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User`s Manual - Frank`s Hospital Workshop

1. Power jack ge gt Hinged side d Interface connector Battery cover WARNING Do NOT connect to any device not approved by Novametrix The battery is keyed so that it can be installed in only one way see illustration inside battery compartment The contacts should go in first and be located toward the top left of the monitor when inserting Make certain the battery cover is properly closed before operating the monitor 10 TIDAL WAVE Sp User s Manual Rev 05 Battery Use Options Preparation for Use Rechargeable Batteries The NiMH rechargeable battery pack Cat No 400043 can be used to power the TIDAL WAVE Sp for approximately 4 5 hours of continuous operation 4 hours when using sampling pump Model 715 Optional Rechargeable battery NiMH 7 2 vdc NOTE Refer to the instruction sheet packaged with the rechargeable battery for complete operating instructions To charge a rechargeable battery while in the monitor External Power Supply Alternatively plug the external power supply directly into the DC power jack on the side of the monitor and connect a hospital grade line cord to an AC source The AC icon v will illuminate green and the battery will charge in approximately 5 5 hours If the monitor has been stored with the battery installed for thirty 30 days or more charge the battery for 24 hours prior to use gt DC input
2. Connect line cord External power supply Cat No 600075 Cat No 9220 10 CAUTION e Use only Novametrix supplied devices when connecting to the power input jacks on the TIDAL WAVE Sp or on the BaseStation Do not attempt to use the adapter for the external battery charger for this function NOTE When powered by the external power supply the TIDAL WAVE Sp will not overcharge a rechargeable battery e external power supply has a universal power input The IEC 320 input receptacle for line cord connection allows compatibility with every country s voltage and frequency requirements Rev 05 TIDAL WAVE Sp User s Manual 11 Section 3 Battery Use and Options Optional BaseStation Power for the BaseStation is supplied by an external power supply PN 9220 10 or the internal battery When the power supply is properly connected to the BaseStation and a monitor is placed within the station the green In Use LED will illuminate The icon on the monitor will also illuminate indicating that external power is connected Connect the external power supply jack to the monitor and connect a hospital grade line cord from the external power supply to an AC source External power supply Monitor in BaseStation Cat No 9220 10 BaseStation Cat No 6998 00 Connect line cord IEC 320 receptacle Cat No 600075 Green In Use LED Illuminates indicating illum
3. 69 TIDAL WAVE Sp User s Manual Lr ne 73 SEVICE POlI spirit 74 Vi TIDAL WAVE Sp User s Manual Rev 05 05 Section 1 General Description Indication for use The Model 710 and Model 715 TIDAL WAVE Sp handheld portable Capnometer Oximeters are intended to be used for monitoring end tidal respiration rate functional oxygen saturation and pulse rate in monitoring environments such as ventilatory support emergency and anesthesia The Model 715 incorporates a miniature vacuum pump to draw expired respiratory gases through the CAPNOSTAT CO Sensor using a sampling airway adapter and nasal cannula TIDAL WAVE Spis designed to monitor adult pediatric and neonatal patients TIDAL WAVE Spis not intended for any other purpose NOTE Components of this product and its associated accessories which have patient contact are free of latex Keypanel Controls and Indicators Page key Display screen Power key Alert key Backlight key Adapter key Battery charge indicator AC indicator and LED Alert LED Controls o Power Key Switches power on off Press the POWER key to place the unit into operate mode ON or to turn the unit OFF Refer to AC Battery Operation on page 9 With monitor ON press and hold the POWER key to enter the MONITORING MODE selection menu Refer to Monitoring Mode on page 41 for more information TIDAL WAVE Sp User s Manual 1 S
4. Facsimile 203 284 0753 World Wide Web http www novametrix com Internet techline novametrix com Copyright 1998 2000 Novametrix Medical Systems Inc This document contains information which is proprietary and the property of Novametrix Medical Systems Inc and may not be reproduced stored in a retrieval system translated transcribed or transmitted in any form or by any means without prior explicit written permission from Novametrix Medical Systems Inc TIDAL WAVE Sp User s Manual 73 Section 10 Service Policy Service Policy Novametrix Medical Systems Inc provides 24 hour a day access to technical support through its Technical Support Department in Wallingford Connecticut and company Service Representatives located throughout the United States Outside the U S primary technical support is handled through our qualified international sales and service distributors Novametrix will provide Warranty Service support within 48 hours of receiving a request for assistance Contact the Technical Support Department by telephone toll free at 800 243 3444 or 203 265 7701 by facsimile at 203 284 0753 or by e mail at techline novametrix com After hours telephone support requests before 8 00 AM and after 5 00 PM Eastern Time will be responded to promptly by the Technical Support on call staff After hours facsimile and e mail requests will be answered the next business day It is suggested that any person calling in for technica
5. Approximate Monitoring Times Configuration Rechargeable NiMH battery AA lithium batteries Model 710 715 CO SpO 4 5 hours 4 0 hours Model 715 Sampling SpO 4 0 hours 3 5 hours Model 710 715 CO only 4 5 hours 4 0 hours Model 715 Sampling only 4 0 hours 3 5 hours Model 710 715 SpO only 7 0 hours 6 5 hours Recharge Time 4 5 hours n a External charger w adapter Recharge Time 5 5 hours in monitor n a External power supply or External power supply BaseStation NOTE Excessive alerting reduces battery life when operating on battery power 14 TIDAL WAVE Sp User s Manual Rev 05 Battery Use Options Preparation for Use Rev 05 Automatic Power Off Feature The automatic power off feature is included to conserve battery power in the event of an unintentional power up of the monitor This option will shut the monitor off if there is no CO breath or pulse detection after 5 minutes from when the unit powers on or after 20 minutes of no monitoring no breath or pulse detected and no alert conditions After the 5 or 20 minutes has elapsed an AUTO POWER OFF IN X XX message will appear on the screen and the timer X XX will count down from one minute to zero Pressing the adapter key or detection of a CO breath or pulse will cancel the shutdown otherwise the unit will shut off Long Term Storage If the monitor has not been used or powered by the external power supply for an extend
6. TIDAL WAVE Sp NOVAMETRIX 572 CAPNOGRAPHY OXIMETRY HANDHELD CAPNOGRAPH OXIMETER Model 710 715 Revision History 30 Oct 98 15 Dec 98 27 Jan 99 10 Dec 99 6 Apr 00 12 Oct 00 Release Rev 00 Revision 01 R N626 Revision 02 Revision 03 R N719 Revision 04 R N746 Revision 05 R N835 Declaration of Conformity with European Union Directives The authorized representative for Novametrix Equipment is European Compliance Services Limited Oakdene House Oak Road Watchfield Swindon Wilts SN6 8TD UK Novametrix manufacturing facility is certified to ISO 9001 and EN46001 MDD93 42 EEC Annex II Novametrix Medical Systems Inc products bear the CE 0086 mark The product is certified by Underwriter s Laboratories UL to bear the UL mark and tested by TUV Rheinland to IEC601 1 EN60601 1 TIDAL WAVE Sp and CAPNOSTAT are registered trademarks and Y Sensor SuperBright and OxySnap are trademarks of Novametrix Medical Systems Inc Velcro is a registered trademark of Velcro USA Inc Cidex is a trademark of Arbook Inc Nafion is a registered trademark of Dow Corning Corp Models 710 and 715 are Year 2000 compliant Copyright 1998 2000 Novametrix Medical Systems Inc This document contains information which is proprietary and the property of Novametrix Medical Systems Inc and may not be reproduced stored in a retrieval system translated transcribed or transmitted in any form or by any means without prior explicit
7. The monitor will shut off if there is no CO breath detection or key IN X XX depressions for ten minutes from when the unit powers on The timer X XX will then count down from two minutes to zero Pressing the adapter key or detection of a breath will cancel the shutdown UNKNOWN ERROR Remove the monitor from use and contact Novametrix service personnel Capnography Messages Message Description CAPNO Sensor is under temperature Wait for the CAPNOSTAT CO WARMING sensor to reach operating temperature CHECK Excessive moisture or secretions detected in the adapter Change ADAPTER adapter Adapter type has been changed e g adult to neonatal Zero the adapter No adapter detected Place an adapter the CAPNOSTAT CO sensor RESP 0 A breath has not been detected for the indicated time XX seconds m ss This message appears when the time since the end of expiration of the last detected breath exceeds the NO RESP TIMER setting in the configuration menu See Configuration Settings on page 17 INSP An inspired level of 3 mmHg or 0 4 or kPa was detected for XX 20 consecutive seconds ZRO HOLD The current through the CAPNOSTAT CO sensor source emitter has ADPT KEY changed or the system is detecting EtCO values less than 3 0 mmHg TIDAL WAVE Sp User s Manual 45 Section 5 46 Messages Message Description CAPNO FAULTY The following errors may be present 1 The current through th
8. 05 Section 3 Preparation for Use The TIDAL WAVE Sp can be powered four ways from seven AA disposable lithium batteries a rechargeable NiMH battery the 9220 10 external power supply or the 6998 00 BaseStation combined with the external power supply all available from Novametrix AC Battery Operation Press the POWER key to place the unit into operate mode ON or to turn the unit OFF The status of the unit is dependent upon both the Power key and the power source The monitor can operate for up to 4 5 hours while powered from a fully charged internal battery 4 hours when using sampling pump Model 715 The battery is charging when the monitor is powered through its DC input and the keypanel icon is green The battery will charge even if the monitor is off Power to the DC input is supplied by the external power supply Cat No 9220 10 with or without the optional BaseStation Cat No 6998 00 Rechargeable and disposable battery capacity is shown in the table titled Battery Life and Recharge Times on page 14 Times may be reduced in colder temperatures or with the sampling adapter operation with the backlight off may slightly increase these times Battery Status and Alerts When the monitor is operating on battery power and the battery is sufficiently charged the battery icon LED Es on the keypanel will be green The battery level is reflected on the battery icon by different colors for example battery fully cha
9. 2 AUTO LIMITS NOT SET and or SPO2 AUTO LIMITS NOT SET will appear If one or both of the screen messages say LIMITS NOT SET exit this screen resume monitoring and retry in 30 seconds when the monitor has collected sufficient data ETCOZ AUTO LIMITS SET SPO2 AUTO LIMITS SET COHTIHLE NOTE Auto Alert Limits are not stored by the monitor If Auto Alert Limits are selected and the unit is powered down default limits will appear on power up regardless of stored values Alert Audio A NO RESPIRATION alert will sound after 20 40 or 60 seconds depending upon the configuration setting if no breaths are detected When this occurs a RESP 0 timer appears indicating the number of seconds since the last detected breath Three breaths must first be detected to initialize this alarm An audible alert is generated any time an alert condition is detected provided that neither the 2 minute silence nor the audible alert muting are enabled If the ALERT VOLUME is set to DISABLED an audible alert is not generated and the alert silence LED will flash red Rev 05 TIDAL WAVE Sp User s Manual 49 Section 5 Capnogram Sample Waveforms and Interpretations Press the 4 Alert key to silence an audible alert for 2 minutes Press again to cancel Press and hold the 4 Alert key to disable audible alerts Press and hold again to cancel The monitor will always power up with the audible alerts settings retained in memo
10. It will increase one step when switched from adult to neonatal and decrease one step when switched from neonatal to adult 42 TIDAL WAVE Sp User s Manual Rev 05 Screen Displays Monitoring SpO Waveform Screen Plethysmogram The pitch of the user selectable Pulse Rate beep tracks the SpO value Decreasing SpO values are signaled by lower pitched beeps increasing values are signaled by higher pitched beeps The plethysmogram waveform is proportional to the signal strength Respiration rate units Status messages are displayed here EtCO value Pulse rate displayed here Selected gas compensation displayed here 0 Os or Oxygen perfusion blank if set to room air SpOz displayed balance here Indicates plethysmogram Plethysmogram screen waveform Trend Screens On screen trends are displayed as a graph Use the key to advance to the EtCO Respiration Rate or SpO trend screen Thirty 30 minutes of data are displayed moving from right to left on the screen Each data point represents 16 8 seconds New data is added on the right side of the screen Refer to the CONFIGURATION menus for scale adjustment NOTE Changing the UNITS in the Configuration menu will result in loss of all stored data When changing CO UNITS in the Configuration menu the message WARNING CHANGING 2 UNITS ERASES STORED TRENDS will display Press the 4 OK key to acknowledge the warning this does n
