Dräger Infinity Instruction Manual

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Page 1

Instructions for use

Infinity Acute Care System

WARNING

To properly use this medical device, read and comply with these instructions for use.

Monitoring Applications Software VG6.n

Page 2

Typographical conventions

1 Consecutive numbers indicate steps of action,

with the numbering restarting with “1” for each new sequence of actions.

 Bullet points indicate individual actions or diffe-

rent options for action.

– Dashes indicate the listing of data, options, or

objects.

(A) Letters in parentheses refer to elements in the

related figure.

A Letters in figures denote elements referred to in

the text.

> The greater-than symbol indicates the navigati-

on path in a dialog.

Bold, italicized text indicates labels on the device and texts that are displayed on the screen.

Figures

Images of products and screen content in this document may differ from the actual products depending on configuration and design.

2 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 3

Trademarks

– Babylog®

– DrägerService

–Evita

– Hemo4®

– Hemo2®

– Infinity

– Innovian

–MCable

– Medical Cockpit®MPod

– PatientWatch®

–TruST

– Monolead

–Perseus®

– Apollo

–Zeus®

– Primus

are trademarks of Dräger.

–Masimo®

– SET

(Signal Extraction Technology)

–Masimo® rainbow® SET®

– PVI

–SpCO

–SpHb

–SpMet

–SpOC

– Pulse CO-Oximeter Signal Extraction

– M-LNCS

are trademarks of Masimo Corporation.

– CapnoLine

– Capnostream

– FilterLine

– Microcap

–MicroPod

–Microstream

– Oridion

–VitalCap

are trademarks of Oridion Medical 1987 Ltd.

– Edwards

– Vigilance

– Vigileo

– EV1000

are trademarks of Edwards Lifesciences, LLC.

– Smart CapnoLineTM Guardian

–BIS VISTA

– Medtronic

– Nellcor

– OxiMax®

– SatSeconds

are trademarks of a Medtronic company

– Dismozon

pur

is a trademark of BODE Chemie GmbH.

– Buraton

– Mikrozid

– perform

are trademarks of Schülke & Mayr.

–Actichlor

– OxyCide

is a trademark of Ecolab USA.

– BruTab 6S

is a trademark of Brulin.

– Descogen

is a trademark of Antiseptica.

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 3

Page 4

–Klorsept

is a trademark of Medentech.

– Virkon

is a trademark of DuPont.

– SERVO-i

is a trademark of Maquet, Inc.

– TOFSCAN

is a trademark of IDMed.

–TOF-Watch

is a trademark of Merck & Co, Inc.

– Internet Explorer

–Microsoft Edge

are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries.

– Citrix Receiver

–Citrix XenApp

are trademarks of Citrix Systems, Inc. and/or one or more of its subsidiaries, and may be registered in the United States Patent and Trademark Office and in other countries.

All devices referenced in these instructions for use may not be approved for sale in all countries. Please check with your local Dräger representative.

Microstream® MicroPod® External Capnography Module patents

The capnography component of this product is covered by one or more of the following US patents: 6,437,316; 6,428,483; 6,997,880; 7,488,229; 8,414,488; 8,412,655 and their foreign equivalents. Additional patent applications pending.

Open-source software

Dräger devices that use software may use opensource software, depending on their setup. Opensource software may be subject to different terms of license. Additional information regarding the opensource software used in this device is available at the following web page:

www.draeger.com/opensource

4 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 5

Safety information definitions

WARNING A WARNING statement provides important in-

formation about a potentially hazardous situation which, if not avoided, could result in death or serious injury.

CAUTION

A CAUTION statement provides important information about a potentially hazardous situation which, if not avoided, may result in minor or moderate injury to the user or patient or in damage to the medical device or other property.

NOTE

A NOTE provides additional information intended to avoid inconvenience during operation.

Abbreviations and symbols

For explanations, refer to sections "Abbreviations" and "Device symbols" in chapter "System overview".

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 5

Page 6

Definition of target groups

Target groups for this product include users, service personnel, and experts.

These target groups must have received instruction in the use of the product and must have the necessary training and knowledge to use, install, reprocess, maintain, or repair the product.

The product must be used, installed, reprocessed, maintained, or repaired exclusively by defined target groups.

Users

Users are persons who use the product in accordance with its intended use.

Service personnel

Service personnel are persons who are responsible for the maintenance of the product. Service personnel must be trained in the maintenance of medical devices and install, reprocess, and maintain the product.

Experts

Experts are persons who perform repair or complex maintenance work on the product. Experts must have the necessary knowledge and experience with complex maintenance work on the product.

6 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 7

Contents

Open-source software . . . . . . . . . . . . . . . . . . . 4

Definition of target groups . . . . . . . . . . . . . . . . 6

For your safety and that of your patients. . . 13

General safety information . . . . . . . . . . . . . . . . 18

Application . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Intended use. . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Indications for use . . . . . . . . . . . . . . . . . . . . . . 24

System overview . . . . . . . . . . . . . . . . . . . . . . 25

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Infinity Medical Cockpit. . . . . . . . . . . . . . . . . . . 26

Infinity PS250 power supply unit (PS250) . . . . 27

Infinity P2500 power supply unit (P2500) . . . . . 27

Infinity M540 patient monitor (M540) . . . . . . . . 28

Infinity M500 docking station (M500) . . . . . . . . 28

Additional hardware . . . . . . . . . . . . . . . . . . . . . 29

Device symbols . . . . . . . . . . . . . . . . . . . . . . . . 32

Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Operating concept . . . . . . . . . . . . . . . . . . . . . 43

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

The IACS components . . . . . . . . . . . . . . . . . . . 45

M540 and Cockpit communication . . . . . . . . . . 46

Communicating with the Infinity network . . . . . 48

Remote control and remote view . . . . . . . . . . . 51

Communication management. . . . . . . . . . . . . . 54

Loss of power . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Locked options . . . . . . . . . . . . . . . . . . . . . . . . . 57

Secondary display . . . . . . . . . . . . . . . . . . . . . . 58

Export protocol . . . . . . . . . . . . . . . . . . . . . . . . . 58

User interface . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Header bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Monitoring area. . . . . . . . . . . . . . . . . . . . . . . . . 61

Supported messages . . . . . . . . . . . . . . . . . . . . 63

Main menu bar and quick access toolbar . . . . . 65

Filtering the parameter content. . . . . . . . . . . . . 67

Auto and manual display modes . . . . . . . . . . . 67

Auto view setup toolbar . . . . . . . . . . . . . . . . . . 68

Customizing the display . . . . . . . . . . . . . . . . . . 68

Parameter priority . . . . . . . . . . . . . . . . . . . . . . 73

Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Profiles/status . . . . . . . . . . . . . . . . . . . . . . . . . 75

Managing profiles and views . . . . . . . . . . . . . . 86

Standby mode . . . . . . . . . . . . . . . . . . . . . . . . . 87

Privacy mode. . . . . . . . . . . . . . . . . . . . . . . . . . 88

Screen lock . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Assembly and preparation . . . . . . . . . . . . . . 91

Assembly overview . . . . . . . . . . . . . . . . . . . . . 92

Docking/undocking the M540 . . . . . . . . . . . . . 93

Locking/unlocking the M540 . . . . . . . . . . . . . . 94

Additional M540 accessories. . . . . . . . . . . . . . 95

Connecting the system cables . . . . . . . . . . . . 95

Mounting the Infinity MCable – Masimo SET/Masimo rainbow SET/ Nellcor OxiMax . . 97

Getting started. . . . . . . . . . . . . . . . . . . . . . . . 99

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Turning the IACS on/off . . . . . . . . . . . . . . . . . . 100

Viewing demographic data . . . . . . . . . . . . . . . 101

Admitting a patient. . . . . . . . . . . . . . . . . . . . . . 102

Discharging a patient. . . . . . . . . . . . . . . . . . . . 103

Patient categories . . . . . . . . . . . . . . . . . . . . . . 104

Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

Overview of alarms . . . . . . . . . . . . . . . . . . . . . 108

Alarm priorities . . . . . . . . . . . . . . . . . . . . . . . . 109

Alarm processing. . . . . . . . . . . . . . . . . . . . . . . 109

Activating or deactivating alarm validation . . . 111

Optical alarm signals . . . . . . . . . . . . . . . . . . . . 112

Acoustic alarm signals. . . . . . . . . . . . . . . . . . . 114

Testing optical and acoustic alarm signals . . . 116

Viewing current alarm messages . . . . . . . . . . 116

Special alarm behavior . . . . . . . . . . . . . . . . . . 117

Pre-silencing alarms . . . . . . . . . . . . . . . . . . . . 120

Pausing acoustic alarm signals (audio pause) 121 Activating or deactivating acoustic alarm

signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

Pausing alarm monitoring temporarily . . . . . . . 123

Activating or deactivating alarm monitoring . . 124 Configuring the alarm settings for a patient. . . 125 Configuring the alarm setup for an individual

