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Passport 8 and 12 Operators Manual

1. Item Name an General OR ICU NICU CCU User Defaults Alarm T On Alm Lev Med TB High 9C 39 0 TB Low 9C T id 36 0 Comp Const i 0 542 Auto TI i Auto Manual TI 9C 2 0 Measuring mode ui Manual C 1 9 CO O M Item Name F General OR ICU NICU CCU User Defaults Alarm fg On Alm Lev Med Operating Mode Measure Sweep id 16 25 mm s Scale mmHg 150 ones Delay Adu Ped 20 Neo 15 RR Source Auto Sidestream CO Setup Adu 120 ml min Flow Rate Ped 100 ml min Neo 70 ml min BTPS Compen a Off N20 Compen 0 O2Compen 21 50 21 Des Compen x 0 Microstream CO Setup BTPS Compen Off Max Hold 120s Auto Standby min We i Mainstream CO Setup Max Hold 1105 O2 Compen Off Balance Gas Room Air AG Compen PE O C 10 Passport 12 Passport 8 Operator s Manual Alarm Limits Adu Ped 50 EtCO High mmHg ee Neo 45 Adu Ped 25 EtCO Low mmHg pe Neo 30 FiCO High mmHg Adu Ped Neo 4 Adu Ped 30 RR High o Neo 100 Adu Ped 8 RR Low A X Neo 30 C 1 10 AG M Item Name ai General OR ICU NICU CCU User Defaults Alarm So pe On Alm Lev Xo qm Med Sweep St AS 6 25
2. 1 Equipotential Grounding Terminal When using the monitor together with other devices connect their equipotential grounding terminals together to eliminate the potential differences between them 2 ACPower Input 3 Parameter Module Slot Used for connecting the parameter modules Passport 12 Passport 8 Operator s Manual 2 7 4 Multifunctional Connector Outputs defibrillator synchronization signals nurse call signals and analogy output signals 5 Reserved for future use 6 USBConnectors Connects a USB disk for data or configuration transfer 7 Network Connector A standard RJ45 connector which connects the monitor to CMS or other monitor for remote view It also connects the monitor to PC for system upgrade 8 VGA Connector Connects a secondary display which extends the display capability of your monitor The contents displayed on the secondary display screen accords with those displayed on the monitor screen 2 4 Modules 1 ee xw a ow E Ci oo 0 0 R p j 1 2 3 4 5 6 1 IBP module contains IBP cable connector 2 Sidestream CO module contains CO watertrap connector and CO gas outlet 3 IBP C O module contains IBP cable connector and C O cable connector 4 IBP C O sidestream CO module contains IBP cable connector
3. Tubing Type Patient Category Part No Adult pediatric infant 6200 30 09688 Reusable Neonate 6200 30 11560 Reusable Cuff Limb Circumference Bladder Width Model Patient Category Measurement Site Part No cm cm Large adult long 35 5 to 46 0683 15 0007 01 Adult long 27 5 to 36 5 0683 15 0006 01 CM1201 Child 10 to 19 9 2 0683 15 0001 01 rm CM1202 Small adult 18 to 26 12 2 0683 15 0002 01 CM1203 Adult 24 to 35 15 1 0683 15 0003 01 CM1204 Large adult 33 to 47 18 3 0683 15 0004 01 CM1205 Thigh Thigh 46 to 66 22 5 0683 15 0005 01 Single Patient Cuff Patient Limb Circumference Bladder Width Model Measurement Site Part No Category cm cm CM1500A 3 1 to 5 7 2 2 001B 30 70692 CM1500B 4 3 to 8 0 2 9 001B 30 70693 Neonate CM1500C 5 8 to 10 9 3 8 001B 30 70694 CM1500D 7 1 to 13 1 4 8 001B 30 70695 Arm CM1501 Child 10 to 19 7 2 0683 14 0001 01 CM1502 Small adult 18 to 26 9 8 0683 14 0002 01 CM1503 Adult 25 to 35 13 1 0683 14 0003 01 CM1504 Large adult 33 to 47 16 5 0683 14 0004 01 CM1505 Adult Thigh 46 to 66 20 5 0683 14 0005 01 Large adult 35 5 to 46 0683 14 0007 01 long Adult long 27 5 to 36 5 0683 14 0006 01 Passport 12 Passport 8 Operator s Manual 27 3 27 4 Temp Accessories Temp Cable Type Model Remark Part No Extension cable reusable MR420B Applicable to sensor MR411 and MR412 0011 30 37391 TEMP adapter cable 2 pi
4. 17 6 TZ 6 Changing the Anesthetic Agent rtr HH NERONE URS ER EUR SIE rece eH te eroe rt eed gt 17 6 17 7 Measurement Limitations oc ecesssessssessseesssssssessssssssessssssssessssssssssssessssessscsssesssssssssssssssssesssesssessssesssessssessseessssssseesssssssesssesssesssesse 17 7 17 8 Troubleshooting esee ree ee e RR etel Eve PE Eee eee e Ee ih 17 7 17 8 1 When the Gas Inlet is BlOCKEC eessssssssessscssssssecsssesescevsesesensnsessenesssseseesnseseccesnsseseesnseseanesnesesersnsesecsesnessceessnessacenneeeesenneseesens 17 7 17 8 2 When an Internal Occlusion OCCULS essscsssesssecsssessscssseessecsssecsecssseessscssseesscsssesssecssnessecsnsessescssseeesssneeseesssneesssssnsesseeasneeeesens 17 7 17 8 3 When an Internal Occlusion Occurs niii 17 7 17 9 Removing Exhaust Gases from the System csssssssssscsssessssssecssssecessseccssscessnsesesssecssssccesusccesnsecssuseeesasecssnsesesusecssusecesnseessaecesneeeesaes 17 8 18 Freezing MUEVE LL RRRRRRRRRRRRRRRRRRRRERRRRE dso nossodaiece nda oeba ocos eos tesos e rekose s n e sosai ossei Soobe ss tesao osssoeaa soso 18 1 Passport 12 Passport 8 Operator s Manual 7 18 1 Freezing Wavefof M Siinses 18 1 18 2 Viewing FrOZEM Waveforfns jt ee T EEE E EE the E E ie 18 1 18 3 Unfreezirig WavefotM Sreser E EAA EEEN EAE EAA EEEE etie rere eO eue Lema ete 18 2 18 4 Recording Frozen Waveforims ssscssssccssssccssss
5. 12 1 Introduction IAE MIL 12 3 Measurement LimitatlOns oet trit ere hte eei en ite eet Ir eene ea bee eek iet see tese ie ere tete ad 12 2 12 4 Measurement Methods iaissessissscisscsssssnassssssiasseasssnsssesecsaiscasennass sebiassassnsasssscosaiseastavazoaasoiaaeqassaanvocssscaaeqascasaveasaciavasastanazocassenusasnnsazsasndiane 12 2 12 5 Setting Up the NIBP Measurement ssrscccssssssccsscczasscestuscosasssecdesesstveesccssecnenslesteascsonseasansssteass E EE R E os 12 3 12 524 Preparing the Patleht iur ERR rti eir tree perire EU caus cvanacsbavengconscanneeseranasccndentenvaragaecontegaceauees 12 3 12 5 2 Preparing TO Measure NIBP iinsert eade aee estre pd quedes decet eee deerat eres 12 3 12 5 3 Starting and Stopping Measurements sssccssssccssesscsssecssseescsnsecesseccssusssecssecssnecsesusecessseeesuscsesusecesseecesasecssneeescnsecesseeessneees 12 4 12 5 4 Correcting the Measurement if Limb is not at Heart Level 0 esssssccssesccsssecssnsesesstecssnessesssecssnsecssnsccesssecssnsceesnseesssees 12 4 12 5 5 Enabling NIBP Auto Cycling and Setting the Interval ssssssssscsssssccssesscsssecsssesecsusecssseeesuseecsuecssnssccsaecesneeeesnsecssaees 12 4 12 5 6 Starting a STAT MeasureMent ssssccsssssesccssssssscenesesssesnesssssessssecssecossesssscenecsssscsnecsssscsnessessesnsseesseenssesssecencessseceneessnscenesssneess 12 4 12 6 Understanding the NIBP NUMELICS ssscssssscsssseccsseesesuseccss
6. Passport 12 Passport 8 Operator s Manual 1 2 Monitoring NIBP 12 1 Introduction The patient monitor uses the oscillometric method for measuring the non invasive blood pressure NIBP This measurement can be used for adults pediatrics and neonates Automatic non invasive blood pressure monitoring uses the oscillometric method of measurement To understand how this method works we ll compare it to the auscultative method With auscultation the clinician listens to the blood pressure and determines the systolic and diastolic pressures The mean pressure can then be calculated with reference to these pressures as long as the arterial pressure curve is normal Since the monitor cannot hear the blood pressure it measures cuff pressure oscillation amplitudes Oscillations are caused by blood pressure pulses against the cuff The oscillation with the greatest amplitude is the mean pressure This is the most accurate parameter measured by the oscillometric method Once the mean pressure is determined the systolic and diastolic pressures are calculated with reference to the mean Simply stated auscultation measures systolic and diastolic pressures and the mean pressure is calculated The oscillometric method measures the mean pressure and determines the systolic and diastolic pressures As specified by IEC 80601 2 30 NIBP measurement can be performed during electro surgery and discharge of defibrillator NIBP diagnostic signi
7. Donotadd unnecessary force to the thermal head Passport 12 Passport 8 Operator s Manual 2 2 Printing 22 1 Printer The monitor can output patient reports via a connected printer The monitor supports the following printer W HP LaserJet 1505n W HP LaserJet P2035n W HP LaserJet P4015n W HP LaserJet Pro 400 M401n401dn W HP LaserJet 600 M602 The reports specifications are W Paper A4 Letter W Resolution 300 dpi For more details about the printer see the document accompanying the printer With product upgrades the monitor may support more printers without prior notice will be given If you have any questions or doubt about your printer contact our company 22 2 Connecting a printer To print the reports or the trend data of a patient you can choose either E the local printer Connect the printer and the monitor directly with a network cable and then start printing what you want W theCMS If your monitor is connected to a CMS it is recommended to use the CMS for printing Passport 12 Passport 8 Operator s Manual 22 1 22 3 Setting Up the Printer To set the printer s properties select Main Menu Print Setup gt gt Printer Setup gt gt In the Printer Setup menu you can W Select a connected printer Select Printer and then select a connected printer as the monitor s printer NOTE e If Panorama is selected in Factory Maintenance the Central Station option
8. The analog output feature is seldom applied in clinical applications You can contact your service personnel for more details 23 2 Exporting the Log The monitor stores system status information including failures abnormity and technical alarms into the log You can export the log to a USB disk To export the log 1 Connecta USB disk to the monitor s USB connector See section 2 3 3 Rear View for the proper location of the USB connector 2 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Others gt gt 3 Select Export Log 23 3 Transferring Data You can transfer the patient data saved in the monitor to a PC via a crossover network cable or within a LAN for data management review or print 23 3 1 Data Export System You must install the data export system on the intended PC before performing the data transfer operation Refer to the document accompanying the installation CD ROM for installation instructions The data transfer feature supports patient management data review data format conversion print etc in addition to data transfer Refer to the help file of the system software for more details Passport 12 Passport 8 23 1 23 3 2 Transferring Data by Different Means NOTE Never enter the data transfer mode when the monitor is in normal operation or performs monitoring You must re start the monitor to exit the data tra
9. Inject solution rapidly and smoothly Inject at end of expiration 15 2 Passport 12 Passport 8 Operator s Manual 15 4 Setting Up the C O Measurement WARNING Use only accessories specified in this manual Make sure that the accessories never come into contact with conductive parts To set up the C O measurement 1 Connect the CO cable to the C O connector on the monitor 2 Interconnect the C O module catheter and syringe as shown below Make sure that The module is securely inserted The PA catheter is in place in the patient The C O cable is properly connected to the module Injectate C O module CO cable Syringe PA catheter Balloon inflation port Ice water NOTE The above picture illustrates when using a TI sensor PN 6000 10 02079 The connection may be different if other TI sensors are used 3 Select the C O parameter window to enter the C O Setup menu Check if the height and weight are appropriate for your patient Change if necessary Passport 12 Passport 8 Operator s Manual 15 3 4 Inthe C O Setup menu Check that the correct computation constant is entered Refer to the Instruction for Use of pulmonary artery catheter to determine the Comp Const according to the entered injectate volume and temperature To change the computation constant select Comp Const and then enter the correct value When a new catheter is use
10. NOTE The calculation feature is independent of other monitoring functions and can be therefore used for patients being monitored by other monitors Any operation in a calculation window does not affect the patient monitoring by the local monitor Passport 12 Passport 8 Operator s Manual 20 1 20 2 Dose Calculations 20 2 1 Performing Calculations To perform a dose calculation 1 2 Select Main Menu Calc gt gt Dose gt gt or select Calculations QuickKey Dose gt gt Select Patient Cat and Drug Name and then select the appropriate settings The dose calculation program has a library of commonly used drugs of which Drug A through Drug E are for those not specified in this library DrugA B C D E Isuprel Aminophylline Lidocaine Dobutamine Nipride Dopamine Nitroglycerin Epinephrine Pitocin Heparin The system gives a set of default values when the above steps are finished However these values cannot be used as the calculated values The user must enter values following the doctor s instructions and only then can the calculated values be used Enter the patient s weight Enter other values Verify if the calculated values are correct 20 2 2 Selecting the Proper Drug Unit Each drug has its fixed unit or unit series Among a unit series one unit may change to another automatically depending on the entered value The units for each d
11. Perform the measurement in a well ventilated environment Passport 12 Passport 8 Operator s Manual 17 1 17 2 Understanding the AG Display The AG module can send waves and numerics for all measured anesthetic gases for display on the monitor including W CO O2 N20 and AA waves W awRR airway respiratory rate W MAC minimum alveolar concentration W End tidal Et and fraction of inspired Fi numerics for CO2 O2 N20 and AA Where AA represents Des desflurane Iso isoflurane Enf enflurane Sev sevoflurane or Hal halothane The AA waveform area displays the primary anesthetic gas s waveform When O2 module does not exist no O2 waveform will be displayed When O2 module exists the O2 waveform will be displayed only when the O2 waveform is currently switched on WARNING To avoid explosion hazard do not use flammable anesthetic agent such as ether and cyclopropane for this equipment 17 3 MAC Values Minimum alveolar concentration MAC is the minimum concentration of the agent in the alveoli It is a basic index to indicate the depth of anesthesia The standard ISO 21647 defines MAC as this alveolar concentration of an inhaled anesthetic agent that in the absence of other anesthetic agents and at equilibrium prevents 5096 of patients from moving in response to a standard surgical stimulus Minimum alveolar concentration MAC values are listed below Agent Des Iso Enf Sev Hal N2
12. Bandwidth Monitor mode 0 5 to 40 Hz 3dB reference frequency 10Hz Surgical mode 1 to 20 Hz ST mode 0 05 to 40 Hz QRS delay lt 25 ms in diagnostic mode and non paced Sensitivity 1V mV 5 PACE rejection enhancement Pace enhancement Signal amplitude Voh22 5V Pulse width 10ms 5 Signal rising and falling time lt 100us IBP Analog Output For Passport 12 only Bandwidth 3dB reference frequency 1Hz DCto 40 Hz Max transmission delay 30 ms Sensitivity 1 V 100 mmHg 5 Nurse Call Signal High level 3 5 to 5 V providing a maximum of 10 mA output current Amplitude Low level 0 5 V receiving a maximum of 5 mA input current Rising and falling time 1ms Defib Sync Pulse Output impedance 1000 Max time delay 35 ms R wave peak to leading edge of pulse High level 3 5 to 5 V providing a maximum of 10 mA output current Amplitude Low level 0 5 V receiving a maximum of 5 mA input current Pulse width 100 ms 10 Rising and falling time 1 ms Alarm output Network connector Alarm delay time from the monitor to remote equipment The alarm delay time form the monitor to remote equipment is x2 seconds measured at the monitor s signal output connector A 5 Data Storage Trends Trends 120 hours at 1 min resolution Mid length trends 4 hours at 5 s resolution Minitrends 1 hour at 1 s resolution
13. 8 2 8 3 4 Checking Paced Status ER RI tle diee reete ee e erede tere deretur 8 3 84 Understanding the ECG DISplay s tette tte pe petes eere tees eel eee asse AU Eee REDE 8 4 8 5 Changing ECG Settings eenia eere AERE eee Eee ree ene tne eee eter 8 5 B25 1 Accessing Ra a CR a AaS Oto 8 5 8 5 2 Setting Pacemaker Rate For Mortara ECG algorithm only ssssscsssssccssesscsssscsssscecsseecssusccssssecesueecssueeesnsecesneecssneeeesaee 8 5 Passport 12 Passport 8 Operator s Manual 8 5 3 Choosing the Alarmi SOUC Emesis ianiai 8 5 8 5 4 Changing ECG Wave SettingS sssscsssssssssssscssssscsseccsssecssssssesssecsssssessnsccessseccsssecesusecssnsscesssecesssceesasecesuscessnsecesuseessnseeesnseeesneeeseee 8 5 8 55 Changing the ECG Filter Settings i2 ee E a LU EPA Aa 8 6 8 5 6 Setting Pacemaker Rate For Mortara only ssssssssssscsssssccsseesssssecsssecessseccssuecessuessnseecssuecsssueesssecessuecessueceessecesnseecsaneessnnensee 8 6 8 5 7 Setting th ECG Lead S etsisi 8 6 8 5 8 Choosing an ECG Display Screen iain a EE E EEE EEn 8 6 8 5 9 Setting the Notch Filter sieur pareti eee b EE etes RR Pob AEEA EO ELER EEE AEE 8 7 8 5 10 Changing the Pacer Reject Settings essssscssssccssecssssscesssecssssseesssecsssusecsssececssecssssecesssecsssscecsssecesssecssneccesnseessnueecsn
14. Screen Setup Screen Layout gt gt W Check that the parameter is turned on in Parameters Switch window CAUTION Unallocated parameters in the Screen Setup window will not display However the monitor still sounds alarms for these parameters 3 6 Passport 12 Passport 8 Operator s Manual 3 10 Displaying the Timer To display the timer in the main screen 1 Select Main Menu Screen Setup gt gt Screen Layout gt gt to access the Screens window 2 Select Screen Setup tab 3 In Area C select Timer from the drop down list of the desired parameter area Refer to section 3 9 Setting the Screen 4 Select 7X to exit the window The main screen will display the timer 00 05 00 Start Clear Setup W Select Start or Pause to start or pause timing W Select Clear to clear current timing result W Select Setup to access the Timer Setup window in which you can set the Direction to Up or Down If you select Down you should set Run Time h min s The available time range is 0 to 100 hours and the default time is 5 minutes Reminder Vol During the last 10 seconds of the countdown the system issues reminder tone The available volume range is 0 to 10 0 means off and 10 the maximum volume Run Time h min s 0 715 10 Reminder Vol 2 3 11 Changing General Settings This chapter covers only general settings such as language brightness
15. A time indicating your current position is displayed at the top of the waveform area Numeric measurement values corresponding to the cursor location are displayed in the parameter area and change as the cursor is moved You can change the ECG wave gain by selecting Gain and then selecting the appropriate setting You can change the waveform sweep speed by selecting Sweep and then selecting the appropriate setting By selecting the Record button you can print out the first three waveforms and measurement numerics by the recorder By selecting or beside the Event button you can position the cursor between events 19 6 Passport 12 Passport 8 Operator s Manual 20 Calculations 20 1 Introduction The calculation feature is available with your monitor The calculated values which are not directly measured are computed based on the values you provide Your can perform the following calculations m Dose calculations W Oxygenation calculations W Ventilation calculations W Hemodynamic calculations W Renalcalculations To perform a calculation select Main Menu Calc gt gt or the Calculations QuickKey and then select the calculation you want to perform WARNING After the calculation is finished verify the entered values are correct and the calculated values are appropriate We assume no responsibility for any consequences caused by wrong entries and improper operations
16. W Select Cancel during a measurement to cancel the measurement Selecting it after a measurement deletes the measured results W Select Record to print out the curves selected for average calculation numerics and averaged values by the recorder W Select Setup gt gt to access the C O Setup menu E Select Calc 2 Hemodynamic gt gt to access the Hemodynamic Calculation menu The system can automatically adjust the X axis scale range to 30 s or 60 s and Y axis scale range to 0 5 C 1 0 C or 2 0 C CAUTION Starting a measurement without blood temperature being stable may cause measuring failure NOTE During a cardiac output measurement blood temperature alarms are inactive Pleasereferto the Instructions for Use of the pulmonary artery catheter to determine the Comp Const and the volume of injectate Passport 12 Passport 8 Operator s Manual 15 5 15 5 Measuring the Blood Temperature As shown below the blood temperature is measured with a temperature sensor at the distal end of the catheter in the pulmonary artery During C O measurements blood temperature alarms are suppressed to avoid false alarms They will automatically recover as soon as the C O measurements are completed Pulmonary artery PA catheter Balloon Right atrium Sensor Right ventricle 15 6 Changing C O Settings 15 6 1 Setting the Temperature Unit Select Unit Se
17. 48 mmHg 48 mmHg 48 mmHg remains the same remains the same remains the same remains the same Same as the Same as the default Same as the FiCO2 N A N A default alarm limitjalarm limit measurement range awRR x 0 5 or 6 awRR 10 or 30 awRRx1 50r30 awRR 25 or85_ Adult pediatric 6 to awRR rpm whichever is rpm whichever is rpm whichever is rpm whichever is 55 greater greater smaller smaller Neonate 10 to 90 7 8 Passport 12 Passport 8 Operator s Manual Low alarm limit High alarm limit Auto alarm limits Module Parameter Adult Adult Neonate Neonate range pediatric pediatric EtCO AG same as CO module FiCO AG awRR x 0 5 or 6 awRR 100r30 awRRx1 50r30 jawRR 25o0r85 jAdult pediatric 6 to awRR rpm whichever is rpm whichever is rpm whichever is rpm whichever is 55 greater greater smaller smaller Neonate 10 to 90 AG FiAA Same as the Same as the Same as the Same as the default Same as the EtAA default alarm limit default alarm limit default alarm limit alarm limit measurement range FiO2 Same as the Same as the Same as the Same as the default Same as the EtCO default alarm limit default alarm limit default alarm limitjalarm limit measurement range FiN20 Same as the Same as the Same as the Same as the default Same as the EtN20 default alarm limit default alarm limit default alarm limitjalarm limit measurement range Adult Adult Same as the C O BT N A
18. Alarms Print review Realtime waves Depends on the selected waveforms Select Main Menu Print Setup gt gt Realtime Reports gt gt Print 22 2 Passport 12 Passport 8 Operator s Manual 22 5 Stopping Report Printouts To stop report printouts select Main Menu Print Setup gt gt Stop All Reports 22 6 Setting Up Reports 22 6 1 Setting Up ECG Reports You can print ECG reports only from the full screen or half screen To set up ECG reports select Main Menu Print Setup gt gt ECG Reports gt gt Amplitude set the amplitude of the ECG waveforms Sweep set the wave print speed to 25 mm s or 50 mm s Auto Interval if Auto Interval is set to On the system will automatically adjust the space between waveforms to avoid overlapping Gridlines choose whether to show gridlines 22 6 2 Setting Up Tabular Trends Reports To set up tabular trends reports select Main Menu Print Setup gt gt Tabular Trends Reports gt gt Start time you can set a time period whose trend data will be printed out by setting From and Back For example if you set From as 2007 4 2 10 00 00 and Back as 2 h the outputted data will be from 2014 4 2 08 00 00 to 2014 4 2 10 00 00 In addition the Back can be set to either Auto if Report Layout is set to Time Oriented the report will be printed by time If Report Layout is set
19. Calc gt gt Oxygenation gt gt or select Calculations QuickKey Oxygenation gt gt 2 Enter values for calculation 3 Selectthe Calculate button The system performs a calculation per the current settings and displays the calculated values Ifa calculated value is outside the range its background will highlight in yellow You can select Range to view its normal range in the unit field Invalid values are displayed as Passport 12 Passport 8 Operator s Manual 20 3 In the Oxygenation Calculation window you can E Change the pressure unit Hb unit and oxygen content unit by selecting Press Unit Hb Unit and OxyCont Unit and then selecting the appropriate settings The changes take effect automatically W Trigger a recording by selecting the Record button The displayed oxygenation calculations are printed out by the recorder W Review the previously performed calculations by selecting Review 20 3 2 Entered Parameters Abbreviation Unit Full spelling CO L min cardiac output FiO 96 percentage fraction of inspired oxygen PaO mmHg partial pressure of oxygen in the arteries PaCO mmHg partial pressure of carbon dioxide in the arteries SaO 96 arterial oxygen saturation PvO mmHg partial pressure of oxygen in venous blood SvO2 venous oxygen saturation Hb g L hemoglobin CaO ml L arterial oxygen content CvO ml L veno
20. Parameter alarms 100 alarms and manual events and related parameter waveforms The waveform recording length can be 8s 16s or 32s A 4 Passport 12 Passport 8 Operator s Manual Arrh events 100 arrhythmia events and relate waveforms and parameters The waveform recording length can be 8s 16s or 32s NIBP measurements 1000 sets Full disclosure waveforms 48 hours at maximum The specific storage time depends on the waveforms stored and the number of stored waveforms A 6 Wireless Network Standards IEEE 802 11b g n support Wi Fi IEEE 802 11n supports 2 4 GHz only Code error of wireless layer 100 ppm Priority All communication data types shall have the same priority Transmission delay Total delay of data transmission from the monitor to the CMS lt 2s Delay of configuration settings transmission from CMS to the monitor lt 2s measured from configuring on CMS to the settings take effect on the monitor Roaming Network switchover is automatically executed when the monitor moves from the coverage area of one AP to that of another AP System capacity Number of the monitor supported by a single AP is 16 Each monitor can communicate with the CMS Dynamic networking stability The monitor meets its functional requirements when it moves at a rate of no more than 3 75 m s within a 15 m non blocking linear distance
21. To avoid inaccurate pressure readings the monitor requires a valid zero Zero the transducer in accordance with your hospital policy at least once per day Zero whenever E Anewtransducer or adapter cable is used W You reconnect the transducer cable to the monitor W The monitor restarts W You doubt the readings Passport 12 Passport 8 Operator s Manual 14 1 To zero the transducer 1 Turn offthe stopcock to the patient Monitor 2 Ventthe transducer to the atmospheric pressure by turning on the stopcock to the air 3 Inthe setup menu for the pressure e g Art select Art Zero gt gt Zero During zero calibration the Zero button appears dimmed It recovers after the zero calibration is completed To zero all IBP channels select Zero IBP hotkey and then select Zero All Channels in the pop up menu 4 After the zero calibration is completed close the stopcock to the air and open the stopcock to the patient NOTE Your hospital policy may recommend that the ICP transducer is zeroed less frequently than other transducers 14 4 Setting Up the Pressure Measurement To set up the pressure measurement 1 Plug the pressure cable into the IBP connector 2 Prepare the flush solution 3 Flush the system to exhaust all air from the tubing Ensure that the transducer and stopcocks are free of air bubbles WARNING If air bubbles appear in the tubing system flush the syst
22. 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Alarm Setup gt gt to enter the Alarm Setup menu 3 Select Alarm Sound and then select ISO Mode 1 or Mode 2 NOTE Useror factory default configurations have no impact on the alarm tone pattern setup The alarm tone pattern remains unchanged after the monitor restarts 7 4 5 Setting the Reminder Tones When the alarm volume is set to zero or the alarm tone is silenced or turned off the monitor issues a periodic reminder tone To set the reminder tones 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Alarm Setup gt gt to enter the Alarm Setup menu Toswitch the reminder tones on or off select Reminder Tones and and then select On or Off Toset the interval between reminder tones select Reminder Interval and then select 1min 2min or 3min In addition you can set the volume of alarm reminder tones To set the volume of alarm reminder tones select Main Menu Alarm Setup gt gt Others or the Alarm Setup QuickKey Others Then select Reminder Vol and then select High Medium or Low Passport 12 Passport 8 Operator s Manual 7 5 7 5 Understanding the Alarm Setup Menu Select the Alarm Setup QuickKey or Main Menu Alarm Setup gt gt to enter the Alar
23. B 1 Handle 3 Recorder 5 Temp probe 1 connector 7 SpO cable connector for 9 NIBP cuff connector Battery compartment Parameter module slot Temp probe 2 connector ECG cable connector Passport 12 Passport 8 Operator s Manual 2 5 2 3 3 Rear View Passport 12 1 AC Power Input 2 Equipotential Grounding Terminal When using the monitor together with other devices connect their equipotential grounding terminals together to eliminate the potential differences between them 3 Parameter Module Slot Used for connecting the parameter modules 4 USB Connectors Connects a USB drive for data or configuration transfer 5 Multifunctional Connector Outputs defibrillator synchronization signals nurse call signals and analogy output signals 2 6 Passport 12 Passport 8 Operator s Manual 6 Network Connector A standard RJ45 connector which connects the monitor to the central station CMS or other monitor for remote viewing It also connects the monitor to a PC for a system upgrade 7 VGA Connector Connects a secondary display which extends the display capability of your monitor The contents displayed on the secondary display screen matches what displays on the monitor screen Passport 8
24. 0 to 10096 N20 0 to 100 Des 0 to 30 Measurement range Sev 0 to 30 Enf 0 to 30 Iso 0 to 30 Hal 0 to 30 awRR 2 to 100 rpm Resolution o M awRR 1 rpm Gases Range ret Accuracy ass Oto 1 0 1 1to5 0 2 CO 5to7 0 3 7to 10 0 5 gt 10 Not specified 0 to 20 2 N20 20 to 100 3 Full accuracy Oto 25 1 O2 25 to 80 2 80 to 100 3 0to1 0 15 1to5 0 2 5 to 10 0 4 Des 10 to 15 0 6 15 to 18 1 gt 18 Not specified Passport 12 Passport 8 Operator s Manual Otol 0 15 1to5 0 2 Sev 5to8 0 4 gt 8 Not specified 0to 1 0 15 Enf Iso Hal 1to5 0 2 gt 5 Not specified 2 to 60 rpm 1 rpm awRR gt 60 rpm Not specified Accuracy drift Meet the requirement for measurement accuracy within 6 hours Apnea alarm time 10s 15 s 20 s 25 s 30 s 35 5 405 Refreshing rate 1s Response time Using the DRYLINE water trap and neonatal DRYLINE sampling line 2 5m 120 ml min 90 ml min 70 ml min CO2 s4S s lt 45s lt 55s N20 lt 4 2 s lt 5s lt 5 55 O 4s 55s 6s Hal Iso Sev Enf 445 5 25 6s Des lt 4 4 s 55s 6s Using the DRYLINE water trap and adult DRYLINE sampling line 2 5m 200 ml min 150 ml min 120 ml min CO lt 4 2 s lt 4 8 s lt 5 55 N20 lt 4 3 s lt 55 lt 5 8 s O2 lt 4s lt 4 6 s lt 5 55 Hal Iso Sev Enf Des lt 4 5 s lt 5 25 65s Anesthetic agent
25. 1 On Extreme Tachy Alarm Passport 12 Passport 8 Operator s Manual C 3 Item Name Algorithm General OR ICU NICU CCU User Defaults C M Extreme Brady Alarm X Alarm Off Asystole Alm Lev High VFib VTac High Alm Lev Vtac Alm Lev High Vent Brady Alm Lev High Extreme Tachy Alm High Lev Extreme Brady Alm High Lev VT22 Alm Lev Low Pause Alm Lev Low Couplet Alm Lev Prompt PVC Alm Lev Prompt Irr Rhythm Alm Lev Prompt PNP Alm Lev Prompt PNC Alm Lev Prompt Missed Beats Alm Prompt Lev X Alm Lev Med X Alm Rec Off PVCs min Off On Alarm RonT Alarm Off On Vent Rhythm Alarm Off On Bigeminy Alarm 1 Off On Trigeminy Alarm Off On Asystole Alarm On Mortara VFib Alarm On VTac Alarm On X Alarm On Asystole Alm Lev High VFib Alm Lev High VTac Alm Lev High VT gt 2 Alm Lev lLow C 4 Passport 12 Passport 8 Operator s Manual Item Name Algorithm General OR ICU NICU CCU User Defaults C M Couplet Alm Lev Prompt PVC Alm Lev Prompt Irr Rhythm Alm Lev Prompt
26. 3 Yes to apply the data in your monitor to the new patient or No to clear any previous patient data Enter the Patient Category and Paced Status for the new patient and then select Ok 4 3 Querying and Obtaining Patient Information The monitor can obtain patient information from Hospital Information System hereafter called HIS through the eGateway To query or obtain patient information from the HIS 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Network Setup gt gt Gateway Comm Setup gt gt and set IP Address and Port Set ADT Query to On Then select Ok 2 Selectthe patient information area to enter the Patient Demographics menu 3 Select Obtain Patient Info gt gt to enter the Obtain Patient Information menu 4 Input a query condition and then select Query The monitor displays the requested patient information 5 Selecta patient and then click Import to update the corresponding patient information 6 Select 7X toexitthe Obtain Patient Information menu NOTE The option Obtain Patient Information is available in the Patient Setup menu only when ADT Query is set to On When obtaining patient information from the HIS only patient information is updated on the monitor The patient s physiological data is not changed and the patient is not discharged 4 4 Associating Patient Information After
27. 3 After warm up is finished you can perform CO measurements CAUTION The watertrap collects water drops condensed in the sampling line and therefore prevents them from entering the module To avoid blocking the airway empty the watertrap container whenever half full Dispose of accumulated fluids in accordance with hospital policy or your local regulations The watertrap has a filter preventing bacterium water and secretions from entering the module After long term use dust or other substances may compromise the performance of the filter or even block the airway In this case replace the watertrap It is recommended that you replace the watertrap once a month or when the watertrap is found leaky damaged or contaminated Do not apply adult watertrap to the neonate patient Otherwise patient injury could result NOTE To extend the life of the watertrap and module disconnect the watertrap and set the CO module operating mode to the Standby mode when CO monitoring is not required Passport 12 Passport 8 Operator s Manual 16 3 16 3 2 Making a Microstream CO Measurement Connect the sampling line to the module and then connect the CO components as shown below After warm up is finished you can perform CO measurements Connector for sampling line Sampling line y 16 4 Changing CO Settings 16 4 1 Accessing CO Menus By selecting the CO parameter window you can access
28. AaDO2 mmHg alveolar arterial oxygen difference PAO2 PaO Pa FiO2 mmHg oxygenation ratio 100 x PaO FiO a AO 96 arterial to alveolar oxygen ratio 100 x PaO2 PAO MV L min minute volume TV x RR 1000 Vd ml volume of physiological dead space TVx 1 PeCO PaCO Vd Vt physiologic dead space in percent of tidal volume 100 x Vd TV VA L min alveolar volume TV Vd x RR 1000 20 5 Hemodynamic Calculations 20 5 1 Performing Calculations To perform a hemodynamic calculation 1 Select Main Menu Calc gt gt Hemodynamic gt gt or select Calculations QuickKey Hemodynamic gt gt 2 Enter values for calculation For a monitored patient HR Art mean PA mean and CVP are automatically taken from the currently measured values If you have just performed C O measurements C O is the average of multiple thermodilution measurements Height and Weight are the patient s height and weight you have entered If the monitor does not provide these values their fields are blank For an unmonitored patient confirm the entered values 3 Selectthe Calculate button The system performs a calculation per the current settings and displays the calculated values If a calculated value is outside the range its background will highlight in yellow You can select Range to view its normal range in the unit field Invalid values are displayed as In the
29. Art Ao UAP BAP FAP LV P1 P2 Arterial Pressure Alarm Limits Adu 160 IBP S High Ped 120 mmHg Neo 90 Adu 90 IBP S Low mmHg Ped 70 Neo 55 Adu 110 IBP M High Ped 90 mmHg Neo 70 IBP M Low Adu 70 C 8 Passport 12 Passport 8 Operator s Manual Item Name c Im General OR ICU NICU CCU User Defaults mmHg Ped 50 Neo 35 Adu 90 IBP D High Ped 70 mmHg Neo 60 Adu 50 IBP D Low Ped 40 mmHg Neo 20 PA Alarm Limits Adu 35 PA S High mmHg Ped 160 Neo 60 Adu 10 PA S Low mmHg Ped 1 24 Neo 24 Adu 20 PA M High Ped 126 mmHg Neo 26 Adu 0 PA M Low Ped NS 12 mmHg Neo 12 Adu 16 PA D High Ped E E SHA mmHg Neo 4 Adu 0 PA D Low mmHg Ped 0 96 ad Neo 4 CVP LAP RAP ICP UVP P3 P4 Venous Pressure Alarm Limits Adu 10 IBP M High Ped Bee ua mmHg Neo 4 Adu 0 IBP M Low Ped 10 mmHg Neo 0 Art Ao BAP FAP LV P1 P2 Arterial Pressure Scale Scale mmHg 10 160 PA Scale Scale mmHg 1 0 30 CVP LAP RAP ICP UVP Scale Scale mmHg 0 20 UAP P3 P4 Venous Pressure Scale Scale mmHg 0 80 Passport 12 Passport 8 Operator s Manual C 9 C 1 8 C O
30. C O cable connector CO watertrap connector and CO gas outlet 5 IBP C O microstream CO module contains IBP cable connector C O cable connector CO2 sampling line connector and CO gas outlet 6 IBP C 0 AG module with O contains IBP cable connector C O cable connector AG watertrap slot and AG gas outlet This module is for Passport 12 only NOTE The above modules with IBP connectors support two invasive blood pressures through an IBP extended cable PN 040 001029 00 2 8 Passport 12 Passport 8 Operator s Manual 2 5 Display Screen This patient monitor adopts a high resolution LED screen to display patient parameters and waveforms A typical display screen is shown below 1 2 3 4 Adu 2013 07 18 10 07 03 y X NIBP DELE 120 80 03 lt AY Alarm Setup au Main Menu 1 Patient Information Area This area shows date time and the patient information such as department bed number patient name and patient category Bl indicates that no patient is admitted or the patient information is incomplete If no patient is admitted selecting this area enters the Patient Setup menu For admitted patients selecting this area enters the Patient Demographics menu 2 Alarm Symbols PA A indicates alarms are paused EN indicates alarms are reset e indicates alarm sounds are turned off 23 PAS D PA indicates the system is in alarm off status Passport 1
31. Cuff Press value is appropriate Change it if necessary 2 Select VeniPuncture 3 Puncture vein and draw blood sample 4 Selectthe NIBP hardkey on the monitor s front panel or the Stop AII QuickKey to deflate the cuff The cuff deflates automatically after a set time if you do not deflate it During measurement the NIBP display shows the inflation pressure of the cuff and the remaining time in venous puncture mode 12 6 Passport 12 Passport 8 Operator s Manual 1 3 Monitoring Temp 13 1 Introduction The equipment is used to monitor skin temperature and core temperature You can simultaneously monitor two temperature sites using the monitor 13 2 Safety WARNING Verify that the probe detection program works correctly before monitoring Remove the temperature probe cable from the T1 or T2 connector and the monitor can display the message T1 Sensor Off or T2 Sensor Off and give alarm tones correctly 13 3 Making a Temp Measurement The equipment is intended for monitoring skin temperature and core temperature 1 Select an appropriate probe for your patient according to patient type and measuring site 2 If you are using a disposable probe connect the probe to the temperature cable 3 Plugthe probe or temperature cable to the temperature connector 4 Attach the probe to the patient correctly 5 Check that the alarm settings are appropriate for this patient 13 4 Understanding
32. E Area A IBP Overlap Resp Off NIBP List forms you want lo view Select to save the setting and exit the window The main screen will display the overlapped IBP waves Selecting the overlapped IBP waveforms on the main screen opens the Overlapping Waveform Setup menu where you can Set Left Scale and Right Scale and then set the scales for the overlapped waveforms The left scale is for Art LV Ao FAP BAP UAP and the arterial waveforms of P1 P4 the right scale is for CVP ICP LAP RAP UVP and the venous waveforms of P1 P4 Set CVP Scale individually if the CVP waveform is combined and CVP unit is different from IBP unit Set PA Scale individually if PA waveform is combined Set Gridlines to On or Off to show gridlines or not in the overlapped waveform area Select Sweep and then set the sweep speed for the overlapped waveforms Select Filter and then set the filter for the overlapped waveforms You can also change above settings from corresponding IBP setup menu Note The CVP scale changes simultaneously with right scale The unit of CVP scale is consistent with CVP parameter unit 14 6 Passport 12 Passport 8 Operator s Manual 14 8 Measuring PAWP Pulmonary Artery Wedge Pressure PAWP values used to assess cardiac function are affected by fluid status myocardial contractility and valve and pulmonary circulation integrity Obtain the measure
33. Insert the battery in need of conditioning in the battery slot of the monitor 3 Apply AC power to the monitor and allow the battery to charge uninterrupted for 10 hours 4 Remove AC power and allow the monitor to run from the battery until it shuts off 5 Apply AC power again to the monitor and allow the battery to charge uninterrupted for 10 hours 6 This battery is now conditioned and the monitor can be returned to service Checking a Battery The performance of a rechargeable battery will deteriorate over time The battery performance test must be performed every six months before monitor repairs or whenever the battery performance is suspected To check the performance of a battery follow this procedure 1 2 Disconnect the monitor from the patient and stop all monitoring or measuring Turn off the monitor Apply AC power to the monitor and allow the battery to charge uninterrupted for 4 hours Remove AC power and allow the monitor to run from the battery until it shuts off Record the battery operating time The battery operating time directly reflects its performance If the battery operating time is noticeably shorter than that stated in the specifications contact your Mindray service personnel NOTE The battery might be damaged or may have malfunctioned if it only operates for a short time after being fully charged The operating time depends on the configuration and operation For example measuring NIBP more
34. NOTE It is recommended to always install a fully charged battery in the monitor to ensure normal monitoring in case of accidental power failure On screen battery symbols indicate the battery status as follows a arr Indicates that the battery works correctly The solid portion represents the current charge level of the battery in proportion to its maximum charge level a mmn Indicates that the battery has low charge level and needs to be charged a C 1 Indicates that the battery is almost depleted and needs to be charged immediately Otherwise the monitor shuts down automatically a Indicates that no battery is installed The capacity of the battery is limited When the battery is low the technical alarm area displays Low Battery the alarm lamp flashes and monitor produces an alarm sound If the battery is depleted the battery symbol on the screen flashes the technical alarm area displays Battery Depleted the alarm lamp flashes and the monitor produces alarm sound Connect the equipment to AC mains to run the equipment and charge the battery Otherwise the equipment will shut down 24 2 Charging a Battery The battery is charged whenever the monitor is connected to an AC power source regardless of whether or not the monitor is turned on When the battery is charging the AC power indicator and battery indicator are both on If the monitor is powered on the battery status symbol on the monitor screen disp
35. Passport 12 Passport 8 Operator s Manual 16 7 16 7 Measurement Limitations Some adverse effects can influence the CO performance CAUTION The following factors may influence the accuracy of measurement Leaks or internal venting of sampled gas Mechanical shock Cyclic pressure up to 10 kPa 100 cmH20 Other sources of interference if any Measurement accuracy may be affected by the breath rate and I E ratio as follow etCO is within specification for breath rate lt 60 bpm and I E ratio x 1 1 etCO is within specification for breath rate lt 30 bpm and I E ratio x 2 1 Measurement accuracy is unspecified for breath rate larger than 60 bpm 16 8 Leakage test When the sidestream CO2 module needs maintenance the monitor displays the message in the CO waveform window Need maintenance Enter CO2 setup menu Then 1 Select Main Menu Maintenance gt gt User Maintenance enter the required password Maintain CO2 gt gt 2 Perform leakage test according to the prompt messages on the menu 16 9 Troubleshooting the Sidestream CO Sampling System When the sampling system of the sidestream CO module does not work correctly check to see if the sampling line is kinked If the sampling line is not kinked remove it from the watertrap If the monitor gives a message indicating the sampling system still does not work correctly it indicates that the watertrap is blocked and should be re
36. Select an appropriate watertrap according to patient category and attach it to the module Connect the gas sample line to the watertrap connector Connect the other end of the gas sampling line to the patient via the airway adapter Connect the gas outlet to a scavenging system using an exhaust tube AG module AS Airway adapter Exhaust tube Gas sample line Connect to the patient Insert the AG module to the monitor and the monitor will prompt AG Startup Then the AG module starts to warmup and at the same time the monitor prompts AG Warmup After 45 seconds the AG module enters the iso accuracy mode After 10 minutes the module enters the full accuracy mode WARNING Make sure that the connections are tight Any leak in the system can result in erroneous readings due to ambient air mixing with patient gases Do not apply adult watertrap to the neonate patient Otherwise patient injury could result Using high frequency electrosurgical units may increase the risk of skin burn In this case do not use antistatic or conductive respiratory tubing Check that the alarm limit settings are appropriate before taking measurement CAUTION Position the airway adapter so that the part connecting to the gas sample line is pointing upwards This prevents condensed water from passing into the gas sample line and causing an occlusion The watertrap collects water drops condensed in the sampling line and th
37. Skin improperly prepared Repeat skin preparation as described in section 8 3 1 Preparing the Patient and Placing the Electrodes This could be the patient s normal QRS complex Verify with another well functioning monitor Electrode could be positioned over a bone or muscle mass Gain set too low Lead wires and patient cable not fully or properly inserted Cable or lead wires damaged Move ECG patches away from the bone or muscle mass Set the gain as required For details refer to section 8 5 4 Changing ECG Wave Settings Check that the leadwires and patient cables are properly connected Change cable and lead wires Base Line Wander Patient moving excessively Secure leadwires and cable to patient Electrodes dry or loose Repeat skin preparation as described in section 8 3 1 Preparing the Patient and Placing the Electrodes and apply fresh and moist electrodes ECG Filter set to ST or Diagnostic mode Set ECG Filter to Monitor mode Passport 12 Passport 8 Operator s Manual FOR YOUR NOTES 8 18 Passport 12 Passport 8 Operator s Manual 9 Monitoring Respiration Resp 9 1 Introduction Impedance respiration is measured across the thorax When the patient is breathing or ventilated the volume of air changes in the lungs resulting in impedance changes between the electrodes Respiration rate RR is calculated from these impedance changes and a respirat