11. PC 1 Connect the Serial Cable PN 600075 sold separately to the RS232 Serial Port connector on the BaseStation 2 Connect the external power supply to the power input jack on the BaseStation then connect a line cord from the power supply to an AC source It is recommended that the monitor be powered by the BaseStation using the external power supply when downloading data from the monitor or updating software This will prevent power loss from a depleted battery 3 Plug the other end of the serial cable into the host computer NOTE The COM port on the computer will be either a 9 pin or a 25 pin D connector Use an adapter if the COM port on the host computer does not match the connector on the end of the Serial Cable 4 Set the monitor inside the BaseStation verify the In Use e LED illuminates Refer to the 6993 23 BaseStation User s Manual for more information Printing The monitor must be set up for printing in the Configuration menus To access the Configuration menus press and hold the e Adapter key then press the 3 Contrast key Press the PAGE key to advance to the RS232 INTERFACE menu then the SELECT key to move the arrow pointer to SEIKO 414 Press the D EXIT key to return to the main menu 252 INTERFACE HOWACOMM SEIKO 414 RESERVED 1 EXIT PAGE SELECT 54 TIDAL WAVE Sp User s Manual Rev 05 Printing Printing and RS232 Options Once the print option is activated press and hold the Page ke
12. Sp User s Manual 55 Section 6 Printing Connecting the Seiko DPU 414 Thermal Printer To connect a Seiko DPU 414 Thermal Printer PN 9140 00 to the TIDAL WAVE Sp 1 Connect the external power supply PN 9220 10 to an AC source using a hospital grade line cord It is recommended that the monitor be powered by the BaseStation using the external power supply when printing This will prevent power loss from a depleted battery 2 Connect the external power supply s cable to the BaseStation s power input jack Monitor in BaseStation DC input Connect line cord External power supply 3 Connect the interface cable PN 9086 00 to the BaseStation s RS232 serial port then to the Seiko printer s serial input connector the 9 D connector 4 Connect the Seiko s AC adapter to the printer then to an AC source Turn the printer on place the monitor in the BaseStation RS232 Serial port Serial input cable Cat No 9086 00 AC adapter Cat No 400052 56 TIDAL WAVE Sp User s Manual Rev 05 Interpreting Printer Output Printing and RS232 Options Interpreting Printer Output Header Each printout starts with a header that identifies the capnograph oximeter TIDAL WAVE Sp The date and time of the printout is furnished by the monitor s calendar clock Space is then provided to enter patient info
13. composition in order to compensate the measurement for gas density Any setting other than the default will cause the mon itor to display O or O N5O on the screen beside the respiration value Room Air WAVEFORM SCALE Small Medium Large Select the desired size of the capnogram waveform Medium WAVEFORM SPEED Slow Fast Medium Select the desired speed of the capnogram waveform Medium NO RESP TIMER 20 sec 40 sec 60 sec Alert setting activates if the end tidal CO portion of the monitor cannot detect regular breaths for periods longer than 10 seconds 20 sec 05 TIDAL WAVE Sp User s Manual 17 Section 3 Configuration Menus UNITS mmHg kPa Select the desired units for both the capnogram and ETCO values Note that changing the CO units in the Configuration menu will result in a loss of all stored data The message WARNING CHANGING CO2 UNITS ERASES STORED TRENDS will display Press CANCEL or press the OK key to acknowledge the warning and return to the CO2 UNITS menu Press the D Adapter key to EXIT mmHg ALERT VOLUME Disabled Low High Select the desired volume of audible alerts Note that care should be taken to set the volume level above ambient noise levels High RS232 INTERFACE used when connected to an external PC with optional software SEIKO 414 used when con
14. number short month name year e g 14 DEC 1998 From within the CONFIGURATION Menu press key to access this screen Select to program or change the time and date The format is TIME HH MM DDmmmYYYY where HH hours from 00 23 MM minutes from 00 59 DD days of the month from 01 31 mmmzmonth Y Y Y Y year using all four digits LANGUAGE languages available in the current software release are listed in this menu SOFTWARE REVISIONS MAIN PROGRAM Date time and version of 710 715 software currently loaded in to this unit CAPNOSTAT SERIAL VERIFY ACCURACY Serial number of CAPNOSTAT CO sensor attached to this monitor Verifying monitor accuracy with calibration gas should be performed only by qualified service personnel TIDAL WAVE Sp User s Manual 19 Section 3 Configuration Menus This page intentionally blank 20 TIDAL WAVE Sp User s Manual Rev 05 Section 4 Sensors Patient Connections Adapter Types Available Pediatric Adult Single Patient Use Airway Adapter Catalog No 6063 For intubated patients with endotracheal tube diameters greater than 4 mm Adds approximately 5 cc of deadspace For connecting to anesthesia non rebreathing or BIPAP CPAP masks for non intubated patients Pediatric Adult Single Patient Use Airway Adapter with mouthpiece Catalog No 6421 For point of care monitoring of pediatric or adult patients Adds a
15. promotes customer participation in warranty repairs should they become necessary A longer useful product life and quicker more cost effective maintenance and repair cycles both during and after the warranty period are benefits of a smooth transition into self maintenance The Technical Support Department can provide technical product support at a level appropriate to your protocol and budget requirements Please contact Technical Support for information on these additional programs and services Focus Series Technical Training Seminars Test Equipment and Test Kits Service Contract Parts Insurance Plans On Site Technical Support Demand Services including Flat rate parts exchange Flat rate return for repair Time and material Full warranty discounted replacement sensors 74 TIDAL WAVE Sp User s Manual Rev 05
16. pulse is indicated visibly by a plethysmogram graphic display and audibly by a beep when configured The TIDAL WAVE Sp must be used in conjunction with SuperBright Sensors See Accessories on page 69 for a list of available sensors and accessories 6 TIDAL WAVE Sp User s Manual Rev 05 Section 2 Safety For maximum patient and operator safety you must follow the following warnings and cautions WARNINGS Indicates a potentially harmful condition that can lead to personal injury Explosion Hazard DO NOT use TIDAL WAVE Sp in the presence of flammable anesthetics Use of this instrument in such an environment may present an explosion hazard e Electrical Shock Hazard Always turn TIDAL WAVE Sp off and remove any external devices before cleaning it Refer servicing to qualified service personnel Failure of Operation If the monitor fails to respond as described do not use it until the situation has been corrected by qualified personnel e Do not operate TIDAL WAVE Sp if it appears to have been dropped or damaged e Do not operate TIDAL WAVE Sp or its accessories when it is wet due to spills or condensation e Never sterilize or immerse the monitor sensor or accessories in liquids monitor does not alert for NO RESPIRATION if the airway adapter is removed from the CAPNOSTAT sensor e Verify the No Resp Timer setting prior to use e Do not position any sensor cable in a way th
17. seconds Settling Time Display settles to within 1 of final reading less than 15 seconds after the sensor is properly applied 66 TIDAL WAVE Sp User s Manual Rev 05 Monitor Specifications Specifications e Alerts The Model 710 715 will have user selectable alert limits for Pulse Rate Monitor Specifications e Classification IEC601 1 Class II internal power source type BF enclosure protection rating of IPX1 Operating Environment 50 to 1042 F 10 to 40 0 90 relative humidity non condensing e Transport Storage short term 14 to 122 F 10 to 50 with NiMH battery long term 14 to 95 10 to 35 with NiMH battery storage 14 to 131 F 10 to 55 without NiMH battery Size 7 9 x 3 25 x 1 5 e Weight 24 ounces e Power 100 250 VAC 38A 50 60 Hz e Battery Rechargeable NiMH battery pack Cat No 400043 or equivalent AA lithium batteries Energizer L91 or equivalent e Battery Life Approximately 4 5 hours of continuous use with fully charged NiMH rechargeable battery pack Approximately 4 0 hours with sample pump in operation e Display LED backlit 2 5 x 1 25 LCD adjustable contrast e LED indicators for Low battery adapter type audio alert status indicates audio off 2 minute silence active alert and external power e Electromagnetic Emissions Conforms to EMC Directive 89 336 EEC CISPR Class A Tested to 55011 1991 and CISPR11 1990 e Ele
18. the fingers or toes to insure that there will be no light transmission through this space 5 maximize sensor life secure the cable along the limb with tape as shown in the following illustrations Rev 05 TIDAL WAVE Sp User s Manual 31 Section 4 5 gt Sensors Leave slack in the wires between the tape and the sensor Adult pediatric finger Neonatal hand Neonatal pediatric foot Pediatric toe WARNING Do not wrap the tape around the limb so tightly that circulation is restricted Inspect the site often for adequate circulation at least once every four hours When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate 32 TIDAL WAVE Sp User s Manual Rev 05 SpO Sensors 2 05 Sensors and Patient Connections To use the adhesive or non adhesive foam wrap With the blue side of the foam wrap facing up press the buttons on the back of each Y sensor head through the holes in the foam wrap The wrap will stretch to fit the buttons The white side of the foam should show two blue circles where the buttons were pushed through Head Y Sensor Head 4 Button Blue Foam Cross section of Sensor head WE _ White Fabric y in the foam wrap Adhesive Foam Wraps Non Adhesive Foa
19. will show a dash When valid data is received the value will display If the parameter is lost the value will return to dashes This will also occur when the monitor is first turned on and before any valid patient data is obtained When monitoring if valid data is received then lost for ETCO respiratory rate SpO or pulse rate an alert condition will occur If the 2 Alert key is pressed and valid data is still not available the numeric value of the parameter in question will display If the 4 key is not pressed within 30 seconds after the loss of data the display will automatically turn to dashes Monitoring Mode Three monitoring modes are available for the TIDAL WAVE Sp CO SpO CO and SpO The factory default is CO SpO To choose a different mode press and hold the 7 Power key to access the menu The currently selected mode will flash Press the 2 SELECT key to move the arrow pointer to the correct mode and the EXIT key to exit the menu When the monitor is in CO mode SpO screens are not be available in SpO mode CO screens not available All screens are available in CO SpO mode MOHITOFIHG MODE Lz 5r z co z SeOz EXIT SELECT amp NOTE Significant power savings can be realized by shutting down monitor functions that are not currently being used Refer to Battery Life and Recharge Times on page 14 Parameters are measured and displa
20. 0 mmHg 5 of reading 70 150 mmHg 8 of reading e Warm up Time Operational in 15 seconds 1 minute to full specifications e Step Response Time less than 200 ms Sampling Rate 180 cc min e Averaging Time 1 breath 10 seconds default 20 seconds instantaneous e Display Resolution 0 25 0 50 and 0 150 mmHg in 31 pixels e Alerts The Model 715 has user selectable alert limits for EtCO Respiratory Rate Sidestream Model 715 e Range 0 70 breaths min e Accuracy 1 breaths min e Alerts The Model 715 has user selectable alert limits for Respiratory Rate e Averaging Time 8 seconds SpO gt Section e Range 0 100 e Accuracy 2 SpO for 80 100 SpO 1 standard deviation or 68 of readings within claim unspecified for 0 79 SpO e Display Resolution 1 e Averaging Time menu selectable times of 2 and 8 seconds default is 8 seconds e Audible SpO Trend Feature Pitch of user selectable pulse rate beep tracks the SpO values i e decreasing SpO values are signaled by lower pitched beeps e Settling Time Display settles to within 1 of final reading less than 15 seconds after the sensor is properly applied e Alerts The Model 710 715 will have user selectable alert limits for SpO Pulse Rate Section e Range 30 250 beats per minute bpm e Accuracy 1 standard deviation 1 of full scale e Display Resolution 1 bpm e Averaging Time menu selectable times of 2 and 8 seconds default is 8