parameter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127

Configuring the alarm setup for multiple

parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 7

Page 8

Contents

Configuring the alarm message behavior. . . . . 131

Configuring the arrhythmia alarm setup . . . . . . 134

Alarm setup for ST . . . . . . . . . . . . . . . . . . . . . 135

Auto setting all alarm limits. . . . . . . . . . . . . . . .138

Alarm history and stored events. . . . . . . . . . . . 139

Viewing a snapshot of a single event . . . . . . . . 141

Viewing current alarms. . . . . . . . . . . . . . . . . . . 142

Configuring alarm settings temporarily. . . . . . . 142

Configuring the SpO2 alarm priority . . . . . . . . . 143

Remote alarm control . . . . . . . . . . . . . . . . . . . . 144

Infinity MCable – Nurse call . . . . . . . . . . . . . . . 146

External device disconnection alarm . . . . . . . . 147

The Code function . . . . . . . . . . . . . . . . . . . . . .147

The Timer function . . . . . . . . . . . . . . . . . . . . . . 148

Alarm ranges and defaults . . . . . . . . . . . . . . . . 149

Trends/data dialogs . . . . . . . . . . . . . . . . . . . .161

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162

Trending behavior. . . . . . . . . . . . . . . . . . . . . . .162

Graphical trends . . . . . . . . . . . . . . . . . . . . . . . . 164

Interacting with the graphical trends pages . . . 166

Analysis tool page . . . . . . . . . . . . . . . . . . . . . .169

Interacting with the Analysis tool page . . . . . . . 170

Tabular trend . . . . . . . . . . . . . . . . . . . . . . . . . . 172

Interacting with the tabular trend . . . . . . . . . . . 174

Mini-trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

Data review pages . . . . . . . . . . . . . . . . . . . . . .177

Reports tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

Calculations . . . . . . . . . . . . . . . . . . . . . . . . . .181

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182

Accessing the calculation functions . . . . . . . . . 183

Viewing the calculation results . . . . . . . . . . . . . 185

Laboratory data . . . . . . . . . . . . . . . . . . . . . . . .186

Calculation equations . . . . . . . . . . . . . . . . . . . . 187

Drug calculations . . . . . . . . . . . . . . . . . . . . . . . 191

Accessing the drug calculation functions . . . . . 191

Customized drug list. . . . . . . . . . . . . . . . . . . . .192

Drug calculator equations. . . . . . . . . . . . . . . . . 194

ECG, arrhythmia, and ST segment . . . . . . . . 197

Overview of ECG and heart rate monitoring . . 199

ECG precautions . . . . . . . . . . . . . . . . . . . . . . . 200

Connecting the 3-, 5-, 6-wire lead sets for

ECG monitoring . . . . . . . . . . . . . . . . . . . . . . . . 201

Connecting the lead sets for 12-lead

monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202

Connecting the lead wires for neonatal

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203

Patient preparation for ECG monitoring . . . . . 204

ECG display . . . . . . . . . . . . . . . . . . . . . . . . . . 205

ECG colors . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

Electrode placement . . . . . . . . . . . . . . . . . . . . 208

12-lead monitoring. . . . . . . . . . . . . . . . . . . . . . 211

Accessing the ECG functions . . . . . . . . . . . . . 211

ECG parameter setup functions . . . . . . . . . . . 212

Monitoring paced patients . . . . . . . . . . . . . . . . 216

Pacemaker precautions. . . . . . . . . . . . . . . . . . 217

Optimizing pacer processing. . . . . . . . . . . . . . 219

Arrhythmia monitoring overview . . . . . . . . . . . 219

Selecting arrhythmia leads . . . . . . . . . . . . . . . 220

Arrhythmia processing. . . . . . . . . . . . . . . . . . . 221

Arrhythmia modes . . . . . . . . . . . . . . . . . . . . . . 221

Arrhythmia display. . . . . . . . . . . . . . . . . . . . . . 223

Accessing the arrhythmia functions. . . . . . . . . 225

Arrhythmia parameter setup functions . . . . . . 225

Monitoring ST overview. . . . . . . . . . . . . . . . . . 226

Standard ST monitoring. . . . . . . . . . . . . . . . . . 226

TruST 12-lead monitoring . . . . . . . . . . . . . . . . 227

12-lead ST monitoring. . . . . . . . . . . . . . . . . . . 227

Connecting lead sets for ST monitoring . . . . . 227

ST display . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228

Reviewing ST complexes . . . . . . . . . . . . . . . . 229

ST measuring points . . . . . . . . . . . . . . . . . . . . 231

ST reference . . . . . . . . . . . . . . . . . . . . . . . . . . 232

ST alarm settings . . . . . . . . . . . . . . . . . . . . . . 233

Accessing the ST settings. . . . . . . . . . . . . . . . 233

ST setup functions. . . . . . . . . . . . . . . . . . . . . . 234

Learning/relearning QRS pattern . . . . . . . . . . 236

Impedance respiratory rate (RRi). . . . . . . . . 239

Overview of respiration monitoring . . . . . . . . . 240

Respiration precautions. . . . . . . . . . . . . . . . . . 240

Connecting the 3-, 5-, 6-wire lead sets for

respiration monitoring . . . . . . . . . . . . . . . . . . . 241

Connecting the lead sets for 12-lead

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242

Connecting the lead wires for neonatal

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243

Patient preparation for respiration monitoring . 244

Respiration display . . . . . . . . . . . . . . . . . . . . . 246

Adjusting the detection threshold and

activating the breath marker . . . . . . . . . . . . . . 247

Respiration measuring modes. . . . . . . . . . . . . 247

Accessing the respiration settings. . . . . . . . . . 248

8 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 9

Contents

Ventilation parameter setup functions . . . . . . . 248

SpO2 and Pulse CO-Ox monitoring with

Masimo SET MCable . . . . . . . . . . . . . . . . . . .251

Overview of SpO2 and Pulse CO-Ox

monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . .252

SpO2 and Pulse CO-Ox precautions . . . . . . . . 254

Connecting the Masimo SET MCable . . . . . . . 256

Connecting the Masimo rainbow SET

MCable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257

Patient preparation . . . . . . . . . . . . . . . . . . . . . . 258

SpO2 and Pulse CO-Ox display . . . . . . . . . . . . 259

Reviewing the SpO2 and Pulse CO-Ox

parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

Accessing the SpO2 settings . . . . . . . . . . . . . .263

SpO2 parameter setup functions . . . . . . . . . . . 264

Masimo rainbow SET Pulse CO-Ox

parameter setup functions . . . . . . . . . . . . . . . .266

Password-protected Masimo rainbow SET

setup functions . . . . . . . . . . . . . . . . . . . . . . . . .269

SpO2 and pulse rate with Nellcor OxiMax

MCable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271

Overview of SpO2 monitoring. . . . . . . . . . . . . .272

SpO2 precautions. . . . . . . . . . . . . . . . . . . . . . .273

Connecting the Nellcor OxiMax MCable. . . . . . 274

Patient preparation for SpO

2 monitoring. . . . . . 275

SpO2 display . . . . . . . . . . . . . . . . . . . . . . . . . . 277

Accessing the SpO2 settings . . . . . . . . . . . . . .278

SpO2 parameter setup functions . . . . . . . . . . . 278

Temperature . . . . . . . . . . . . . . . . . . . . . . . . . .281

Overview of temperature monitoring . . . . . . . .282

Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . 282

Connecting the temperature sensors . . . . . . . . 283

Temperature display . . . . . . . . . . . . . . . . . . . . . 286

Accessing the temperature settings . . . . . . . . . 287

Temperature parameter setup functions. . . . . . 287

Non-invasive blood pressure (NIBP) . . . . . . 289

Overview of non-invasive blood pressure

monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Non-invasive blood pressure precautions . . . . 291

Connecting the non-invasive blood pressure

hose and cuff . . . . . . . . . . . . . . . . . . . . . . . . . . 292

Patient preparation for non-invasive blood

pressure monitoring . . . . . . . . . . . . . . . . . . . . .293

Non-invasive blood pressure display. . . . . . . . 294

Non-invasive blood pressure measurement

modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296

Venous stasis . . . . . . . . . . . . . . . . . . . . . . . . . 299

Accessing the non-invasive blood pressure

settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300

Non-invasive blood pressure parameter setup

functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300

Invasive blood pressure (IBP) . . . . . . . . . . . 301

Overview of invasive blood pressure

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302

Invasive blood pressure precautions. . . . . . . . 304

Connecting the Hemo4 pod and Hemo2 pod . 305

Connecting the MPod – QuadHemo . . . . . . . . 306

Connecting the Dual Hemo MCable . . . . . . . . 307

Patient preparation for invasive blood

pressure monitoring. . . . . . . . . . . . . . . . . . . . . 308

Invasive blood pressure display . . . . . . . . . . . 308

Labeling invasive blood pressure channels. . . 310

Standard labels . . . . . . . . . . . . . . . . . . . . . . . . 311

Pressure label conflicts . . . . . . . . . . . . . . . . . . 312

Zeroing a pressure transducer . . . . . . . . . . . . 312

Pulmonary wedge pressure. . . . . . . . . . . . . . . 315

Starting wedge measurements from the pods. 316 Accessing the invasive blood pressure

settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

Invasive blood pressure parameter setup

functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

Cardiac output (C.O.) . . . . . . . . . . . . . . . . . . 321

Overview of cardiac output monitoring . . . . . . 322

C.O. precautions . . . . . . . . . . . . . . . . . . . . . . . 322

Connecting the cardiac output hardware. . . . . 323

Patient preparation for cardiac output

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325

Cardiac output display . . . . . . . . . . . . . . . . . . . 326

Cardiac output computation constant . . . . . . . 327

Cardiac output measuring modes . . . . . . . . . . 329

Saving the cardiac output value . . . . . . . . . . . 332

Reviewing the cardiac output averages . . . . . 333

Accessing the cardiac output settings . . . . . . . 334

Cardiac output parameter setup functions . . . 334

Mainstream CO

Overview of Mainstream CO

2 monitoring. . . . . . . . . . . . . 337

2 monitoring . . . . 338

CO2 precautions . . . . . . . . . . . . . . . . . . . . . . . 339

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 9

Page 10

Contents

Connecting the CO Patient preparation for CO

2 sensor . . . . . . . . . . . . . . .340

2 monitoring . . . . . . 341

CO2 display . . . . . . . . . . . . . . . . . . . . . . . . . . .342

Using the CO2 dialog . . . . . . . . . . . . . . . . . . . . 345

2 parameter setup . . . . . . . . . . . . . . . . . . . . 345

Performing a calibration check . . . . . . . . . . . . . 348

Microstream CO

Overview of Microstream® CO

2 display . . . . . . . . . . . . . . . . . . . . . . . . . . .351

2 monitoring . . . . . . . . . . . . 349

2 monitoring . . . 350

Using the CO2 dialog box. . . . . . . . . . . . . . . . . 353

CO2 parameter setup . . . . . . . . . . . . . . . . . . . . 354

Calibration Check . . . . . . . . . . . . . . . . . . . . . . . 355

Scio Monitoring . . . . . . . . . . . . . . . . . . . . . . . 357

Overview of Scio monitoring. . . . . . . . . . . . . . . 358

Using the Scio dialog . . . . . . . . . . . . . . . . . . . . 361

CO2 display . . . . . . . . . . . . . . . . . . . . . . . . . . . 366

O2 display . . . . . . . . . . . . . . . . . . . . . . . . . . . .370

Agent display . . . . . . . . . . . . . . . . . . . . . . . . . . 372

xMAC (MAC multiple). . . . . . . . . . . . . . . . . . . . 377

Zeroing the gas analyzer . . . . . . . . . . . . . . . . . 378

External Device – Bispectral index (BIS) . . . 379

Overview of BIS monitoring . . . . . . . . . . . . . . .380

BIS precautions . . . . . . . . . . . . . . . . . . . . . . . . 381

BIS display . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381

Accessing the BIS settings. . . . . . . . . . . . . . . .384

BIS parameter setup functions . . . . . . . . . . . . . 384

External Device – Neuromuscular

transmission (NMT) . . . . . . . . . . . . . . . . . . . .385

Overview of NMT monitoring . . . . . . . . . . . . . .386

NMT precautions . . . . . . . . . . . . . . . . . . . . . . . 387

NMT display . . . . . . . . . . . . . . . . . . . . . . . . . . . 387

Printing NMT information . . . . . . . . . . . . . . . . .390

Accessing the NMT settings. . . . . . . . . . . . . . . 390

The NMT page . . . . . . . . . . . . . . . . . . . . . . . . . 391

External device – continuous cardiac

output (CCO). . . . . . . . . . . . . . . . . . . . . . . . . . 393

Overview of CCO monitoring . . . . . . . . . . . . . . 394

CCO precautions . . . . . . . . . . . . . . . . . . . . . . . 397

CCO/SvO2 display . . . . . . . . . . . . . . . . . . . . . .398

Viewing the CCO/SvO2 parameters. . . . . . . . . 398

Accessing the CCO/SvO2 settings. . . . . . . . . . 399

SvO2 parameter setup functions . . . . . . . . . . . 399

External devices – MEDIBUS.X devices . . . 401

External device monitoring . . . . . . . . . . . . . . . 402

Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . 403

Compatible MEDIBUS.X devices . . . . . . . . . . 403

Supported MEDIBUS.X ventilator and

anesthesia data. . . . . . . . . . . . . . . . . . . . . . . . 404

Viewing MEDIBUS.X parameter data . . . . . . . 411

Parameter fields . . . . . . . . . . . . . . . . . . . . . . . 411

Viewing loops . . . . . . . . . . . . . . . . . . . . . . . . . 412

The Show all pages. . . . . . . . . . . . . . . . . . . . . 413

Accessing parameter setup functions . . . . . . . 414

Paw setup functions . . . . . . . . . . . . . . . . . . . . 415

Ventilator parameter setup functions. . . . . . . . 415

2 setup functions . . . . . . . . . . . . . . . . . . . . 418

External devices – Servo-i ventilator. . . . . . 419

Overview of ventilation monitoring . . . . . . . . . 420

Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . 421

Device compatibility. . . . . . . . . . . . . . . . . . . . . 421

Supported Servo-i parameters . . . . . . . . . . . . 422

Viewing parameter data. . . . . . . . . . . . . . . . . . 423

Parameter fields . . . . . . . . . . . . . . . . . . . . . . . 424

Viewing loops . . . . . . . . . . . . . . . . . . . . . . . . . 425

The Show all page. . . . . . . . . . . . . . . . . . . . . . 426

Accessing the parameter setup functions . . . . 426

Ventilator Paw setup functions . . . . . . . . . . . . 427

Ventilator parameter setup functions. . . . . . . . 428

2 parameter setup functions. . . . . . . . . . . . 429

External devices – Evita 2D, Evita 4, Evita

XL (Medibus) . . . . . . . . . . . . . . . . . . . . . . . . . 431

Overview of ventilation monitoring . . . . . . . . . 432

Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . 433

Device compatibility. . . . . . . . . . . . . . . . . . . . . 433

Supported Medibus ventilator data . . . . . . . . . 434

Viewing Medibus parameter data . . . . . . . . . . 436

Parameter fields . . . . . . . . . . . . . . . . . . . . . . . 437

Viewing loops . . . . . . . . . . . . . . . . . . . . . . . . . 437

The Show all page. . . . . . . . . . . . . . . . . . . . . . 438

Accessing the parameter setup functions . . . . 439

Ventilator Paw setup functions . . . . . . . . . . . . 439

Ventilator parameter setup functions. . . . . . . . 440

2 parameter setup functions. . . . . . . . . . . . 441

System configuration . . . . . . . . . . . . . . . . . . 443

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 444

Screen setup . . . . . . . . . . . . . . . . . . . . . . . . . . 444

10 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 11

Contents

Screen setup – general settings . . . . . . . . . . . . 445

Screen setup – auto view functions . . . . . . . . . 446

Configuring parameters for display. . . . . . . . . .448

Screen setup – configuring views. . . . . . . . . . . 451

Screen setup – configuring main menu bar

buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452

Screen setup – configuring the multi-tab split

screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455

Screen setup – the View editor. . . . . . . . . . . . . 456

Configuring the alarm setup . . . . . . . . . . . . . . . 458

Configuring the recording and report settings . 467

Biomed setup . . . . . . . . . . . . . . . . . . . . . . . . . . 470

Biomed IT setup . . . . . . . . . . . . . . . . . . . . . . . .479

Profile setup . . . . . . . . . . . . . . . . . . . . . . . . . . . 484

Saving profiles . . . . . . . . . . . . . . . . . . . . . . . . .485

Configuring profiles. . . . . . . . . . . . . . . . . . . . . . 487

Transferring profiles . . . . . . . . . . . . . . . . . . . . . 489

Importing and exporting profiles using a USB

flash drive . . . . . . . . . . . . . . . . . . . . . . . . . . . . .490

Reports/recordings . . . . . . . . . . . . . . . . . . . . 493

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494

R50N recorder . . . . . . . . . . . . . . . . . . . . . . . . . 494

Timed recordings . . . . . . . . . . . . . . . . . . . . . . .495

Continuous recordings . . . . . . . . . . . . . . . . . . . 497

Requesting recordings . . . . . . . . . . . . . . . . . . . 497

Available reports. . . . . . . . . . . . . . . . . . . . . . . .498

Printing reports . . . . . . . . . . . . . . . . . . . . . . . . . 498

Configuring a case summary report . . . . . . . . .502

IT applications (options) . . . . . . . . . . . . . . . .503

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 504

Configuring IT tabs . . . . . . . . . . . . . . . . . . . . . . 504

Accessing an IT tab . . . . . . . . . . . . . . . . . . . . .505

Supported IT applications. . . . . . . . . . . . . . . . . 506

Connecting to the network . . . . . . . . . . . . . . . . 507

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . .509

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 510

Device communication messages . . . . . . . . . . 510

Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513

ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517

ST. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520

ARR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521

Respiration (RRi) . . . . . . . . . . . . . . . . . . . . . . .523

SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 526

Non-invasive blood pressure (NIBP) . . . . . . . . 534

Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . 537

Invasive blood pressure (IBP) . . . . . . . . . . . . . 539

Mainstream CO

2 . . . . . . . . . . . . . . . . . . . . . . . 543

Microstream CO2. . . . . . . . . . . . . . . . . . . . . . . 547

Cardiac Output (C.O.) . . . . . . . . . . . . . . . . . . . 551

Recording status messages . . . . . . . . . . . . . . 554

Scio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 556

Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . 567

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 568

Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569

Visual inspection . . . . . . . . . . . . . . . . . . . . . . . 569

Inspection / safety checks . . . . . . . . . . . . . . . . 570

Preventive maintenance . . . . . . . . . . . . . . . . . 572

Maintenance Restart . . . . . . . . . . . . . . . . . . . . 573

Reprocessing. . . . . . . . . . . . . . . . . . . . . . . . . 575

Disassembly . . . . . . . . . . . . . . . . . . . . . . . . . . 576

Information on reprocessing . . . . . . . . . . . . . . 577

Information on disinfectants. . . . . . . . . . . . . . . 577

Classifications for reprocessing. . . . . . . . . . . . 579

Reprocessing list . . . . . . . . . . . . . . . . . . . . . . . 580

Reprocessing procedures . . . . . . . . . . . . . . . . 581

Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 583

EU Directive 2002/96/EC (WEEE) . . . . . . . . . 583

Technical data . . . . . . . . . . . . . . . . . . . . . . . . 585

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 586

Device combinations . . . . . . . . . . . . . . . . . . . . 586

Infinity PS250 power supply . . . . . . . . . . . . . . 587

Infinity P2500. . . . . . . . . . . . . . . . . . . . . . . . . . 589

Infinity MCable – Nurse call. . . . . . . . . . . . . . . 591

Infinity R50N . . . . . . . . . . . . . . . . . . . . . . . . . . 592

Sound pressure . . . . . . . . . . . . . . . . . . . . . . . . 593

Secondary display . . . . . . . . . . . . . . . . . . . . . . 593

Electromagnetic compatibility . . . . . . . . . . . . . 593

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 601

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12 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

