Page 1 INSTRUCTIONS FOR USE IntelliVue X2 Multi-Measurement Module R el ea se G . 0 w i t h S o f tw ar e R ev i si o n G . 0x . xx P a t i e n t M o n i t o r i n g To Purchase, Visit Avobus.com...
Page 2 Printed in Germany 09/08 *M3002-9001B* Part Number M3002-9001B 4512 610 28261...
Page 3: Table Of Contents
Checking Out the Monitor Operating the Monitor Setting the Date and Time Checking Country-Specific Default Settings Handing Over the Monitor 2 Basic Operation Introducing the IntelliVue X2 Controls, Indicators and Connectors Extending Measurements Operating and Navigating Operating Modes Understanding Screens...
Page 4 4 Alarms Visual Alarm Indicators Audible Alarm Indicators Acknowledging Alarms Pausing or Switching Off Alarms Alarm Limits Reviewing Alarms Latching Alarms Testing Alarms Alarm Behavior at On/Off Alarm Recordings 5 Patient Alarms and INOPs Patient Alarm Messages Technical Alarm Messages (INOPs) 6 Managing Patients Admitting a Patient Quick Admitting a Patient...
Page 5 Understanding the Arrhythmia Display Arrhythmia Relearning Arrhythmia Alarms About ST Monitoring Switching ST On and Off Understanding the ST Display and Windows Updating ST Baseline Snippets About the ST Measurement Points ST Alarms Viewing ST Maps About QT/QTc Interval Monitoring QT Alarms Switching QT Monitoring On and Off 8 Monitoring Pulse Rate...
Page 6 11 Monitoring NBP Introducing the Oscillometric NBP Measurement Preparing to Measure NBP Starting and Stopping Measurements Enabling Automatic Mode and Setting Repetition Time Enabling Sequence Mode and Setting Up The Sequence Choosing the NBP Alarm Source Switching Pulse from NBP On/Off Assisting Venous Puncture Calibrating NBP 12 Monitoring Temperature...
Page 7 Trends Databases Screen Trends 18 Recording Starting and Stopping Recordings Overview of Recording Types Creating and Changing Recordings Templates Recorder Status Messages 19 Printing Patient Reports Starting Report Printouts Stopping Reports Printouts Setting Up Reports Setting Up Individual Print Jobs Checking Printer Settings Printing a Test Report Switching Printers On Or Off for Reports...
Page 8 23 Accessories ECG/Resp Accessories NBP Accessories Invasive Pressure Accessories Accessories Temperature Accessories Mainstream CO Accessories Sidestream CO Accessories Mainstream CO Accessories (for M3016A) Microstream CO Accessories Battery Accessories 24 Specifications Intended Use Manufacturer’s Information Symbols Installation Safety Information Altitude Setting Monitor Safety Specifications EMC And Radio Regulatory Compliance Out-Of-Hospital Transport - Standards Compliance...
Page 9: Installation
If you have purchased a “customer-installable bundle”, it is assumed that your own hospital personnel will install and, if necessary, configure the monitor. You can contact Philips Support for assistance if required; any assistance will be associated with additional costs.
Page 10: Unpacking And Checking The Shipment
Use) Claims for Damage If the shipping cartons are damaged, contact the carrier. If any of the equipment is damaged, contact both the carrier and your local Philips service organization for repair or replacement arrangements. Repacking Retain the original packing carton and material, in case you need to return equipment to Philips for service.
Page 11: Mounting The Monitor
Mounting the Monitor 1 Installation Mounting the Monitor The monitor can be rested on a flat, level surface, hung on the bed rail, mounted on a wall or on a rollstand, or on the left side of the Flexible Module Rack (FMS). See the Service Guide for details. Mounting the External Power Supply (M8023A) The external power supply (M8023A) can be rested on its rubber feet on a flat, level surface, or mounted as described in the Service Guide.
Page 12 1 Installation Connecting the Monitor to AC Mains Host Monitor as Power Source When connected to a host monitor, via the Measurement Link (MSL) cable or when directly attached to the host, the X2 obtains its power from the host, including that needed for battery charging. Note that the X2 will operate and charge its battery even when attached to a host monitor running on battery power.
Page 13: Checking Out The Monitor
Checking Out the Monitor 1 Installation AC power cord. Connect to AC mains socket. Connect LAN cable here. For connection to a PC or Information Center. Measurement Link (MSL) cable. Supplies AC input power to the monitor for AC operation and for battery charging.
Page 14: Operating The Monitor
1 Installation Operating the Monitor Operating the Monitor To complete installation you will need to operate the monitor to check basic functionality. Here is a quick introduction to the monitor. Switch on the monitor. After start-up the Touch something on the screen (numerics, monitor display will become active.
Page 15: Setting The Date And Time
Setting the Date and Time 1 Installation Setting the Date and Time To set the date and time: Press the SmartKeys key to enter the SmartKeys window. Select the Main Setup SmartKey to enter the Main Setup menu. Select the Date, Time screen element from the monitor’s info line to enter the Date, Time menu.
Page 16: Handing Over The Monitor
1 Installation Handing Over the Monitor Handing Over the Monitor If you are handing over the monitor to the end-users directly after configuration, make sure that it is in Monitoring mode. Users must be adequately trained to use the monitor before monitoring a patient. To achieve this, they should have access to, and read, the following documentation delivered with the monitor: •...
Page 17: Basic Operation
Basic Operation These Instructions for Use are for clinical professionals using the IntelliVue X2 (M3002A) Multi- Measurement Module. This basic operation section gives you an overview of the device and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching a measurement on and off, setting up and adjusting wave speeds, working with profiles).
Page 18 2 Basic Operation Introducing the IntelliVue X2 In this book, the X2 is generally referred to as “the monitor”, except in situations describing its use with a host monitor, where it is referred to as “the X2” to distinguish it from the host monitor.
Page 19: Controls, Indicators And Connectors
Controls, Indicators and Connectors 2 Basic Operation Controls, Indicators and Connectors X2 Overview On/Standby Switch Power and battery indicators (see “X2 Controls and Indicators” on page 12) 3.5-inch TFT LCD touchscreen QVGA display Alarm lamps (see “X2 Controls and Indicators” on page 12) Battery eject button Keys (see “X2 Controls and Indicators”...
Page 20 2 Basic Operation Controls, Indicators and Connectors X2 Controls and Indicators On/Standby switch. Disabled when X2 is connected to a host monitor On/Standby LED. Green when monitor is on. Red indicates an error. Battery status LED. Yellow when charging. Flashing red when battery is empty, or a battery malfunction is detected.
Page 21 Controls, Indicators and Connectors 2 Basic Operation X2 Patient Connectors, Right Side Symbols (International) Text (English versions only) Pressure (option) Temperature (option) Noninvasive blood pressure ECG sync pulse output (See page 255 for specifications) ECG/Respiration (option) X2 Left Side Loudspeaker MSL Connector.
Page 22: Extending Measurements
Extending Measurements Extending Measurements Your monitor is compatible with Philips measurement extensions for use with other IntelliVue patient monitoring devices. These allow you to add specific measurements to those already integrated into your monitor. These measurement extensions are referred to as MMS extensions.
Page 23 Extending Measurements 2 Basic Operation M3014A, M3015A and M3016A Measurement Extensions When attached to an X2 connected to external power (either via the external power supply or a host monitor), the optional M3014A Capnography extension adds mainstream capnography, and optionally one pressure plus either a pressure or a temperature to the monitor. When the X2 is connected to a host monitor, Cardiac Output (C.O.) measurements can be performed and can be used to calibrate Continuous Cardiac Output (CCO).
Page 24 2 Basic Operation Extending Measurements M3012A Hemodynamic MMS Extension MSL Connector to X2 Pressure connectors (red) Cardiac Output (orange; optional) Temperature connectors (brown) When attached to an X2 connected to external power (either via the external power supply or a host monitor), the optional M3012A Hemodynamic extension adds temperature, pressure, and an additional pressure or a temperature to the monitor.
Page 25: Operating And Navigating
Operating and Navigating 2 Basic Operation Operating and Navigating The principle method of operating your monitor is via the touchscreen. Almost every element on the screen is interactive. Screen elements include measurement numerics, information fields, alarms fields, waveforms and menus. There are also four keys to the right of the screen (see also “X2 Controls and Indicators”...
Page 26 2 Basic Operation Operating and Navigating A typical main screen looks like this: Bed9 Adult ALARMS OFF Sinus Rhythm Temp Sys. All Sett. reset Profile Adult X2 Screen Elements Item Description Comments Place for Alarm Volume Off indicator is displayed when the alarm volume is set to zero (0).
Page 27 Operating and Navigating 2 Basic Operation X2 Screen Elements Item Description Comments Measurement label Touch the measurement to enter the measurement setup menu. Paced status Displayed below the HR label. Measurement numeric/values Touch the numeric to enter the measurement setup menu. Measurement wave Touch the wave to enter the measurement setup menu.
Page 28 2 Basic Operation Operating and Navigating Key to measurement setup menu: Item Description Comment INOP and alarm message field. These are always displayed at the top of the screen. Wave/numerics window. The main measurement numeric and wave (if applicable) are shown in this window so that you do not lose sight of the current measurement while making changes in the menu.
Page 29 Operating and Navigating 2 Basic Operation No Central Monit. NBPs HIGH SmartKeys Admit/ Start/ Measmt. Dischrge Stop Select. Touch to view more Alarm Vitals Profiles SmartKeys Limits Trend Alarm Monitor Volume Volume Standby Main Setup is one of the SmartKeys. enter standby mode - suspends patient monitoring.
Page 30 2 Basic Operation Operating and Navigating start veni puncture (inflate cuff to stop current NBP measurement subdiastolic pressure) set the NBP repeat time access patient reports switch CO pump off zero invasive pressure transducer new lead setup set standard or EASI lead placement review vital signs trend review graph trend unpair equipment and continue...
Page 31: Operating Modes
Operating Modes 2 Basic Operation Operating Modes When you switch the monitor on, it starts up in monitoring mode. To change to a different mode: Select the Main Setup menu. Select Operating Modes and choose the mode you require. Your monitor has four operating modes. Some are passcode protected. •...
Page 32: Understanding Screens
2 Basic Operation Understanding Screens STANDBY Press any key or select any field on the screen to resume monitoring The monitor enters Standby mode automatically after the End Case function is used to discharge a patient. Standby suspends patient monitoring. All waves and numerics disappear from the display but all settings and patient data information are retained.
Page 33: Using The Xds Remote Display
Using the XDS Remote Display 2 Basic Operation Changing a Screen’s Content If you do not want to change the entire Screen content, but only some parts of it, you can substitute individual waves, numerics, or trends. Be aware that these changes cannot be stored permanently in Monitoring Mode.
Page 34: Understanding Profiles
2 Basic Operation Understanding Profiles Press the Main Screen key to open the Change Screen menu. Select the name of the visitor Screen configured for your monitor from the list of available Screens. To select a Screen with waves and numerics again, Touch the gray rectangle in the center of the screen showing the visitor Screen’s name, or press the ♦...
Page 35 Understanding Profiles 2 Basic Operation You can change from one complete profile to another or swap individual settings blocks (display screen/monitor settings/measurement settings) to change a subset of a profile. Changes you make to any element within the settings blocks are not saved when you discharge the patient, unless you save them in Configuration Mode.
Page 36: Understanding Settings
2 Basic Operation Understanding Settings Understanding Settings Each aspect of how the monitor works and looks is defined by a setting. There are a number of different categories of settings, including, Screen Settings, to define the selection and appearance of elements on each individual Screen Measurement settings, to define settings unique to each measurement, for example, high and low alarm limits Monitor settings, including settings that affect more than one measurement or Screen and define...
Page 37: Using Labels
Using Labels 2 Basic Operation Changing Wave Speeds Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the speed expands the waveform, giving you a more detailed view. The monitor distinguishes two groups of wave speed settings, •...
Page 38 2 Basic Operation Using Labels Any labels already being used in the monitor are shown “grayed-out” in the list and cannot be selected. Resolving Label Conflicts Each label must be unique, that is, it can only be assigned once. If you have a MMS Extension equipped with a pressure measurement connected to the monitor, there is a potential conflict with, for example, the ABP label.