38. are appropriate for your patient 5 Referto the appropriate measurement section for details of how to perform the measurements you require Passport 12 Passport 8 Operator s Manual 3 3 3 3 Turning Off the Monitor Before turning off the monitor 1 Ensure that the monitoring of the patient has been completed 2 Disconnect the cables and sensors from the patient 3 Make sure to save or clear the patient monitoring data as required 4 Press and hold the power on off switch for more than 2seconds to turn off the monitor Shutting down is displayed on the screen and then the monitor shuts down CAUTION Press and hold the power on off switch for 10 seconds to forcibly shut down the monitor if it could not be shut down normally This may cause loss of patient data The monitor restores the latest configuration if it restarts within 60 seconds after a power failure The monitor restores the default configuration rather than the latest configuration if it restarts 120 seconds after a power failure The monitor may load either the latest configuration or the default configuration if it restarts from 60 120 seconds after a power failure Powerfailure may cause data corruption on the SD card It is recommended to turn off the monitor according to the normal procedures Do not directly unplug the power cord unless a charged battery is installed or remove the battery before shutting down the monitor
39. date and time etc Refer to measurement and other settings in their respective sections 3 11 1 Setting up a Monitor To install a monitor or change its location 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Inthe User Maintenance menu set Monitor Name Department and Bed No or edit their settings 3 11 2 Changing Language To change the language 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Inthe User Maintenance menu select Language and then select the desired language 3 Restart the monitor Passport 12 Passport 8 Operator s Manual 3 7 NOTE The changed language is applied only after the monitor is restarted 3 11 3 Adjusting the Screen Brightness To adjust the screen brightness 1 Select the Main Menu Screen Setup gt gt Brightness 2 Selectthe appropriate setting for the screen brightness 10 is the brightest and 1 is the dimmest If the monitor operates on battery power setting a dimmer screen brightness will prolong the battery operating time When the monitor enters Standby mode the screen automatically changes to the dimmest setting 3 11 4 Showing Hiding Help Text The monitor provides online help information The user can display or hide the help text as needed 1 Select Main Menu Screen Setup gt gt 2 Select Help
40. depending on the configuration in a typical patient population A 7 6 Temp Standards Meet standard of EN12470 4 Technique Thermal resistance Measurement range 0 to 50 C 32 to 122 F Resolution 0 1 C Accuracy 0 1 C without probe Refreshing rate 1s Minimum time for accurate measurement Body surface 100 s Body cavity 80 s Passport 12 Passport 8 Operator s Manual Alarm limit Range Step T1 T2 High low limit 1 to 50 C T1 T2 Low 0 1 to high limit 1 C 0 1 C TD High 0 1 to 50 C A 7 7 IBP Standards Meet standard of EN60601 2 34 IEC60601 2 34 Technique Direct invasive measurement IBP Measurement range 50 to 300 mmHg Resolution 1 mmHg Accuracy 2 or 1 mmHg whichever is greater without sensor Refreshing rate 1s Pressure transducer Excitement voltage 5 VDC 2 Sensitivity 5 uV V mmHg Impedance range 300 to 30000 Alarm limit Range mmHg Step mmHg Sys High Mean High low limit 2 to 300 Dia High 1 Sys Low Mean Low 50 to high limit 2 Dia Low A 7 8 C O Measurement method Thermodilution method CO 0 1 to 20 L min Measurement range TB 23 to 43 C TI Oto 27 C CO 0 1 L min Resolution TB TI 0 1 C C O 5 or 0 1 L min whichever is greater Accuracy TB TI 0 1 C without sensor Repeatability C
41. gt gt to change the nurse call settings as follows E Select Signal Type and then select Pulse or Continuous Pulse the nurse call signal is a pulse signal and each pulse lasts one second When multiple alarms occur simultaneously only one pulse signal is outputted If an alarm occurs but the previous one is not cleared a new pulse signal will also be outputted Continuous the nurse call signal lasts until the alarm ends i e the duration of a nurse call signal is equal to that of the alarm condition 23 2 Passport 12 Passport 8 W Select Contact Type and then select Normally Open or Normally Closed Normally Open select if your hospital s nurse call relay contact is normally open Normally Closed select if your hospital s nurse call relay contact is normally closed W Select Alm Lev and set the alarm level for nurse call triggering alarms W Select Alarm Cat and then select the category to which the nurse call triggering alarms belong Alarm conditions are indicated to nurses only when W The nurse call system is enabled W An alarm that meets your preset requirements occurs and E The monitor is not in the alarm paused or silence status WARNING To obtain the nurse call signal use the nurse call cable PN 009 003116 00 we supply Otherwise the nurse call function will not work and the monitor may be damaged Do not rely exclusively on the nurse call system f
42. numerics Measurement is invalid Check that the sensor is properly applied Change the application site if necessary Do not see SpO parameter tiles in display Parameter not configured to display Switch the SpO2 monitoring function on as described in section 3 12 1 Switching the Parameters On Off Unable to obtain SpO reading Patient has poor perfusion Switch limbs notify physician Sensor not on patient Check if the SPO2 Sensor Off alarm is reported If so reapply the sensor If not contact the service personnel Cables loose not connected Check if the sensor and cable are properly connected Ambient light Check if the 5pO2 Too Much Light alarm is reported If so move the sensor to a place with lower level of ambient light or cover the sensor to minimize the ambient light Passport 12 Passport 8 Operator s Manual Symptoms Possible Cause Correction Action No SpO waveform Waveform not selected to display Switch the SpO2 monitoring function on as described in 3 12 1 Switching the Parameters On Off Cable or sensor not plugged in Check that the cable is properly connected and sensor securely applied Low amplitude SpO signal SpO sensor on same limb as cuff Check that the sensor is properly applied Change the application site if necessary Patient has poor perfusion Change the application site
43. select the configurations and User Maintenance Settings to export Then select the Export button A status message will report completion of the transfer To import the configuration from the USB drive to the monitor 1 2 Connect the USB drive to the monitor s USB port Select Import Config gt gt in the Manage Configuration menu In the Import Config menu select the configurations and User Maintenance Settings to import Then select the Import button A status message will report completion of the transfer Passport 12 Passport 8 Operator s Manual 5 5 5 9 Loading a Configuration You may make changes to some settings during operation However these changes or the pre selected configuration may not be appropriate for the newly admitted patient Therefore the monitor allows you to load a desired configuration to ensure that all the settings are appropriate for your patient To load a configuration 1 Select Load Configuration gt gt from the Main Menu The pop up menu shows the existing configurations on the monitor 2 Selecting Config on USB drive gt gt to show the existing configurations on the USB drive 3 Select a desired configuration 4 Select View to see the configuration details In the pop up menu you can select Alarm Setup gt gt Screen Setup gt gt or Parameter gt gt to view the corresponding contents The alarm setup items which are different than those
44. 12 Passport 8 Operator s Manual D Alarm Messages This chapter lists only the most important physiological and technical alarm messages Some messages appearing on your monitor may not be included In this chapter W The I column indicates how indications of technical alarms perform after the alarm system is reset A means that some technical alarms are cleared B indicates that some technical alarms are changed to the prompt messages and C indicates that a V appears before the alarm message appears in the alarm symbol area and the indication of the alarm lamp depends on the alarm light setting Refer to section 7 8 Resetting Alarms for details W The Level field indicates the alarm level H means high M means medium and L means low means the alarm level is user adjustable E XX represents a measurement or parameter label such as ECG NIBP HR ST I PVCs RR SpO PR etc In the Cause and Solution column corresponding solutions are given instructing you to troubleshoot problems If the problem persists contact your service personnel D 1 Physiological Alarm Messages Measurement Alarm messages L Cause and solution XX Too High M XX value has risen above the high alarm limit or fallen below the low XX alarm limit Check the patient s condition and check if the patient XX Too Low M ba n category and alarm limit settings are correct The
45. 6000 10 02183 9850A Cable kit with TI Sensor 0012 00 1519 27 7 CO Accessories Sidestream CO module Material Patient Category Remark Part No DRYLINE Watertrap Adult pediatric 9200 10 10530 Reusable DRYLINE Watertrap Neonate 9200 10 10574 Sampling Line Adult 2 5m Adult pediatric 9200 10 10533 Sampling Line Neonate 2 5m Neonate 9200 10 10555 Adult Nasal CO Sample Cannula Adult Disposable M024A 10 25937 Pediatric Nasal CO Sample Cannula Pediatric M024A 10 25938 Infant Nasal CO2 Sample Cannula Neonate M02B 10 64509 DRYLINE Airway Adapter Adult pediatric Straight disposable 9000 10 07486 Passport 12 Passport 8 Operator s Manual 27 8 AG Accessories for Passport 12 only Material Patient Category Remark Part No Adult pediatric 9200 10 10530 Watertrap Reusable Neonate 9200 10 10574 Adult pediatric 9200 10 10533 Sampling line Disposable Neonate 9200 10 10555 Adult pediatric neonate Disposable straight 9000 10 07486 Airway adapter Adult pediatric neonate Disposable elbow 9000 10 07487 27 9 Others Material Part No Lithium battery 022 000008 00 U S power cord DA8K 10 14452 DC power line to vehicle for Passport 8 only M03 010089 00 Grounding cable 1000 21 00122 Nurse call cable lt 60W x2A x36VDC x25VAC 009 003116
46. 60601 2 34 IEC Std 60601 2 49 IEC Std 80601 2 30 ISO Std 80601 2 55 ISO Std 80601 2 56 ISO Std 80601 2 61 Certified to CSA Std C22 2 NO 60601 1 NO 60601 6 NO 60601 1 8 NO 60601 2 25 NO 60601 2 26 NO 60601 2 27 NO 60601 2 34 NO 60601 2 49 NO 80601 2 30 NO 80601 2 55 NO 80601 2 56 NO 80601 2 61 Passport 12 Passport 8 Operator s Manual 2 The Basics 2 1 Intended Use The Passport Series Patient Monitors including Passport 8 and Passport 12 are intended to be used for monitoring displaying reviewing storing and alarming of multiple physiological parameters including ECG 3 lead or 5 lead selectable arrhythmia detection and ST Segment analysis heart rate HR respiration Resp temperature Temp pulse oxygen saturation SpO pulse rate PR non invasive blood pressure NIBP invasive blood pressure IBP cardiac output C O carbon dioxide CO2 and anesthetic gas AG All the parameters can be applied to single adult pediatric or neonatal patients with the exception of the following C O monitoring is restricted to adult patients only PAWP monitoring is not intended for neonatal patients The Mortara ECG Algorithm arrhythmia detection and ST Segment analysis is intended for adult and pediatric patients The Mindray ECG Algorithm arrhythmia detection currently unavailable in the US and Canada is intended for adult and pediatric patients and the Mindray ECG Algorithm
47. 7 4 Alarm Tone Configuration 7 4 1 Setting the Minimum Alarm Volume To set the minimum alarm volume 1 2 3 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Select Alarm Setup gt gt to enter the Alarm Setup menu Select Minimum Alarm Volume and then select a value between 0 and 10 The minimum alarm volume refers to the minimum value you can set for the alarm volume which is not affected by user or factory default configurations The minimum alarm volume setting remains unchanged when the monitor shuts down and restarts 7 4 2 Changing the Alarm Volume To change the alarm volume 1 4 Select the Volume Setup QuickKey or the Alarm Setup QuickKey Others or Main Menu Alarm Setup gt gt Others Select the appropriate volume from Alm Volume X to 10 in which X is the minimum volume depending on the set minimum alarm volume and 10 the maximum volume Select High Alarm Volume to set the high priority alarm volume as Alm Volume 0 Alm Volume 1 or Alm Volume 2 Select Reminder Vol to set the volume of the reminder tone as High Med or Low When alarm volume is set to 0 the alarm sound is turned off anda symbol appears in the alarm symbols area of the screen 7 4 3 Setting the Interval Between Alarm Sounds You cannot change the interval between alarm tones if you choose mode 1 or 2 as your desired
48. 7 Overlapping IBP Waveforms ssssscsssssscssssccsssscssssscessseccssessesssecssssccesusssssusecssnsecesssecssnscsesssecssssecesusccesssecssnscecsusecsssseecsssecesaseessnseeessneesesees 14 6 IEEE IZ TiS 14 7 14 8 1 Preparing to Measure PAWP cssscssssssssssscssscssssesssesessssncassssssssscensssussssceussssessssenssensssassnossussesecsaccusssneenoeanssssecsanessaccsscenssessoses 14 7 14 8 2 Setting Up the PAWP Measurement ccccssscssssssccssecssssssccsssscssseessssssesssecssnsccesnsecssnsceesasecesnscessnscecsasecesneesscnsecesneeessneesesnseesse 14 8 14 8 3 Understanding the PAWP Setup Menu u cesssssccsscssssssccsseccsssecesssseecssecssssssesnsecssnsecessuecessseessuseeesaseesssseeesnsecssnecessaneessaseesse 14 8 14 9 Troubleshooting ere tee erectos aiae Ee i TEER E ete Peete TEETE Caa T EALA 14 9 15 Monitoring Cardiac Output RR eoSt s rce 15 1 TSS TMAEFO AUCH OM nanea AA EEA DE 15 1 15 2 Understanding the C O Display ssissicsscsasscasssscsaissessccasasssssssanssasconcatdsadancvnissaravsecsssecsaassacasdecdazesssouascteiacapauatscenssscavddasentiesesiesiosanbeotaiandic 15 1 15 3 MPIC AGING Factors rise n E EE T EEEE A E ONAR RNEER 15 2 15 4 Setting Up the C O Measurement csccsssssccssssccessecccnseecrssecssssseccssccsssseessnsccessseesssnsecsssecssssecssnceessseesssusecssseecesusecssseceesusecesneeessseseesees 15 3 15 5 Measuring the Blood Tempe rature csscsssssscssssccsssecssnsssecss
49. 8 s 4 seconds respectively before and after the alarm or manual event trigger moment W 16 s 8 seconds respectively before and after the alarm or manual event trigger moment W 32s 16 seconds respectively before and after the alarm or manual event trigger moment 7 5 6 Entering CPB Mode Cardiopulmonary Bypass Mode When performing CPB you can put the monitor in CPB mode in order to reduce unnecessary alarms The CPB mode is activated only if you set the department to OR To set the department to OR 1 Press the Menu hardkey on the monitor s front panel to enter Main Menu 2 Select Maintenance gt gt Manage Configuration gt gt Enter the required password and then select Ok 3 Select Change Department gt gt OR In the CPB mode all the physiological alarms technical alarms and prompt alarms are switched off In the CPB mode CPB Mode is displayed in the physiological alarm area with a red background color To enter CPB mode 1 Select the CPB Mode Quickkey or select Enter CPB Mode in the Others window of the Alarm Setup menu 2 Then select Ok in the pop up dialog box 7 6 Pausing Alarms If you want to temporarily prevent alarms from sounding you can pause alarms by pressing the Alarm Pause hardkey on the monitor s front panel When alarms are paused W Noalarm lamps flash and no alarms are sounded W Nonumerics or alarm limits flash W Noalarm messages are shown W The rema
50. Auto Zoom Auto Set as End Case Report Unselected Realtime Report Sweep Auto Select Wave Current C 2 8 Others O M Item Name En General OR ICU NICU CCU User Defaults Brightness i 5 Key Volume 7 2 View Other Auto Alarm On Patient C 3 User Maintenance Items O M Item Name General OR ICU NICU CCU User Defaults Changing Bed No Protected Atmospheric Pressure 760 mmHg Height Unit cm Weight Unit kg ST Unit mV Press Unit ii mmHg CVP Unit cmH20 CO Unit mmHg Passport 12 Passport 8 Operator s Manual Item Name General OR ICU NICU CCU User Defaults O2 Unit ul 96 Temp Unit C Network Type LAN Latching Alarms n o No Alarm Pause Time 2min Minimum Alarm Volume 72 1 2 Reminder Tone Off Reminder Interval 1 min ECGLeadOff Lev Low SpO2SensorOff Lev r Low Alarm Tone Interval FA ETE o Med Low Level Alarm 20s Lethal Arrh OFF Disable Silence Other Bed On Extended Arrh Enable Wave Line Mediate ECG Standard AHA Notch Freq 50Hz Data Transfer Method Module Transferred Data Length 4h Data Transfer Strategy Always Ask SpO2 Tone Mode 1 Signal Type Continuous Contact Type Normally Closed Signal Type Continuous RUE Contact Type Normally Closed Alm Lev oo d High Med Low Alarm Cat a WE Phys Tech C 16 Passport
51. Hemodynamic Calculation window you can W Trigger a recording by selecting the Record button The currently displayed hemodynamic calculations are printed out by the recorder m Review the previously performed calculations by selecting Review 20 6 Passport 12 Passport 8 20 5 2 Entered Parameters Abbreviation Unit Full spelling CO L min cardiac output HR bpm heart rate PAWP mmHg pulmonary artery wedge pressure Art Mean mmHg artery mean pressure PA Mean mmHg pulmonary artery mean pressure CVP mmHg central venous pressure EDV ml end diastolic volume Height cm height Weight kg weight 20 5 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula BSA m body surface area Wt995 x Ht9 75 x 0 007184 Cll L min m cardiac index C O BSA SV ml stroke volume C O HR x 1000 SI ml m stroke index SV BSA SVR DS cm systemic vascular resistance 79 96 x AP MAP CVP C O SVRI DS m cm systemic vascular resistance index SVR x BSA PVR DS cm pulmonary vascular resistance 79 96 x PAMAP PAWP C O PVRI DS m cm pulmonary vascular resistance index PVR x BSA LCW kg m left cardiac work 0 0136 x APMAP x COO LCWI kg m m left cardiac work index LCW BSA LVSW gm left ventricular stroke work 0 0136 x APMAPx SV LVSWI g m m left ventricular stroke work index LVSW BSA RCW kg m right cardiac wor
52. Low perfusion PR accuracy 3 bpm PR from Nellcor SpO Module Measurement range 20 to 300 bpm Resolution 1 bpm 20 to 250 bpm 3 bpm Accuracy 251 to 300 bpm not specified Refreshing rate 1s PR from NIBP Module Measurement range 40 to 240 bpm Resolution 1 bpm Accuracy 3bpm or 396 whichever is greater PR from IBP Module Measurement range 25 to 350 bpm Resolution 1 bpm Accuracy 1 bpm or 1 whichever is greater Refreshing rate 1s A 7 5 NIBP Meet standards of EN60601 2 30 IEC60601 2 30 EN1060 1 EN1060 3 SP10 and Standards EN1060 4 Technique Oscillometry Mode of operation Auto mode repetition intervals Manual Auto and STAT 1 min 2 min 2 5 min 3 min 5 min 10 min 15 min 20 min 30 min 1 h 1 5 h 2h 3 h 4h 8h STAT mode cycle time 5 min Adult pediatric 180s Max measurement time Neonate 90s Adult Pediatric Neonate Measurement ranges Systolic 40 to 270 40 to 200 40 to 135 mmHg Diastolic 10 to 210 10 to 150 10 to 100 Mean 20 to 230 20 to 165 20to 110 Max mean error 5 mmHg Accuracy Max standard deviation 8 mmHg Resolution 1mmHg A 10 Passport 12 Passport 8 Operator s Manual Adult 80 to 280 Initial cuff inflation pressure range Pediatric 80 to 210 mmHg Neonate 60 to 140 Adult 160 Default initial cuff inflation pressure Pediatric 140 mmHg Neona
53. N A BT 1 C BT 1 C measurement range 7 5 3 Setting Alarm Delay Time You can set the alarm delay time for alarms of continuously measured parameters If the alarm condition is resolved within the delay time the monitor will not sound the alarm To set the alarm delay time 1 2 Select Main Menu Maintenance gt gt User Maintenance gt gt Enter the required password and then select Ok Select Alarm Setup gt gt Alarm Delay Alarm delay is not applied to the following physiological alarms Apnea ST alarms Arrhythmia alarms ECG Weak Signal Resp Artifact SpO Desat No Pulse Nellcor SpO over alarm limits FiO Shortage Measurements of noncontinuous parameters over alarm limits HR over alarm limits Anesthetic Mixture s MAC 3 You can set Apnea Delay and ST Alarm Delay separately Passport 12 Passport 8 Operator s Manual 7 9 7 5 4 Setting SpO Technical Alarm Delay You can set the Tech Alarm Delay in the Others tab of the Alarm Setup menu The options are Off 5 s 10 s and 15 s The delay is effective to the following technical alarms SpOz Sensor Off SpO2 Too Much Light SpO Low Signal and SpO Interference 7 5 5 Setting Recording Length You can change the length of the recorded waveforms In the Others window of the Alarm Setup menu select Recording Length and then select 8 s 16 s or 32 s W
54. NOTE To completely disconnect the power supply unplug the power cord 3 4 Using the Knob Using the knob on the front panel of the monitor can do the following operations Rotate the knob clockwise or counterclockwise to move the cursor Press the knob to select one item such as accessing a menu or confirming the selection 3 5 Using Keys The monitor has three types of keys Softkey A softkey is a graphic key on the screen giving you fast access to certain menus or functions The monitor has two types of softkeys Parameter keys Each parameter area can be seen as a softkey You can enter a parameter setup menu by selecting its corresponding parameter or waveform area QuickKeys QuickKeys are configurable graphical keys located at the bottom of the main screen For details refer to the section 2 6 QuickKeys Hardkeys A hardkey is a physical key on a monitoring device such as the Main Menu hardkey on the monitor s front panel 3 4 Passport 12 Passport 8 Operator s Manual W Pop up Keys Pop up keys are task related keys that appear automatically on the monitor screen when needed For example the Confirm pop up key appears only when you need to confirm a change 3 6 Using the Touchscreen Select screen items by pressing them directly on the monitor s screen You can enable or disable touchscreen operation by pressing and holding the Main Menu QuickKey for 3 seconds A padlock symbol
55. O 2 or 0 1 L min whichever is greater Alarm range TB 23 to 43 C A 12 Passport 12 Passport 8 Operator s Manual Alarm limit Range Step TB High low limit 1 to 43 C 0 1 C TB Low 23 to high limit 1 C A 7 9 CO2 Measurement mode Sidestream microstream mainstream Technique Infrared absorption Sidestream CO Module Standard Meet standard of ISO 21647 CO Measurement range 0 to 99 mmHg 0 to 40 mmHg 2 mmHg Accuracy 41 to 76 mmHg 5 of the reading 77 to 99 mmHg 10 of the reading Accuracy drift Meet the requirement for measurement accuracy within 6 hours Resolution 1 mmHg Adult 70 ml min 100 ml min 120 ml min 150 ml min Sample flowrate Pediatric neonate 70 ml min 100 ml min Sample flowrate tolerance 1596 or 15 ml min whichever is greater Iso accuracy mode 45s Warm up time Full accuracy mode x10 min Measured with a neonatal watertrap and a 2 5 meter neonatal sampling line or an adult watertrap and a 2 5 meter adult sampling line 400 ms Q 70 ml min Rise time 330 ms Q 100 ml min 300 ms 120 ml min 240 ms 150 ml min Measured with a neonatal watertrap and a 2 5 meter neonatal sampling line 4 s 100 ml min 4 5 s 70 ml min Measured with an adult watertrap and a 2 5 meter adult sampling line Gas sampling delay time 4 5 s 150 ml min 55s 120 ml min 5 5 s 100 ml min 6 5 s 70 ml mi
56. PNP Alm Lev Prompt PNC Alm Lev Prompt Missed Beats Alm Prompt Lev X Alm Lev Med X Alm Rec Off X represents a certain arrhythmia event Refer to the Specifications chapter for details The X in X Alm Lev refers to all arrhythmia events except for those specially marked ones Passport 12 Passport 8 Operator s Manual C 1 2 RESP O M Item Name m General OR ICU NICU CCU User Defaults Alarm ear On Alm Lev EN ES Med Sweep zv 6 25 mm s Lead Sos RE II Gain LM ES x2 Adu Ped 30 RR High Neo 100 Adu Ped 8 RR Low M fas Neo 30 Adu Ped 20 Apnea Delay AS E Neo 15 Detection Mode KE Auto RR Source P Auto C 1 3 PR O M Item Name ESI General OR ICU NICU CCU User Defaults Alarm SA fI On Alm Lev Se oi Med Adu 120 HR PR High Ped 3 pn 160 Neo 200 Adu 50 HR PR Low Ped san 75 Neo 100 PR Source Ww Be SpO2 Beat Vol v Fa 2 1 C 6 Passport 12 Passport 8 Operator s Manual C 1 4 SpO O M Item Name z General OR ICU NICU CCU User Defaults Alarm m On Alm Lev id Med Adu Ped 100 SpO High E a Neo 95
57. Passport 12 Passport 8 Operator s Manual Sensitivity 200V lead II HR averaging method In compliance with the requirements in Clause 4 1 2 1 d of ANSI AAMI EC13 the following method is used Heart rate is computed by averaging the most recent 16 RR intervals unless the HR by averaging the most recent 4 heart beats is less than or equal to 48 The HR value displayed on the monitor screen is updated every second Response to irregular rhythm In compliance with the requirements in Clause 4 1 2 1 e of ANSI AAMI EC13 the heart rate after 20 seconds of stabilization is displayed as follows Ventricular bigeminy 3a 80 1 bpm Slow alternating ventricular bigeminy 3b 60 1 bpm Rapid alternating ventricular bigeminy 3c 120 1 bpm Bidirectional systoles 3d 90 2 bpm Response time to heart rate change Time to alarm for tachycardia Meets the requirements of ANSI AAMI EC13 Section 4 1 2 1 f From 80 to 120 bpm less than 11 s From 80 to 40 bpm less than 11 s Meets the requirements of ANSI AAMI EC13 section 4 1 2 1 g Waveform 4ah range 11s 4a range 11s 4ad range 11s Waveform 4bh range 11s 4b range 11s Abd range 11s Tall T wave rejection capability When the test is performed based on part 4 1 2 1 c of ANSI AAMI EC 13 2002 the heart rate meter will reject all 100 ms QRS complexes with less than 1 2 mV of amplitude and T waves with T wave interval of 180
58. Passport 8 Operator s Manual Contents LET 1 1 IEEE AH M M 1 1 UNS RElMDIS T ISEE 1 1 Jeanne R 1 2 1 1 3 Notes ete ene eser tees en A dee e OEE eade oo een atr oues des resi EE 1 2 1 2 Equipment SVMS mo a 1 3 PAULI T 2 1 2 1 Intended luJs8 s tete e Hb eoe ele Ee bee ehe ee re be tede oe eee aiii 2 1 Z2 Applied Part RETE ED 2 1 23 Main UU eS 2 2 PASIN ES ead p EE e 2 2 PE SPASTTe AI AU NND crc erc nr 2 4 23 3 REAM VIG W E ERN 2 6 2 Modules epic a REUS RD ERO OUR duda eed ta caves beta e merde UE 2 8 2 5 Display SCKeON epe PURUS 2 9 2 6 QuickKeys Rte e e E Ee I dian ERU EE ut eee A castle nen ERE eR 2 1 3 Basic TCU NCC P 3 1 Bed Stall ati ry anuni EE EE E A EEE AE EE a aat 3 1 3 1 T Unpackinig and Checkirig etre rte ee ette edere deett N 3 1 3 1 2 Environmental Requirements zsiros sis SA NES Sia E KEE RRS i i eetet 3 2 3 2 Getting Stakted s erret ERE ERE OR RP ER A E A tus 3 2 322 1 GONNECKINIG tO POWER SOURCE sista M 3 2 3 2 2TUPNING POWel OM Js eee rere e rete ea iei TINSEN beide esp e ne dete 3 3 3 2 3 Starting MOnitOriNg Peut sonia vna 3 3 3 3 Turning Off the
59. RU 11 3 11 5 3 Setting SpO SensitiVIty rette eet eile ta eee er ERAN en tele cb eei e d eR 11 3 11 5 4 Changing Averaging Time ssssassccssissssascsnsasssassszeauscancsatcsasazcssisaacassecbasscatacendssassdeazssisnstdeoucdstovasscandicaosdaesoassanssdescsstentascsdcusectansced 11 3 11 5 5 Monitoring SpO and NIBP SiMUltaNeOUSly essssescccssecsssescccssecessseecsssececssecsesssecsssecessseeecsuecessuscessuecssueesesueccsneeeesneesssnees 11 3 11 5 6 Sat Seconds Alarm Management sccssssscsssssscssseccssesscssssecssecessueecssnscessuecsssusecssnsesssusecssuscessusecesusecssusecesusecssaseessueeeeneessaeees 11 5 7 Changing the Speed of the Pleth Wave EZ wA nido M 11 5 9 Setting the Alarm Level for SpO Sensor Off Alarim esssssscsssssssssseccssseccsseecesussessseccesusecssnscessucecsuseessnseeesuecssneceesneessaees 11 5 115 10 Setting the SpO ToneMode 5 rbd tete Le et eee UR RR EE Re e des e ee ai 11 5 11 6 Measurement Limitations sinnini iina Na aN E ARENE O ERN NR R EE 11 6 HV MasiMo INfOrmMAtION veisaisscsssonssisscosssseaseonssisscoiasscstsonsasescosaisqateonssisscbiadssaiqnsoiscosaiseassnsadbcscbiadssassnondbaScosaisqasensabeasedtadsqassnonbssscdesundascesabsenndeaea 11 6 11 8 Nellcor Iriformatio Mesas snnm NRE TNA E E N ERREN NARE 11 7 SN ES TrOUBISSHO OCI e cT 11 7 12 Monitoring NIBP
60. View Other Patient Window When you first open the View Other Patient window the monitor automatically selects a device from the network to display in the View Other Patient window View Other Patient 1 ICU 004 Alarm Reset 5 The View Other Patient window covers the lower part of the waveform area and consists of 1 Information Area shows the patient information including department bed number patient name etc network status symbol View Area shows physiological waveforms and parameters You can switch a waveform area to a parameter area by selecting your desired waveform area and then selecting Switch to Parameter Area or switch a parameter area to a waveform area by selecting your desired parameter area and then selecting Switch to Waveform Area Care Group Overview Bar See section 6 4 2 Viewing the Care Group Overview Bar for information Message Area shows physiological technical and prompt messages from the currently viewed monitor It also shows the alarm given by the device such as nurse call or event By selecting this area you can enter the Alarm Information List to view all physiological technical and prompt messages coming from the currently viewed patient Alarm Reset button resets alarms from the currently viewed bed Refer to section 7 8 Resetting Alarms When the Reset Other Bed s Alarms is disabled no button will appear here Additionally you can change a waveform or paramet
61. a problem with any of the equipment contact your service personnel or Mindray The service personnel must be properly qualified and thoroughly familiar with the operation of the equipment 26 1 General Inspection Athorough inspection should be performed by qualified service personnel to ensure the reliability before first use after your monitor has been used for 6 to 12 months or whenever your monitor is repaired or updated Follow these guidelines when inspecting the equipment Make sure that the environment and power supply meet the specifications Inspect the equipment and its accessories for mechanical damage Inspect all power cords for damage and make sure that their insulation is in good condition Make sure that only specified accessories are applied Inspect if the alarm system functions correctly Make sure that the recorder functions correctly and the recorder paper meets the specifications Make sure that the batteries meet the performance specifications Make sure that the monitor is in good working condition In case of any damage or abnormity do not use the monitor Contact the hospital s biomedical engineers or your service personnel immediately Passport 12 Passport 8 Operator s Manual 26 1 26 2 Maintenance and Testing Schedule The following maintenance and tests except for visual inspection power on test touchscreen calibration battery check ECG calibration NIBP leakage CO leakage and A
62. as they may emit higher levels of electromagnetic radiation 1 1 2 Cautions CAUTIONS Only use parts and accessories specified in this manual Always install or carry the equipment properly to avoid damage caused by drop impact strong vibration or other mechanical force Dry the equipment immediately in case of rain or water spray Ensure that the patient monitor is supplied with continuous electric power during work Sudden power failure may lead to data loss This equipment is intended for single patient use Store and use the equipment in specified environmental condition The monitor and accessories may not meet the performance specification due to aging stored or used outside the specified temperature and humidity range 1 1 3 Notes NOTES Put the equipment in a location where you can easily view and operate the equipment During normal use the operator is expected to face the front of the equipment The equipment uses a mains plug as a means of isolation to the mains power supply Do not position the equipment in a place difficult to operate the mains plug Keep this manual in the vicinity of the equipment so that it can be conveniently referenced when needed The software was developed in compliance with IEC60601 1 4 The possibility of hazards arising from software errors is minimized Passport 12 Passport 8 Operator s Manual NOTES This manual des
63. by a clinical operator properly configure the alarm system and adjust alarm settings as per the patient s condition 7 5 2 Adjusting Alarm Limits Automatically The monitor can automatically adjust alarm limits according to the measured vital signs When auto limits are selected the monitor calculates safe auto limits based on the latest measured values To get accurate auto alarm limits you need to collect a set of measured vital signs as a baseline Then in the Main Menu select Alarm Setup Parameters Auto Limits Ok The monitor will create new alarm limits based on the measured values Before applying these automatically created alarm limits confirm if they are appropriate for your patient in the Alarm Setup Menu If not you can adjust them manually These alarm limits will remain unchanged until you select auto limits again or adjust them manually The monitor calculates the auto limits based on the following guidelines Low alarm limit High alarm limit Auto alarm limits Module Parameter Adult Adult Neonate Neonate range pediatric pediatric HR x 0 8 or 40 HR 30 or 90 HR x 1 25 or 240 HR 40 or 200 Adult pediatric 35 to ECG HR PR bpm whichever is bpm whichever is bpm whichever is bpm whichever is 240 greater greater smaller smaller Neonate 55 to 225 RR x 0 5 or 6 rpm RR 10 or 30 rpm RR x 1 5 or 30 RR 25 or 85 rpm Adult pe
64. cable WARNING e If the sensor is too tight because the application site is too large or becomes too large due to edema excessive pressure for prolonged periods may result in venous congestion distal from the application site leading to interstitial edema and tissue ischemia Passport 12 Passport 8 Operator s Manual 11 5 Changing SpO Settings 11 5 1 Accessing SpO Menus By selecting the SpO parameter window or waveform area you can access the SpO2 Setup menu 11 5 2 Adjusting the Desat Alarm The desat alarm is a high level alarm notifying you of potentially life threatening drops in oxygen saturation Select Alarm Setup gt gt from the SpO2 Setup menu From the pop up menu you can set low alarm limit alarm switch and alarm recording for Desat When the SpO value is below the desat alarm limit and desat alarm switch is set on the message SpO2 Desat is displayed 11 5 3 Setting SpO Sensitivity For Masimo SpO2 module you can set Sensitivity to Normal or Maximum in the SpO2 Setup menu When the Sensitivity is set to Maximum the monitor is more sensitive to minor signals When monitoring critically ill patients whose pulsations are very weak it is strongly recommended that the sensitivity is set to Maximum When monitoring neonatal or non critically ill patients who tend to move a lot noise or invalid signals may be caused In this case it is recommended that the sensitivity is set to Nor
65. current Measuring electrode 0 1 pA Drive electrode 1 pA Input offset current Measuring electrode 0 1 pA Drive electrode x1 pA Baseline recovery time 5 s after defibrillation Patient leakage current 10uA Calibration signal 1mV peak to peak value Accuracy 5 ESU protection Cut mode 300 W Coagulate mode 100 W Recovery time x10 s In compliance with the requirements in clause 4 2 9 14 of ANSI AAMI EC 13 2002 ESU noise suppression Based on the test method in clause 5 2 9 14 of EC 13 use ECG lead wires which are in compliance with AAMI Compared with ECG baseline the noise of peak to peak value x2 mV Pace Pulse Pace pulse markers Pace pulses meeting the following conditions are labelled with a PACE marker Amplitude 2 to 700 mV Width 0 1 to 2 ms Rise time 10 to 100 us Pace pulse rejection When tested in accordance with the ANSI AAMI EC13 Sections 4 1 4 1 and 4 1 4 3 the heart rate meter rejects all pulses meeting the following conditions Amplitude 2 to 700 mV Width 0 1 to 2 ms Rise time 10 to 100 us Pacer pulse detector rejection of fast 10V s RTI when measured in accordance with ANSI AAMI EC13 Section 4 1 4 3 ECG signals HR Neonate 15 to 350 bpm Measurement range Pediatric 15 to 350 bpm Adult 15 to 300 bpm Resolution 1 bpm Accuracy 1 bpm or 1 whichever is greater A 6
66. displayed on the monitor screen is the average of data collected within a specific time The shorter the averaging time is the quicker the monitor responds to changes in the patient s blood pressure Contrarily the longer the averaging time is the slower the monitor responds to changes in the patient s blood pressure but the measurement accuracy will be improved For critically ill patients selecting shorter averaging time will help understanding the patient s state To set the averaging time in the parameter setup menu select Sensitivity and then select High Med or Low the corresponding averaging time is about 1 s 8 s and 12 s respectively 14 6 4 Setting Up the IBP Wave In the setup menu for the pressure you can W Select Sweep and then select the appropriate setting The faster the wave sweeps the wider the wave is W Select Scale and then select the appropriate setting If Auto is selected the size of the pressure s waveform will be adjusted automatically E Select Filter and then select the desired option 14 6 5 Setting the Pressure Unit Select Unit Setup gt gt from the User Maintenance menu In the pop up menu select Press Unit and then select mmHg or kPa Select CVP Unit and then select mmHg cmH20 or kPa 14 6 6 Enabling PPV Measurement and Setting PPV Source PPV indicates pulse pressure variation To enable PPV measurement set PPV Measurement to On You can select P
67. for SpO Sensor Off Alarm Select Alarm Setup gt gt from the User Maintenance menu You can set the SpO2SensorOff Lev in the pop up menu 11 5 10 Setting the SpO Tone Mode Select Others gt gt from the User Maintenance menu In the pop up menu you can set SpO2 Tone as Mode 1 or Mode 2 WARNING The same SpO tone mode shall be used for the same monitors in a single area Passport 12 Passport 8 Operator s Manual 11 5 11 6 Measurement Limitations If you doubt the SpO measurement check the patient s vital signs first Then check the monitor and SpO sensor The following factors may influence the accuracy of measurement Ambient light Physical movement patient and imposed motion Diagnostic testing Low perfusion Electromagnetic interference such as MRI environment Electrosurgical units Dysfunctional haemoglobin such as carboxyhemoglobin COHb and methemoglobin MetHb Presence of certain dyes such as methylene and indigo carmine Inappropriate positioning of the SpO sensor or use of incorrect SpO sensor Drop of arterial blood flow to immeaurable level caused by shock anemia low temperature or vasoconstrictor 11 7 Masimo Information YMS Masimo Patents This device is covered under one or more the following U S A patents 5 758 644 6 011 986 6 699 194 7 215 986 7 254 433 7 530 955 and other applicable patents listed at www masimo com patents htm
68. periods of normal rhythm and when the ECG signal is relatively noise free If ECG learning takes place during ventricular rhythm the ectopics may be incorrectly learned as the normal QRS complex This may result in missed detection of subsequent events of V Tach and V Fib 8 8 2 Automatic ECG Relearning ECG relearning is initiated automatically whenever W The ECG lead or lead label is changed W The ECG lead is re connected E Anew patient is admitted W After the ECG calibration is completed and Stop Calibrating ECG is selected W A switch happens between the options of screen type during 5 ECG monitoring E The paced status of the patient is changed 8 9 Troubleshooting This section lists the problems that might occur If you encounter the problems when using the equipment or accessories check the table below before requesting for services If the problem persists contact your service personnel CAUTION Never try to disassemble the equipment or supplied accessories There are no internal user serviceable parts Symptoms Possible Cause Correction Action Noisy ECG traces Loose or dry electrodes Apply fresh and moist electrodes 8 16 Passport 12 Passport 8 Operator s Manual Symptoms Possible Cause Correction Action TET Defective electrode wires Replace wires if necessary Patient cable or leads are routed too close to other electrical devices Move th
69. sample flow rate to zero When exiting the Standby mode the AG module continues to work at preset sample flow rate with no need to warm up again After nearly 1 minute the module enters the full accuracy mode The AG module Standby mode relates to the Standby mode of the monitor as follows W If the monitor enters the Standby mode the AG module also enters the Standby mode W If the monitor exits the Standby mode the AG module also exits the Standby mode E If the AG module enters or exits the Standby mode it does not affect the monitor To enter or exit the Standby mode manually in the agent s setup menu select Operating Mode and then select Standby or Measure You can also set a period of time after which the AG module enters the Standby mode automatically if no breath is detected since the last detected breath To set the Standby time in the agent s setup menu select Auto Standby min and then select the appropriate setting 17 5 6 Setting up the AG Wave Select the AG parameter area to access the AG Setup menu in which you can W Select CO2 Wave Type and then select Draw or Fill Draw The CO wave is displayed as a curved line Fill The CO wave is displayed as a filled area E Select Sweep and then select the appropriate setting The faster the wave sweeps the wider the wave is W Change the size of the waveform by adjusting the scale 17 5 7 Setting RR Source To set RR source 1 Select the AG p
70. select the waveforms you want You can also turn off a waveform recording by selecting Off These settings are intended for realtime and scheduled recordings 21 2 Passport 12 Passport 8 Operator s Manual 21 4 3 Setting the Realtime Recording Length After starting a realtime recording the recording time depends on your monitor s settings In the Record Setup menu select Length and then select 8 s or Continuous W 8 s record 4 second waveforms respectively before and after current moment E Continuous record the waveforms from the current moment until stopped manually 21 4 4 Setting the Interval between Timed Recordings Timed recordings start automatically at preset intervals Each recording lasts 8 seconds To set the interval between timed recordings in the Record Setup menu select Interval and then select the appropriate setting 21 4 5 Changing the Recording Speed In the Record Setup menu select Paper Speed and then select 25 mm s or 50 mm s This setting is for all recordings containing waveforms 21 4 6 Clearing Recording Tasks In the Record Setup menu select Clear All Tasks All queued recording tasks are cleared and the current recording is stopped 21 5 Loading Paper 1 Pressthe latch in the upper right corner of the recorder door to open it 2 Inserta new roll into the compartment as shown below 3 Closethe recorder door 4 Checkif paper is loaded correctly and the paper
71. the CO2 Setup menu 16 4 2 Entering the Standby Mode The Standby mode of the CO module relates to the Standby mode of the monitor as follows If the monitor enters the Standby mode the CO module will also enter the Standby mode W If the monitor exits the Standby mode the CO module will also exit the Standby mode W If the CO2 module enters or exits the Standby mode it will not affect the monitor To enter or exit the Standby mode manually 1 Select Operating Mode in the CO2 Setup menu 2 Select Standby or Measure When you set the sidestream CO2 module to the Standby mode the CO gas sample intake pump automatically sets the sample flow rate to zero When exiting the Standby mode the CO2 module continues to work at the previously set sample flow rate For the sidestream CO2 module you can set a delay time after which the CO2 module will enter the Standby mode if no breath is detected 16 4 Passport 12 Passport 8 Operator s Manual For the microstream CO module you can also set a period of time after which the CO module enters the Standby mode if no breath is detected or since the CO2 module was powered on or since the CO module was switched to the measuring mode or the automatic Standby time is re set To set the Standby time 1 Select the CO parameter window to access the CO2 Setup menu 2 Select Auto Standby and then select the appropriate setting 16 4 3 Setting the CO Unit To set
72. the CO unit 1 Select Main Menu Maintenance User Maintenance enter the required password Unit Setup gt gt 2 Inthe Unit Setup menu select CO2 Unit and then select mmHg 96 or kPa 16 4 4 Setting up Gas Compensations N WARNING e Make sure to use the appropriate compensations Inappropriate compensations may cause inaccurate measurement values and result in misdiagnosis For the sidestream CO2 module 1 Select the CO parameter window to access the CO2 Setup 2 According to the actual condition set the concentration required for the following compensations 02 Compen N20 Compen Des Compen For the microstream CO module gas compensations are not required 16 4 5 Setting up Humidity Compensation Sidestream and microstream CO2 modules are configured to compensate CO readings for either Body Temperature and Pressure Saturated Gas BTPS to account for humidity in the patient s breath or Ambient Temperature and Pressure Dry Gas ATPD P 1 ATPD c pine mmHg CO vol x P amb 2 pps Pco2mmHg CO vol x P 47 100 Where partial pressure vol CO concentration P sun ambient pressure and unit is mmHg Pco Passport 12 Passport 8 Operator s Manual 16 5 For the sidestream and microstream CO2 module you can set the humidity compensation on or off according to the actual condition To set the humidity compensation 1 S
73. the Multicast Parameters reete t ROMAE RR IS eR RR RR ROI SEM ye iere ri Hh eMe ge nee qaom 23 5 j Ur 24 1 p MS Pi M M H Q 24 1 24 2 C hargirigia Battery cere ER ERR TO UD EU Mie eH dori ded 24 1 243 Replacing a Battery uode dele e OE e RE OH nde el deed e P obire t eee wa estie eiut RR 24 2 24 4 Battery Guideliries 5 iret eb e ertet bereitet ee a Reb EORR 24 2 24 5 Battery Maintenance sissanta M 24 3 24 6 Battery REC Cl g eusse A E AN E N ENE 24 4 Passport 12 Passport 8 Operator s Manual 9 25 Car and Cleaning isiscssssccaseasensscnssovccsacensscnvensscvecnsosescnassesouasenceanssuasdasensscnsduass senessnsasecsus sestucssusoasesesocossnasesesupescasecscuaseanse 25 1 25 31 General POMS aero re aches R EEO EM M UD ED D D PUN ED UP anteaa cart 25 1 pinea h PTT 25 2 pscasiradpee T RES 25 2 pim Erdrcinpm H 25 2 26 User Maintenance RR M 26 1 26 1 GEM Fal IMSPSCCION MOL K m T 26 1 26 2 Maintenance and Testing Schedule sssscsssssccssessssssecsssesssssecccsseccssusecesssecssuccsesusecssusccssuscessusecssusesssusecssuecessusecssuecessuseeesuecssnseseseee 26 2 26 3 Checking Monitor and Module Information esssecsssssscssseccssessecseeccsssecssnscs
74. the alarm system is reset E For some technical alarms including the NIBP related alarms a v appears before the alarm message and appears in the alarm symbol area indicating that the alarm is acknowledged The indication of the alarm lamp depends on the alarm light setting W Some technical alarms are changed to the prompt messages W Some technical alarms are cleared The monitor gives no alarm indications For details about the indications of technical alarms when the alarm system is reset refer to appendix D 2 Technical Alarm Messages 7 9 Latching Alarms The alarm latching setting for your monitor defines how the alarm indicators behave when you do not acknowledge them When alarms are set to non latching their alarm indications end when the alarm condition ends If you switch alarm latching on all visual and audible alarm indications last until you acknowledge the alarms except that the measurement numeric and violated alarm limit stop flashing as soon as the initial alarm condition goes away To set alarms to latching or non latching 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Alarm Setup gt gt 3 Select Latching Alarms and then select High only Hi amp Med All or Off NOTE If you select High only only high priority alarms are latched If you select Hi amp Med both high priority alarms and med