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For your safety and that of your patients

Strictly follow these instructions for use . . . . . . 14

Storing the instructions for use. . . . . . . . . . . . . 14

Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Installing accessories . . . . . . . . . . . . . . . . . . . . 15

Sterile accessories . . . . . . . . . . . . . . . . . . . . . . 15

Restriction of distribution . . . . . . . . . . . . . . . . . 15

Restrictions for use. . . . . . . . . . . . . . . . . . . . . . 15

Connected devices. . . . . . . . . . . . . . . . . . . . . . 15

Safe connection with other electrical

equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Electrical safety . . . . . . . . . . . . . . . . . . . . . . . . 16

Connection to hospital network . . . . . . . . . . . . 16

Patient safety . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Patient monitoring. . . . . . . . . . . . . . . . . . . . . . . 17

General safety information . . . . . . . . . . . . . . 18

Not for use in areas of explosion hazard . . . . . 19

Information on electromagnetic compatibility . . 19

Operating location . . . . . . . . . . . . . . . . . . . . . . 19

Defibrillator precautions . . . . . . . . . . . . . . . . . . 20

Electrosurgery . . . . . . . . . . . . . . . . . . . . . . . . . 20

Virus protection. . . . . . . . . . . . . . . . . . . . . . . . . 20

Security recommendations. . . . . . . . . . . . . . . . 21

For your safety and that of your patients

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 13

Page 14

For your safety and that of your patients

Strictly follow these instructions for use

NOTE

The Infinity Acute Care System provides the following additional instructions for use:

– Infinity Acute Care System – Infinity M540

patient monitor (describes the M540 user interface)

– Infinity Acute Care System – Medical Cockpit

(describes the hardware of the Cockpit)

– Infinity Acute Care System – Monitoring

accessories (describes all of the IACS accessories).

Please refer to these additional instructions for use for device-specific information.

WARNING Risk of incorrect operation and use.

Any use of the medical device requires full understanding and strict observation of all sections of these instructions for use. The medical device must only be used for the purpose specified under "Application" and in conjunction with appropriate patient monitoring.

Strictly observe all WARNING and CAUTION statements throughout these instructions for use and all statements on medical device labels. Failure to observe these safety information statements constitutes a use of the medical device that is inconsistent with its intended use.

Storing the instructions for use

WARNING Risk of incorrect use.

Instructions for use must be kept accessible for the user.

Training

Training for users is available from the responsible Dräger organization, see www.draeger.com.

Maintenance

WARNIN G Risk of medical device failure and of patient

injury.

The medical device must be inspected and serviced regularly by service personnel. Repair and complex maintenance carried out on the medical device must be performed by experts.

If the above is not complied with, medical device failure and patient injury may occur. Observe the chapter "Maintenance".

Dräger recommends that a service contract is obtained with DrägerService and that all repairs are performed by DrägerService. For maintenance Dräger recommends the use of authentic Dräger repair parts.

Accessories

WARNIN G Risk due to incompatible accessories.

Dräger has only tested the compatibility of accessories listed in the current list of accessories. If other accessories are used, there is a risk of patient injury due to medical device failure. Dräger recommends that the medical device is only used with accessories listed in the current list of accessories.

14 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

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For your safety and that of your patients

Installing accessories

CAUTION

Risk of device failure

Install accessories to the basic device in accordance with the instructions for use of the basic device. Make sure that there is a safe connection to the basic device.

Strictly observe instructions for use and assembly instructions.

Sterile accessories

CAUTION

Risk of medical device failure and of patient injury.

Do not use sterile-packaged accessories if the packaging has been opened, is damaged or if there are other signs of non-sterility. Single-use accessories must not be reused, reprocessed, or resterilized.

Restriction of distribution

Federal Law (U.S.) restricts this device to sale by or on the order of a physician.

Restrictions for use

CAUTION

Device for use in health care facilities only and exclusively by persons as defined in the target groups (see "Definition of target groups" on page 6).

Connected devices

WARNING Risk of electric shock and of device

malfunction.

Any connected devices or device combinations not complying with the requirements mentioned in these instructions for use can compromise the functional integrity of the medical device and lead to electric shock. Before operating the medical device, strictly comply with the instructions for use of all connected devices and device combinations.

WARNING To avoid electric shock, the equipment should

only be connected to a power source that is properly grounded (protective earth ground).

Safe connection with other electrical equipment

WARNING Risk of patient injury.

Electrical connections to equipment which are not listed in these instructions for use should only be made following consultation with the respective manufacturers. Equipment malfunction may result with the risk of patient injury.

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 15

Page 16

For your safety and that of your patients

WARNING The leakage current increases when multiple

medical devices are connected to a patient. Make sure that the galvanic isolation of each device is suitable for the intended application. Connect only equipment that is set up and tested according to IEC standards to the analog and digital signal inputs and outputs. Connect only passive USB devices to the IACS (Infinity Acute Care System) Cockpit.

To protect the patient from possible injury due to electrical shock, peripheral devices should only be connected to a monitor within the same room. The installer or service provider should verify that the leakage current of the interconnected system meets the electrical safety requirements of IEC 60601-1.

Electrical safety

WARNING Because of the risk of electric shock, never

remove the cover of a device while it is in use or plugged into a power socket.

CAUTION

Connect the PS250 or the P2500 with an attached power cable only to hospital-grade electrical power sockets to make sure that it is properly grounded.

Connection to hospital network

Many medical devices manufactured by Dräger use networks to transmit patient data in real-time and to notify clinical users of alarm conditions. Hospitals should refer to IEC 80001-1 before attempting to connect such medical devices to their IT networks.

Patient safety

The design of the medical device, the accompanying documentation, and the labeling on the medical device are based on the assumption that the purchase and the use of the medical device are restricted to persons familiar with the most important inherent characteristics of the medical device. Instructions and WARNING and CAUTION statements are therefore largely limited to the specifics of the Dräger medical device.

These instructions for use do not contain any information on the following points:

– Risks that are obvious to users

– Consequences of obvious improper use of the

medical device

– Potentially negative effects on patients with dif-

ferent underlying diseases

Medical device modification or misuse can be dangerous.

CAUTION

To avoid injuring the patient, do not touch any connector or mounting screw on the device when you are touching the patient. Do not allow the conductive parts of electrodes and cables to contact other conductive parts or the ground.

16 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 17

Patient monitoring

The user of the medical device is responsible for choosing a suitable patient monitoring system that provides appropriate information on medical device performance and patient condition.

Patient safety may be achieved by a wide variety of means ranging from electronic surveillance of medical device performance and patient condition to direct observation of clinical signs.

The responsibility for selecting the best level of patient monitoring lies solely with the user of the medical device.

For your safety and that of your patients

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 17

Page 18

For your safety and that of your patients

General safety information

The following WARNING and CAUTION statements apply to general operation of the medical device.

WARNING and CAUTION statements specific to subsystems or particular features of the medical device appear in the respective sections of these instructions for use or in the instructions for use of another product being used with this medical device.

WARNING Risk of explosion and of chemical burns.

Improper handling of batteries can result in explosions and chemical burns.

Do not throw batteries into fire. Do not force batteries open.

Observe the applicable laws and regulations for battery disposal.

WARNING To avoid electric shock, inspect all cables

before use. Never use cables that appear cracked, worn, or damaged in any way (doing so may compromise performance or put the patient at risk).

WARNING Do not cover the device with blankets or bed

sheets. To prevent burns to the patient, avoid direct contact between external surfaces and the patient.

CAUTION

Read all cleaning instructions (for example, originating from the disinfectant manufacturer and the hospital) carefully before cleaning the device. Refer to the chapter entitled "Reprocessing" on page 575 for device-specific cleaning instructions. Moisture may damage the circuits, compromise critical performance and present a safety risk.

WARNIN G Dräger recommends using the Infinity Acute

Care System or the M540 (if on wireless transport) for primary diagnosis and the (ICS) Infinity CentralStation for patient viewing only.

For countries subject to the EU directive 2002/96/EC

This device is subject to EU directive 2002/96/EC (WEEE). In order to comply with its registration according to this directive, this device may not be disposed of at municipal collection points for waste of electrical and electronic equipment. Dräger has authorized a company to collect and dispose of this device.

To initiate collection or for further information, visit Dräger on the Internet at www.draeger.com. Use the Search function with the keyword "WEEE" to find the relevant information. If access to the Dräger website is not possible, contact the local Dräger organization.

CAUTION

To avoid injuring the patient, disconnect all sensors that will not be used during transport, before moving the patient.

18 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

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For your safety and that of your patients

Not for use in areas of explosion hazard

WARNING Risk of explosion

This medical device is neither approved nor certified for use in areas where oxygen concentrations greater than 25% (combustible or explosive gas mixtures) are likely to occur.

Information on electromagnetic compatibility

General information on electromagnetic compatibility (EMC) according to international EMC standard IEC 60601-1-2:

Medical electrical equipment is subject to special precautionary measures concerning electromagnetic compatibility (EMC) and must be installed and put into operation in accordance with the EMC information provided on page 593.

Portable and mobile radio frequency communications equipment can affect medical electrical equipment.

WARNING

Do not connect connectors with an ESD warning symbol and do not touch their pins without implementing ESD protective

measures. Such protective measures may include antistatic clothing and shoes, touching a potential equalization pin before and during connection of the pins, or using electrically insulating and antistatic gloves. All users concerned must be instructed in these ESD protective measures.

Operating location

Only use devices (monitor, MPod, MCable, and accessories) in areas that meet the environmental requirements outlined in the technical data section.

WARNING To avoid interfering with device operation, do

not operate devices (monitor, MPod, MCable, and accessories) within equipment that emits microwave or other high-frequency emissions. For recommended separation distances, see page 598.

WARNING Make sure that the device is properly mounted

and secured to prevent injury. Make sure the requirements for maximum load and slope of floor are met. Consult the documentation of the mounting manufacturer for detailed information.

WARNING To minimize the risk of patient strangulation,

carefully position and secure sensor cables. Also position the sensor cables to minimize inductive loops.

WARNING To avoid patient injury as the result of a falling

monitor when using a rolling trolley, universal bed hook, or handle hook mount, do not apply excessive force to the monitor or mount when entering or exiting elevators or passing over thresholds and other uneven surfaces.

CAUTION

To prevent overheating, do not place the device in direct sunlight or near radiant warmers.

CAUTION

After extended exposure in a cold environment, acclimate the device carefully so that condensation does not form on the electronic parts and damage the device.

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 19

Page 20

For your safety and that of your patients

CAUTION

To avoid damaging the touch-sensitive screen, do not allow sharp instruments to touch the front of the devices.

CAUTION

To avoid short-circuiting and otherwise damaging the device, Dräger recommends that no fluids come in contact with the IACS devices when they are connected to a power socket. If fluids are accidentally spilled on the equipment, remove the affected device from service as soon as possible and have service personnel verify that patient safety is not compromised.

Defibrillator precautions

The IACS and the peripheral devices are protected against high-frequency interference from defibrillators and electrosurgical units and against 50-Hz and 60-Hz power line interference.

WARNING To avoid electrical shock, always remove

accessories that are not resistant to defibrillation before defibrillating a patient.

CAUTION

To prevent burns and electric shock due to rerouting of electrical current through electrodes, do not position the defibrillator pads near any electrodes or sensors.

Electrosurgery

Observe the following precautions during electrosurgery to reduce electrosurgical unit (ESU) interference and improve user safety and patient safety.

WARNIN G For better performance and to reduce the

hazard of burns during surgery, always use accessories designed for ESU environments.

WARNIN G To reduce the hazard of burns during

electrosurgery, keep the sensor or transducer (ECG, pressure, SpO2) and their associated cables away from the surgical site, the ESU return electrode, and earth ground.

NOTE

Cover internally placed reusable temperature sensors with temperature sensor sheaths.

Virus protection

CAUTION

The IACS does not have virus protection software and relies therefore on the firewall of your institution to prevent access to infected files. While setting up IT applications to access websites, evaluate each website with regard to possible virus infection.

CAUTION

Only defibrillate across the chest.

CAUTION

To protect the patient during defibrillation and to ensure accurate ECG information, use only ECG electrodes and cables specified by Dräger. Removal of applied parts that are not rated defibrillation-proof such as disposable SpO2 sensors may be required to prevent sensor breakdown and energy shunting.