Page 39: Changing Monitor Settings
Changing Monitor Settings 2 Basic Operation When the X2 is connected to a host monitor, the Measurement Selection window can be opened, but only the measurement Setup key is functional. Derived measurements are not active and cannot be activated, but become active again when the X2 is disconnected from the host monitor. Resolve any label conflicts at the host monitor.
Page 40: Checking Your Monitor Revision
2 Basic Operation Checking Your Monitor Revision Select the appropriate setting for the screen brightness. 10 is the brightest, 1 is the least bright. Optimum is suitable for most monitoring locations and optimizes power usage for battery powered monitors. Your monitor may be configured with a lower brightness for Standby mode and also for transport to conserve battery power.
Page 41 Getting Started 2 Basic Operation Measurements from measurement extensions attached to the monitor are only available when the monitor is operating from external power (when connected to a host monitor or to the external power supply). The measurement extensions are not active when the monitor is operating from battery power.
Page 42: Disconnecting From Ac Mains Power
2 Basic Operation Disconnecting from AC Mains Power Disconnecting from AC Mains Power To disconnect the X2 from AC mains power, disconnect the MSL cable, or detach the X2 from the host monitor (if directly connected) or unplug the power cord for the optional external power supply (M8023A) from the mains socket.
Page 43: Using The X2 With A Host Monitor (Companion Mode Indicated)
Using the X2 with a Host Monitor (Companion Mode Indicated) 2 Basic Operation Using the X2 with a Host Monitor (Companion Mode Indicated) Host monitors that can support the X2 as a multi-measurement module require software revision F.00.00 or higher. When you connect an X2 to a host monitor, an integrated system is formed for monitoring a single patient.
Page 44: Unpairing The Host Monitor And The Paired Device
2 Basic Operation Unpairing the Host Monitor and the Paired Device Unpairing the Host Monitor and the Paired Device If the patient will no longer be monitored with the paired X2, or only with the paired X2 and no longer with the host monitor, you need to end the device pairing.
Page 45: What's New
What’s New? This section lists the most important new features and improvements to the monitor and its user interface introduced with each release. Further information is provided in other sections of this book. You may not have all of these features, depending on the monitor configuration purchased by your hospital.
Page 46 3 What’s New? What’s New in Release F.0? What’s New in Release F.0? QT/QTc Interval Monitoring QT interval monitoring is used to assist in the detection of prolonged QT interval syndrome. The QT interval is measured and the heart-rate corrected QT value, QTc, is calculated. The monitor also provides a ΔQTc value which tracks variation in the QT interval in relation to a baseline value.
Page 47: What's New In Release G.0
What’s New in Release F.0? 3 What’s New? New Patient Check The monitor can be configured to ask you in certain situations: after a specified power-off period, after a specified standby period and when no basic vitals (HR, RR, Pulse, SpO , NBP) have been measured for a specified period, whether a new patient is now being monitored.
Page 48: What's New In Release F.0
3 What’s New? What’s New in Release F.0?
Page 49: Alarms
Alarms The alarm information here applies to all measurements. Measurement-specific alarm information is discussed in the sections on individual measurements. The monitor has two different types of alarm: patient alarms and INOPs. Patient Alarms are red and yellow alarms. A red alarm indicates a high priority patient alarm such as a potentially life threatening situation (for example, asystole).
Page 50: Visual Alarm Indicators
4 Alarms Visual Alarm Indicators The monitor sounds an audible indicator for the highest priority alarm. If more than one alarm condition is active in the same measurement, the monitor announces the most severe. Your monitor may be configured to increase alarm indicator volume automatically during the time when the alarm is not acknowledged.
Page 51: Audible Alarm Indicators
• change the base volume of the red and yellow alarm tones and the INOP tones • change the alarm sound to suit the different alarm standards valid in different countries. Traditional Audible Alarms (HP/Agilent/Philips/Carenet) • Red alarms and red INOPs: A high pitched sound is repeated once a second.
Page 52: Acknowledging Alarms
4 Alarms Acknowledging Alarms ISO/IEC Standard Audible Alarms • Red alarms and red INOPs: A high pitched tone is repeated five times, followed by a configurable pause. • Two-star yellow alarms and yellow INOPs: A lower pitched tone is repeated three times, followed by a configurable pause.
Page 53: Pausing Or Switching Off Alarms
Pausing or Switching Off Alarms 4 Alarms To acknowledge all active alarms and INOPs, press the Silence key. This switches off the audible alarm indicators and alarm lamps. A check mark beside the alarm message indicates that the alarm has been acknowledged.
Page 54 4 Alarms Pausing or Switching Off Alarms To Pause All Alarms Press the Alarms key. ♦ If your monitor is configured to infinite pause time, the lamp next to the ♦ alarms off symbol is red, and pressing this key switches alarms off. Depending on the configuration, you may need to select Confirm to complete the change.
Page 55: Alarm Limits
Alarm Limits 4 Alarms If a NO SENSOR or NO TRANSDUCER INOP is present and alarms are paused or switched off, the measurement in question is switched off. The alarms off symbol is not displayed when the X2 is connected to a host monitor. Restarting Paused Alarms To manually switch on alarm indication again after a pause, press the Alarms key again.
Page 56 4 Alarms Alarm Limits Viewing All Alarm Limits The Alarm Limits overview window lists the currently set alarm limits for all measurements. If an Apnea alarm delay time is set, this is also shown. The ALARMS OFF symbol is shown beside the measurement label of any measurement whose alarm switched off.
Page 57 Alarm Limits 4 Alarms • Touch the high limit on the alarm limits menu button. Choose the high alarm limit from the pop-up list that opens. • Touch the low limit on the alarm limits menu button. Choose the low alarm limit from the pop-up list that opens. Alternatively, you can use the keys in the measurement Change Limits window, which you access by selecting the measurement label in the Alarm Limits window.
Page 58 4 Alarms Alarm Limits To change alarm limits, Enter the Alarm Limits window. To set the high alarm limit, select the high yellow alarm field to open a pop-up list of high alarm limits. Select a limit from the list. Repeat to set the low yellow alarm field. If you set the yellow alarm limit outside the red alarm limit, the monitor will automatically set the red alarm to the yellow alarm limit.
Page 59: Reviewing Alarms
Reviewing Alarms 4 Alarms AutoLimits are not available for all measurements. The list of measurements for which AutoLimits can be used is defined in the monitor’s Configuration mode. Use the Change Limits window to check AutoLimits before you apply them to ensure that they are appropriate for your individual patient and their clinical condition.
Page 60: Latching Alarms
4 Alarms Latching Alarms No entries are made in the Review Alarms window of the X2 while it is connected to a host monitor, except the time when the X2 was connected to the host (Companion Entered), and when it was disconnected (Companion Left). Alarms can be reviewed on the host monitor. When you select an item from the list, you can get additional information about that item.
Page 61: Testing Alarms
Testing Alarms 4 Alarms Alarm Latching Behavior Red and Yellow Measurement Non-latching Visual and audible Visual latching, Alarms alarms latching audible non-latching Alarm has not been Alarm condition Alarm tone on. Alarm lamp on. Alarm message. Flashing numerics. acknowledged. still present. Alarm condition All audible and visual Alarm tone on.
Page 62 4 Alarms Alarm Recordings For the desired measurement(s), choose the alarm condition to trigger an alarm recording: Red Only: an alarm recording will automatically be triggered when the measurement enters a red alarm condition. Red&Yell: both yellow and red alarms will trigger an alarm recording. Off: disables automatic alarm recording.
Page 63: Patient Alarms And Inops
Patient Alarms and INOPs This chapter lists patient alarms and technical alarms (INOPs) alphabetically, irrespective of their priority. INOPs start on page 61. All alarms and INOPs are listed here; the ones which can appear on your monitor will depend on the model and the individual options. Patient Alarm Messages The measurement labels and abbreviations for pressure, temperature, SpO , and anesthetic agent...
Page 64 5 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication **BIS LOW The Bispectral Index value has dropped numeric flashes and low limit below the low alarm limit. is highlighted, yellow alarm lamp, alarm tone. ***BRADY/P xxx<yyy Press, SpO The heart rate from the Pulse signal has numeric flashes and alarm...
Page 65 Patient Alarm Messages 5 Patient Alarms and INOPs Alarm Message From Condition Indication The heart rate high alarm limit has numeric flashes and high limit **HR HIGH been exceeded. is highlighted, yellow alarm lamp, alarm tone. If configured to short yellow, the sound switches off after 5 seconds if Arrhythmia is On.
Page 66 5 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication PRESS The pressure is non-pulsatile and the numeric flashes, red alarm ***<Pressure> DISCONNECT mean pressure is continuously less than lamp, alarm tone. 10mmHg (1.3kPa). This alarm occurs only with arterial pressures (P, ABP, ART, Ao, BAP, FAP, PAP, UAP, P1, P2, P3, P4).
Page 67 Patient Alarm Messages 5 Patient Alarms and INOPs Alarm Message From Condition Indication **RR LOW RESP The respiration rate has dropped below numeric flashes and low limit the low alarm limit. is highlighted, yellow alarm lamp, alarm tone. */**RUN PVCs HIGH ECG/ A run of PVCs greater than 2 was numeric flashes, yellow alarm...
Page 68 5 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication Telemetry This is a generic alarm from the yellow or red alarm lamp and */**/***TELE ALARM telemetry system. The specific alarm alarm tone cause is indicated in the alarm message in the Telemetry Data Window.
Page 69: Technical Alarm Messages (Inops)
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) If an INOP interrupts monitoring and alarm detection, the measurement numeric will be replaced by -?-. If an INOP may lead to unreliable measurement values, a ? appears next to the numeric. INOP Message, Indication Source What to do...
Page 70 BIS CABLE INCOMPAT The semi-reusable sensor cable connected is unknown or not INOP tone. supported by your software revision. Replace it with a Philips- supported sensor cable. BIS CABLE USAGE The semi-reusable sensor cable has exceeded the maximum INOP tone.
Page 71 Unsupported sensor connected or sensor type unknown or not supported by your software revision. Replace the sensor, using INOP tone only Philips supported sensors. BIS SENSOR MALFUNC Malfunction in the sensor hardware, most often caused by liquids permeating into the connectors OR patient interface INOP tone cable (PIC) or DSC or BISx may be faulty.
Page 72 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do BIS SENSOR USAGE Excessive sensor usage. Replace sensor. A Cyclic Impedance Check will start automatically. INOP tone BIS SQI < 15% (INOP tone) If the signal quality is below 50%, BIS numerics cannot be reliably derived.
Page 73 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do CCO NO <Pressure label> C.O. CCO/CCI cannot be calculated. Make sure that the pressure numeric is replaced by -?- chosen in the Setup CCO menu under CCO From INOP tone may sound...
Page 74 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do CHARGER MALFUNC Batteries There is a problem with the battery charger in the monitor. Connect the monitor to mains power and contact your service INOP tone, battery LED may flash personnel.
Page 75 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do Check Screen Res Monitor The Screen you have selected uses a resolution which is not INOP tone supported by the display. The monitor will show a generic Screen instead until you select a different Screen.
Page 76 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do DEACTIVATED The CO measurement label in the measurement device has INOP tone. been deactivated by deactivating the label in the Measurement Selection window. The measurement automatically disappears from the display.
Page 77 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do C.O. UNPLUGGED C.O. Plug in the C.O. module. Silencing this INOP switches off the numeric is replaced by -?- measurement. INOP tone. UPDATE FW The software in the Measurement Extension does not match Numeric is replaced by a -?- the software in the MMS.
Page 78 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do DEVICE REAL DATA IntelliBridge The monitor is in DEMO mode but the device connected to INOP tone the IntelliBridge module reports data that are not flagged as demo data.
Page 79 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do EEG<X> LEAD OFF One or more electrodes are not connected. Check in the [X = channel] Impedance/Montage window on the monitor which at Information Center electrode(s) are affected and reconnect the electrodes.
Page 80 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do LA LEAD OFF The LA electrode has become detached from the patient or the Numeric is replaced by -?- for 10 lead set has been changed. Reattach the electrode or select seconds;...
Page 81 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do NBP Deactivated The NBP measurement label in the measurement device has INOP tone. been deactivated by deactivating the label in the Measurement Selection window. The measurement automatically disappears from the display.
