computer is not established within 3 minutes and the remote module is not plugged into wall power When connection is complete waveform sweeps appear on the display as flat lines FUNCTION CHARGE LIFE moving left to right at the selected sweep speed Upon acquisition of a satisfactory signal the waveform will appear and the trace will change to a Battery Life between Battery Charges oo as color corresponding to each sensor ECG SpO CO 9 HOURS ECG SpO BP re Trace or Digit Modality Color ECG SpO BP CO 5 HOURS Green ECG Orange NIBP Blue SpO BP measurement interval of every 5 minutes ei C O Preparation White Temp Digits Only Purple O PROCEED ONLY AFTER YOU HAVE SUCCESSFULLY INSTALLED THE SOFTWARE AND ane Cen Primary Agent Digits Only HAVE COMPLETED THE BLUETOOTH DISCOVERY PROCESS SEE PC DISPLAY MANUAL Red Secondary Agent Digits 1 T
45. s or is using a Bluetooth adapter different from what is supplied by Vmed Technology Do not install this software unless you are using the Windows 2000 operating system or unless instructed to do so by a support representative Windows XP SP2 or SP3 computers use the included Microsoft plug n play Bluetooth drivers Computer Display The screen below shows a typical computer display from an operating VetGard EI DEMO PC etGard Patient ID 20090928 Wireless Monitor File View Tools Help tit Q TEAME o R Y v v gt 140 omv Js 4 LA da n f E r AE aL aL A a ee A AIM abode all 90 JALI Dil 4 6 A v Y N v v 4 BP mmHg Cuff Neo 5 7 _ Ont a a n oem Par i A EP ge PE P PA le TE D PE en EY PE PA 120 09 28 2009 14 21 47 iz im Seconds TEMP F 100 4 73 0 Figure 1 Computer display of VetGard information showing ECG Lead II SpO and CO waveforms NOTE BP is not turned on PC Display Toolbar See PC Display manual for details The PC Display toolbar allows quick access to selections Many of these icons are duplicated on the VetGard control panel PC VetGard Patient ID Spot Jones Vmed Wireless Monitor Fie View Tools Help HEMME oa e MBOot e e 2 5 6 8 9 10 i 2 B 14 15 16 17 18 19 1 3 4 7 Figure 1 PC Display toolbar 10 Toolbar Icons 1 Toggle waveform grid Click this once to turn on the grid behind the ECG and CO wavefor
46. ten used in surgery For long term patient monitoring leg clips or disposable chest electrodes should be used Accurate diagnostic lead II ECG on the other hand requires information on both the rate and rhythm of the heart and evaluation of the ECG complexes themselves Conductive abnormalities for example are manifested by higher than normal R and S amplitudes For routine ECG and pre surgical screening the chest sensor is most convenient and is recommended for this application however the method may produce inaccuracies in amplitude if the chest probe is not positioned at the correct angle to the heart For this reason whenever a beat characteristic or signal amplitude seems abnormal when using the chest sensor a follow up trace should be taken using the leg clips to confirm the reading NOTE Alcohol ECG electrolyte or ultrasound gel provide good contact medium A magenta colored ECG trace no valid ECG signal no heart rate readout or double counting of heart rate are all indications of poor electrode placement Use salt free electrolyte to reduce corrosion of metal clips 20 Using the Chest Probe 1 Place the patient in the right lateral recumbent or standing position Pull the front legs cranial if patient is on its side Liberally apply alcohol to the left lateral chest wall where the electrodes will make contact Position the chest probe over the heart cable toward the left rear leg and press firmly enough t
47. ter or clear attenuating obstacle Try VetGard power button Plug in to power Check Bluetooth device USB connection e Re start PC Display 54 SITUATION POSSIBLE CAUSE S CORRECTIVE ACTION Cannot turn VetGard unit back e Battery is totally discharged and e Plug power back in to remote unit on remote is disconnected from power e Press and immediately release the e User is pressing and holding power power button to turn on holding down button the Power button for a second or more will turn the remote off again e Refer to the Blood Pressure measurement section of Chapter 3 for Blood Pressure measurement gives e Hose connector placement may be reversed not a tight enough air seal no readings e Incorrect cuff or placement appropriate setup procedures e Incorrect cuff selected within PC Display Table 2 Trouble Shooting Guide 55 Appendix A Appendix A Computer Requirements and Specifications Computer Minimum Requirements e 1 GHz PC desktop laptop or tablet computer e Windows XP Windows XP SP 3 Recommended Windows Vista Windows 7 e 1 GB RAM for Windows XP 2 GB RAM for Windows Vista and Windows 7 e SVGA display 256 colors 800 x 600 resolution e Spare 1 1 or 2 0 USB port e CD Rom Drive e 60 MB available hard disk space for PC Display program plus approximately 100k Bytes per patient stored e Windows supported printer e MAPI compliant E Mail system such as Microsoft Ou