75. the monitor s database and reviewed in the graphic tabular trends in trend graphs as the PR curve is in the same color with the PR source it is unlikely to distinguish the PR source Mis sent via the network to the CMS if available To set which pulse rate as PR source 1 Enterthe SpO2 Setup menu 2 Select PR Source and then select a label or Auto from the pop up menu The pop up menu displays the currently available PR sources from top to bottom by priority When you select Auto the system will automatically select the first option as the PR source from the pop up menu When the current PR source is unavailable the system will automatically switch PR Source to Auto When you select IBP the system will automatically select the first pressure label as the PR source from the pop up menu Passport 12 Passport 8 Operator s Manual 10 1 10 3 Selecting the Active Alarm Source In most cases the HR and pulse numerics are identical In order to avoid simultaneous alarms on HR and PR the monitor uses either HR or PR as its active alarm source To change the alarm source select Alm Source in the ECG Setup or SpO2 Setup menu and then select either W HR The monitor will use the HR as the alarm source for HR pulse W PR The monitor will use the PR as the alarm source for HR pulse W Auto If the Alm Source is set to Auto the monitor will use the heart rate from the ECG measurement as the alarm source whe
76. those who use the monitor 6 1 1 Changing the Waveform Line Size To change the waveform line size 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Others gt gt 3 Select Wave Line and select Thick Med or Thin 6 1 2 Changing Measurement Colors To change the measurement colors 1 Select Main Menu Screen Setup gt gt Measurement Color Setup gt gt 2 Selectthe color box next to your desired parameter and then select a color from the pop up menu 6 1 3 Changing Screen Layout Select the Screens QuickKey or Main Menu Screen Setup gt gt Screen Layout gt gt to enter the Screens menu W Youcan choose the desired screen type in the Choose Screen window W You can select the parameters and waveforms you want to view in the Screen Setup window For details please refer to the section 3 9 Setting the Screen You can select the parameters you want to view on the big numerics screen in the Big Numerics Screen Setup window W You can switch the connected parameter modules on or off in the Parameters Switch window If a parameter module is switched off parameter values and waveforms will not display on the screen Passport 12 Passport 8 Operator s Manual 6 1 6 2 Viewing Minitrends 6 2 1 Having a Split Screen View of Minitrends You can split the normal screen so that the left hand side continuousl
77. to Parameter Oriented the report will be printed by parameter All if you select All all trend data will be printed out In this case there is no need to set From Interval choose the resolution of the tabular trends printed on the report Report Layout if you select Time Oriented the report will be printed by time If you select Parameter Oriented the report will be printed by parameter Select Parameter gt gt from the pop up menu you can Currently Displayed Trended Parameters print the parameter trend data selected from the Tabular Trends Standard Parameter Group select the standard parameter group for printing Custom define a parameter group for printing from the parameters displayed in the lower part of the menu Passport 12 Passport 8 Operator s Manual 22 3 22 6 3 Setting Up Graphic Trends Reports To set up graphic trends reports select Main Menu Print Setup gt gt Graphic Trends Reports gt gt Setting up graphic trends reports is similar with tabular trends reports Refer to section 22 6 2 Setting Up Tabular Trends Reports for details 22 6 4 Setting Up Realtime Reports To set up realtime reports select Main Menu Print Setup gt gt Realtime Reports gt gt W Sweep set the wave print speed to 12 5 mm s 25 mm s 50 mm s or Auto W Select Wave gt gt from the pop up menu you can Current print the currently displayed waves S
78. 0 1MAC 6 1 15 1 7 2 1 0 77 105 The data is taken from a 25 year old patient indicates 1 MAC nitrous oxide can only be reached in hyperbaric chamber Passport 12 Passport 8 Operator s Manual NOTE The MAC values shown in the table above are those published by the U S Food and Drug Administration for a healthy 40 year old adult male patient In actual applications the MAC value may be affected by age weight and other factors The formula to calculate the MAC value is as follows MAC y eee EtAgent i o AgentVol zye Where N is the number of all agents including N20 that the AG module can measure EtAgenti is the concentration of each agent and AgentVolagei is the concentration of each agent at 1 MAC with age correction The formula for calculating age correction of 1 MAC is MAC MAC x1 Q 0 00269 age 40 age For example the Des concentration at 1 MAC of a 60 year old patient is 696 x 1 9 909099099 6 x0 88 The AG module measures there are 4 of Des 0 5 of Hal and 50 of N20 in the patient s end tidal gas o 0 0 MAC 4 0 is 0 5 de 50 2 04 6 x0 88 0 77 x0 88 105 x 0 88 NOTE The formula above is only suitable for patients who are older than one year If the patient is less than one year the system uses one year to do age correction Passport 12 Passport 8 Operator s Manual 17 3 17 4 Preparing to Measure AG
79. 00 analog output cable 009 003117 00 Synchronization cable 009 003118 00 LCD display 17 0000 10 11284 USB drive 4G 023 000217 00 023 000218 00 Recorder TR6F 30 67306 Thermal paper 0683 00 0505 01 Wall mount bracket for external display 0010 30 42956 Bedrail Hook subassembly Passport 12 115 012698 00 Bedrail Hook subassembly Passport 8 115 012697 00 Transition Plate Kit for rolling stand and wall mount 115 012695 00 Data output package CD Cable User s Guide 6800 30 51213 Rolling Stand with Quick Release Passport 8 Transport stand for rolling stand Passport 12 045 000924 00 115 002966 00 Quick Release for wall mount Passport 8 Passport 12 Quick release for Passport 12 rolling stand 045 000954 00 M series wall mount with Quick Release Passport 8 and Passport 12 045 000931 00 VHM wall mount Passport 8 and Passport 12 115 00691 1 00 27 6 Passport 12 Passport 8 Operator s Manual A Product Specifications A 1 Monitor Safety Specifications A 1 1 Classifications The monitor is classified according to IEC60601 1 Type of protection against electrical shock Class I equipment energized from an external and internal electrical power source Degree of protection against electrical shock Type BF defibrillation proof for CO and AG monitoring Type CF defibrillation pro
80. 16 53 30 3 k 50 sun oe Trend Group Zoom Waves 1 Event mark area 2 Time axis 3 Graphic trends area 4 Parameter area 5 Cursor Events are marked with colors in the event mark area Red represents high level alarm event Yellow represents medium low level alarm event Green represents manual event In this review window W Select Trend Group and you can select a trend group for viewing in the popup menu If Custom 1 or Custom 2 is selected you can further select Define Trend Group Then you can select the parameters for viewing in the popup menu E Select Zoom to set the time length of the review window W Select Waves to set the number of waves displayed in one page Passport 12 Passport 8 Operator s Manual 19 1 To browse the graphic trends you can either Select or beside Scroll to move the cursor one step to the left or right to navigate through the graphic trends or Select 9 or to move the cursor one page to the left or right to navigate through the graphic trends A time indicating your current position displays above the parameter area Numeric measurement values corresponding to the cursor location change as the cursor is moved The measurement value that triggered a high level alarm has a red background The one that triggered a medium low level alarm has a yellow background Select or beside Event to position the cursor to a different event time Select the Reco
81. 2 Passport 8 Operator s Manual 2 9 Technical Alarm Area This area shows technical alarm messages and prompt messages When multiple messages occur the messages scroll Select this area and the technical alarm list displays Physiological Alarm Area This area shows physiological alarm messages When multiple alarms occur the messages scroll Select this area and the physiological alarm list displays Waveform Area This area shows measurement waveforms The waveform name displays at the upper left corner of the waveform Select this area and the corresponding measurement setup menu displays Parameter Area A This area shows measurement parameters Each monitored parameter has a parameter window and the parameter name displays at the upper left corner The corresponding waveform of each parameter displays in the same row in the waveform area Select this area and the corresponding measurement setup menu displays Parameter Area B For the digital parameters displayed in this area their corresponding waveforms are not displayed Prompt Message Area This area shows the prompt messages network status icons and battery status icons etc For details about battery status symbols refer to chapter 24 Batteries e El indicates the monitor is successfully connected to a wired network EXE indicates the monitor has failed to connect to a wired network E indicates the wireless function optional is working EJ indicates the
82. 2 Passport 8 Operator s Manual E Symbols and Abbreviations E 1 Symbols HA uV us A Ah bpm bps oC cc cm dB DS oF 9 GHz GIT mcg mEq mg min ml mm mmHg cmH20 ms mV mW MQ nm microampere microvolt Microsecond ampere ampere hour beat per minute bit per second centigrade cubic centimeter centimeter decibel dyne second fahrenheit gram gigahertz gutta hour hertz inch kilogram kilopascal litre pound meter milliampere hour mega byte microgram milli equivalents milligram minute milliliter millimeter millimeters of mercury centimeters of water millisecond millivolt milliwatt megaohm nanometer Passport 12 Passport 8 Operator s Manual rpm IV A V A Il x breath per minute second volt volt ampere ohm watt minus negative percent per divide or plus equal to less than greater than less than or equal to greater than or equal to plus or minus multiply E 2 Abbreviations AaDO AAMI AC ACI Adu AG AHA ANSI Ao Art aVF aVL aVR awRR BAP BIS BP BPSK BSA BT BTPS Cll CCI C O alveolar arterial oxygen gradient Association for Advancement of Medical Instrumentation alternating current acceleration index adult anaesthesia gas American Heart Association American National Standard Institute aortic pressure arterial left foot augmented lead left arm augmented lead right arm augmented lead airway respir
83. 21 1 21 3 Starting and Stopping Recordings To manually start a recording you can either W Press the Record hardkey on the front of the monitor E Select the s hardkey on the front of the recorder module or W Select the Record button from the current menu or window Automatic recordings will be triggered in the following conditions E Timed recordings will start automatically at preset intervals W If both Alarm and Alm Rec for a measurement are set on an alarm recording will be triggered automatically as alarms occur To manually stop a recording you can either Press the Record or s hardkey again or W Select Clear All Tasks in the Record Setup menu Recordings stop automatically when m Arecording is completed W The recorder runs out of paper W When the recorder has an alarm condition When a recording is stopped the following markers will be added W Automatically stopped recording prints two columns of at the end of the report W Manually or abnormally stopped recording prints one column of at the end of the report 21 4 Setting up the Recorder 21 4 1 Accessing the Record Setup Menu By selecting Main Menu Record Setup gt gt you can access the Record Setup menu 21 4 2 Selecting Waveforms for Recording The recorder can record up to 3 waveforms at a time You can select in order Waveform 1 Waveform 2 and Waveform 3 in the Record Setup menu and then
84. 3 5 kg 7 8 pound batteries for Passport 12 Passport 12 Passport 8 Operator s Manual A 4 Hardware Specifications A 4 1 Display Host display Screen Size Screen type Resolution diagonal Passport 12 12 1 color TFT LCD 800x600 pixels Passport 8 8 4 External display Screen type Medical grade TFT LCD A 4 2 Recorder Method Thermal dot array Paper width 50 mm 1 mm Paper speed 25 mm s or 50 mm s with accuracy within 5 Number of waveform channels Maximum 3 A 4 3 LEDs Alarm lamp 1 two color coded yellow and red Power on LED 1 green AC power LED 1 green Battery LED 1 green A 4 4 Audio Indicator Speaker Give alarm tones 45 to 85 dB key tones QRS tones support PITCH TONE and multi level tone modulation alarm tones comply with IEC60601 1 8 A 4 5 Monitor Interface Specifications Power 1 AC power input connector Wired network 1 RJ45 connector 100 Base TX IEEE 802 3 USB 2 connectors USB 2 0 Equipotential Grounding Terminal 1 Multifunctional connector 1 VGA connector 1 Passport 12 Passport 8 Operator s Manual A 4 6 Outputs Analog Output Standard Meets the requirements of IEC60601 1 for short circuit protection and leakage current ECG Analog Output Diagnostic mode 0 05 to 150 Hz
85. 6 seconds The resulting Sat Seconds are 96 SpO Seconds Sat Seconds 2x 2 4 4x 3 12 6x 6 36 Total Sat Seconds 52 After approximately 10 9 seconds a Sat Second alarm would sound because the limit of 50 Sat Seconds would have been exceeded SpO2 90 88 OTT 86 IPTPP 84 012 34 5 6 7 8 9 10 11 Seconds 11 4 Passport 12 Passport 8 Operator s Manual Saturation levels may fluctuate rather than remaining steady for a period of several seconds Often the patient 96 SpO may fluctuate above and below an alarm limit re entering the non alarm range several times During such fluctuation the monitor integrates the number of 96SpO points both positive and negative until either the Sat Seconds limit is reached or the patient SpOz re enters the non alarm range and remains there NOTE The SpO2 Too Low or SpO2 Too High alarm is presented in the case that SpO value violates the alarm limits for 3 times within one minute even if the setting of Sat Seconds is not reached 11 5 7 Changing the Speed of the Pleth Wave In the SpO2 Setup menu select Sweep and then select the appropriate setting The faster the waveform sweeps the wider the waveform is 11 5 8 Zooming PI Value For Masimo SpO module you can display PI value in larger characters for better view To zoom in the display of PI value set PI Zoom to Yes from the SpO2 Setup menu 11 5 9 Setting the Alarm Level
86. 950 safety standards for information technology equipment and IEC 60601 1 safety standards for medical electrical equipment The system configuration must meet the requirements of the IEC 60601 1 medical electrical systems standard Any personnel who connect devices to the equipment s signal input output port is responsible for providing evidence that the safety certification of the devices has been performed in accordance to the IEC 60601 1 If you have any questions please contact Mindray If itis not evident from the equipment specifications whether a particular combination with other devices is hazardous for example due to summation of leakage currents please consult the manufacturers or else an expert in the field to ensure the necessary safety of patients and all devices concerned will not be impaired by the proposed combination CAUTION The equipment should be installed by authorized Mindray personnel NOTE The software equipment copyright is solely owned by Mindray No organization or individual shall resort to modifying copying or exchanging it or to any other infringement on it in any form or by any means without due permission 3 1 1 Unpacking and Checking Before unpacking examine the packing case carefully for signs of damage If any damage is detected contact the carrier or Mindray If the packing case is intact open the package and remove the equipment and accessories carefully C
87. A 1 A1 Monitor Safety SpecificatiOris eee e t RHENUM e Re EUH EP a ere e ep eie epe etd A 1 A 2 Power S pply Specificationis et eee ente eet E eerte eee et ee ee eee eee iet A 2 A 3 Physical SPecifications lt ssvcsscascsscsacccscassbecsis coanzacatesscceavssscosasdessussiavsuseavetessssesesdccsaslscdsbacashasannsedasensssadssaasbutat S E L a R A 2 A A Hardware Specificatioris oerte E E EA NNE RREN EEREN A 3 A5 Datta Storag Eisirein iiaii AE EELEE ENN EEEE AEEA SEENE AN LEENS A 4 A 6 Wireless Network EE REER IE Ee ET e e RRN A 5 A Meas rement Specification irosicoerosi cierto robos tos a beate praebe Mene Hoe Eo reb roe e eed TAERE SRSA red Ceci SESER edet A 5 B EMC and Radio Regulatory Compliance eee eee eese eese eene essent enses etna tese ta senses etas en setas essen seen sese ta sees senses seas eaae B 1 B IEMG S reete be Are fece rer ete eere eee E er eee este Ree aed epe i oet fere ese egit pests B 1 B 2 Radio Regulatory Com pliant ce aicenacsicsssccsaacassssssccsscssasscasisacccanscasssasstoasedeazeacsanssdnbesdasaedascanatcsasdaecoudscensdesscsdicnadasdnaueuccanssdasenssinteceaierssenettchis B 5 eiPriED D EeSTOIRI CAMPI RES arois C 1 CT Parameters Configuratiori 4 ri tere hee Re enel eei e ee eet Ree ee eee teet dre C1 C2 Routine CONFIQUIPATION sicesssszesisccsasssstssssccessestosancobades
88. CG waveform cannot be set off C 2 4 Review O M Item Name ecu General OR ICU NICU CCU User Defaults Interval TT ES 30 min 5min 30 min Tabular Trends Trend Group m Standard Graphic Trends Trend Group Standard Minitrend Length 2h Full Disclosure Save Waves A S Save ECG1 by default C 2 5 Event O M Item Name z General OR ICU NICU CCU User Defaults M Waveform 1 II Waveform 2 l Pleth l Waveform 3 Pleth Resp Pleth C 2 6 Record O M Item Name e General OR ICU NICU CCU User Defaults Length X 8s Interval y Off Paper Speed gi 25 mm s Alm Rec X Off X represents a parameter label Passport 12 Passport 8 Operator s Manual C 2 7 Print Item Name E General OR ICU NICU CCU User Defaults Paper Size A4 Amplitude 10mm mV ECG Reports Sweep 25 mm s Auto Interval Off Set as End Case Report Unselected Back Auto Spacing Auto Tabular Trends Report Layout Parameter Oriented Reports Currently Displayed Trended Selected Parameters Standard Parameter Group Unselected Custom Unselected Set as End Case Report Unselected Graphic Trends accor Back
89. Demo mode 1 Select Main Menu Maintenance gt gt 2 Select Demo gt gt Enter the required password and then select Ok To exit the Demo mode 1 Select Main Menu Maintenance gt gt 2 Select Exit Demo and then select Ok 3 The monitor exits the Demo mode A WARNING The Demo mode is for demonstration purpose only To avoid the potential risk of the simulated data being mistaken for the monitored patient s data do not enter the Demo mode while monitoring a patient Otherwise improper patient monitoring and delayed treatment could occur Passport 12 Passport 8 Operator s Manual 26 5 FOR YOUR NOTES 26 6 Passport 12 Passport 8 Operator s Manual 2 7 Accessories The accessories listed in this chapter comply with the requirements of IEC 60601 1 2 when in use with the patient monitor The accessory material that contacts the patients has undertaken the bio compatibility test and is verified to be in compliance with ISO 10993 1 For details about the accessories refer to the instructions for use provided with the accessory WARNING Use accessories specified in this chapter Using other accessories may cause damage to the patient monitor or not meet the claimed specifications Single use accessories are not designed to be reused Reuse may cause a risk of contamination and affect the measurement accuracy CAUTION Checkthe accessories and
90. E PER CHEN TN UEM EH REOR 20 3 1 Performing Calculations 20 32 Entered Paramete Sinsen hnnan eie t ue leet eet e e reete dee obice trete n 20 3 3 Calculated Parameters and Formulas scssssscsssssssseseccssesscsnssccsnecessuecccssseccssceesusecssnsceesusecesuseessnseeesnscessusecesnsecssneceecnseeesaes 20 4 204 VentilationiCalculatioris rettet P a e eee e te HP eti reser a reed e 20 5 204 1 Performinig Calculatioris aeree nee ette Ree e URP RR Te bee eee EAE Ee ere e cbe 20 5 20 42 Entered Parameters ise ree e re ere ree ee RE ee E etre eee E 20 5 20 4 3 Calculated Parameters and Formulas scssssssssssssssssssecsseeccsneccsnecessuecsssnsccssuceesusecssnsceccusecesuscessusecesnscessusceesnseessneeeeenseessaee 20 6 20 5 Hemodynamic Calculations s ER ISERNIA HN verser qve EE ND eMe re 20 6 20 5 1 Performing Calculations 2 eere apte ler R ie e e e Eae RR iaaa 20 6 20 5 2 Entered Parameters reed e e isdem e eere ee eee 20 7 20 5 3 Calculated Parameters and Formulas csscssssccssssssssseecssesscsnssecsnecessuescesseecssseesesusecssnsceesusecesuscessusecessscessuseessnseessnecesenseeesaee 20 7 20 6 Renal Calculations ERR EUN SERRE REINES EE TROE OEA 20 8 20 6 Performing Calculations seasick ae en see Rete tit epa ee TORRE ee LR e e eee bap nae 20 8 20 6 2 Entered Parameters an etr Rte re ern RGR ORR ENEN 20 8 20 6 3 Calculated Parameters and Formulas scsssssssssssscsssssccssesscsnsecssnecessnccssssecssseeses
91. ECG signal is too weak for the monitor to perform ECG analysis ECG Weak Signal H Check the patient s condition and the ECG connections Asystole H VFib VTac H Vtac H Vent Brady H Extreme Tachy H ECG Extreme Brady H Arrhythmia has occurred to the patient Check the patient s RonT M condition and the ECG connections VT gt 2 M Couplet M PVCs min M Bigeminy M Trigeminy M Passport 12 Passport 8 Operator s Manual D 1 Measurement Alarm messages L Cause and solution Tachy M Brady M Missed Beats M Irr Rhythm M Vent Rhythm M Multif PVC M Nonsus Vtac M Pause M PNP M The pacer appears abnormal Check the pacer PNC M The respiration signal was too weak for the monitor to perform Resp Apnea H respiration analysis Check the patient s condition and the Resp Resp connections The patient s heartbeat has interfered with his respiration Check the Resp Artifact H patient s condition and the Resp connections The SpO value has fallen below the desaturation alarm limit Check SpO Desat H the patient s condition and check if the alarm limit settings are correct SpO2 The pulse signal was too weak for the monitor to perform pulse No Pulse H analysis Check the patient s condition SpO2 sensor and measurement site CO CO Apnea H The patient stops breathing or the respiration signal was too weak for the monitor to perform respiration analysis Che
92. Following is an electrode configuration when using 3 leadwires W RA placement directly below the clavicle and near the right shoulder W LA placement directly below the clavicle and near the left shoulder W LL placement on the left lower abdomen 5 Leadwire Electrode Placement Following is an electrode configuration when using 5 leadwires BA W RA placement directly below the clavicle and near the right shoulder W LA placement directly below the clavicle and near the left shoulder T AN E RL placement on the right lower abdomen e 7 j W LL placement on the left lower abdomen RL W V placement on the chest 8 2 Passport 12 Passport 8 Operator s Manual The chest V electrode can be placed on one of the following positions W V1 placement on the fourth intercostal space at the right sternal border W V2 placement on the fourth intercostal space at the left sternal border W V3 placement midway between the V2 and V4 electrode positions W V4 placement on the fifth intercostal space at the left midclavicular line W V5 placement on the left anterior axillary line horizontal with the V4 electrode position W V6 placement on the left midaxillary line horizontal with the V4 electrode position W V3R V6R placement on the right side of the chest in positions corresponding to those on the left W VEplacement over the xiphoid process W V7 placement on posterior chest at the left posterior
93. G leakage should be carried out by the service personnel only Ensure the monitor is safety and performance tested by qualified service personnel before initial installation after repair or upgrade or during regularly scheduled maintenance Contact your service personnel if any maintenance is required Make sure to clean and disinfect the equipment before any test and maintenance CAUTION Changing the settings in User Settings gt gt and Factory Maintenance gt gt menus may cause data loss Service personnel should acquaint themselves with the test tools and make sure that the test tools and cables are applicable Check Maintenance Item Recommended Frequency Performance Tests Visual inspection When first installed or reinstalled Performance test ECG test Verificvation Resp performance test SpO test Pressure check NIBP test Leakage test Temp test IBP test Performance test C O test Leakage test CO tests and Pressure check calibration Calibration Leakage test AG test Performance test Calibration 1 If the user suspects that the measurement is incorrect 2 Following any repairs or replacement of relevant module 3 At least once every two years Note At least once a year is recommended for NIBP CO and AG Nurse call relay performance test Analog output performance test If the user suspects that the an
94. Monitor 13 4 3 4 Using the Knob 3 4 BD USING KEYS met RN 3 4 3 6 Using the aIoj etna 3 5 3 7 Using the On screen Keyboard cciescsscscescszscevscsnssczssuwessneencasgeansvayeteusesenteestansysanseesnasocavaucensecedvastaunssyatosevenadeatescesoasdeatmuasseunanenvaneng tees 3 5 3 8 Using the Main Mehl ettet tails DANN RE E NURSE L S RUN Rte e EARN IR eo nee Rer eats 3 5 3 9 Setting the Screens suse n pi ee E Ee pe Rete ete e RH eer TE HR e ERA 3 6 3 10 Displaying Uca MP 3 7 31 Changing General Settings ott ee RE E EA ETA T EA E v EHE Aa S 3 7 3 11 1 Setting UP a MONITOR er H 3 7 311 2 CRAG oro HE Lars ae fesse eases ALL SSAA T HERD INED 3 7 3 11 3 Adjusting the Screen Brightness ssssscssssccsseccessssccssscesssecsssusecssseecesuceccsucessusccesuscessuecsesusecssuseeesuseessuscessusecesusecssneeeesnseessaees 3 8 31 4 Showing Hiding Help Text ette ec epe pneri dete de eR PEN eri eerte etia 3 8 321125 Setting the Date and Time teet eret sere e aree RR Reel ee e ERE e edet Reps 3 8 Be 1T 6 Adjusting Volume eie te n ei Ree hee HR nene eee be eet a ette 3 8 EM PASSEZ AGERET ETT AaS u paS bSAE00SSSs SEESE SSSA ESSAEENVV ESAS NASKAS KESSENS ENESESSE ESIS iESO 3 9 3 12 1 Switching the Parameters On Off ssssessscsssesssccsssessscessesesccsnsesencesneseseesnsessscesseseecesnssssecesnesecse
95. Network interruption alarm When a network interruption occurs the equipment shows a disconnection icon on the screen and presents the related alarms When the network interruption is resolved wireless connection recovers automatically A 7 Measurement Specifications The adjustable range of alarm limits is the same with the measurement range of signals unless otherwise specified A 7 1 ECG ECG Standards Meet standards of EC11 EC13 EN60601 2 27 IEC60601 2 27 and IEC60601 2 25 3 lead I II Ill Lead set 5 lead I II Ill aVR aVL aVF V ECG standard AHA IEC Display sensitivity 1 25 mm mvV X0 125 2 5 mm mvV X0 25 5 mm mYV X0 5 10 mm mvV X1 20 mm mvV X2 40 mm mV X4 Accuracy 5 Sweep speed 6 25 mm s 12 5 mm s 25 mm s 50 mm s Accuracy 10 Bandwidth 3dB 0 05 to 150 Hz 0 5 to 40 Hz 1 to 20 Hz Diagnostic mode Monitor mode Surgical mode Passport 12 Passport 8 Operator s Manual A 5 ST mode 0 05 to 40 Hz Diagnostic mode gt 90 dB Monitor mode gt 105 dB Common mode rejection ratio Surgical mode gt 105 dB ST mode gt 105 dB Notch 50 60 Hz Differential input impedance 25MO Input signal range 8 mV peak to peak value Accuracy of reappearing input signal Based on EC11 to determine system total error and frequency response Electrode offset potential tolerance 500 mV Lead off detection
96. No Implied License Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized sensors or cables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device Passport 12 Passport 8 Operator s Manual 11 8 Nellcor Information W Nellcor Patents This device may be covered by one or more of the following US patents and foreign equivalents 5 485 847 5 676 141 5 743 263 6 035 223 6 226 539 6 411 833 6 463 310 6 591 123 6 708 049 7 016 715 7 039 538 7 120 479 7 120 480 7 142 142 7 162 288 7 190 985 7 194 293 7 209 774 7 212 847 7 400 919 W Nolmplied License Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized replacement parts which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device 11 9 Troubleshooting This section lists the problems that might occur If you encounter the problems when using the equipment or accessories check the table below before requesting for services If the problem persists contact your service personnel NOTE Never try to disassemble the equipment or supplied accessories There are no internal user serviceable parts Symptoms Possible Cause Correction Action Dashes display in place of
97. No Sensor A Make sure that the sensor is connected CO Main Board Err C CO Checking Sensor C There is a problem with the CO module Re plug the CO Replace Scrubber amp Pump C module or restart the monitor CO 15V Overrange C CO Hardware Err C Check the connections of the watertrap and re connect AG No Watertrap B it AG AG Change Watertrap A Wait until the change is completed AG Watertrap Type Wrong A Make sure that a correct watertrap has been used O Accuracy Unspecified A The measured value has exceeded the specified accuracy Passport 12 Passport 8 Operator s Manual D 5 Measurement Alarm message l Cause and solution N20 Accuracy Unspecified A range CO Accuracy Unspecified A Enf Accuracy Unspecified A Iso Accuracy Unspecified A Sev Accuracy Unspecified A Hal Accuracy Unspecified A Des Accuracy Unspecified A awRR Accuracy Unspecified A Remove the AG module Stop using the module and AG Hardware Err A contact your service personnel AG Airway Occluded A Check the airway and remove the occlusion Re plug the module or restart the monitor and then AG Zero Failed A perform a zero calibration again 12V Too High C 12V Too Low C 5V Too High C There is a problem with the system power supply Restart 5V Too Low C the monitor 3 3V Too High C 3 3V Too Low C Connect the monitor to an AC pow
98. Numerics This example shows ST numerics with 5 lead ECG Your monitor screen may look slightly different from the illustration 8 6 3 2 ST Segment ST segment shows a QRS complex segment for each measured ST lead The current ST segment is drawn in the same color as the ECG wave usually green superimposed over the stored reference segment drawn in a different color The information is updated once every ten seconds To display the ST segment on normal screen 1 2 Enter the ST Analysis menu Set ST Analysis to On Enter the Screen Setup window from the Screens menu Set ST Segment to be displayed Passport 12 Passport 8 Operator s Manual 8 9 Select the ST parameter window or ST segment area to enter the ST Analysis menu ST Analysis Ea ST Analysis M Change Ref gt Save Ref Delete Ref Adjust STpoint gt gt ST Alarm Setup gt gt Record Switch on off ST analysis 8 6 4 Saving the Current ST Segment as Reference Select Save Ref in the ST Analysis menu to save the current segment as a reference Up to 20 reference segment groups can be saved NOTE If the memory is full and you do not delete a group before saving a new one the earliest saved group is deleted automatically 8 6 5 Changing the Reference Segment Select the 4 and X arrow keys beside the Change Ref to switch between different reference segment groups 8 6 6 Deleting a Re
99. PV source by enabling the PPV measurement WARNING This monitor can calculate PPV from beat to beat values of any arterial pulsatile pressure The circumstances under which the calculation of a PPV value is clinically meaningful appropriate and reliable must be determined by a physician The clinical value of the derived PPV information must be determined by a physician According to recent scientific literature the clinical relevance of PPV information is restricted to sedated patients receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia PPV calculation may lead to inaccurate values in the following situations atrespiration rates below 8 rpm during ventilation with tidal volumes lower than 8 ml kg for patients with acute right ventricular dysfunction cor pulmonale ThePPV measurement has been validated only for adult patients Passport 12 Passport 8 Operator s Manual 14 5 14 7 Overlapping IBP Waveforms The IBP waveforms can be displayed together To combine IBP waveforms 1 2 4 Select Main Menu Screen Setup gt gt Screen Layout gt gt to access the Screens window Select the Screen Setup tab In Area A select IBP Overlap from the drop down list and then select the IBP waves to be overlapped on the left side of the same line Choose Screen Screen Setup Big Numerics Screen Setup B Parameters Switch
100. Passport 12 Passport 8 Patient Monitor Operator s Manual C 0123 Copyright 2014 Shenzhen Mindray Bio Medical Electronics Co Ltd All rights reserved E Release time 2014 12 E Revision 1 0 WARNING Federal Law USA restricts this device to sale by or on the order of a physician Intellectual Property Statement SHENZHEN MINDRAY BIO MEDICAL ELECTRONICS CO LTD hereinafter called Mindray owns the intellectual property rights to this Mindray product and this manual This manual may refer to information protected by copyrights or patents and does not convey any license under the patent rights of Mindray nor the rights of others Mindray intends to maintain the contents of this manual as confidential information Disclosure of the information in this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden Release amendment reproduction distribution rental adaption and translation of this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden mindra y i Lg and MINDRAY arethe registered trademarks or trademarks owned by Mindray in China and other countries All other trademarks that appear in this manual are used only for editorial purposes without the intention of improperly using them They are the property of their respective owners Passport 12 Passport 8 Operator s Manual Ma
101. Placing Resp Electrodes As the skin is a poor conductor of electricity preparing the skin is necessary for a good respiration signal You can refer to the ECG section for how to prepare the skin For details refer to section 8 3 1 Preparing the Patient and Placing the Electrodes As the respiration measurement adopts the standard ECG electrode placement you can use different ECG cables 3 lead or 5 lead Since the respiration signal is measured between two ECG electrodes if a standard ECG electrode placement is applied the two electrodes should be RA and LA of ECG Lead I or RA and LL of ECG Lead Il NOTE To optimize the respiration waveform place the RA and LA electrodes horizontally when monitoring respiration with ECG Lead I place the RA and LL electrodes diagonally when monitoring respiration with ECG Lead Il Lead Lead II 9 4 1 Optimizing Lead Placement for Resp If you want to measure Resp and you are already measuring ECG you may need to optimize the placement of the two electrodes between which Resp will be measured Repositioning ECG electrodes from standard positions results in changes in the ECG waveform and may influence ST and arrhythmia interpretation 9 4 2 Cardiac Overlay Cardiac activity that affects the Resp waveform is called cardiac overlay It happens when the Resp electrodes pick up impedance changes caused by the rhythmic blood flow Correct electrodes placement can help to reduce cardiac ov
102. ST Segment analysis currently unavailable in the US and Canada is intended for adult patients only Arrhythmia detection ST Segment analysis and AG monitoring are available for Passport 12 Patient Monitors only The monitors are to be used in healthcare facilities by clinical physicians or appropriate medical staff under the direction of physicians 2 2 Applied Parts The applied parts of the Passport 8 12 patient monitors are ECG electrodes and leadwires SpO sensor NIBP cuff Temp probes IBP transducer C O sensor CO sampling line nasal sampling cannula and water trap AG sampling line water trap and airway adapter Passport 12 Passport 8 Operator s Manual 2 1 2 3 Main Unit 2 3 1 Front View f mindray y e9 9c9 COCOCO Ma N J 12 1 Alarm lamp When a physiological alarm or technical alarm occurs this lamp flashes as defined below High level alarms the lamp quickly flashes red Mediumlevelalarms the lamp slowly flashes yellow Low level alarms the lamp lights yellow without flashing 2 Display Screen 3 AC power LED 2 2 Passport 12 Passport 8 Operator s Manual 10 11 12 Power On Off Switch Pressing this switch turns the monitor on When the monitor is on pressing and holding this switch turns the monitor off An indicator is built into this switch It turns o
103. SpO Low ig 90 Desat Limit i 80 Sweep id 25 mm s NIBP Simul bi Off Sensivity Masimo Normal Averaging Masimo x 8s Sat Seconds Nellcor X Os C 1 5 Temp O M Item Name E General OR ICU NICU CCU User Defaults M Alarm On Alm Lev Med T1 T2 High 9C 38 0 T1 T2 Low 9C d sd 35 0 TD High 9C 2 0 C 1 6 NIBP O M Item Name 3 General OR ICU NICU CCU User Defaults M Alarm On Alm Lev Med Interval 115 min 5 min 15 min 30 min 15 min NIBP End Tone Off Adu 80 Cuff Press Ped M a 60 mmHg Neo 40 Adu 160 Initial Pressure Ped RS se 140 mmHg Neo 90 Passport 12 Passport 8 Operator s Manual C 7 Alarm Limits Adu 160 NIBP S High Ped 1120 mmHg Neo 90 Adu 90 NIBP S Low Ped 70 mmHg Neo 40 Adu 110 NIBP M High Ped 190 mmHg Neo 70 Adu 60 NIBP M Low Ped 50 mmHg Neo 25 Adu 90 NIBP D High Ped 70 mmHg Neo 60 Adu 50 NIBP D Low Ped 140 mmHg Neo 20 C 1 7 IBP O M Item Name c General OR ICU NICU CCU User Defaults Alarm On Alm Lev Med P1 Measure All P2 Measure All P3 Measure x Mean P4 Measure Mean Sensitivity id Med Sweep d 25 mm s Filter 12 5 Hz
104. Wait until the message Transfer from storage medium successful appears before removing the USB drive CAUTION The USB drive you use may be write protected In this case make sure the USB drive is in read write mode Do not remove the storage medium during data transfer process Otherwise data files may be damaged The normal monitoring function will be affected during data export Do notperform any monitoring activity during data export 4 8 Connecting to a CMS If your monitor is connected to a CMS All patient information measurement data and settings on the monitor can be transferred to the CMS All patient information measurement data and settings can be displayed simultaneously on the monitor and CMS For some functions such as editing patient information admitting a patient discharging a patient starting stopping NIBP measurements etc bi directional control can be achieved between your monitor and the CMS For details refer to the CMS s instructions for use 4 4 Passport 12 Passport 8 Operator s Manual 5 Managing Configurations 5 1 Introduction When performing continuous patient monitoring the clinical professional often needs to adjust the monitor s settings according to the patient s condition The collection of all these settings is called a configuration Allowing you to configure the monitor more efficiently the monitor provides different sets of configurations to accommodate the varying pa
105. X 2 Select Setup in the View Other Patient window 3 Select the desired monitors from the Connected Monitor List and then select the X button The selected monitors constitute a Care Group NOTES e Monitors using software version prior to 05 17 00 cannot view or be viewed by monitors of software version 05 17 00 or later 6 4 2 Viewing the Care Group Overview Bar OR 023 OR 099 The Care Group overview bar is located at the bottom of the View Other Patient window In the overview bar the department and bed label for any Care Group beds are displayed For telemetry is displayed before the department label The color in which a Care Group bed appears matches its status Red indicates the bed is having high level physiological alarms or the telemetry is in alarm such as nurse call or event W Yellow indicates the bed is having medium level or low level physiological alarms or medium level technical alarms Blue indicates the bed is having low level technical alarms W Light grey indicates the bed fails to be networked Dark grey indicates the bed is in the Standby mode You can view a Care Group bed s alarms by selecting it from the Care Group and you can select the View This Patient button to view the bed in the View Other Patient window For more details about Care Group alarms refer to the chapter 24 Batteries 6 4 Passport 12 Passport 8 Operator s Manual 6 4 3 Understanding the
106. act Medex IBP Reusable Cable REF 5203511 to be used in connection with the Adapter Cable 0010 20 42795 Combitrans Monitoring Set contact Braun for detailed information noe Combitrans Attachment Plate Holder REF 5215800 Combitrans Attachment Plate contact Braun for detailed information 27 4 Passport 12 Passport 8 Operator s Manual Manufacturer Accessories Truck cable 0010 21 43082 SP844 Physiological Pressure Transducer Memscap 844 26 Monitoring Line Set 84X 49 Mounting Bracket Reusable Blood Pressure Monitor Interface Cable REF 650 206 Deltran Disposable Pressure Transducer System More Deltran sensors are available from Utah For detailed information contact Utah an Pole Mount Unit ERF 650 150 Deltran Three Slot Organizer Attaches to I V Pole Mount REF 650 100 Deltran Four Slot Organizer Attaches to I V Pole Mount REF 650 105 IBP Truwave Reusable Cable 0010 21 12179 Pressure Monitoring Kit With Truwave Disposable Pressure Transducer Edwards More Truwave sensors are available from Edwards For detailed information contact Edwards DTSC IV Pole Clamp for Model DTH4 Backplate Holder DTH4 Disposable Holder for DPT 27 6 C O Accessories Model Material Part No CO7702 12Pin C O cable 0010 30 42743 SP4042 TI Sensor 6000 10 02079 SP5045 TI Sensor Housing 6000 10 02080 MX387 12CC Control Syringe W 1CC Stop W Rotator 6000 10 02081 131HF7 Thermodilution catheter
107. adult pediatric mode 70 to 10096 3 measured without motion in neonate mode Accuracy 70 to 10096 3 measured with motion 1 to 69 Not specified Refreshing rate 1s SpO averaging time 2 4 s 4 6 s 8 s 105 125 14 5 16s Low perfusion conditions Pulse amplitude gt 0 02 Light penetration gt 5 Low perfusion SpO2 accuracy 2 PI measurement range 0 02 20 Nellcor SpO2 Module Standards Meet standards of ISO9919 Measurement range 0 to 100 Resolution 1 70 to 100 2 adult pediatric Accuracy 70 to 100 3 neonate 0 to 69 Not specified When the SpOz sensor is applied for neonatal patients as indicated the specified accuracy range is increased by 1 to compensate for the theoretical effect on oximeter measurements of fetal hemoglobin in neonatal blood A 7 4 PR Alarm limit Range bpm Step bpm PR High low limit 2 to 300 PR Low 15 to high limit 2 PR from Masimo SpO Module Measurement range 25 to 240 bpm Resolution 1 bpm 3 bpm measured without motion Accuracy 5 bpm measured with motion Passport 12 Passport 8 Operator s Manual A 9 Refreshing rate 1s SPO averaging time Low perfusion conditions 2 45 4 6 s 8 s 105 125 14 5 16s Pulse amplitude gt 0 02 Light penetration gt 5
108. alarm limit measurement range SYS 15 or 45 SYS 15 or105 Adult 45 to 270 IBP ART SYS x 0 68 10 SYS x 0 86 38 IBP S mmHg whichever mmHg whichever Pediatric 45 to 185 Ao mmHg mmHg is greater is smaller Neonate 35 to 115 UAP BAP Dia 15 or 20 Dia 15 or 80 Adult 25 to 225 Dia x 0 68 6 Dia x 0 86 4 32 FAP IBP D mmHg whichever mmHg whichever Pediatric 25 to 150 mmHg mmHg LV is greater is smaller Neonate 20 to 90 P1 P4 Mean 15 or 35 Mean 15 or95 Adult 30 to 245 Arterial Mean x 0 68 8 Mean x 0 86 IBP M mmHg whichever mmHg whichever Pediatric 30 to 180 pressure mmHg 35 mmHg is greater is smaller Neonate 25 to 105 IBP S SYS x 0 75 SYS x 0 75 SYS x 1 25 SYS x 1 25 PA IBP D Dia x 0 75 Dia x 0 75 Dia x 1 25 Dia x 1 25 3to 120 mmHg IBP M Mean x 0 75 Mean x 0 75 Mean x 1 25 Mean x 1 25 IBP CVP ICP LAP RAP IBP M Mean x 0 75 Mean x 0 75 Mean x 1 25 Mean x 1 25 3to 40mmHg UVP P1 P4 Venous pressure 0 to 32 mmHg 0 to 32 mmHg Oto32 mmHg 0 to 32 mmHg remains the same remains the same remains the same remains the same 32to35 mmHg 32to35 mmHg 32to35 mmHg 32to 35 mmHg 29 mmHg 29 mmHg 41 mmHg 41 mmHg 35to45 mmHg 35to 45 mmHg 35 to45 mmHg 35 to 45 mmHg Same as the tCO etCO2 6 mmHg etCO 6 mmHg etCO2 6 mmHg etCO2 6 mmHg measurement range 45 to 48 mmHg 45to48 mmHg 45 to48 mmHg 45 to 48 mmHg CO 39 mmHg 39 mmHg 51 mmHg 51 mmHg 48 mmHg
109. alarm tone pattern For these two patterns the interval between alarm tones identifies the alarm levels as follows E Mode 1 Interval between high level alarm tones continuously Interval between medium level alarm tones 5s Interval between low level alarm tones 20s E Mode2 Interval between high level alarm tones 1s Interval between medium level alarm tones 5s Interval between low level alarm tones 20s If you choose the ISO pattern you can change the interval between alarm tones To change the interval between alarm tones 1 2 3 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Select Alarm Setup gt gt to enter the Alarm Setup menu Select High Alarm Interval s Med Alarm Interval s and Low Alarm Interval s in order and then select the appropriate settings 74 Passport 12 Passport 8 Operator s Manual WARNING When the alarm sound is switched off the monitor will give no audible alarm tones even if a new alarm occurs Therefore the user should be very careful about whether to switch off the alarm sound or not Do not rely exclusively on the audible alarm system for monitoring Adjustment of alarm volume to a low level may result in a hazard to the patient Always keep the patient under close surveillance 7 4 4 Changing the Alarm Tone Pattern To change the alarm tone pattern
110. alog output does not work well Electrical Safety Tests Electrical safety tests At least once every two years Other Tests Power on test 1 When first installed or reinstalled 2 Following any maintenance or the replacement of any main unit parts Touchscreen calibration 1 When the touchscreen appears abnormal 2 After the touchscreen is replaced Recorder check Following any repair or replacement of the recorder Functionality test 1 When first installed Battery check 2 Whenever a battery is replaced Performance test Once a year or if the battery run time reduced significantly 26 2 Passport 12 Passport 8 Operator s Manual 26 3 Checking Monitor and Module Information To view the information about system start time selftest etc select Main Menu Maintenance gt gt Monitor Information gt gt You can print out the information for the convenience of troubleshooting The information will not be saved during shut down You can also view the information about the monitor configuration and system software version by selecting Main Menu Maintenance gt gt Software Version gt gt 26 4 ECG Verification The ECG signal may be inaccurate due to hardware or software problems As a result the ECG wave amplitude becomes greater or smaller In that case you need to verify the ECG module 1 Select the ECG parameter window or wavefor
111. alysis O M Item Name Algorithm General OR ICU NICU CCU User Defaults C M Arrhythmia Threshold Settings Adu Ped 10 PVCs High Neo N A Adu 120 Tachy Ped 160 Neo N A Adu 50 Brady Ped 75 Neo N A Adu Ped 5 Asys Delay np Neo N A Adu Ped 130 Vtac Rate Mindray ai Neo N A Adu Ped 6 Vtac PVCs Ka as Neo N A Multif PVC s a lz Adu Ped 15 Window Neo N A Adu 160 Extreme Tachy Ped 180 Neo N A Adu 35 Extreme Brady Ped 50 Neo N A Passport 12 Passport 8 Operator s Manual Item Name Algorithm General OR ICU NICU CCU User Defaults C M Adu Ped 40 Vbrd Rate e Neo N A Adu Ped 5 Vbrd PVCs PME Neo N A Ad Ped 2 Pause Time PH Neo N A Adu Ped 10 PVCs High Neo N A Adu Ped 4 Asys Delay Spp Neo N A Adu Ped 130 Vtac Rate EE D Neo N A Adu Ped 6 Vtac PVCs RE d Neo N A Mortara Multif PVC s e Adu Ped 15 Window Neo N A Adu 120 Tachy Ped 160 Neo N A Adu 50 Brady Ped 75 Neo N A Arrhythmia Alarm Settings PVCs min Off On Alarm RonT Alarm Off On Nonsus Vtac Alarm Off On Vent Rhythm Alarm Off On Bigeminy Alarm Off On Trigeminy Alarm Off On Mindray Asystole Alarm 1 On VFib VTac Alarm Vtac Alarm 1 On Vent Brady Alarm