21. 21 30 SPO2 98 PULSE 64 bem 2 44 mmHg RR 23 BRM INSP O 15 22 00 Sp02 98 PULSE 55 bpm ETCO2 43 mmHs RR 19 BRM INSP 0 mmHe 15 22 30 SP02 98 PULSE 55 bem ETCO2 43 mmHg RR 20 BRM INSP O mmHe 15 23 00 02 98 PULSE 59 bpm ETCO2 44 mmHg 19 BRM INSP 0 mmHs 60 TIDAL WAVE Sp User s Manual Rev 05 Section 7 Maintenance Cleaning and Sterilization Follow the cleaning and sterilization instructions listed below to clean and or sterilize the monitor and its accessories Monitor BaseStation and External Power Supply Turn the monitor off and unplug the BaseStation and the external power supply from the AC power source before cleaning e The monitor BaseStation and external power supply can be cleaned and disinfected by wiping with solutions such as a 70 isopropyl alcohol 2 gluteraldehyde or 10 bleach solution Wipe down with a water dampened clean cloth to rinse Dry before use e Do not immerse the monitor BaseStation or external power supply e Do not attempt to sterilize the monitor BaseStation or external power supply SpO Finger Sensor sensor can be cleaned and disinfected by wiping with solutions such as a 70 isopropyl alcohol 2 gluteraldehyde or 10 bleach solution Then wipe down with a water dampened clean cloth to rinse Dry before use certain that the finger sensor windows are clean and dry before reuse e
22. 9 al 37 mmHa AGLT 98 30 ZERO CANCEL E NOTE If breaths are detected while attempting to zero the adapter the icon will display and the zero menu will be exited automatically remove the CO source wait 15 seconds and repeat the procedure from step 1 If the sensor is not at the proper temperature the icon will display and the zero menu will be exited automatically wait 15 seconds and repeat the procedure from step 1 The TIDAL WAVE Sp will return to monitor mode automatically when the procedure is complete When SAMPLING has been selected from the ADAPTER menu the sampling pump will turn on when the CAPNOSTAT sensor is snapped onto the sampling adapter When zeroing the sampling adapter place the cannula away from all sources of including patient and operator breath and ventilator exhaust valves Verify the integrity of all pneumatic connections Rev 05 TIDAL WAVE Sp User s Manual 23 Section 4 CAPNOSTAT Sensor Airway Adapter Setup CAPNOSTAT Sensor and Airway Adapter Setup Patients requiring mechanical ventilation 1 Selecta new Single Patient Use airway adapter Pediatric Adult Cat No 6063 for ET tube size greater than 4 0 mm see Fig 1 Neonatal Cat No 6312 for ET tube size 4 0 mm or less see Fig 2 Verify that the windows are clean and dry Place the airway adapter in the patient s ventilator circuit It should be positioned between the ET
23. Do not immerse the finger sensor e Do not attempt to sterilize the finger sensor e After cleaning the finger sensor verify that the sensor is physically intact with no broken or frayed wires or damaged parts Make certain that the connectors are clean and dry with no signs of contamination or corrosion Do not use a broken or damaged sensor or one with wet contaminated or corroded connectors e Perform a Quick Check to verify the integrity of the sensor See Finger Sensor Quick Check on page 29 5 gt Y Sensor Do not immerse connector on the Y Sensor Y Sensor may be immersed up to but not including the connector in a 2 gluteraldehyde solution or 10 bleach solution Refer to manufacturer s instructions and standard hospital protocols to determine recommended times for disinfection and sterilization e Rinse thoroughly with water and dry before use do not rinse the connector Rev 05 TIDAL WAVE Sp User s Manual 61 Section 7 Cleaning and Sterilization Do not attempt to sterilize Y Sensor except as stated above e After cleaning or sterilizing the Y Sensor verify that the sensor is physically intact with no broken or frayed wires or damaged parts Make certain that the connectors are clean and dry with no signs of contamination or corrosion Do not use a broken or damaged sensor or one with wet contaminated or corroded connectors e Perform a Quick Check to verify the integr
24. E Sp Model 710 715 Handheld Capnograph Oximetry Monitor TIDAL WAVE Sp User s Manual T1 Section 9 This page intentionally blank 72 TIDAL WAVE Sp User s Manual Rev 05 05 Section 10 Warranty Equipment manufactured or distributed by Novametrix Medical Systems Inc is fully guaranteed covering materials and workmanship for a period of one year from the date of shipment except for certain disposable products and products with stated guarantees other than one year Novametrix reserves the right to perform guarantee service s at its factory at an authorized repair station or at the customer s installation Novametrix obligations under this guarantee are limited to repairs or at Novametrix option replacement of any defective parts of our equipment except fuses batteries and calibration gasses without charge if said defects occur during normal service Claims for damages during shipment must be filed promptly with the transportation company All correspondence concerning the equipment must specify both the model name and number and the serial number as it appears on the equipment Improper use mishandling tampering with or operation of the equipment without following specific operating instructions will void this guarantee and release Novametrix from any further guarantee obligations Service Department For factory repair service call toll free 1 800 243 3444 In Connecticut call Collect 203 265 7701
25. ERAGING 1_BREATH 7 28 SEC TEST EXIT PAGE SELECT 5P z AVERAGING z SEC ac SEC Lt EXIT e PAGE SELECT ALERT LIMITS DISABLED ENABLED ERIT e PAGE SELECT PULSE BEEP VOLUME OFF p HIGH EXIT PAGE SELECT RESP TREND SCALE EXIT FAGE SELECT AUTO POWER OFF ENABLED AM DISHBLED PAGE SELECT Press SELECT to scroll down to INST in the EtCO Averaging menu 16 TIDAL WAVE Sp User s Manual Rev 05 Configuration Menus Displays selected setting Selects screen Press to set time date Preparation for Use Changes settings of selected item Press to exit NOTE If an attempt is made to change units after data has been collected a message warning that trend memory will be erased is displayed To change units and erase trends press the OK key to continue then the 9 EXIT key to confirm and exit Configuration Settings The CONFIGURATION menus can be programmed by the user to customize the TIDAL WAVE Sp Any changes made will be retained when the monitor is turned off NOTE To reset the monitor to its factory default settings with the monitor off press and hold the A key and the Xx key then press the key to turn the monitor on Options are listed below with descriptions following Parameter Settings and Description Factory Default GAS COMPENSATION Room air O gt 60 N20 gt 60 Use this setting to enter the gas
26. Less than 18 g without cable Sensor Size 1 3 x 1 67 x 85 inches 3 30 x 4 24 x 2 16 cm 6 foot cable 1 83 m Construction Durable high performance plastic ultra flexible cable Shock Resistant CAPNOSTAT CO sensor withstands a 6 foot drop to a tile floor e Airway Adapter Single Patient Use less than 5 cc deadspace meets ANSI Z 79 EtCO Section Mainstream e Range 0 150 mmHg CO partial pressure Accuracy 0 40 mmHg 2 mmHg 41 70 mmHg 5 of reading 70 150 mmHg 8 of reading e Warm up Time Operational in 15 seconds 1 minute to full specifications e Step Response Time 60 ms adult less than 50 ms neonate e Averaging Time 1 breath 10 seconds default 20 seconds instantaneous e Display Resolution 0 25 0 50 and 0 150 mmHg in 31 pixels e Alerts The Model 710 has user selectable alert limits for EtCO Allows for halogenated anesthetic agents which may be present at normal clinical levels The presence of desfluane in the exhaled breath beyond normal levels 5 696 may positively bias Carbon Dioxide values by up to an additional 2 3 mmHg Rev 05 TIDAL WAVE Sp User s Manual 65 Section 8 5 2 Section Respiratory Rate Mainstream e Range 0 150 breaths min e Accuracy 1 breaths min e Alerts The Model 710 715 has user selectable alert limits for Respiratory Rate e Averaging Time 8 seconds EtCO Section Sidestream e Range 0 150 mmHg CO partial pressure e Accuracy 0 40 mmHg 2 mmHg 41 7
27. RS and ACCESSORIES 8954 00 Single Patient Use Sampling Adapters 10 per box 8954 25 Single Patient Use Sampling Adapters 25 per box 8955 00 Single Patient Use Adapter w Nasal CO Sampling Cannula A dult 10 per box 8955 25 Single Patient Use Adapter w Nasal CO Sampling Cannula Adult 25 per box 8956 00 Single Patient Use Adapter w Nasal CO Sampling Cannula Pediatric 10 per box 8956 25 Single Patient Use Adapter w Nasal CO Sampling Cannula Pediatric 25 per box 8957 00 Single Patient Use Adapter w Nasal CO Sampling and Delivery Cannula A dult 10 per box 8957 25 Single Patient Use Adapter w Nasal Sampling and O Delivery Cannula A dult 25 per box 8958 00 Single Patient Use Adapter w Nasal CO Sampling and O Delivery Cannula Pediatric 10 box 8958 25 Single Patient Use Adapter w Nasal CO Sampling and O Delivery Cannula Pediatric 25 box 8908 00 Nafion Dehumidification Tubing 10 per box 5 SENSORS and ACCESSORIES Reusable DB 9 SpO SENSORS 9168 00 SuperBright Finger Sensor with DB 9 connector 3 ft 9169 00 SuperBright Y Sensor with DB 9 connector 3 ft Rev 05 TIDAL WAVE Sp User s Manual 69 Section 9 70 Catalog No Description SINGLE PATIENT USE SpO2 SENSORS AND CABLES 6455 00 6455 25 6480 00 6480 25 Pediatric Adult Single Patient Use SpO Sensor Terminates in DB 9 c
28. STAT sensor Nasal cannula adapter assembly Sampling adapter Cat No 8955 8956 To monitor sampling 8957 or 8958 inlet 4 Ensure that the unit is in sampling mode a Press the S Adapter key to set adapter type b Use the SELECT key until the arrow points to SAMPLING Press the EXIT key to select SAMPLING 5 When SAMPLING has been selected from the ADAPTER menu the sampling pump will turn on when the CAPNOSTAT CO sensor is snapped onto the adapter The sampling adapter requires a zero when the monitor displays CHECK ADAPTER To perform a zero refer to Adapter Zero Procedure on page 22 6 If using a Nasal CO Sampling and O Delivery Cannula attach the O tubing to the administration device and set the device to the prescribed O setting 26 TIDAL WAVE Sp User s Manual Rev 05 Sensors Sensors and Patient Connections 7 Position the cannula on the patient Insert the cannula tips into the nostrils pass the cannula tubing over the ears then slide the retaining sleeve up the tubing toward the neck to a comfortable fit under the chin 8 Check that the connections have been made properly by examining the CO waveform capnogram on the monitor display NOTE If possible position the Sampling Adapter with its windows a vertical and NOT a horizontal position this helps keep moisture from pooling on the windows To prevent rain out and moisture from drai
29. The BaseStation provides RS232 serial communications as supported by the monitor with or without the external power supply connected In addition the BaseStation is capable of providing power to charge a rechargeable battery inside the monitor when used with the external power supply The internal battery will slowly discharge over long periods of non use TIDAL WAVE Sp User s Manual 15 Section 3 Configuration Menus Configuration Menus CONFIGURATION menus are provided on the TIDAL WAVE Sp to allow customizing of various settings To access the CONFIGURATION menus press and hold the key then simultaneously press the key until the first CONFIGURATION menu is displayed Press the PAGE key to move through the menus The SELECT key moves the arrow pointer the parameter chosen will flash Press the EXIT key at any time to return to monitoring mode selections will be saved GAS COMPEHSRTION EDOM AIR gt BB HzO gt 60 ERIT PAGE SELECT 02 WAVEFORM SCALE SMALL MEDIUM tr LARGE EXIT e PAGE SELECT COz WAVEFORM SPEED SLOW MEDIUM tr FAST EXIT e PAGE SELECT HO RESP TIMER 28 E 64 sec ERIT PAGE SELECT EXIT FAGE SELECT ALERT WOLUME DISABLED LEN ERIT PAGE SELECT R5232 INTERFACE HOVACOMM gt SEIKO 414 te RESERUED 1 EXIT PAGE SELECT SMALL MEDIUM t LARGE WAVEFORM FILL UMFILLED FILLED ERIT PAGE SELECT ETCOz AV
30. This page intentionally blank 68 TIDAL WAVE Sp User s Manual Rev 05 Section 9 Accessories TIDAL WAVE Sp Model 710 715 Capnography Oximetry Monitor Catalog No Description 9110 00 TIDAL WAVE Sp Handheld Mainstream Capnograph with Pulse Oximetry Model 710 includes Single Patient Use Adult Airway Adapter 6063 01 Carrying Case 315127 and choice of oximetry sensor Finger 9168 00 or Y sensor 9169 00 9146 00 TIDAL WAVE Sp Handheld Mainstream Capnograph with Pulse Oximetry and Sidestream Sampling Model 715 includes Single Patient Use Adult Airway Adapter 6063 01 Carrying Case 315127 choice of oximetry sensor Finger 9168 00 or Y sensor 9169 00 and Single Patient Use Sampling Adapter with Adult Nasal Sampling Cannula 8955 01 AIRWAY ADAPTERS and ACCESSORIES For monitoring with the CAPNOSTAT sensor 6063 00 Pediatric Adult Single Patient Use Airway Adapters 10 per box 6063 25 Pediatric Adult Single Patient Use Airway Adapters 25 per box 6421 00 Pediatric Adult Single Patient Use Airway Adapters with mouthpiece 10 per box 6421 25 Pediatric Adult Single Patient Use Airway Adapters with mouthpiece 25 per box 6312 00 Neonatal Pediatric Single Patient Use Airway Adapters 10 per box 6312 25 Neonatal Pediatric Single Patient Use Airway Adapters 25 per box 8751 00 CAPNOSTAT Sensor Cable Holding Clips 50 per box SAMPLING ADAPTE