Page 82 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do PPV BAD SIGNAL The arterial pressure source selected for PPV is not providing a at Information Center pulsatile signal. PPV CHK SOURCES The arterial pressure source selected for PPV is unplugged or switched off.
Page 83 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do <pTemp label> CHECK PROBE Predictive Check that the probe holder is correctly installed and that a Numeric is replaced by -?- Temp compatible probe is in use. If the INOP does not clear, remove INOP tone.
Page 84 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do !!/!!! REPLACE BATTERY T Telemetry The battery in the telemetry device is almost empty and must be replaced. Severe yellow/red INOP tone. During this INOP, alarms cannot be paused or switched off.
Page 85 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do <SO Label>LIGHT INTENS The intensity changed considerably since the last light intensity calibration. This may indicate that the catheter tip is positioned Numeric is replaced by -?- against a blood vessel wall or that there is low blood flow.
Page 86 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do SPIRO NO BREATH Spirometry No breath was detected for more than 25 seconds. Breath derived numerics are not available. SPIRO GAS COMPENS? Spirometry Gas compensation is set to “gas analyzer” but not all gases necessary for compensation are measured by a gas monitor.
Page 87 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do <SpO LABEL> PULSE? The detectable pulsations of the SpO signal are outside the specified pulse rate range. Numeric is replaced by -?- INOP tone <SpO LABEL>...
Page 88 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do Tblood NO TRANSDUC C.O. No transducer attached to the module or catheter Numeric is replaced by -?- disconnected. INOP tone Tblood OVERRANGE C.O. Tblood out of range 17°C - 43°C. Numeric is replaced by -?- Tcereb INOPS TEMP...
Page 89 Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs INOP Message, Indication Source What to do !!/!!!TELE DISCONNECT Telemetry Telemetry transceiver was disconnected or short range radio INOP tone link was lost. For cable connections; check Telemetry interface, cable connection and setup. For short range radio connections: if the telemetry transceiver has not moved out-of-range, check for interference sources close to the monitor (bluetooth devices, DECT phones,...
Page 90 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do <Temp label> OVERRANGE TEMP Try changing the application site of the transducer. ° ° Numeric is replaced by -?- [The temperature is less than -1 C, or greater than 45 INOP tone.
Page 91 The VueLink module has not been configured during VueLnk NO CONFIG INOP tone. installation. The installation process should be completed by either your biomedical engineering department or the Philips service engineer. VueLink INOP abbreviations may differ slightly depending on the device category.
Page 92 5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
Page 93: Managing Patients
Managing Patients Use the Patient Demographics window and its associated pop-up keys to admit, discharge, and transfer (ADT) patients. All patient demographic and ADT information is shared between the patient monitor and the Information Center, for example, patients admitted to the monitor are automatically admitted to a connected Information Center.
Page 94 6 Managing Patients Admitting a Patient SBed10 Adult Doe, John Patient Demographics Last Name : Doe First Name : John : 12345678 Patient : Adult Cat. Dischrge Admit Transfer Patient Case Patient Clear any previous patient data by selecting the Dischrge Patient or End Case pop-up key and then Confirm.
Page 95: Quick Admitting A Patient
Quick Admitting a Patient 6 Managing Patients WARNING Patient Category and Paced status will 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 profile, which might not be correct for your patient.
Page 96: Transferring Patients
6 Managing Patients Transferring Patients – clears the information in the Patient Demographics window – erases all patient data (including trend data) from the monitor and Information Center. This ensures that data from a previous patient are not mixed with data from the new patient. –...
Page 97 Transferring Patients 6 Managing Patients Transferring a Centrally-Monitored Patient WARNING Measurements from a MMS extension connected to an X2 are not available when the X2 is running on battery power. They are only available when the X2 is powered from AC mains, either when connected to a host monitor or the external power supply (M8023A).
Page 98 6 Managing Patients Transferring Patients Connect the X2 to the new host monitor. The monitor detects a patient mismatch and a window will open showing your patient’s data and asking Complete transfer of this patient?. Select Yes to complete the transfer.This re-admits the patient from the transfer list to the new monitor.
Page 99 Transferring Patients 6 Managing Patients It is important to resolve the mismatches as soon as they are identified. Failure to do so could result in using incorrect/confusing data to make clinical decisions. Certain settings, for example Paced and Patient Category, may not match between the Information Center and the monitor. If the Paced status is set incorrectly, the system could mistake a pace pulse for a QRS and fail to alarm in the case of asystole.
Page 100 6 Managing Patients Transferring Patients Patient Mismatch - If One Set of Patient Data is Correct Select Patient If there is a mismatch between an ♦ Information Center and a monitor, choose DOE, JOHN F the data set you want to continue using for 1234HG9556, 2008/00123 this patient by selecting one of the sectors in Adult Non-Paced...
Page 101: Ecg, Arrhythmia, St And Qt Monitoring
ECG, Arrhythmia, ST and QT Monitoring 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 arrhythmia monitoring (see page 109), ST monitoring (see page 121) and QT monitoring (see page 131). Skin Preparation for Electrode Placement Good electrode-to-skin contact is important for a good ECG signal, as the skin is a poor conductor of electricity.
Page 102: Selecting The Primary And Secondary Ecg Leads
CAUTION To protect the monitor from damage during defibrillation, for accurate ECG information and to protect against noise and other interference, use only ECG electrodes and cables specified by Philips. Selecting the Primary and Secondary ECG Leads The monitor uses the primary and secondary lead to compute HR and to analyze and detect cardiac arrhythmias.
Page 103: Understanding The Ecg Display
Understanding the ECG Display 7 ECG, Arrhythmia, ST and QT Monitoring WARNING Pace pulse rejection must be switched on for paced patients by setting “Paced” to Yes. Switching pace pulse rejection off for paced patients may result in pace pulses being counted as regular QRS complexes, which could prevent an asystole event from being detected.
Page 104: Monitoring Paced Patients
Monitoring Paced Patients Pacer spikes configured to have a fixed size Defibrillator synchronization marks: If an HP/Agilent/Philips defibrillator is connected, the synchronization marks (vertical lines on the ECG wave) are shown on the ECG wave. The synchronization marks will be shown in yellow, unless the ECG wave is yellow, then they will be green.
Page 105: Changing The Size Of The Ecg Wave
Changing the Size of the ECG Wave 7 ECG, Arrhythmia, ST and QT Monitoring Setting the Paced Status (Pace Pulse Rejection) In the Setup ECG menu, select Paced to toggle between Yes and No. Paced ♦ You can also change the paced status in the Patient Demographics window. When Paced is set to Yes: –...
Page 106: Changing The Volume Of The Qrs Tone
7 ECG, Arrhythmia, ST and QT Monitoring Changing the Volume of the QRS Tone In the lead menu, select Size Up to increase wave size or Size Down to decrease the size. Selecting AutoSize lets the monitor choose the optimal adjustment factor for all displayed ECG waves.
Page 107: Selecting Positions Of Va And Vb Chest Leads (For 6-Lead Placement)
Selecting Positions of Va and Vb Chest Leads (for 6-lead placement) 7 ECG, Arrhythmia, ST and QT Monitoring – Diag: 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 segments are visible.
Page 108: Ecg Lead Fallback
7 ECG, Arrhythmia, ST and QT Monitoring ECG Lead Fallback ECG Leads Monitored If you are using these leads are available: Resp is measured between electrodes: a 3-electrode set I, II, III RA and LL a 5-electrode set I, II, III, aVR, aVL, aVF, V and MCL RA and LL a 6-electrode set I, II, III, aVR, aVL, aVF, Va, Vb...
Page 109 ECG Lead Placements 7 ECG, Arrhythmia, ST and QT Monitoring Electrode labels Electrode colors AAMI EASI AAMI Brown/Green White/Green Brown/Blue White/Brown Brown/Orange White/Black Brown/Violet White/Violet Standard 3-Lead Placement RA placement: directly below the clavicle and near the right shoulder LA placement: directly below the clavicle and near the left shoulder LL placement: on the left lower abdomen...
Page 110 7 ECG, Arrhythmia, ST and QT Monitoring ECG Lead Placements 6-Lead Placement For a 6-lead placement use the positions from the 5-lead diagram above but with two chest leads. The two chest leads, Va and Vb, can be positioned at any two of the V1 to V6 positions shown in the chest electrode diagram below.
Page 111 ECG Lead Placements 7 ECG, Arrhythmia, ST and QT Monitoring 10-Lead Placement When monitoring 12-leads of ECG, using a 10-Electrode Lead Placement, it is important to correctly place electrodes and to label all 12-lead ECG reports with the correct lead placement. Conventional 12-Lead ECG In conventional 12-Lead ECG using 10 electrodes, an electrode is placed on the right...
Page 112: Capture 12-Lead
7 ECG, Arrhythmia, ST and QT Monitoring Capture 12-Lead Modified 12-Lead ECG 1 - LA 2 - V1 - V6 3 - LL 4 - RL 5 - RA 6 - Angle of Lewis If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System), place the four limb electrodes close to the...
Page 113: Easi Ecg Lead Placement
EASI ECG Lead Placement 7 ECG, Arrhythmia, ST and QT Monitoring EASI ECG Lead Placement Using a standard 5-electrode set in EASI lead placement you can monitor up to 12 standard ECG leads simultaneously and continuously at the bedside. EASI provides a monitoring method for trending ST segment changes that can provide an early indication of ischemia.
Page 114: Ecg And Arrhythmia Alarm Overview
7 ECG, Arrhythmia, ST and QT Monitoring ECG and Arrhythmia Alarm Overview ECG and Arrhythmia Alarm Overview The ECG and arrhythmia alarms available depend on which measurements are switched on, and the arrhythmia option enabled for your monitor. • Cardiotach alarms are available when HR is on and the active alarm source is ECG, but arrhythmia is switched off •...
Page 115: Using Ecg Alarms
Using ECG Alarms 7 ECG, Arrhythmia, ST and QT Monitoring Using ECG Alarms ECG alarms can be switched on and off and the high and low alarm limits changed just like other measurement alarms, as described in the Alarms section. Special alarm features which apply only to ECG are described here.
Page 116: Ecg Safety Information
7 ECG, Arrhythmia, ST and QT Monitoring ECG Safety Information ECG Safety Information CAUTION Interference from instruments near the patient and ESU interference can cause problems with the ECG wave. See the monitor specifications for more information. WARNING Defibrillation and Electrosurgery: Do not touch the patient, or table, or instruments, during defibrillation.
Page 117: About Arrhythmia Monitoring
About Arrhythmia Monitoring 7 ECG, Arrhythmia, ST and QT Monitoring External pacing electrodes: When a pacemaker with external pacing electrodes is being used on a patient, arrhythmia monitoring is severely compromised due to the high energy level in the pacer pulse. This may result in the arrhythmia algorithm’s failure to detect pacemaker noncapture or asystole.
Page 118: Switching Arrhythmia Analysis On And Off
7 ECG, Arrhythmia, ST and QT Monitoring Switching Arrhythmia Analysis On and Off Switching Arrhythmia Analysis On and Off In the Setup Arrhy menu, select Arrhythmia to toggle between On and Off. Select the Confirm pop-up key which appears at the bottom of the screen. Be aware that when arrhythmia analysis is switched off, –...
Page 119: Understanding The Arrhythmia Display
Understanding the Arrhythmia Display 7 ECG, Arrhythmia, ST and QT Monitoring • PR interval deviation must be large • P-wave region must not match well Atrial fibrillation analysis is only available for adult patients and atrial fibrillation detection cannot be performed on PVCs or Paced beats.
Page 120 7 ECG, Arrhythmia, ST and QT Monitoring Understanding the Arrhythmia Display PVC Numeric HR Numeric Ectopic status message Delayed arrhythmia wave Viewing Arrhythmia Waves To review arrhythmia beat labels, in the Setup Arrhy menu, select Annotate Arrhy. ♦ The wave showing the primary ECG lead will be delayed by six seconds and shown on a grey background.
Page 121 Understanding the Arrhythmia Display 7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Status Messages The monitor displays two types of status messages: • Rhythm Status Messages -- to indicate the patient’s rhythm. • Ectopic Status Messages -- to indicate the presence of ectopic beats. These status messages are shown on the right hand side of the primary ECG wave.