112. amage and make sure that all external cables plug ins and accessories are properly connected 2 Checkthe power supply specification is met if mains power is used Only use a power outlet that is properly grounded 3 Plug the power cord into the AC power source If you run the monitor on battery power ensure that the battery is sufficiently charged 4 Pressthe power on off switch on the monitor s front panel The monitor will perform alarm system self test during start up After pressing the power on off button the system shows a Loading screen sounds a beep and the alarm lamp simultaneously turns yellow then red and then turns off followed by the start up screen being shown Then the start up screen disappears The alarm system self test succeeds The monitor enters the normal monitoring screen NOTE Carefully check if the system performs the self test as described above Contact your service personnel or Mindray if the self test is abnormal WARNING Do not use the monitor on a patient if you suspect it is not working properly or if it is mechanically damaged Contact your service personnel or Mindray 3 2 3 Starting Monitoring 1 Decide which measurements you want to take 2 Connectthe required modules patient cables and sensors 3 Make sure that the patient cables and sensors are correctly connected 4 Make sure that the patient settings such as Patient Cat Paced etc
113. anage Configuration Department General 5 3 Changing Department Select Default Config gt Save Current Settings As Edit Config Delete Config Export Config gt gt Import Config Modify Password gt gt If the current department configuration is not the one you want to view you can select Change Department gt gt in the Manage Configuration menu and then choose the one you want for viewing as shown below Select Department BEE Ok Cancel NOTE Changing the department will delete all current user configurations 5 2 Passport 12 Passport 8 Operator s Manual 5 4 Setting Default Configuration The monitor will load the pre set default configuration in the following cases W The monitor restarts after being switched off for more than 120 seconds E A patient is admitted W A patient is discharged W Patient data is cleared Wi Patient category is changed To set the default configuration 1 Select Select Default Config gt gt in the Manage Configuration menu 2 Inthe Select Default Config menu select Load the Latest Config or Load Specified Config When you select Load Specified Config the restored configuration is subject to the patient category adult pediatric or neonate This configuration can be either factory configuration or a saved user config
114. and select either On or Off 3 11 5 Setting the Date and Time To set the date and time 1 Select Main Menu Maintenance gt gt System Time gt gt 2 Setthe date and time 3 Select Date Format and select either yyyy mm dd mm dd yyyy or dd mm yyyy 4 Select Time Format and select either 24h or 12h If your monitor is connected to a central station CMS the date and time are automatically synchronized to that CMS In that case you cannot change the date and time settings on your monitor CAUTION Changing date and time affects the storage of trends and events and may cause data loss Save or record any needed data prior to changing the date and time 3 11 6 Adjusting Volume Alarm Volume To adjust the alarm volume 1 Select the Volume Setup QuickKey or Main Menu Alarm Setup gt gt Others 2 Select Alm Volume and then select the appropriate volume X 10 in which X is the minimum volume depending on the set minimum alarm volume refer to the chapter Alarm and 10 is the maximum volume 3 8 Passport 12 Passport 8 Operator s Manual Key Volume When you press the navigation knob the touchscreen or the hardkeys on the panel the monitor prompts you by making a sound of the key volume you have set To adjust the key volume 1 Select the Volume Setup QuickKey or Main Menu Screen Setup gt gt 2 Select Key Volume and then select the ap
115. appears in the Printer drop down list automatically Select the option and then you can print real time waveforms graphic and tabular trends displaying on the screen of Panorama Central Station for the patient Wi Search for a printer If your selected printer is not in the list or a new printer is added into the network you can select the Search Printer to re search for all printers in the network WI Set up the paper Select Paper Size and and select A4 or Letter 22 4 Starting Report Printouts Reports Contents Procedures ECG reports ECG waveforms and relevant parameter values Select Main Menu Print Setup gt gt ECG Reports gt gt Print Tabular trends Depends on the selected parameter group resolution and time period Select Main Menu Print Setup gt gt Tabular Trends Reports gt gt Print or select Main Menu Review gt gt Tabular Trends Print Print Graphic trends Depends on the selected parameter group resolution and time period Select Main Menu Print Setup gt gt Graphic Trends Reports gt gt Print or select Main Menu Review gt gt Graphic Trends Print Print Arrh alarm review Parameter alarm ECG waveforms and relevant parameter values Depends on the selected alarms Select Print in Arrh Events Select Main Menu Review
116. arameter area to access the AG Setup menu 2 Select RR Source and then select a source or Auto from the dropdown list The RR Source setting takes effect simultaneously to the Resp CO2 and AG modules For details please refer to the section 9 9 Setting Respiration Rate Source 17 6 Changing the Anesthetic Agent When the anesthetic agent used on the patient is changed the AG module detects the mixed anesthetic gas during the transition of two anesthetic agents The time required for completing the replacement of anesthetic agent depends on anesthesia type low flow or high flow and the characteristics of anesthetic agents pharmacokinetics During the transition of two anesthetic agents the monitor gives no prompt messages and the MAC value displayed may be inaccurate The AG module can identify two anesthetic agents automatically When the proportion of the primary and secondary anesthetic agents in the mixture changes the AG module can distinguish between them according to their contributions to the MAC value Then the primary and secondary anesthetic agents will be exchanged for display 17 6 Passport 12 Passport 8 Operator s Manual 17 7 Measurement Limitations The following factors may influence the measurement accuracy W Leaks or internal venting of sampled gas W Mechanical shock W Cyclic pressure up to 10 kPa 100 cmH20 W Other sources of interference if any 17 8 Troubleshooting 17 8 1 When the Gas I
117. associating patient information with the HIS the monitor automatically updates the patient information if the corresponding HIS information changes The monitor can associate the patient s MRN Medical Record Number first name last name date of birth and gender with the HIS NOTE A keyword takes effect only when being defined in the eGateway Refer to eGateway Integration Manager Installation Guide P N 046 002447 00 for details The monitor displays corresponding patient information only when all the keywords have been entered 4 5 Editing Patient Information To edit the patient information after a patient has been admitted when the patient information is incomplete or when you want to change the patient information 4 2 Passport 12 Passport 8 Operator s Manual 1 Select the Patient Setup QuickKey or Main Menu Patient Setup gt gt 2 Select Patient Demographics and then make the required changes 3 Select Ok 4 6 Discharging a Patient To discharge a patient 1 Select the Patient Setup QuickKey or Main Menu Patient Setup gt gt 2 Select Discharge Patient In the pop up menu you can either Select Ok to discharge the current patient or Select Standby then Ok The monitor enters the Standby mode after discharging the current patient or Select Cancel to exit without discharging the patient NOTE Discharging a patient clears all history data stored in th
118. atory gas in the patient s airway by setting the flow rate To set the flow rate 1 Select the CO parameter window to access the CO2 Setup menu 2 Select an appropriate setting from Flow Rate 16 6 Passport 12 Passport 8 Operator s Manual WARNING Please consider the patient s actual bearing capability and select the appropriate flow rate when setting the flow rate 16 4 9 Setting up the CO Wave Select the CO parameter window to access the CO2 Setup menu in which you can W Select Wave Type and then select Draw or Fill Draw The CO wave is displayed as a curved line Fill The CO wave is displayed as a filled area W Select Sweep and then select the appropriate setting The faster the wave sweeps the wider the wave is W Change the size of the CO waveform by adjusting the wave Scale 16 5 Setting RR Source To set RR source 1 Selectthe CO parameter window to access the CO2 Setup menu 2 Select RR Source and then select a source or Auto from the dropdown list The RR Source setting takes effect simultaneously to the Resp CO2 and AG modules For details please refer to section 9 9 Setting Respiration Rate Source 16 6 Barometric Pressure Compensation Both sidestream and microstream CO modules have the function of automatic barometric pressure compensation the system automatically measures the barometric pressure which the monitor is exposed to
119. atory rate brachial arterial pressure bispectral index blood pressure binary phase shift keying body surface area blood temperature body temperature and pressure saturated cardiac index Continuous Cardiac Index cardiac output E 2 Passport 12 Passport 8 Operator s Manual CCO CaO CCU CFI CIS CISPR CMOS CMS CO COHb CP CPI CPO CVP DC Des Dia DPI dPmx DVI DO DOil ECG EDV EEC EEG EMC EMG EMI Enf ESU Et EtCO2 EtN2O EtO EtO EVLW ELWI FAP FCC FDA FEV1 0 Fi FiCO FiN20 FiO Continuous Cardiac Output arterial oxygen content cardiac coronary care unit cardiac function index Clinical Information System International Special Committee on Radio Interference complementary metal oxide semiconductor central monitoring system carbon dioxide carboxyhemoglobin cardiopulmonary cardiac power index Cardiac Power Output central venous pressure direct current desflurane diastolic dot per inch left ventricular contractility digital video interface oxygen delivery oxygen delivery index electrocardiograph end diastolic volume European Economic Community electroencephalogram electromagnetic compatibility electromyography electromagnetic interference enflurane electrosurgical unit end tidal end tidal carbon dioxide end tidal nitrous oxide ethylene oxide end tidal oxygen extravascular lung water extravascular lung water index femoral arterial pressure Federa
120. aults Patient Cat Screen Setup gt gt Parameters gt gt Save Save as Back Select Alarm Setup gt gt Screen Setup gt gt or Parameters gt gt to enter the corresponding menu in which settings can be changed The changed alarm setup items will be marked in red You can select Save or Save as to save the changed configuration Select Save to overwrite the original configuration Select Save as to save the changed configuration as another file with another name 5 4 Passport 12 Passport 8 Operator s Manual 5 7 Deleting a Configuration To delete a configuration 1 2 Select Delete Config gt gt in the Manage Configuration menu The pop up menu shows the existing monitor s user configurations Selecting Config on USB drive gt gt will show the existing user configurations on the USB drive Select the user configurations you want to delete and then select Delete Select Yes in the pop up 5 8 Transferring a Configuration When installing several monitors with identical user configurations it is not necessary to set each unit separately Use a USB drive to transfer the configuration from monitor to monitor To export the current monitor s configuration 1 2 Connect the USB drive to the monitor s USB port Select Export Config gt gt in the Manage Configuration menu In the Export Config menu
121. axil TB TD Temp TFC TFI TFT Toral TP Trect TVe TVi UAP UPS USB UVP VAC VEPT Vi VO VO WLAN respiration rate rapid shallow breathing index arterial oxygen saturation spectral edge frequency sevoflurane self maintenance stroke index satellite module rack arterial oxygen saturation from pulse oximetry signal quality index suppression ratio systolic time ratio stroke volume Stroke Volume Index systemic vascular resistance systemic vascular resistance index stroke volume variation mixed venous oxygen saturation central venous oxygen saturation synchronization systolic pressure axillary temperature Blood Temperature temperature difference temperature thoracic fluid content thoracic fluid index thin film technology oral temperature total power rectal temperature expiratory tidal volume inspiratory tidal volume umbilical arterial pressure uninterruptible power supply universal serial bus umbilical venous pressure volts alternating current volume of electrically participating tissue velocity index oxygen consumption oxygen consumption index wireless local area network E 6 Passport 12 Passport 8 Operator s Manual P N 046 004417 00 1 0
122. axillary line in the fifth intercostal space W V7Rplacement on posterior chest at the right posterior axillary line in the fifth intercostal space Lead Placement for Surgical Patients The surgical site should be taken into consideration when placing electrodes on a surgical patient e g for open chest surgery the chest electrodes can be placed on the lateral chest or back To reduce artifacts and interference from electrosurgical units you can place the limb electrodes close to the shoulders and lower abdomen and the chest electrodes on the left side of the mid chest Do not place the electrodes on the upper arm Otherwise the ECG waveform will be very small WARNING When using electrosurgical units ESU patient leads should be placed in a position that is equal distance from the Electrosurgery electrotome and the grounding plate to avoid burns to the patient Never entangle the ESU cable and the ECG cable together When using electrosurgical units ESU never place ECG electrodes near to the grounding plate of the ESU as this can cause a lot of interference on the ECG signal 8 3 4 Checking Paced Status It is important to set the paced status correctly when you start monitoring ECG The paced symbol a is displayed in the ECG waveform area when the Paced status is set to Yes The pace pulse markers are shown on the ECG wave when the patient has a paced signal If Paced is set to No or the pati
123. ay com 86 755 81888998 86 755 26582680 Mindray DS USA Inc 800 MacArthur Boulevard Mahwah New Jersey 07430 USA 1 800 288 2121 1 201 995 8000 www mindray com Passport 12 Passport 8 Operator s Manual Preface Manual Purpose This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety This manual is based on the maximum configuration and therefore some contents may not apply to your product If you have any questions please contact Mindray This manual is an integral part of the product It should always be kept close to the equipment so that it can be conveniently referenced when needed Intended Audience This manual is intended for clinical professionals who are expected to have a working knowledge of medical procedures practices and terminology as required for monitoring of patients Illustrations All illustrations in this manual serve as examples only They may not necessarily reflect the setup or data displayed on your monitor Manual Conventions talic textis used to quote the referenced chapters or sections W is used to enclose screen text W isused to indicate operational procedures Passport 12 Passport 8 Operator s Manual V FOR YOUR NOTES VI Passport 12
124. btracting ICP from the Art mean Passport 12 Passport 8 Operator s Manual 14 3 14 6 Changing IBP Settings 14 6 1 Changing a Pressure for Monitoring To change a pressure for monitoring 1 Select the pressure you want to change to enter its setup menu In the menu there is a figure showing the current IBP measurement connector IBP1Label Scale Upper Scale Lower Scale Sweep Filter Sensitivity PPY Measurement PPV Source Art Zero Alarm Setup gt gt Auto o 2 Select Label and then select your desired label from the list Labels already used cannot be selected Label Description Label Description PA Pulmonary artery pressure CVP Central venous pressure Ao Aortic pressure LAP Left atrial pressure UAP Umbilical arterial pressure RAP Right atrial pressure BAP Brachial arterial pressure ICP Intracranial pressure FAP Femoral arterial pressure UVP Umbilical venous pressure Art Arterial blood pressure LV Left ventricular pressure P1 to P4 Non specific pressure label NOTE e When two pressures are detected having the same label the monitor changes one pressure label to a currently unused one 14 6 2 Setting Alarm Properties Select Alarm Setup gt gt from the parameter setup menu You can set alarm properties for this parameter in the pop up menu 14 4 Passport 12 Passport 8 Operator s Manual 14 6 3 Changing Averaging Time The IBP value
125. c e b e ve e e Ree RA Ae EER ea cr ee Y en EA E b ete E Yee EO eR 22 4 pad IgCuUEI pe C H M A 22 4 228 1 Printer Out of Paper cdi Ere iE REN TTA FERE ARE eee EN ve YEA RE REI 22 4 22 82 Printer Status Messages erret eee Pea e br cousccveusosvaston cudevedepeubnanssonengssuasvanecuccoudbavsvoaaseconscensentaven 22 4 23 Other FUNCIONS 23 1 23 T Analog OUtpUt ssec ERE ie E AN NE EA 23 1 232 Exporting the LOg aste dee epe ERR LUE DR te e RP EE e tee A EAE N ERa 23 1 23 3 Transferring Data rien ER ebd Ree ue eode E mele reote eee e ER eben ERAS 23 1 23 3 1 Pctri um M M 23 1 23 3 2 Transferring Data by Different Means 23 4 Nurse Call 23 2 23 5 Network Connection sessie e pesti sente e eese ded e enter eerta e se cet rt dec 23 3 23 5 I Settinig the Network DIype ccrte aia es xS UR peat eek ese EAEE RR rele inan 23 3 23 5 2 Setting up the Wireless Network ssssscsssssscssssccsssscccssecssseecesssecessscessuscsesssecssssesesusecesusecssuseessusecssuccesuseessusececaseessuseessnseeesaee 23 4 23 6 Setting the CMS 5 arte edat EGRE ERN Rt eR cede ie e RA deua a eds EE A a 23 4 23 6 1 Selecting a CMS 5i coo eit e HH HR Pe E tn e ir e a 23 5 23 6 2 Clearing the Selected CMS at Startupa eesssssecssssssccssecssssseccsseccsneessnscsessseessusessusecssssceccnsccessecssneccesssecssneeessnseessneeessneeeesaee 23 5 23 7 Setting
126. cally with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the ME EQUIPMENT or ME SYSTEM is used exceeds the applicable RF compliance level above the ME EQUIPMENT or ME SYSTEM should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as re orienting or relocating the ME EQUIPMENT or ME SYSTEM b Over the frequency range 150 kHz to 80 MHz field strengths should be less than3 V m WARNING The monitor is configured with a wireless network connector to receive wireless signal Other devices may interfere with this monitor even though they meet the requirements of CISPR Passport 12 Passport 8 Operator s Manual B 3 Recommended separation distances between portable and mobile RF communications equipment and the device The device is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the device can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the device as recommended below according to the maximum output power of the communications equipment Rated maximum output power of transmitter W Separation distance in
127. ccessueecsssscessuscssnseccssueceesusecssuecessuseessuscessusesssuseessusesesuseccsuecessuecesuseesseceessees 12 5 12 7 C hanging NIBP Settirigs ttr RR DIRE ORAE AESSR RIEN EUN UBER AREIS RE E REE 12 5 Passport 12 Passport 8 Operator s Manual 5 12 7 1 Setting the Initial Cuff Inflation Pressure sessssssscssssccsseccessscessusecssseesssussessucesssueccsssecessueecssseecessecessuceesssecesneeessnseeesaeeenss 12 5 12 72 Setting NIBP Alarm Propetties coo r ER IRRENeERBUEH RN OI RHINITE ee E E 12 5 127 3 Displaying NIBP Fist eot eia eee HR ee RR cia RR RAE ee Ue e elias 12 6 12 7 4 Setting the Pressure Uni cer tte e t eee RIT ee EN e rece be perdet 12 6 12 7 5 Switching On NIBP End Tone iscessccsscsscossscavassascsiseceasccssnssasoasessaavetsonvatatsacesassasctncacaonssecnaaestavssecsisesoussandssactdagesatsassnasaceaaseizesuaticn 12 6 12 8 ASSISTING Veno s PUNCU seoor anenai eseni EE ASNE EE E ERREEN EA ESSEEN EEE A VERESS E EEE EE 12 6 13 Monitoring Temp PR 13 1 TBAT eoo leifo e aiaa 13 1 13 2 Safe M EE 13 1 13 3 Making a Temp Measurement ee te ee eet esee UR RR eese ee RE eoe eee ee cbe s 13 1 13 4 Understanding the Temp Display ssscssssscsssssccssseccsneesesssscsssssecsssecesssecssnseecsusecssssecesssecsssssccssuscesnscessnssecssuecsenscecss
128. ced patients only Multif PVC More than 2 PVCs of different forms occur in the predefined search window 3 31 Couplet Paired PVCs are detected VT 2 Ventricular HR is greater than or equal to the preset threshold and the number of PVCs is greater than or equal to 3 but less than the preset threshold Vent Rhythm Ventricular HR is less than the preset threshold and the number of PVCs is greater than or equal to 3 Bigeminy A dominant rhythm of N V N V N V Trigeminy A dominant rhythm of N N V N N V N N V RonT Ron Tis detected Irr Rhythm Consistently irregular rhythm 8 12 Passport 12 Passport 8 Operator s Manual Missed Beats No beat detected for 1 75x average R R interval for HR 120 or No beat for 1 second with HR gt 120 for non paced patients only or No beat detected for more than the set pause threshold Brady The HR is less than the set bradycardia low limit Tachy The HR is greater than the set tachycardia high limit Mindray ECG algorithm currently unavailable in the US and Canada Arrhythmia message Description Category No QRS detected within the set time threshold in absence of ventricular Asystole fibrillation or chaotic signal A fibrillatory wave for 6 consecutive seconds Vfib Vtac A dominant rhythm of adjacent Vs and a HR the V Tac HR limit Lethal Vtac The consecutive PVCs Vtac PVCs limit and the HR the Vtac
129. ches back to impedance respiration if you press the Alarm Reset key during an apnea alarm The priority of RR source is from high to low CO measurement and impedance respiration measurement The RR Source settings of Resp CO2 and AG module are linked The RR source options and description are shown in the table below Option Description Auto RR source is automatically selected according to the priority CO RR source is from CO2 measurement ECG RR source is from impedance respiration measurement 9 10 Setting Alarm Properties Select Alarm Setup gt gt from the Resp Setup menu In the pop up menu you can set alarm properties for this parameter 9 4 Passport 12 Passport 8 Operator s Manual 1 0 Monitoring PR 10 1 Introduction The pulse numeric counts the arterial pulsations that result from the mechanical activity of the heart You can display a pulse from any measured SpOor any arterial pressure see chapter 14 Monitoring IBP The displayed pulse numeric is color coded to match its source 1 PR detected beats per minute 2 PRSource NOTE A functional tester or SpO2 simulator can be used to determine pulse rate accuracy 10 2 Setting the PR Source The current pulse source is displayed in the PR parameter area The pulse rate chosen as pulse source W is monitored as system pulse and generates alarms when you select PR as the active alarm source His stored in
130. ck the patient s AG Apnea H P condition and the RM connections AG Check the patient s condition the ventilated O2 content and the AG FiO Too Low H connections D 2 Technical Alarm Messages Measurement Alarm message L l Cause and solution XX SelfTest Err H C AX Init Eri A An error occurred to the XX module or there is a problem XX Init Err N H A with the communications between the module and the Nis within 1 to 8 monitor Re plug the module and restart the monitor or XX XX Comm Err H A plug the module into another monitor XX Comm Stop H C XX parameter limit is accidentally changed Contact your XX Limit Err L C service personnel D 2 Passport 12 Passport 8 Operator s Manual Measurement Alarm message L I Cause and solution The measured XX value is not within the specified range XX Overrange L C for XX measurement Contact your service personnel ECG Lead Off L B ECG YY Lead Off L B The electrode has become detached from the patient or Note YY represents the leadwires V V1 the lead wire has become disconnected from the adapter V2 V3 V4 V5 V6 LL LA RA as per AHA cable Check the connections of the electrodes and standard or C C1 C2 C3 C4 C5 C6 F L leadwires and R as per IEC standard The ECG signal is noisy Check for any possible sources of ECG Noisy L A signal n
131. components should not be used adjacent to or stacked with other equipment If adjacent or stacked use is necessary the device or its components should be observed to verify normal operation in the configuration in which it will be used The device needs special precautions regarding EMC and needs to be installed and put into service according to the EMC information provided below Other devices may interfere with this monitor even though they meet the requirements of CISPR When the inputted signal is below the minimum amplitude provided in technical specifications erroneous measurements could result Portable and mobile communication equipment may affect the performance of this monitor Guidance and Declaration Electromagnetic Emissions The device is intended for use in the electromagnetic environment specified below The customer or the user of the device should assure that it is used in such an environment Emission tests Compliance Electromagnetic environment guidance Radio frequency RF emissions Group 1 The device uses RF energy only for its internal function Therefore its CISPR 11 RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Class A The device is suitable for use in all establishments other than Harmonic emissions Class A domestic and those directly connected to the public IEC61000 3 2 low voltage power supply n
132. cover consumable items such as but not limited to batteries external cables and sensors Mindray shall not be liable for any incidental special or consequential loss damage or expense directly or indirectly arising from the use of its products Liability under this warranty and the buyer s exclusive remedy under this warranty is limited to servicing or replacing the affected products at Mindray option at the factory or at an authorized distributor for any product which shall under normal use and service appear to Mindray to have been defective in material or workmanship Recommended preventative maintenance as prescribed in the service manual is the responsibility of the user and is not covered by this warranty No agent employee or representative of Mindray has any authority to bind Mindray to any affirmation representation or warranty concerning its products and any affirmation representation or warranty made by any agent employee or representative shall not be enforceable by buyer or user THIS WARRANTY IS EXPRESSLY IN LIEU OF AND MINDRAY EXPRESSLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED WARRANTIES INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY NON INFRINGEMENT OR FITNESS FORA PARTICULAR PURPOSE AND OF ANY OTHER OBLIGATION ON THE PART OF MINDRAY Passport 12 Passport 8 Operator s Manual Damage to any product or parts through misuse neglect accident or by affixing any non standard accessory attachments or by a
133. cribes all features and options Your equipment may not have all of them Atthe end of its service life the equipment as well as its accessories must be disposed of in compliance with the guidelines regulating the disposal of such products If you have any questions concerning disposal of the equipment please contact Mindray When disposing of the packaging material be sure to observe the applicable waste control regulations and keep it out of children s reach 1 2 Equipment Symbols Some symbols may not appear on your equipment A Caution C O Power ON OFF for a part of the equipment Battery indicator A Alternating current Equipotentiality E gt VGA output Graphical record e USB connector B Network connector e Zero key lt gt Input Output Check sensor v Calibrate key DO Measure standby b d Inserted direction gt Gas outlet Serial number mi DATE OF MANUAFACTURE Catalog number Electrostatic sensitive devices DEFIBRILLATION PROOF TYPE CF APPLIED PART DEFIBRILLATION PROOF TYPE BF APPLIED PART Passport 12 Passport 8 Operator s Manual 1 3 ETL CLASSIFIED 3191955 The presence of this label indicates the machine was certified by ETL with the statement Conforms to AAMI Std ES 60601 1 IEC Std 60601 1 6 IEC Std 60601 1 8 IEC Std 60601 2 25 IEC Std 60601 2 26 IEC Std 60601 2 27 IEC Std
134. currently used are marked in red 5 Select Load 5 10 Restoring the Latest Configuration Automatically During operation you may make changes to some settings However these changes may not be saved as a user configuration To prevent the changes from being lost in case of a sudden power failure the monitor stores the configuration in real time The saved configuration is the latest configuration The monitor restores the latest configuration if it restarts within 60 seconds after the power failure And it will restore the default configuration rather than the latest configuration if it restarts 120 seconds after the power failure The monitor loads either the latest configuration or the default configuration if it restarts from 60 120 seconds after the power failure 5 11 Modifying Password To modify the password for accessing the Manage Configuration menu 1 Select Modify Password gt gt in the Manage Configuration menu 2 Input anew password in the pop up menu 3 Select Ok Passport 12 Passport 8 Operator s Manual 6 User Screens 6 1 Configuring Your Screens You can configure your monitor s screens by setting W Waveform line size W The color in which each measurement s numerics and waveforms are displayed E The parameter to monitor Changing some settings may be hazardous Therefore those settings are password protected and can be modified by authorized personnel only Once a change is made notify
135. d the computation constant should be adjusted in accordance with the manufacturer s instructions for use Set the Auto TI to Manual or Auto If you select Auto the system automatically detects the injectate temperature and the Manual TI C is disabled If you select Manual you need to enter the injectate temperature at Manual TI C manually Set the Measuring Mode to Manual or Auto In Auto mode the monitor automatically takes C O measurement after establishing a baseline blood temperature In Manual mode you need to click the Start button in the C O measurements window when the monitor is ready for new C O measurement 5 Select Enter C O Screen to enter the C O measurements window C Ready for new set of measurement C O Avg 2 g C l Avg EN r Limin Lime Start Record Comp Const 0 542 BSA m Setup gt gt Calc gt gt Accept Average C a B gt mud D A Currently measured numeric B Currently measured COO curve C Prompt message area D Buttons E Averaged values F Measurement windows 6 Proceed as follows In Manual measure mode select the Start button and then inject the solution quickly when you see the message Ready for new set of measurement As shown in the figure above during the measurement the currently measured thermodilution curve is displayed At the end of the measurement th
136. d for the displayed waveform Change the size of the PA waveform by adjusting the scale height 14 8 Passport 12 Passport 8 Operator s Manual 14 9 Troubleshooting This section lists the problems that might occur If you encounter the problems when using the equipment or accessories check the table below before requesting for services If the problem persists contact your service personnel CAUTION Never try to disassemble the equipment or supplied accessories There are no internal user serviceable parts Symptoms Possible Cause Correction Action Damped invasive waveform Air bubbles in tubing Eliminate air from tubing as described in section 14 4 Setting Up the Pressure Measurement Kinked catheter Change the position of catheter Blood in tubing Pressurize the solution bag to 300 mmHg For details refer to the instructions for use of the solution bag IBP not displayed no IBP waveform Improper setup Check display setup in monitor setup Cable not plugged in Check that the cables are properly connected Transducer not connected Check that the transducer is properly connected Stopcock turned improperly Check that the stopcock is turned to the correct position Transducer not zeroed Check and zero the transducer as described in section 14 3 Zeroing the Transducer Dashes display in place of numerics The m
137. diatric 6 to Resp RR whichever is whichever is rpm whichever is whichever is 55 greater greater smaller smaller Neonate 10 to 90 Same as the Same as the Same as the Same as the default Same as the SpO2 SpO2 default alarm limit default alarm limit default alarm limit alarm limit measurement range SYS 15 or 45 SYS 15 or 105 Adult 45 to 270 SYS x 0 68 10 SYS x 0 86 38 NIBP S mmHg whichever mmHg whichever Pediatric 45 to 185 mmHg mmHg is greater is smaller Neonate 35 to 115 Dia 15 or 20 Dia 15 or 80 Adult 25 to 225 Dia x 0 68 6 Dia x 0 86 32 NIBP NIBP D mmHg whichever mmHg whichever Pediatric 25 to 150 mmHg mmHg is greater is smaller Neonate 20 to 90 Mean 15 or 35 Mean 15 or95 Adult 30 to 245 Mean x 0 68 8 Mean x 0 86 NIBP M mmHg whichever mmHg whichever Pediatric 30 to 180 mmHg 35 mmHg is greater is smaller Neonate 25 to 105 Passport 12 Passport 8 Operator s Manual 7 7 Low alarm limit High alarm limit Auto alarm limits Module Parameter Adult Adult Neonate Neonate range pediatric pediatric T1 T1 0 5 C T1 0 5 C T1 0 5 C T1 0 5 C 1 to 49 C T T2 T2 0 5 C T2 0 5 C T2 0 5 C T2 0 5 C 1 to 49 C emp a Same as the Same as the Same as the Same as the default Same as the default alarm limit default alarm limit default alarm limit
138. dnscsansssessousscoavetecnsduscobsigdssacconedvescspiqsa asandvaiebsuasatospeddssssctedestbcapiteadsddndesvecniaissetlessesaizcnes C 12 3 User MaimtenanGe ltem S sisccssrucsscoscssusessasonsccunsonssssnvesansessensaseticazedcsgulsnsanyenna REEERE ERE EA C 15 10 Passport 12 Passport 8 Operator s Manual D Alarm Messages acesunensbsnsbnsstusnessseseseecesssenssscsannesdeanveseneusesensusescbenessnaeasesusscesedonseseususeseuensssenscsesucusessnsdecsonsnceseneacesseauseseneace D 1 Dt Physiological Alaris Messages sessczecscsscsesscsasestesccesasastegevsdavaccssieeStasssecassechanssacevlconancdesatstetabeectngeadeuag dieuasecnsseeabepenscesbuastienete conseshensetateieee D 1 D 2 Technical Alarm Messages ee a e ee ether bo de e e ee EH Dee eee ea eee DNA e teet tesi e Edu D 2 SES PSI REGIE TOIEHDIDIER Prok E 1 E T Symbols ese eno RERO N e e E Re M o M ale estin E 1 E 2 A lees lior ee E 2 Passport 12 Passport 8 Operator s Manual 11 Passport 12 Passport 8 Operator s Manual 1 Safety 1 1 Safety Information WARNING Indicates a potential hazard or unsafe practice that if not avoided could result in death or serious injury CAUTION Indicates a potential hazard or unsafe practice that if not avoided could result in minor personal injury or product property damage NOTE Provides application t
139. dow which is adjustable Nonsus Vtac The consecutive PVCs the Vtac PVCs limit but gt 2 and HR the Vtac Rate limit Pause No QRS detected within the set time threshold of pause Irr Rhythm Consistently irregular rhythm Passport 12 Passport 8 Operator s Manual 8 13 8 7 2 Changing Arrhythmia Alarm Settings To change arrhythmia alarm settings select the ECG parameter area or waveform area ECG Setup Arrh Analysis gt gt In the pop up menu you can set the Alm Lev to High Med Low or Message or switch on lethal arrhythmia analysis alarms only or switch on off all arrhythmia analysis alarms In the Alarm Setup menu from the User Maintenance menu you can enable disable turning off lethal arrhythmia analysis alarms WARNING If you switch off all arrhythmia analysis alarms the monitor cannot give any arrhythmia analysis alarm Always keep the patient under close surveillance The priority of lethal arrhythmia alarms is always high It is unchangeable 8 7 3 Changing Arrhythmia Threshold Settings Select the ECG parameter window or waveform area Arrh Analysis gt gt Arrh Threshold and you can then change threshold settings for some arrhythmia alarms When an arrhythmia violates its threshold an alarm will be triggered The asystole delay time relates to ECG relearning When HR is less than 30 bpm it is recommended to set the as
140. e instrument or part whose serial number is not legible W Others not caused by instrument or part itself Service Mindray maintains a network of service representatives and factory trained distributors Prior to requesting service perform a complete operational check of the instrument to verify proper control settings If operational problems continue to exist In North America contact the Service Department at 800 288 2121 ext 8116 for Technical Support or 201 995 8000 for assistance in determining the nearest field service location Please include the instrument model number the serial number and a description of the problem with all requests for service Any questions regarding the warranty should be directed to your local sales or service representative NOTE Upon request Mindray provides circuit diagrams component part lists descriptions calibration instructions or other information which assist the user s appropriately qualified technical personnel to repair those parts of the equipment which are designated by Mindray DS USA Inc as repairable Passport 12 Passport 8 Operator s Manual I Company Contact Manufacturer Address Website E mail Address Tel Fax Distributor Address Tel Website Shenzhen Mindray Bio Medical Electronics Co Ltd Mindray Building Keji 12th Road South Hi tech industrial park Nanshan Shenzhen 518057 PR China www mindray com service mindr
141. e monitor 4 7 Transferring Patient Data You can transfer patient data between monitors with a USB drive without re entering the patient demographic information Transferring of patient data enables you to review the patient s condition history The patient data that can be transferred includes patient demographics trend data alarm events and parameter alarm limits From the User Maintenance menu select Others gt gt In the pop up menu you can set Transferred Data Length The default is 4 h You can also set Data Transfer Method The default is Off WARNING Donot discharge a patient before the patient is successfully transferred After a patient is successfully transferred check if the patient settings especially patient category paced status and alarm limits settings etc on the monitor are appropriate for this patient NOTE The system automatically enables the HR alarm and lethal arrhythmia alarm after transferring the patient data 4 7 1 Transferring Data from the Monitor to a USB Drive To transfer data from the monitor to a USB drive 1 Connecta USB drive into the monitor s USB port Select Main Menu Patient Setup gt gt 2 Select Transfer to Storage Medium In the pop up menu you can Select Ok to transfer the patient data or Passport 12 Passport 8 Operator s Manual 4 3 Select Cancel to exit the menu Wait until the following messa
142. e monitoring a patient Otherwise improper patient monitoring and delayed treatment could occur 3 13 5 Standby Mode In Standby mode you can temporarily stop patient monitoring without turning off the monitor To enter the Standby mode select the Standby QuickKey E Passport 12 Passport 8 Operator s Manual 3 11 FOR YOUR NOTES 3 12 Passport 12 Passport 8 Operator s Manual 4 Managing Patients 4 1 Admitting a Patient The monitor displays physiological data and stores it in trends as soon as a patient is connected This allows you to monitor a patient that is not admitted yet However it is recommended that you admit a patient so that you can clearly identify them on recordings reports and networking devices To admit a patient 1 Select the Patient Setup QuickKey or Main Menu Patient Setup gt gt 2 Select Discharge Patient to clear any previous patient data If you do not erase data from the previous patient the new patient s data is combined with the previous patient s data The monitor makes no distinction between the old and the new patient data 3 If Discharge Patient button appears dimmed directly select Admit Patient and then select Yes to apply the data saved in the monitor to the new patient or No to clear the data saved in the monitor 4 Inthe Patient Demographics menu enter the demographic details of which Patient Cat allows the user to
143. e patient cable or leads away from the electrical device Excessive Electro surgical Interference Muscle Noise Intermittent Signal Wrong ECG cable used Inadequate skin preparation prior to application of electrode tremors tense subject and or poor electrode placement Connections not tight and or properly secured Use ESU proof ECG cables For details refer to section 27 1 ECG Accessories Repeat skin preparation as described in section 8 3 1 Preparing the Patient and Placing the Electrodes and re place the electrodes Apply fresh moist electrodes Avoid muscular areas Check that the cables are properly connected Electrodes dry or loose Repeat skin preparation as described in section 8 3 1 Preparing the Patient and Placing the Electrodes and apply fresh and moist electrodes Cable or lead wires damaged Change cable and lead wires Excessive alarms heart rate lead fault Electrodes dry Repeat skin preparation as described in section 8 3 1 Preparing the Patient and Placing the Electrodes and apply fresh moist electrodes Excessive patient movement or muscle tremor Reposition the electrodes Replace fresh and moist electrodes if necessary Low Amplitude ECG Signal No ECG Waveform Gain set too low Set the gain as required For details refer to section 8 5 4 Changing ECG Wave Settings Electrodes dry old Apply fresh and moist electrodes
144. e sensor CO Sensor High Temp C Check stop using or replace the sensor CO Sensor Low Temp C Check stop using or replace the sensor The operating temperature of the CO2 module goes CO Temp Overrange C beyond the specified range After it restores within the specified range the module will restart automatically CO Airway High Press C An error occurred in the airway pressure Check the patient connection and patient circuit and then restart CO Airway Low Press C the monitor CO High Barometric Press C Check the CO connections make sure that the monitor application site meets the requirements and check for CO Low Barometric Press C special sources that affect the ambient pressure Restart the monitor The airway or watertrap was occluded Check the airway CO FilterLine Occluded C and remove the occlusion CO No Watertrap B Check the watertrap connections There is a problem with the airway adapter Check clean CO Check Adapter A CO or replace the adapter Check if there is a leak in the CO sample line or the CO2 CO FilterLine Err C sample line has been occluded Check the CO connections After the sensor s CO Zero Failed A temperature becomes stabilized perform a zero calibration again CO System Err A Re plug the module or restart the monitor CO Check Cal C Perform a calibration CO Check Airway C An error occurred to the airway CO No Filterline A Make sure that the filterline is connected CO
145. e thermodilution curve is transferred to one of the 6 measurement windows and the monitor prompts you to wait for a certain period of time before starting a new measurement 15 4 Passport 12 Passport 8 Operator s Manual In Auto measure mode the monitor consecutively takes C O measurements automatically without the need for pressing the Start button between two measurements A new thermodilution measurement is possible as soon as the message Inject now is displayed on the screen The monitor automatically detects further thermodilution measurements 7 Consecutively take 3 to 5 single measurements as instructed by Step 6 A maximum of 6 measurements can be stored If you perform more than six measurements without rejecting any the oldest will automatically be deleted when a seventh curve is stored Select from the 6 measurement curves and the system will automatically calculate and display the averaged C O and C I values Then select the Accept Average button to accept and store the averaged values When injecting the stopcock to the PA catheter is open and the stopcock to the injectate solution is closed After the measurement is completed turn off the stopcock to the PA catheter and turn on the stopcock to the injectate solution and then draw the injectate solution into the injectate syringe In the buttons area you can W Select Start to start a C O measurement E Select Stop to stop the current measurement
146. easured result is invalid or out of range IBP might be set to non pulsatile labels like CVP LA RA and ICP Change to a pulsatile label Abnormally high or low readings Transducer too High or too Low Adjust the position of the transducer and make sure that it is level with the heart approximately at the level of the midaxillary line Zero the transducer as described in 14 3 Zeroing the Transducer Unable to Zero Stopcock not open to atmosphere Check the transducer and make sure the stopcock is turned to the air PAWP button disabled One IBP channel must be labeled PA Label an IBP channel as PA Also Label an IBP channel as P1 P2 P3 P4 it will automatically change to PA Passport 12 Passport 8 Operator s Manual 14 9 FOR YOUR NOTES 14 10 Passport 12 Passport 8 Operator s Manual 1 5 Monitoring Cardiac Output 15 1 Introduction The cardiac output C O measurement invasively measures cardiac output and other hemodynamic parameters using the right heart atria thermodilution method A cold solution of known volume and temperature is injected into the right atrium through the proximal port of a pulmonary artery PA catheter The cold solution mixes with the blood in the right ventricle and the change in blood temperature is measured with a thermistor at the distal end of the catheter in the pulmonary artery The temperature change is displayed as a curve in the C O split
147. eathing circuit through an airway adapter and a gas sampling line With non intubated patients the gas sample is drawn through a nasal cannula The measurement provides 1 ACO waveform 2 End tidal CO value EtCOz2 the CO value measured at the end of the expiration phase 3 Fraction of inspired CO FiCO the smallest CO value measured during inspiration 4 Airway respiration rate awRR the number of breaths per minute calculated from the CO waveform Passport 12 Passport 8 Operator s Manual 16 1 16 2 CO Module This monitor uses an external module to perform CO monitoring ol 3 2 ex co n 2 t amp H 1 AM wW T We 1 CO watertrap seat 2 Gas outlet 3 Connector for sampling line 16 3 Preparing to Measure CO WARNING Checkthatthe alarm limit settings are appropriate before taking measurement Eliminate the exhausted gas before performing the measurement NOTE Perform the measurement in a well ventilated environment 16 2 Passport 12 Passport 8 Operator s Manual 16 3 1 Making a Sidestream CO Measurement To make a sidestream CO2 measurement 1 Attach the watertrap to the module and then connect the CO2 components as shown below Watertrap fixer Sampling line Watertrap 2 The CO2 module needs time to warm up to reach operating temperature The message CO2 Sensor Warmup is displayed during warm up