20 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 21

Security recommendations

Dräger makes the following security recommendations:

– Physical security of the patient monitors is rec-

ommended and is the responsibility of the operating organization.

– Physical security of the telecommunications

closet is recommended and is the responsibility of the operating organization.

– Dräger recommends that operating organiza-

tions restrict physical access to unused ethernet ports on the IACS.

– Dräger recommends that operating organiza-

tions restrict physical access to unused USB and serial ports on the IACS.

– Dräger relies on the medical device isolation

mechanism of the VLANs and the proper configuration, implementation, and use of the operating organization's security measures to prevent the introduction of malware onto the Infinity network.

For your safety and that of your patients

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 21

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22 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 23

Application

Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Indications for use . . . . . . . . . . . . . . . . . . . . . 24

Application

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 23

Page 24

Application

Intended use

The IACS is intended for multi-parameter, physiologic patient monitoring of adult, pediatric, and neonatal patients in environments where patient care is provided by trained health care professionals.

The IACS obtains the physiologic, multi-parameter data from the connection to the M540 monitor and optional medical devices and displays. The transfer of this data is accomplished by the Infinity network.

Indications for use

The M540 monitors the following parameters:

– Heart rate

– Arrhythmia (adult and pediatric patients only)

– 12-lead analysis

– ST segment analysis including TruST

and pediatric patients only)

– Apnea

– Impedance respiratory rate (RRi)

– Invasive blood pressure (IBP)

– Non-invasive blood pressure (NIBP)

– Temperature

– Cardiac output, only available when the M540 is

docked in an IACS configuration (adult and pediatric patients only)

– Arterial oxygen saturation (SpO

– Pulse rate

– Perfusion index (PI)

– Total arterial hemoglobin (SpHb) (adult and

pediatric patients only)

– Total oxygen content (SpOC) (adult and

pediatric patients only)

® (adult

The IACS and any connected optional hardware are not intended for use in the following hospital environments:

– Hyperbaric chambers

– Environments containing MRI equipment

– Carboxyhemoglobin saturation (SpCO) (adult

and pediatric patients only)

– Methemoglobin saturation (SpMet)

– Pleth variability index (PVI)

– Carbon dioxide (CO

– Oxygen (O2) (adult and pediatric patients only)

– Nitrous oxide (N2O) (adult and pediatric

patients only)

– Anesthetic agents (Sevoflurane, Desflurane,

Isoflurane, Halothane, Enflurane) (adult and pediatric patients only)

– xMAC (adult and pediatric patients only)

24 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 25

System overview

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Infinity Medical Cockpit . . . . . . . . . . . . . . . . . 26

Infinity PS250 power supply unit (PS250) . . 27

Infinity P2500 power supply unit (P2500). . . 27

Infinity M540 patient monitor (M540) . . . . . . 28

Infinity M500 docking station (M500) . . . . . . 28

Front view of the M500. . . . . . . . . . . . . . . . . . . 28

Rear view of the M500 . . . . . . . . . . . . . . . . . . . 29

Additional hardware . . . . . . . . . . . . . . . . . . . . 29

Device symbols . . . . . . . . . . . . . . . . . . . . . . . 32

Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . 36

System overview

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 25

Page 26

System overview

Overview

These instructions for use describe the Cockpit (Medical Cockpit), the primary display and user interface of the Infinity Acute Care System – Monitoring Applications – M540 patient monitor (IACS). Specifically, these instructions for use describe the setup tasks and features available on the Cockpit. For detailed information on the M540 patient monitor, refer to the Instructions for use Infinity Acute Care System – Infinity M540.

Some terms used in these instructions for use:

– Cockpit – refers to the Infinity C700 Medical

Cockpit or the Infinity C500 Medical Cockpit.

– M540 – refers to the Infinity M540 transport

component and patient connection point of the IACS.

– M500 – refers to the Infinity M500 docking sta-

tion that secures the M540, provides communication between the M540 and the Cockpit, and charges the battery in the M540.

– PS250 – refers to the Infinity PS250 power sup-

ply Com Hub (power supply unit).

– P2500 – refers to the Infinity P2500.

– Docking the M540 – refers to placing the M540

on the M500.

– Undocking the M540 – refers to removing the

M540 from the M500 for patient transport.

The following diagram shows the basic components of the IACS. In addition, you can connect various hardware to expand the viewing and monitoring capabilities (see “Additional hardware“on page 29).

001

A C500 / C700

B PS250 or P2500

C M500

D M540

Infinity Medical Cockpit

The Infinity Medical Cockpit (referred to in this IFU as Cockpit) is the primary display and user inter-

face for the IACS and is available in the sizes listed in "Overview" on page 44.

For detailed description regarding the front and back panel of the Cockpit, refer to the Instructions for use Infinity Acute Care System – Infinity Medical Cockpit.

26 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

NOTE

On the second-generation Cockpit, the yellow key on the front has changed to .

Page 27

Infinity PS250 power supply unit (PS250)

System overview

The following diagram shows the bottom of the PS250.

Infinity P2500 power supply unit (P2500)

The following diagram shows the bottom of the P2500.

A Infinity network connectors

B Nurse call connector

C Export protocol connector

D Power cable connection

E Two interchangeable system cable connectors

– one for the M540, one for the Cockpit

F Network connection LEDs

The front of the PS250 has the following two LEDs:

– Power mains – lights up green when the

device is connected to AC power.

– Battery indicator – yellow LED that

004

lights up briefly during startup or fault conditions such as a faulty battery.

A Two interchangeable system cable connectors

– one for the M540, one for the Cockpit

B Power cable connection

C Infinity network connector

D Nurse call connector

E Export protocol connector

The front of the P2500 has the following two LEDs:

– Power mains – lights up green when the

device is connected to AC power.

– Battery indicator – yellow LED that

lights up briefly during startup or fault conditions such as a faulty battery.

357

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 27

Page 28

System overview

Infinity M540 patient monitor (M540)

The following diagram shows the M540 when it is docked in the M500 docking station.

Infinity M500 docking station (M500)

The M500 is the mechanical device that secures and powers the M540. It also charges the battery and controls the communication between the M540 and the Cockpit through an optical Ethernet link.

Front view of the M500

A M540 patient monitor

B M500 docking station

The M540 acquires patient signals, processes them, and relays them to the Cockpit for display. The M540 also provides patient monitoring when it is undocked during patient transport. For more detailed information on the M540, refer to the Instructions for use Infinity Acute Care System – Infinity M540.

M540IFUcoverVG6

A Locking mechanism – secures the M540 (for

more detailed information, see “Locking/unlocking the M540“on page 94)

B Release buttons for undocking the M540 (you

only have to press one button to release the M540)

C Optical Ethernet links

D Pins for charging the battery of the M540 and

for providing power to the M540 when it is docked

28 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

301

Page 29

Rear view of the M500

Additional hardware

The following table lists the additional devices that can be connected to the IACS.

System overview

A System cable connector

B Nurse call connector

C LED – lights up green when connected to the

network

302

Device Description Connection

Infinity MCable – Masimo SET Measures the percentage of

functional hemoglobin saturated with oxygen (%SpO2) and reports the perfusion index (PI) and the pulse rate (PLS).

Infinity MCable – Masimo SET rainbow

Infinity MCable – Nellcor OxiMax Measures the percentage of

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 29

Measures the percentage of functional hemoglobin saturated with oxygen (%SpO2) and reports the perfusion index (PI) and the pulse rate (PLS). In addition, it measures total arterial hemoglobin (SpHb), total oxygen content (SpOC), pleth variability index (PVI), Carboxyhemoglobin saturation (SpCO), methemoglobin saturation (SpMet).

functional hemoglobin saturated with oxygen (%SpO2) and the pulse rate (PLS).

Connects directly to the SpO2 connector of the M540 (see page 256 and page 274).

Page 30

System overview

Device Description Connection

Hemo4 pod

Infinity MPod – QuadHemo

Hemo2 pod Measures up to 2 pressures,

Measures up to 4 pressures, cardiac output, core and body temperature.

Connects directly to the Hemo connector of the M540 (see information starting on page 305).

cardiac output, core and body temperature.

Infinity MCable – Dual Hemo Measures up to 2 pressures.

Infinity MCable – Mainstream CO2

Measures mainstream CO2. Connects directly to the CO2

connector of the M540 (see page 340).

Infinity MCable – Microstream

Measures Microstream CO2. Connects directly to the CO2

connector of the M540 patient monitor (see page 350).

Scio Four Measures the concentration of

CO2, N2O, and anesthetic agents (Sevoflurane, Desflurane, Isoflurane, Halothane, and Enflurane) in the breathing gas.

Scio Four Oxi Measures the concentration of

2, N2O, O2, and anesthetic

CO agents (Sevoflurane, Desflurane, Isoflurane, Halothane, and Enflurane) in the breathing gas.

Scio Four plus Measures the concentration of

2, N2O, and anesthetic agents

CO (Sevoflurane, Desflurane, Isoflurane, Halothane, and Enflurane) in the breathing gas.

Scio Four Oxi plus Measures the concentration of

2, N2O, O2, and anesthetic

CO agents (Sevoflurane, Desflurane, Isoflurane, Halothane, and Enflurane) in the breathing gas.

Infinity MCable – Nurse call Provides remote notification of

medium and high-priority alarm conditions.

Connects directly to the CO2 connector of the M540 (see the instructions for use Infinity Acute Care System – Infinity M540).

Connects to the PS250 / P2500 (see page 27) or to the M500 (see page 28).

30 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 31

Device Description Connection

Infinity MCable – Analog/Sync Provides a sync pulse to

synchronize defibrillators to the heart beat of the patient during cardioversion. The cable’s analog

Connects to the Temp/Aux connector of the M540 (see page 283) or to the CO

connector with a Y-cable. out function provides an ECG and arterial blood pressure signal to a device such as intra-aortic balloon pump.

Secondary video display Extends the viewing capabilities

of a Cockpit to an additional video display. Secondary displays mirror the content of the Cockpit.

Connects to a Cockpit using the

DVI 1 connector located on the

back panel (see the instructions

for use Infinity Acute Care

System – Medical Cockpit).

R50N recorder Produces timed and continuous

recordings.

Laser printer Prints various reports and Cockpit

Connects to the Infinity network

or the PS250 / P2500.

Connects to the Infinity network. print screens.

System overview

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 31

Page 32

System overview

Device symbols

Warning! Strictly follow these instructions for use

Consult instructions for use Upper alarm limits

Caution! Observe the accompanying documentation!

Directive 93/42/EEC concerning Medical Devices

Lower alarm limits

Autoset alarm limits

Alarm monitoring deactivated temporarily

Access to trend pages Alarm monitoring deactivated

permanently

The button next to this symbol accesses special procedure pages

Access to alarm functions Acoustic alarm signal turned off

32 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Acoustic alarm signal paused temporarily

permanently

Page 33

System overview

Access to the standby and privacy modes, and access to patient discharge

Access to pre-configured views and layouts

Access to parameter pages Heart blip that flashes with each

Adult patient category Pediatric patient category

Neonatal patient category Pacer detection is activated; the heart

Change clinical password

Change biomed password

Lung symbol that pulsates with each detected breath

detected pulse

symbol flashes with each detected paced pulse

Battery status LED Scrolls to additional tabs and pages

Battery charging error Power on/off

AC power mains Non-disposable part

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 33

Page 34

System overview

Function/setting is unlocked Component number and revision

Function/setting is locked Device serial number

Data entry with numeric keypad Date of manufacture

Trend configuration Complete screen calibration procedure

Keyboard access Repeat screen calibration procedure

Nurse call Display filter. When selected, only the

connected parameters and associated setup pages are displayed. When deselected, all parameters and associated setup pages are displayed.

Manufacturer Zeroing all pressures

Parameter is excluded from display Parameter is represented as a

parameter field only

34 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 35

System overview

Parameter is represented as a waveform and a parameter field

Save modifications (for example, changes to a view)

Save as symbol IPXx Degree of protection against solid

Navigates forward on a web page Refreshes a web screen

Displays the main screen Navigates backward on a web page

Import functions (for example, importing profiles)

ESD warning

particle and liquid ingress, e.g., IPX1, IPX4, etc.

Defibrillation-proof Type CF equipment

Gas in Defibrillation-proof Type BF equipment

Gas out Caution: Federal law restricts this device

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 35

Stops loading the web page

to sale by or on the order of a physician.

Page 36

System overview

Not made with natura

Not made with natural rubber latex Not made with natural rubber latex

Do not re-use, single patient use Keep away from sunlight

Do not re-use

Caution: This product contains natural rubber latex which may cause an allergic reaction

Abbreviations

The following table lists the abbreviations used in these instructions for use and those that are displayed on the Cockpit. For any abbreviations of parameters originating from external devices, refer to the corresponding instructions for use.