Page 122: Arrhythmia Relearning
7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Relearning Ectopic Status Messages The label B or E indicates basic (B) or enhanced (E) arrhythmia capability. Ectopic Status Message Explanation B or E (No message displayed) No ectopic activity within the last minute More than 2 consecutive PVCs within the last minute RUN PVCs Pair PVCs within the last minute...
Page 123: Arrhythmia Alarms
Arrhythmia Alarms 7 ECG, Arrhythmia, ST and QT Monitoring Automatic Arrhythmia Relearn Arrhythmia relearning is initiated automatically whenever: • ECG monitoring is switched on • The ECG Lead or Lead Label of the primary/secondary lead is changed manually, or when fallback occurs •...
Page 124 7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Alarms Yellow Arrhythmia Alarms Yellow arrhythmia alarms are short yellow alarms specific to arrhythmia-related patient conditions. Depending on your monitor and Information Center configuration, they may be shown with one or two stars. The heart rate alarms (High HR and Low HR) can be configured as short yellow or standard yellow alarms.
Page 125 Arrhythmia Alarms 7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Alarm Timeout Periods Normally, an arrhythmia alarm is announced when an alarm condition is detected. However, there are certain situations that can inhibit the audible and visible indications of the alarm even though the alarm condition was detected.
Page 126 7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Alarms If you silence a yellow arrhythmia alarm and the alarm condition still exists, the visual indicators continue until the condition stops. You will get an alarm reminder every time the configured timeout period has expired.
Page 127 Arrhythmia Alarms 7 ECG, Arrhythmia, ST and QT Monitoring Red Arrhythmia Alarms Asystole Vent Fib/Tach V-Tach Extreme Tachy/Extreme Brady Yellow Arrhythmia Alarms Rate Alarms Chain PVC Alarms Chain Beat Detection Alarms Chain Non-sustain VT/ Pause Vent Rhythm Pacer Not Captured/ First level HR High/ HR Low Pacer Not Pacing/...
Page 128 7 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Alarms V-Tach Run Limit ** Non-Sustain VT ***V-Tach **Pair PVC Run < 8 ≥ PVC Run PVCs HR > 100 HR > 100 PVC = V-Tach Heart Rate Limit ** Run PVCs ** Vent Rhythm ≤...
Page 129: About St Monitoring
About ST Monitoring 7 ECG, Arrhythmia, ST and QT Monitoring About ST Monitoring The monitor performs ST segment analysis on normal and atrially paced beats and calculates ST segment elevations and depressions. This information can be displayed in the form of ST numerics and snippets on the monitor.
Page 130: Understanding The St Display And Windows
7 ECG, Arrhythmia, ST and QT Monitoring Understanding the ST Display and Windows Choose a lead from the list for ST monitoring. This closes the Choices window and adds the selected lead to the list of chosen leads. To disable ST monitoring for a lead: Choose a lead from the list in the Setup ST Leads window.
Page 131: Updating St Baseline Snippets
Updating ST Baseline Snippets 7 ECG, Arrhythmia, ST and QT Monitoring ST Snippets ST snippets show a one second wave segment for each measured ST lead. The most recent snippet is drawn in the same color as the ECG wave, usually green, superimposed over the stored baseline snippet, drawn in a different color.
Page 132: About The St Measurement Points
7 ECG, Arrhythmia, ST and QT Monitoring About the ST Measurement Points About the ST Measurement Points The ST value for each beat complex is the vertical difference between the ISO point and the ST point, as shown in the diagram below. The isoelectric (ISO) point provides the baseline, the ST point is at the midpoint of the ST segment.
Page 133 About the ST Measurement Points 7 ECG, Arrhythmia, ST and QT Monitoring Select the ST point you need to adjust by touching the appropriate point on the screen. The current choice is highlighted (ISO point -80 in the screen example). ST label and the ST numeric that would apply using the Adjust ST Points...
Page 134: St Alarms
7 ECG, Arrhythmia, ST and QT Monitoring ST Alarms To update the ST snippet shown in the Adjust ST Points window, select the Update pop- up key. ST Alarms ST alarms are yellow alarms. Each ST lead has its own alarm limit. ST alarms are triggered when an ST value exceeds its alarm limit for more than one minute.
Page 135 Viewing ST Maps 7 ECG, Arrhythmia, ST and QT Monitoring SBed10 Adult ST-II HIGH ST Map (Current) ST map Limb Leads Chest Leads ST label and polarity of corresponding lead Size Size Show Show Down Baseline Scroll to view Values more pop-up keys Trend Select...
Page 136 7 ECG, Arrhythmia, ST and QT Monitoring Viewing ST Maps Additionally, when both ST maps are displayed, you can view the currently available ST values in the ST Map window (Current or Trend) at any time. To do this, select the Show Values pop-up key. The ST values are shown in place of the second ST map, and the pop-up key text changes to Hide Values.
Page 137 Viewing ST Maps 7 ECG, Arrhythmia, ST and QT Monitoring In this diagram, V4 was either temporarily switched off, or in INOP, for around 30 seconds. No data was recorded. Consequently, the affected maps are not closed. Viewing an ST Map To display an ST map, In the Setup ST Analysis menu, select ST Map.
Page 138 7 ECG, Arrhythmia, ST and QT Monitoring Viewing ST Maps Changing the Trending Interval To determine how frequently the monitor displays a trended sample, In Trend view, select Select Interval. Select the required interval from the menu. The interval ranges between 12 seconds to 30 minutes. Printing an ST Map Report To print the most recently viewed (current or trend) window, Select Main Setup - >...
Page 139: About Qt/Qtc Interval Monitoring
About QT/QTc Interval Monitoring 7 ECG, Arrhythmia, ST and QT Monitoring About QT/QTc Interval Monitoring The QT interval is defined as the time between the beginning of the Q-wave and the end of the T-wave. It measures the total duration of the depolarization (QRS duration) and repolarization (ST-T) phases of the ventricular action potential.
Page 140 7 ECG, Arrhythmia, ST and QT Monitoring About QT/QTc Interval Monitoring Indications For Use Of QT Interval Monitoring Of special concern for QT monitoring is the administration of QT prolonging drugs to patients identified with risk factors for Torsade de Pointe. Females, older patients and patients with bradycardia, impaired left ventricular function (ischemia, left ventricular hypertrophy), hypokalemia and hypomagnesemia are in this increased risk category.
Page 141 About QT/QTc Interval Monitoring 7 ECG, Arrhythmia, ST and QT Monitoring Changing the lead(s) used for QT measurements will not cause the baseline to be reset. QT View In the window you can verify that the QT algorithm detects correct Q and T points. QT View The current waves are shown in the upper half of the window and the baseline waves in a different color below.
Page 142: Qt Alarms
7 ECG, Arrhythmia, ST and QT Monitoring QT Alarms If no baseline has been set for this patient, the first five minute value after the start of monitoring is automatically set as baseline. If you set a new baseline the previous baseline is discarded. As the ΔQTc alarm is based on the difference between the baseline and the current value, setting an inappropriate new baseline may prevent a ΔQTc alarm from being generated.
Page 143: Switching Qt Monitoring On And Off
Switching QT Monitoring On and Off 7 ECG, Arrhythmia, ST and QT Monitoring Switching Individual QTc Alarms On and Off Each QTc alarm can be switched off individually. To switch an alarm on or off, in the Setup QT Analysis menu, select QTc Alarm or ♦...
Page 144 7 ECG, Arrhythmia, ST and QT Monitoring Switching QT Monitoring On and Off...
Page 145: Monitoring Pulse Rate
Monitoring Pulse Rate The pulse numeric counts the arterial pulsations that result from the mechanical activity of the heart in beats per minute (bpm). You can display a pulse from any measured SpO signal (pleth wave), or any arterial pressure (P, ABP, ART, Ao, PAP, UAP, FAP, BAP: see the pressure section for an explanation of the pressure labels).
Page 146: Switching Pulse On And Off
8 Monitoring Pulse Rate Switching Pulse On and Off Switching Pulse On and Off To switch a particular pulse numeric on or off, enter the Setup Pulse menu via the measurement setup menu or wave menu of the pulse source. For example, to switch an SpO pulse numeric on or off, Enter the Setup Pulse menu by selecting the Pulse numeric or by selecting Pulse in the...
Page 147 Using Pulse Alarms 8 Monitoring Pulse Rate WARNING Selecting Pulse as the active alarm source for HR/Pulse switches off the arrhythmia alarms listed in the section “ECG and Arrhythmia Alarm Overview” on page 106, including Asystole, Vfib and Vtach alarms, and the heart rate alarms. This is indicated by the message ECG/ARRH ALARM OFF (unless this has been configured off for your monitor), and the crossed-out alarm symbol beside the ECG heart rate numeric.
Page 148 8 Monitoring Pulse Rate Using Pulse Alarms To Purchase, Visit Avobus.com or call 1-800-674-3655...
Page 149: Monitoring Respiration Rate (Resp)
Monitoring Respiration Rate (Resp) For the respiratory measurement (Resp), the monitor measures the thoracic impedance between two ECG electrodes on the patient’s chest. Changes in the impedance due to thoracic movement produce the Resp waveform on the monitor screen. The monitor counts the waveform cycles to calculate the respiration rate (RR).
Page 150: Understanding The Resp Display
9 Monitoring Respiration Rate (Resp) Understanding the Resp Display Lateral Chest Expansion Some patients, especially neonates, expand their chests laterally. In these cases it is best to place the two respiratory electrodes in the right midaxillary and left lateral chest areas at the patient’s maximum point of breathing movement to optimize the respiratory wave.
Page 151: Changing The Size Of The Respiration Wave
Changing the Size of the Respiration Wave 9 Monitoring Respiration Rate (Resp) • the algorithm expects a heart rate and therefore needs at least 3 electrodes attached to the patient. If you are monitoring respiration with only two electrodes, the detection algorithm becomes less sensitive which may result in reduced breath detection performance.
Page 152: Changing The Speed Of The Respiration Wave
9 Monitoring Respiration Rate (Resp) Changing the Speed of the Respiration Wave Changing the Speed of the Respiration Wave Resp waveforms are usually viewed at a slower speed than other waveforms. For this reason, the Resp measurement has its own speed control and is not affected by the wave speed settings of the other measurements.
Page 153 Resp Safety Information 9 Monitoring Respiration Rate (Resp) Rate adaptive pacemakers: Implanted pacemakers which can adapt to the Minute Ventilation rate may occasionally react on the Impedance measurement used by patient monitors for the determination of the Resp value and execute pacing with the maximum programmed rate. Switching off the Resp measurement can prevent this.
Page 154 9 Monitoring Respiration Rate (Resp) Resp Safety Information To Purchase, Visit Avobus.com or call 1-800-674-3655...
Page 155: Monitoring Spo
Monitoring SpO Philips pulse oximetry uses a motion-tolerant signal processing algorithm, based on Fourier artefact suppression technology (FAST). It provides four measurements: • Oxygen saturation of arterial blood (SpO ) - percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin (functional arterial oxygen saturation).
Page 156: Connecting Spo 2 Cables
Extremities to Avoid: Avoid placing the sensor on extremities with an arterial catheter, or intravascular venous infusion line. Connecting SpO Cables Connect the sensor cable to the color-coded socket on the X2. You can connect some Philips ♦ sensors directly to the measurement device. For other sensors, use the corresponding adapter cable. CAUTION Extension cables: Do not use more than one extension cable (M1941A).
Page 157: Spo 2 Signal Quality Indicator (Fast Spo 2 Only)
Signal Quality Indicator (Fast SpO only) 10 Monitoring SpO WARNING Inspect the application site every two to three hours to ensure skin quality and correct optical alignment. If the skin quality changes, move the sensor to another site. Change the application site at least every four hours.
Page 158: Changing The Averaging Time
10 Monitoring SpO Changing the Averaging Time Changing the Averaging Time Depending on the monitor configuration, you may be able to change the averaging time for the SpO values. The averaging time represents the approximate time period used for the calculation. The exact averaging algorithm depends on the SpO technology (option) used and on the signal conditions.
Page 159: Pleth Wave
Pleth Wave 10 Monitoring SpO CAUTION If you measure SpO on a limb that has an inflated NBP cuff, a non-pulsatile SpO INOP can occur. If the monitor is configured to suppress this alarm there may be a delay of up to 60 seconds in indicating critical patient status, such as sudden pulse loss or hypoxia.