148. eccasecesssecssaseeessseessaees 7 4 7 4 4 Changing the Alarm Tone Patterna csscssssssccsssscsssssccssscesssecsssssecssneecssscecssusecssnsecesssecssueceesuseessuccessuscessuseessuseeesusecssaseeesnseessaees 7 5 7 4 5 Setting the Reminder Tomes ccsscsssccsassssssssssivseceascsasssssdteucssssesssconaiesasesdeenassesiiescossseosssscnntescssa saaisaatbaasctaveseacsssatassssnnseassendtieasstasnsiss 7 5 7 5 Understanding the Alarm Setup M Nu ecsssssccssssccssssessssecssussccssecsesuseccsnesssucessuecessusccesusecssueeeesusecssasccesueecssuecssnsesesusecssnecesnseessnseessne 7 6 7 5 1 Setting Alarm Properties for All ParaMeters essssscssssssssssescssseccsseecesssecssssseesssecessscessnsecesasccssuseeesnsecssaseeccaseceessecssneceessueessaees 7 6 7 5 2 Adjusting Alarm Limits Automatically essssssesssssssccsssscesseesssssecssneecesuecssaceessuseeesuseesssseessusecssnsesesusecssusecesnseessnsecssneesesnseessnees 7 7 7 533 Setting NEHPI AD Pe M H QM 7 9 7 5 4 Setting SpO Technical Alarm Delay scsssssscsssscsssssscsssecsssseccssseccsssecssnsecesusecssusscecusecssasecesusecesuseessnsecesusecssnsceesnsecesueessneeessase 755 Setting Recording L ength s te ertt Re PAPAE RR ERR RR Prts ER EH re EHE ne a 7 5 6 Entering CPB Mode Cardiopulmonary Bypass Mode PERMANERE P N 7 7 Switching OffAILAIarEs s co t t e te erede tee A EE 7 1 7 8 Resetting Alarms asset beet d
149. ecesssecssssecesusecssneeessnseessneessneees 8 16 8 8 2 Automatic ECG Relearninhg sissisotaa eeii iasi aiii iaiia aiaa 8 16 8 9 Troubleshooting sener erre re REEE E E E OER T ORES 8 16 9 Monitoring Respiration Resp Bees 9 1 FX Icelilae p PEES AE TETT T AO 9 1 9 2 Safety INformations m ann ERE AE A RA AEAEE E EEEE VE NEEE NEES 9 1 9 3 Understanding the Resp Display sssssssscsssssscsssscsssessccsssccsnsecssnseccsssecssssscecssecsssseessusecesssecssnssecsasecesssseccsuecessuecesssceessseesesusecssneeesanseeesnees 9 1 9 4 Placing R sp Electrodes i err ieri tes A estes E N E AT aee ree 9 2 9 4 1 Optimizing Lead Placement for RESP ssssscccsssscssecssssssecsseccssessessseessssecesssccssueessnsceesssecesnscsesssecssnscessusecesnscessneeeesasecssneeeeenseets 9 2 9 4 2 Cardiac Overlay s e ette ede ERR ENERO eret 9 2 944 3 Abdominal Breathing 2 ott a dete relieve be ABA eoe ERU eg eden 9 2 9 4 4 Lateral Chest Expansionn csescosscsssssnesssnssesssessssesssessssesssssnsessnsssnsesenessesssenssensesenssesasscssssensscssvssassssnnscossssnnsensesensscsansensscssnsenssesasseese 9 3 9 5 Choosing the Respiration Lead p M 9 3 9 6 Changing the Apnea Alarm Delay cccassccacscssssscossesesessccnezessasspseascgendencatsuveacasscsuatvessenacazqnavennaessconsestoveba teva EE T Ena 9 3 4 Passport 12 Passport 8 Operator s Manual 9 7 Changing Resp Detection MOde cssssscsssssscsssscssssssccnsescssseessnss
150. ecssnsssesssecsssusesssseeesssecessuecesssecsssseeessnscessuscssnsecsascsesuseccaseeessueecssneeessneeseness 15 6 15 6 Changing Ra SettihNg e 15 6 15 6 1 Setting the Temperature Unita csesssssscccssecsssescccsssccssseccsnsescssscessuessesssecssssssesucecssuecssnsecesssecssueesesusecssnseeesucecesuceessnesesaensss 15 6 15 62 Setting Alarm Prop erties ode n ee ea ees t EIU dae eset ecl etude tede ede deed 15 6 16 MONitoring aep 16 1 16 1 Atrod UCONN THES 16 1 6 Passport 12 Passport 8 Operator s Manual 162 Oa VOU Mee eer mur Ur MCI TTE ees 16 2 16 3 Preparing to Measure CO ett eei rie EE EREE ERONEN Etc Du 16 2 16 3 1 Making a Sidestream CO2 Measurement escsssssccssescsssscsssesscsnsecesuscessnsccesusecssnscsesusecesnscecsssecesuscessnseeccssecssneeescuseeesneeeesaeses 16 3 16 3 2 Making a Microstream CO2 Measurement sessccsssssccstsccsseecesnsecesssccesnscsesssecssnsecesusecssnscessssecesaseessaseeecusecssnsceccuseessnseeseanees 16 4 16 4 CHANGING derer eerte MS 16 4 16 41 Accessing RE SPAI IU E 16 4 16 4 2 Entering the Standby Mode csssssssssssssssscsssesccsssecssseccssseecssnecssssecssssscessseesesuseesssecsssusecesnecesssecsesusecsssescenseecssneeessneecessseessaeses 16 4 16 4 3 Setting the CO Unit i o ete eei ee item tee ertet eere E arii 16 5 16 4 4 Setting
151. eessseesssesssnseessssecessscsessseessnsceesssecessseecsasecessuecsssecessseesssssecsasecesneceseaneessaes 9 3 9 8 Changing Resp Wave Settihigs t ete S OMS estan Se RENE RIEN NETTEN ERE TERR DIEN Eee 9 4 9 9 Setting Respiration Rate SOUECe sistere tib ote ten e UR rea essit ride eee eee Eee EEE a ope rk Reb ebh Saas 9 4 9 10 Setting Alarm Properties eee te I ee IAEA RERO He ee ER eee Re en 9 4 10 Monitoring PR 10 1 TOT INtrOdUCON pt 10 1 10 2 Setting the PR Source e ree e t eret tie ob eere esee bete t 10 1 10 3 Selecting the Active Alarm SOUICE sssssssssscssssecssseesssssecsssesessseecssuesessusssssusecsssessesusecssuecessusecssuseessuscsesuseessusesesusecessccessuecessuseessseesesass 10 2 TOA ORS TOMS e 10 2 11 Monitoring ST PR 11 1 HR sure trei r RN 11 1 iA M M dana caret auen cab iacerucra P 11 2 11 3 Identifying Spo Modules nainn AEEA R ee 11 2 TI Applying the Sensor s tee A Mere Ae Ree EAN Es 11 2 JU Box Changing eee OPES ot 11 3 11 5 ACCESSING SPOMENU Sainn E AEEA SEE Q UEM OEREN DN e dea 11 3 11 5 2 Adjusting the Desat Alarcon te ete tei ee DARE EUR N e U Rd Rr RR eben eee e RA
152. elect Wave select the desired waves for printing 22 7 End Case Reports ECG reports tabular trends reports graphic trends reports NIBP review reports and realtime reports can be set as end case reports When you discharge a patient the system will automatically print all contents that are set as end case reports For example to set the ECG report as an end case report 1 Select Main Menu Print Setup gt gt ECG Report gt gt 2 Select End Case Report Set as End Case Report and then select Ok from the pop up dialog box 3 Setasdescribed in section 22 6 1Setting Up ECG Reports 22 8 Printer Statuses 22 8 1 Printer Out of Paper When the printer is out of paper the printer will not print until the paper is replaced If there are too many print jobs that are not printed a printer error may occur In this case you need to install paper and then re send the print request Restart the printer if necessary To avoid this ensure that there is enough paper in the printer before sending a print request 22 8 2 Printer Status Messages If the monitor prompts that selected printer is not available check that the printer is switched on correctly connected and installed with paper 22 4 Passport 12 Passport 8 Operator s Manual 2 3 Other Functions 23 1 Analog Output The monitor provides analog output signals to accessory equipment via the multifunctional connector on the rear of the monitor NOTE
153. elect the CO parameter window to access the CO2 Setup menu and then select BTPS Compen 2 Select either On for BTPS or Off for ATPD depending on which compensation applies 16 4 6 Setting the Apnea Alarm Delay To set the apnea alarm delay 1 Select the CO parameter window to access the CO2 Setup menu 2 Select Apnea Delay and then select the appropriate setting The monitor will alarm if the patient has stopped breathing for longer than the selected apnea time The setting of Apnea Delay takes effect simultaneously to the Resp CO and AG modules NWARNING The respiration measurement does not recognize the cause of apneas It only indicates an alarm if no breath is detected when a pre adjusted time has elapsed since the last detected breath Therefore it cannot be used for diagnostic purpose 16 4 7 Choosing a Time Interval for Peak Picking For microstream modules you can select a time interval for picking the highest CO as the EtCO and the lowest as the FiCO2 To set the time interval 1 Select the CO parameter window to access the CO2 Setup menu 2 Select Max Hold 3 Select Single Breath 10 s 20 s or 30 s Single Breath EtCO2 and FiCO are calculated for every breath 10s 20 s or 30 s EtCOz and FiCOs are calculated using 10 20 or 30 seconds of data 16 4 8 Setting the Flow Rate For the sidestream CO2 module you can change the sampling rate of respir
154. em with the infusion solution again Air bubble may lead to wrong pressure reading 4 Connect the pressure line to the patient catheter 5 Position the transducer so that it is level with the heart approximately at the level of the midaxillary line 14 2 Passport 12 Passport 8 Operator s Manual 6 Selectthe appropriate label 7 Zerothe transducer After a successful zeroing turn off the stopcock to the air and turn on the stopcock to the patient Heparinized fluid bag Pressure transducer Stopcock Flushing set Adapter cable for using Pressure line disposable transducers Monitor WARNING If measuring intracranial pressure ICP with a sitting patient level the transducer with the top of the patient s ear Incorrect leveling may give incorrect values 14 5 Understanding the IBP Display The IBP measurement is displayed on the monitor as a waveform and numeric pressures The figure below shows the waveform and numerics for the Art pressure For different pressures this display may be slightly different 1 Waveform 2 Pressure unit 3 Systolic pressure 4 Diastolic pressure 5 Mean pressure For some pressures the parameter window may show the mean pressure only For different pressures their defaults unit may be different If the Art and ICP pressures are measured simultaneously the ICP parameter area will display numeric CPP which is obtained by su
155. end is feeding from the top Paper roll Passport 12 Passport 8 Operator s Manual 21 3 CAUTION Use only specified thermal paper Otherwise it may cause damage to the recorder s printhead the recorder may be unable to print or poor print quality may result Never pull the recorder paper with force when a recording is in process Otherwise it may cause damage to the recorder Do not leave the recorder door open unless you are reloading paper or resolving an issue 21 6 Removing Paper Jam If the recorder works incorrectly or produces unusual sounds check if there is a paper jam first If a paper jam is detected follow this procedure to remove it 1 Openthe recorder door 2 Takeoutthe paper and tear off the draped part 3 Reload the paper and close the recorder door 21 7 Cleaning the Recorder Printhead If the recorder has been used for a long time deposits of paper debris may collect on the printhead compromising the print quality and shortening the lifetime of the roller Follow this procedure to clean the printhead 1 Take measures against the static electricity such as Disposable Wrist Strap for the work 2 Openthe recorder door and take out the paper 3 Gently wipe around the printhead using cotton swabs dampened with alcohol 4 After the alcohol has completely dried reload the paper and close the recorder door CAUTION Do not use anything that may destroy the thermal element
156. ent s paced status is not selected the symbol will be shown in the ECG waveform area To change the paced status you can select either W the patient information area or W Main Menu Patient Setup Patient Demographics or W the ECG parameter window or waveform area Others gt gt and then select Paced from the pop up menu and then select Yes or No Passport 12 Passport 8 Operator s Manual 8 3 If you do not set the paced status the monitor issues a prompt tone when pace pulse is detected At the same time the paced symbol flashes and the message Please confirm the pace of patient appears in the ECG waveform area Then please check and set the paced status of the patient WARNING For paced patients you must set Paced to Yes If it is incorrectly set to No the monitor could mistake a pace pulse for a QRS and fail to alarm when the ECG signal is too weak Do not rely entirely on rate meter alarms when monitoring patients with pacemakers Always keep these patients under close surveillance Fornon paced patients you must set Paced to No Theauto pacer recognition function is not applicable to pediatric and neonatal patients False low heart rate indicators or false Asystole calls may result with certain pacemakers because of pacemaker artifact such as electrical overshoot of the pacemaker overlapping the true QRS complexes 8 4 Understanding the ECG Display Your disp
157. enu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Others gt gt Notch Freq and then select 50Hz or 60Hz according to the power line frequency 8 5 10 Changing the Pacer Reject Settings Select ECG Setup Others gt gt Pacer Reject and then select On or Off When Paced is set to Yes W When Pacer Reject is switched on the pace pulses are not counted as extra QRS complexes W The pace pulse marks are shown on the ECG wave when pace pulses are detected When Paced is set to No the pace markers are not shown on the ECG wave and the options of Pacer Reject are invalid 8 5 11 Enabling Smart Lead Off When the smart lead off function is set on and there is a lead off in the lead that has an ECG waveform in filter mode and notch status if another lead is available this available lead automatically becomes that lead The system will re calculate HR and analyze and detect arrhythmia When the lead off condition is corrected the leads are automatically switched back To switch on off the smart lead off function select Others gt gt from the ECG Setup menu select Smart Lead Off and then select On or Off from the pop up menu 8 5 12 Setting the Alarm Level for ECG Lead Off Alarms Select Alarm Setup gt gt from the User Maintenance menu You can set ECGLeadOff Lev from the pop up menu Passport 12 Passport 8 Operato
158. er Maintenance menu W Measurement range of the ST segment 2 0 mV to 42 0 mV NOTE The ST algorithm has been tested for accuracy of the ST segment data The significance of the ST segment changes need to be determined by a clinician 8 8 Passport 12 Passport 8 Operator s Manual 8 6 1 Switching ST On and Off To switch ST monitoring on or off 1 2 In the ECG Setup menu select ST Analysis gt gt Select ST Analysis and then select On or Off Reliable ST monitoring can hardly be ensured if You are unable to get a lead that is not noisy Arrhythmias such as atrial fib flutter cause irregular baseline The patient is continuously ventricularly paced The patient has left bundle branch block In these cases you may consider switching ST monitoring off 8 6 2 Changing ST Filter Settings ST segment analysis can be carried out only when the filter mode is set to Diagnostic or ST When ST segment analysis is switched on Filter will automatically switch to ST if it is not Diagnostic or ST When ST segment analysis is switched off the filter mode automatically switches to previous manual setting However if you switch Filter to Monitor or Surgery ST segment analysis will turn off automatically If you change Monitor or Surgery to Diagnostic or ST ST segment analysis remains off you can turn it on manually 8 6 3 Understanding the ST Display 8 6 3 1 ST
159. er for viewing W To change a waveform for viewing select the waveform segment where you want a new waveform to appear and then select the waveform you want from the pop up menu W To change a parameter for viewing select the parameter window where you want a new parameter to appear and then select the parameter you want from the pop up menu Passport 12 Passport 8 Operator s Manual 6 5 WARNING Thedata presented in the View Other Patient window has a delay Do not rely on this window for realtime data e The icon indicates network disconnection You cannot view other monitors when this icon is displayed 6 5 Understanding the Big Numerics Screen To enter the big numerics screen 1 Select the Screens QuickKey or Main Menu Screen Setup gt gt Screen Layout gt gt 2 Select Big Numerics X 2013 07 18 14 26 56 NIBP f Manual 93 5 Review Standby Alarm Setup Mil Main Menu You can select your desired parameters to display in this screen select the Screens QuickKey Big Numerics Screen Setup and then select the parameters you want to view For parameters having a waveform the waveform will also be displayed 6 6 Passport 12 Passport 8 Operator s Manual 7 Alarms Alarms triggered by an abnormal vital sign or technical issue with the monitor as visually and audibly indicated to the user WARNING A potential hazard can exist if differe
160. er source and allow Battery Too Low C the batteries to charge Power The two batteries have different charge capacity or the batteries unspecified have been used or there is a Different Battery Voltages C problem with the batteries Make sure that correct batteries are used and the batteries are not damaged or replace the batteries The power consumption of the equipment is too high Battery Power Overload C Power the monitor using an AC power source RT Clock Not Exist C Contact your service personnel Recorder Init Err N A Restart the monitor Nis within 1 to 8 Recorder SelfTest Err A Recorder Comm Err A Recorder Stop the recording and restart the monitor Recorder S Comm Err A Recorder Unavailable A Recorder VIt High C Anerror occurred to the system power supply Restart Recorder Vlt Low C the monitor D 6 Passport 12 Passport 8 Operator s Manual Measurement Alarm message I Cause and solution The recorder has been working for too long time Stop Recorder Head Hot C the recording and resume the recording till the recorder s printhead cools down Rec Paper Wrong Pos A Re load the recorder paper System Watchdog Err C System Software Err C System CMOS Full C System System CMOS Err C An error occurred to the system Restart the monitor System FPGA Err C System Err N C N is within 2 to 12 Passport 12 Passport 8 Operator s Manual FOR YOUR NOTES D 8 Passport 1
161. erefore prevents them from entering the module To avoid blocking the airway empty the watertrap container whenever half full Dispose of accumulated fluids in accordance with the hospital policy or your local regulations The watertrap has a filter preventing bacterium water and secretions from entering the module After long term use dust or other substances may compromise the performance of the filter or even block the airway In this case replace the watertrap Replacing the watertrap once a month is recommended 17 4 Passport 12 Passport 8 Operator s Manual 17 5 Changing AG Settings 17 5 1 Setting Gas Unit For N20 and AA the unit of the measured gas is fixed to X90 To set the gas unit 1 Select Main Menu Maintenance gt gt User Maintenance enter the required password Unit Setup gt gt 2 Inthe Unit Setup menu you can select CO2 Unit or O2 Unit and then select mmHg 96 or kPa 17 5 2 Setting the Apnea Alarm Delay To set the apnea alarm delay 1 Selectthe AG parameter area to access the AG Setup menu 2 Select Apnea Delay and select the appropriate setting The monitor alarms if the patient has stopped breathing for longer than the preset apnea time The Apnea Delay setting takes effect simultaneously to the Resp CO and AG modules WARNING The respiration measurement does not recognize the cause of apneas It only indicates an alarm if no breath is detected
162. erforming measurement and that the patient do not talk during measurement It is recommended that 5 min should elapse before the first reading is taken The operator shall not touch cuff and tubing during NIBP measurement 12 5 2 Preparing to Measure NIBP To prepare for the NIBP measurement 1 Power on the monitor 2 Verify that the patient category is correct If not select the Patient Setup QuickKey Patient Demographics Patient Cat and set the patient category to Adu Ped or Neo 3 Plug the air tubing into the NIBP connector on the patient monitor 4 Select a correct sized cuff and then apply it as follows Determine the patient s limb circumference Select an appropriate cuff by referring to the limb circumference marked on the cuff The width of the cuff should be 4096 5096 for neonates of the limb circumference or 2 3 of the upper arm s length The inflatable part of the cuff should be long enough to encircle at least 5096 to 8096 of the limb Apply the cuff to the patient s upper arm or leg and make sure the marking on the cuff matches the artery location Do not wrap the cuff too tightly around the limb It may cause discoloration and ischemia of the extremities Make sure that the cuff edge falls within the marked range If it does not use a larger or smaller cuff that will fit better 5 Connect the cuff to the air tubing Avoid compression or restriction of pressure tub
163. erlay avoid the liver area and the ventricles of the heart in the line between the respiratory electrodes This is particularly important for neonates 9 4 3 Abdominal Breathing Some patients with restricted movement breathe mainly abdominally In these cases you may need to place the left leg electrode on the left abdomen at the point of maximum abdominal expansion to optimise the respiratory wave 9 2 Passport 12 Passport 8 Operator s Manual 9 4 4 Lateral Chest Expansion In clinical applications some patients especially neonates expand their chests laterally causing a negative intrathoracic pressure In these cases it is better to place the two respiration electrodes in the right midaxillary and the left lateral chest areas at the patient s maximum point of the breathing movement to optimise the respiratory waveform 9 5 Choosing the Respiration Lead In the Resp Setup menu set Resp Lead to I H or Auto 9 6 Changing the Apnea Alarm Delay The apnea alarm is a high level alarm used to detect apneas You can set the apnea alarm delay time after which the monitor alarms if the patient stops breathing In the Resp Setup menu select Apnea Delay and then select the appropriate setting The Apnea Delay of Resp CO and AG module keeps consistent with each other 9 7 Changing Resp Detection Mode In the Resp Setup menu select Detection Mode and then select Auto or Manual E In auto detection m
164. es Air must pass unrestricted through the tubing WARNING Continuous CUFF pressure due to connection tubing kinking may cause blood flow interference and resulting harmful injury to the patient Passport 12 Passport 8 Operator s Manual 12 3 NOTE Equipment use is restricted to one patient at a time 12 5 3 Starting and Stopping Measurements Select the NIBP Measure QuickKey and you can start the desired measurement from the popup menu You can select Stop All QuickKey to stop all NIBP measurements You can also start and stop measurements by using the NIBP hardkey on the monitor s front panel 12 5 4 Correcting the Measurement if Limb is not at Heart Level The cuff should be applied to a limb at the same level as the patient s heart If the limb is not at the heart level to the displayed value W Add0 75 mmHg 0 10 kPa for each centimetre higher or W Deduct 0 75 mmHg 0 10 kPa for each centimeter lower 12 5 5 Enabling NIBP Auto Cycling and Setting the Interval To enable the NIBP auto cycling and set the interval 1 Select the NIBP parameter window to enter the NIBP Setup menu 2 Select Interval and then select a desired time interval Selecting Manual switches to manual mode 3 Start a measurement manually The monitor will then automatically repeat NIBP measurements at the set time interval 12 5 6 Starting a STAT Measurement To start a STAT measurement 1 Select the NIBP parameter wi
165. escesusecsssssssnsecssssecssusccesssecssnscsesnsecsssseeccanecesssecssnsecessneesenees 5 6 5 11 Modifying PassWord Reese Ree ee ee eee eee e e e e e be eR end 5 6 6 User 6 1 6 1 Configuring Your Screens edet t eb eoe RR Re LUE EN daca UOTE UP A re LR sea reed 6 1 6 1 1 Changing the Waveform Line Size ssssssscssssecssssssccssecsssseccsnsecssnseecsssecesssecssssecesssecssnsecesusecssusceesssecesusecssnsccesasecssnsesesnseessneeesses 6 1 6 1 2 Changing Measurement Colors scssssscccsssscssssecssssccsseessssccsnsecsssseecssecesnsccssusecesssecssnsessusecsssscessusecessscessneecesaecssnseeesnseessaeeesses 6 1 6 1 3 Changing Screen layo t ssrss enasini 6 1 6 2 Viewing Minitrend oc T ESEA Eiei 6 2 6 2 1 Having a Split Screen View of Minitrends csessssssssssssssccsseesssssscsssecssssecesssccesssecssnseecssseccssusecsssecessuceessuecessseessnseessaseesenseeesee 6 2 6 22 Setting MiNItrEndS E TR ERE UU mm 6 2 CERVI IRISH SIS CE EORR m 6 3 6 4 Viewing Other Patients etti decere e eee edere LN eH DAR Re Hd Rte ees re eee eiae ded 6 4 oj Nar ERETO LE epe PH EUE 6 4 6 4 2 Viewing the Care Group Overview Bar ssssssssssccsssssssecsssssscssseesssscecsssecessuescsssecesssecssssscessuecsssscecsssecessueeesssecesnsecssneeecsaneessneeesees 6 4 6 4 3 Understanding the Vie
166. esssccssuescessseesssseessusceesasecssnseeesasecssneceeenecesaueeesneeeesaee 26 3 26 4 ECG VErifiGation m rS 26 3 26 5 NIBP Leakage Test S eer EEEE eher E e ERR nestled eee e eet nunc 26 3 26 6 eDE CIE lime M 26 4 PE ACRI cm A 26 5 26 71 AG Leakage Test ec M 26 5 26 8 Calibrating the Touchscreen senienas i en AE iE E e ionet iieri ennn iiia 26 5 26 9 Entering Exiting Demo Mode ssssssisscascssssersssecsssacosansessisazsssaiseassensisastiatesansensiatessessuassassinassszsveaassensiatassesnaissqgnsiaassedsnaiaseatbuacassiswnisiaatics 26 5 27 Accessories M M M 27 ECGAccessoties s e tese eed entia eee RN e HA E E I e ERAN FU e e Mte edente 27 2 SPOJA CCE SOFIES Ainiin erisa Tr ESSEC sE iSS AEHRRUE FEE EBEXRE GEHE ES EUREN O CEER EEVEE RR RENE FEE SE CSERE dee 27 3 NIBP ACCGSSOFIGS EEA E S E E E E 27 4 Ioa aee d ORC Q 27 5 IBP ICP Accessories VG uat ge 27 CO ACCESSOFIGSU scite geret ito ERR SRVER NERONI EEE EI QUARO E eR E eH verna ec inei e end cu eee EAE redeat 27 8 AG Accessories for Passport 12 only tete titt donet eee fe ee UR MR EE nnde eee hes uen eei 27 6 27 9 Others eee br ipe te e be tr pe eee ee ete e EAE NONSE 27 6 A Product Specifications R
167. etwork that supplies buildings used Voltage Fluctuations Flicker Complies for domestic purposes Emissions IEC 61000 3 3 WARNING This equipment system is intended for use by healthcare professionals only This equipment system may cause radio interference or may disrupt the operation of nearby equipment It may be necessary to take mitigation measures such as re orienting or relocating the ME EQUIPMENT or ME SYSTEM or shielding the location Passport 12 Passport 8 Operator s Manual B 1 Guidance and Declaration Electromagnetic Immunity The device is intended for use in the electromagnetic environment specified below The customer or the user of the device should assure that it is used in such an environment Immunity test 1EC60601 test level Compliance level Electromagnetic environment guidance Electrostatic discharge ESD IEC 61000 4 2 6 kV contact 8 kV air 6 kV contact 8 kV air Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 3096 Electrical fast transient burst IEC 61000 4 4 2 kV for power supply lines 1 kV for input output lines 2 kV for power supply lines 1 kV for input output lines Surge IEC 61000 4 5 1 kV line s to line s 2 kV line s to earth 1 kV line s to line s 2 kV line s to earth Mains power quality should be tha
168. ference Segment To delete the current ST reference segment select Delete Ref in the ST Analysis menu and then select Ok in the pop up 8 6 7 Recording the ST Segment To record the current ST segment and reference segment select Record in the ST Analysis menu 8 6 8 Changing the ST Alarm Limits High and low ST alarm limits can be set individually for each ECG lead Alarm limits can also be set separately for single lead and multi lead ST monitoring You can select ST Alarm Setup gt gt from ST Analysis menu and then change ST alarm settings for each lead 8 10 Passport 12 Passport 8 Operator s Manual 8 6 9 Setting the ST Alarm Delay Time To set the ST alarm delay time 1 Select Main Menu Maintenance gt gt User Maintenance gt gt Enter the required password and then select OK 2 Select Alarm Setup gt gt gt ST Alarm Delay 8 6 10 Adjusting ST Measurement Points As shown in the figure below the ST measured for each beat complex is the vertical difference between two measurement points with the R wave peak as the baseline for the measurement R wave peak ISO electric point ST measurement point The ISO and ST points need to be adjusted when you start monitoring and if the patient s heart rate or ECG morphology changes significantly Exceptional QRS complexes are not considered for ST segment analysis WARNING Always make sure that the ST measurement poin
169. ficance must be decided by the doctor who performs the measurement NOTE Blood pressure measurements determined with this device are equivalent to those obtained by a trained observer using the cuff stethoscope auscultatory method or an intra arterial blood pressure measurement device within the limits prescribed by the American National Standard Manual electronic or automated sphygmomanometers Passport 12 Passport 8 Operator s Manual 12 1 12 2 Safety WARNING Be sure to select the correct patient category setting for your patient before measurement Do not apply the higher adult settings for pediatric or neonatal patients Otherwise it may present a safety hazard Do not measure NIBP on patients with sickle cell disease or on the limb where skin damage has occurred or is expected Use clinical judgment to determine whether to perform frequent unattended blood pressure measurements on patients with severe blood clotting disorders because of the risk of hematoma in the limb fitted with the cuff Do not use the NIBP cuff on a limb with an intravenous infusion or arterial catheter in place This could cause tissue damage around the catheter when the infusion is slowed or blocked during cuff inflation NIBP reading can be affected by the measurement site the position of the PATIENT exercise or the patient s physiologic condition If you doubt the NIBP measurements determine the patient s vital signs by alte
170. form there is an upward arrow The freeze time displays below the arrow and the initial frozen time is 0 s With the waveforms scrolling the freeze time changes at intervals of 1 second This change will be applied for all waveforms on the screen Passport 12 Passport 8 Operator s Manual 18 1 18 3 Unfreezing Waveforms To unfreeze the frozen waveforms you can either m Selectthe button atthe upper right corner of the Freeze menu Select the Freeze hardkey on the monitor s front panel or E Perform any other action that causes the screen to be readjusted or opens a menu such as inserting or removing a module pressing the Menu hardkey etc 18 4 Recording Frozen Waveforms To record the frozen waveforms 1 Inthe Freeze menu select in order Wave 1 Wave 2 and Wave 3 and then select your desired waveforms 2 Selectthe Record button The selected waveforms and all numerics at the frozen time are printed out by the recorder 18 2 Passport 12 Passport 8 Operator s Manual 1 9 Review 19 1 Accessing Respective Review Windows 1 Select the Review QuickKey or Main Menu Review gt gt 2 Select Graphic Trends Tabular Trends Events or Full Disclosure to access their respective review windows 19 2 Reviewing Graphic Trends In the Review menu select Graphic Trends to access the following window Graphic Trends Tabular Trends Events Full Disclosure ie m 07 18
171. frequently will also shorten the operating time Replace a battery that has visual signs of damage or no longer holds a charge Remove the old battery from the monitor and recycle it according to local laws 24 6 Battery Recycling Remove the old battery from the monitor and recycle it properly Follow local laws for proper battery disposal NWARNING Do not disassemble batteries dispose of them in fire or cause them to short circuit They may ignite explode leak or heat up causing personal injury 24 4 Passport 12 Passport 8 25 Care and Cleaning In this chapter we only describe cleaning and disinfection of the main unit For the cleaning and disinfection of other reusable accessories refer to instructions for use of corresponding accessories WARNING Useonly Mindray approved cleaners and disinfectants and methods listed in this chapter to clean or disinfect your equipment Warranty does not cover damage caused by unapproved substances or methods We make no claims regarding the efficacy of the listed chemicals or methods as a means for controlling infection For the method to control infection consult your hospital s Infection Control Officer or Epidemiologist CAUTION The responsible hospital or institution shall carry out all cleaning and disinfection procedures specified in this chapter 25 1 General Points Keep your equipment and accessories clean To avo
172. g the patient under close surveillance is the most reliable way for safe patient monitoring The physiological data and alarm messages displayed on the equipment should be reviewed by a clinician before being used for diagnostic interpretation and treatment Passport 12 Passport 8 Operator s Manual 1 1 WARNINGS To avoid inadvertent disconnection route all cables in a way to prevent a stumbling hazard Wrap and secure excess cabling to reduce risk of entanglement by patients or personnel Do not touch the equipment s metal parts or connectors when in contact with the patient otherwise patient injury may result Never mix patient electrode types or brands Dissimilar metals or other incompatibilities may cause considerable baseline drift and may increase trace recovery time after defibrillation To reduce the hazard of burns during high frequency surgical procedure ensure that the monitor s cables and transducers never come into contact with the electro surgery unit ESU The neutral electrode of the electro surgery unit ESU shall properly contact the patient Otherwise burns may result Magnetic and electrical fields are capable of interfering with the proper performance of the equipment For this reason make sure that all external devices operated in the vicinity of the equipment comply with the relevant EMC requirements Mobile phone X ray equipment or MRI devices are a possible source of interference
173. ge appears Transfer to storage medium successful Please remove the USB drive Remove the USB drive from monitor 4 7 2 Transferring Data from a USB Drive to the Monitor To transfer data from a USB drive to the monitor 1 2 Connect the USB drive to the destination monitor Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Others gt gt Data Transfer Method USB Drive Then Select Transfer to transfer the patient data to the monitor or Select Cancel Transfer to cancel the transfer operation Select Unload USB Drive to unload the USB drive without transferring the patient data After you select Transfer in the pop up menu you can select the patient data contents that need to be transferred Patient Demographics must be selected After Ok is selected the monitor compares the patient information stored in both the storage medium and monitor and manages the patient data based on the following Different The monitor erases all the current patient data transfers the patient data from the Patient storage medium and loads the configuration according to the patient category Same Patient In the pop up dialog box you can E Select Yes to merge the patient data in the monitor and storage medium W Select No to erase all the current patient data in the monitor and transfer the patient data from the storage medium
174. heck all materials against the packing list and check for any mechanical damage Contact Mindray in case of any problem CAUTION When disposing of the packaging material be sure to observe the applicable waste control regulations and keep it out of children s reach Before use please verify whether the packages are intact especially the packages of single use accessories In case of any damage do not apply it to patients Passport 12 Passport 8 Operator s Manual 3 1 NOTE Save the packing case and packaging material as they can be used if the equipment must be reshipped 3 1 2 Environmental Requirements The equipment operating environment must meet the requirements specified in this manual The equipment operating environment should be reasonably free from noises vibration dust corrosive flammable and explosive substances To maintain good ventilation the equipment should be at least 2 inches 5 cm away from surrounding objects When the equipment is moved from one place to another condensation may occur as a result of temperature or humidity difference In this case never start the system before the condensation disappears CAUTION e Make sure that the equipment operating environment meets the specific requirements Otherwise unexpected consequences e g damage to the equipment could result Putthe equipment in a location where you can easily see the screen access the opera
175. id damage to the equipment follow these guidelines W Always dilute cleaners and disinfectants according the manufacturer s instructions or use lowest possible concentration E Donot immerse part of the equipment into liquid W Donot pour liquid onto the equipment or accessories W Do not allow liquid to enter the case W Never use abrasive materials such as steel wool or silver polish or erosive cleaners such as acetone or acetone based cleaners WARNING Be sure to turn off the system and disconnect all power cables from the outlets before cleaning the equipment CAUTION Ifyou spill liquid on the equipment or accessories contact Mindray or your service personnel Passport 12 Passport 8 Operator s Manual 25 1 NOTE To clean or disinfect reusable accessories refer to the instructions delivered with the accessories 25 2 Cleaning Your equipment should be cleaned on a regular basis Before cleaning the equipment consult your hospital s regulations for cleaning the equipment Recommended cleaning agents are W Sodium hypochlorite bleach 10 W Hydrogen peroxide 3 E Ethanol 70 E sopropanol 70 To clean your equipment follow these rules 1 Shutdown the monitor and disconnect it from AC power 2 Clean the display screen using a soft clean cloth dampened with a cleaning agent 3 Clean the exterior surface of the equipment using a soft cloth dampened
176. ing Patient Data seem tem E e ee E A a enia 4 3 4 7 1 Transferring Data from the Monitor to a USB Drive uu esssssssssecsssesccsusecssscesssseccsuecssnsceesusccssseccesuseessascessusecesueecssnessenensts 4 3 4 7 2 Transferring Data from a USB Drive to the Monitor ou sssscssssecsssescesseeccsseccesseecesusecssnsecssssecssneccesusecssnscessucesesuecssneeeeseeeesee 4 4 4 8 Connecting toa CMS s alae cer ee RA RR pea bote edere e Ee EDI AXE dde deba dee eee obedece Red eee ba eren 4 4 5 Managing EeGTHI D UL CH CIE RRR 5 1 E BI eus fero enorme M 5 1 5 2 Entering the Manage Configuration Menu 5 3 Changing Department 4 serere eee tesi terere ebrei deer teret tae n eee ire 5 4 Setting Default Configuration sasccsscss ccascssscsssciosscsssnaassonsisssndsscosassenavezandsensasscaninseceapsossnsaesbeiasseavasacsssatesodshoosadeshastesasussaiasansadvanssbecnavaastbeaee 5 3 5 5 SAVING GUIFEMUSCCINGS e H M 5 3 5 6 Editing Configuratio nsnsi RU He EA E AN repre Ete aee hod re Le bere e 5 4 5 7 Deleting a Configuration rettet eh Ree i erbe hee eerte eee beide eere restare eet 5 5 5 B Transterrimg a derniilelUIr u oe E etea ie 5 5 5 9 Eoading a Config UratiORi ioter ee HEISE ET E E N EHE EE D Ee S teretes 5 6 5 10 Restoring the Latest Configuration Automatically eesssssssssssccssseccss
177. ining pause time is displayed in the physiological alarm area W The alarms paused symbol is displayed in the sound symbol area If the time interval of the monitor s last shutdown from this start up is greater than 2 minutes the monitor enters into the alarm paused status as soon as it is turned on The alarm pause time is fixed to be 2 minutes When the alarm pause time expires the alarm paused status is automatically cancelled and the alarm tone will sound You can also cancel the alarm paused status by pressing the Alarm Pause hardkey 7 10 Passport 12 Passport 8 Operator s Manual You can set the alarm pause time to 1 min 2 min 3 min 5 min 10 min 15 min or Permanent The default alarm pause time is 2 minutes 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Alarm Setup gt gt Alarm Pause Time and then select the appropriate setting from the pop up list 7 7 Switching Off All Alarms If Alarm Pause Time is set to Permanent the monitor enters into the alarm off status after the Alarm Pause hardkey is pressed During the alarm off status W For physiological alarms no alarm lamps flash and no alarms are sounded W For physiological alarms no numerics or alarm limits flash W No physiological alarm messages are shown W Alarm Off is displayed in the physiological alarm area with a red background W Fortechnical alarms no alar
178. ion waveform appears on the monitor screen 9 2 Safety Information WARNING When monitoring the patient s respiration do not use ESU proof ECG cables Ifyou do not set the detection level for the respiration correctly in manual detection mode it may not be possible for the monitor to detect apnea If you set the detection level too low the monitor is more likely to detect cardiac activity and to falsely interpret cardiac activity as respiratory activity in the case of apnea The respiration measurement does not recognize the cause of apneas It only indicates an alarm if no breath is detected when a pre configured time has elapsed since the last detected breath Therefore it cannot be used for diagnostic purpose If operating under conditions according to the EMC Standard EN 60601 1 2 Radiated Immunity 3V m field strengths above 1V m may cause erroneous measurements at various frequencies Therefore it is recommended to avoid the use of electrically radiating equipment in close proximity to the respiration measurement unit 9 3 Understanding the Resp Display 1 2 3 4 1 Gain 2 Resplead label 3 Respiration rate 4 RRsource By selecting the waveform area or parameter area you can enter the Resp Setup menu NOTE Respiration monitoring is not for use on the patients who are very active as this will cause false alarms Passport 12 Passport 8 Operator s Manual 9 1 9 4
179. ips or other useful information to ensure that you get the most from your product 1 1 1 Warnings WARNINGS Before putting the system into operation the operator must verify that the equipment connecting cables and accessories are in correct working order and operating condition To avoid risk of electric shock this equipment must only be connected to a supply mains with protective earth If a properly grounded power outlet is not available operate the monitor on battery power The equipment is not intended to be used within the Magnetic Resonance MR environment To avoid an explosion hazard do not use the equipment in the presence of oxygen rich atmospheres flammable anesthetics or other flammable agents such as gasoline Before connecting the equipment to the power line check that the voltage and frequency ratings of the power line are the same as those indicated on the equipment s label or in this manual Do not open the equipment housings All servicing or future upgrades must be carried out by Mindray trained and authorized personnel Do not come into contact with patients during defibrillation Otherwise serious injury or death could result Do not rely exclusively on the audible alarm system for patient monitoring Adjustment of alarm volume to a low level or off may result in a hazard to the patient Remember that alarm settings should be customized according to different patient situations and always keepin
180. is displayed at the time the event is triggered Passport 12 Passport 8 Operator s Manual 19 3 19 4 2 Reviewing Events The monitor saves the events in real time You can review these events In the Review menu select Events to access the following window You can review the parameter alarm events arrhythmia alarm events and manual events When an event occurs the system stores all the measurement numerics at the event triggering time and related waveforms 4 seconds 8 seconds or 16 seconds before and after the event triggering time as per the setting of recording length NOTE Pausingor switching off alarms will not be recorded as events The time of these operations will not be recorded in the system log Earlier recorded events might be overwritten by later ones if the events log reaches capacity Review Graphic Trends B Tabular Trends Events Full Dis Te ESOS es s I Event Level In this window W Select Event to view the desired events W Selecting Level to view the desired events according to the alarm priority After selecting the desired event you can select Details to access the following window In this window the waveform area displays the waveforms related to the event and the parameter area displays the parameter values happened at the event trigger time NOTE e A total loss of power has no impact on the saved events 19 4 Passport 12 Passport 8 Operator s Man
181. itii tte e ee hene tere ree rede sre ee eee tUe es 21 3 Di 5 EOT OTIMO Pape me Q 21 3 ZIU G REMOVING Paper Jaime tecto erit ab tese eee eth et NR PASE HR e XH e SEESE Ea e Ee ATTA REESS aaa TE E 21 4 21 7 Cleaning the Recorder Printhead cscsssssscssseccssssscsssecsssscecsuscccsuscessnsecesuecssnsecesusecessecessuseccsuscessuseeesusecssusecesusecesuceeesuseeesneessuceeennsentes 21 4 PPAJITDEM M 22 1 PANI m 22 1 22 2 C npecting a Wo d MI EE eaasdissccandessadbadigsdavtavaate 22 1 223 Setting Wp the Printer set ette e REDE ee te ees ledge 22 2 22 4 Starting Report PrintOUts ger ini So ni Soe 22 2 22 5 STOPPING Report Printout Seeks eie RH DERE TERN DAMM RA ETA SERE RM REN PEU Re RE 22 3 22 6 Setting UP een M 22 3 22 6 1 Setting UP ECG Reports s rettet An RAN RNS A ertet qas 22 3 22 6 2 Setting Up Tabular Trends Reports scscsssssscsssecsssessccsecssnssscsusecesscessnsececssecssnsseesusecssnseessnseessusecssnsecesasecssasceesnseessaseessneeeesaee 22 3 22 6 3 Setting Up Graphic Trends Reports ettet ERN RERO HERES MHTERENNEN SERRE H IEEE RENS eode pente 22 4 22 64 Setting Up Realtime Reports Re a NAR ere Re eben eL Dee eR ende tse ete dee enden 22 4 22 7 End Case Reports re ee
182. ium priority alarms are latched If you select All all alarms are latched If you select Off the alarm latching is turned off Changing of alarm priority may affect the latching status of corresponding alarms Determine if you need to reset the latching status for the specific alarm after changing its alarm priority When the alarm system is reset the latched physiological alarms are cleared 7 10 Testing Alarms When the monitor starts up a self test is performed In this case the alarm lamp is lit in yellow and red respectively and the system gives a beep This indicates that the visible and audible alarm indicators are functioning correctly For further testing of individual measurement alarms perform the measurement on yourself for example SpO2 or CO2 or use a simulator Then adjust alarm limits and check that appropriate alarm behavior is observed 7 12 Passport 12 Passport 8 Operator s Manual 7 11 Using Care Group Alarms 7 11 1 Care Group Auto Alarms When a Care Group is set up on your monitor a flashing symbol will appear beside the QuickKeys area if any monitor in your Care Group which is not currently viewed by your monitor is alarming The alarm symbol is shown as below When a monitor in the Care Group is disconnected the flashing symbol is shown as below The department and bed label of the alarming monitor appear on the symbol You can enter the View Other Patient window by pressi
183. ized users Authentication and encryption other than WPA2 PSK may expose sensitive data leak or malicious setting The total throughput of all the wireless devices connected to the wireless network should be less than the effective transmitting capability of the wireless network The throughput capacity of a single Passport 8 is 729 kbps and a single Passport 12 is 747 kbps Do not connect non medical devices to the wireless network Where the monitor is located the signal strength of other Wi Fi devices on the same channel should be no greater than 85 dBm Where the monitor is located the signal strength of other Wi Fi devices on adjacent channels should be no greater than 50 dBm The recommended distance between the patient monitor and other non Wi Fi wireless devices including wireless devices at the frequency of 2 4GHz e g cellular mobile communication networks microwave ovens interphones cordless phones and electro surgical units is no less than 20 cm 23 6 Setting the CMS You can configure up to 30 CMSs for your monitor To set the CMSs 1 2 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Network Setup gt gt Central Station Setup gt gt Set CMS names and corresponding IP addresses 23 4 Passport 12 Passport 8 23 6 1 Selecting a CMS If Select CMS is enabled you can select the CMS for the current monitoring To se