31. Window Mask 1 Select a new Single Patient Use airway adapter Pediatric Adult Cat No 6063 2 Place the adapter onto a mask with a 22 mm connector Fig 4 3 Place the mask on the patient s face and instruct him her to breath normally NOTE If the patient requires low flow oxygen therapy it may be provided by placing the mask over the nasal cannula This will have a minimal effect on measurements Fig 4 Pediatric Adult with Mask 22mm connector CAPNOSTAT CO sensor Te Pediatric Adult Single Patient Use airway adapter Sidestream Sampling Model 715 The Single Patient Use Sampling Airway Adapter Cat No 8954 should be used in conjunction with a nasal sampling cannula to monitor non intubated patients 1 Select a new Single Patient Use sampling adapter 2 Align the arrow on the bottom of the sampling adapter with the arrow on the bottom of the CAPNOSTAT CO sensor and press the sensor and adapter together until they click Rev 05 TIDAL WAVE Sp User s Manual 25 Section 4 CAPNOSTAT Sensor Airway Adapter Setup 3 Connect the nasal cannula sampling adapter assembly to the Sampling Inlet 2 port located on the end of the monitor Cat No Cannula Type 8955 Nasal CO Sampling Cannula Adult 8956 Nasal CO Sampling Cannula Pediatric 8957 Nasal CO Sampling and O Delivery Cannula Adult 8958 Nasal CO Sampling and O Delivery Cannula Pediatric CAPNO
32. any of the parameters are violated with alert limits ENABLED two up or two down JV arrows will replace the parameter indicating whether the violation was above or below the alert limit 34 97 Data Screen RESP PR Wd 96 Indicates respiration rate lower limit violation Setting Alert Limits The alert limits for the monitor can be manually or automatically adjusted To access AUTO ALERTS or SET ALERTS the alert limits must be ENABLED from the Configuration menu See Configuration Menus on page 16 NOTE To configure the monitor with the default limit values power up while pressing and holding the XX Backlight and 4 Alert keys This will cause all parameters to return to their default values Rev 05 TIDAL WAVE Sp User s Manual 47 Section 5 Setting Alert Limits Manually Setting Alert Limits Press the Alert key to access the ALERT menu Press the SET ALERTS softkey to display the SET ALERT LIMITS menu When selected this screen will appear for 3 seconds then automatically return to the previous display 23 ri 37 mmHa AGLT ge Alert Screen AUTO SET ALERTS ALERTS e Using the menu control keys adjust the settings as desired press the SELECT key to move to the desired parameter for adjusting the selected parameter will flash Use the xx Backlight key to decrease la parameter value and the e Adapter key to increase the selected value Maximum and minimum high and low li
33. at may cause entanglement or strangulation e TIDAL WAVE Sp 15 not intended to be used as a primary diagnostic apnea monitor and or recording device e Patient Safety Care should be exercised to assure continued peripheral perfusion distal to the SpO sensor site after application e Inspect the SpO sensor site often for adequate circulation at least once every four hours When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate e Data Validity As with all pulse oximeters inaccurate SpO and Pulse Rate values may be caused by Incorrect application or use of sensor Significant levels of dysfunctional hemoglobin carboxyhemoglobin or methemoglobin Significant levels of indocyanine green methylene blue or other intravascular dyes Exposure to excessive illumination such as surgical lamps especially those with a xenon light source or direct sunlight Excessive patient movement Venous pulsations Electrosurgical interference e The external battery charger should NOT be used to recharge the battery near or in close proximity to patients and or other medical equipment in operation It is intended for use in service areas only i e nurses station biomed lab etc Rev 05 TIDAL WAVE Sp User s Manual 7 Section 2 e Connectio
34. ct the sampling inlet tubing Connect the external power supply and turn the monitor on Allow the sampling pump to operate for several minutes This will help to remove any trapped water Connect a sampling tubing set to the Sampling Inlet Block the open end of tubing with your finger Alternate blocking and unblocking tubing end at least ten times Use a quick brisk motion when blocking and unblocking the tubing Keep the tubing blocked and unblocked for several seconds at a time Repeat the same blocking and unblocking action with your finger on the sampling exhaust o port Allow the sampling system to run for at least 30 minutes without the sampling assembly tubing and the sampling exhaust tubing connected This will speed dry the system pneumatics Once these cleaning and disinfection instructions have been completed normal sampling system operation can be resumed See Sidestream Sampling Model 715 on page 25 for more information Battery Maintenance Ifthe monitor has not been used or powered by the external power supply for an extended time 3 months or more allow the battery to charge before use or replace the battery with a fully charged battery and TIDAL WAVE Sp User s Manual 63 Section 7 Maintenance Schedules continue monitoring The monitor may not power up on battery power if the battery is not sufficiently charged Refer to Battery Life and Recharge Times on page 14 for charging times and instructio
35. ctromagnetic Immunity Conforms to EMC Directive 89 336 EEC 50082 1 1992 Tested to IEC801 3 1984 Radiated Immunity Conforms to Medical Device Directive 93 42 EEC and 60601 1 2 1993 Tested to IEC801 2 1991 ESD IEC801 4 1988 EFT and IEC1000 4 5 1995 Surge Immunity Additional Features e Audible SpO Trend Feature Pitch of Pulse Rate beep tracks the SpO value user selectable volume e Alert Limits Automatic or menu selected high and low limits for ETCO Respiratory Rate SpO and Pulse Rate NO RESPIRATION alert selectable between 20 40 and 60 seconds Visible and audible alerts are immediate e 2 Minute Silence When key is pressed audible alerts are deactivated for two minutes Indicated by yellow 2 minute LED and flashing Lt bell icon e Audio Off Press and hold ES key for 3 seconds to deactivate audible alerts Indicated by flashing yellow Audio Off LED and flashing LA bell icon e Trend Memory 24 hour trend memory capacity battery backed On screen 30 minute trends for ETCO Respiration Rate and SpO Other parameters are stored internally and can be downloaded to a PC e Digital Data Output Serial RS232 connect only to Novametrix approved devices e Sampling System Model 715 Standard Allows gas sampling of non intubated patients e Internal Battery backed Real Time Clock External power supply excluded Rev 05 TIDAL WAVE Sp User s Manual 67 Section 8 Additional Features
36. e Interval ETCO Maximum value Resp Rate Average Inspired CO Maximum value SpO Average Pulse Rate Average Messages Status Messages Status messages indicate conditions that should be corrected or monitored they may or may not be tied to an alert condition These conditions can be a result of a hardware or sensor fault condition Status messages are displayed on the screen in the same manner as alert messages Following is a list of status and alert messages that may appear on the monitor 44 TIDAL WAVE Sp User s Manual Rev 05 Messages Rev 05 System Messages Monitoring Message Description PRESSURE FAULTY The barometric pressure sensor is returning a value which is out of range lt 400 mmHg or gt 800 mmHg The monitor will default to 760 mmHg for calculation purposes Refer servicing to qualified personnel EtCO2 AUTO LIMITS This message is displayed when the monitor has successfully determined and SET set the auto alert limits for SpO and ETCO SpO2 AUTO LIMITS SET RESETTING TO setup and alert settings have just been reset to factory default values FACTORY DEFAULTS ERASING STORED The trends stored in the monitor s memory have been erased TRENDS CHECK CLOCK Time and date may not be properly set The time and date can be adjusted in TIME AND DATE the CONFIGURATION menu by pressing the Xx Backlight key See Configuration Settings on page 17 AUTO POWER OFF
37. e source is too high or low 2 The checksum for the CAPNOSTAT calibration data is wrong 3 The revision of the calibration data in the CAPNOSTAT is not compatible with the software in the TIDAL WAVE Sp Monitor Refer servicing to qualified personnel CAPNO The temperature of the case or detector heater is over 50 C HI TEMP Refer servicing to qualified personnel CAN NOT An error was detected which did not allow the system to zero the ZERO CO2 current adapter being used Refer servicing to qualified personnel CO OUT The detected waveform value is beyond the measurement range of the OF RANGE monitor 0 100 mmHg 0 13 2 or kPa A changing level of CO was detected during an adapter zero procedure Wait 30 seconds and retry CAPNOSTAT sensor has not reached operating temperature while attempting to zero Wait for the sensor to reach operating temperature ADAPTER ZERO IN PROGRESS TIME REMAINING 0 XX An airway adapter zero is in progress XX indicates the number of seconds remaining WARNING CHANGING CO2 UNITS ERASES STORED TRENDS Changing CO units mmHg kPa in the Configuration menu will cause this message to appear Oxygen Saturation Messages Message Description SPO2 LOW The pulse strength as detected by the sensor is too small for proper monitor STRENGTH operation This message will disappear when the problem is corrected INSUFF Sensor is p
38. ection 1 Keypanel Controls and Indicators Page Key Press to set display screen to Data Display waveform plethysmogram trend Respiration trend or SpO trend Press and hold to enter the PRINT SELECTION menu See Printing on page 54 Alert Key When pressed will set the 2 minute silence audible alerts muted for two minutes and displays the SET ALERTS menu If the SET ALERTS menu is not needed it will automatically disappear after 3 seconds For 2 minute silence the ft icon will illuminate for the duration Press again to cancel Press and hold for 3 seconds to disable audible alerts and the LX icon will flash Press and hold again to cancel The Alert Key LED will display the following e Steady yellow audio silenced for 2 min no alert in progress e Flashing yellow audio silenced no alert in progress e Flashing red and yellow alert in progress audio is off or 2 minute silence Audible alerts may be permanently disabled from the Configuration menu Refer to Configuration Menus on page 16 for more information Adapter Key Press to set adapter type adult neonatal or sampling Press and hold for 4 seconds to zero an adapter See Adapter Zero Procedure on page 22 for more information Press to cancel Auto Power Off function 205 Backlight Key Press to turn backlight on off or press and hold to adjust contrast for up down viewing angles and for adjustment due to extreme temperature
39. ed time 3 months or more allow the battery to charge before use or replace the battery with a fully charged battery and continue monitoring The monitor may not power up on battery power if the battery is not sufficiently charged Refer to Battery Life and Recharge Times on page 14 NOTE New batteries or batteries stored for extended periods of time may need to be fully charged and discharged up to five 5 times before performing at full capacity With a new battery or a battery that has not been used for 30 days charge the battery for 24 hours prior to use Serial Communications Power Interface Connector Located on the enclosure rear is a six pin modular contact which provides an RS232 interface as well as a power input for unit operation and battery charging when connected to Novametrix accessories This connector meets the patient safety requirements of the following agencies IEC 601 1 UL544 The BaseStation Cat No 6998 00 is an optional accessory onto which Novametrix hand held monitors can be placed providing a platform for communication support between the monitor and a host computer or printer The BaseStation is meant for table top horizontal not pole mounted vertical applications and can be used anywhere the T DAL WAVE Sp monitor is used including but not limited to the sleep lab ICU anesthesia post anesthesia emergency department respiratory care home care and pre hospital emergency
40. efer to qualified service personnel when battery replacement is required Separate collection Appropriate steps must be taken to ensure that spent batteries are collected separately when disposed of This symbol is found on the internal battery and should not concern the common user Refer to qualified service personnel when battery replacement is required Principle of operation CO TIDAL WAVE Sp uses the CAPNOSTAT CO sensor to measure CO by using the infrared absorbtion technique which has endured and evolved in the clinical setting for over two decades and remains the most popular and versatile technique today The principle is based on the fact that molecules absorb infrared IR light energy of specific wavelengths with the amount of energy absorbed being directly related to the concentration When an IR beam is passed through a gas sample containing CO the electronic signal from the photodetector which measures the remaining light energy can be obtained This signal is then compared to the energy of the IR source and calibrated to accurately reflect concentration in the sample To calibrate the photodetector s response to a known concentration of CO is stored at the factory in the monitor s memory A reference channel accounts for optical changes in the sensor allowing the system to remain in calibration without user intervention 5 gt TIDAL WAVE Sp determines oxygen saturation