Page 160: Perfusion Numeric
10 Monitoring SpO Perfusion Numeric minimum size for reliable SpO value Perfusion Numeric The perfusion numeric (Perf) gives a value for the pulsatile portion of the measured signal caused by the pulsating arterial blood flow. As pulse oximetry is based on the pulsatile nature of the signal, you can also use the perfusion numeric as a quality indicator for the SpO measurement.
Page 161: Setting The Qrs Volume
Setting the QRS Volume 10 Monitoring SpO Tone modulation is licensed under US patent US 4,653,498 from Nellcor Puritan Bennett Incorporated. Setting the QRS Volume In the Setup SpO menu, select QRS Volume and set the appropriate QRS tone volume. ♦...
Page 162 10 Monitoring SpO Setting the QRS Volume...
Page 163: Monitoring Nbp
Monitoring NBP This monitor uses the oscillometric method for measuring NBP. In adult and pediatric mode, the blood pressure measurements determined with this device comply with the American National Standard for Electronic or Automated Sphygmomanometers (ANSI/AAMI SP10-1992) in relation to mean error and standard deviation, when compared to intra-arterial or auscultatory measurements (depending on the configuration) in a representative patient population.
Page 164: Preparing To Measure Nbp
11 Monitoring NBP Preparing to Measure NBP CAUTION If you spill liquid onto the equipment or accessories, particularly if there is a chance that it can get inside the tubing or the measurement device, contact your service personnel. Measurement Limitations Measurements are impossible with heart rate extremes of less than 40 bpm or greater than 300 bpm, or if the patient is on a heart-lung machine.
Page 165 Plug the air tubing into the red NBP connector. Avoid compression or restriction of pressure tubes. Air must pass unrestricted through the tubing. Make sure that you are using a Philips-approved correct sized cuff and that the bladder inside the cover is not folded or twisted.
Page 166: Starting And Stopping Measurements
11 Monitoring NBP Starting and Stopping Measurements During measurements the cuff pressure is displayed instead of the units and the repeat time. An early systolic value gives you a preliminary indication of the systolic blood pressure during measurement. Starting and Stopping Measurements CAUTION Use clinical judgement to decide whether to perform repeated series of STAT measurements because of the risk of purpura, ischemia and neuropathy in the limb with the cuff.
Page 167: Switching Pulse From Nbp On/Off
Switching Pulse from NBP On/Off 11 Monitoring NBP Menu option Pressure value monitored Sys. systolic Dia. diastolic Mean mean Sys&Dia systolic and diastolic in parallel Dia&Mean diastolic and mean in parallel Sys&Mean systolic and mean in parallel Sys&Dia&Mean all three pressures in parallel If mean is not selected as alarm source (Sys, Dia, or Sys&Dia selected), but the monitor can only derive a mean value, mean alarms will nevertheless be announced using the most recent mean alarm limits.
Page 168: Calibrating Nbp
11 Monitoring NBP Calibrating NBP Venous puncture measurement mode Cuff pressure Time left in venous puncture mode 01:45 (60) Calibrating NBP NBP is not user-calibrated. Cuff-pressure transducers must be verified and calibrated, if necessary, at least once every two years by a qualified service professional. See the Service Guide for details.
Page 169: Monitoring Temperature
Monitoring Temperature WARNING Measurements from an MMS extension connected to an X2 are not available when the X2 is running on battery power. They are only available when the X2 is powered from AC mains, either when connected to a host monitor or the external power supply (M8023A). You can measure temperature using the built-in temperature measurement (optional), or one of the MMS extensions.
Page 170: Calculating Temp Difference
12 Monitoring Temperature Calculating Temp Difference WARNING Make sure you set alarm limits for the correct label. The alarm limits you set are stored for that particular label only. Changing the label may change the alarm limits. Selecting a Temperature for Monitoring Tell the monitor which temperature you want to monitor by selecting its temperature label.
Page 171: Monitoring Invasive Pressure
Monitoring Invasive Pressure WARNING Measurements from an MMS extension connected to an X2 are not available when the X2 is running on battery power. They are only available when the X2 is powered from AC mains, either when connected to a host monitor or the external power supply (M8023A). CAUTION Do not use the X2 in combination with monitors using an M1006A pressure module and the HP1290A pressure transducer.
Page 172 13 Monitoring Invasive Pressure Setting up the Pressure Measurement Connect the pressure line to the patient catheter. If you are using an infusion pressure cuff with the pressure line, attach the pressure cuff to the fluid to be infused. Inflate it according to your standard hospital procedure, then start the infusion. Position the transducer so that it is level with the heart, approximately at the level of the midaxillary line.
Page 173: Zeroing The Pressure Transducer
Zeroing the Pressure Transducer 13 Monitoring Invasive Pressure Zeroing the Pressure Transducer 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). You must perform a zero: •...
Page 174: Adjusting The Calibration Factor
13 Monitoring Invasive Pressure Adjusting the Calibration Factor Troubleshooting the Zero The status line lists the probable cause of an unsuccessful zero: Message Corrective Action can’t zero; The hardware is faulty. Contact your service personnel. equipment malf. Make sure the transducer is vented to air and try again. If this fails, the hardware can’t zero;...
Page 175: Optimizing The Waveform
Optimizing the Waveform 13 Monitoring Invasive Pressure Optimizing the Waveform In the Setup <Press> menu, select Optimum Scale to let the monitor select the best ♦ minimum and maximum scales for the current wave. Non-Physiological Artifact Suppression Some clinical procedures may affect blood pressure, for example, a flush procedure or a blood sample. Your monitor may be configured to suppress these non-physiological artifacts for a specified duration (Artifact Suppression is configured to 30, 60, or 90 seconds).
Page 176 13 Monitoring Invasive Pressure Choosing the Pressure Alarm Source Extreme Extreme High Low Limit High Limit Limit Limit Δ Extreme Low Δ Extreme High You need to know which values have been configured for your monitor. Changing the high and low alarm limits automatically changes the extreme alarm limits within the allowed range.
Page 177: Calibrating Reusable Transducer Cpj840J6
Calibrating Reusable Transducer CPJ840J6 13 Monitoring Invasive Pressure Calibrating Reusable Transducer CPJ840J6 Depending on your monitor’s configuration, you may be able to perform a calibration in monitoring mode. Perform a mercury calibration when you use a new transducer, and at regular intervals according to your hospital policy.
Page 178: Calculating Cerebral Perfusion
13 Monitoring Invasive Pressure Calculating Cerebral Perfusion Select the calibration pressure from the list, for example 200 mmHg. Select Confirm to recalculate the calibration factor using the applied pressure. When the monitor displays <Press> calibration done at <date and time>, remove the manometer tubing, syringe and extra stopcock.
Page 179: Monitoring Carbon Dioxide
Monitoring Carbon Dioxide WARNING • Measurements from an MMS extension connected to an X2 are not available when the X2 is running on battery power. They are only available when the X2 is running on external power, either when connected to a host monitor or the external power supply (M8023A). •...
Page 180 14 Monitoring Carbon Dioxide Measuring CO using the CO Option or M3014A Depending on the Max Hold setting configured for your monitor, the etCO numeric shows either the highest CO value measured within the configured time period (Max Hold set to 10 sec or 20 sec) or the etCO numeric shows breath-to-breath value (Max Hold set to Off).
Page 181: Measuring Co 2 Using The Co 2 Option Or M3014A
Measuring CO using the CO Option or M3014A 14 Monitoring Carbon Dioxide Choose the appropriate airway adapter and connect it to the sensor head. The airway adapter clicks into place when seated correctly. To zero the sensor: – expose the sensor to room air and keep it away from all sources of including the ventilator, the patient’s breath and your own.
Page 182 14 Monitoring Carbon Dioxide Measuring CO using the CO Option or M3014A – When you see the message Zero done at <date and time> on the status line, the zero calibration is finished and you can begin monitoring. For intubated patients requiring an airway adapter: Install the airway adapter at the proximal end of the circuit between the elbow and the ventilator Y- section.
Page 183: Measuring Mainstream Co 2 Using M3016A
Measuring Mainstream CO using M3016A 14 Monitoring Carbon Dioxide Removing Exhaust Gases from the System WARNING Anesthetics: When using the sidestream CO measurement on patients who are receiving or have recently received anesthetics, connect the outlet to a scavenging system, to avoid exposing medical staff to anesthetics.
Page 184 14 Monitoring Carbon Dioxide Measuring Mainstream CO using M3016A Enter the calibration value printed on the calstick then press to start calibration. Confirm When the message CO CAL1 done;Start CAL2 cal appears, put the transducer on the other cell and select Start CAL2 then press Confirm When you see the message CO cal done;leave Cal.
Page 185: Measuring Microstream Co
Measuring Microstream CO using M3015A 14 Monitoring Carbon Dioxide Measuring Microstream CO using M3015A The M3015A Microstream CO Extension measures the partial pressure of carbon dioxide in a patient’s expired gas using Microstream technology. The measurement is equipped with an automatic barometric pressure compensation. Preparing to Measure Microstream CO Use appropriate accessories for: •...
Page 186: Setting Up All Co 2 Measurements
14 Monitoring Carbon Dioxide Setting up all CO Measurements Disconnect the FilterLine during suctioning and nebulizing therapies. Check the table in the Microstream CO Accessories section of the Accessories chapter for typical usage times for the different Microstream accessories. values for non-intubated patients using Microstream accessories will always tend to be lower than for intubated patients.
Page 187 Setting up all CO Measurements 14 Monitoring Carbon Dioxide Correction In the Setup CO menu, select Oxy. Corr and select a value between 20% and 100%, the default value is 20%. If you are not measuring the expired O , estimate it (M3014A 5% from the inspired O only)
Page 188 14 Monitoring Carbon Dioxide Setting up all CO Measurements To change the imCO high limit: Select imCO High and choose the high alarm limit from the pop-up list that opens. ♦ Changing the Apnea Alarm Delay This determines the time limit after which the monitor alarms if the patient stops breathing. In the Setup CO menu, select awRR.
Page 189: Assigning Two Devices To One Patient
A telemetry device can be: • any Philips telemetry device (only for indirect connections, see below). • a TRx+/TRx+ Intellivue Telemetry system transceiver. • an X2 Multi-measurement module with a telemetry interface, declared as a telemetry device and with a telemetry equipment label.
Page 190 15 Assigning Two Devices to One Patient How Can You Combine Devices? Telemetry Data Window The measurements from the telemetry device are shown in the telemetry data window on the monitor when there is no direct connection via short range radio link. TELE INOP * TELE ALARM ** HR 140>120...
Page 191 How Can You Combine Devices? 15 Assigning Two Devices to One Patient • Controls on the Telemetry Device (e.g. nurse call) will be inactive when the device is directly connected to the monitor except in the case when the monitor has no network connection and data are transferred via the telemetry device.
Page 192 15 Assigning Two Devices to One Patient How Can You Combine Devices? Correct channel configuration is important, refer to the Configuration Guide for details. If a TELE DISCONNECT INOP occurs when the telemetry device goes out-of-range, the INOP will disappear (without being silenced) as soon as the ECG signal from the telemetry device is available at the Information Center via standard telemetry transmission.
Page 193: Functions Available When The Telemetry Data Window Is Displayed
Functions Available When the Telemetry Data Window is Displayed 15 Assigning Two Devices to One Patient select the Unpair To Tele SmartKey to end pairing and have the Information ♦ Center receive the measurement data from the telemetry device use the Unpair function at the Information Center. ♦...
Page 194: Functions Available For Devices Connected Via Srr
15 Assigning Two Devices to One Patient Functions Available For Devices Connected Via SRR Refer to the Information Center Instructions for Use for more details on the Suspend/Pause alarms behavior of the Information Center and telemetry device. Using Standby When you select Standby mode at the monitor, the bedside goes into Standby mode but the telemetry device will continue monitoring.
Page 195: General Telemetry-Related Functions
General Telemetry-related Functions 15 Assigning Two Devices to One Patient Setting Up Measurements The Setup ECG and Setup SpO T pop-up keys give you access to the measurement setup menus. The Measmt. Select. pop-up key takes you directly to the Measurement Selection window where all connected measurement devices are shown.