184. k 0 0136 x PAMAP x C O RCWI kg m m right cardiac work index RCW BSA RVSW gm right ventricular stroke work 0 0136 x PAMAP x SV RVSWI g m m right ventricular stroke work index RVSW BSA EF 96 ejection fraction 100 x SV EDV Passport 12 Passport 8 Operator s Manual 20 7 20 6 Renal Calculations 20 6 1 Performing Calculations To perform a renal calculation 1 Select Main Menu Calc gt gt Renal gt gt or select Calculations QuickKey Renal gt gt 2 Enter values for calculation 3 Select the Calculate button The system performs a calculation per the current settings and displays the calculated values In the Renal Calculation window you can view its normal range in the unit field Invalid values are displayed as If a calculated value is outside the range its background will highlight in yellow You can select Range to Trigger a recording by selecting the Record button The displayed renal calculations are printed by the recorder m Review the previously performed calculations by selecting Review 20 6 2 Entered Parameters Abbreviation Unit Full spelling URK mmol L urine pstassium URNa mmol L urinary sodium Urine ml 24h urine Posm mOsm kgH O plasm osmolality Uosm mOsm kgH O urine osmolality SerNa mmol L serum sodium Cr pmol L creatinine UCr pmol L urine creatinine BUN mm
185. l Communication Commission Food and Drug Administration first second forced expiratory volume ratio fraction of inspired fraction of inspired carbon dioxide fraction of inspired nitrous oxide fraction of inspired oxygen Passport 12 Passport 8 Operator s Manual E 3 FPGA FV GEDV GEDI GEF Hal Hct Hb Hb CO HbO HIS Art mean MDD MetHb MRI MRN field programmable gate array flow volume global end diastolic volume global end diastolic volume index global ejection fraction halothane haematocrit hemoglobin carbon mono oxide hemoglobin oxyhemoglobin hospital information system heart rate inspiratory expiratory ratio invasive brood pressure impedance cardiography intracranial pressure intracranial catheter tip pressure transducer intensive care unit identification International Electrotechnical Commission Institute of Electrical and Electronic Engineers inspired minimum internet protocol isoflurane injectate temperature Intrathoracic Blood Volume Index Intrathoracic Blood Volume left arm left atrial pressure lateral liquid crystal display left cardiac work left cardiac work index light emitting diode left leg low voltage directive low voltage differential signal left ventricular ejection time left ventricular stroke work left ventricular stroke work index minimum alveolar concentration mean arterial pressure Medical Device Directive methemoglobin magnetic resonance imaging
186. lated an audible alarm immediately sounds When the patient 96 SpO2 fluctuates near an alarm limit the alarm sounds each time the limit is violated Such frequent alarms can be distracting Nellcor s Sat Seconds alarm management technique is used to reduce these nuisance alarms The Sat Seconds feature is available with the Nellcor SpO module to decrease the likelihood of false alarms caused by motion artifacts To set the Sat Seconds limit select Sat Seconds in the SpO2 Setup menu and then select the appropriate setting With Sat Seconds alarm management high and low alarm limits are set in the same way as traditional alarm management A Sat Seconds limit is also set The Sat Seconds limit controls the amount of time that SpOz saturation may be outside the set limits before an alarm sounds The method of calculation is as follows the number of percentage points that the SpOz saturation falls outside the alarm limit is multiplied by the number of seconds that it remains outside the limit This can be stated as the equation Sat Seconds Points x Seconds Only when the Sat Seconds limit is reached the monitor gives a Sat Seconds alarm For example the figure below demonstrates the alarm response time with a Sat Seconds limit set at 50 and a low SpOz limit set at 90 In this example the patient 96 SpO2 drops to 88 2 points and remains there for 2 seconds Then it drops to 86 4 points for 3 seconds and then to 8496 6 points for
187. lay may be configured to look slightly different 1 Lead label of the displayed wave 2 ECGgain 3 ECG filter label 4 Notch filter status Besides when a paced signal has been detected the pace pulse marks are shown on the ECG wave if the Paced has been set to Yes 1 Current heart rate alarm limits 2 Current heart rate 3 Heart beat symbol Passport 12 Passport 8 Operator s Manual 8 5 Changing ECG Settings 8 5 1 Accessing ECG Menus By selecting the ECG parameter window or waveform area you can access the ECG Setup menu 8 5 2 Setting Pacemaker Rate For Mortara ECG algorithm only Some pacemaker pulses can be difficult to reject When this happens the pulses are counted as a ORS complex and could result in an incorrect HR and failure to detect some arrhythmias You can set Pacemaker Rate to the pacemaker s rate in the ECG Setup menu In this way the monitor can calculate HR and detect arrhythmias more accurately When Paced is set to No the pacemaker rate cannot be set 8 5 3 Choosing the Alarm Source In most cases the HR and PR numerics are identical In order to avoid simultaneous alarms on HR and PR the monitor uses either HR or PR as its active alarm source To change the alarm source select Alm Source in the ECG Setup menu and then select either HR if you want the HR to be the alarm source for HR PR PR if you want the PR to be the alarm source for HR PR Aut
188. lays i when the charging is complete Passport 12 Passport 8 24 1 24 3 Replacing a Battery When the Passport 12 patient monitor uses two battery packs one battery pack can be easily exchanged while the monitor operates from the other If the Passport 12 patient monitor uses one battery pack you should insert a new battery pack before the old one depletes When the Passport 8 patient monitor operates on battery power make sure the monitor is powered off before replacing a battery To replace a battery follow this procedure 1 Openthe battery door Pull here to open the battery door Passport 12 Passport 8 2 Pushaside the latch fixing the battery to be replaced and remove the battery 3 Inserta battery into the slot with its contact pointed inward 4 Closethe battery door 24 4 Battery Guidelines Battery life expectancy depends on how frequent and how long it is used For a properly maintained and stored lithium ion battery its life expectancy is about 3 years For more aggressive use models life expectancy can be less We recommend replacing lithium ion batteries after 500 full charge discharge cycles or every 3 years from first use whichever occurs first To get the most out of the battery observe the following guidelines W The battery performance test must be performed every six months before monitor repairs or whenever battery performance is suspect W Conditio
189. lect the CMS select the prompt message area at the bottom of the screen Then the selected CMS name will display If no CMS is selected this area displays 23 6 2 Clearing the Selected CMS at Startup You can clear the selected CMS each time the monitor restarts after being powered off for more than 2 minutes To clear the selected CMS 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Others gt gt 2 Set Clear CMS IP at startup to On The selected CMS will not be cleared when only one CMS is configured or the monitor is restarted within 2 minutes This function is switched off by default 23 7 Setting the Multicast Parameters To set the Multicast parameters 1 Select Main Menu gt Maintenance gt gt User Maintenance gt gt enter the required password Network Setup gt gt Multicast Setup gt gt 2 Set Multicast Addr and TTL 3 Select Ok to save the setting Passport 12 Passport 8 23 5 FOR YOUR NOTES 23 6 Passport 12 Passport 8 24 Batteries 24 1 Overview This monitor is designed to operate from rechargeable Lithium ion battery power when AC power is not available If the AC power is interrupted during patient monitoring the monitor automatically runs from the battery The Passport 12 patient monitor is capable of storing up to two batteries The Passport 8 patient monitor is capable of storing one battery
190. lectromagnetic environment guidance level level Conduced RF 3 Vrms 3Vrms Portable and mobile RF communications equipment should IEC61000 4 6 150 kHz to 80 MHz be used no closer to any part of the system including cables than the recommended separation distance calculated from the equation appropriate for the frequency of the transmitter Recommended separation distances d 2124 P Radiated RF 3V m 3V m Recommended separation distances IEC61000 4 3 80MHz to 2 5GHz 80 MHz 800 MHz d 2124 P 800MHz 2 5GHz d 234P Where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following e symbol Note 1 At 80 MHz to 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people aField strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoreti
191. limit Primary anesthetic agent In full accuracy mode 0 1596 Second anesthetic agent In full accuracy mode 0 396 or 596 REL 1096 in ISO accuracy mode of primary agent if primary agent is greater than 1096 Effect of interference gases on AG measurements Quantitive effect 96ABS Gas Concentration CO N20 Agent 02 CO2 0 1 0 0 2 N20 0 1 0 1 0 2 Agent 0 1 0 15 0 1 1 0 Xenon lt 100 0 1 0 0 Helium lt 50 0 1 0 0 Ethanol lt 0 1 0 0 0 Acetone lt 1 0 1 0 1 0 Methane lt 1 0 1 0 1 0 Saturated Isopropanol vapour 0 1 0 0 O2 0 1 0 1 0 1 1 Agent represents one of Des Iso Enf Sev and Hal A 16 Passport 12 Passport 8 Operator s Manual 2 Multiple agent interference on CO N20 and Oz is typically the same as single agent interference 3 For CO N20 and Agents maximum interference from each gas at concentrations within specified accuracy ranges for each gas The total interference of all gases is never larger than 5 reL 4 Applicable to type AAG module representing the interference effect of secondary anesthetic agents on primary anesthetic agent 5 Measurement interference to type M AG module originates from the applied anesthetic agent that is configured manually Alarm limit Range Step EtCO High l
192. ly high ambient temperature may activate battery overheat protection resulting the monitor powering off Ifthe battery shows signs of damage or signs of leakage replace it immediately Do not use a faulty battery in the monitor The Lithium ion batteries have a service life of 3 years Please replace your battery when it reaches the end of its service life Failure to replace the battery may cause serious damage to your device from battery overheating 24 5 Battery Maintenance Conditioning a Battery A battery should be conditioned before it is used for the first time A battery conditioning cycle is one uninterrupted charge of the battery followed by an uninterrupted battery discharge and charge Batteries should be conditioned regularly to maintain their useful life NOTE The battery charge level indicator does not indicate the capacity or operating time of the battery It only indicates the current battery charge level The actual battery capacity decreases over time with the use of the battery For an old battery its capacity and operating time may not fulfill battery specifications even the battery charge level indicates the battery is in full charge Please replace the battery if its operating time is significantly lower than the specified time Passport 12 Passport 8 24 3 To condition a battery follow this procedure 1 Disconnect the monitor from the patient and stop all monitoring or measuring 2
193. m W Pause You can select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password select Alarm Setup gt gt and set Extended Arrh to Enable or Disable When Extended Arrh is set to Disable the monitor does not analysis the extended arrhythmia events and corresponding alarms are not given CAUTION Set Extended Arrh to Disable when the monitor is connected to the CMS of version prior to 06 01 00 Failure to do so may cause the CMS to fail to display extended arrhythmia related alarms normally when extended arrhythmia occurs 8 7 5 Reviewing Arrhythmia Events Please refer to section 19 4 Reviewing Events Passport 12 Passport 8 Operator s Manual 8 8 ECG Relearning 8 8 1 Initiating an ECG Relearning Manually During ECG monitoring you may need to initiate an ECG relearning when the patient s ECG template changes dramatically A change in the ECG template could result in Incorrect arrhythmia alarms W Lossof ST measurement and or E Inaccurate heart rate ECG relearning allows the monitor to learn the new ECG template to correct arrhythmia alarms and HR value and restore ST measurements To initiate relearning manually select the ECG parameter window or waveform area Relearn When the monitor is learning the message ECG Learning is displayed in the technical alarm area WARNING Initiate ECG relearning only during
194. m Setup where you can E Set alarm properties for all parameters Change ST alarm settings Change arrhythmia alarm settings Set the threshold for some arrhythmia alarms Change other settings Alarm Setup Paramete KE E2 E a EC NOTE The On Off column is only visible when used with a CMS This column is not visible with Panorama CMS Refer to the chapter 8 Monitoring ECG for how to change ST alarm settings how to change arrhythmia alarm settings and how to set the threshold for some arrhythmia alarms 7 5 1 Setting Alarm Properties for All Parameters In the Main Menu select Alarm Setup gt gt Parameters You can review and set alarm limits alarm switches alarm level and alarm recordings for all parameters When a measurement alarm occurs automatic recording of all the measurement numerics and related waveforms is possible when the measurement s On Off and Record are set on 7 6 Passport 12 Passport 8 Operator s Manual WARNING Make sure that the alarm limit settings are appropriate for your patient before monitoring Setting alarm limits to extreme values may cause the alarm system to become ineffective For example high oxygen levels may predispose a premature infant to retrolental fibroplasia If this is a consideration do NOT set the high alarm limit to 10096 which is equivalent to switching the alarm off When monitoring patients that are not continuously attended
195. m area Filter Diagnostic 2 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Module Maintenance gt gt Calibrate ECG A square wave appears on the screen and the message ECG Calibrating is displayed 3 Compare the amplitude of the square wave with the wave scale The difference should be within 5 4 After the calibration is completed select Stop Calibrating ECG You can print the square wave and wave scale and then measure the difference between them if necessary If the difference exceeds 596 contact your service personnel 26 5 NIBP Leakage Test The NIBP leakage test checks the integrity of the system and of the valve It is required at least once a year or when you doubt the measured NIBP If the test failed corresponding prompt messages will be given If no message is displayed it means no leakage is detected Tools required W Anadultcuff W Anair tubing E Acorrect sized cylinder Follow this procedure to perform the leakage test 1 Set the patient category to Adu 2 Connect the cuff to the NIBP connector on the monitor 3 Wrap the cuff around the cylinder as shown below Passport 12 Passport 8 Operator s Manual 26 3 Monitor Cylinder Connector for Air tubing Cuff 4 Select Main Menu Maintenance gt gt User Maintenance gt gt Enter the required password and then select Ok 5 Select Module Mai
196. mal so that the interference caused by motion can be filtered and therefore the measurement stability can be ensured 11 5 4 Changing Averaging Time The SpO value displayed on the monitor screen is the average of data collected within a specific time The shorter the averaging time is the quicker the monitor responds to changes in the patient s oxygen saturation level Contrarily the longer the averaging time is the slower the monitor responds to changes in the patient s oxygen saturation level but the measurement accuracy will be improved For critically ill patients selecting shorter averaging time will help understanding the patient s state To set the averaging time for Masimo SpO2 module 1 Select Averaging in the SpO2 Setup menu 2 Then select 2 4 s 4 6 s 8 s 10 s 12 s 14 s or 16 s 11 5 5 Monitoring SpO and NIBP Simultaneously When monitoring SpO2 and NIBP on the same limb simultaneously you can switch NIBP Simul on in the SpO2 Setup menu to lock the SpO alarm status until the NIBP measurement ends If you switch NIBP Simul off low perfusion caused by NIBP measurement may lead to inaccurate SpO readings and therefore cause false physiological alarms Passport 12 Passport 8 Operator s Manual 11 3 11 5 6 Sat Seconds Alarm Management With traditional alarm management high and low alarm limits are set for monitoring oxygen saturation During monitoring as soon as an alarm limit is vio
197. me measurements their related prompt messages are displayed in their respective parameter windows Passport 12 Passport 8 Operator s Manual 7 1 7 2 Alarm Levels The monitor s alarms can be classified into three severity categories high level medium level and low level Physiological alarms Technical alarms High level Indicate that the patient is in a life Indicate a severe device malfunction or an improper operation threatening situation such as Asystole which could make it possible that the monitor cannot detect Vfib Vtac and so forth and emergency critical patient status and thus threaten the patient s life treatment is required Medium Indicate that the patient s vital signs Indicate a device malfunction or an improper operation which level appear abnormal and immediate may not threaten the patient s life but may compromise the treatment is required monitoring of vital physiological parameters Low level Indicate that the patient s vital signs Indicate a device malfunction or an improper operation which appear abnormal and immediate may compromise a certain monitoring function but will not treatment may be required threaten the patient s life 7 3 Alarm Indicators When an alarm occurs the monitor will indicate it to the user through visual or audible alarm indications W Alarm lamp W Alarm message Flashing numerics Audible alarm tones 7 3 1 Alarm Lamp If a technical alarm or physi
198. medical record number E 4 Passport 12 Passport 8 Operator s Manual MVe MVi N A N2 N20 Neo NIBP O2 OxCI OR OR OxyCRG PA pArt D pArt M pArt S Paw PAWP PD Ped PEEP PEF PEP PIF PIP Pleth Pmean Pplat PPV PR PVC PVR PVRI PVPI PPV pArt pCVP RA RAM RAP Rec Resp RHb RL RM expiratory minute volume inspiratory minute volume not applied nitrogen nitrous oxide neonate noninvasive blood pressure oxygen oxygen consumption index oxygen extraction ratio operating room oxygen cardio respirogram pulmonary artery diastolic artery pressure mean artery pressure systolic artery pressure airway pressure pulmonary artery wedge pressure photodetector pediatric positive end expiratory pressure peak expiratory flow pre ejection period peak inspiratory flow peak inspiratory pressure plethysmogram mean pressure plateau pressure Pulse Pressure Variation pulse rate premature ventricular contraction pulmonary vascular resistance pulmonary vascular resistance index pulmonary vascular permeability index pulse pressure variation artery pressure central venous pressure right right arm random access memory right atrial pressure record recording respiration reduced hemoglobin right leg respiratory mechanics Passport 12 Passport 8 Operator s Manual E 5 RR RSBI SaO SEF Sev SFM SI SMR SpO2 SQI SR STR SV SVI SVR SVRI SVV SvO ScvO Sync Sys T
199. ment by introducing a balloon tipped pulmonary artery flotation catheter into the pulmonary artery When the catheter is in one of the smaller pulmonary arteries the inflated balloon occludes the artery allowing the monitor to record changes in the intrathoracic pressures that occur throughout the respiration cycle The pulmonary wedge pressure is the left ventricular end diastolic pressure when the airway pressure and valve function are normal The most accurate PAWP values are obtained at the end of the respiration cycle when the intrathoracic pressure is fairly constant and the artifact caused by respiration is minimal WARNING e PAWP monitoring is not intended for neonatal patients 14 8 1 Preparing to Measure PAWP To prepare for the PAWP measurement 1 Prepare the same accessories as in the C O measurement Connect the parts such as catheter syringe etc following the C O measurement steps and use the balloon inflation port Refer to section 15 4 Setting Up the C O Measurement for more information 2 Connect the PAWP cable into the IBP connector on the monitor Since PAWP is measured on PA selecting PA as the IBP label is recommended 3 Selectthe PA parameter window or waveform area to enter its setup menu Then select PAWP to enter the PAWP measurement window You can also enter the PAWP measurement window from the P1 P4 parameter window PAWP CYP 7 Setup NOTE After entering the PAWP mea
200. meters m according to frequency of the transmitter 150 kHz 80 MHz d 2124 P 80 MHz 800 MHz d 2124 P 800 MHz 2 5 GHz d2234P 0 12 0 01 0 12 0 23 0 1 0 38 0 38 0 73 1 1 20 1 20 2 30 10 3 80 3 80 7 30 100 12 00 12 00 23 00 For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer Note 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people B 4 Passport 12 Passport 8 Operator s Manual B 2 Radio Regulatory Compliance This Wi Fi device complies with Canadian ICES 001 Cet appareil ISM est conforme a la norme NMB 001 du Canada The patient monitor including Wi Fi module US only complies with part 15 of the FCC Rules Operation is subject to the condition that this device does not cause harmful interference Operation of this equipment requires the prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service The patient monitor including Wi Fi module FCC and I
201. mm s O2 Compen Off On Off Operating Mode Pin a Measure Adu Ped 120 ml min Flow Rate T Ie Neo 70 ml min Auto Standby Xi ops Off Apnea Time SMS 20s RR Source id Auto CO Setup Wave Type ee Draw when unit is mmHg 50 Scale 3 PS when unit is 96 or KPa 7 0 Adu Ped 50 EtCO High mmHg MEE Neo 45 Adu Ped 25 EtCO Low mmHg A p Neo 30 FiCO High mmHg X n 4 Adu Ped 30 RR High Neo 100 Adu Ped 8 RR Low X me Neo 30 Gas Setup Agent ch AA N20 Scale Xo p 50 when unit is mmHg 400 O Scale s when unitis or KPa 50 AA Scale ERE i 9 0 Hal Enf Iso Scale o 2 5 Passport 12 Passport 8 Operator s Manual Item Name 2m General OR ICU NICU CCU User Defaults Des Scale sae fa 9 0 Sev Scale ee 0 EtO2 High sell cs 88 EtO2 Low X ape 18 FiO High EIE Adu Ped 100 Neo 90 FiO Low EREN Ls 18 EtN O High 155 EtN20 Low ME Dad 0 FiN O High X pee 53 FiN20 Low Som 0 EtHal Enf Iso High ee 13 0 EtHal Enf Iso Low 10 0 FiHal Enf Iso High 12 0 FiHal Enf Iso Low 10 0 EtSev High 1 6 0 EtSev Low xr o 0 0 FiSev High MM 5 0 FiSev Low Sec Wot 0 0 EtDes High Eo qe 8 0 EtDes Low 0 0 FiDes High Pe es 6 0 FiDes Low x gm 0 0 C 2 Routine Configuration C 2 1 Alarm Item Name FEE F General OR ICU NICU CCU User Default
202. ms and those with Q T interval of 350 ms Arrhythmia Analysis Classifications Asystole Vfib Vtac Vent Rhythm Couplet VT gt 2 Bigeminy Trigeminy R on T Multif PVC Irr Rhythm Tachy Brady Missed Beats PNP PNC ST Segment Analysis Measurement range 2 0 to 2 0 mV RTI 0 8 to 0 8 mV 0 02 mV or 10 whichever is greater Accuracy Beyond this range Not specified Refreshing rate per 16 heartbeats Resolution 0 01 mV Alarm limit Range Step HR High low limit 2 to 300 bpm 1bpm HR Low 15 to high limit 2 bpm ST High low limit 40 2 to 2 0 mV 0 1mV STLow 2 0 to high limit 0 2 mV Passport 12 Passport 8 Operator s Manual A 7 Mindray algorithm currently unavailable in the US and Canada Only the differences from the Mortara algorithm are listed HR HR averaging method In compliance with the requirements in Clause 4 1 2 1 d of ANSI AAMI EC13 the following method is used If the last 3 consecutive RR intervals are greater than 1200 ms the 4 most recent RR intervals are averaged to compute the HR Otherwise heart rate is computed by subtracting the maximum and minimum ones from the most recent 12 RR intervals and then averaging them The HR value displayed on the monitor screen is updated every second Arrhythmia Analysis Classifications Asystole VFib VTac Vtac Vent Brady Extreme Tachy Extreme Brady PVC Couplet Bigeminy Trigemin
203. ms are sounded W The alarm off symbol is displayed in the alarm symbol area You can cancel the alarm off status by pressing the Alarm Pause hardkey WARNING Pausingor switching off alarms may result in a hazard to the patient 7 8 Resetting Alarms By selecting the QuickKey you can reset the alarm system to acknowledge the on going alarms and enable the alarm system to respond to a subsequent alarm condition For physiological alarms except the NIBP related alarms when the alarm system is reset W The alarm sound is silenced W Avappears before the alarm message indicating that the alarm is acknowledged The icon appears in the alarm symbol area The parameter numeric and alarm limits still flash The indication of alarm lamp for the physiological alarm depends on the alarm light setting W When Alarm Light on Alarm Reset is set to On the alarm lamp remains flashing W When Alarm Light on Alarm Reset is set to Off the alarm lamp stops flashing To set Alarm Light on Alarm Reset 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Alarm Setup gt gt to enter the Alarm Setup menu Passport 12 Passport 8 Operator s Manual 7 11 3 Select Alarm Light on Alarm Reset and then select On or Off The default setting for Alarm Light on Alarm Reset is On Technical alarms give different alarm indicators when
204. n awRR measurement range Oto 120 rpm awRR measurement precision 2 rpm Apnea time 10s 15 s 20 s 25 s 30 s 35 s 40 s Note The response time is the sum of the rise time and the delay time Passport 12 Passport 8 Operator s Manual A 13 Effect of interference gases on CO measurements Gas Concentration 96 Quantitive effect N20 lt 60 Hal lt 4 Sev lt 5 1 mmHg Iso lt 5 Enf lt 5 Des lt 15 2 mmHg means an extra error should be added in case of gas interference when CO2 measurements are performed between 0 40mmHg Alarm limit Range Step EtCO2 High low limit 2 to 99 mmHg EtCO Low 1 to high limit 2 mmHg 1 mmHg FiCO High 1 to 99 mmHg Adult pediatric low limit 2 to 100 rpm awRR High Neonate low limit 2 to 150 rpm 1rpm awRR Low 0 to high limit 2 rpm Microstream CO Module Standard Meet standard of ISO 21647 CO Measurement range 0 to 99 mmHg 0 to 38 mmHg 2 mmHg Accuracy 39 to 99 mmHg 5 of the reading 0 08 of the reading 38 Accuracy drift Meet the requirement for measurement accuracy within 6 hours This accuracy is applied to respiration rate no greater than 80 rpm For respiration rate greater than 80 rpm and EtCO value greater than 18 mmHg the accuracy is 4 mmHg or 12 of the reading whichever is greater For respiration rate greater than 60 rpm the above accurac
205. n High level alarms triple double triple double beep Medium levelalarms triple beep Low level alarms single beep W Mode 1 High level alarms high pitched single beep Mediumlevelalarms double beep Low level alarms low pitched single beep W Mode2 High level alarms high pitched triple beep Mediumlevelalarms double beep Low level alarms low pitched single beep NOTE When multiple alarms of different levels occur simultaneously the monitor will select the highest level alarm light the alarm lamp and give alarm sounds accordingly while all the alarm messages are displayed circularly on the screen Some physiological alarms such as Asystole are exclusive They have identical alarm tones and alarm lights with normal high level physiological alarms but their alarm messages are displayed exclusively That is when an exclusive physiological alarm and a normal high level physiological alarm are triggered simultaneously only exclusive physiological alarm messages will be displayed 7 3 5 Alarm Status Symbols Apart from the aforementioned alarm indicators the monitor still uses the following symbols telling the alarm status PAY a A indicates alarms are paused NN E indicates alarm is reset a indicates the alarm sound is turned off a indicates individual measurement alarms are turned off or the system is in alarm off status Passport 12 Passport 8 Operator s Manual 7 3
206. n displays if touchscreen operation is disabled 3 7 Using the On screen Keyboard The on screen keyboard enables you to enter information W Usethe key to delete the previously entered character m Usethe amp key to toggle between uppercase and lowercase letters E Select to confirm what you have entered and close the on screen keyboard W Select to access the symbol keyboard E Select D to exit the symbol keyboard 3 8 Using the Main Menu To enter the Main Menu select the Main Menu on screen QuickKey or the Menu hardkey on the monitor s front panel Most of monitor operations and settings can be performed through this Main Menu IIHNEEEEE NN D Calc gt gt Alarm Setup gt gt Patient Data gt gt l Review gt dH Maintenance Screen Setup gt gt Load Configuration gt Record Setup gt gt Unload USB Drive Print Setup gt Mark Event gt gt Parameters gt gt gt Other menus are similar to the Main Menu and contain the following parts 1 Heading displays the title for the current menu 2 Main body displays options buttons prompt messages etc The menu buttons with gt gt open a secondary window to reveal more options or information Passport 12 Passport 8 Operator s Manual 3 Online help area displays help information for the highlighted menu item 4 X select to exit the curre
207. n the batteries every 3 months or when its run time becomes noticeably shorter W Take out the battery before the monitor is shipped or will not be used for more than two weeks W Remove the battery from the monitor if it is not being used regularly Leaving the battery in a monitor that is not in regular use will shorten the life of the battery 24 2 Passport 12 Passport 8 W The shelf life of a lithium lon battery is about 6 months when the battery is stored with the battery power being 5096 of the total power In 6 months the battery power must be depleted before the Lithium lon battery is fully charged Then run the monitor on this fully charged battery When its battery power becomes 5096 of the total power take out the battery from the monitor and store it W When storing batteries make sure that the battery terminals do not come into contact with metallic objects If batteries are stored for an extended period of time they should be placed in a cool place with a partial charge of 4096 to 6096 capacity Storing batteries at a high temperature for an extended period of time will significantly shorten the life expectancy of a battery Do not store the battery at a temperature beyond 20 C 60 C 4 F 140 F CAUTION Keep the battery out of the reach of children Use only specified batteries Charge the batteries in this monitor High ambient temperature shortens battery run time Extreme
208. n to MR421 0010 30 43056 audio Temp Probes Type Model Patient Category Measurement Site Part No MR401B TT Esophageal Rectal 0011 30 37392 ult MR403B Skin 0011 30 37393 Reusable MR402B Esophageal Rectal 001 1 30 37394 Pediatric infant MR404B Skin 0011 30 37395 MR411 Esophageal Rectal 0011 30 37398 Disposable Adult pediatric infant MR412 Skin 0011 30 37397 27 5 IBP ICP Accessories Material Part No IBP adapter cable IBP extended cable with dual receptacle 0010 30 43055 040 001029 00 BD IBP Cable 12 pin 001C 30 70757 Edwards IBP Cable 12 pin 0010 21 12179 Hospira IBP Cable 12 pin 001C 30 70759 It is proved through tests that the following accessories are compatible with the patient monitor Only the accessories uyn proceeded by manufacturers and make sure if these accessories are approved for sale in local are available from our company If you want to purchase other accessories contact respective Manufacturer Accessories MX961Z14 Logical Cable to be used in connection with the Adapter Cable 0010 20 42795 MX960 Reusable Transducer Kit Smith Medical MX261 Logical Clamp For Transducer Bracket Medex MX262 Logical Clamp For 2 Transducer Mount Plates MX960E6441 Logical Transducer Mounting Plate More Logical Clamps are available from Medex For detailed information cont
209. n when the monitor is on and turns off when the monitor is off Battery LED On when the battery is installed and the AC source is connected Off when no battery is installed or the installed battery is malfunctioning or no AC source is connected when the monitor is powered off Flashing when the monitor operates on battery power Alarm Reset Press to reset the alarms Alarm Pause Press to pause or restore alarms Freeze Press to freeze or unfreeze waveforms Record Press to start or stop recordings NIBP Press to start or stop NIBP measurements Menu If no menu is currently displayed on the screen pressing it enters the main menu If a menu is currently displayed on the screen pressing it closes that menu Knob Rotate the knob clockwise or counter clockwise to move the cursor Press the knob to select one item such as accessing a menu or confirming the selection Passport 12 Passport 8 Operator s Manual 2 3 2 3 2 Side View Passport 12 mi rr ge Handle Recorder Temp probe 1 connector IBP cable connector ECG cable connector 10 2 Battery compartment 4 Parameter module slot 6 Temp probe 2 connector 8 SpO2 cable connector 10 NIBP cuff connector Passport 12 Passport 8 Operator s Manual Passport 8
210. ndow to enter the NIBP Setup menu 2 Select NIBP STAT The STAT mode initiates 5 minutes of continuous sequential automatic NIBP measurements WARNING Continuous non invasive blood pressure measurements may cause purpura ischemia and neuropathy in the limb with the cuff Inspect the application site regularly to ensure skin quality and inspect the cuffed limb for normal color warmth and sensitivity If any abnormity occurs move the cuff to another site or stop the blood pressure measurements immediately 12 4 Passport 12 Passport 8 Operator s Manual 12 6 Understanding the NIBP Numerics The NIBP display shows numerics only as below Your display may be configured to look slightly different NIBP 095i 0 00 15 min 4 mmHg 120 80 93 1 Time of last measurement 2 Timeremaining to next measurement 3 Measurement mode 4 Unit of pressure mmHg or kPa 5 Prompt message area shows NIBP related prompt messages 6 Systolic pressure 7 Diastolic pressure 8 Mean pressure obtained after the measurement and cuff pressure obtained during the measurement If the NIBP measurement exceeds the measurement range will be displayed 12 7 Changing NIBP Settings By selecting the NIBP parameter window you can enter the NIBP Setup menu 12 7 1 Setting the Initial Cuff Inflation Pressure You can set the initial cuff inflation pressure manually In the NIBP Setup menu select Initial Pressu
211. ndustry Canada Radio Compliance This device complies with Part 15 of the FCC Rules and RSS 210 of Industry Canada Operation is subject to the following two conditions 1 this device may not cause harmful interference and 2 this device must accept any interference received including interference that may cause undesired operation Any changes or modifications to this equipment not expressly approved by Mindray may cause harmful radio frequency interference and void your authority to operate this equipment The maximum antenna gain permitted complies with the e i r p limits as stated in RSS 210 The maximum antenna gain permitted complies with the e i r p limits specified for point to point operation as stated in RSS 210 Cc The radio device used in this product is in compliance with the essential requirements and other relevant provisions of Directive 1999 5 EC Radio Equipment and Telecommunications Terminal Equipment Directive CAUTION Keep a distance of at least 20cm away from the monitor when Wi Fi function is in use Passport 12 Passport 8 Operator s Manual B 5 FOR YOUR NOTES B 6 Passport 12 Passport 8 Operator s Manual C Default Configurations This chapter lists some of the most important factory default settings for each department in configuration management You cannot change the factory default configuration itself However you can make changes to the settings from the factory default co
212. never the ECG measurement is switched on and a valid heart rate is available If the heart rate becomes unavailable for example if leads becomes disconnected and a pulse source is switch on and available the monitor will automatically switch to Pulse as the alarm source When the Leads Off condition is corrected the monitor will automatically switch back to the heart rate as the alarm source 10 4 QRS Tone When PR is used as the alarm source the PR source will be used as a source for the ORS tone You can change the ORS volume by adjusting Beat Vol in the SpO2 Setup menu When a valid SpO2 value exists the system will adjust the pitch tone of QRS volume according to the SpO value 10 2 Passport 12 Passport 8 Operator s Manual 11 Monitoring SpO 11 1 Introduction SpO monitoring is a non invasive technique used to measure the amount of oxygenated haemoglobin and pulse rate by measuring the absorption of selected wavelengths of light The light generated in the probe passes through the tissue and is converted into electrical signals by the photodetector in the probe The SpO module processes the electrical signal and displays a waveform and digital values for SpO2 and pulse rate This device is calibrated to display functional oxygen saturation It provides the following measurements 1 2 3 4 5 1 Pleth waveform Pleth visual indication of patient s pulse The waveform is not normalized 2 Oxygen saturation of a
213. nfiguration and then save the changed configuration as a user configuration The last column of the following tables is for your notes and review Note In this chapter O M means the monitor s operating mode Column C refers to the settings that can be changed in configuration management Column M refers to the settings that can be changed in monitoring mode C 1 Parameters Configuration C 1 1 ECG ECG Setup O M Item Name m General OR ICU NICU CCU User Defaults Lead Set Auto Alm Source A p HR Alarm ERJ On Alm Lev me eae Med Adu 120 HR PR High _ Ped A Gal 160 Neo 200 Adu 50 HR PRLow Ped ey 75 Neo 100 Sweep ae 25 mm s Beat Vol Yom 2 1 Paced x No Notch Filter xo pe Weak Gain aa X1 Filter mou Monitor Surgery Monitor Diagnostic ECG Display Alen Normal Pacemaker Rate 60 Passport 12 Passport 8 Operator s Manual C1 ST Analysis O M Item Name General OR ICU NICU CCU User Defaults M ST Analysis Off On Alarm Off Alm Lev Med when ST Unit is mV 0 20 ST X High x when ST Unit is mm 2 0 when ST Unit is mV 0 20 ST X Low F when ST Unit is mm 2 0 ISO 80 ms J To 48 ms ST J4 60 ms X represents I Il Ill aVR aVL aVF V V1 V2 V3 V4 V5 or V6 Arrh An
214. ng this symbol 7 11 2 Setting Care Group Alert Tone When a monitor in the Care Group issues an alarm your monitor prompts you by sounding an alert tone To set the alert tone 1 Inthe Main Menu select Screen Setup gt gt Screen Layout gt gt Choose Screen 2 Inthe Choose Screen window select View Others Screen 3 Inthe view other patient window select Setup gt gt and set Alert Tone to Repeat Once or Off 7 11 3 Resetting Care Group Alarms You can reset the alarm of the currently viewed bed in the View Other Patient window This function can be set in the Alarm Setup menu from the User Maintenance menu only When Reset Other Bed s Alarms is set to On in Maintenance User Maintenance Alarm Setup the Alarm Reset button appears on the View Other Patient window You can reset the alarm system for the selected monitor by pressing the button Refer to section 7 8 Resetting Alarms for details When Reset Other Bed s Alarms is set to Off there is no button appearing on the View Other Patient window Passport 12 Passport 8 Operator s Manual 7 13 FOR YOUR NOTES 7 14 Passport 12 Passport 8 Operator s Manual 8 Monitoring ECG 8 1 Introduction The electrocardiogram ECG measures the electrical activity of the heart and displays it on the monitor as a waveform and a numeric This section also tells you about ST monitoring and arrhythmia monitoring ECG monitoring p
215. nlet is Blocked If the gas inlet including watertrap sampling line and airway adapter is occluded by condensed water the message AG Airway Occluded appears To remove the occlusion W Check the airway adapter for an occlusion and replace if necessary W Check the sampling line for an occlusion or kinking and replace if necessary W Check the watertrap for a build up of water Empty the watertrap If the problem persists replace the watertrap 17 8 2 When an Internal Occlusion Occurs Condensed water may enter the module and cause contamination and or internal occlusions In this case the message AG Airway Occluded displays To remove the occlusion W Check the airway adapter for an occlusion and replace if necessary W Check the sampling line for an occlusion or kinking and replace if necessary W Check the watertrap for a build up of water Empty the watertrap If the problem persists replace the watertrap 17 8 3 When an Internal Occlusion Occurs Condensed water may enter the module and cause contamination and or internal occlusions In this case the message AG Airway Occluded displays To remove the occlusion W Check for any occlusion in the gas inlet and or outlet system m If the problem persists internal occlusions may exist Contact your service personnel Passport 12 Passport 8 Operator s Manual 17 7 17 9 Removing Exhaust Gases from the System WARNING e Anesthetics When using the AG measureme
216. nsfer mode Transfer data via a crossover network cable Before transferring data using a crossover network cable 1 Connectone end of the crossover network cable to the monitor and the other end to the PC 2 Set the IP address of the PC This IP address must be in the same network segment with that of the monitor 3 Make sure that the data export system is active on the PC Then follow this procedure to transfer data 1 Select Main Menu Patient Data gt gt Transfer Data 2 Select Yes from the popup message box 3 Inputthe IP address already set on the PC 4 Select Start to start transferring data Transfer data within a LAN Before transferring data within a LAN 1 Connectthe monitor and the intended PC into the same LAN and acquire the PC s IP address 2 Make sure that the data export system is active on the PC Follow the same procedure as via a crossover network cable to transfer data 23 4 Nurse Call The monitor provides a nurse call connector to output nurse call signal when a user defined alarm occurs To obtain nurse call signal use the nurse call cable PN 009 003116 00 we supply to connect the hospital nurse call system to the nurse call connector of the monitor and then follow this procedure 1 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 2 Select Others gt gt to access the Others menu 3 Select Nurse Call Setup
217. nt alarm presets are used for the same or similar equipment in any single area e g an intensive care unit or cardiac operating room If your monitor is connected to a CMS alarms can be controlled remotely Remote suspension inhibition and reset of monitor alarms via the CMS may cause a potential hazard For details refer to the CMS s operator s manual For troubleshooting specific alarms see appendix D Alarm Messages 7 1 Alarm Categories The monitor s alarms can be classified into two categories physiological alarms and technical alarms 1 Physiological alarms Physiological alarms also called patient status alarms are triggered by a monitored parameter value that violates set alarm limits or an abnormal patient condition Physiological alarm messages are displayed in the physiological alarm area Technical alarms Technical alarms also called system status alarms are triggered by a device malfunction or a patient data distortion due to improper operation or mechanical problems Technical alarm messages are displayed in the technical alarm area Apart from the physiological and technical alarm messages the monitor will Show some messages telling the system status or patient status Messages of this kind are included in the prompt message category and usually displayed in the prompt information area Some prompt messages that indicate the arrhythmia events are displayed in the physiological alarm area For so
218. nt menu If changes are made in the menu they take effect after selecting this button 3 9 Setting the Screen You can enter the Screen Setup window as shown below by selecting Main Menu Screen Setup Screen Layout gt gt In this window you can arrange the positions of the parameters and waveforms Unselected parameters or waveforms will not display Screen Setup Big Numer Area A Off off Area C Area B Temp NIBP List The ECG parameter and the first ECG waveform always display in the first row The configurable areas can be classified as Area A Area B and Area C W In Area A you can choose to display the parameter windows and their waveforms if one exists Each parameter and the associated waveform are displayed in the same row in Area B you can choose to display the parameter windows But if all parameters in area C are set to Off both the parameter and waveform selected in the first row of area B will be displayed W in Area C you can choose to display the timer and any parameters without associated waveforms The screen automatically adjusts to ensure the best view based on your screen setup If no corresponding parameter or waveform displays after the module is inserted perform the following inspections W Check the connection between the module and lead cable sensor or external device W Enter the Screen Setup window for the desired display configuration by selecting Main Menu
219. nt on patients who are receiving or have recently received anesthetics connect the outlet to a scavenging system or to the anesthesia machine ventilator to avoid exposing medical staff to anesthetics To remove the sample gas to a scavenging system connect an exhaust tube to the gas outlet connector of the module 17 8 Passport 12 Passport 8 Operator s Manual 1 8 Freezing Waveforms During patient monitoring the freeze feature allows you to freeze the currently displayed waveforms on the screen so that you can have a close examination of the patient s status Besides you can select any frozen waveform for recording 18 1 Freezing Waveforms To freeze waveforms select the Freeze hardkey on the monitor s front panel W The system closes the displayed menu if any and opens the Freeze menu Wave 1 mg Wave 2 Wave3 Plelh Scroll gt Record W Alldisplayed waveforms are frozen i e the waveforms stop being refreshed NOTE The freeze feature exerts no effect on the split screen view of minitrends OxyCRG and other patients 18 2 Viewing Frozen Waveforms To view the frozen waveforms you can either E Select the Scroll button and then rotate the knob clockwise or counter clockwise or W Directly select the or beside the Scroll button using the touchscreen The frozen waveforms will scroll left or right accordingly And meanwhile at the lower right corner of the last wave
220. ntenance gt gt NIBP Leakage Test The NIBP display shows Leakage Testing After about 20 seconds the monitor will automatically deflate This means the test is completed If the message NIBP Pneumatic Leak is displayed it indicates that the NIBP airway may have leakages Check the tubing and connections for leakages If you ensure that the tubing and connections are all correct perform a leakage test again If the problem persists contact your service personnel NOTE The leakage test is intended for use to simply determine whether there are leakages in the NIBP airway It is not the same as that specified in the EN 1060 3 standard 26 6 CO Leakage Test For sidestream and microstream CO modules leakage test is needed every year or when you suspect the measurement Follow this procedure to perform the test 1 Connect the CO2 module with the patient module 2 Wait until CO warmup is finished and then use your hand or other objects to completely block the gas inlet of the module or watertrap The sidestream and microstream CO modules will behave as follows Sidestream The alarm message CO2 FilterLine Err is displayed on the screen after certain time Block the gas inlet for another 30 s If the alarm message does not disappear it indicates that the module does not leak Microstream The alarm message CO2 Purging is displayed on the screen after certain time Block the gas inlet for ano
