CNAP MONITOR 500 HD Quick Manual

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CNAP® MONITOR 500 “HD“

QUICK GUIDE

Version 07/2016 | V1.5.5 ENThis Quick Guide DOES NOT REPLACE the user manual!

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SET UP

MEASUREMENT

FAQs

CONTENT

NAVIGATION

FUNCTIONS:

FAST ACCESS

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Hemodynamic Parameters...................................................................................5

Measurement Select Measurement Mode / Start Measurement...................16

Started Measurement: Perfusion Index / Signal Quality.........17

Choose Patient Category / Enter Biometric Data....................18

Stop / Resume Measurement...................................................19

Set Up Checklist for fast Set Up.............................................................6

Power Up CNAP® Monitor.......................................................... 7

Prepare CNAP

Monitor for Measurement - Components................8

Prepare CNAP

Monitor for Measurement - Connections...................9

Connecting to a Patient Monitor.............................................10

Zeroing of CNAP® and patient monitor...................................11

Overview CNAP® Monitor Patient Set Up ...............................12

Choose correct CNAP

finger sensor size.................................13

Place CNAP

finger sensor and CNAP® Controller...................14

Place NBP Cuff ..........................................................................15

Navigation Navigation Frames....................................................................20

Function of Navigation Frames................................................21

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CONTENT

Main Keys and Status Indicators.............................................23

The “SETUP“ Key......................................................................25

Calibration Modes: Function / Benefits.................................. 26

Triggering A Manual NBP - Fast Access...................................27

When is it recommended to trigger a manual NBP?.............28

“Change Finger“ manually......................................................29

Functions Fast Access

FAQs: 1. How can I change alarm settings for current measurement?......31

2. How can I change alarm settings permanently?...........................32

3. Enabling hemodynamic parameters for a measurement?...........33

4. How can I improve measurement quality?....................................34

5. How can I adjust trend, signal and time settings?........................35

6. The battery?....................................................................................36

7. Service intervals for the CNAP® Monitor? ....................................37

8. What to do if CNAP® needs service ?............................................38

9. SERVICE HOTLINE ?.........................................................................39

10. Where can I get additional information?......................................40

11. How can I contact CNSystems directly? .........................................41

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HEMODYNAMIC PARAMETERS

CNAP® Monitor Measurement Type

BP BP + PPV BP + HD

CNAP

continuous noninvasive arterial pressure, sys, dia, mean

x x x

NBP

noninvasive oscillometric blood pressure sys, dia

x x x

Pulse

pulse rate

x x x

PPV

pulse pressure variation

x x

SVV

stroke volume variation

continuous noninvasive cardiac output

cardiac index

stroke volume

SVI

stroke volume index

SVR

systemic vascular resistance

SVRI

systemic vascular resistance index

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SET UP CHECKLIST

SET UP

CHECKLIST

STEP 1

STEP 3

STEP 4

STEP 5

STEP 6

STEP 7

STEP 2

Start the device and connect the CNAP® Controller Cable (orange connectors)

to CNAP® Monitor and CNAP® Controller (see also p.7,9)

Select the right NBP cuff size for the patient using the indicator on the inside of the NBP cuff and connect the black hose to the CNAP® Monitor. (see p.15)

Fit the NBP cuff on the patient‘s upper arm. The NBP cuff can be placed ipsilaterally or contralaterally to the CNAP® finger sensor. (see p.15)

Use the indicator on the CNAP

Controller to find the correct CNAP® finger

sensor size for the patient. (see p. 13) Slide the finger sensor over two neighbouring fingers, and fix the CNAP

Controller on the forearm using the Velcro fixation cuff. (see p. 14) Be sure that the CNAP

Controller is in the center of the forearm cuff so

that the patient can freely bend his / her wrist. (see p.14)

Start measurement by clicking “Start New Measurement“. Choose patient category “Adult“ or “Pediatric“. (see p.16, 18)

During CNAP ® initialisation the patient needs to be in a stable position. During general anesthesia start CNAP ® before or after the induction phase!

ATTENTION

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Press POWER ON / OFF button

When alarm sounds, confirm by pressing the yellow alarm button.

POWER UP CNAP® MONITOR

SET UP

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PREPARE CNAP® MONITOR FOR MEASUREMENT

SET UP

COMPONENTS

CNAP® Monitor

CNAP

Controller

CNAP

Finger sensor

NBP Cuff

NBP Air hose

CNAP

Controller Cable

2 4

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PREPARE CNAP

MONITOR FOR MEASUREMENT

SET UP

CONNECTIONS

Connect the controller cable to the orange connector of the CNAP ® Controller.

Connect finger sensor to black

connection of

CNAP ® Controller.