Page 196: Use Models With Telemetry
15 Assigning Two Devices to One Patient Use Models With Telemetry 1.Va and Vb leads are reset to default (V2, V5) if the configured Va or Vb lead for the telemetry device is not one of V1 through V6. 2.These setting will only be synchronized when the Information Center supports QT Analysis for Telemetry. WARNING •...
Page 197: Enhancing Telemetry Monitoring With The Monitor
Enhancing Telemetry Monitoring with the Monitor You can use a monitor without a network connection to view measurement data from a telemetry transceiver at the bedside. You can also use the monitor to make additional measurements and send this measurement data to the Information Center via the telemetry transceiver. The monitor can so be used as a mobile viewer and measurement device, and is set up to simplify the assign/unassign procedures when used with short range radio.
Page 198 16 Enhancing Telemetry Monitoring with the Monitor...
Page 199: Trends
Trends Trends are patient data collected over time and displayed in graphic or tabular form to give you a picture of how your patient’s condition is developing. Trend information is stored in the trends database for continuously-monitored measurements, such as ECG, as well as for aperiodically- measured parameters, such as Cardiac Output.
Page 200 17 Trends Viewing Trends Pop-Up Keys Selecting this pop-up key lets you..Select see a pop-up list of trend groups and select a group for viewing. Group Select see a pop-up list of available data resolution settings and select the level of detail shown in the trend view.
Page 201: Setting Up Trends
Setting Up Trends 17 Trends Place the cursor at a specific time by touching the graph. Viewing Vital Signs Trends Vital Signs: Standard etCO imCO awRR Aperiodic values are shown with a timestamp Select Scroll to view more Interval pop-up keys Print Select Graph...
Page 202 17 Trends Setting Up Trends In the expanded view, you can also highlight a measurement to make it more easily visible (for example when multiple ST trends are in one segment). To highlight a measurement, in the Segment menu, select Highlight repeatedly until the highlight is on the required ♦...
Page 203 Setting Up Trends 17 Trends Select Main Setup -> Trends -> Trend Groups Select the Trend Group you want to change and use the pop-up keys to Add, Change, or Delete the selection of measurements trended. To temporarily change the order in which the measurements are displayed in a group, Select Main Setup ->...
Page 204: Documenting Trends
17 Trends Documenting Trends Select Global Style and choose • Line to display the trends as a continuous line • Band to fill the area between the trend lines, for example, between the systolic and diastolic pressures, with color. This sample ABP trend shows the continuously- measured values for...
Page 205: Screen Trends
Screen Trends 17 Trends - 24 - 48 hours hours hours time 4 hours @12 second resolution 24 hours @ 1 minute resolution 48 hours @ 5 minute resolution Aperiodic Trends Database Aperiodic trends do not count toward the maximum number of trends allowed by the trend configuration.
Page 206 17 Trends Screen Trends SBed9 Adult ALARMS OFF Perf Arrhythmia Off Measurement Measurement numerics wave Temp Auto 15 min Sys. NBPs -60min -30min NBPs -60min -30min NBP graphical screen trend Example of other graphical screen trends: ABP SBed9 Adult ALARMS OFF Pulse Arrhythmia Off Measurement...
Page 207 Screen Trends 17 Trends Setting the Screen Trend Time To set the ScreenTrend Time for all graphical, histogram and horizon screen trends (“global” trend time), Select a screen trend then select Setup Trend, or select Main Setup -> Trends. Select ScreenTrend Time and select the required time: 30 minutes, one, two, four, eight, or twelve hours.
Page 208 17 Trends Screen Trends Sys. Horizon View The horizon view presents trend information superimposed over a defined baseline or base range. This helps you visualize changes in your patient’s condition since the baseline was set. The horizon view is made up of: •...
Page 209 Screen Trends 17 Trends Select Set Scale Delta and select a value to define the distance between the horizon and the upper and lower scale limits. Be aware that changing the horizon trend scale can change the angle of the trend indicator, without the patient’s condition having changed.
Page 210 17 Trends Screen Trends...
Page 211: Recording
Recording Central For central recording from the bedside, your monitor must be connected via a network to an Recording Information Center. You can use either the M1116B 2-Channel Recorder or the standalone M3160A 4-Channel Recorder. See the documentation supplied with the Information Center for information on the 4-Channel Recorder.
Page 212: Overview Of Recording Types
18 Recording Overview of Recording Types Overview of Recording Types Delayed Alarm Realtime (RT) Type of recording manual automatic, triggered by defined alarm manual conditions central central printer central Recording Destination from the start trigger from the start trigger from the start trigger Information minus the delay time minus the delay time...
Page 213: Recorder Status Messages
Recorder Status Messages 18 Recording – Secondary Lead will always record the current secondary lead in the chosen recorder channel • Overlap: define whether the recorded waveforms will be printed overlapping or beside each other. • Speed: choose the recording print speed. •...
Page 214 18 Recording Recorder Status Messages To Purchase, Visit Avobus.com or call 1-800-674-3655...
Page 215: Printing Patient Reports
Printing Patient Reports Starting Report Printouts Most patient reports can be printed by selecting Main Setup - > Reports (or the Reports SmartKey) and then selecting the report name in the top half of the Reports menu. Report names are shown only for reports that have been correctly set up. Data from the time of the print request is printed, even if the print job is delayed in the printer queue.
Page 216: Stopping Reports Printouts
19 Printing Patient Reports Stopping Reports Printouts Report types Report contents How to start printing reports Print Vital Signs Report depends on selected trend group, data In the Vital Signs window, select resolution, and period. Print Graphic Trends Report In the Graphic Trends window, select ECG Report ECG Reports Depends on format selected...
Page 217 Setting Up Reports 19 Printing Patient Reports Select Annotation and toggle to On if the printed ECG wave should be annotated with beat labels or not. See the chapter on ECG for a list of beat labels. Pace pulse marks are automatically printed beside the wave for paced patients.
Page 218: Setting Up Individual Print Jobs
19 Printing Patient Reports Setting Up Individual Print Jobs Setting Up Individual Print Jobs To adjust the appearance of individual print jobs, in the Reports menu, Select Main Setup -> Reports -> Setup Reports to enter the Setup Reports menu. Select Report and then select the report you want to set up.
Page 219: Dashed Lines On Reports
Dashed Lines on Reports 19 Printing Patient Reports In the Setup Printers menu, select Printer and then select the name of the device you want to switch on or off for Reports printing from the pop-up list. Select Printer Status to toggle between the settings Enabled and Disabled. If you set this to Disabled, no reports will be printed to the named printer.
Page 220: Printer Status Messages
19 Printing Patient Reports Printer Status Messages • Patient name (except for system reports such as the battery status report) • Request date and time • Report paper format • Job status: Preparing, Printing, Waiting, In Database, In Companion, Retry, Cancelling, Error Individual reports can be deleted from the list with the Delete Report key, and all reports with the Delete All Reps key.
Page 221: Sample Report Printouts
Sample Report Printouts 19 Printing Patient Reports Printer Status Message Possible causes and suggested action Printing on A report is in progress, or the monitor is waiting for the central printer to <Printer name> accept the print job. NoPrinter <Printer The chosen device is unavailable.
Page 222 19 Printing Patient Reports Sample Report Printouts Alarm Limits Report Doe, John NBed6 123456789-P1 Alarm Limits 19 Apr 07 15:59:37 ST-aVF ST-V6 ST-V1 SpO2 ST-I ST-V2 NBPs ST-II ABPs ST-V3 ST-III ST-aVR ST-V4 ST-aVL ST-V5 Apnea Time 20 sec Measurement labels, with alarms off symbol where Graphic view of current alarm limits in relation to alarms are switched off currently monitored measurement value...
Page 223 Sample Report Printouts 19 Printing Patient Reports ECG Reports Patient information Numeric block Wave area Below the header on ECG Reports, the numeric block shows the current HR, PVC, and ST values. The wave area shows the printed waves for all available ECG leads. A 1 mV calibration bar is printed at the beginning of each wave.
Page 224 19 Printing Patient Reports Sample Report Printouts...
Page 225: Care And Cleaning
Warranty does not cover damage caused by using unapproved substances or methods. Philips makes no claims regarding the efficacy of the listed chemicals or methods as a means for controlling infection. Consult your hospital’s Infection Control Officer or Epidemiologist. For comprehensive details on cleaning agents and their efficacy refer to “Guidelines for Prevention of...
Page 226: Cleaning The Monitor
20 Care and Cleaning Cleaning the Monitor Cleaning the Monitor Clean with a lint-free cloth, moistened with warm water (40°C/104°F maximum) and soap, a diluted non-caustic detergent, tenside, ammonia- or alcohol-based cleaning agent. Do not use strong solvents such as acetone or trichloroethylene. Take extra care when cleaning the screen of the monitor because it is more sensitive to rough cleaning methods than the housing.
Page 227: Cleaning, Sterilizing And Disinfecting Monitoring Accessories
Cleaning, Sterilizing and Disinfecting Monitoring Accessories 20 Care and Cleaning Cleaning, Sterilizing and Disinfecting Monitoring Accessories To clean, disinfect and sterilize reusable transducers, sensors, cables, leads, and so forth, refer to the instructions delivered with the accessory. Cleaning Batteries and the Battery Compartment Wipe with a lint-free cloth, moistened with warm water (40°C/104°F maximum) and soap.
Page 228 20 Care and Cleaning Cleaning Batteries and the Battery Compartment...
Page 229: Using Batteries
Using Batteries When monitoring a patient, one Philips M4607A rechargeable Lithium Ion battery must always be inserted into the battery compartment on the right side of the X2. This applies even when you are running the X2 external power, either via the external power supply or when connected to a host monitor.
Page 230: Battery Power Indicators
21 Using Batteries Battery Power Indicators Battery Power Indicators The battery LED and battery status information on the Main Screen, in combination with INOP messages and prompts, help you keep track of the battery power status. The indicators always show the remaining capacity in relation to the battery’s actual maximum capacity, which may lessen as the battery ages.
Page 231 Battery Power Indicators 21 Using Batteries Battery status/malfunction indicator: Normal battery function is indicated by the battery power gauge, together with the remaining operating time, on the Main Screen. You are informed of problems or changes in the status of the battery by the battery status/malfunction indicator. This consists of a blank battery gauge containing a symbol.
Page 232: Checking Battery Charge
21 Using Batteries Checking Battery Charge TimeToEmpty tells you approximately how long you can continue to use the monitor with this battery. Note that this time fluctuates depending on the system load (the display brightness and how many measurements you carry out), the age of the battery, and the remaining capacity of the battery. TimeToFull is shown in place of TimeToEmpty if the monitor is connected to mains power via a host monitor or the M8023A external power supply, and tells you how much time is left until the battery is charged to 90%.
Page 233: Replacing A Battery
Replacing a Battery 21 Using Batteries Replacing a Battery To replace the battery, Press the battery eject button. This releases the battery. Battery eject button The INOP !!INSERT BATTERY is suppressed for 15 seconds, allowing you sufficient time to load a new battery. Remove the battery from the compartment.
Page 234 21 Using Batteries Optimizing Battery Performance Note that your monitor may be configured to dim or brighten the display brightness automatically when you disconnect from power, to suit the most common transport scenario (“TransportBrightn” setting). Charging a Battery A battery can be charged in a monitor during monitoring. You can also use the M8043A Smart Battery Charger to charge batteries.
Page 235: Battery Safety Information
Battery Safety Information WARNING Use only Philips batteries part number M4607A. Use of a different battery may present a risk of fire or explosion. Do not open batteries, or dispose of them in fire, or cause them to short circuit. They may ignite, explode, leak or heat up, causing personal injury.
Page 236 21 Using Batteries Battery Safety Information...
Page 237: Maintenance And Troubleshooting
Examine all system cables, the power plug and cord for damage. Make sure that the prongs of the plug do not move in the casing. If damaged, replace it with an appropriate Philips power cord. Inspect the patient cables, leads and their strain reliefs for general condition. Make sure there are no breaks in the insulation.
Page 238: Maintenance Task And Test Schedule
Ensure that these tasks are carried out as indicated by the monitor’s maintenance schedule, or as specified by local laws. Contact a Philips-qualified service provider if your monitor needs a safety or performance test. Clean and disinfect equipment to decontaminate it before testing or maintaining it.