Abbreviation Description

% MVspon Spontaneous minute volume,

fractional

% leak Relative leakage

%PACED Percentage of paced beats

SC-∆Psupp goal

∆O2 Inspiratory/expiratory oxygen

AAMI Association for the Advancement

AHA American Heart Association

Pressure support goal (SmartCare)

concentration difference

of Medical Instrumentation

rubber latex

Abbreviation Description

Air cons Cumulated air consumption

AIVR Accelerated idioventricular

rhythm

alv Alveolar

APR Arterial pulse rate

ARR Arrhythmia

ART Arterial blood pressure

ART D ART diastolic value

ART M ART mean value

ART S ART systolic value

ARTF Artifact

ASY Asystole

aVF ECG lead aVF

aVL ECG lead aVL

36 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 37

System overview

Abbreviation Description

aVR ECG lead aVR

AW-Temp Gas temperature (airway)

BCT Burst count

BIS Bispectral index

BGM Bigeminy

BRADY Bradycardia

BSA Body surface area

BSR Suppression ratio

CaO2 Arterial oxygen content

CCO Continuous cardiac output

CCI Continuous cardiac index

C.O. Cardiac output

Cdyn Dynamic lung compliance

C20/Cdyn Ratio of compliance during last

20% of inspiration over dynamic compliance

CI Cardiac index

CISPR International special committee

on radio interference

2 Carbon dioxide

CPP Cerebral perfusion pressure

CPT Ventricular couplet

Cs Static lung compliance

Cstat Static lung compliance

CvO2 Venous oxygen content

DCO2 CO

2 elimination coefficient during

HFO

CVP Central venous blood pressure

Des Desflurane

Des cons Cumulated desflurane

consumption

DHCP Dynamic host configuration

protocol

DNS Domain name system

DO2 Oxygen delivery

DO2I Oxygen delivery index

Abbreviation Description

dV1 to dV6 Derived chest leads

DVI Digital visual interface

E Lung elastance

ECG Electrocardiogram

EDV End-diastolic volume

EDVI End-diastolic volume index

EF Ejection fraction

EIP End inspiratory pressure

Enf Enflurane

Enf cons Cumulated enflurane

consumption

ESV End-systolic volume

ESVI End-systolic volume index

et End-tidal (in combination with gas

values)

etDes End-tidal desflurane

concentration

etEnf End-tidal enflurane concentration

etHal End-tidal halothane concentration

etIso End-tidal isoflurane concentration

etN2O End-tidal N2O concentration

etO2 End-tidal oxygen concentration

etSev End-tidal sevoflurane

concentration

FiO2 Fractional inspired O

FV Flow-Volume loop

GP1 D to GP4 DGeneral pressure 1-4 diastolic

value

GP1 M to

GP 1 to 4 mean value

GP4 M

GP1 S to GP4 SGP 1 to 4 systolic value

Hal Halothane

Hal cons Cumulated halothane

consumption

HFO High-frequency oscillation

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 37

Page 38

System overview

Abbreviation Description

Ht Height

Hgb Hemoglobin

HR Heart rate

I ECG lead I

IACS Infinity Acute Care System –

Monitoring Applications

I:E Inspiratory to expiratory ratio

I (I:E) Inspiratory:expiratory ratio

(inspiratory component)

E (I:E) Inspiratory:expiratory ratio,

expiratory component

I (I:Espon) Inspiratory:expiratory ratio,

spontaneous, inspiratory component

E (I:Espon) Inspiratory:expiratory ratio,

spontaneous, expiratory component

IBP Invasive blood pressure

ICI Intermittent cardiac index

ICO Intermittent cardiac output

ICP Intracranial pressure

ICS Infinity CentralStation

IEC International Electrotechnical

Commission

inCO2 Inspiratory CO

2 concentration

II ECG lead II

III ECG lead III

in Inspiratory (in combination with

gas values)

inj Injectate temperature

inDes Inspiratory desflurane

concentration

inEnf Inspiratory enflurane

concentration

inHal Inspiratory halothane

concentration

Abbreviation Description

inIso Inspiratory isoflurane

concentration

inxMAC MAC factor

inN2O Inspiratory N2O concentration

inSev inspiratory sevoflurane

concentration

Insp. term. Inspiratory termination criterion

based on peak inspiratory flow

iO2 Inspired O

ISO Isoelectric point

Iso Isoflurane

Iso cons Cumulated Isoflurane

consumption

LA Left arm (ECG)

LA Left atrial blood pressure

LHCPP Left heart coronary perfusion

pressure

LV Left ventricular blood pressure

LV D LV diastolic value

LV M LV mean value

LV S LV systolic value

LVSW Left ventricular stroke work

LVSWI Left ventricular stroke work index

Pmean Mean airway pressure

MV Total minute volume

MValv Alveolar minute volume

MV ds Minute volume, dead space

MVe Minute volume, total expiratory

MVe s Minute volume, spontaneous

expiratory

MVi Minute volume, total inspiratory

MVi s Minute volume, spontaneous

inspiratory

MVleak Minute volume leakage

MVmand Minute volume, mandatory

38 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 39

System overview

Abbreviation Description

MVspon Minute volume, expired

spontaneous

N2O Nitrous oxide

N2O cons Cumulated N2O consumption

NIBP Non-invasive blood pressure

NIBP D NIBP diastolic value

NIBP M NIBP mean value

NIBP S NIBP systolic value

NIF Negative inspiratory force

NMT Neuromuscular transmission

O2 cons Cumulated O

2 consumption

OR Operating room

P2500 Power supply unit

P0.1 Occlusion pressure

PA Pulmonary arterial blood pressure

PA D PA diastolic value

PA M PA mean value

PA S PA systolic value

PaO2 Arterial O

2 pressure

Pause Pause pressure

Paw Airway pressure

PAW min Minimum airway pressure

PaCO2 Arterial CO

2 pressure

Pb Ambient pressure

PeCO2 Mixed expired CO

2 pressure

PEEP Positive end expiratory pressure

PEEPi Intrinsic positive-end expiratory

pressure

∆Phf Δ pressure amplitude during HFO

Phigh Upper pressure level during

APRV

PI Perfusion index (SpO2)

PIP Peak inspiratory pressure

Pinsp Inspiratory pressure

Abbreviation Description

Plow Lower pressure level during

APRV

PLS Pulse rate from SpO2

ART Arterial blood pressure – pulse

PLS

rate

Pmax Maximum inspired pressure

Pmean Mean airway pressure

Pmin Minimum airway pressure

Pplat Plateau pressure

PTC Post tetanic count

PS250 Power supply unit

∆Psupp Pressure amplitude above PEEP

in pressure support

SC-∆Psupp rated

Pressure support by internal controller (SmartCare)

PV Pressure-Volume loop

PVC/min Rate of PVC (pre-ventricular

contractions) per minute

PVI Pleth variability index

PVR Pulmonary vascular resistance

PVRI Pulmonary vascular resistance

index

PWP Pulmonary wedge pressure

PWR Total signal power

Qs/Qt Intrapulmonary right-left shunt

R50N Strip recorder

R Resistance (airway)

r2 Parameter correlation factor

RA Right arm (ECG)

RA Right atrial blood pressure

Raw Resistance (airway)

Raw exp Expiratory resistance (airway)

Raw insp Inspiratory resistance (airway)

Resp. Respiration

RR Respiratory rate

RRapn Rate for apnea ventilation

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 39

Page 40

System overview

Abbreviation Description

RPP Rate pressure product

RRc Respiratory rate (CO

RRi Respiratory rate (impedance)

RRmand Mandatory respiratory rate

RRs Respiratory rate, spontaneous

RRspon Respiratory rate, spontaneous

RR Respiratory rate, ventilation

RSB Rapid shallow breathing index

RUN Ventricular run

RV Right ventricular blood pressure

RV D RV diastolic value

RV M RV mean value

RV S RV systolic value

RVSW Right ventricular stroke work

RVSWI Right ventricular stroke work

index

SaO2 Arterial oxygen saturation

SC-duration Duration of patient session

(SmartCare)

SC-etCO2 etCO2 (SmartCare)

SC-RRspon Spontaneous frequency

(SmartCare)

SC-VT Tidal volume (SmartCare)

Sev cons Cumulative sevoflurane

consumption

SEF Spectral edge frequency

SpCO Carboxyhemoglobin saturation

SpHb Total arterial hemoglobin

SpHbv Total venous hemoglobin

SpMet Methemoglobin saturation

SpOC Total oxygen content

SpO2 Oxygen saturation measured by

pulse oximetry

SpO2/CO-Ox CO-oximetry

Abbreviation Description

SQI Signal quality index

ST(x) ST deviation of lead (x)

STdV1 STdV3

ST-segment deviations of derived

leads STdV4 STdV6

SV Stroke volume

SVI Stroke volume index

SvO2 Venous oxygen saturation

SVR Systemic vascular resistance

SVRI Systemic vascular resistance

index

SVT Supraventricular tachycardia

SVV Stroke volume variation

TACH Tachycardia

Tapn Apnea

Tblood Blood temperature

TC Time constant

Tcase Therapy case duration

Thigh Time of upper pressure level in

APRV

Ti Inspired time

Ti set Inspired time setting

Tinj Injectate temperature

Tispon Spontaneous inspiratory time

Tlow Time of low pressure level in

APRV

TOF Cnt Train of four (NMT)

TPR Total pulmonary resistance

Trapped VOL Trapped volume

TruST Algorithm that provides a TruST

12-lead-ECG (including derived

chest leads dV1, dV3, dV4, dV6)

using a 6-wire lead set that

provides leads I, II, III, aVL, aVR,

aVF, V2, V5.

VTe Tidal volume, expiratory

40 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 41

System overview

Abbreviation Description

TVd aw Tidal volume, dead space

Vds/VTe Tidal volume, relative dead space

VTi Tidal volume, inspired

TVR Total vascular resistance

V Chest lead from a 5- or 6-wire

lead set.

V+ Second chest lead from a 6-wire

lead set

V1 - V6 ECG chest leads V1 to V6

2 CO2 production

V'CO

VCO2 CO

2 production

Vds Dead space

Vds/VTe Relative dead space

VESA Video Electronics Standard

Association

VF Ventricular fibrillation

VO2 Oxygen consumption

VO2I Oxygen consumption index

VTACH Ventricular tachycardia

VT Tidal volume

VTe Tidal volume, expired

VTemand Mandatory expiratory tidal volume

VTespon Spontaneous expired total volume

VTespon mean

Spontaneous expired mean total volume

VThf Tidal volume for HFO

VTimand Mandatory inspired tidal volume

VTi Tidal volume, inspired

VTispon Spontaneous inspired tidal

volume

VTispon mean

Spontaneous inspired mean total volume

VTmand Tidal volume, mandatory

VTspon mean Spontaneous mean tidal volume

Abbreviation Description

VTspon Spontaneous tidal volume,

leakage-corrected

Vtrap Trapped volume

VT/Wt Tidal volume per kg body weight

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 41

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42 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Page 43

Operating concept

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

The IACS components . . . . . . . . . . . . . . . . . . 45

M540 and Cockpit communication . . . . . . . . 46

Docking the M540. . . . . . . . . . . . . . . . . . . . . . . 46

Undocking the M540. . . . . . . . . . . . . . . . . . . . . 47

Communicating with the Infinity network . . 48

Loss of connection to the network . . . . . . . . . . 48

M540 in standalone mode . . . . . . . . . . . . . . . . 48

Network data transfer . . . . . . . . . . . . . . . . . . . . 49

Remote control and remote view . . . . . . . . . 51

Remote view from the Cockpit . . . . . . . . . . . . . 51

Central monitoring . . . . . . . . . . . . . . . . . . . . . . 53

Network communication interruptions . . . . . . . 53

Remote control . . . . . . . . . . . . . . . . . . . . . . . . . 54

IT applications . . . . . . . . . . . . . . . . . . . . . . . . . 54

Communication management . . . . . . . . . . . . 54

Loss of power . . . . . . . . . . . . . . . . . . . . . . . . . 57

Locked options. . . . . . . . . . . . . . . . . . . . . . . . 57

Temporary options . . . . . . . . . . . . . . . . . . . . . . 57

Secondary display . . . . . . . . . . . . . . . . . . . . . 58

Filtering the parameter content . . . . . . . . . . 67

Auto and manual display modes . . . . . . . . . 67

Auto view mode. . . . . . . . . . . . . . . . . . . . . . . . 67

Manual view mode . . . . . . . . . . . . . . . . . . . . . 67

Auto view setup toolbar . . . . . . . . . . . . . . . . 68

Customizing the display. . . . . . . . . . . . . . . . 68

Screen brightness . . . . . . . . . . . . . . . . . . . . . . 68

Touchscreen versus mouse. . . . . . . . . . . . . . . 68

Calibrating the touchscreen. . . . . . . . . . . . . . . 68

Cockpit screen in split screen mode . . . . . . . . 69

Cockpit split screen mode with mini-trends . . . 70 Cockpit split screen mode with multi-tab split

screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Cockpit split screen mode with mini-trends

and IT tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Parameter priority . . . . . . . . . . . . . . . . . . . . . 73

Configuring the parameter priority and

display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Parameter priority list . . . . . . . . . . . . . . . . . . . 73

Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Selecting a view . . . . . . . . . . . . . . . . . . . . . . . 74

The view editor . . . . . . . . . . . . . . . . . . . . . . . . 74

Export protocol. . . . . . . . . . . . . . . . . . . . . . . . 58

User interface . . . . . . . . . . . . . . . . . . . . . . . . . 59

Header bar. . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Monitoring area. . . . . . . . . . . . . . . . . . . . . . . . 61

Parameter fields . . . . . . . . . . . . . . . . . . . . . . . . 62

Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Freezing/stopping waveforms. . . . . . . . . . . . . . 63

Supported messages . . . . . . . . . . . . . . . . . . . 63

Dialogs and pages . . . . . . . . . . . . . . . . . . . . . . 64

Main menu bar and quick access toolbar . . 65

Main menu bar . . . . . . . . . . . . . . . . . . . . . . . . . 65

Quick access toolbar . . . . . . . . . . . . . . . . . . . . 66

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 43

Profiles/status . . . . . . . . . . . . . . . . . . . . . . . . 75

Patient and default profiles . . . . . . . . . . . . . . . 75

Settings included in a profile . . . . . . . . . . . . . . 76

Settings not included in a profile . . . . . . . . . . . 81

System profiles . . . . . . . . . . . . . . . . . . . . . . . . 82

Managing profiles and views . . . . . . . . . . . . 86

Transferring profiles. . . . . . . . . . . . . . . . . . . . . 86

Standby mode . . . . . . . . . . . . . . . . . . . . . . . . 87

Privacy mode . . . . . . . . . . . . . . . . . . . . . . . . . 88

Screen lock . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Page 44

Operating concept

Overview

The IACS is a fully networked solution that offers patient monitoring, therapy, and IT applications at the point of care.