48. thin or deeply pigmented to permit appropriate light transmission If any of these situations occur reposition the sensor or try another sensor site If the sensor site is covered with fur or hair try shaving the site and reapplying the sensor 1 Attach the sensor as illustrated above Ensure that the sensor cable is positioned along the side of the animal s face and body to avoid entanglement with the animal E 2 Plug the sensor connector into the receptacle on the VetGard and verify proper operation NOTE To verify correct placement of the sensor on the site manually take a pulse rate reading at another site on the animal If the sensor is placed correctly the manual reading should correspond to the pulse rate reading displayed on the VetGard computer screen CAUTION For the comfort of the animal and to avoid damaging the sensor do not pull on the cable when removing the sensor and clip from the sensor site 3 To remove the sensor and clip from the animal press the clip open and remove 4 To remove the sensor from the clip grasp the end of each sensor pad and pull it through to the inside of the clip The sensor should pop out of the clip easily Do not pull on the cable NOTE The source of the heart rate and beat tone within PC Display will default to ECG as long as there is a Jeads on or green ECG tracing with noticeable beats 28 29 Non Invasive Blood Pressure Monitoring The blood press
49. tient CAUTION Nomolines are non sterile devices Do not autoclave CAUTIONS CAUTION Do not sterilize or immerse the ISA gas analyzer in liquid 1 Do not autoclave any part of the sampling line CAUTION Do not use Chlorine solutions cleaners near the ISA gas analyzer 2 Do not pull on the ISA cable or Nomoline 44 45 3 Do not sterilize the ISA or immerse in liquid 4 There is no need to manually zero the ISA gas analyzer since it will perform its own zeroing automatically SYSTEM SET UP Airway Adaptor ISA Sidestream Analyzer and Cable Nomoline Sampling Line PRE USE CHECK Before connecting the Nomoline sampling line to the breathing circuit do the following 1 Connect the ISA analyzer to the VetGard and connect via Bluetooth the VetGard to your computer 2 Connect the sampling line to the ISA gas inlet connector 3 Connect the gas sample exhaust port to a scavenging system or return the gas to the patient circuit to prevent pollution of the operation room when anesthetic agents are being used 46 Check that the Nomoline connector of the ISA analyzer shows a steady green light indicates that the system is OK Breathe into the sampling line and check that a valid CO waveform and values are displayed on the computer Occlude the sampling line with a fingertip and wait 10 seconds Check that an occlusion alarm is displayed and that the Nomoline connector of the ISA
50. tion from the Tools menu of PC Display Tools gt Zero CO2 Probe 7 If your IRMA gas probe has warmed up enough then you will be asked if you wish to proceed with the zeroing process Click the OK button 8 You should now see a message indicating that the zeroing command has been sent to your IRMA gas probe Your IRMA gas probe will also in most cases blink a green light on the sensor end for a few seconds if the zeroing process is successful 43 Sidestream Airway Gas Monitoring WARNINGS INTENDED USE 1 Use only sampling lines manufactured by Phaseln The ISA product family consists of CO only and the AX which monitors CO N O and 2 D t use i f flammable anesthetics anesthesia gas agents including Halothane Isoflurane Enflurane Sevoflurane and a E E E ears D Desflurane ISA devices are intended to be connected to a patient breathing circuit for 3 Do not use Nomolines on more than one patient unless accuracy is confirmed monitoring patient inspired expired gases during anesthesia recovery and ICU 4 Use infant Nomoline configuration on animals weighing less than 6 pounds only Use The ISA product family is not intended to be used as the only means of monitoring a ji heavier animals wili canse flowTesistance patient but must be used in conjunction with other vital signs monitoring modalities and or professional human judgments of patient condition Only trained and authorized personnel 5 Use adult No