Page 239: Troubleshooting
You can disassemble the monitor as described in the Service Guide. You will find detailed disposal information on the following web page: http://www.medical.philips.com/main/company/sustainability/recycling/patient_monitoring/ The Recycling Passports located there contain information on the material content of the equipment, including potentially dangerous materials which must be removed before recycling (for example, batteries and parts containing mercury or magnesium).
Page 240 22 Maintenance and Troubleshooting Disposing of Empty Calibration Gas Cylinders...
Page 241: Accessories
Accessories You can order parts and accessories from Philips supplies at www.medical.philips.com or consult your local Philips representative for details. WARNING Reuse: Never reuse disposable transducers, sensors, accessories and so forth that are intended for single use, or single patient use only. Reuse may compromise device functionality and system performance and cause a potential hazard.
Page 242 23 Accessories ECG/Resp Accessories 3-Electrode Cable Sets Description Length AAMI Part No. IEC Part No. OR Grabber shielded 1.0m M1675A M1678A ICU Grabber shielded 1.0m M1671A M1672A ICU snap shielded 1.0m M1673A M1674A ICU Clip non-shielded 0.45m M1622A ICU Clip non-shielded 0.7m M1624A M1626A...
Page 243 ECG/Resp Accessories 23 Accessories One-piece Cables Description Length AAMI Part No. IEC Part No. 3-lead Grabber, ICU 1.0m 989803143181 989803143171 5-lead Grabber, ICU 1.0m 989803143201 989803143191 Radio-translucent Cables Pack of five single wires, radio-translucent, 0.9m, M1649A Set Combiners and Organizers Set combiners and organizers Part No.
Page 244 23 Accessories ECG/Resp Accessories 3-Electrode Cable Sets Description Length AAMI Part No. IEC Part No. 1.0m M1601A M1611A ICU Grabber shielded 1.0m M1603A M1613A ICU snap shielded 1.0m M1605A M1615A ICU Clip non-shielded 0.45m M1608A M1618A ICU Clip non-shielded 0.7m M1609A M1619A 5-Electrode Cable Sets...
Page 245: Nbp Accessories
NBP Accessories 23 Accessories NBP Accessories These cuffs and tubings are designed to have special protection against electric shocks (particularly regarding allowable leakage currents), and are defibrillator proof. You can use them during electrosurgery. Adult/Pediatric Multi-Patient Comfort Cuffs and Disposable Cuffs Patient Category Limb Bladder...
Page 246: Invasive Pressure Accessories
23 Accessories Invasive Pressure Accessories Adult/Pediatric Soft Single Patient Single-Hose Disposable Cuffs Patient Category Limb Circumference Bladder Part No. Tubing (cm) Width Adult (Thigh) 45 - 56.5 cm 20.4 cm M4579A M1598B (1.5m) Large Adult X-Long 35.5 - 46 cm 16.4 cm M4578A M1599B (3m)
Page 247: Spo 2 Accessories
• Masimo adapter cables, • Philips reusable sensors or adapter cables with part numbers ending in -L (indicates “Long” version). All listed sensors operate without risk of exceeding 41°C on the skin, if the initial skin temperature does not exceed 35°C.
Page 248 M1195AN Special Edition (SE) Infant sensor (1.5m cable) for patients between 4 kg and 15 kg. Any finger except thumb. Philips disposable sensors. Not available in the USA and Canada. M1904B Identical to OxiMax MAX-A Use adapter cable M1943A or...
Page 249 M1943AL together OxiCliq I See OxiMax MAX-I with OC-3 adapter OxiCliq N See OxiMax MAX-N cable. Extension / Adapter Cables for Philips and Nellcor Sensors M1941A Extension cable (2 m) For use with Philips reusable sensors and adapter cables. M1943A Adapter cable (1.1 m cable)
Page 250 23 Accessories Accessories Product Description Comments Number OC-3 Adapter Cable for OxiCliq sensors Available from Nellcor only. Product Philips Part Description Number Number ® MASIMO LNOP reusable sensors. LNOP DC-I Adult Finger Sensor (> 30 kg) 989803140321 LNOP DC-IP Pediatric Finger Sensor (10 - 50 kg)
Page 251: Temperature Accessories
Temperature Accessories 23 Accessories The Philips M3002A option A01 uses Masimo certified pulse oximetry for reduced noise and low perfusion performance with Masimo Sensors under the Masimo NR&LP protocol available from Masimo. Temperature Accessories Temperature Probes Part No. Minimum measurement time...
Page 252: Sidestream Co 2 Accessories
23 Accessories Sidestream CO Accessories Sidestream CO Accessories Description Part No. Sensor M2741A Nasal and Oral-Nasal Cannulas Nasal Cannula, Adult M2744A Nasal Cannula, Pediatric M2745A Nasal Cannula, Infant M2746A Nasal Cannula, Adult M2750A Nasal Cannula, Pediatric M2751A Nasal Cannula, Infant 989803144471 Oral-Nasal Cannula, Adult M2756A...
Page 253: Battery Accessories
Critical Care, EMS, Lab, Long-term Sleep Lab Sedation, Critical Pain Management Care, EMS, ED Philips part numbers (A = Adult, P= Pediatric, I = Infant, N = Neonate) FilterLine Set: FilterLine H Set: Smart CapnoLine CapnoLine HO CapnoLine H: Smart CapnoLine:...
Page 254 23 Accessories Battery Accessories...
Page 255: Specifications
The monitor is indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. WARNING The monitors are not intended for use in an MRI environment or in an oxygen-enriched environment (for example, hyperbaric chambers. Manufacturer’s Information You can write to Philips at this address...
Page 256: Symbols
Philips Medizin Systeme Boeblingen GmbH Hewlett-Packard-Str. 2 71034 Boeblingen Germany Visit our website at: www.philips.com. © Copyright 2002 - 2008. Koninklijke Philips Electronics N.V. All Rights Reserved. Trademark Acknowledgement ® ® The following are trademarks of Nellcor Puritan Bennett Incorporated: Nellcor...
Page 257: Installation Safety Information
Installation Safety Information 24 Specifications Symbols Masimo SET Nellcor OxiMax LAN connection technology compatible indicator for connection to a wired network Silence Alarms Alarms Alarms Off ECG connector Error LED Identifies year 2002- and month of manufacture IntelliVue Always use separate Monitor supports 12- Instrument collection for waste...
Page 258: Altitude Setting
(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 Philips Medical Systems may cause harmful radio frequency interference and void your authority to operate this equipment.
Page 259: Out-Of-Hospital Transport - Standards Compliance
Any changes or modifications to this equipment not expressly approved by Philips Medical Systems may cause harmful radio frequency interference and void your authority to operate this equipment.
Page 260 24 Specifications Out-Of-Hospital Transport - Standards Compliance – LAN, Battery can be used in a transport environment such as a road ambulance, airplane or helicopter. For this purpose the monitor fulfils the following additional mechanical, EMC and environmental requirements: • Shock Tests according to IEC TR 60721-4-7, Class 7M3. Test procedure according to IEC/EN 60068-2-27 (peak acceleration up to 100 g).
Page 261 Out-Of-Hospital Transport - Standards Compliance 24 Specifications Physical Specifications Specification Comments Maximum Weight 1.25 kg including battery, without options (2.8 lb) Size (W x H x D) 188 x 99 x 86 mm without handle and options 7.4 x 3.9 x 3.4 in M8023A External Power Supply Weight and Dimensions Maximum Weight 700 g ±10%...
Page 262: Monitor Performance Specifications
24 Specifications Monitor Performance Specifications Item Condition Range Altitude Range Operating -500 m to 3000 m (10000 ft) Storage including -500 m to 4600 m (15000 ft) transportation Ingress Protection Monitor IP32 (protected against ingress of water when the water is dripping vertically and the monitor is tilted up to 15°) External Power Supply IP31(protected against the ingress of solid foreign objects 2.5 mm...
Page 263 Monitor Performance Specifications 24 Specifications X2 (M3002A) Performance Specifications Alarm signal System delay less than 3 seconds Pause duration 1,2,3 minutes or infinite, depending on configuration Extended alarm pause 5 or 10 minutes Review Alarms Information all alarms / inops, main alarms on/off, alarm silence and time of occurrence Capacity 300 items...
Page 264 24 Specifications Monitor Performance Specifications X2 (M3002A) Interface Specifications Wireless Network Signals RD+/-, TD+/-: IEEE 802.3 10Base-T, PWR, GND Device Interface 12.5 V ±20 %, 3.5 W continuous (integrated, for Frequency Band USA: 2.400 – 2.483GHz, 5.15 ~ 5.35Ghz, 5.725 ~ 5.825Ghz compatible network Europe: 2.400 –...
Page 265: M4607A Battery Specifications
24 Specifications Compatible Devices IntelliVue Instrument Telemetry Wireless Network (USA only) Internal WMTS Adapter Technology compatible with Philips Cellular Telemetry System (CTS), cellular infrastructure Frequency Band WMTS, 1395-1400 MHz and 1427-1432 MHz IntelliVue Instrument Telemetry Wireless Network (except USA) Internal ISM Adapter...
Page 266: Measurement Specifications
24 Specifications Measurement Specifications Measurement Specifications See the Appendix on Default Settings for a list of the settings the monitor is initially shipped with. ECG/Arrhythmia/ST/QT Complies with IEC 60601-2-25:1993 + A1:1999 /EN60601-2-25:1995 + A1:1999, IEC 60601-2- 27:2005/EN60601-2-27:2006, IEC 60601-2-51:2003 /EN 60601-2-51:2003 and AAMI EC11/ EC13:1991/2002.
Page 267 Measurement Specifications 24 Specifications ECG/Arrhythmia/ST Performance Specifications Bandwidth Diagnostic Mode Adult/neo/pedi: 0.05 to 40 Hz Extended Neo/pedi: 0.5 to 40 Hz when the ECG is Monitoring Mode transmitted from a telemetry device via short Monitoring Mode Adult: 0.5 to 40 Hz range radio Neo/pedi: 0.5 to 40 Hz Filter Mode...
Page 268 24 Specifications Measurement Specifications ECG/Arrhythmia/ST Supplemental Information as required by AAMI EC11/13 Time to Alarm for Vent Tachycardia Gain 0.5, Range 6.5 to 8.4 seconds, Average 7.2 seconds Tachycardia 1 mV ,206 bpm Gain 1.0 Range 6.1 to 6.9 seconds, Average 6.5 seconds Gain 2.0, Range 5.9 to 6.7 seconds, Average 6.3 seconds Vent Tachycardia Gain 0.5, Range 5.4 to 6.2 seconds, Average 5.8 seconds...
Page 269 Measurement Specifications 24 Specifications Respiration Alarm Specifications Range Adjustment Delay High Adult/pedi: 10 to 100 rpm under 20 rpm: 1 rpm steps max. 14 seconds Neo: 30 to 150 rpm over 20 rpm: 5 rpm steps Adult/pedi: 0 to 95 rpm under 20 rpm: 1 rpm steps for limits from 0 to 20 rpm: Neo: 0 to 145 rpm...
Page 270 M1191T, M1192T, M1193T (Adult), M1196T = 3% (70% to 100%) M1193T (Neonate) = 4% (70% to 100%) Philips Disposable Sensors with M1943A(L): M1132A, M1133A (adult/infant) = 2% M1901B, M1902B, M1903B, M1904B, M1131A, M1133A (neonate) = 3% (70% to 100%) ®...
Page 271 Measurement Specifications 24 Specifications Alarm Specifications Range Adjustment Delay Adult: 50 to 100% 1% steps (0, 1, 2, 3,... 30) Pedi/Neo: 30 to 100% +4 seconds Desat Adult: 50 to Low alarm limit 1% steps Pedi/Neo: 30 to Low alarm limit Pulse 30 to 300 bpm Adult:...
Page 272 24 Specifications Measurement Specifications NBP Performance Specifications Cuff Inflation Time Typical for normal adult cuff: Less than 10 seconds Typical for neonatal cuff: Less than 2 seconds Initial Cuff Inflation Pressure Adult: 165 ±15 mmHg Pedi: 130 ±15 mmHg Neo: 100 ±15 mmHg Auto Mode Repetition Times 1, 2, 2.5, 3, 5, 10, 15, 20, 30, 45, 60 or 120 minutes STAT Mode Cycle Time...