Connect NBP air

hose to NBP Cuff

Connect the

NBP air hose and the CNAP ® Controller cable to the CNAP ®

Monitor.

Plug in straight, not tilted!

ATTENTION

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CONNECTING TO A PATIENT MONITOR

SET UP

Connect Transducer cable and patient monitor interface cable.

Prepare patient

Interface cable

Transducer Cable

Select right color from list in user manual (Chapter 4-5-2) and connect it to the BP wave out port on the CNAP ® Monitor.

connect to

Zeroing neccessary! (see next page)

ATTENTION

BP Wave Out port

monitor Interface Cable and connect it to the arterial port of your patient monitor.

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ZEROING OF CNAP® AND PATIENT MONITOR

Go to parameter frame on CNAP ® Monitor: *click*

*click*

1 2

Select IBP: Zeroing Start - *click*

*click*

Stop Zeroing on CNAP ®:

Select IBP: Zeroing Stop

- *click*

then zero transducer on patient monitor

CNAP ® Zeroing is automatically active when the CNAP

Monitor is on and connected to the patient monitor but no measurement has been started so far.

TIP

SET UP

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OVERVIEW: PATIENT SET UP

NBP Cuff

CNAP® Controller

Connections

CNAP® Finger sensor

SET UP

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STEP 1. CHOOSE CORRECT CNAP

FINGER SENSOR SIZE

AVAILABLE SIZES: small, medium or large

Put proximal phalanx of index finger on indicator

of CNAP ® Controller align with the grey line on the left.

Choose the sensor

size indicated on the shortest bar which is still visible.

Always choose the larger sensor if you are in doubt about the size!

ATTENTION

SET UP

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STEP 2. PLACE CNAP® FINGER SENSOR AND CNAP® CONTROLLER

SET UP

Make sure that the CNAP ® Controller is placed in central position of the slide and fix the strap.

Slide the finger sensor over two neighbouring fingers, make sure that it is not placed on the finger joints!

ATTENTION

slide back fully!

12 hours before lifetime expiration of the finger sensor a message appears. It automatically disappears and does not affect measurements.

Please make sure to contact your local distributor in time for a new sensor.

NOTE

See also:

Operators Manual – chapter 16.1

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STEP 3. PLACE NBP CUFF

SET UP

Fasten NBP cuff on the upper arm (ipsilaterally or contralaterally to arm with fingersensor).

Align marker (white arrow) with the brachial artery in the crook of

the arm.

Choose the right NBP cuff from 4 different sizes

by using the size indicator on the inside of the cuff.

See also:

Operators Manual –

chapters 3.2.3 and 10.

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Once the patient set up is completed, select the measurement mode in the pop-up menu from three options:

> BP only > BP + PPV > BP + HD (full hemodynamics)

BP + PPV and BP + HD must be enabled to be selectable. Contact your distributor for a licence key if you cannot select these options.

NOTE

SELECT MEASUREMENT MODE / START MEASUREMENT

MEASUREMENT

Confirm by clicking the wheel.

*click*

2 3

To start the measurement, select “Start New Measurement“ and confirm with the click wheel.

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If perfusion is poor (=red), try pushing the finger sensor to the back of the finger, warming the hand (use exam glove or towel), changing finger sensor size, or changing hands.

TIP

MEASUREMENT

STARTED MEASUREMENT

no signal good perfusion

Once measurement has started, finger sensor checks perfusion index (PI):

At the same time menu window opens for choosing patient category and for entering biometric data (see next page). Calibration to NBP reference value also takes place.

•

Keep patient still, do not move hand!

•

No changes in body posture!

ATTENTION

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Choose patient category (Adult or Pediatric) in the pop-up menu and enter biometric patient data (for full hemodynamics).

This is important as alarm ranges and NBP

NOTE

inflation pressure are different!

CHOOSE PATIENT CATEGORY AND ENTER BIOMETRIC DATA

MEASUREMENT

Confirm with “ok“ by clicking the wheel.

Calculation of hemodynamic parameters starts; display after a few seconds.

*click*

2 3

Before starting any interventions, make sure

ATTENTION

that the calibration has been completed: numerical values should not have gray background anymore!

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STOP / RESUME MEASUREMENT

Press the Start/Stop Button to STOP measurement (e.g. when finished or to readjust set-up).

RESUME a measurement with the Start/Stop Button (e.g. after readjusting set-up, patient transfer, etc.) Patient data remain displayed!

Do not remove the CNAP

finger sensor when measurement is still in progress! STOP MEASUREMENT FIRST!

ATTENTION

MEASUREMENT

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NAVIGATION FRAMES

Alarm frame

Signal and Trend View selector frame

Hemodynamic frame

Signal & Trend

frame

Parameter frame (= default)

clickwheel

*turn*

*click*

The monitor has a clickwheel and 5 different “frames“ on the screen to access all menus / functions.