51. tlook or Outlook Express for direct email feature of ECG Reviewer software e Windows NET Framework 2 0 Physical Specifications TYPE Multi parameter patient monitor with integrated Bluetooth wireless module CONSTRUCTION High impact ABS PC plastic DIMENSIONS OVERALL LENGTH 6 0 WIDTH 8 75 THICKNESS 1 1 WEIGHT WITH BATTERIES 19 oz CONTROLS FLAT PANEL KEYPAD SWITCHES TACTILE PUSH TYPE MASTER ON OFF BP ON OFF RECORD ECG OPEN INTERPRETER SILENCE ALARMS TREND SELECT STOP START SWEEP SELECT GAIN PRINT SELECT UP DOWN ARROWS INDICATORS CONNECTION STATUS LED Changes from red to yellow to blinking green LOW BATTERY LED Turns steady red when battery needs recharging 56 CHARGE LED Yellow when charging green when charge complete CABLE CONNECTION ECG Circular mini DIN 6 pin SpO RS 232 9 pin Rectal temperature 2 5 mm phone plug CO RS 232 9 pin NIBP Female Luer twist lock BATTERY TYPE Lithium Ion Rechargeable 3 7 V BATTERY LIFE ECG Temp SpO only 8 hours continuous operation ECG Temp SpO CO only 6 hours continuous operation ECG Temp SpO CO NIBP every 3 min 3 hours continuous operation STANDARD PATIENT CABLES AND LEADS 36 Interface cable with three lead receptacle yoke and connector Three electrode chest probe with 32 cable and connector Three wire 80 Zip cable with removable low force skin clips Rectal temperature sensor with 5 cable Esophageal probes with 36
52. ure module must be turned on by depressing the red BP power switch D on the VetGard keypad or by clicking the BP icon on the PC Display upper tool bar NOTE The BP function uses the most battery power so its measurement cycle must be enabled manually PRECAUTIONS Connect BP air hose to correct fittings Use only the tubing provided by Vmed Do not use the BP function if oscillometric pulses may be altered by other devices or techniques Do not attach cuffs to limb being used for IV infusions as the cuff inflation can block the infusion with potential harm to the patient Accuracy of any blood pressure measurement may be affected by the position of the patient its physical condition and use not in accordance with operating instructions Interpretation of blood pressure measurements should be made only by a veterinarian or trained medical staff Extremely small or large cuffs may cause errors depending on the BP mode selection Pulse Oximetry readings taken on the same extremity as the blood pressure cuff will be altered when the cuff is inflated due to artery occlusion Cuffs of the wrong size or if placed incorrectly may result in incorrect or no readings When cuff is positioned for an extended period of time the limb should be periodically checked for proper circulation 30 Connection 1 Connect airline to monitor Note color coding on some monitors 2 Connect selected cuff to airline as sho
53. use the remote while plugged in to power Clear signal path Disable built in Bluetooth and use the Bluetooth device provided by Vmed Cannot acquire satisfactory ECG signal e Not enough electrolyte fluid used e Not making adequate skin contact e Corroded electrodes e Broken or corroded lead wire cable or plug e Bad cable connection Re apply electrolyte Re position electrodes and trim excessive hair Also try again with clip leads connected to moist human fingers to verify equipment functionality Wiggle the ECG lead wire at the connector to see if this makes a difference in the signal Replace electrodes Replace lead wire or cable Remove and re insert all plugs Excessive noise in the ECG signal e Inappropriate filter selected e Poor electrode skin contact e Excessive motion e GAIN set too high e RFI or electromagnetic interference Change the filter selection in the Tools drop down menu Re apply electrolyte and re position electrodes Also try again with clip leads connected to moist human fingers to verify equipment functionality Reduce patient motion Set GAIN to 1 Shut off electrical devices near the VetGard Lost wireless connection with computer e VetGard out of range of computer or behind signal attenuator e VetGard lost power e Bluetooth device loose in USB port e Computer turned off or PC Display closed Move toward compu
54. ved automatically 14 Open currently saved episodes Once at least one episode has been completely saved toggling the record button on and then off during the current connection of the wireless remote this button will become enabled yellow in color indicating that you may choose an episode to view using the default Vmed viewing application either ECG Reviewer or ECG Interpreter 12 15 Start stop sweep Click to freeze pause the display of all the waveforms Click on it again to resume Any recordings will continue regardless of whether the screen has paused using this feature 16 Toggle NIBP measurement Click on this button to begin the blood pressure measurement cycle You will first be presented with a window asking you which size of blood pressure cuff you are using Select the cuff being used from the list and then click OK to begin the measurement cycle Click this button again to stop the measurement cycle 17 Mark event Click to mark on the point of the ECG waveform that you wish to review later This will put an orange arrow on the immediate display as well as an event within a saved ECG episode that includes the vital signs at that moment 18 Software information Click on this button to open the information window that shows the version number of PC Display as well as the various hardware and software components of the currently connected remote module 19 Select anesthetic agents Click on t