Page 273 Measurement Specifications 24 Specifications Invasive Pressure and Pulse Complies with IEC 60601-2-34:2000/EN60601-2-34:2000. Invasive Pressure Performance Specifications Measurement Range –40 to 360 mmHg Pulse Rate Range 25 to 350 bpm Accuracy ±1% Full Range Resolution 1 bpm Input Sensitivity Sensitivity:5 µV/V/mmHg (37.5 µV/V/kPa) Adjustment range:±10% Load Impedance:200 to 2000 Ω...
Page 274 24 Specifications Measurement Specifications Invasive Pressure Alarm Specifications Range Adjustment Delay Tachycardia Difference to high limit 0 to 5 bpm steps max. 50 bpm 14 seconds Clamping at 150 to 5 bpm steps 300 bpm Bradycardia Difference to low limit 0 to 5 bpm steps max.
Page 275 Measurement Specifications 24 Specifications M3015A Microstream CO Performance Specifications Rise Time 190 ms for neonatal mode (measured with FilterLine H for neonatal) 240 ms for adult mode (measured with FilterLine H for adult) Sample Flow Rate 50 + 15/-7.5 ml/minute Gas Sampling Delay Time Maximum: 3 seconds (2m sample lines)
Page 276 24 Specifications Measurement Specifications M3014A Sidestream CO Performance Specifications Warm-up Time 2 minutes with CO sensor attached for full accuracy specification Sample Flow Rate 50 ±10 ml/minute Total System Response Time 3 seconds Operating Temperature 0 to 40°C (32 to 100°F) M3002A/M3014A Mainstream and Sidestream CO Humidity Correction Factor Either BTPS or ATPD can be selected as the humidity correction factor for the CO...
Page 277 Measurement Specifications 24 Specifications Alarm Specifications Range Adjustment Delay etCO High 20 to 95 mmHg (2 to 13 kPa) 1 mmHg (0.1 kPa) M8102A/M3014A/M3016A: less than 14 seconds etCO 10 to 90 mHg (1 to 12 kPa) M3015A: less than18 seconds. imCO High 2 to 20 mmHg...
Page 278: Safety And Performance Tests
1 Vrms for conducted disturbances induced by RF fields. Electromagnetic fields with field strengths above 1 V/m and conducted disturbances above 1 Vrms may cause erroneous measurements. Therefore Philips recommends that you avoid using electrically radiating equipment in the close proximity of this measurement.
Page 279 Safety and Performance Tests 24 Specifications WARNING The monitor should not be used next to or stacked with other equipment. If you must stack the monitor, you must check that normal operation is possible in the necessary configuration before you start monitoring patients.
Page 280 24 Specifications Safety and Performance Tests Portable and mobile RF communications equipment should be used no closer to any part of the monitor, including cables, than the recommended separation distance calculated from the equation appropriate for the frequency of the transmitter. Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey, should be less than the compliance level in each frequency range.
Page 281 Safety and Performance Tests 24 Specifications Recommended separation distances from portable and mobile RF communication equipment The monitor is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or user of the monitor can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment and the monitor as recommended below, according to the maximum output power of the communications equipment.
Page 282 24 Specifications Safety and Performance Tests...
Page 283: Default Settings Appendix
Default Settings Appendix This appendix documents the most important default settings of your monitor as it is delivered from the factory. For a comprehensive list and explanation of default settings, see the Configuration Guide supplied with your monitor. The monitor’s default settings can be permanently changed in Configuration Mode.
Page 284 25 Default Settings Appendix Country-Specific Default Settings Belize AAMI Benin AAMI Bermuda AAMI Bhutan AAMI Bolivia AAMI Bosnia and Herzegovina Botswana Bouvet Island AAMI Brazil AAMI British Indian Ocean Territory AAMI Brunei Darussalam AAMI Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada AAMI...
Page 285 Country-Specific Default Settings 25 Default Settings Appendix Finland France French Guiana French Polynesia AAMI French Southern Territories AAMI Gabon Gambia, The Georgia AAMI Germany Ghana Gibraltar AAMI Greece Greenland AAMI Grenada AAMI Guadeloupe Guam AAMI Guatemala AAMI Guernsey Guinea AAMI Guinea-Bissau AAMI Guyana...
Page 286 25 Default Settings Appendix Country-Specific Default Settings Liberia Libyan Arab. Jamahiriya AAMI Liechtenstein AAMI Lithuania Luxembourg Macao AAMI Macedonia, The former Yugoslavian Republic of Madagascar Malawi Malaysia Maldives AAMI Mali Malta Marshall Islands AAMI Martinique Mauritania Mauritius AAMI Mayotte AAMI Mexico AAMI Micronesia, Federal States of...
Page 287 Country-Specific Default Settings 25 Default Settings Appendix Philippines AAMI Pitcairn AAMI Poland Portugal Puerto Rico AAMI Qatar AAMI Reunion AAMI Romania Russian Federation Rwanda Saint Helena AAMI Saint Kitts and Nevis AAMI Saint Lucia AAMI Saint Pierre and Miquelon AAMI Saint Vincent and the Grenadines AAMI Samoa...
Page 288 25 Default Settings Appendix Country-Specific Default Settings Turkey Turkmenistan AAMI Turks and Caicos Islands AAMI Tuvalu AAMI Uganda AAMI Ukraine AAMI United Arab Emirates AAMI United Kingdom United States AAMI United States Minor Outlying Islands AAMI Uruguay AAMI Uzbekistan AAMI Vanuatu AAMI Venezuela...
Page 289: Alarm And Measurement Default Settings
Alarm and Measurement Default Settings 25 Default Settings Appendix Alarm and Measurement Default Settings Settings are only entered once per table row if they are the same for all patient categories Alarm Default Settings Alarm Settings Factory Default Alarm Volume Alarms Off 2 min.
Page 290: Ecg, Arrhythmia, St And Qt Default Settings
25 Default Settings Appendix ECG, Arrhythmia, ST and QT Default Settings ECG, Arrhythmia, ST and QT Default Settings Factory Defaults ECG Settings Adult Pedi High Limit 120 bpm 160 bpm 200 bpm Low Limit 50 bpm 75 bpm 100 bpm Alarms Alarm Source Auto...
Page 291 ECG, Arrhythmia, ST and QT Default Settings 25 Default Settings Appendix Factory Defaults Arrhythmia Settings Adult Pedi Vent Rhythm SVT HR SVT Run PVCs/min Non-Sustain Vent Rhythm Run PVCs Pair PVCs R-On-T PVCs V.Bigeminy V.Trigeminy PVCs/min Multif. PVCs Pacer N. Cap Pacer N.
Page 292 25 Default Settings Appendix ECG, Arrhythmia, ST and QT Default Settings Factory Defaults Lead-independent ST Settings Adult Pedi ST Alarm Mode Single ST Alarms ST Analysis ST-Index ISO Point -80 ms J Point 48 ms ST Point J+60 Factory Defaults Lead I, II, III, V, aVR, aVL, aVF, V1-6, MCL Settings Factory Adult...
Page 293: Pulse Default Settings
Pulse Default Settings 25 Default Settings Appendix Pulse Default Settings Factory Defaults Pulse Settings Adult Pedi Alarms Source Auto Pulse (Label) System Pulse Alarms Off Enabled Alarm Source Sel. Enabled Factory Defaults Pulse Alarm Settings Adult Pedi Pulse (SpO2) Pulse Alarms High Limit 120 bpm 160 bpm...
Page 294: Spo 2 Default Settings
25 Default Settings Appendix Default Settings Default Settings Factory Defaults Settings Adult Pedi Alarms QRS Volume Tone Modulation Tone Mod. Type Enhanced Speed 25 mm/s Perfusion Average 10 sec NBP Alarm Suppr. Extd. Auto OnOff Disabled Color light blue (cyan) Alarm Default Settings Setting Adult...
Page 295: Nbp Default Settings
NBP Default Settings 25 Default Settings Appendix NBP Default Settings Factory Defaults NBP Settings Adult Pedi Mode Auto Manual Alarms from Sys. High Alarm Limit 160/90 (110) 120/70 (90) 90/60 (70) Low Alarm Limit 90/50 (60) 70/40 (50) 40/20 (24) Alarms Repetition Time 10 min...
Page 296 25 Default Settings Appendix Invasive Pressure Default Settings Factory Defaults ABP, ART, Ao, BAP, FAP, P, P1, P2, P3, P4, UAP Settings Adult Pedi ΔExtreme High ΔExtreme Low High Clamp 190/100 (125) 140/80 (100) 105/75 (75) Low Clamp 80/45 (65) 60/35 (45) 45/15 (30) Scale...
Page 297 Invasive Pressure Default Settings 25 Default Settings Appendix Factory Defaults PAP Settings Adult Pedi Alarms from Dia. High Limit 34/16 (20) 60/4 (26) 60/4 (26) Low Limit 10/0 (0) 24/-4 (12) 24/-4 (12) Alarms Extreme Alarms Enabled Enabled Enabled ΔExtreme High ΔExtreme Low High Clamp 45/20 (25)
Page 298: Cardiac Output Default Settings
25 Default Settings Appendix Cardiac Output Default Settings Cardiac Output Default Settings Factory Defaults C.O. Settings Adult Pedi Auto-Calibration Tblood High Limit 39.0 ºC Tblood Low Limit 36.0 ºC Tblood Alarm On/Off °C Temperature Unit Color Green CCO/CCI Settings Factory Adult Factory Pedi Factory Neo Settings common to CCO and CCI...
Page 299 Default Settings 25 Default Settings Appendix Factory Defaults Settings Adult Pedi Max Hold AwRR AwRR Alarms AwRR high limit AwRR low limit Apnea time 20 secs Color Yellow...
Page 300 25 Default Settings Appendix Default Settings...
Page 301 Nellcor adhesive sensors intermittent bundle branch block desat, SpO2 (disposable) learning during ventricular rhythm effect on pressure alarms during Philips sensors (disposable) levels of analysis zero Philips sensors (reusable) monitoring non-paced patients extending pause time temperature monitoring paced patients...
Page 302 all yellow on/off safety information checking paced status chaining severe INOP checklist latching status indicator delivery multiple symbol installation pvc-related alarms time to empty cleaning sinus and SV rhythm ranges time to full infection control switching on/off battery eject symbol method timeout periods battery performance...
Page 303 current view end case reports ST map accessories setup alarms off (Config Mode) enhanced arrhythmia option changing lead sets exclamation mark symbol choosing electrode sites damage exhaust gases, removing conventional 12-lead mechanical extension cable for SpO2 external pacing electrodes damage claims external pacing electrodes filter settings date, setting...
Page 304 alarms, behavior measurement server ECG connector latching arrhythmia alarms measurement settings IMV (Resp) lateral chest expansion (neonates) monitoring Resp measurement setup menu indicators battery malfunction lead fallback measurements battery status and arrhythmia relearning setting up switching on and off infection control lead fallback (ECG) cleaning mechanical damage...
Page 305 Philips contact information service swapping setting block physiological alarms operating room ECG cable prompts pleth alarm source orange ECG cable pulse pleth wave...
Page 306 pulse numerics for SpO2 realtime report screen re-routing adjusting brightness PVC-related alarms scheduled screen trend setting up trend time ST map screen trends QRS tone stopping printouts screens changing volume re-routing reports changing content QRS tone pitch, SpO2 resolution switching QRS volume, changing trends understanding...
Page 307 FAST technology status messages (arrhythmia) using Nellcor adhesive sensors ectopic (disposable) transducer rhythm perfusion indicator CO2, accuracy Philips sensors (disposable) sterilizing CO2, calibrating Philips sensors (reusable) infection control pressure, zeroing pleth as alarm source stopping reports printouts transferring centrally-monitored pleth wave...
Page 308 visitor screen vislatching (arrhythmia alarms) vital signs report voltage setting volume alarm warnings wave adjusting changing speed scale (CO2) scale (pressure) size (CO2) size (pressure) wave channel speed wave group speed wave size Resp wave size (ECG) changing wave speed eeg speed wave speed global speed...

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