Dräger developed the IACS to solve problems common in the acute care environment. As a result, the IACS provides standardized user interfaces, improves workplace ergonomics and flexibility, and centralizes patient data at the point of care. The IACS also provides the ability to backfill information automatically after patient transport. An M540 on wireless transport transmits the data to the ICS (Infinity CentralStation) during transport.

The central component of the IACS is the Cockpit. This medical-grade workstation provides centralized viewing and control of Infinity monitoring systems and IT applications at the point of care. The Cockpit is available in the following sizes:

Display Screen width

C500 (2

C700 (2

generation) 17-inch (43.2 cm)

generation) 20-inch (50.8 cm)

Both offer a large viewing angle, extended screen layout capabilities, and a fan-less design.

The common Dräger-standardized user interface offers intuitive operation via a touchscreen and a rotary knob. A 360-degree alarm bar alerts the user to the alarm conditions of a patient.

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The IACS components

MPP

The following diagram shows a possible IACS configuration.

Operating concept

A C500/C700

B DVI cable

C Secondary display (option)

D USB cable

E Keyboard and mouse (option)

F Device connectivity cable (option)

G M540 patient monitor

H M500 docking station

I System cables

J *R50N recorder (option)

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*Not available in the EU

K AC power

L Infinity network

M Infinity MCable – Nurse call (option)

N P2500 / PS250

O Hospital network

P Ethernet cable

005

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Operating concept

M540 and Cockpit communication

Communication between the M540 and the Cockpit starts as soon as the M540 is docked in the M500 (see page 93). The M540 acquires physiological signals from the patient and relays them to the Cockpit for display. The Cockpit then makes the patient data available to the Infinity network.

When the M540 is docked, the Cockpit assumes the annunciation of all acoustic alarm signals. However, alarms are always reported optically at the Cockpit and at the M540. When the M540 is undocked for transport, it provides acoustic alarm signals. In addition, the ICS can assume the annunciation of acoustic alarm signals for an M540 on wireless transport.

NOTE

For alarms to also sound at the M540 when it is docked, select the alarm volume at the M540 manually. For information, refer to the M540 instructions for use.

The only exceptions are Cockpit-specific alarm messages such as External device disconnected for which the M540 does not report any acoustic and optical alarm signals.

When the M540 is docked, any changes to the patient setup such as alarm limits made on the Cockpit are automatically transferred to the M540 (and vice versa).

Docking the M540

As soon as the user docks the M540 in the M500, the following happens at the Cockpit:

– The message Connecting to M540 appears in

the center of the Cockpit screen.

– The Cockpit makes the data of the M540

available to the Infinity network.

NOTE

If the user docks an M540 with a patient category that differs from the one selected on the Cockpit, the patient category setting of the Cockpit changes to match the one of the M540.

Docking to the same Cockpit

If the user undocks an M540 from a Cockpit and later docks the M540 to the same Cockpit, the data collection continues seamlessly. The Cockpit automatically retrieves any data the M540 collected while on patient transport and merges it with the data set for that patient.

NOTE

If the M540 cannot communicate with the Cockpit, the Cockpit sounds an alarm. In addition, an alarm indicating a loss of communication is broadcast over the network to the Infinity CentralStation (ICS) provided the patient is admitted there. The M540 continues to monitor the patient.

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Operating concept

Docking to a different Cockpit

CAUTION

Before connecting the M540 to a different Cockpit, make sure that the units of measure align between the two devices. Differing units of measure could result in loss of data or a patient discharge.

If the user undocks an M540 from a Cockpit and later docks the M540 to a different Cockpit, the original data are automatically retrieved over the network by the new Cockpit. The new Cockpit then automatically merges this data with any data the M540 collected while on patient transport. The original Cockpit automatically discharges the patient once all patient data are transferred.

When moving the M540 between Cockpits in different monitoring units, the time stamps may differ occasionally between the Cockpit and the M540.

If not all patient data was transferred, the message Transfer of Data Incomplete appears in the header bar of the new Cockpit. In this case, the original Cockpit does not discharge the patient.

Undocking the M540

When the user undocks the M540, the following happens:

– The message Disconnected from M540

appears in the center of the Cockpit screen.

– When the M540 is not in wireless mode, a

message appears at the ICS that the bed is disconnected. When the wireless option for an M540 is activated and configured properly, the ICS displays the wireless symbol.

– Data are no longer trended at the Cockpit.

– With each docking or undocking of an M540,

there is a short transition period. One minute of trend data collected during this transition period may not be displayed at an ICS equipped with software version VG1. However, this trend data can be reviewed at the Cockpit.

– Several buttons remain active on the main

menu bar of the Cockpit:

– Alarms... for accessing the alarm history.

– Trends/ Data... for accessing the trend

data.

– Start/Standby... for accessing the Start tab

from where the user can initiate a patient discharge.

– The current patient data from the Cockpit are no

longer available to the Infinity network. However, when the wireless option for an M540 is activated and configured properly, it continues to make the data available to the Infinity network.

– Parameter values acquired using the device

connectivity option are no longer available to the Infinity network.

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Operating concept

Communicating with the Infinity network

When the M540 is docked on the M500 and the IACS is connected to the network, the patient data are available on the Infinity network. When the setting, Enable Central Station is activated, the Cockpit provides additional messages and alarm tones for central monitoring. For more information, see page 46.

Communicating with the Infinity network has the following benefits:

– Patient data are sent across the Infinity network

to connected devices.

– The alarm status of the patient is reported to the

Infinity network and its connected devices. If multiple alarm conditions are present, the alarm with the highest alarm priority is reported.

– The patient can be admitted at the ICS for

central monitoring. The IACS is fully compatible with ICS software VG8.12 or higher.

WARNING When the M540 is connected to the Infinity

network, make sure that the ICS is equipped with software version VF8.10 or a later version. On earlier versions of the ICS, gaps in the waveform may be displayed in the Full Disclosure application of the ICS after docking or undocking a wireless M540.

– You can view the Cockpit from other Infinity

monitors within the same monitoring unit using the remote view function (see page 53).

– From the Cockpit you can view other bedside

monitors (including other Cockpits) in the same monitoring unit using the remote view function (see page 51).

NOTE

Two IACS monitoring devices in the same monitoring unit on the network, may result in a perceived time drift of a maximum of 80 seconds between each other.

Loss of connection to the network

When the Cockpit loses connection to the Infinity network and the feature Offline detection is activated (see page 476), the following happens:

– A single notification alarm of low alarm priority

sounds once within 25 seconds of the offline condition until the communication with the network is restored or the alarm is acknowledged. The alarm tone sounds even if alarms are paused or the alarm volume has been deactivated.

– The alarm volume is automatically adjusted to

100% until the network connection is restored. Once the Cockpit re-establishes communication with the network, the previous alarm volume is restored.

– The message Offline appears on cyan

background in the network message area of the Cockpit until the connection to the network is restored.

When the wireless option is activated and configured properly, the M540 switches to wireless transport mode automatically within ten seconds of being undocked from the M500 (see “Undocking the M540“ on page 47). For detailed information on how an M540 behaves on wireless transport, refer to the instructions for use Infinity Acute Care

System – Infinity M540.

M540 in standalone mode

When the wireless option is activated and configured, a standalone M540 communicates wirelessly with the Infinity network when undocked. When docked, a wireless M540 transitions back to a wired connection, and the wireless symbol is replaced by the network symbol .

For detailed information on how the M540 behaves in standalone mode, see the Instructions for use entitled Infinity Acute Care System – Infinity M540.

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Network data transfer

The IACS supports the transfer of patient data to and from the following devices assigned to the same monitoring unit:

– Infinity Delta/Delta XL/Kappa (software version

VF7 to VF9.x)

– Other IACS monitoring Cockpits

NOTE

You can also transfer patient data by undocking and redocking an M540.

The following data are included in a patient data transfer:

– Demographic data (see page 101 for

information of what demographic data is included)

– Trends (up to 60 trended

NOTE

The amount of data being transferred over the network depends on how much data is available at the source device. A maximum of 60 trend parameters can be transferred over the network based on the parameter priority of the Cockpit.

For Delta series monitors, the maximum amount of data is 24 hours. For a network transfer between IACS Cockpits, the maximum of data is 96 hours.

– Events containing up to 32 parameters for

(C500) or up to 40 parameters for (C700)

– Hemodynamic, oxygenation, and ventilation

calculation results

– Laboratory data values are not transferred

during a network transfer. The following diagram shows the Transfer page which is used for patient data transfers.

NOTE

Due to a possible time variation between cockpits, the trend time stamp may vary by one minute after a network transfer.

parameters)

Operating concept

006

A Transfer tab

B Care area selection arrow

C Current patient column

D Device name column

E Start transfer button

To transfer data over the network

The IACS network supports the transfer of patient data from a source device, such as an Infinity Delta, Delta XL/Kappa or an IACS Cockpit, to another Cockpit.

1 Place the source device in standby mode.

2 Go to the Cockpit to which you wish to transfer

data.

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Operating concept

CAUTION

To prevent mixing the data of two patients, first discharge the patient admitted at the destination Cockpit. If the patient is not discharged, the new data is appended to the existing data stored at the destination Cockpit.

3 Select the Start/Standby... button on the main

menu bar.

4 Select the Transfer tab (if not already

selected). The Transfer page (see page 54) lists all of the devices in the currently selected care area who are in standby mode.

5 Use the care area selection arrow (B) on the

Transfer page to select the care area from the list in which the source device is located.

6 Select the source device in the Device name

column (D).

7 Select the Start transfer button (E).

8 Press the rotary knob. A Confirm transfer

dialog appears with the following message: The network transfer will delete existing patient data on this device.

9 Select one of the following buttons:

– Cancel – to prevent the data transfer and

return to the Transfer page.

– Transfer – to discharge the patient from the

Cockpit and initiate the data transfer. During the transfer, the Cockpit and M540 display the message Transferring data...

CAUTION

Do not touch the screen or undock the M540 during the transfer, or a network failure will occur, and the transfer will not be completed.

A successful transfer results in the following:

– The Cockpit returns to the main screen.

– The message Transfer Complete appears in

the Cockpit header.

A failed transfer results in the following:

– The Cockpit returns to the Transfer page.

– The messageTransfer of data incomplete

displays in the network message header of the Cockpit.

– The M540 returns to the last monitoring screen

before the transfer started.

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Remote control and remote view

Operating concept

When a Cockpit is connected to the Infinity network, data can be shared among Infinity devices that are connected to the network. From the Cockpit, the user can view other Infinity devices

Remote view from the Cockpit

The remote view function of the Cockpit allows the user to view patient data from other Infinity monitors within the same monitoring unit. If the user is viewing another Cockpit, the remote view window shows the Auto 90 (see page 67) of the remote Cockpit.

The remote view function also allows the user to pause acoustic alarm signals and request timed and continuous recordings of the remote device from the Cockpit.

To access the remote view

1 Select the Views... button on the main menu

bar to access the Views dialog.

2 Select the Remote view tab. This dialog lists all

of the beds in the monitoring unit of the Cockpit.

3 Select a bed from the list in the Views... dialog

to access the remote view of an individual patient.

4 Select the Connect button.

When there are multiple alarms in the same p-box, the p-box in remote view for the selected bed on IACS does not match the bed when Quiet Mode is set to OFF.

and perform several remote functions. The user can also allow other Infinity devices to view a Cockpit and perform remote functions by activating the remote control function (see page 475).

NOTE

When there are multiple alarms of different states and/or priorities in the same parameter field, the remote view parameter fields may not display correct color and flashing when Quiet mode is set to Off. However, when Quiet mode is set to On, remote view updates the correct alarm status for all parameters from the remote bed.

In the remote view of the Cockpit, the message Pacer off does not appear when the pacer detection is deactivated on the source monitor.

The following diagram shows a Remote view.

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Operating concept

Views...

007

A Disconnect button

B Audio Pause button

C Continuous Recording button

D Timed Recording button

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Operating concept

Using remote view functions

From the Remote view dialog, the user can perform the following functions:

– Select the Disconnect button (A) to exit the

remote view.

– Select the Audio Pause button (B) to pause

acoustic alarm signals at the remote device.

– Select the Continuous Recording (C) or

Timed Recording (D) buttons to request a recording of the remote device. The recordings are printed on the recorder that is assigned to the Cockpit.

Central monitoring

When a Cockpit communicates with the Infinity network, the user can admit the patient at the ICS for central monitoring. A Cockpit patient is represented on the ICS with a viewport and a bed view. A viewport consists of the top Cockpit waveform and the associated parameter field. The ICS also provides a bed view which is a window displaying the content of the Cockpit in greater detail. When the Cockpit is communicating with the ICS, the waveforms and parameter fields are assigned to the bed view based on the parameter priority order.

NOTE

Due to potential time drifts between the IACS and the ICS, when an alarm is generated from the IACS, the waveform displayed on the ICS event disclosure may not align with the timestamp of the event. Place the cursor at the timestamp of the

event and then go to the ICS's Full Disclosure for a more complete view of the waveforms.

Network communication interruptions

When the Cockpit loses communication with the ICS, the following happens at the Cockpit when the Enable Central Station setting is activated (see page 475):

– The message Not Monitored By Central

appears on cyan background in the network message area of the Cockpit.

– A single notification alarm of low alarm priority

sounds within 25 seconds until communication with the ICS is restored or the alarm is acknowledged. The alarm tone sounds even when alarms are paused or the alarm volume has been deactivated.

– The alarm volume is adjusted automatically to

100% until the condition clears. Once the Cockpit re-establishes communication with the ICS, the previous alarm volume is restored.