221. nual Detection Mode cardiac overlay can in certain situations trigger the respiration counter This may lead to a false indication of a high respiration or an undetected apnea condition If you suspect that cardiac overlay is being registered as breathing activity raise the detection level above the zone of cardiac overlay If the Resp wave is so small that raising the detection level is not possible you may need to optimize the electrode placement as described in section 9 4 4 Lateral Chest Expansion 9 8 Changing Resp Wave Settings WARNING When monitoring in manual detection mode make sure to check the respiration detection level after you have increased or decreased the size of the respiration wave In the Resp Setup menu you can Select Gain and then select an appropriate setting The bigger the gain is the larger the wave amplitude is E Select Sweep and then select an appropriate setting The faster the wave sweeps the wider the wave is 9 9 Setting Respiration Rate Source To set RR source 1 Enterthe Resp Setup menu 2 Select RR Source and then select a source or Auto from the dropdown list The dropdown list displays the currently available RR source When you select Auto the system will automatically select the RR source according to the priority When the current RR source does not have valid measurement the system will automatically switch the RR Source to Auto RR source swit
222. nufacturer s Responsibility Contents of this manual are subject to changes without prior notice All information contained in this manual is believed to be correct Mindray is not liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing performance or use of this manual Mindray is responsible for the effects on safety reliability and performance of this product only if allinstallation operations expansions changes modifications and repairs of this product are conducted by Mindray authorized personnel the electrical installation of the relevant room complies with the applicable national and local requirements W the product is used in accordance with the instructions for use WARNING Onlyskilled trained clinical professionals should operate this equipment It is important for the hospital or organization that uses this equipment to perform a recommended service maintenance plan Neglect of this may result in machine breakdown or personal injury Warranty Mindray warrants that components within its products will be free from defects in workmanship and materials for a period of one year from the date of purchase except that disposable or one time use products are warranted to be free from defects in workmanship and materials up to a date one year from the date of purchase or the date of first use whichever is sooner This warranty does not
223. ny customer modification voids this warranty Mindray makes no warranty whatsoever in regard to trade accessories such being subject to the warranty of their respective manufacturers A condition of this warranty is that the equipment or accessories which are claimed to be defective be returned when authorized freight prepaid to Mindray DS USA Inc Mahwah New Jersey 07430 or its authorized representative Mindray shall not have any responsibility in the event of loss or damage in transit Exemptions Mindray s obligation or liability under this warranty does not include any transportation or other charges or liability for direct indirect or consequential damages or delay resulting from the improper use or application of the product or the use of parts or accessories not approved by Mindray or repairs by people other than Mindray authorized personnel This warranty does not extent to W Malfunction or damage caused by improper use or man made failure W Malfunction or damage caused by unstable or out of range power input W Malfunction or damage caused by force majeure events such as i flood fire and earthquake or other similar elements of nature or acts of God ii riots war civil disorders rebellions or revolutions in any country or iii any other cause beyond the reasonable control of Mindray W Malfunction or damage caused by improper operation or repair by unqualified or unauthorized service people W Malfunction of th
224. o If the Alm Source is set to Auto the monitor will use the heart rate from the ECG measurements as the alarm source whenever a valid heart rate is available If the heart rate becomes unavailable for example the ECG module is turned off or becomes disconnected the monitor will automatically switch to PR as the alarm source 8 5 4 Changing ECG Wave Settings In the ECG Setup menu You can select ECG ECG1 or ECG2 to select a lead to view The waveform of selected lead should have the following characteristics The QRS should be either completely above or below the baseline and it should not be biphasic The QRS should be tall and narrow The P waves and T waves should be less than 0 2mV If the wave is too small or clipped you can change its size by selecting an appropriate Gain setting If you select Auto from Gain the monitor will automatically adjust the size of the ECG waves In normal screen only the selected ECG wave s size is adjusted In other screens all ECG waves size is adjusted simultaneously You can change the wave sweep speed by selecting Sweep and then selecting the appropriate setting Passport 12 Passport 8 Operator s Manual 8 5 8 5 5 Changing the ECGFilter Settings The ECG filter setting defines how ECG waves are smoothed To change the filter setting select Filter from ECG Setup and then select the appropriate setting W Monitor Use under normal measurement condition
225. ode the monitor adjusts the detection level automatically depending on the wave height and the presence of cardiac artifact Note that in auto detection mode the detection level a dotted line is not displayed on the waveform Use auto detection mode for situations where The respiration rate is not close to the heart rate Breathing is spontaneous with or without continuous positive airway pressure CPAP Patients are ventilated except patients with intermittent mandatory ventilation IMV W In manual detection mode you adjust the dotted detection level line to the desired level by selecting Upper Line A or Lower Line and then selecting or Y beside them Once set the detection level will not adapt automatically to different respiration depths It is important to remember that if the depth of breathing changes you may need to change the detection level Use manual detection mode for situations where The respiration rate and the heart rate are close Patients have intermittent mandatory ventilation Respiration is weak Try repositioning the electrodes to improve the signal In Auto Detection Mode if you are monitoring Resp and ECG is switched off the monitor cannot compare the ECG and Resp rates to detect cardiac overlay The respiration detection level is automatically set higher to prevent the detection of cardiac overlay as respiration Passport 12 Passport 8 Operator s Manual 9 3 In Ma
226. of for ECG RESP TEMP SpO NIBP IBP and C O Mode of operation Continuous Degree of protection against harmful ingress of water IPX1 Protection against vertically falling water drops A 1 2 Environmental Specifications CAUTION The equipment may not meet the performance specifications if stored or used outside the specified temperature and humidity ranges Main unit Item Operating conditions Storage conditions Passport 8 30 to 70 Temperature C 0 to 40 Passport 12 20 to 60 Relative humidity noncondensing 1596 to 9596 1096 to 9596 Barometric kPa 57 0to 107 4 16 0 to 107 4 Microstream CO module Item Operating conditions Storage conditions Temperature C 0 to 40 20 to 60 Relative humidity noncondensing 1596 to 9596 1096 to 9596 Barometric kPa 57 3to 105 3 57 3to 105 3 Sidestream CO module Item Operating conditions Storage conditions Temperature C 5to40 20 to 60 Relative humidity noncondensing 15 to 95 10 to 95 Barometric kPa 57 3 to 105 3 57 3 to 105 3 Passport 12 Passport 8 Operator s Manual AG module Storage conditions Item Operating conditions Temperature C 10 to 40 Relative humidity noncondensing 15 to 95 Barometric kPa 70 to 107 4 20 to 60 10 to 95 70 to 107 4 NOTE The environmental specifica
227. oise around the cable and electrode and check the patient for great motion Artifacts are detected on the ECG analysis lead and as a result heart rate cannot be calculated and Asystole Vfib and Vtac cannot be analyzed Check the connections of ECG Artifact L A the electrodes and leadwires and check for any possible EG source of interference around the cable and electrode Check the patient s condition and check the patient for great motion High frequency signals are detected on the ECG analysis ECG High Freq Noise L A lead Check for any possible source of interference around the cable and electrode Low frequency signals are detected on the ECG analysis ECG Low Freq Noise L A lead Check for any possible source of interference around the cable and electrode The ECG amplitude didn t reach the detected threshold ECG Amplitude Too Small L C Check for any possible source of interference around the cable and electrode ECG configuration is wrongly downloaded Check the ECG Config Err L C downloaded configuration and re download the correct configuration Resp Resp Disturbed L A The respiration circuit is disturbed Restart the monitor Temp Cal Err H C A calibration failed Restart the monitor Temp T1 Sensor Off L A TheTemp sensor has become detached from the patient T2 Sensor Off L A or the module Check the sensor connections SpO Sensor Off E B The SpO sensor has become detached from the patient SpO Sensor Fault L C or the module or
228. ol L blood urea nitrogen Height cm height Weight kg weight 20 8 Passport 12 Passport 8 20 6 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula URNaEx mmol 24h urine sodium excretion Urine x URNa 1000 URKEx mmol 24h urine potassium excretion Urine x URK 1000 Na K 96 sodium potassium ratio 100 x URNa URK CNa ml 24h Clearance of sodium URNa x Urine SerNa Clcr ml min creatinine clearance rate Ucr x Urine Cr BSA 1 73 1440 FENa 96 fractional excretion of sodium 100 x URNa x Cr SerNa x Ucr Cosm ml min osmolar clearance Uosm x Urine Posm 1440 CH O ml h free water clearance Urine x 1 Uosm Posm 24 U P osm None urine to plasma osmolality ratio Uosm Posm BUN Cr None blood urea nitrogen creatinine ratio 1000 x BUN Cr U Cr None urine serum creatinine ratio Ucr Cr BUN Cr is a ratio under the unit of mol 20 7 Understanding the Review Window With the review feature you can review oxygenation ventilation hemodynamic and renal calculations The review window for each calculation is similar Take the hemodynamic calculations review window for example you can access it by selecting Review in the Hemodynamic Calculation window In this review window W You can select 4 b 44 or FF toview more values W The values that exceed the range are displayed in a yellow background The Unit field displays parameter
229. ological alarm occurs the alarm lamp will flash The color and flashing frequency match the alarm level as follows W High level alarms the lamp quickly flashes red W Medium level alarms the lamp slowly flashes yellow W Low level alarms the lamp lights yellow without flashing 7 3 2 Alarm Messages When an alarm occurs an alarm message will appear in the technical or physiological alarm area For physiological alarms the asterisk symbols before the alarm message match the alarm level as follows W High level alarms REX W Mediumlevelalarms W Low level alarms Additionally the alarm message uses different background color to match the alarm level W High level alarms red W Medium level alarms yellow W Low level alarms yellow You can view the alarm messages by selecting the physiological or technical alarm area 7 2 Passport 12 Passport 8 Operator s Manual 7 3 3 Flashing Numeric If an alarm triggered by an alarm limit violation occurs the numeric of the measurement in alarm will flash every second and the corresponding alarm limit will also flash at the same frequency indicating the high or low alarm limit is violated 7 3 4 Audible Alarm Tones The alarm tone is distinct from heart beat tone keystroke tone and pulse tone in frequency This monitor has three alarm tones and patterns ISO Mode 1 and Mode 2 For each pattern the alarm tones identify the alarm levels as follows W ISO patter
230. operating modes Passport 12 Passport 8 Operator s Manual 3 9 3 13 1 Monitoring Mode This is the normal everyday working mode that you use for monitoring patients Your monitor automatically enters the Monitoring mode after being turned on 3 13 2 Night Mode To avoid disturbing the patient Night mode may be used To activate the Night mode 1 Select the Night Mode QuickKey or Main Menu Screen Setup gt gt Night Mode gt gt 2 Inthe pop up menu set the desired brightness alarm volume QRS volume key volume NIBP end tone or whether to stop NIBP measurements or not When Stop NIBP is selected all the NIBP measurements terminate after entering the Night mode 3 Selectthe Enter Night Mode button To cancel the Night mode 1 Select the Night Mode QuickKey or Main Menu Screen Setup gt gt Night Mode gt gt 2 Select Ok in the pop up CAUTION Before entering Night mode confirm the brightness settings alarm volume QRS volume and key volume Consider the potential risk when the setting value is low 3 13 3 Privacy Mode Privacy mode is only available when an admitted patient at a monitor is also monitored by the CMS To activate the Privacy mode select Main Menu Screen Setup gt gt Privacy Mode The monitor does the following after activating Privacy mode The screen turns blank and the message Under monitoring Press any key to exit the pri
231. or alarm notification Remember that the most reliable alarm notification combines audible and visual alarm indications with the patient s clinical condition NOTE If no setting is selected from Alm Lev or Alarm Cat no nurse call signal will be triggered whatever alarms occur 23 5 Network Connection CAUTION Disconnecting from the network may result in loss of data including parameter waveforms and measurements alarm events trends and patient data or cause function failure In case of network disconnection check the patient and solve the network problem as soon as possible 23 5 1 Setting the Network Type The monitor supports both wired and wireless network To set the network type you can select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password Network Setup gt gt Passport 12 Passport 8 23 3 23 5 2 Setting up the Wireless Network A Mindray proprietary wireless network installed by approved Mindray service personnel is required to support wireless networking This proprietary network will have the following capabilities W Support the 802 11g wireless protocol W Have a channel bandwidth of 20 MHz W Support WPA2 PSK security Provide a signal strength at the monitor of no less than 65 dBm NOTE Keep network authentication information e g password safe to protect the network from being accessed by unauthor
232. orm At the bottom there are controls 1 Event You can enter the Review menu by selecting the Event button Trend length list box In the trend length list box you can select 1 min 2 min 4 min or 8 min Setup Select the Setup button to enter the Setup menu in which you can select the parameters for display the time length to be saved before and after an event and the scale of the graphic trends and waveform The trend area can display two parameter trends e g HR trend and RR trend simultaneously Auto Scale Select the Auto Scale button and the system automatically adjusts the scaling Print Select Print to print the real time OxyCRG to a printer Record Select Record to print the currently displayed OxyCRG trends to the recorder Passport 12 Passport 8 Operator s Manual 6 3 6 4 Viewing Other Patients 6 4 1 Care Group You can select up to 10 monitors including telemetry connected to the sameCMS into a care group This lets you View information on the monitor screen from another bed in the same Care Group Be notified of physiological and technical alarm conditions at the other beds in the same Care Group To have a Care Group 1 Openthe View Other Patient window by Selecting Others QuickKey or Selecting Screens QuickKey fehoose Screen View Others Screen x Of Selecting Main Menu Screen Setup gt gt Seteen Layout gt gt Choose Screen Yiew Others Screen
233. our patient s condition including heart rate PVC rate rhythm and ectopics WARNING Arrhythmia analysis program is intended to detect ventricular arrhythmias It is not designed to detect atrial or supraventricular arrhythmias It may incorrectly identify the presence or absence of an arrhythmia Therefore a physician must analyze the arrhythmia information with other clinical findings Thearrhythmia detection is not intended for neonatal patients Heart rate reading may be affected by cardiac arrhythmias Do not rely entirely on rate meter alarms when monitoring pat ients with arrhythmia Always keep these patients under close surveillance 8 7 1 Understandi Mortara ECG algorithm ng the Arrhythmia Events Arrhythmia Message Description Category Asystole No QRS complex detected within the set time threshold in absence of Lethal ventricular fibrillation or chaotic signals arrhythmia Vfib Ventricular fibrillation occurs and persists for 6 seconds Vtac Ventricular HR is greater or equal to the preset threshold and the number of consecutive PVCs is greater than the preset threshold PVCs PVCs min exceeds high limit Nonlethal PNP No pace pulse detected for 60 1000 pace rate 90 milliseconds following a ORS arrhythmia complex or a pacer pulse for paced patients only PNC No QRS complex detected for 300 milliseconds following a pace pulse for pa
234. ow limit 2 to 99 mmHg EtCO Low 1to high limit 2 mmHg 1 mmHg FiCO2 High 1 to 99 mmHg Adult pediatric low limit 2 to 100 rpm awRR High Neonate low limit 2 to 150 rpm 1 rpm awRR Low 0 to high limit 2 rpm EtO2 High low limit 2 to 100 96 EtO2 Low 18 to high limit 2 0 1 FiO High low limit 2 to 100 96 FiO2 Low 18 to high limit 2 EtN20 High low limit 2 to 100 EtN20 Low 0 to high limit 2 1 FiN O High low limit 2 to 100 96 FiN2O Low 0 to high limit 2 96 EtHal Enf Iso High low limit 0 2 to 5 0 96 EtHal Enf Iso Low 0 to high limit 0 2 96 0 196 FiHal Enf Iso High low limit 0 2 to 5 0 96 FiHal Enf Iso Low 0 to high limit 0 2 96 EtSev High low limit 0 2 to 8 0 96 EtSev Low 0 to high limit 0 2 96 0 196 FiSev High low limit 0 2 to 8 0 96 FiSev Low 0 to high limit 0 2 96 EtDes High low limit 0 2 to 18 0 96 EtDes Low 0 to high limit 0 2 0 1 FiDes High low limit 0 2 to 18 0 FiDes Low 0 to high limit 0 2 Passport 12 Passport 8 Operator s Manual FOR YOUR NOTES Passport 12 Passport 8 Operator s Manual B EMC and Radio Regulatory Compliance B 1 EMC The device meets the requirements of IEC 60601 1 2 Note Using accessories transducers and cables other than those specified may result in increased electromagnetic emission or decreased electromagnetic immunity of the patient monitoring equipment The device or its
235. placed with a new one Otherwise the sampling line is blocked and should be replaced with a new one 16 8 Passport 12 Passport 8 Operator s Manual 16 10 Removing Exhaust Gases from the System WARNING Anesthetics When using the Sidestream or Microstream CO measurement on patients who are receiving or have recently received anesthetics connect the outlet to a scavenging system or to the anesthesia machine ventilator to avoid exposing medical staff to anesthetics To remove the sample gas to a scavenging system connect an exhaust tube to the gas outlet connector of the module 16 11 Zeroing the Sensor Zero calibration eliminates the effect of baseline drift during CO measurement exerted on the readings and therefore maintains the accuracy of the CO measurements For sidestream and microstream CO modules a zero calibration is carried out automatically when necessary You can also start a manual zero calibration if necessary To manually start a zero calibration 1 Select Main Menu Maintenance gt gt User Maintenance enter the required password Maintain CO2 gt gt 2 Select Calibrate CO2 Start Zero Cal Disconnecting the patient airway is not required when performing a zero calibration Passport 12 Passport 8 Operator s Manual 16 9 16 12 Calibrating the Sensor For sidestream or microstream CO modules a calibration should be performed once every yea
236. propriate volume 0 means off and 10 is the maximum volume QRS Volume The QRS tone is derived from either the HR or PR depending on which is currently selected as the alarm source in ECG Setup or SpO2 Setup When monitoring SpOz there is a variable pitch tone which changes as the patient s saturation level changes The tone pitch rises as the saturation level increases and falls as the saturation level decreases The tone volume is user adjustable To adjust the ORS volume 1 Select the Volume Setup QuickKey or the ECG parameter window gt Others gt gt or the SpO2 parameter window 2 Select QRS Volume or Beat Vol and then select the appropriate volume 0 means off and 10 is the maximum volume 3 12 Setting Parameters 3 12 1 Switching the Parameters On Off To switch the parameters on or off select Main Menu Screen Setup gt gt Screen Layout gt gt Parameters Switch When a parameter is switched off its corresponding parameter module stops working and its parameter value and waveform are not shown on the monitor display NOTE e ECG is always selected and you can not switch it off 3 12 2 Accessing the Parameters Menu Select Parameters gt gt from the Main Menu or select corresponding parameter area or waveform area to access a parameter setup menu 3 13 Operating Modes Your monitor has different operating modes Some are password protected This section lists the major
237. r or when the readings go far beyond the range Oridion Information 16 13 Oridion Information Microstream This trademark is registered in Israel Japan German and America Oridion Patents The capnography component of this product is covered by one or more of the following US patents 6 428 483 6 997 880 6 437 316 7 488 229 7 726 954 and their foreign equivalents Additional patent applications pending No Implied License Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized CO2 sampling consumables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device and or CO2 sampling consumable 16 10 Passport 12 Passport 8 Operator s Manual 17 Monitoring AG 17 1 Introduction The anaesthetic gas AG module measures the patient s anesthetic and respiratory gases by connecting to the airway of intubated patients or collecting the gases with specified accessories It also incorporates the features of the O2 module and BIS module The AG measurement is applicable for adult pediatric and neonatal patients AG monitoring is for Passport 12 patient monitors only The AG module determines the concentration of certain gases using the infrared IR light absorption measurement The gases that can be measured by the AG module absorb IR light Each gas has its own absorption characteristic The gas i
238. r s Manual 8 7 8 5 13 Adjusting QRS Volume QRS sounds are produced based on the alarm source To adjust the QRS volume select Others gt gt from the ECG Setup menu select QRS Volume from the pop up menu and select the appropriate setting When a valid SpO measured value is available the system adjusts the pitch tone of QRS sound based on the SpO value 8 5 14 About the Defibrillator Synchronization A defibrillator synchronization pulse 100 ms 5V is outputted through the Multifunctional connector every time the monitor detects an R wave To use the defibrillator synchronization function 1 Connectthe monitor and the defibrillator with a synchronization cable 2 Set Filter to Diagnostic on the monitor WARNING Improper use of a defibrillator may cause injury to the patient The user should determine whether to perform defibrillation or not according to the patient s condition e After defibrillation is finished select the filter mode as required 8 6 About ST Monitoring W ST segment analysis is not intended for neonatal patients W ST segment analysis calculates ST segment elevations and depressions for individual leads and then displays them as numerics in the ST1 and ST2 areas H A positive value indicates ST segment elevation a negative value indicates ST segment depression W Measurement unit of the ST segment mV or mm You can set the unit in the Unit Setup menu from the Us
239. rate limit arrhythmia The consecutive PVCs the Vbrd threshold and the ventricular HR the Vbrd Vent Brady Rate threshold Extreme Tachy The heart rate is equal to or greater than the extreme tachycardia limit Extreme Brady The heart rate is equal to or less than the extreme bradycardia limit PVCs PVCs min exceeds high limit No pace pulse detected for 1 75 x average R to R intervals following a QRS Pacer not paced complex for paced patients only No QRS complex detected for 300 milliseconds following a pace pulse for Pacer not capture paced patients only PVC One PVC detected in normal heartbeats Couplet Paired PVCs detected in normal heartbeats VT 2 More than 2 consecutive PVCs within the last minute Bigeminy A dominant rhythm of N V N V N V Trigeminy A dominant rhythm of N N V N N V N N V RonT Ron T detected in normal heartbeats Nonlethal No beat detected for 1 75 x average R R interval for HR 120 or No beat for 1 i arrhythmia Missed Beats second with HR gt 120 for non paced patients only or No beat detected for more than the set pause threshold Brady The average heart rate is equal to or less than the bradycardia limit Tachy The average heart rate is equal to or greater than the tachycardia limit Vent Rhythm The consecutive PVCs 2 the Vbrd PVCs limit and the HR 2 Vbrd Rate limit but lt the Vtac Rate limit Multif PVC Multiform PVCs detected in Multif PVC s Win
240. rd button to print the currently displayed graphic trends by the recorder Select the Print button to set and print the graphic trends report by the printer For how to set the graphic trends report refer to chapter 22 Printing 19 3 Reviewing Tabular Trends In the Review menu select Tabular Trends to access the following window xu gt ee s gt ev Trend Group Interval Events are marked with colors in window s top area Red represents high level alarm event Yellow represents medium low level alarm event Green represents manual event In this review window Select Trend Group and you can select a trend group for viewing in the popup menu If Custom 1 or Custom 2 is selected you can further select Define Trend Group Then you can select the parameters for viewing in the popup menu Select Interval to change the resolution of the trend data and then select the appropriate setting 19 2 Passport 12 Passport 8 Operator s Manual 5 s or 30 s select to view up to 4 hours of tabular trends at 5 or 30 second resolution 1 min 5 min 10 min 15 min 30 min 1 h 2 h or 3 h select to view up to 120 hours of tabular trends at your selected resolution NIBP select to view the tabular trends when NIBP measurements were acquired W To browse the tabular trends you can either Select or beside Scroll to drag the scrollbar left or right to naviga
241. re and then select the appropriate setting NOTE For known hypertensive patients you need to set initial cuff pressure to a higher value to reduce the measurement time 12 7 2 Setting NIBP Alarm Properties Select Alarm Setup gt gt from the NIBP Setup menu You can set the alarm properties for this parameter in the popup menu Passport 12 Passport 8 Operator s Manual 12 5 12 7 3 Displaying NIBP List Select Screens QuickKey Screen Setup You can set NIBP List to be displayed on the screen where the most recent NIBP measurements display Then multiple sets of most recent NIBP measurements will be displayed And the displayed PR is derived from NIBP MIB iP List PR Time 120 80 93 60 168 B You can not display NIBP list in some screens such as the big numerics screen 12 7 4 Setting the Pressure Unit Select Unit Setup gt gt from the User Maintenance menu In the popup menu select Press Unit and then select mmHg or kPa 12 7 5 Switching On NIBP End Tone The monitor can issue a reminder tone at the completion of NIBP measurement The NIBP End Tone is off by default You can switch it on by accessing the NIBP Setup menu 12 8 Assisting Venous Puncture You can use the NIBP cuff to cause sub diastolic pressure to block the venous blood vessel and therefore help venous puncture 1 Select VeniPuncture gt gt from the NIBP Setup menu In the popup menu verify that the
242. rnative means and then verify that the monitor is working correctly Do not apply cuff on the arm on the side of a mastectomy 12 3 Measurement Limitations Measurements are impossible with heart rate extremes of less than 40bpm or greater than 240bpm or if the patient is on a heart lung machine The measurement may be inaccurate or impossible If a regular arterial pressure pulse is hard to detect With excessive and continuous patient movement such as shivering or convulsions With cardiac arrhythmias Rapid blood pressure changes Severe shock or hypothermia that reduces blood flow to the peripheries Obesity where a thick layer of fat surrounding a limb dampens the oscillations coming from the artery 12 4 Measurement Methods There are three methods of measuring NIBP Manual measurement on demand Auto continually repeated measurements at set intervals STAT continually rapid series of measurements over a five minute period then return to the previous mode 12 2 Passport 12 Passport 8 Operator s Manual 12 5 Setting Up the NIBP Measurement 12 5 1 Preparing the Patient In normal use perform NIBP measurement on a patient who is in the following position W Comfortably seated E Legs uncrossed W Feet flat on the floor W Back and arm supported and W Middle of the cuff at the level of the right atrium of the heart NOTE It is recommended that the patient relax as much as possible before p
243. rovides two algorithms W Mortara algorithm W Mindray algorithm currently unavailable in the US and Canada The monitor incorporating Mortara algorithm is labelled with the Mortara logo 8 2 Safety WARNING Useonly ECG electrodes and cables specified by the manufacturer Make sure the conductive parts of electrodes and associated connectors for applied parts including the neutral electrode should not contact any other conductive parts including earth Periodically inspect the electrode application site to ensure skin quality If the skin quality changes replace the electrodes or change the application site Usedefibrillation proof ECG cables during defibrillation Do not touch the patient or table or instruments during defibrillation The neutral electrode of the HF surgical unit shall properly contact the patient Otherwise burns may result The equipment is not intended for direct cardiac application CAUTION Interference from a non grounded instrument near the patient and electrosurgery interference can cause problems with the waveform NOTE After defibrillation the screen display recovers within 10 seconds if the correct electrodes are used and applied in accordance with the manufacturer s instructions for use Passport 12 Passport 8 Operator s Manual 8 1 8 3 Preparing to Monitor ECG 8 3 1 Preparing the Patient and Placing the Electrode
244. rred to the air pressure Verify that the monitor application site meets the environmental NIBP Air Pressure Err requirements and check if there is any source that affects the air pressure The patient s pulse is weak or the cuff is loose Check the NIBP Weak Signal patient s condition and change the cuff application site If the error persists replace the cuff The NIBP signal is saturated due to excess motion or NIBP NIBP Signal Saturated other sources The measured NIBP value is not within the specified NIBP Overrange range Check the patient s condition and reduce the patient NIBP Excessive Motion motion The NIBP airway may be occluded Check the airway and NIBP Cuff Overpress measure again NIBP Equip Err An error occurred during NIBP measurement and NIBP Timeout therefore the monitor cannot perform analysis correctly Check the patient s condition and NIBP connections or NIBP Measure Failed replace the cuff An illegal reset occurred during NIBP measurement NIBP Illegally Reset Check if the airway is occluded YY Sensor Off Check the sensor connection and reconnect the sensor IBP YY Non Pulsatile The catheter may be occluded Please flush the catheter D 4 Passport 12 Passport 8 Operator s Manual Measurement Alarm message I Cause and solution YY represents an IBP label C O TB Sensor Off A Check the sensor connection and reconnect th
245. rterial blood SpO2 percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin 3 Perfusion index PI gives the numerical value for the pulsatile portion of the measured signal caused by arterial pulsation PI is an indicator of the pulsatile strength You can also use it to assess the quality of SoO2 measurement Above 1 is optimal Between 0 3 and 1 is acceptable Below 0 3 indicates low perfusion When PI is below 0 3 a question mark is displayed to the right of the SpO value indicating that the SpO value may be inaccurate R eposition the SpO sensor or find a better site If low perfusion persists choose another method to measure oxygen saturation if possible Pl is available for Masimo SpO2 module For Masimo SpO module PI value can be displayed under the PR value in larger characters if PI Zoom is enabled 4 Perfusion indicator the pulsatile portion of the measured signal caused by arterial pulsation 5 Pulse rate derived from the pleth wave detected pulsations per minute NOTE A functional tester or SpO2 simulator cannot be used to assess the accuracy of a SpO module or a SpO2 sensor Passport 12 Passport 8 Operator s Manual 11 1 11 2 Safety WARNING Use only SpO sensors specified in this manual Follow the SpO sensor s instructions for use and adhere to all warnings and cautions When a trend toward patient deoxygena
246. rug are as follows Drug A B C Aminophylline Dobutamine Dopamine Epinephrine Isuprel Lidocaine Nipride and Nitroglycerin use the unit series g mg and mcg Drug D Heparin and Pitocin use the unit series Unit KU kilo units and MU million units Drug E uses the unit mEq milli equivalents You must select the proper drug name A B C D or E according to the units when you define a drug not listed in this library NOTE For neonate patients Drip Rate and Drop Size are disabled 20 2 Passport 12 Passport 8 20 2 3 Titration Table To open the titration table select Titration Table gt gt in the Dose Calculation window after the dose calculation is finished In the titration table when you change E Reference m Interval E Dose Type The titrated values change accordingly You can also P B Select or or or beside the vertical scrollbar to view more values W Select Record to print the displayed titrated values by the recorder 20 2 4 Drug Calculation Formulas Abbreviation Unit Formula Conc g ml unit ml or mEq ml Amount Volume Dose Dose hr Dose kg min Rate x Conc Volume ml Rate x Duration Amount g unit mEq Rate x Duration Duration h Amount Dose Drip Rate gtt min INF Rate x Drop Size 60 20 3 Oxygenation Calculations 20 3 1 Performing Calculations To perform an oxygenation calculation 1 Select Main Menu
247. s W Diagnostic Use when diagnostic quality is required The unfiltered ECG wave is displayed so that changes such as R wave notching or discrete elevation or depression of the ST segment are visible W Surgery Use when the signal is distorted by high frequency or low frequency interference High frequency interference usually results in large amplitude spikes making the ECG signal look irregular Low frequency interference usually leads to wandering or rough baseline In the operating room the surgery filter reduces artifacts and interference from electrosurgical units Under normal measurement conditions selecting Surgery may suppress the ORS complexes too much and then interfere with ECG analysis W ST Use when ST monitoring is applied CAUTION The Diagnostic filter is recommended when monitoring a patient in an environment with slight interference only 8 5 6 Setting Pacemaker Rate For Mortara only Some pacemaker pulses can be difficult to reject When this happens the pulses are counted as a ORS complex and could result in an incorrect HR and failure to detect some arrhythmias You can set Pacemaker Rate to the pacemaker s rate in the ECG Setup menu In this way the monitor can calculate HR and detect arrhythmias more accurately When Paced is set to No the pacemaker rate cannot be set 8 5 7 Setting the ECG Lead Set You can set the Lead Set by selecting ECG Setup Others gt gt Yo
248. s Alm Volume 254 2 1 2 Reminder Vol sl fa Low Recording Length e 16s Abre Der a lz Adu Ped 20 s Neo 15s Alarm Delay Fe e 6s ST Alarm Delay Be 30s C 12 Passport 12 Passport 8 Operator s Manual C 2 2 Screens Item Name T General OR ICU NICU CCU User Defaults Choose Screen pe Normal Screen Display the ST segments on ECG screen onl Unselected Select QuickKeys NIBP Measure Stop All Review Standby 1 ECG1 2 ECG2 Select Wave Sequence rud for Normal Screen P NE 5 Any IBP 6 CO 7 Resp Parameter 1 ECG Select Parameters for Parameter 2 ilb SpO2 PR Big Numerics Screen Parameter 3 Resp Parameter 4 NIBP C 2 3 Waveform O M Item Name e General OR ICU NICU CCU User Defaults ECG Green NIBP White SpO2 Cyan PR Cyan TEMP White Art Ao UAP FAP BAP LV P1 P4 Red arterial pressure PA Yellow CVP ICP P1 P4 venous pressure Ps Parameter Ie P rple Wave Colour RAP Orange UVP Cyan CO Yellow RESP Yellow AA Yellow N20 Blue O2 Green Hal Red Enf Orange Iso Purple Des Cyan Passport 12 Passport 8 Operator s Manual Sev C O Yellow White X represents a waveform label such as ECG RESP CO and so forth The E
249. s To prepare the patient and place the electrodes 1 Prepare the patient s skin Proper skin preparation is necessary for good signal quality at the electrode site as the skin is a poor conductor of electricity To properly prepare the skin choose flat areas and then Shave hair from skin at chosen sites Gently rub skin surface at sites to remove dead skin cells Thoroughly cleanse the site with a mild soap and water solution We do not recommend using ether or pure alcohol because this dries the skin and increases the resistance Dry the skin completely before applying the electrodes 2 Attach the clips or snaps to the electrodes before placing them 3 Placethe electrodes on the patient 4 Attach the electrode cable to the patient cable and then plug the patient cable into the ECG connector 8 3 2 Choosing AHA or IEC Lead Placement To choose AHA or IEC lead placement 1 Select the ECG parameter window or waveform area to enter the ECG Setup menu 2 Select Others Lead Set and then select 3 lead 5 lead or Auto according to the applied electrodes 3 Select Main Menu Maintenance gt gt User Maintenance gt gt enter the required password 4 Select Others gt gt ECG Standard and then select AHA or IEC according to the hospital standard 8 3 3 ECG Lead Placements The electrode placement illustrations in this chapter adopt the AHA standard 3 Leadwire Electrode Placement
250. s transported into a sample cell and an optical IR filter selects a specific band of IR light to pass through the gas For multiple gas measurements there are multiple IR filters The higher the concentration of gas in a given volume the more IR light is absorbed This means that higher concentration of IR absorbing gas cause a lower transmission of IR light The amount of IR light transmitted after it has been passed through an IR absorbing gas is measured From the amount of IR light measured the concentration of gas present can be calculated Oxygen does not absorb IR light as other breathing gases and is therefore measured relying on its paramagnetic properties Inside the O2 sensor are two nitrogen filled glass spheres mounted on a strong rare metal taut band suspension This assembly is suspended in a symmetrical non uniform magnetic field In the presence of paramagnetic oxygen the glass spheres are pushed further away from the strongest part of the magnetic field The strength of the torque acting on the suspension is proportional to the oxygen concentration From the strength of the torque the concentration of oxygen is calculated AG module can identify two anesthetic gases in a mixture automatically and distinguish between them according to their contributions to the MAC value for display as the primary and secondary anesthetic agents NOTE The AG module is configured with automatic barometric pressure compensation function
251. screen and the monitor calculates the C O value from this curve The C O value is inversely proportional to the area under the curve As cardiac output varies continuously a series of measurements must be carried out to achieve a reliable C O average value Always use the average of multiple thermodilution measurements for therapy decisions The monitor is capable of storing 6 measurements WARNING C O monitoring is restricted to adult patients only 15 2 Understanding the C O Display The C O measurement is displayed on the monitor as numeric C O C I and TB in the C O parameter window as shown below To enter the C O Setup menu select the C O parameter window 1 Cardiac output 2 Timeat which the C O average is calculated 3 Cardiac index 4 Blood temperature Passport 12 Passport 8 Operator s Manual 15 1 15 3 Influencing Factors The factors that affect cardiac output are W temperature of injectate solution W volume of injectate solution WI patient s baseline blood temperature patient s inspiratory expiratory cycle W placement of catheter with relation to proximity of lung field W the catheter itself E the patient rhythm and hemodynamic status and any other rapid IV solutions which are infused while the C O measurement is being performed Followings are some technical suggestions to obtain accurate C O Injectate solution must be cooler than the patient s blood
252. scssesssssseccsseecssssecssssssesusessueessnsescsssecssnsccesusecsssseessusccessseessnssecssseesssscecsaseessssecesneeeessueeseaees 18 2 UUO 19 1 19 1 Accessing Respective Review WiINGOWS sssssscssssssssssssccsecsssssecsssecsssseecssuecessscesssuscessuecsssuseessuecessuesssuscessueesssusecssnecsesueecssueeessneeeesass 19 1 IDPERL SUIS IBPEecoildmi cg 19 1 19 3 Reviewing BEST EUM ERE 19 2 19 4 Reviewing Eventis c N 19 3 TOAD Marking Events est epe tte ie eee Riese ee ADR eo RU ERU eg eie P R 19 3 TOAD u oedat cpente c 19 4 19 5 REVIEWING RIETI M 19 6 20 Calculations 20 1 20 1 Introduction e e te e e ee e E tb e e RE e E ee EPOR ee ete ee 20 1 PIUPAD Tear SERAS E aai 20 2 2021 Performing Calculations s ERR EENA Te OUTRE ERR SEE e re erit ttn 20 2 20 2 2 Selecting the Proper Drug Unit ete ette tte ee RE E HRS TER RUIN ASE 20 2 20 2 3 Titration Table iesnu ina eee t ien tiec ite ence di coc Se Pe e eet dedu 20 3 20 2 4 Drug Calculation Formulas rtr tttes tet eieeesete reti teet teeth tertiis a enas SASE SERS veo lae eb Sedaaa adsan inea tenait 20 3 20 3 Oxygenatiorn Calculations ettet ERIS ERN AER E
253. secessueessueeesaneeseness 13 1 13 5 Setting the Temperatur Unitic 9 13 2 14 Monitoring IBP 14 1 14 1 Introduction ee Re a ee te i he see a he testes cet eite ee eth f eden di 14 1 IE e 14 1 14 3Zeroing the TrabsdUCcetz e SER Hed ate ix ere e ved delete dee e ee 14 1 14 4 Setting Up the Pressure Measurement sccssssccssseccsssssccssecssssseccssecssssceccsnecesssecsssusccssseesesusccssuccessusecessseessseesesusecssnsesesueecesneeessneeeesass 14 2 14 5 Understanding the IBP Display sssssscsssssscssssccssseccsnsecesssecssnsceesssecssuscessnsecessseessuscessusecsssssessasecessseessnsscessuecesssceccsscessuceessseeessneeseness 14 3 T436 GHANGING IBP SOCEM Se sescesssccssacasasessccess M 14 4 14 6 1 Changing a Pressure for Monitoring esssssscssssssccsseccsssseccssecesssccesssececssecsenscecsnsccssnscecsssecesusecssnseecsssceesusesecusecesneceeenseeesneeesse 14 4 14 62 Setting Alarm Properties cette tribe e patet e ER PE ep veni eee e ines beer bes 14 6 3 Changing Averaging Time 14 6 4 Setting Up the IBP WaV CPR M 14 6 5 Setting the Pressure Unit e oper ettet a a ee eee eee oco 14 5 14 6 6 Enabling PPV Measurement and Setting PPV SOUICE sssscsssssssssessesssecessseccssecssssccesssecesseessnseecenseessaseeesnseessneeesenseees 14 5 14
254. seessneseeste 8 7 8 5 Til Enabling esjuor aded c 8 7 8 5 12 Setting the Alarm Level for ECG Lead Off Alarms sessssssssssssseccssescssssscssseessssecssueecssnseessusecssnsccesusecssscessusecesueecesueessneecses 8 7 8 5 13 AdjJu sting ORS VIUM E itt etel RR RE NR RR Sea aaa RAD once be eoe UR ERAS eeu 8 8 8 5 14 About the Defibrillator Synchronization ssescsssscssssssccsseccssuseccssecesssescsssecesssecsssssecsssecsessceesssecessuecessuscessseessnseeesasecssaeeesses 8 8 B GADGUE Rcg MOMItOr iin RR 8 8 amp o6 I Switching ST Ori and Off Rep e AH BERT REUS MEET HH Need senes 8 9 8 6 2 Changing ST Eilter Settings iir ertt EA berti bnert eb e EEE E e needed epis 8 9 8 6 3 Understanding the ST Display escssssscsssesssssseccssssscsnseccsseeccsnsecssasecssusecesssecssnscessuecssnsesesusecesuscessuseessusecesnscsesuecssneeessnseessueeessee 8 9 8 6 4 Saving the Current ST Segment as Reference ecsssssscsssscssssssccsecsssssessssseccssecssssseesssecessucecssnecesssceessutecssueesesuecssueeessueeessnees 8 10 8 6 5 Changing the Reference SEGMent ssscssssscsssesssssssccssessesseeessueeessuecssuscessuecsesusecsssscessusecssuscessusecesusecssnseeesusecssaseessuseeesueessneees 8 10 8 6 6 Deleting a Reference Sement nsoni iiaii A EEE iE AEEA AE ARN 8 10 8 6 7 Recording the ST Seg iment tete E E EAEE ERR ERR RN 8 10 8 6 8 Changing the ST Alarim LIMitS
255. select patient size Neo Ped Adu which will determine the way your monitor processes and calculates some measurements and what safety and alarm limits are applied for your patient Paced determines whether to show pace pulse marks on the ECG waveform When the Paced is set to No pace pulse marks are not shown in the ECG waveform 5 Select Ok WARNING The Patient Cat and Paced fields always contain a value regardless of whether the patient is fully admitted or not If you do not specify settings for these fields the monitor uses the default settings from the current configuration which might not be correct for your patient For paced patients you must set Paced to Yes If it is incorrectly set to No the monitor could mistake a pace pulse for a QRS and fail to alarm when the ECG signal is too weak Fornon paced patients you must set Paced to No 4 2 Quick Admitting a Patient Use Quick Admit only if you do not have the time or information to fully admit a patient Complete the rest of the patient demographic details later Otherwise the BP symbol always displays in the patient information area 1 2 Select the Patient Setup QuickKey or Main Menu Patient Setup gt gt Select Quick Admit If a patient has been admitted select Ok to discharge the current patient If no patient is admitted you can choose either Passport 12 Passport 8 Operator s Manual 4 1