41. ient It is secured to the patient using a Y Strip tape foam wrap or ear clip see below The Y Sensor center strip is not a functional part of the sensor Its twofold purpose is to aid in the placement of the sensor into the Y Strip or other securing system and to keep the distance between the sensor heads to no more than 25 mm The center strip may be removed carefully cut away if the distance between the sensor heads needs to be reduced to less than 25 mm Sensor heads X Strip may be removed Rev 05 TIDAL WAVE Sp User s Manual 29 Section 4 SpO Sensors Y Sensor Application using Y Strip Tapes or Foam Wrap Select a Y Strip or foam wrap based on the patient type and intended sensor location Wrap Style Tapes Y Strip tapes are available in two color coded sizes 25 mm tapes have green liners and 20 mm tapes have blue liners The size refers to the distance between the holes in the tape A Catalog No 8828 20mm blue neonatal foot hand pediatric toe finger Catalog No 8829 25mm green neonatal foot hand Finger Style Tapes Catalog No 8831 20mm blue pediatric finger adult finger Catalog No 8832 25mm green adult finger Non Adhesive Foam Wraps X m Qy e Catalog No 8836 Large adult pediatric finger neonatal pediatric foot CELA or hand Catalog No 8943 Small neonatal foot or hand pediatric toe or finger Adhesive Foam Wraps Cata
42. inates indicating external power a monitor is in place and the power supply 268 Canadian Standards Assoc is active SEMKO Sweden VDE Germany E FINKO Finland D DEMKO Denmark The 9220 10 Power Supply is approved by the following regulatory agencies CAUTION Although other connectors may physically fit do not attempt to connect any device other than power supplies approved by Novametrix for use with this device Doing so may damage the TIDAL WAVE Sp and will void the warranty Never sterilize or immerse the monitor sensor or accessories in liquids 12 TIDAL WAVE Sp User s Manual Rev 05 Battery Use Options Preparation for Use Charging NiMH Rechargeable Battery with External Charger In a non patient area connect the adapter to an AC source then plug the adapter jack into the charger Remove the battery from the TIDAL WAVE Sp and insert it into the external charger The battery will be fully charged in approximately 4 5 hours The external charger is for use with the NiMH rechargeable battery pack Cat No 400043 only Refer to the instructions supplied with the charger for additional information NiMH Rechargeable Battery Cat No 400043 Connect adapter Battery is keyed to fit into slot in WARNING external battery charger should NOT be used to recharge the battery near or in close proximity to patients and or other medical equipment in opera
43. it Alert States Within ims fibove lims Histogram Data a oro gr o dor do d 0 v wD l Average Average Min Max Rr ES End of Trend END OF TREND PRINTOUT Tabular Mode Text Printout To start a Tabular Mode Printout Ensure the printer is connected and ready to print 2 Press and hold the Page key to display the Print Options screen 3 arrow pointer will flash beside the currently selected option Press the SELECT key to select TABULAR 4 Press the EXIT key to exit and begin printing 5 PRINTING IN PROGRESS appears Press STOP to terminate printing The printer stops automatically when the printout is complete Rev 05 TIDAL WAVE Sp User s Manual 59 Section 6 Interpreting Printer Output Tabular Data Format Tabular Mode Text Printouts start off with a header refer to previous section followed by one section of text printed at 30 seconds intervals This text includes oxygen saturation pulse rate EtCO respiration rate and inspired in the units set in the monitor s Configuration menus The format of the tabular text line is 55 SPO2 XXX PULSE YYY bpm where HH MM SS is the hour minute and seconds 24 hour format XXX is the displayed saturation value and YYY is the displayed pulse rate NOVAMETRIX MEDICAL SYSTEMS INC TIDAL WAVE SP MONITOR PRINTED 15 20 15 5 1998 PATIENT NAME NOTES TABULAR MODE 15
44. ity of the sensor See Y Sensor Quick Check on page 36 SpO gt Y Strip Tapes and Foam Wraps e Treat Y Strip Tapes and foam wraps in accordance with hospital protocol for single patient use items Ear Clip e Do not immerse the ear clip e Clean the ear clip with a cloth dampened with 70 isopropyl alcohol After cleaning wipe the ear clip down thoroughly with a clean water dampened cloth to rinse CAPNOSTAT Sensor e Clean the sensor surface with a damp cloth e Make certain that the sensor windows are clean and dry Do not immerse CAPNOSTAT CO sensor Do not attempt to sterilize the CAPNOSTAT CO sensor Single Patient Use Airway Adapters e Treat all single patient use airway adapters in accordance with hospital protocol for single patient use items External Sampling System Components Model 715 Nasal Sampling Cannulas and adapters are for single patient use 62 TIDAL WAVE Sp User s Manual Rev 05 Battery Maintenance Maintenance 10 11 12 13 14 Rev 05 Internal Sampling System Components Model 715 Acceptable fluids for cleaning and sterilizing the internal pneumatic parts of the Sampling System include isopropyl alcohol Cidex or equivalent or a 5 25 water solution by weight of sodium hypochlorite bleach CAUTION Do not attempt to pump cleaning sterilizing liquid with the sampling pump This may cause accelerated wear on the pump bearings Alway
45. ivered This is due to the increased viscosity of the medications which may contaminate the sensor windows causing the sensor to fail prematurely e Where electromagnetic devices i e electrocautery used patient monitoring may be interrupted due to electromagnetic interference Electromagnetic fields up to 3V m will not adversely affect system performance e Refer servicing to qualified personnel Indicates points of particular interest or emphasis for more efficient or convenient operation e TIDAL WAVE Sp monitor is intended for operation with Novametrix Single Patient Use airway adapters e Operating the TIDAL WAVE Sp below 50 F 10 C will result in longer warm up time and reduce battery life e Components of this product and its associated accessories which have patient contact are free of latex e Certain rebreathing circuits or the presence of artifacts such as cardiogenic oscillations may cause TIDAL WAVE Sp to react to non respiratory CO fluctuations as if they were breaths This condition affects only the RESP numerical displays the capnogram display continues to provide an accurate picture of the waveform e After the life cycle of our equipment and all accessories has been met disposal of the equipment should be accomplished following the national requirements Contact the local Novametrix representative for questions concerning disposal 8 TIDAL WAVE Sp User s Manual Rev 05
46. l support have the equipment available for product identification and preliminary troubleshooting Novametrix reserves the right to repair or replace any product found to be defective during the warranty period Repair may be provided in the form of replacement exchange parts or accessories on site technical repair assistance or complete system exchanges Repairs provided due to product abuse or misuse will be considered non warranty and invoiced at the prevailing service rate Replaced or exchanged materials are expected to be returned to Novametrix within 10 days in order to avoid additional charges Return materials should be cleaned as necessary and sent directly to Novametrix using the return paperwork and shipping label s provided Transferring return materials to a local sales or dealer representatives does not absolve you of your return responsibility Novametrix manufactures equipment that is generally field serviceable When repair parts are provided the recipient can call Technical Support for parts replacement assistance and repair assurance In the event a replacement part requires increased technical capability Technical Support may request Biomedical assistance provide on site technical support or complete replacement equipment If the customer requires the return of their original product the exchange material will be considered loaner material and exchanged again after the customer equipment is repaired Novametrix
47. laced on a site too thick opaque for adequate light transmission Move LIGHT sensor to a different site PULSE Pulse must be within 30 250 beats per minute inclusive RANG ERR SHIELD Ambient light source sunlight warming lights etc are interfering with sensor SPO2 PRB operation Shield sensor from these light sources SPO2 PRB Remove sensor from use and contact qualified service personnel FAULTY SPO2 BAD Monitor not receiving valid signals from the sensor May be caused by excessive SIGNAL motion cardiac arrhythmia or other situations leading to poor signal CONNECT Sensor not connected to unit SPO2 PRB TIDAL WAVE Sp User s Manual Rev 05 Alerts Monitoring Message Description SPO2 PRB Sensor not on patient OFF PAT MONITOR Remove the monitor from use and contact qualified service personnel FAULTY Alerts Alerts are generated for ETCO respiration rate SpO and pulse rate These alerts occur when the high or low limits for a particular parameter are exceeded There is also an alert when there is a loss of pulse rate or when there is a loss of respiration for a consecutive twenty seconds other limit times may be selected for the NO RESP TIMER see Configuration Menus on page 16 Alert messages are displayed in the message center or in the particular area of the display when they occur For example a RESP 0 message will be displayed in the respiration section of the screen When
48. llustrations WARNING Treat foam wrap in accordance with hospital protocol for single patient use Check site regularly to ensure adequate circulation and proper sensor positioning 34 TIDAL WAVE Sp User s Manual Rev 05 Sensors Sensors and Patient Connections Y Sensor Application using Ear Clip 1 Remove center strip from the Y Sensor Sensor heads 2 Slide each Y Sensor head into the ear clip s receptacles The heads should face each other ee Sensor head EI 9 2 5 Ear clip receptacle Squeeze here to apply gt 4 3 Gently squeeze the end of the ear clip shown in diagram and apply the sensor to the patient Rev 05 TIDAL WAVE Sp User s Manual 35 Section 4 5 gt Sensors If a satisfactory reading cannot be obtained rub the site and or use adhesive dots for better response The adhesive dots Catalog No 8700 included with the ear clips will also help in preventing the ear clip from falling off during exercise for example Adult ear Optional placements WARNING Inspect the site often for adequate circulation at least once every four hours When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate Y Sensor Quick Check 1 With the Y Sensor connected to the monitor but not a
49. log No 6929 Large adult pediatric finger neonatal pediatric foot or hand Catalog No 6968 Small neonatal foot or hand pediatric toe or finger To use Y Strip tapes 1 Remove the portion of the release liner containing the holes Remove release liners with holes Senn 7 BED Wrap style tape Finger style tape 30 TIDAL WAVE Sp User s Manual Rev 05 Sensors Sensors and Patient Connections 2 Omit this step if using the 25 mm Y Strip tape If using the 20 mm Y Strip tape carefully remove the Y Sensor center strip using a pair of scissors or a sharp blade The center strip does not effect sensor operation its purpose is to aid putting the sensor into the 25 mm tape and to keep the distance between the sensor heads at 25 mm 3 Press the button on the back of each sensor head through a hole in the tape Press in from the sticky side of the tape The tape will stretch to fit the sensor button Y Sensor placed on Y Strip tape Liner this 4 Side top AN y Y Strip tape Grose section mz Button 4 Remove the remaining release liner s if applicable and apply the sensor tape to the patient Make certain that the sensor heads are directly opposite each other through the tissue This prevents the sensor from being placed on a site too thick for proper operation Position the sensor so that the tape does not extend over the space between