55. wer up the BP Module will default to the following settings e Initial Inflation Pressure 160mmHg e Large Animal Mode NOTE After the first BP reading is performed the next initial inflation pressure will be at least 30 mmHg above the previous systolic reading This inflation pattern will continue until the module is turned off an error occurs or the initial pressure Is set by the SET INITIAL_INFLATE command 33 Blood Pressure Display The blood pressure display on the computer screen includes symbols to denote the phase of each measurement cycle This allows the operator to know if the BP module is off taking a measurement or between measurements Some symbols are dynamic and include audio tones This functionality is only available on more recently shipped PC VetGard remotes Figure 6 Blood pressure module is turned off Figure 7 An animated icon will play while blood pressure is being measured Figure 8 A single tone will sound indicating a new measurement is ready to read and a stopwatch icon will appear when the system is between measurements 34 Mainstream Airway Gas Monitoring PRECAUTIONS Do not submerge autoclave or allow moisture on the gas sensor Do not touch the window on the airway adaptor or expose adaptors to organic solvents Dispose of depleted O sensors in accordance with biohazard protocol Do not place sensor between the ET tube and a line elbow since secretions may accumulate and block
56. wn below NOTE Later monitors use a threaded connector aa Ea P NOILO JNNOO ANX 3LLY MOT J YYH a a 2 ee CO2 02 GAS Sp Vmed Technology EMP Figure 5 Press the male fitting at the end of the air line into the inside of cuff fitting MOTE The threads on the outside of the cuff fitting are not used in the configuration shown Some air hoses use a twist nut that engages the threads on the cuff In this case twist nut to the right so it is snug Animal Modes There are two animal modes that are needed to handle the large variety of animal sizes within the dog cat and horse populations These are Small and Large Animal modes The Small Animal Mode has been developed to perform on smaller animals including cats and small dogs Cats typically have very low oscillometric signal strength and are difficult patients for non invasive blood pressure measurement The Small Animal 31 Mode in the veterinary BP algorithm was specifically designed for this patient population and cuff placement plays a key role in obtaining BP measurements This mode is automatically selected when a 3 cuff or smaller is selected on the BP cuff size drop down window on the VetGard computer display Dogs equal to or less than 8kg 17 5 lb should also have their blood pressures measured in this mode Dogs or cats that require a 4 cuff or larger and when selected on the computer drop down window will shift automatically to the L
57. y and correct positioning Some patients may require moving the sensor more often PRECAUTIONS Failure to apply sensor properly may cause incorrect measurements Exposure of bright light at the point of sensor attachment may cause inaccurate measurements Cover sensor with an opaque material to block ambient light Move sensor to a new site at least every four hours It may be necessary to move the sensor more often with some patients Do not use supplemental tape or straps to secure sensor to the site since this may restrict blood flow and cause inaccurate readings Use of Intravascular dyes may cause inaccurate measurements Motion particularly repetitive motion may compromise performance If readings cannot be obtained change the site Carefully route all monitoring cables to reduce the possibility of entanglement or strangulation Do not use during MRI scanning Do not alter or modify the sensor in any way since accuracy will be affected Do not use any other brands of SpO sensor with the VetGardt Clean the sensor and clip separately before and after each use Refer to cleaning instructions below 26 Application NELLCOR S VETSAT VETERINARY SENSOR __ The sensor comes with two sizes of clips so it can be applied to various sites on the animal Other Sites e Paw e Ear e Prepuce BIRR s Other Sites e Tongue e Lower leg e Tail EQUINE Other Sites e Lip e Vulva e Nostril
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