256. sisisi iiris iistart soeia iaia iE eai aeia inan i 8 10 8 6 9 Setting the ST Alarm Delay Timo ianea a A Ir AA a ni 8 11 8 6 10 Adjusting ST Measurement Points ssssscsssecccssssccssesscssseccsuecessueecssuscesssecsssusecssncsssnseessuscessuseeesnscessuseeesusecssaseessuseeesuseessasees 8 11 8 7 About Arrhythmia Monitoring ccsssssccsssssccsssesssssecssssesssssecsssecssssecesssscessseessnssecsssecesssessssuecessusessnscencsseesenssecsssceesauseeesuecessnecesnsceneaneeseness 8 12 8 7 1 Understanding the Arrhythmia Event sssscsssssccssesscssssesssescssuseccsssecssnsecesusecssnssssnsecssnscessnsesesusecesasecesusecssneeessasecesneessneees 8 12 8 7 2 Changing Arrhythmia Alarm Settings secsssssccssssccssesscsssscsssessssseeccsneccsssseecsuseccsusceesnsecsssscessnsccesuseessasecesusecssneeescnseessuseessaeees 8 14 8 7 3 Changing Arrhythmia Threshold Settings ssscsssssccsssecsssesscssseccssssessnseccssseessueeeesnsecsssscecsnsecesnseessnsecessuecssaseessnseessseeeesaeses 8 14 8 7 4 Setting the Extended Arrhythmia For Mindray ECG Algorithm only currently unavailable in the US and LENAT E ere TAAA E 8 15 8 7 5 Reviewing Arrhythmia Events jJ er eO ERR CSS ERROR e qoe ER dde ES 8 15 nda alorem cT M P a 8 16 8 8 1 Initiating an ECG Relearning Manually ssssssssssccssssscssssesssessssseeccsseecssnsesesusecsssesessusecssscessus
257. snsessecesneeseessssesecesnesesseasseseees 3 9 Passport 12 Passport 8 Operator s Manual 3 12 2 Accessing the Parameters Menu ssssscsssssssssssccssssesssecesusecsssssscsusecsssscessssccssuscessnsecesusecsssseeccusecssuseessnsecessscessnesesuseessneeeeenseees 3 9 3 13 Operating Modes rr ERREUR ANNE NNI AERE HE E eM RIEN eee oU 3 9 3 13 1 Monitorirnig Moe At ee e RR re RR RARI eae eR RE be e Re RE a e eue Le hene 3 10 Bel Bed Nig NEMOJ er 3 10 CREE rade H Q 3 10 3 134 Demo iore eet HEN 3 11 3 135 Standby Mde EO 3 11 4 Managing OCT CR 4 1 4 TAdmitting a Patlets scene rec DRE NU OU EE BER NE E ARN SEN 4 1 4 2 Quick AAMittling a PatieDt ettet tdi Ee RE RUE ee NR a dentato eee eo ceste cete 4 1 4 3 Querying and Obtaining Patient Information sessssssssssssssccssssccsseecssssecsssscsesnscessuccssusccesssecssuscsesusecssnsceecsseeesusecssneceesaseessneeessnseees 4 2 4 4 Associating Patient Information ssssccsssecssssssccssscssssecssnssccssscesssssscsssccssssceesssecessseessnsecessuecsesssecsssecesssescessecsssecsesssecssseeeesueecssneeessnesees 4 2 A S Editing Patient Informatio Ness osgoi n E HERREN DAN REN ERES DEM EE ER ENTERS NUN Met neges 4 2 4 6 Discharging a Patientinnen n AEEA 4 3 4 7 Transferr
258. sscessnsecesssecssnecsesusecssnsecesusecesssecssnsecesasecssneceesnsecesnseessneesesaee 16 9 16 11 Zeroing eet eee ESEA RE 16 9 16 12 C librating the Sensor eet E RAE A A HE e RITU reds 16 10 16 13 Oridion Informatio ape i 16 10 IA DCCIL pom 17 1 FAN MI urrofi ev ape 17 1 17 2 Understanding the AG Display tst die tele b E cats Eee er Ee A P eter de Meere 17 2 TZ3 MAC Val es inr etie eee bb Re b eee ee Re RE HS tte bo e eb eta e ed 17 2 LEE Preparing to EPA M N 17 4 175 Changihg AG Setting Sissu anreta RHEINE EEUU REE REE NIS 17 5 175 1 Setting Gas U Mites T P 17 5 17 5 2 Setting the Apnea Alarm Delay cssssssssssccssecssssssccssessssseeccsuscessueecssuscessuecessusecssuscessueecssuscessusecssuseessneeeesusecssaeecssuseeseneessaeees 17 5 17 5 3 Changing the Sample Flow Rate ssssssssscssecssssseccssesccsuscccsuecessnsecesusccssuecsesusecssssceesueessuscessuseeesusecssuseeesusecssnseessuseesneeessaeses 17 5 17 5 4 Setting up the Qz Combperisatloli tee ERES HERE e e e eU e ERNEUT e re bere 17 5 17 5 5 Eriterinig the Stand by Moda ertet ee itt tee BARRE RR ERR See P URP RS ee ER Neben ee Ede RR 17 6 17 5 6 Setting up the AG Wave ente et n Ate ente e eerte reir ee 17 6 17 5 7 Setting RR Teu a
259. surement window the monitor will turn off the PA alarm automatically Passport 12 Passport 8 Operator s Manual 14 7 14 8 2 Setting Up the PAWP Measurement To setup the PAWP measurement 1 Wedge the flotation catheter into the pulmonary artery Then inflate the balloon and pay attention to the PA waveform changes on the screen PAWP O 2 After obtaining a stable PAWP waveform press the Freeze key to freeze the waveform and deflate the balloon 3 You can adjust the PAWP scale to an appropriate position by adjusting or Y beside the Adjust button Press the Confirm key to save one PAWP measurement 4 Ifyou need to start a new measurement select Next Measure WARNING Prolonged inflation can cause pulmonary hemorrhage infarction or both Inflate the balloon for the minimum time necessary to get an accurate measurement If the PAWP is greater than the PA systolic deflate the balloon and report the incident in accordance with hospital policy Because the pulmonary artery could be accidentally ruptured and the PAWP value derived will not reflect the patient s hemodynamic state but will merely reflect the pressure in the catheter or balloon 14 8 3 Understanding the PAWP Setup Menu Select Setup to enter the PAWP Setup menu In this menu you can Select an ECG lead wave as the first reference wave Select a respiration wave as the second reference wave Select a sweep spee
260. t neonate 040 000146 00 1m Long disposable 5 Electrode Cable Sets Compatible Patient Type Model Part No Length Remark with Category 0012 00 1514 01 0 457m 0012 00 1514 02 0 61m Clip AHA 0012 00 1514 03 1 016m Long EL6501A 0010 30 42727 0 6m EL6503A 0010 30 42729 1m to 1 4m Long Adult pediatric 0012 00 1503 01 0 457m 0012 00 1503 02 0 61m 0012 00 1503 03 1 016m Long Snap AHA 1 4m for RL EL6501B 0010 30 42735 and LL 1m Long for others 27 2 SpO Accessories Extension Cable Module type Remarks Part No Masimo 8 pins purple connector 115 020768 00 Nellcor 8 pins 0010 20 42712 SpO Sensors Masimo SpO Module Type Model Patient Category Part No LNCS NeoPt Pediatric neonate 0600 00 0125 LNCS Neo Neonate 0600 00 0157 Disposable LNCS Inf Infant 0600 00 0158 LNCS Pdtx Pediatric 0600 00 0122 LNCS Adtx Adult 0600 00 0121 LNCS DCI Adult 0600 00 0126 Reusable LNCS DCIP Pediatric 0600 00 0127 27 2 Passport 12 Passport 8 Operator s Manual Wavelength emitted by the sensors is between 600 nm and 1000 nm The maximum photic output consumption of the sensor is less than 18 mW The information about the wavelength range and maximum photic output consumption can be especially useful to clinicians for example when photodynamic therapy is performed 27 3 NIBP Accessories
261. t of a typical commercial or hospital environment Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 5 96 Ur gt 95 96 dip in Ur for 0 5 cycle 40 Ur 60 96 dip in Ur for 5 cycles 70 96 Ur 30 96 dip in Ur for 25 cycles 5 96 Ur gt 95 96 dip in Ur for 5s 5 96 Ur gt 95 96 dip in Ur for 0 5 cycle 40 96 Ur 60 96 dip in Ur for 5 cycles 70 96 Ur 30 dip in Ur for 25 cycles 5 96 Ur gt 95 96 dip in Ur for 5s Mains power quality should be that of a typical commercial or hospital environment If the user of our product requires continued operation during power mains interruptions it is recommended that our product be powered from an uninterruptible power supply or a battery Power frequency 50 60 HZ magnetic field IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment Note Ur is the AC mains voltage prior to application of the test level B 2 Passport 12 Passport 8 Operator s Manual Guidance and Declaration Electromagnetic Immunity The device is intended for use in the specified electromagnetic environment The customer or the user of the device should assure that it is used in such an environment as described below Immunity test IEC60601 test Compliance E
262. te 90 Adult 29743 mmHg Software overpressure protection Pediatric 240 3 mmHg Neonate 147 3 mmHg Adult 330 mmHg Hardware overpressure protection Pediatric 330 mmHg Neonate 165 mmHg Alarm limit Range mmHg Step mmHg Adult low limit 5 to 270 Sys High Pediatric low limit 5 to 200 Neonate low limit 5 to 135 Sys Low 40 to high limit 5 Adult low limit 5 to 230 Mean High Pediatric low limit 5 to 165 5 Neonate low limit 5 to 110 Mean Low 20 to high limit 5 Adult low limit 5 to 210 Dia High Pediatric low limit 5 to 150 Neonate low limit 5 to 100 Dia Low 10 to high limit 5 Measurement accuracy verification In adult and pediatric modes the blood pressure measurements measured with this device are in compliance with the American National Standard for Electronic or Automated Sphymomanometers ANSI AAMI SP10 1992 in terms of mean error and stardard deviation by comparing with intra arterial or auscultatory measurements depending on the configuration in a typical patient population For auscultatory reference the 5th Korotkoff sound was used to determine the diastolic pressure In neonatal mode the blood pressure measurements measured with this device are in compliance with the American National Standard for Electronic or Automated Sphymomanometers ANSI AAMI SP10 1992 and AAMI ANSI SP10A 1996 in terms of mean error and stardard deviation by comparing with intra arterial measurements
263. te through the trend database or Select 9 or to scroll left or right to navigate through the trend database The measurement value that triggered a high level alarm has a red background The one that triggered a medium low level alarm has a yellow background W Select or beside Event to position the cursor to a different event time W Select the Record button to access the Record Setup menu and set the start and end time of the tabular trends you want to record This feature is not available when reviewing a patient s history By further selecting Record you can print the displayed tabular trends with the recorder W Select the Print button to set and print the tabular trends report with the printer For how to configure the tabular trends report refer to chapter 22 Printing 19 4 Reviewing Events 19 4 1 Marking Events During monitoring some events may affect the patient and change the displayed waveforms or numerics displayed on the monitor To help analyze these waveforms or numeric changes you can mark these events Select Main Menu Mark Event gt gt In the popup menu you can select the waves to store after triggering a manual event You can select Trigger Manual Event from the Mark Event menu or the Manual Event QuickKey to trigger a manual event and store it at the same time When you are reviewing graphic trends tabular trends or full disclosure waveforms the manual event symbol
264. the Temp Display The temperature monitoring is displayed on the monitor as three numerics T1 T2 and TD By selecting this area you can enter the Alarm Setup menu Passport 12 Passport 8 Operator s Manual 13 1 13 5 Setting the Temperature Unit Select Unit Setup gt gt from the User Maintenance menu In the pop up menu select Temp Unit and then select C or F 13 2 Passport 12 Passport 8 Operator s Manual 1 4 Monitoring IBP 14 1 Introduction The Passport 12 monitor can monitor up to 4 invasive blood pressures and Passport 8 monitors can monitor up to 2 invasive blood pressures using an external module The monitor can display the systolic diastolic and mean pressures and a waveform for each pressure 14 2 Safety WARNING Use only pressure transducers specified in this manual Never reuse disposable pressure transducers e Make sure that the applied parts never contact other conductive parts To reduce the hazard of burns during high frequency surgical procedure ensure that the monitor s cables and transducers never come into contact with the high frequency surgical units When using accessories their operating temperature should be taken into consideration For details refer to instructions for use of accessories The neutral electrode of the electro surgery unit ESU shall properly contact the patient Otherwise burns may result 14 3 Zeroing the Transducer
265. their packages for any sign of damage Do not use them if any damage is detected Usethe accessories before the expiry date if their expiry date is indicated The disposable accessories shall be disposed of according to hospital s regulations 27 1 ECG Accessories ECG Electrodes Model Quantity Patient Category Part No 31499224 10 pieces Adult 0010 10 12304 2258 3 3 pieces Neonate 900E 10 04880 12 Pin Separable Trunk Cables Leadwire Compatible with Type Patient Category Part No supported 3 leadwire AHA IEC Defibrillation proof 0010 30 42720 3 leadwire AHA IEC ESU proof Infant neonate 0010 30 42724 3 leadwire Defibrillation proof 040 000754 00 3 5 leadwire AHA IEC Defibrillation proof 0010 30 42719 Adult pediatric 3 5 leadwire AHA IEC ESU proof 0010 30 42723 3 5 leadwire Defibrillation proof 040 001416 00 Adult pediatric 3 5 leadwire ESU proof 009 003652 00 Passport 12 Passport 8 Operator s Manual 27 1 Cable Sets 3 Electrode Cable Sets Type Compatible with Model Patient Category Part No Length Remark EL6303A Adult pediatric 0010 30 42731 1m Long Clip AHA EL6305A Infant neonate 0010 30 42896 1m Long EL6301B Adult pediatric 0010 30 42734 1m Long Snap AHA EL6311B Infan
266. ther 30s If alarm message CO2 FilterLine Err is shown it indicates that the module does not leak 26 4 Passport 12 Passport 8 Operator s Manual 26 7 AG Tests 26 7 1 AG Leakage Test Follow this procedure to perform the test 1 Plug the AG module into the module rack 2 Waituntil the AG module warmup is finished and then use your hand or other objects to completely block the gas inlet of the AG module An alarm message AG Airway Occluded will appear on the screen 3 Block the gas inlet for 60 s Select Main menu Maintenance gt gt User Maintenance gt gt enter the required password Calibrate AG gt gt and check that current flow rate is less than 10ml min If the flow rate is less than 10ml min and the alarm message AG Airway Occluded does not disappear it indicates that the module does not leak If the alarm message does not appear or the flow rate is greater than or equal to 10ml min it indicates that the module leaks If the problem remains contact your service personnel for help 26 8 Calibrating the Touchscreen 1 Select Main Menu Maintenance gt gt Cal Touchscreen 2 will in turn appear at different positions of the screen Select each as it appears on the screen 3 After the calibration is completed the message Screen Calibration Completed is displayed Select Ok to confirm the completion of the calibration 26 9 Entering Exiting Demo Mode To enter the
267. there is a fault with the SpO2 sensor or an unspecified SpO2z sensor has been used Check the SpO2 SpO2 No Sensor L B sensor application site and the sensor type and make SpO Unknown Sensor L s sure if the sensor is damaged Reconnect the sensor or SpO Sensor Incompatible L C use a new sensor Passport 12 Passport 8 Operator s Manual Measurement Alarm message Cause and solution There is too much light on the SpO2 sensor Move the SpO Too Much Light sensor to a place with lower level of ambient light or cover the sensor to minimize the ambient light SpO2 Low Signal The SpO signal is too low or too weak Check the SpO Weak Signal patient s condition and change the sensor application SpO2 Weak Pulse site If the error persists replace the sensor The SpO signal has been interfered Check for any SpO Interference possible sources of signal noise around the sensor and check the patient for great motion There is a problem with the SpO2 measurement board SpO Board Fault Do not use the module and contact your service personnel NIBP Loose Cuff The NIBP cuff is not properly connected or there is a leak NIBP Air Leak in the airway NIBP Pneumatic Leak Check the NIBP cuff and pump for leakages The cuff type applied mismatches the patient category NIBP Cuff Type Wrong Verify the patient category and replace the cuff An error occu
268. tient categories and departments You can change the settings from a default configuration and then save it as a user configuration The default configurations provided for your monitor are department oriented You can choose either from M General m OR m ICU W NICU E CCU Each department has three different sets of configurations one for each patient category Neo Ped and Adu NOTE The configuration management function is password protected The configuration management tasks must be performed by clinical professionals The system configuration items can be classified as m Parameter configuration items These items relate to parameters e g waveform gain alarm switch alarm limits W Conventional configuration items These items define how the monitor works e g screen layout record print and alarm settings W User maintenance items These items relate to user maintenance settings e g unit setup time format and data format For the important configuration items and their default values and user maintenance items see appendix C Default Configurations Passport 12 Passport 8 Operator s Manual 5 1 5 2 Entering the Manage Configuration Menu To access the Manage Configuraion menu 1 Pressthe Menu hardkey on the monitor s front panel to enter the Main Menu 2 Select Maintenance gt gt Manage Configuration gt gt Enter the required password and then select Ok M
269. ting controls and disconnect the equipment from AC power 3 2 Getting Started 3 2 1 Connecting to Power Source Using AC Power Source To use the AC power source connect one end of the power cord with the AC power input on the equipment s back panel and the other end with a wall AC mains outlet WARNING Alwaysuse the accompanying power cord with the monitor Usethe battery if the integrity of the protective earth conductor or the protective earthing system in the installation is in doubt Using a Battery This monitor can be equipped with rechargeable lithium ion battery If a battery is installed the monitor system automatically switches to the battery for power if AC power is interrupted NOTE When a battery has been stored for a long time or the battery is depleted recharge the battery at once Otherwise the low battery may not be sufficient to power the monitor if the AC power is unavailable 3 2 Passport 12 Passport 8 Operator s Manual Refer to Chapter 24 Batteries for detail Connecting Accessories Insert the connector of accessory cables necessary for the measurements to be performed by your monitor to the corresponding connector on the monitor For details about the parameter connectors refer to 2 3 2 Side View 3 2 2 Turning Power On Once the monitor is installed before beginning measurements 1 Checkthe monitor and plug in modules for any mechanical d
270. tion is indicated blood samples should be analyzed by a laboratory co oximeter to completely understand the patient s condition The equipment is not intended for use in an MRI environment Prolonged continuous monitoring may increase the risk of undesirable changes in skin characteristics such as irritation reddening blistering or burns Inspect the sensor site every two hours and move the sensor if the skin quality changes Change the application site every four hours For neonates or patients with poor peripheral blood circulation or sensitive skin inspect the sensor site more frequently 11 3 Identifying SpO Modules To identify which SpO module is incorporated into your monitor see the color of the SpO2 connector and the company logo located at the monitor The color of the cable connector matches the company as shown below Masimo SpO module a purple connector with a logo of Masimo SET Nellcor SpO module a grey connector with a logo of Nellcor The connectors for these three SpO sensors are mutually exclusive 11 4 Applying the Sensor To apply the sensor 1 Select an appropriate sensor according to the module type patient category and weight 2 Remove colored nail polish from the application site 3 Apply the sensor to the patient 4 Select an appropriate adapter cable according to the connector type and plug this cable into the SpO connector 5 Connect the sensor cable to the adapter
271. tions of unspecified parameters are the same as those of the main unit of Passport 12 A 2 Power Supply Specifications AC power Line voltage 100 to 240 VAC X 1094 Current 1 3 to 0 5A Frequency 50 60 Hz 3Hz Battery Battery Type Chargeable Lithium lon 11 1DVC 4 5 Ah gt 4 hours when powered by one new fully charged battery 25 C SpO2 ECG disconnected from Temp cable Auto NIBP measurements at intervals of 15 minutes Passport 12 gt 8 hours when powered by two new fully charged batteries 25 C SpO2 sensor and ECG cable Run time connected Temp cable not connected Auto NIBP measurements at an interval of 15 minutes gt 6 hours when powered by a new fully charged battery 25 C SpO2 sensor and ECG cable eae connected Temp cable not connected Auto NIBP measurements at an interval of 15 minutes aede Less than 3 hours to 9096 and less than 4 hours to 10096 when the monitor is off Less than 8 hours to 9096 and less than 12 hours to 10096 when the monitor is on Shutdown delay at least 20 min after a low battery alarm first occurs A 3 Physical Specifications Model Size Width X Height X Thickness Weight Remark Passport 12 318mm X 274mm X 128mm 12 6inch X 10 8inch X 5 1 inch Standard parameters lt 4 5 kg 10 pound including touchscreen and Passport 8 238mm X 225mm X 128mm 9 4 inch X 8 9inch X 5 1 inch recorder and battery 2 lt
272. tr E ERROREM e Ie SER e eA eua ee IER TRA re bie Re EERAS 7 11 7 9 Eatching Alatins ee te a ree e ERE eee EE e e ne bee e eto tere en 7 12 pA LBS ep late mette aia 7 12 7AT Using Care Group Alarms cott oe e HERENNIUM EUN eH HO 7 13 71 1 Care Group Auto Alarms ei trier tre reae e E e P Pre pes tre a bees tee ure esito us 7 13 7 11 2 Setting Care Group Alert Tone cssssssssscsssesccsssscsssescesseecssseccesnsccesusecssnsceesusecssussessuseccsuseessusecesueccsnsecesusecssnseeesuesesueessnseeesess 7 13 7 11 3 Resetting Care Group Alarms scssssssssssscssssasessncsnssasstensedeavessasssadsonssisasoassonsiesosdaesesascsnsdesensnacsesesanatascluasssasssassdabedsanesansassicraclibests 7 13 ERU DDIeCInngdecm 8 1 8A Introduction ie Rt ERR RI HD DNI eO EA DONA Uem Oe PU RR Het t ele ne eden 8 1 CAT C m a 8 1 8 3 Preparing LO Monitor ECGs neea Q 8 2 8 3 1 Preparing the Patient and Placing the Electrodes uu ssssssssssesssssssccsecssssscesnsecsssseecsssecesssecssnsscessueesssseeecsuecessueecesneeessueesesess 8 2 8 3 2 Choosing AHA or IEC Lead Placeme nt ssssscsssssssssssccssssessnsesssusecssneecesusecssusccssusseesusecssusesesusecssnsesesusecssuscessnsecesaseessnseeesnseessaees 8 2 8 3 3 ECG Lead uia uIdc T
273. ts are appropriate for your patient To adjust the ST measurement points 1 Inthe ST Analysis menu select Adjust ST Point gt gt In the Adjust ST Point window three vertical lines represent the ISO J and ST point positions respectively 2 Usethearrows and besides the View Leads button to select an ECG lead with obvious J point and R wave 3 Sdjustthe position of ISO J or ST Point ThelSO point isoelectric position is given relative to the R wave peak Position the ISO point in the middle of the flattest part of the baseline between the P and Q waves The J point position is given relative to the R wave peak and helps locating the ST point Position the J point at the end of the ORS complex and the beginning of the ST segment TheST point is positioned a fixed distance from the J point Move the J point to position the ST point at the midpoint of the ST segment Position the ST point relative to the J point at either J 60 80ms J 40ms J 60ms or J 80ms When J 60 80ms is selected the ST point will be positioned 80 ms heart rate 120 bpm or less or 60 ms heart rate more than 120 bpm from the J point Passport 12 Passport 8 Operator s Manual 8 11 NOTE e Only Mindray ECG algorithm currently unavailable in the US and Canada has the function of automatic J point detection 8 7 About Arrhythmia Monitoring Arrhythmia analysis provides information about y
274. tup gt gt from the User Maintenance menu In the pop up menu select Temp Unit and then select C or F 15 6 2 Setting Alarm Properties Select Alarm Setup gt gt from the C O Setup menu You can set alarm properties for this parameter in the pop up menu 15 6 Passport 12 Passport 8 Operator s Manual 1 6 Monitoring CO 16 1 Introduction CO monitoring is a continuous non invasive technique for determining the concentration of CO in the patient s airway by measuring the absorption of infrared IR light of specific wavelengths CO has its own absorption characteristic and the amount of light passing the gas probe depends on the concentration of the measured CO2 When a specific band of IR light passes through respiratory gas samples some of IR light will be absorbed by the CO2 molecules The amount of IR light transmitted after it has been passed through the respiratory gas sample is measured with a photodetector From the amount of IR light measured the concentration of CO is calculated Sidestream Microstream measurement samples expired patient gas at a constant sample flow from the patient s airway and analyzes it with a CO sensor built into the CO module The sidestream and microstream CO measurement can be used with specified accessories with intubated and non intubated adult pediatric and neonatal patients With intubated patients a sample of the respiratory gas is drawn from the patient s br
275. u can set the Lead Set as Auto if the auto lead detection function is available 8 5 8 Choosing an ECG Display Screen When monitoring with a 5 lead set you can select the Screens Quickkey In the Choose Screen window choose the screen type as W Normal Screen The ECG waveform area shows 2 ECG waveforms W ECG 7 Lead Full Screen The whole waveform area shows 7 ECG waveforms only W ECG 7 Lead Half Screen The upper half part of the whole waveform area displays 7 ECG waveforms When the screen type is set to Normal Screen cascaded ECG waveforms can be displayed To cascade ECG waveforms 1 Select the Screens Quickkey Screen Setup 2 Select ECG1 Casc in the second row A cascaded waveform is displayed in two waveform positions 8 6 Passport 12 Passport 8 Operator s Manual 8 5 9 Setting the Notch Filter The notch filter removes the line frequency interference Only when Filter is set to Diagnostic the Notch Filter is adjustable To set the notch filter 1 Select the ECG parameter window or waveform area to enter its setup menu Then select Others gt gt 2 Set Notch Filter to Strong when waveform interference is strong such as spikes Weak when waveform interference is weak Off to turn the notch filter off Set notch frequency according to the electric power frequency of your country To set notch filter frequency 1 When Notch Filter is turned on select Main M
276. ual Graphic Trends Tabular Trends Events Full Disc 1 NIBP Logd 2 M t gt e Ea EZ Gain Sweep 1 Waveform area 2 Parameter area In this window m Youcanselect or P to navigate through the waveforms m Youcanselect or P beside the Event button to switch between events m You can set the desired Gain for ECG waveform W You can set the desired Sweep W By selecting the Record button you can print the displayed alarm events with the recorder W Select Print to print the displayed alarm event to the pre connected laser printer W Select Events List to view the events list Passport 12 Passport 8 Operators Manual 19 5 19 5 Reviewing Waveforms In the Review menu select Full Disclosure to access the following window Review hic Trends Tabular Trends Events 07 13 16 30 00 NIBP elec o gt ht EM tv CINCTNIS HEN TTE E7073 TT Gain Seen In this review window To review full disclosure waveforms you need to save waveforms first Select Save Waves gt gt and then select the parameters whose waveforms you want to view To save full disclosure waveforms your monitor must have a storage card To view the waveforms you can either Select or beside the Scroll button to move the cursor one step left or right to navigate through the waveforms or Select 9 or to move the cursor one page left or right to navigate through the waveforms
277. units If some parameter values are outside of their normal ranges you can view their normal range in the Unit field by selecting Range W You can review an individual calculation by selecting its corresponding column and then selecting Original Calc You can record the currently displayed calculations or perform another calculation is this window Passport 12 Passport 8 Operator s Manual 20 9 FOR YOUR NOTES 20 10 Passport 12 Passport 8 2 1 Recording 21 1 Using a Recorder The thermal recorder prints patient information measurement numeric and waveforms etc Start Stop key press to start a recording or stop the current recording Indicator On when the recorder works correctly Off when the monitor is switched off Flashes if an error occurred to the recorder e g the recorder runs out of paper Paper outlet Latch Recorder door 21 2 Overview of Recording Types By the way recordings are triggered the recordings can be classified into the following categories W Manually triggered realtime recordings E Timed recordings Alarm recordings triggered by an alarm limit violation or an arrhythmia event W Manually triggered task related recordings NOTE For details about alarm recording refer to the chapter 7 Alarms For details about task related recordings refer to respective sections of this manual Passport 12 Passport 8 Operator s Manual
278. up Gas COMpPENsaAtiONS reccssccsesssssesnesecsessnessssesscssecssscrsseessscenecssssesnecssssesnesssssessssecsecensscssseceneessseeeseesssseeneeseneess 16 5 16 4 5 Setting up Humidity Compensation ou essssccssssccssescessescsssecessseccsuscessnsecesusecssnecsesusecesuecessusesessscessasecesusecssaeeessasecesneeessaeees 16 5 16 4 6 Setting the Apnea Alarm Delay de iaei a eee ie euge e an deeds 16 6 16 4 7 Choosing a Time Interval for Peak Pickinng ssscsssssscssssccssesscsssecssssecesssescsnsccssnscsesnecsssscsesssecesseessssceecssecsenseeecnsecesneeessanees 16 6 164 8 Setting the Ane dicm 16 6 16 4 9 Setting Upthe COs Wave REIR SRM A E E E EER 16 7 16 5 Setting RR SOULE D 16 7 16 6 Barometric Pressure Compensation ssssssscsssssessscsssssuccssssssssscsssessesssccsscsusssusssscenscsascsucsasceusceuccasccascsucessesascsuccauscascsucessccaseeseesseeseesss 16 7 16 7 Measurement Limitations ccsssessseesssesssssssesssssssessssesssessssssssessssessssesssessseessussssssssssssssesssesssessssesssessssesssessssssssessssssseesssesssessssesse 16 8 16 8 Leakage test eere rd RE eR URB QUEMAR tee inmate oa NEAN dO 16 8 16 9 Troubleshooting the Sidestream CO Sampling System sssecsssssccssesccssssessneeccsuseccsseesssusecssuecessueceesueeessnseeesusecssneeeesnecesneeeseee 16 8 16 10 Removing Exhaust Gases from the System ssssscssssscsssesscsssecsssecccnsecc
279. up to four QuickKeys on the screen To select your desired QuickKeys Load Config QuickKey Default configurations Start C O QuickKey Start cardiac output procedure Calculations QuickKey Perform calculations Others QuickKey Have a split screen view of another patient s conditions OxyCRG QuickKey Have a split screen view of OxyCRG trends 7 Lead ECG QuickKey Enter the full screen 7 lead ECG screen Parameters QuickKey Enter the Parameters menu NIBP STAT QuickKey Start NIBP STAT measurement Unit Setup QuickKey Enter the Unit Setup menu PAWP QuickKey Enter the PAWP measurement screen CPB Mode QuickKey Enter the CPB mode Privacy Mode QuickKey Enter the Privacy mode Night Mode QuickKey Enter the Night mode 1 Select Main Menu Maintenance gt gt Manage Configuration gt gt enter the required password Ok 2 Inthe Manage Configuration menu select Edit Config gt gt 3 Inthe pop up menu select the desired configuration and then select Edit 4 Inthe pop up menu select Screen Setup gt gt 5 Selectthe Select QuickKeys tab and then configure your desired QuickKeys and the order of them 2 12 Passport 12 Passport 8 Operator s Manual 3 Basic Operations 3 1 Installation WARNING Connect only approved devices to this equipment Devices connected to the equipment must meet the requirements of the applicable IEC standards e g IEC 60
280. uration As an example select Default Adu Config and then select Defaults or user configuration s When you select Load the Latest Config the latest configuration when the monitor is started or a patient is admitted is loaded NOTE To identify which configuration is restored when the monitor starts enter the main screen to check the prompt information at the lower part of the screen displayed for about 10 seconds 5 5 Saving Current Settings Current settings can be saved as a user configuration Up to 5 user configurations can be saved To save current settings 1 Select Save Current Settings As gt gt in the Manage Configuration menu 2 Inthe pop up dialog box enter the configuration name and then select Ok The current settings are saved as a user configuration with the name you entered Passport 12 Passport 8 Operator s Manual 5 3 5 6 Editing Configurations To edit a configuration 1 2 Select Edit Config gt gt in the Manage Configuration menu The following menu appears Edit Config O Defaults Ped O Defaults Neo Config on USB drive Edit Back The pop up menu shows the existing monitor configurations Selecting Config on USB drive gt gt will show the existing configurations on the USB drive Select the desired configuration and then select the Edit button The following menu appears Edit Config Def
281. us oxygen content VO ml min oxygen consumption RQ None respiratory quotient ATMP mmHg atmospheric pressure Height cm height Weight kg weight 20 3 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula BSA m body surface area Wt 45 x Ht 725 x 0 007184 VO calc ml min oxygen consumption C a v O2x C O C a v O2 ml L arteriovenous oxygen content difference CaO CvO OER oxygen extraction ratio 100xC a v O2 CaO DO ml min oxygen transport C O x CaO PAG ET partial pressure of oxygen in the alveoli FiO2 100 x ATMP 47 PaCO x FiO2 100 1 FiO2 100 RO AaDO2 mmHg alveolar arterial oxygen difference PAO2 PaO CcO2 ml L capillary oxygen content Hb x 1 34 0 031 x PAO venous admixture 100x 1 34 x Hb x 1 5Sa02 100 0 031x Qs Qt PAO PaOz 1 34 x Hb x 1 SvO2 100 0 031x PAO PvO C O calc L min calculated cardiac output VO CaO CvO 20 4 Passport 12 Passport 8 20 4 Ventilation Calculations 20 4 1 Performing Calculations To perform a ventilation calculation 1 Select Main Menu Calc gt gt Ventilation gt gt or select Calculations QuickKey Ventilation gt gt 2 Enter values for calculation If the monitor is connected to an anesthesia machine or a ventilator the system automatically loads the supported parameter values to the Ventilation Calculation
282. usecssnsceesnsccesnseessnsecesssecssueeesuecssnececcnseeesaee 20 9 20 7 Understanding the Review Window ssssscsssssccsssssssssecsssessssssecssucscssueeessusecsssessesuecssuccessuscessueessusesessecssnsesesuseessueceesueeesnecssseseenees 20 9 2I Cras e ET e H 21 1 PA USING Ez dot ONKO Le D RR 21 1 21 2 Overview of Recording DSi re ERES RRNEU tH n i 21 1 21 3 Starting and Stopping Recordings 3 e i egeta ette debe e ee Re t deb see ia 21 2 214 Setting p the Recorders c ERR dette hee e PR ette eee b M tt bote ee aaah ae 21 2 21 4 1 Accessing the Record Setup Menu cessssssccssssccsssscssseecssscesssssessneccssusssssscessucesesusecssuscessusceesuscessnsecesusecssusseesnsecssuscessneeeesaee 21 2 21 4 2 Selecting Waveforms for Recording sssssscsssssccseesesuseccssessesusecssnecessusecesusccssuecsssusecssusssesusecesusecssssecesucecssuseeesnsecssasecssneeeesaee 21 2 8 Passport 12 Passport 8 Operator s Manual 21 4 3 Setting the Realtime Recording LENngth ssecsssssscsssecssssssccssecesseessssesesssecssnessesnsecsssseeccssecessseessnsceessseeesaeeessnseessaseeceneeeesaes 21 3 21 4 4 Setting the Interval between Timed Recordings ssssssscssssscsssssscssssccsseecesusecssnccesusecesaeessusceesuecesnseeesusecssnseeesnsecesneessee 21 3 21 4 5 Changing the Recording Speed ende eee e Rte ce RR TNR ce koe bene e pee e eere Eee eiae 21 3 21 4 6 Clearing Recording Tasks t
283. vacy mode displays W Monitoring and data storing continue but patient data is only visible at the CMS W Alarms can still be triggered But all audible alarms are suppressed and the alarm light is deactivated at the monitor All system sounds are suppressed including heart beat tone pulse tone all prompt tones etc To cancel the Privacy mode press any key The monitor exits the Privacy mode automatically in any of the following situations W The monitor disconnects from the CMS W Thealarm Battery Too Low or System will shut down soon Please replace the batteries or use the external power is presented 3 10 Passport 12 Passport 8 Operator s Manual The touchscreen is locked automatically in the Privacy mode WARNING During Privacy Mode all audible alarms are suppressed and the alarm light is deactivated at the monitor Alarms sound only at the CMS 3 13 4 Demo Mode Demo mode is password protected and it is used for demonstration purposes only To enter Demo mode 1 Select Main Menu Maintenance gt gt 2 Select Demo gt gt enter the required password and then select Ok To exit Demo mode 1 Select Main Menu Maintenance gt gt 2 Select Exit Demo Ok WARNING The Demo mode is for demonstration purposes only To avoid the potential risk of the simulated data being mistaken for the monitored patient s data do not enter the Demo Mode whil
284. w Other Patient WiINGOW ssscsssscsssssecsssescessseccssecessueecssucesssecssssecssneccesuscessuecessuecesueccsneesenetentee 6 5 2 Passport 12 Passport 8 Operator s Manual 6 5 Understanding the Big Numerics SCFEEN ssesssssscsssesccsseecessecesstcccsnsceesusecssuscessusccssuscessusecesuccssnecsesusecssuscessusccesssecesnsccesueecssneseesnseessnees 6 6 VE ALIE M T 7 1 7 4 Alarm Categories RR REA RARE T M tee EE RENE eA RATER RA 7 1 pA 7 2 Led Alarmi ieto Le cor POPE 7 2 FTA EMT eL T 7 2 Z 3 2 Alarmi Messages ere ea e ee ee e HR eet eter Hee bei RR 7 2 13 3 dPCeRM UI 7 3 FSA Audible Alarm T0685 sitet E decipiat nus tip deca dist eiae tem hus 7 3 73 5 Alarm Status Symbols e eite eee i A rie aa ee d dele getto dde dede Rep e 7 3 TA Alarm Tone Configuration eee eei eee et ee eee neret bete tede eee epe dedere ee eue 7 4 7 4 1 Setting the Minimum Alarm Volume ccssssssccsecssssssccssesesssecsssssecssneecesueessucccssuccssuscessueceesusecssnsesecuseessusecesusecesasecssneessnsecssaees 7 4 7 4 2 Ghanging the Alarrm Vol tne ote RR RENDERE NER ISER ERAI ten NEG A 7 4 7 4 3 Setting the Interval Between Alarm SOUMAS ssssscssssscssseesessecsssscesusecsssssecsssecessseessnsecessseesssuseccusecssss
285. when a pre adjusted time has elapsed since the last detected breath Therefore it cannot be used for diagnostic purposes 17 5 3 Changing the Sample Flow Rate In the setup menu for any gas select Flow Rate and then choose either W High 200 ml min for adult and pediatric patients and 120 ml min for neonatal patients W Med 150 ml min for adult and pediatric patients and 90 ml min for neonatal patients W Low 120 ml min for adult and pediatric patients and 70 ml min for neonatal patients 17 5 4 Setting up the O Compensation If the AG module does not incorporate the O2 module you need to manually select O2 Compen and then select Off or an appropriate setting according to the amount of O in the ventilation gas mixture When the amount of O is less than 3096 switch the compensation off If the AG module incorporates the O2 module the system directly uses the O2 concentration detected by the O2 module to make compensation At this time the O2 Compen in the setup menu for any gas is fixed to Off WARNING e Make sure to use the appropriate compensations Inappropriate compensations may cause inaccurate measurement values and result in misdiagnosis Passport 12 Passport 8 Operator s Manual 17 5 17 5 5 Entering the Standby Mode For the AG module the default operating mode is measure When you set the AG module to the Standby mode the AG gas sample intake pump automatically sets the
286. window 3 Selectthe Calculate button The system performs a calculation per the current settings and displays the calculated values Ifa calculated value is outside the range its background will highlight in yellow You can select Range to view its normal range in the unit field Invalid values are displayed as In the Ventilation Calculation window you can W Change the pressure unit by selecting Press Unit and then selecting the appropriate setting Corresponding pressure values shall convert and update automatically W Trigger a recording by selecting the Record button The displayed ventilation calculations are printed out by the recorder m Review the previously performed calculations by selecting Review 20 4 2 Entered Parameters Abbreviation Unit Full spelling FiO 96 percentage fraction of inspired oxygen RR rpm respiration rate PeCO mmHg partial pressure of mixed expiratory CO PaCO mmHg partial pressure of carbon dioxide in the arteries PaOz mmHg partial pressure of oxygen in the arteries TV ml tidal volume RQ None respiratory quotient ATMP mmHg atmospheric pressure Passport 12 Passport 8 Operator s Manual 20 5 20 4 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula PAO mmHg partial pressure of oxygen in the alveoli Mere ne UE FiO2 100 1 FiO 100 RO
287. wireless function optional is not working indicates a USB drive is inserted QuickKeys Area This area contains QuickKeys that provide quick access to functions 2 10 Passport 12 Passport 8 Operator s Manual 2 6 QuickKeys A QuickKey is a configurable graphical key located at the bottom of the main screen They give you fast access to functions Their availability and the order in which they appear on your screen depend on your monitor configuration The following QuickKeys are available r4 zy _ Display more QuickKeys Hide the QuickKeys Main Menu QuickKey Enter the Main Menu Standby QuickKey Enter Standby mode Alarm Setup QuickKey Change alarm settings AM Review QuickKey Review the patient s data NIBP Measure QuickKey Enter the NIBP Measurement menu Stop All QuickKey Stop all NIBP Measurements Zero IBP QuickKey Zero IBP zT Realtime Print QuickKey m Start the realtime print Print Setup QuickKey Print Setup Alarm Reset QuickKey Reset the alarms A Alarm Pause QuickKey E Pause or restore alarms Screens Da Change screen Patient Setup QuickKey Enter the Patient Setup menu 5 Manual Event QuickKey Trigger a manual event Minitrends QuickKey Have a split screen view of minitrends Volume Setup QuickKey Enter the Volume Setup menu Passport 12 Passport 8 Operators Manual m HE Ki E i You can configure
288. with a cleaning agent 4 Wipe off all the cleaning solution with a dry cloth after cleaning if necessary 5 Dry your equipment in a ventilated cool place 25 3 Disinfecting Disinfect the monitor as required in your hospital s servicing schedule Cleaning equipment before disinfecting is recommended The recommended disinfectants include E sopropanol 70 W Ethanol 70 E Perform classic concentrate OXY KHSO solution CAUTION Never use EtO or formaldehyde for disinfection 25 4 Sterilization Sterilization is not recommended for this equipment related products accessories or supplies unless otherwise indicated in the Instructions for Use that accompany the products accessories or supplies 25 2 Passport 12 Passport 8 Operator s Manual 26 User Maintenance CAUTION Failure on the part of the responsible individual hospital or institution using this equipment to implement a recommended maintenance schedule may cause undue equipment failure and possible health hazards The safety checks or maintenance involving any disassembly of the equipment should be performed by professional servicing personnel Otherwise undue equipment failure and possible health hazards could result No modification of this equipment is allowed Do not open the equipment housings All servicing and future upgrades must be carried out by the personnel trained and authorized by Mindray only If you discover
289. y R on T VT gt 2 PVCs Tachy Brady Missed Beats Vent Rhythm PNP PNC Multif PVC Nonsus Vtac Pause Irr Rhythm ST Segment Analysis Refreshing rate A 7 2 Resp Technique Trans thoracic impedance Lead Options are lead and Il The default is lead II Respiration excitation waveform 300 pA RMS 62 8 kHz 10 Baseline impedance range Bandwidth 200 to 25000 using an ECG cable with 1kQ resistance 0 2 to 2 5 Hz 3 dB Sweep speed 6 25 mm s 12 5 mm s or 25 mm s Accuracy 10 Respiration Rate Measurement range Adult 0 to 120 rpm Pediatric neonate 0 to 150 rpm Resolution 1 rpm 7to 150 rpm 2 rpm or 296 whichever is greater Accuracy Oto 6 rpm Not specified Apnea alarm time 10s 15 s 20 s 25 s 30 s 35 s 40 s Alarm limit Range rpm Step rpm Adult pediatric low limit 2 to 100 RR High Neonate low limit 2 to 150 1 RR Low 0 to high limit 2 A 8 Passport 12 Passport 8 Operator s Manual A 7 3 SpO Alarm limit Range 96 Step 96 SpO High low limit 2 to 100 Masimo Desat to high limit 2 SpO Low 1 Nellcor Desat or20 whichever is greater to high limit 2 Desat 0 to high limit 2 Masimo SpO Module Standards Meet standards of IS09919 SpO measurement range 1 to 100 Resolution 196 70 to 10096 2 measured without motion in
290. y can be achieved by using the CapnoLine H Set for Infant Neonatal In the presence of interfering gases the accuracy specification deteriorates by 4 of the above accuracy Resolution 1 mmHg 7 5 Sample flow rate 50 ml min Initialization time 30 s typical Measured with a FilterLine of standard length 2 9 s typical 4 5 s Maximum Response time The response time is the sum of the rise time and the delay time Rise time 190 ms 10 to 90 Delay time 2 7 s typical awRR measurement range Oto 150 rpm Oto 70 rpm 1 rpm awRR measurement accuracy 71 to 120 rpm 2 rpm 121 to 150 rpm 3 rpm A 14 Passport 12 Passport 8 Operator s Manual Apnea alarm time 10s 15 s 20 s 25 s 305 35 5 405 Alarm limit Range Step EtCO High low limit 2 to 99 mmHg EtCO2 Low 1 to high limit 2 mmHg 1 mmHg FiCO High 1 to 99 mmHg Adult pediatric low limit 2 to 100 rpm awRR High Neonate low limit 2 to 150 rpm 1 rpm awRR Low 0 to high limit 2 rpm A 7 10 AG For Passport 12 only Standards Meet standard of ISO 21647 Technique Infrared absorption Warm up time Iso accuracy mode Full accuracy mode lt 455s 10 min Adult pediatric 120 150 200 ml min Sample flow rate Neonate 70 90 120 ml min Accuracy 10 ml min or 10 whichever is greater CO 0 to 30 Ox
291. y shows graphic minitrends beside waveforms as shown in the figure below To have a split screen view of minitrends W Select the Minitrends QuickKey or E Select the Screens QuickKey Choose Screen Minitrends Screen x or W Select Main Menu Screen Setup gt gt Sekeen Layout gt gt Choose Screen Minitrends Screen X 2013 07 18 14 02 40 0 20 0 10 0 00 0 10 100 NIBP MN 120 80 93 lt A Alarm Setup au Main Menu Minitrends View The split screen view provides minitrends for multiple parameters In each field the label and scale are respectively displayed at the top and left The time is displayed at the bottom of the minitrends view as shown below Time 6 2 2 Setting Minitrends Select the minitrends area From the pop up Minitrend Setup menu Select the parameters to be displayed or W Select Minitrend Length and then select the appropriate setting 6 2 Passport 12 Passport 8 Operator s Manual 6 3 Viewing OxyCRG To have a split screen view of oxyCRG Select the OxyCRG QuickKey Select the Screens QuickKey fChoose Screen OxyCRG Screen x Of Select Main Menu Screen Setup gt gt Screen Layout gt gt Choose Screen OxyCRG Screen X Setup Auto Scale Print Record The split screen view covers the lower part of the waveform area and shows HR trend SpO gt trend RR trend and a compressed waveform Resp or CO wavef
292. ystole delay time to 10 seconds Mortara ECG algorithm Arrh event Range Default Step Unit PVCs High 1 to 100 10 1 min Asys Delay 2to 10 5 1 S Vtac Rate 100 to 200 130 5 bpm Vtac PVC 3to 12 6 1 beats Multif PVC 3to31 15 1 beats Adult 100 to 300 Adult 100 Tachy High 5 bpm Pediatric 160 to 300 Pediatric 160 Adult 15 to 60 Adult 60 Brady Low 5 bpm Pediatric 15 to 80 Pediatric 80 Mindray ECG algorithm currently unavailable in the US and Canada Arrh event Range Default Step Unit PVCs High 1 to 100 10 1 min Asys Delay 3to 10 5 1 S Adult 120 Tachy High 60 to 300 5 bpm Pediatric 160 Adult 50 Brady Low 15to 120 5 bpm Pediatric 75 Adult 160 Extreme Tachy 120 to 300 5 bpm Pediatric 180 Adult 35 Extreme Brady 15 to 60 5 bpm Pediatric 50 8 14 Passport 12 Passport 8 Operator s Manual Arrh event Range Default Step Unit Multif PVC s Window 3to31 15 1 min Vtac Rate 100 to 200 Adult pediatric 130 5 bpm Vtac PVCs 3to 99 6 1 min Pause Time 1 5 2 0 2 5 2 S Vbrd PVCs 3 to 99 5 1 min Vbrd Rate 15 to 60 40 5 bpm 8 7 4 Setting the Extended Arrhythmia For Mindray ECG Algorithm only currently unavailable in the US and Canada The following arrhythmia events are defined as extended arrhythmia m Extreme Tachy m Extreme Brady W Vent Brady W Nonsus Vtac W Multif PVC W Irr Rhyth

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