– The message System not monitored by ICS is

recorded in the alarm history.

When the communication between the Cockpit and the ICS is restored, the Cockpit displays the message System monitored by ICS in the alarm history. The patient data are again accessible at the ICS.

When the setting Enable Central Station is deactivated (see page 475), none of the above features are supported.

NOTE

When you select an event disclosure at the ICS for a parameter with a decimal value, the parameter rounds to the nearest whole number.

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Operating concept

Remote control

If the remote control feature is activated (see page 475), the user can perform the following Cockpit functions remotely from the ICS:

NOTE

Remote control of arrhythmia settings from ICS is only possible if the full arrhythmia option is enabled on the Cockpit.

– Autoset alarm limits

– Initiate a relearning phase

– Audio pause acoustic alarm signals (see

page 121)

– Configure alarm limits and ST and arrhythmia

settings

– Request timed and continuous recordings

If the remote control feature is activated (see page 475), the user can perform the following Cockpit functions remotely from one of the following devices: Delta XL or Kappa, Vista XL, Gamma X XL:

– Request timed and continuous recordings

– Audio pause acoustic alarm signals

If several devices modify the patient settings of a single Cockpit, the last update is always implemented. For detailed information on performing these functions at the ICS, refer to the instructions for use Infinity CentralStation.

IT applications

Several optional IT applications provide remote access to patient data from the Cockpit. For example, the PatientWatch application (accessible with the Infinity Gateway) allows viewing of up to four different bedside monitors that are connected to the Infinity network. If configured accordingly, IT applications are accessible by selecting a tab on the Cockpit. For more information, see “IT applications (options)“on page 503.

Communication management

The following table summarizes how the Cockpit, the M540, and the M500 function under specific circumstances.

What happens if... Behavior

the user switches on the M540? The M540 emits a high-pitched tone followed by two

power-up tones, performs a selftest, and displays the New patient? prompt.

Docking/undocking an M540

the user docks an M540? Certain functions such as trends, alarm history,

profiles, and biomed setup are not accessible for a brief period of time.

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Operating concept

What happens if... Behavior

the user docks an M540 and it is unable to communicate with the Cockpit?

an M540 whose acoustic alarm signals have been paused docks to a Cockpit?

the user docks an M540 with a different alarm pause state than that of the Cockpit?

Connection/power problems

there is a power supply failure? – The LEDs on the front indicate that the Cockpit and

the system cable is disconnected from the power supply or the M500?

– An alarm of medium priority sounds at the Cockpit,

at the M540, and at the ICS (provided the patient is admitted there).

– The message M540 communication failure

appears at the Cockpit.

– The M540 continues to monitor the patient and

provides acoustic and optical alarm signals.

Alarm behavior

All acoustic alarm signals are paused for two minutes on both devices.

Both devices observe the remaining alarm pause interval.

the M540 are on battery charge.

– The Cockpit sounds an alarm of medium priority

and switches to battery charge for up to five minutes before performing a safe shutdown.

– The M540 switches to battery charge for up to three

hours before shutting down.

– The Cockpit sounds an alarm tone of low priority.

– The Cockpit displays the message Please plug in

system cable in the header bar and the message Disconnected from M540 appears in the

monitoring area.

– The Cockpit no longer displays any parameters

and waveforms.

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Operating concept

What happens if... Behavior

the Cockpit loses communication with the ICS?

the Cockpit loses communication with an external device?

the Cockpit and the M540 are monitoring a patient and the user puts either device in standby mode?

the Cockpit and the M540 are monitoring a patient and the user discharges the patient on either device?

a function such as initiating a non-invasive blood pressure measurement is requested at the M540 and almost simultaneously on the Cockpit?

When the setting Enable Central Station is activated (see page 475), the following happens at the Cockpit:

– On the Cockpit the Alarm volume setting (see

page 458) changes to 100% volume regardless of whether an alarm condition exists or not. The setting Off for the Alarm volume selection is no longer available. For more information on adjusting the alarm volume, see page 115. Once the communication is restored, the previously selected Alarm volume setting is restored.

– The M540 produces one alarm tone.

– The Cockpit displays the message Not Monitored

By Central.

When the setting Enable Central Station is deactivated (see page 475), none of the above features are supported.

– The Cockpit tries to restore the link.

– If the corresponding function is activated, an alarm

sounds and the message External device disconnected appears on the Cockpit and ICS (see “External device disconnected alarm control“on page 461).

Miscellaneous

Both devices are put in standby mode.

– The patient is discharged from both devices.

– The patient discharge is annotated at the Cockpit in

the Alarm history page with the message Patient transferred.

The function is canceled on both devices.

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Loss of power

Operating concept

A loss of power has the following effect:

– The Cockpit switches to battery charge for up to

five minutes before performing a safe shutdown that preserves the integrity of the patient data and reverts to the user-defined patient default profile.

Locked options

The IACS supports several locked options. For a list of options, refer to the instructions for use

Infinity Acute Care System – Monitoring Accessories.

Temporary options

Temporary options make it possible for an M540 in an IACS configuration to perform the intended functions together with the Cockpit when the devices do not share the same option setup. For example, when an M540 with permanent options docks to an IACS Cockpit that does not have the same options activated, the M540 options temporarily loans these options to the Cockpit.

Temporary options are deactivated when a patient is discharged. However, they are retained if the user turns the Cockpit or the M540 off and on.

– A medium-priority alarm is triggered at the

Cockpit and the message please plug in power supply appears.

– The M540 switches to battery charge for up to

three hours before performing a safe shutdown that preserves the integrity of the patient data and the user settings.

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Operating concept

Secondary display

To extend the display capabilities of a Cockpit, connect a secondary display to the DVI connector of the Cockpit using a DVI to DVI to VGA cable type.

The secondary display duplicates the content of the Cockpit screen. It does not produce any acoustic alarm signals and does not support any user interaction. A secondary display has to meet certain technical specifications (see page 593):

Export protocol

This function allows sharing data with other Dräger and third-party devices such as clinical information and anesthesia record systems and data loggers.

The export protocol connector is located on the P2500/PS250 (see page 27).

Refer to the section “Connected devices“on page 15 when connecting third-party devices.

Display Resolution

C500 (2

C700 (2

generation) 1440 x 900 pixels

generation) 1680 x 1050 pixels

NOTE

Exporting temperatures is only supported in Celsius, and exporting blood pressure values is only supported in mmHg. However, these values can be converted to the desired unit of measurement once exported.

NOTE

Export does not indicate parameters that are no longer on display.

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User interface

The following sections describe the user interface of the Cockpit when it is connected to an M540.

The screen of a monitoring Cockpit is divided into the following main areas:

A Header bar

B Main menu bar

C Auto view toolbar (if activated)

D Monitoring area

For a more detailed overview of general user interface components of the IACS, refer to the instructions for use Infinity Acute Care System –

Medical Cockpit.

Operating concept

008

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Operating concept

Header bar

The blue header bar appears along the top of the Cockpit screen. It is always visible regardless of what is displayed in the monitoring area.

A Patient category field

B System data field

C Patient name field

D Time and date field

E Alarm message field

F Alarm status field

The patient category field

The patient category field (A) of the header bar identifies the currently selected patient category. It contains one of the following symbols:

– Adult

– Pediatric

– Neonate

Touching this field opens the Start/Standby... dialog for accessing the Demographics page (see page 102).

The system data field

The system data field (B) of the header bar contains the following information:

– Product label

– Care unit

– Monitoring mode (for example, OR Alarms) or

the battery symbol indicating the battery status for the PS250 or the P2500.

Touching this field opens the System setup dialog with the Biomed activation code keypad.

The patient name field

The patient name field (C) of the header bar displays the patient name. Selecting this field opens the Demographics page (see page 101).

The content of the patient name field changes when

009

the Code button is selected on the main menu bar to activate a set of user-defined emergency monitoring functions. In this case, the patient data field displays a timer along with a Stop and a Reset button. For more information on the Code function, see page 147.

The date and time field

The data/time field (D) of the header bar displays the current date and time. Selecting this field opens the System setup dialog with the Biomed activation code keypad.

The alarm message field

The alarm message field (E) of the header bar is reserved for alarm and technical messages. The background color of the alarm message corresponds to the alarm priority (see page 112).

The following table illustrates how the alarm message field is further subdivided.

More... Alarm message Alarm message

Local technical messages

A maximum of two messages can be displayed side by side. If more than two patient alarm messages are active simultaneously, the More... button appears. Selecting this button accesses the Current alarms page (see “Viewing current alarm messages“on page 116).

Network-related messages

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Operating concept

The alarm status field

The alarm status field (F) of the header bar (see page 509) indicates the current alarm status. The following are some examples of alarm-related symbols and messages that can appear in this field.

Symbol Label Description

Audio paused Appears with a timer when the yellow key located next to the rotary

knob is pressed.

where n is the numeric percentage

Audio off Indicates that the alarm volume has been turned off, the Cockpit is

All alarms paused

All alarms off Indicates that all alarms are off after selecting the Alarms... > All

The alarm volume percentage corresponding to the selected alarm volume. The higher the alarm tone, the more the symbol is filled in (50% in the example). If the symbol appears empty, the alarm volume has been turned off (see next message).

in OR mode or monitored by the ICS.

Indicates that all alarms are paused after selecting the Alarms... >

All alarms paused buttons.

alarms off buttons.

For a complete list of supported messages, see page 510.

For more detailed information on alarm monitoring, see the “Alarms“chapter.

Monitoring area

The monitoring area of the Cockpit screen contains waveforms and parameter fields that report the current vital signs of the patient. The monitoring area can also contain dialogs, mini-trends, an auto view toolbar, ST parameters, vent loops, and so on. The appearance of the monitoring area depends on the selected view, which controls the layout and content of the screen (see “Views“on page 74). The appearance of the monitoring area also depends on whether or not the split screen mode or minitrend display is selected (see page 458).

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When opening a dialog, the waveform channels and parameter fields are reduced to fit on the right side of the screen (see figure on page 64). This display behavior prevents the vital signs from being obscured while the user is performing setup tasks.

Selecting the Home button on the main menu bar or pressing the rotary knob closes any open dialogs and refreshes the screen.

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Operating concept

Parameter fields

Each parameter field contains real-time values of a parameter and a combination of the following information:

– Parameter labels (including dynamic pressure

labels)

– Alarm limits (or crossed triangle symbols when

the alarm functions are deactivated)

– Units of measure (can be activated/deactivated)

– ECG heart blip (and pacer blip for paced

pulses), RRi blip, and SpO2 blip

–Time stamps

– Timers and time stamps for non-invasive blood

pressure

– Special source labels (for example, PLS for

heart rate signal source for pulse oximetry)

– Parameter-specific message fields for non-

invasive blood pressure and SpO2

The amount of information on a screen affects the parameter field display. For example, the following diagram shows a typical expanded SpO2 parameter field when enough space is available for the larger parameter field. The primary parameter value (A) appears bigger than the other subordinate parameters who are displayed below each other (B, C). The parameter labels (D) appear above the respective parameter values.

The following example shows how the same parameter field changes when more parameters occupy the main screen. Each parameter field has less space to display its content. The primary parameter value (A) still appears bigger than the subordinate parameters (B, C) which now all appear on one line. The parameter labels (D) still appear above the respective values.

479

When a parameter is in alarm, the parameter field flashes in the color of the alarm priority and a corresponding alarm message appears in the header bar (see “Troubleshooting“on page 509). The parameter fields displayed on the Cockpit for each parameter are described in detail in each parameter chapter.

Waveforms

The Cockpit displays a minimum of six seconds of waveform data per waveform channel at a sweep speed of 25 mm/s when no dialogs are open. The amount of displayed waveforms depend on the size of the Cockpit.

When the waveform option is activated, the Cockpit displays up to 16 waveforms.

The following functions allow customization of the waveforms:

480

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Operating concept

– Changing the colors for individual parameters

(see, for example, how to change the color for ECG on page 214)

– Changing the sweep speeds (see page 445)

Waveforms are drawn from left to right and can contain the following information:

– Signal scales

–Grids

– Units of measure

– Parameter labels

– Pacer spikes

– QRS synchronization markers

– Respiration waveform markers to indicate

breath detection

– Messages (see page 63)

Supported messages

The Cockpit displays numerous messages that indicate a special monitoring state that may affect certain functionality. For example, when cardiac bypass monitoring is activated, alarms are turned off. The alarm message field of the header bar turns red and the message Bypass Audio alarms off appears.

For a complete list of these messages, see "Messages" on page 513.

NOTE

If the acquired signal does not fit in the waveform channel, the top of the waveform may appear clipped.

Freezing/stopping waveforms

 Select the Freeze waveforms button on the

main menu bar.

All waveforms stop and the message Waveforms stopped appears on each waveform channel. After approximately 60 seconds, the waveforms start scrolling again. To restart the waveforms earlier, select the Freeze waveforms button again.

Freezing waveforms does not affect continuous monitoring of all parameters and does not freeze waveforms on the M540.

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Operating concept

E E

Dialogs and pages

The following diagram shows how the monitoring area appears when the user accesses a dialog. The left side is reserved for the dialog while the right side displays the monitoring area (F) with realtime data. A dialog contains horizontal tabs (B) that open pages. Some pages also contain vertical tabs (E) which access subordinate pages.

Selecting the corresponding button followed by dots on the main menu bar opens the corresponding dialog. For example, the Alarms... button opens the Alarms dialog. The user can also access parameter-specific dialogs and pages directly by selecting the corresponding parameter fields on the main screen. For example, if the user selects the heart rate (HR) parameter field, the Sensor parameters dialog with the ECG page appears.

A Dialog title

B Horizontal tabs – the selected tab appears light

blue.

C Button that closes the dialog.