50. m Wraps Y Sensor placed on foam wrap Center strip removed NOTE If using the first and third holes on the foam wrap it may be necessary to cut the center strip off the Y sensor If you are using an adhesive wrap remove both sides of the release liner Face the blue side of the wrap toward the skin and wrap around the site Velcro tab may be removed and replaced to allow excess foam to be cut as necessary Secure with the Velcro tab WARNING Do not wrap the tape around the limb so tightly that circulation is restricted Inspect the site often for adequate circulation at least once every four hours When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate TIDAL WAVE Sp User s Manual 33 Section 4 5 gt Sensors 3 Ensure the sensor heads are directly opposite each other through the tissue This prevents the sensor from being placed on a site too thick for proper operation B Neonatal hand Neonatal pediatric foot Pediatric toe Adult pediatric finger Adult toe 4 Position the sensor so that the foam wrap does not extend over the spaces between the fingers or toes This ensures no light transmission through this space To maximize sensor life secure the cable along the limb with tape as shown in the i
51. mits are preset for each parameter and cannot be exceeded Also the range between high and low alert limits is restricted to a minimum of five units For example default ETCO settings are high 55 mmHg low 25 mmHg If the user decreases the high setting to 30 mmHg within 5 units of the low setting and continues to lower the setting both high and low settings will decrease maintaining the five unit range Selected parameter Default values are shown will flash NOTE When the monitor is turned off manual alert limit settings will be retained even if AC power and the battery are disconnected Alert Limits Ranges ETCO 150 max 10 min Resp Rate 150 max 5 min SpO 100 max 50 min Pulse Rate 249 max 30 min 48 TIDAL WAVE Sp User s Manual Rev 05 Alert Audio Monitoring Auto Alert Limits To set alert limits automatically press the Alert key and AUTO ALERTS will appear over the Page key Press the Page key and ENABLE AUTO ALERTS will appear Press YES The monitor will automatically set alert limits based on recent patient data 23 LX ri 3 mmHa gf Alert Screen AUTO SET ALERTS ALERTS The screen will display 2 AUTO LIMITS SET 5 2 AUTO LIMITS SET messages Press CONTINUE to return to the previous screen If auto alert limits cannot be determined for one or both limits the message
52. n of an external device e g printer or computer to the RS232 serial port on the BaseStation may compromise patient safety CAUTIONS Indicates a condition that may lead to equipment damage or malfunction e Federal U S A law restricts this device to sale distribution or use by or on the order of a licensed medical practitioner e Use only an external power supply approved by Novametrix for use with this device Use of any other power supply may damage the TIDAL WAVE Sp and void the warranty e Donotoperate TIDAL WAVE Sp or its accessories when it is wet due to spills or condensation Donot operate TIDAL WAVE Sp if it appears to have been dropped or damaged e Keep TIDAL WAVE Sp and its accessories clean e Inspect the integrity of the TIDAL WAVE Sp and its accessories prior to use e Never sterilize or immerse the monitor sensor or accessories in liquids e Do not sterilize or immerse sensors except as directed in this manual e Do not apply excessive tension to any sensor cable or pneumatic tubing e Do not store the monitor or sensors at temperatures less than 14 F 10 C or above 131 F 55 e Do not operate the monitor or sensors at temperatures below 50 F 10 or above 104 F 40 e Ifa Single Patient Use Sampling Adapter becomes occluded replace and discard the adapter e Itis recommended that the CAPNOSTAT CO sensor be removed from the circuit whenever an aerosolized medication is del
53. nected to the Seiko DPU 414 Thermal Printer RESERVED 1 and RESERVED 2 Novametrix use WAVEFORM FILL Unfilled Filled Select the desired appearance of the capnogram waveform Unfilled AVERAGING 1 Breath 10 sec 20 sec INST Select the interval from which the displayed value of end tidal ETCO is calculated 10 sec SpO gt AVERAGING 2 sec 8 sec Select the interval from which the displayed value of oxygen saturation SpO is calculated 8 sec ALERT LIMITS Disabled Enabled Enable or disable the Alert Limits function Select the desired high and low alert limits by exiting the CON FIGURATION menu and pressing the A Alert key Disabled PULSE BEEP VOLUME Off Low High Select the desired volume of pulse beep Note that care should be taken to set the volume level above ambient noise levels OFF RESP TREND SCALE Small Medium Large Select the desired size of the respiration trend waveform Medium AUTO POWER OFF Enabled Disabled Selects automatic shut off of unit if no signal is detected to conserve battery power Enabled 18 TIDAL WAVE Sp User s Manual 05 Configuration Menus Rev 05 Preparation for Use The following parameters are accessed by pressing Xx from one of the previous Configuration menus Press X to move through the menus SET TIME AND DATE Press the 24 hour format Day
54. ning into the Sampling Adapter do NOT place the Sampling Adapter in a gravity dependent position f a Single Patient Use Sampling Adapter becomes occluded replace and discard the adapter SpO Sensors CAUTION Connect only Novametrix SpO sensor extension cables and or SuperBright SpO sensors to the TIDAL WAVE Sp Do not use other SpO sensors or accessories with TIDAL WAVE Sp Before connecting to the patient or to the monitor ensure that sensor extension cables and or sensors are physically intact with no broken frayed or damaged components 1 Plug the connector into the end panel SpO sensor input The sensor connector is keyed to fit into the input in only one direction Model 710 SuperBright series DB 9 connector Model 715 The connector clicks into place when properly seated Sensors may be connected or removed whether or not the monitor is turned on Rev 05 TIDAL WAVE Sp User s Manual 27 Section 4 SpO Sensors Finger Sensor The reusable Finger Sensor is intended for adult or appropriate size pediatric fingers and is not designed for neonatal applications 3 enr Finger sensor 1 Gently squeeze the grips at the rear of the sensor indicated by arrows below Cable exits above finger Placement guide 2 Position fingertip against placement guide with fingernail toward the red light Do not position the finger so as to
55. ns Maintenance Schedules When the monitor powers up a self test is performed which checks the internal electronics of the monitor If this self test fails remove the monitor from use and contact qualified service personnel The monitor should undergo routine inspection and safety checks on a quarterly basis or according to hospital protocol The TIDAL WAVE Sp Service Manual Catalog No 9110 90 9146 90 contains procedures and safety test instructions component parts lists circuit diagrams theory of operation and other information to assist qualified service personnel in servicing the monitor The internal battery will slowly discharge over long periods of non use 64 TIDAL WAVE Sp User s Manual Rev 05 Section 8 Specifications General Specifications for the Novametrix TIDAL WAVE Sp Monitor Model 710 715 are listed for informational purposes only and are subject to change without notice Capnograph e Principle of Operation Non Dispersive Infrared NDIR absorption dual wavelength ratiometric single beam optics e Sensor Type Mainstream no gas sample drawn from breathing circuit e Initialization Time Capnogram in 15 seconds full specifications in 60 seconds e Response Time 60 ms e Gas Compensation Room Air O gt 60 N50 gt 60 Operator selectable in configuration screen e Barometric Pressure Compensation Automatic range 400 800 mmHg CAPNOSTAT CO Sensor and Airway Adapter Weight
56. oe eee bib ei nS 41 Monitoririg Moge irte t tete EE etes re totg e ete EE dv ert 41 ScreeniDIsplays bci e RE eui Po CHEER in i ERE 42 Messages tbe eter da ae S edd Eee tie 44 Alertes ec 47 Setting Alert Limitada 47 O 49 Capnogram Sample Waveforms and Interpretations 50 Reference Handbooks 444440 5 0 51 Printing and RS232 Options 53 Power RS232 Serial Port Communications 2 53 Printing zo eie tetti i oe C tete oed ta eb t uet eti cedit 54 Interpreting Printer Output nennen nennen nnne nnns 57 iD Le 61 Cleaning and Sterilization 2 0 242 1 10 eene 61 Battery Maintenance Eee Ae er ei dio 63 Maintenance Schedules sse enne ennt 64 Specifications nui uui deii 65 GONG Vall 65 Capnograph REN 65 2 cet duet Get id 66 Pulse Rate lt 2 di e re ct E ru anas 66 Monitor Specifications 67 Additional Features 67 A
57. onnector 10 per box Pediatric Adult Single Patient Use SpO Sensor Terminates in DB 9 connector 25 per box Neonatal Pediatric Single Patient Use SpO Sensor Terminates in DB 9 connector 10 per box Neonatal Pediatric Single Patient Use SpO Sensor Terminates in DB 9 connector 25 per box Y STRIP TAPES FOAM WRAPS and EAR CLIPS for use with the Y Sensor 8828 00 8829 00 8831 00 8832 00 8836 00 8943 00 6929 00 6968 00 6131 50 6131 25 8700 20mm Wrap Style Y Strip Taping System 100 per box Use on neonatal foot and hand or on pediatric toe or finger 20mm tapes use Blue color coded liners 25mm Wrap Style Y Strip Taping System 100 per box Use on neonatal foot and hand 25mm tapes use Green color coded liners 20mm Finger Style Y Strip Taping System 100 per box Use on pediatric finger or on small adult finger Omm tapes use Blue color coded liners 2 25mm Finger Style Y Strip Taping System 100 per box Use on adult finger 25mm tapes use Green color coded liners Non Adhesive Foam Wraps 25 per box For use with Y Sensor Neonatal Pediatric Non Adhesive Foam Wraps 25 per box For use with Y Sensor Adhesive Foam Wraps 25 per box For use with Y Sensor Neonatal Pediatric Adhesive Foam Wraps 25 per box For use with Y Sensor Ear Clips For use with Y Sensor 5 per box Ear Clips For use with Y Sensor 25 per box Adhesive Dot
58. ot erase the data and return to the CO2 UNITS menu Select the correct unit or press D to EXIT EtCO and Respiration Rate Trend Screen Previous data discarded as new data Current data trend is stored graph starts here 29 rr Trend icon indicates f mmHa HDLT 9 Indicates EtCO that trend screen is Respiration Rate trend displayed Thirty 30 minutes of data are displayed moving from right to left on the screen Each data point represents 16 8 seconds Rev 05 TIDAL WAVE Sp User s Manual 43 Section 5 Messages SpO Trend Screen Previous data Status messages are displayed here discarded as new data is stored Current data trend Trend icon indicates graph starts here that trend screen is displayed 798 In addition to on screen trends the TIDAL WAVE Sp has internal battery backed trend memory that stores EtCO respiration rate SpO and pulse rate calculated parameters for 24 hours at an eight second resolution The chart below describes the storage interval for each parameter Stored parameter values can be downloaded transferred to a PC and viewed using the optional NovaCARD software or printed on the Seiko DPU 414 Thermal Printer See Printing and RS232 Options on page 53 for more information To erase stored trends press and hold both Xx and Ep keys after pressing the key to power the monitor on Trending Storag
59. p User s Manual Rev 05 Section 6 Printing and RS232 Options Power and RS232 Serial Port Communications Two serial communications modes are available for the Model 710 715 the Seiko DPU 414 Printer or the NovaCOMM Interface designed to output data in formats easily read by a computer or data logging device The monitor must be placed in the BaseStation PN 6998 00 to use either serial communication mode Located on the BaseStation is a six pin modular contact which provides RS232 interface as well as a power output for unit operation and battery charging when connected to Novametrix hand held monitors This connector meets the patient safety requirements of IEC 601 1 and UL544 When the monitor is placed within the BaseStation contact is made between the 6 pin connector in the BaseStation and the Features connector on the bottom of the monitor This connection is transferred to the RS232 Serial Port connector on the BaseStation Features connector BaseStation 6 pin connector WARNING Patient safety may be compromised if an external device e g printer or computer is connected to the RS232 serial port on the BaseStation Rev 05 TIDAL WAVE Sp User s Manual 53 Section 6 Printing The RS232 Serial Port 9 D connector allows connection to a host computer or printer RS232 Serial Port for optional Serial Cable Power input jack Downloading Data to a
60. pplied to patient position the sensor heads so that they face each other the red light shines at the detector Is SPO2 PRB OFF PAT displayed 2 the Y Sensor to your index finger Does the monitor show reasonable SpO and pulse rate values 3 A YES to BOTH 1 and 2 indicates that the sensor is working properly Apply the sensor to the patient as instructed above The quick check is also a functional test of the extension cable 36 TIDAL WAVE Sp User s Manual Rev 05 Sensors Sensors and Patient Connections Single Patient Use SpO Sensors Select a Y Strip or foam wrap based on the patient type and intended sensor location Single Patient Use Pediatric Adult Sensor Catalog No 6455 CR The single patient use SpO sensor can be used when monitoring adult or pediatric patients with Novametrix Pulse Oximeters SuperBright gt series Single Patient Use Neonatal Pediatric Sensor Catalog No 6480 e The single patient use SpO sensor can be used when monitoring neonatal or pediatric patients with Novametrix Pulse Oximeters SuperBright series WARNING Use the Single Patient Use sensor and DB 9 extension cable only with Novametrix SuperBright compatible pulse oximeters Use with any other device may result in equipment damage or patient injury CAUTION These SpO sensors are intended for single patient use The sensors can be reapplied to various sites on