NAVIGATION

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FUNCTION OF NAVIGATION FRAMES

> manual NBP triggering > manual finger change > finger change interval setting > alarm settings > zeroing of IBP port > NBP measurement type

> intervention setting > change of trend view

(graphic numeric)

> scaling of trend curve > selection of trending

parameters (up to 2 additional)

> change of time range

> display of alarm and

status messages

> direct access to alarm

settings as long as alarm message is visible

> display of battery status,

date, next finger change, next NBP measurement

Signal & Trend frameParameter frame Alarm & Status frame

This is the default frame!

NAVIGATION

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FUNCTION OF NAVIGATION FRAMES

NAVIGATION

> switch between signal

view and parameter trends

Hemodynamic frameSignal & Trend View Selector

> activating/ deactivating HD > manual entry or change of

patient data

> discharging of patient (data of

current measurement are deleted for measurement with new patient)

> changes between absolute

and indexed values

> manual entry of external

CO value for calibration

> selection Fluid Parameter

PPV or SVV

> manual entry of CVP

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SETUP:

access to configuration menu

MAIN KEYS FOR FAST ACCESS

FAST ACCESS KEYS and STATUS INDICATORS

POWER ON / OFF:

hold for 2 seconds to power on/off.

MAIN SCREEN:

return to main screen from any submenu

power “on“ indicator:

green: switched on

orange: system error

FUNCTIONS

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MAIN KEYS FOR FAST ACCESS

PRINTING START/ STOP:

press once: print blood

pressure curve

press and hold for one

second: print trend view

START/ STOP:

stop and resume

measurement

ALARM PAUSE/ OFF:

alarm functions control:

Press once: alarm

acknowledgement

Press twice: set alarm

to pause / off

Press three times:

re-activate alarm function

Battery charge status:

green = ok

orange = less than 25%

red = l

ess than15 minutes

left!

FUNCTIONS

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THE “SET UP“ KEY

For service purposes only!

3. Service Settings

> NBP Mode: select calibration mode (see next page) > NBP Interval > CNAP Calibr. Interval > Hemodynamic (on/off, change settings) > Display Options: Interventions, Views, Scales,etc. > Trend Parameters: select parameters to be displayed in the trend view > Print options > Parameter averaging > Patient category

2. Measurement Settings

> Change Language / Time / Date > En-/ disable device features:

PPV, HD, Record, Analog Out, enter licence keys, etc.

> Recording on/off (if activated) > Switch between Metric / US customary units > Access PPU measurement statistics

1. Monitor Settings

FUNCTIONS

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CALIBRATION MODES

AUTOMATIC NBP CALIBRATION: “INTERNAL“ (= DEFAULT)

Calibration to automatic NBP measurements triggered by the integrated NBP module in adjustable intervals between 5-60 minutes. Can be stopped any time by pressing Start/Stop Button.

This is the default mode delivering absolute values automatically as long as no other blood pressure reference value (NBP or IBP) is entered manually (see also: external calibration mode).

MANUAL BP CALIBRATION: “EXTERNAL“

Calibration to a manually entered NBP , IBP or height offset reference value from external devices.

CNAP® can be operated without internal NBP measurement calibrating to a manually entered value for absolute BP information. Useful for special applications.

TRENDING MODE: “EMPIRIC CALIBATION“

Automatic calibration to a heart level value based on an emipric database for bridging the short time until CNAP® is calibrated to a measured or externally entered NBP value.

Blood pressure curve is displayed only 10 secs after start-up for a quick trending prior to calibration to the directly measured reference value.

FunctionFunctionFunction

Benefit

BenefitBenefit

FUNCTIONS

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TRIGGERING A MANUAL NBP

Go to parameter frame:

*click*

Choose NBP: Start - *click*

Triggering a manual NBP is possible at ANY TIME in any mode!

NOTE

*click*

FUNCTIONS

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WHEN IS IT RECOMMENDED TO TRIGGER A MANUAL NBP ?

After an intervention or whenever you feel that an update to the NBP reading may be beneficial.

2. In situations that quickly require updated calibration

Trigger a manual NBP after moving or repositioning the patient or the patient‘s hand or whenever hydrostratic change/ offset happens.

1. Upon hand movement or patient repositioning

ATTENTION

FUNCTIONS

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“CHANGE FINGER“ MANUALLY

Go to parameter frame:

*click*

Choose CNAP: Change Finger - *click*

Switching a measurement to the other finger is possible at ANY TIME except during a NBP measurement!

NOTE

*click*

FAST ACCESS: Parameter frame

is the default frame. If not changed, just click wheel 2

times to change finger!

TIP

FUNCTIONS

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FREQUENTLY ASKED QUESTIONS