61. pproximately 8 cc of deadspace Neonatal Pediatric Single Patient Use Airway Adapter Catalog No 6312 For intubated patients with endotracheal tube diameters no more than 4 mm Adds approximately 5 cc of deadspace Sampling Adapter Single Patient Use Catalog No 8954 For monitoring non intubated patients with nasal cannulas For monitoring pediatric tracheostomy patients Setting Adapter Type The TIDAL WAVE Sp uses three types of disposable Single Patient Use adapters Adult Pediatric Neonatal and Sampling Press the D Adapter key to access the adapter menu then the SELECT key to move the arrow pointer to the correct type The selected adapter type is displayed in the message area in the center of the display screen Rev 05 TIDAL WAVE Sp User s Manual 21 Section 4 Adapter Zero Procedure mmHa RDLT ge HD 1 AFTER PE If the adapter type placed on the CAPNOSTAT sensor does not match the currently selected adapter type a CHECK ADAPTER message will appear If the adapter type is correct see the Adapter Zero Procedure on page 22 Adapter Zero Procedure An adapter zero allows the monitor to accommodate the optical characteristics of each different type of adapter Before zeroing verify the selected adapter type is correct and the adapter setting is correct NOTE This procedure is to be performed with a new unused single patient use adapter only Perform
62. protrude past the placement guide 3 Release the finger grips WARNING Inspect the site often for adequate circulation at least once every four hours When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate 4 To remove sensor gently squeeze grips and slide the sensor from the finger 28 TIDAL WAVE Sp User s Manual Rev 05 Sensors Sensors and Patient Connections CAUTION Overstretching the pulse oximeter finger sensor can damage the sensor and potentially affect pulse oximeter readings Do not stretch the finger sensor open beyond the limit for which it was designed Overstretching can be prevented avoid opening the sensor by any means other than squeezing the grips DO NOT force the sensor onto large objects such as a bedrail Finger Sensor Quick Check 1 s SPO2 PRB OFF PAT displayed when the sensor is connected to the monitor but not applied to the patient 2 Apply the sensor to your index finger Are reasonable SpO and pulse rate values displayed 3 A YES to BOTH 1 and 2 indicates that the sensor is OK Apply the sensor to the patient as instructed above The quick check is also a functional test of the extension cable Y Sensor The reusable Y Sensor is a flexible sensor designed for use on any pat
63. ram based on the printed portion of trend memory is printed after the graphical data for all trend printouts Total Elapsed Time Time trending was active the total time covered by the printout Non Monitoring Time Total time spent in a non monitoring condition Limit Alert Status Percent of monitoring time spent above below and within the parameter alert limits as shown on the printout Histogram Data A numerical and graphical display of the percentage of monitoring time non monitoring time excluded spent in each of the ranges listed Note that some time but less than one percent of the total time can be spent in any category 58 TIDAL WAVE Sp User s Manual Rev 05 Interpreting Printer Output Printing and RS232 Options Average Min and Max The minimum and maximum recorded parameter values are printed Average refers to the most often recorded value and not the mathematical mean of all readings End of Trend Printout Message shows Histogram is a part of the Print Trend feature m HISTOGRAM Total Elapsed Time Total Elapsed Time 00 98 24 Non monitoring Time Non menitovine Time 00124243 ETCO2 mmHa uM Below lims Within 1 5 EtCO or 5 gt E UE lims gt 71 1 64 71 9 56 63 0 48 55 25 4D 47 75 32 39 0 24 31 0 16 23 0 8 15 0 1 7 0 Average 47 Min 44 Max 77 Resp Rate or Pulse Rate RESP RATE br min gt Below lims Lim
64. re icon Displayed when performing an adapter zero and the sensor is not at operating temperature Waveform Icon CO detected icon Displayed when selecting an adapter zero and the monitor detects breaths v Heart Icon Pulse detected icon Displayed when SpO sensor is attached to patient and the monitor detects a pulse Lung Icon Breaths detected icon Displayed when CAPNOSTAT CO sensor is attached to patient and breaths are detected TIDAL WAVE Sp User s Manual 3 Section 1 Connections and Labeling DB 9 5 sensor connection Endview Model 710 CO sensor connection DC input Io Rearview Sideview Model 710 715 RS232 connection and external power Battery compartment Mee Y 4 TIDAL WAVE Sp User s Manual Sampling system input Model 710 715 input from BaseStation Connections and Labeling Sampling system outpu Endview Model 715 05 Principle of operation General Description Rev 05 Symbols Patient isolation Identifies connection as type BF AN Attention Consult manual for detailed information Sampling System Gas output Sampling System Gas input 6 DC input Connect external power supply to this port Use Novametrix external power supply Catalogue number 9220 10 Recyclable item This symbol is found on the internal battery and should not concern E 7 common user R
65. rged green battery low flashing yellow The LED on the keypanel flashes red when the monitor is powered by its internal battery and approximately 5 minutes remain The monitor will sound an audible alert then when the battery is depleted turn itself off This alert can only be silenced by connecting the external supply or turning the monitor off The NiMH battery pack should be replaced or the TIDAL WAVE Sp BaseStation Cat No 6998 00 or external power supply Cat No 9220 10 should be connected to recharge the battery rechargeable batteries only and power the monitor See Battery Life and Recharge Times on page 14 NOTE When the battery is low red blinking battery LED Es on keypanel the monitor has shut down SpO functions Connect to AC power as soon as possible TIDAL WAVE Sp User s Manual 9 Section 3 Battery Use and Options NOTE The battery life indicator may not reflect the true battery status upon power up for approximately 30 seconds The battery life indicator is inactive when the monitor is powered by the BaseStation or the external power supply Battery Use and Options Removing and Installing the Battery Grasp the finger grips on each end of the battery cover Squeeze together and pull so that the cover opens to reveal the internal battery the cover is hinged on the bottom of the case Remove the battery from the monitor Finger grip
66. rmation The type of printout Tabular Trend is then identified Trend Printout To create a Trend Printout from the graphical or histogram trend display 1 Ensure the printer is connected and ready to print 2 Press and hold the Page key to display SELECT PRINT OPTIONS menu 3 arrow pointer will flash beside the currently selected option Press the SELECT key to select TREND 4 Press the EXIT key to exit and begin printing 5 PRINTING IN PROGRESS appears Press STOP to terminate printing The printer stops automatically when the printout is complete Graphical Data A graphical depiction of trend memory is printed after the header for all Trend printouts Column A and B Information The next two lines refer to Columns A and B in the printout Column A represents the monitor s audible alarm status A mark black bar in this column indicates that the audible alarms were silenced during this portion of the printout Column B shows marks where Events were added to trend memory Data Scales The data scales are printed and dotted lines within the data section correspond to the major divisions shown on the scale lines Data Ratio The line following the data scales shows the date the recording was initiated and the data ratio The data compression ratio depends on the type of printout selected For example one dot on the printout may correspond to 8 or 64 seconds Alert Limit Settings Following the data ratio and ju
67. rt secure the cable along the limb with tape An extension cable Cat No 9174 00 1s available for use with the disposable sensors WARNING Do not wrap the sensor around the limb so tightly that circulation is restricted Inspect the site often at least every four hours for adequate circulation When applying sensors take note of patient s physiological condition For example burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate Single Patient Use SpO Sensor Quick Check 1 With the sensor connected to the monitor but not applied to patient position the sensor heads so that they face each other the red light shines at the detector Is SPO2 PRB OFF PAT displayed on the screen 2 Attach the Single Patient Use sensor to your index finger Does the monitor show reasonable SpO and pulse rate values 3 YES to BOTH 1 and 2 indicates that the sensor is working properly Apply the sensor to the patient as instructed above This quick check is also a functional test of the extension cable TIDAL WAVE Sp User s Manual 39 Section 4 SpO Sensors This page intentionally blank 40 TIDAL WAVE Sp User s Manual Rev 05 Section 5 Monitoring Display of Data The TIDAL WAVE Sp measures and displays EtCO respiration rate saturation and pulse rate Until valid data is received for any parameter that parameter
68. ry The audible alert volume can be adjusted or disabled from the CONFIGURATION menu Press the Xx Backlight and D Adapter keys simultaneously then the 8 Page key until the ALERT VOLUME menu appears NOTE Make sure that the audible alert volume is not set too low to be heard over ambient noise levels Capnogram Sample Waveforms and Interpretations Normal The normal capnogram is a waveform that represents the varying CO level throughout the breath cycle Rebreathing Elevation of the baseline indicates rebreathing may also show a corresponding increase in EtCO Obstruction Obstructed expiratory gas flow is noted as a change in the slope of the ascending limb of the capnogram the expiratory plateau may be absent an Endotracheal tube in the esophagus eo 50 TIDAL WAVE Sp User s Manual Rev 05 Reference Handbooks Monitoring Inadequate seal around endotracheal tube The downward slope of the plateau blends in with the descending limb Accidental extubation dj Reference Handbooks For a discussion on waveform interpretations refer to the Novametrix Reference Handbooks on capnography respiratory mechanics and pulse oximetry Contact Novametrix Customer Service or your local sales representative for more information Rev 05 TIDAL WAVE Sp User s Manual 51 Section 5 Reference Handbooks This page intentionally blank 52 TIDAL WAVE S
69. s 250 per box EXTENSION CABLES FOR SpO SENSORS 9174 00 9175 00 9180 00 4 5 Foot Extension Cable DB 9 to DB 9 Receptacle 4 5 Foot Extension Cable DB 9 to OxySnap 6 Inch Adapter Cable DB 9 to Hypertronics Receptacle POWER SUPPLY OPTIONS 6998 00 9220 10 6862 00 400050 400043 400049 TIDAL WAVE Sp User s Manual BaseStation External Power Supply and or computer cable not included External DC Power Supply power cord not included AA Lithium Battery Pack requires 7 batteries AA Lithium Battery 7 required NiMH Rechargeable Battery Battery Charger w AC Adapter Universal Input Voltage for type DR30 NiMH battery Power cord included Hev 05 05 Catalog No Accessories Description MISCELLANEOUS 140084 315127 6065 00 600026 600075 9086 00 9140 00 400052 300017 608 1 00 8364 10 9110 9146 90 Pole shelf mount kit Transport Pouch NovaCARD for Windows Data Archive Software 3 2 diskette Power Cord N America only Cable BaseStation to Personal Computer with 9 pin connector Cable BaseStation to Seiko DPU 414 Printer Seiko DPU 414 Thermal Printer w Battery AC Adapter for Seiko DPU 414 Printer 120 VAC Thermal Printing Paper Seiko DPU 414 5 rolls per box Gas regulator for use with precision gas mixture Cat No 8364 10 Precision gas mixture for validation Service Manual T DAL WAV
70. s flush liquids with a syringe as described in the following instructions To clean and disinfect the pumping system Turn the monitor off and disconnect the external power supply if connected Remove both the sampling inlet tubing set and the sampling exhaust tubing if any Attach an exhaust port line 1 8 inch or 3 16 inch I D tubing from the Sampling Exhaust o port to a suitable container located below the bottom level of the monitor Use a 60 cc catheter tip syringe Fit it to the Sampling Inlet 2 connector Flush the sterilizing solution slowly through the pumping system Push the entire 60 cc of solution through the Sampling Inlet Repeat this process two more times to use total of 180 of solution Remove the syringe and leave the cleaning sterilizing fluid within the sampling pump system for 30 minutes to disinfect the system Follow sterilant manufacturer s instructions for disinfection After 30 minutes fill the syringe with distilled water and flush the system three times Allow the cleaning disinfection solution and distilled water to drain through the Sampling Exhaust o output Push several syringes of air slowly through the system to ensure that most of the liquid has been drained Follow this with at least three more syringes of distilled water followed by at least two more syringes of air to make sure that most of the distilled water has been drained Remove the syringe from the unit Do not conne
71. st before the actual data are the alert limit settings Both the pulse rate and saturation scales have two triangle shaped markers that represent the upper and lower alert limit settings as shown the monitor s display Dashed lines extend from these markers down into the data section of the printout If the alert limits were changed during the time the printed data was originally collected the new alert limits will be printed with a message indicating that the limits were changed Rev 05 TIDAL WAVE Sp User s Manual 57 Section 6 Interpreting Printer Output Data Section The data is printed based on the ratio A time stamp is placed at regular intervals and appears as a horizontal line printed between the scales NOVAMETRIX MEDICAL SYSTEMS INC TIDAL WAVE SP MONITOR PRINTED AT 15 22 15 SEP 1998 PATIENT NAME Denotes either EtCO NOTES Denotes either RESP RATE Trend or Pulse Rate Ios Eie Tend or 5 2 for SpO2 Trend TREND PRINTOUT OL AUDIO STATUS IS AUDIY OFF CAL B EVENT MARK an 5 16 UEM STARIS RTT og 14 F Columns A and B BED e Data Scales E enm i 15756071938 j 14 42 1 ix Data Ratio Alert Limit Settings i ej BING STARTS wise tes ss LC 7 Ly Data Section ES Histogram Data A histog
72. the same patient but should not be used on multiple patients Do not attempt to clean or disinfect the sensor as system performance will be compromised NOTE The Single Patient Use sensor should be discarded if sensor integrity becomes questionable Rev 05 TIDAL WAVE Sp User s Manual 37 Section 4 SpO Sensors Single Patient Use Sensor Application 1 Select the appropriate size sensor based on the patient type Connect the DB 9 connector to the TIDAL WAVE Sp rear panel connector Pediatric adult sensor z Adult toe Adult finger Neonatal pediatric sensor Neonatal hand Neonatal foot Pediatric toe 2 To apply the sensor place the blue side of the sensor wrap against the skin wrap it around the site and secure with Velcro tab The Velcro tab on the neonatal pediatric version is removable to allow the foam wrap to be cut before applying to the patient Neonatal pediatric sensor is Reattach Cut Velcro tab 0 x Velcro is a registered trademark of Velcro USA Inc 38 TIDAL WAVE Sp User s Manual Rev 05 SpO Sensors 05 Sensors Patient Connections Make certain that the sensor heads are positioned directly opposite each other through the tissue The adhesive dots Catalog No 8700 which are included with each sensor can be applied to the sensor before patient application for additional adhesion to the site 3 For additional suppo
73. this procedure only if the CHECK ADAPTER message persists or if deemed necessary by qualified personnel Do not perform this procedure while the CAPNO WARMING Model 710 message is displayed Do not perform this procedure while the adapter is connected to a breathing circuit mouthpiece or mask on a patient The pediatric adult neonatal and sampling adapters must be zeroed independently ensure that the proper adapter type is selected Attach the selected adapter type to the CAPNOSTAT CO sensor Select the adapter type pediatric adult neonatal or sampling to be zeroed by pressing the e Adapter key to access the adapter menu Press the SELECT key to move the arrow pointer to the correct type of adapter and confirm the selection with the gy EXIT key Press and hold the D Adapter key for five seconds to enter the zero menu WARNING Zeroing with the incorrect adapter type will cause incorrect readings Zeroing the wrong adapter type on the wrong adapter setting will cause incorrect readings Do not zero the CAPNOSTAT sensor without a single patient use adapter attached Incorrect readings or no readings will result 22 TIDAL WAVE Sp User s Manual Rev 05 Adapter Zero Procedure Sensors and Patient Connections 3 With all sources of CO away from the adapter including the patient s and your own exhaled breath press the ZERO key to begin the procedure or 4 CANCEL to exit 2
74. tion It is intended for use in service areas only i e nurses station biomed lab etc NOTE With a new battery or a battery that has not been used for 30 days or more charge the battery for 24 hours prior to use e When powered by the external power supply or the BaseStation the TIDAL WAVE Sp will not overcharge a rechargeable battery monitor may not operate on battery power if the battery is not sufficiently charged e Dispose of batteries in accordance with local laws Rev 05 TIDAL WAVE Sp User s Manual 13 Section 3 Battery Use and Options AA Lithium Batteries To power TIDAL WAVE Sp from AA lithium batteries insert seven disposable batteries Energizer L91 or equivalent into the optional Battery Case Cat No 6862 00 following the polarity markings on the Battery Case Standard AA lithium batteries 7 ea disposable WARNING Batteries can explode leak or catch on fire if heated or exposed to fire or high temperatures Do not mix battery types e g disposable and rechargeable AA batteries Battery Life and Recharge Times Configuring the monitor to turn off unused functions will result in longer battery life The following table lists battery operation times with Sampling pump off Model 710 715 Sampling pump on Model 715 for each mode 5 CO or SpO See Monitoring Mode on page 41 Power source
75. tube elbow and the circuit wye with its window in a vertical position NOTE In a pediatric or neonatal ventilator s circuit the elbow may not be present Fig 2 2 Besure the airway adapter is positioned vertically and located so that patient secretions and condensate water will flow AWAY from the adapter s windows not through or into it 3 Snapthe CAPNOSTAT CO sensor onto the airway adapter 4 CO waveform or EtCO trend EtCO values and respiratory rate should be displayed on the monitor Fig 1 Pediatric Adult Single Patient Use airway adapter Cat No 6063 CAPNOSTAT Wye CO sensor Patient connector pediatric adult Fig 2 Neonatal Single Patient Use airway adapter Cat No 6312 CAPNOSTAT CO sensor Patient connector neonatal 24 TIDAL WAVE Sp User s Manual Rev 05 CAPNOSTAT Sensor Airway Adapter Setup Sensors and Patient Connections Spontaneously Breathing Non Intubated Patients Mouthpiece 1 Select an airway adapter with mouthpiece Cat No 6421 Fig 3 2 Snap the CAPNOSTAT CO sensor onto the airway adapter 3 Instruct the patient to breath normally through his her mouth while keeping a tight seal around the mouthpiece NOTE It has been reported in the literature that the presence of a mouthpiece may alter a patient s breathing pattern This usually has a minor impact on EtCO Fig 3 Pediatric adult with mouthpiece Cat No 6421
76. using sensors that contain red and infrared 660 and 940 nanometer light sources called light emitting diodes LEDs The light energy from each LED is beamed through a tissue sample a pulsating vascular bed such as the patient s finger or toe The remaining light energy not absorbed by the tissue sample reaches a photodiode light receptor in the sensor Oxygen saturated blood absorbs TIDAL WAVE Sp User s Manual 5 Section 1 Principle of operation different amounts of light at each wavelength as compared to desaturated blood Therefore the amount of light absorbed by the blood in each pulse can be used to calculate oxygen saturation The TIDAL WAVE Spis calibrated to display functional saturation This differs from the fractional saturation value displayed by most co oximeters Functional saturation is defined as 100 COHb METHb Functional Saturation HbO Fractional Oxyhemoglobin COHb Carboxyhemoglobin METHb Methemoglobin This can be considered to represent the amount of oxyhemoglobin as a percentage of the hemoglobin that can be oxygenated Dysfunctional hemoglobins COHb and METHb not included in the measurement of functional saturation Pulse Rate is calculated by measuring the time interval between peaks of the infrared light waveform The inverse of this measurement is displayed as pulse rate The oxygen saturation and pulse rate values are updated once each second Presence of a
77. variations Indicators Fe Battery Alert Indicator Illuminates when the unit is on battery power Green battery is fully charged slow flashing yellow battery power is low approximately 20 minutes of operation remains Fast flashing red battery is exhausted approximately 5 minutes of operation remains The battery alert indicator is off when external power is connected Refer to AC Battery Operation on page 9 for information on connecting AC power and charging the battery e AC Power Indicator Illuminated green when the monitor is connected to an AC power source e g the external power supply 9220 10 or the BaseStation PN 6998 00 while powered by the external power supply 2 TIDAL WAVE Sp User s Manual Rev 05 Keypanel Controls Indicators General Description Rev 05 Icons The icons listed below may appear on the display screen when the TIDAL WAVE Sp is in use LA Alert Silence Icon Audible alerts silenced IE 2 Minute Silence Icon Audible alert silenced for two minutes Jut Alert Limits Disabled Icon Alert limits disabled Select ENABLED or DISABLED in the CONFIGURATION menu Airway Adapter Icon Indicates adapter key e Time Date Icon Set time date Press XX from the CONFIGURATION menu to set time and date Backlight Icon Indicates backlight key Trend Screen Icon Displayed beside any Trend screen Temperature Icon Sensor not up to temperatu
78. written permission from Novametrix Medical Systems Inc Rev 05 0086 TIDAL WAVE Sp User s Manual iii TIDAL WAVE Sp User s Manual Rev 05 05 Contents General Description siccecceeccetscecestinceseeescentecennteeecnseenstceceenceienseeeecuobteeceaeetececesccerestenseeee 1 Indication Tor Use aa et tenter e end tet d 1 Keypanel Controls and Indicators 2 24 1 0 1 Connections and Labeling crust ins ette tne een giae 4 operation ten tq et tg hes P 5 Lii cq I LT MEE 7 Preparation for Use 9 AG Battery Operation coi reiecit rte tems 9 Battery Status and Alerts eene nennen nennen 9 Battery Use and Options 2 2 eee e pt Ec ied ees 10 Configuration Menus sse eene nnne enr sentent enn nnne 16 Sensors and Patient Connections 1 ennt 21 Adapter Types Available asioina E E NEATA nnne 21 Setting Adapter Type ice cet etie e ra tie edat ee 21 Adapter Zero Procedure 2 244 nennen nennen nennen 22 CAPNOSTAT CO2 Sensor and Airway Adapter Setup 24 SPOs SONSOMS RR UR I Dt EO CR pecie duds 27 Monitoring A A desee 41 Display ot Datacenter e
79. y for 3 seconds to access the SELECT PRINT OPTION menu Press the 4 SELECT key to move the arrow pointer to the correct option CO Trend SpO Trend and Tabular mode text printouts are available SELECT PRINT OPTION CO2 TREND SpO2 TREND wy TABULAR S CANCEL EXIT SELECT E Configuring the Seiko DPU 414 Printer The Seiko DPU 414 Thermal Printer Cat No 9140 00 must be configured to communicate with the TIDAL WAVE Sp When properly configured the Seiko printer will retain the settings even when turned off Top view Rear view D SERIAL PARALLEL CT M DPU 414 THERMAL PRINTER Serial connection AC adapter OFF LINE PAPER END ON LINE FEED On Off switch The printer must be configured to the following settings Input Serial Printing Columns 40 Data Length 8 bits Printing Speed High User Font Back up ON Data Parity No Auto Loading ON Character Select Normal Parity Condition Odd Auto LF OFF Zero Normal Busy Control H W Busy Setting Command Enable International Character Set U S A Baud Rate Select 9600 bps Printing Density 100 Information about the correct DIP switch settings can be found in the Seiko DPU 414 Thermal Printer Operation Manual included with your printer Rev 05 TIDAL WAVE
80. yed on the various screens in the following sections Rev 05 TIDAL WAVE Sp User s Manual 41 Section 5 Screen Displays Screen Displays The last screen used will automatically appear on power up with the exception of the Trend screens Data Screen The Data screen displays End Tidal respiration rate oxygen saturation and pulse rate in larger easy to read text without waveforms A pulse bar that is proportional to the signal strength appears in the lower right corner indicating the patient s pulse a breath bar in the lower left corner indicates the patient s inhaled and exhaled breaths Selected gas compensation displayed here 0 O or units Status messages are displayed here blank if set to room air balance Oxygen perfusion SpO gt displayed here EtCO value 17 97 AGLT x Pulse rate Respiration rate RESP displayed here n d 25 B Pulse bar Breath bar CO Waveform Screen Capnogram Respiration rate units Status messages are displayed here Selected gas compensation displayed here N2O or TT Pulse rate blank if set to room air displayed here balance Oxygen perfusion EtCO value 5 displayed here Capnogram scale upper Capnogram CO waveform number flashes if CO is Indicates CO be filled or unfilled and sweep off scale waveform screen Speed is selectable NOTE The capnogram sweep speed is automatically adjusted when switching modes

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