D Display filter on/off button for switching between

a display that shows only connected parameters or one that shows all parameters.

E Vertical tabs for accessing additional pages –

the selected tab appears light blue.

64 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

F Monitoring area showing vital signs in real time.

G Page that contains groups of related settings in

the selected tab.

010

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Main menu bar and quick access toolbar

B B B B B B

Operating concept

The following diagram shows the main menu bar with the quick access symbols and a quick-access toolbar. The main menu bar and the quick-access symbols are located along the right edge of the screen and are always visible. The quick-access toolbars remain visible after the user selects the corresponding quick access symbol.

A Quick access symbols

B Main menu bar buttons

C Quick access toolbar

Main menu bar

The content of the main menu bar can be customized. By adding and removing buttons, the menu bar can contain the most frequently used buttons. However, several buttons with essential functionality are permanently placed on the menu bar and cannot be moved. This key configuration becomes part of a profile. For more information, see page 452.

The following buttons appear on the main menu bar.

Alarms... Opens the Alarms dialog.

Mark event Stores an event in the alarm

history.

Code Executes pre-configured

functions during an emergency.

Views... Opens the Views dialog.

Print screen

Freeze waveforms

Trends/ Data... Opens the Trends/Data dialog.

Procedures... Opens the Procedures dialog.

Sensor

011

parameters...

NIBP start/stop Starts or stops an NIBP

Zero all

System setup... Opens the System setup

Start/Standby... Opens the Start/Standby

Home Returns to the main screen and

This button only appears on the main menu bar of the C700.

Prints the contents of the current screen on a connected laser printer.

Stops all waveforms for 60 seconds.

Opens the Sensor parameters dialog.

measurement. The button remains selected during a measurement. To cancel the measurement, select the button again.

Zeroes all pressures

dialog.

closes any dialog.

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Operating concept

Quick access toolbar

Functions that are commonly used are grouped on quick access toolbars for easy access. These quick access functions are accessible by selecting the corresponding quick access symbols on the main menu bar.

To activate a quick access function

1 Select the symbol to open the associated tool-

bar.

2 Select the desired button from the toolbar to

activate the function directly.

The following table lists the quick access symbol and the associated toolbar they open when selected.

Quick access

Associated Toolbar

symbol

All alarms off or All alarms paused (depending on

Located next to the Alarms... button

configuration)

Auto set all

Show all ECG

Remote view

Located next to the

Views... button

Print screen (C700 only)

ECG report

Rest ECG report

Located next to the

Trends/ Data... button

ST report

Alarm history report

Trend graph report

Trend table report

Calculations report

Timed wvf. report

Continuous wvf. report

Timed recording

Continuous recording

Print case summary

Zero all

NIBP continuous

Located next to the

Sensor parameters...

button

Venous stasis

Standby

Discharge

Located next to the

Start/Standby... button

Privacy

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Filtering the parameter content

Operating concept

To filter the content of the displayed parameters, use the display filter button which appears in the following dialogs:

– Parameter field of the Trends/Data dialog (see

page 162).

– Sensor parameters dialog where it appears to

the right of the parameter tabs.

– Alarms dialog (see page 129).

– Setup page for configuring the trend pages

(see page 167).

Auto and manual display modes

The user interface has two display modes: Auto view and manual view.

Auto view mode

Auto view mode is a plug-and-play concept where the content of the main screen depends on the connected parameter signals. For example, as soon as an SpO2 MCable is connected, the associated parameters become available for display. When the MCable is disconnected, the parameters are removed from the screen automatically.

NOTE

The NIBP parameter is always displayed. The M540 does not detect the connection status for this parameter.

The filter button toggles between an unfiltered and filtered display. The filter is activated when the display filter button appears on the light green background. Any parameter that is not being actively monitored is removed from the screen, including parameter-specific setup buttons or tabs.

Selecting the button again changes the background to dark green and deactivates the display filter. All parameters, whether monitored or not, including associated setup buttons or tabs are displayed.

Manual view mode

In manual view mode, parameters for display can be selected even if they are not yet connected. In this mode, the parameter pick list in the Auto view page (see page 74) contains all parameters. The parameters that are not connected appear gray in the parameter pick list. In addition, the display filter button is deactivated.

To select the desired display mode

1 Select System setup... from the main menu

bar.

2 Select the Screen setup tab.

3 Select the Auto view tab located along the right

side of the System setup dialog.

4 Select the Auto or Manual button next to the

Display mode menu selection.

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Operating concept

Auto view setup toolbar

When the auto view mode is activated (see page 446), the auto view setup toolbar appears along the bottom of the screen. The auto view setup toolbar is for configuring the parameter priority and display status of a parameter. The auto view setup toolbar is also visible whenever the user selects a view that contains an auto view component.

Customizing the display

To suit clinical workflow needs, the following changes can be made to the display:

– Screen brightness

– Method of interaction with the Cockpit

– Touchscreen calibration

– Monitoring area customization

Screen brightness

Control the brightness of the Cockpit screen by selecting night and day mode (see page 445). Night mode reduces the luminance of the screen so it is less disturbing to a patient while providing enough contrast for the clinical staff. During night time mode, the entire background of the screen appears almost black. All buttons turn dark gray.

Touchscreen versus mouse

It functions dynamically with the Auto view page (see page 446) where the user selects the maximum number of waveforms and parameter fields and determines the parameter priority. Any changes made on the auto view setup toolbar are reflected on the Auto view page and vice versa.

Calibrating the touchscreen

If the touchscreen of the Cockpit is out of alignment, it can be calibrated. During the calibration of the screen, no waveforms are displayed on the Cockpit. Therefore, never calibrate the screen while monitoring a patient.

To calibrate the touchscreen

1 Press the rotary knob until the Calibrate Touch

Screen popup appears (requires several seconds).

2 Select the Calibrate button in the popup or

press the rotary knob again to access the calibration screen.

3 Touch the red dots that appear on the screen in

sequence.

4 Select the green check mark symbol to

complete the calibration procedure.

Use the touchscreen or a mouse to interact with the Cockpit. If the cursor is not visible after the mouse has been connected, press the Alt and F10 keyboard keys simultaneously to display the cursor.

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Cockpit screen in split screen mode

Operating concept

The following diagram shows the Cockpit display when the following options/features are activated:

– The web-enabled layouts option is unlocked.

– The split screen mode is activated (see

page 447).

The monitoring area of the Cockpit is reduced to accommodate an additional panel (E). The larger right side continues to display the real-time

parameters while the left panel displays either a tabular trend, loops, ECG show all page, ECG/ventilation, ECG/ST, or ST parameters (see page 446). If the web-enabled IT option is also activated, this panel also displays IT applications that are accessible using IT tabs (see page 72).

The following diagram shows how the split screen mode divides up the screen.

A Header bar

B Main screen menu bar

C Auto view setup toolbar (if activated)

D Monitoring area with real-time vital signs

E Split screen panel (content depends on user-

selection, and activation of web-enabled layouts option)

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Operating concept

Cockpit split screen mode with mini-trends

The following diagram shows the Cockpit display when the following options/features are activated:

– The web-enabled layouts option is unlocked

and the Split screen feature is activated (see page 447).

–The Mini trends feature is activated (see

page 447).

If the split screen mode is not activated, the minitrend panel shifts to the left edge of the screen.

Mini-trends are updated continuously. NIBP mini trends can either be represented in tabular or graphical format (see "Trending behavior" on page 162). All other parameters appear only as graphical mini-trends.

A Header bar

B Main screen menu bar

C Auto view setup toolbar (if activated)

D Monitoring area with real-time vital signs

E Split screen panel (content depends on

user-selection)

F Mini-trend panels

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Cockpit split screen mode with multi-tab split screen

The following diagram shows the Cockpit display when the Multi-tab split screen feature is activated by itself (see page 447).

Operating concept

A Header bar

B Main screen menu bar

C Monitoring area with real-time vital signs

D Multi-tab split screen – three tabs whose

content is configurable. To configure the Multitab split screen, see page 455.

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Operating concept

Cockpit split screen mode with mini-trends and IT tabs

The Cockpit supports IT applications that are accessible via tabs.

The following diagram shows the Cockpit display when the following options are unlocked and the features are activated:

– The web-enabled layouts option is unlocked

and the Split screen feature is activated (see page 447).

– The web-enabled IT tabs option is unlocked

– The Mini trends feature is activated (see

page 447).

Once the application is configured and the IT application feature is activated (see page 479), the corresponding tab appears to the left of the monitoring area. The Patient tab (G) always appears as the top tab. It always returns to the main screen of the Cockpit for viewing the real-time parameter display. For detailed information on setting up IT tabs, refer to the DrägerService technical documentation.

A Header bar

B Main screen menu bar

C Auto view setup toolbar (if activated)

D Monitoring area with real-time vital signs

E Mini-trend panel

F Split screen panel (content depends on the

user-selection)

72 Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

G IT tabs

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Parameter priority

Operating concept

The parameter priority determines what position a parameter occupies on the screen. The number of parameters appearing as waveforms and parameter fields depends also on the selected Waveforms setting (see page 447).

Use the Auto view page (see page 446) to determine the display location and display status of each parameter. Also, use the auto view setup toolbar in auto view mode to change the parameter priority (see page 449). In manual mode, the parameter priority can be changed only in the Auto view page.

Configuring the parameter priority and display

The location of a parameter in the window determines not only where a parameter appears on the screen but also how it is displayed. Parameters are arranged in descending order in the window and occupy the same position on the screen. For example, the top parameter in the parameter selection window occupies the top spot on the main screen. For more information see, “Configuring parameters for display“on page 448.

Parameter priority list

The priority list appears in the parameter selection window of the Auto view page (see page 446). Change the parameter priority by switching the position of the parameters in the Auto view page. For more information, see "To configure the parameter priority and display from the Auto view setup toolbar" on page 449.

The following list shows the default parameter priority list. Pressures without assigned labels appear as GP1, GP2, GP3, or GP4.

1 ECG

2 ECG2

3 SpO2

4 RRi

5 ART

6 PA

7 CVP

8 RA

9 LV

10 LA

11 RV

12 ICP

13 GP1

14 GP2

15 GP3

16 GP4

17 NIBP

18 CO

2 (from Infinity MCable – Mainstream CO2,

Infinity MCable – Microstream CO2 and Scio (Scio not available in neonate mode))

19 CO2 (non-MEDIBUS.X ventilators)

20 O

2 (Scio, not available in neonate mode)

21 Agent (Scio, not available in neonate mode)

22 C.O. (not available in neonatal mode)

23 SvO2

24 T (temperature)

25 T1

26 CO

2 (MEDIBUS.X)

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Operating concept

27 Vent

28 O

2 (MEDIBUS.X)

29 Agent (MEDIBUS.X)

Views

Each Cockpit supports eight pre-configured Dräger views and, as an option, up to eight custom views. Views control the content and appearance of the screen.

To adjust the screen layout to the needs of the current monitoring session, switch to a different view.

Views can be shared among various profiles which are pre-configured setups. This sharing of views eliminates time-consuming setup tasks. Views can be assigned to each profile (see page 488).

Selecting a view

30 BIS (not available in neonate mode)

31 NMT

32 CO-Ox

The view editor

The view editor (option) allows authorized personnel to create and modify customized views. Dräger views cannot be modified. Access to the view editor is password-protected. For more information, see page 456.

Reconfigure the screen by selecting a different view.

To select a view

1 Select the Views... button on the main menu

bar.

2 Select the Views tab if it is not already selected

to open a popup with pre-configured views.

3 Select the desired view from the Custom views

(option) or the Draeger views pick lists.

The monitoring area is configured accordingly.

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Profiles/status

Operating concept

Cockpits are adaptable to different care areas. This adaptability is partially due to profiles which allow clinical personnel to create unique setups for the patient population of specific care areas.

Patient and default profiles

A patient profile consists of user-defined settings which are customized for each patient category (adult, pediatric, neonate). For example, a profile may be unique to an adult patient population in a high-acuity OR setting, while another caters to neonatal patients in a low-acuity OR setting. A profile remembers patient and device settings for future use. With a profile, time-consuming setup tasks that would otherwise have to be repeated for each monitoring session are eliminated.

For each patient category, five unique profiles can be set up and saved. Included in the five profiles is a Dräger default profile that cannot be changed.

The Dräger default profile is activated when the Cockpit is booted up for the first time, new software is installed, or factory defaults are restored.

The user-defined patient default profile is activated whenever a new patient category is selected. In addition, the patient default profile is activated after patient data are transferred physically or over the network.

Profiles are divided into the following two categories:

– Patient and default profiles

– System profiles (see page 82)

The selected patient profile remains unchanged under the following circumstances:

– When the Cockpit is turned off and on again

– When a patient is discharged

– When a monitor transitions out of standby mode

– When a monitor transitions out of privacy mode

Whenever an M540 is docked in an IACS configuration, the profile of the connected Cockpit overwrites any M540 profile settings. The only exceptions are the following profile settings which remain unchanged on the M540:

–Cable type

– etCO2 Atm. pressure

– SpO2 alarm delay

– Patient category (adult, pediatric, neonatal)

– Demographic data

– Invasive blood pressure labels

– QRS detection threshold

– M540 offline detection

– M540 battery alarm

After a patient discharge, all patient data are deleted and the most recently used profile is restored.

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Operating concept

Settings included in a profile

The following table lists all of the settings included in a patient profile. For details on each setting, such as available selections and detailed descriptions of the setting, refer to the cross-referenced pages.

Parameter Included settings

Parameter-specific profile settings

ECG (see page 212)

Arrhythmia (see page 225)

Arrhythmia alarm settings (see page 134)

Size [mV/cm]

Size All ECG [mV/cm]

Pulse tone volume

Tone source

HR source

Waveforms

Leads

Filter

Pacer detection

QRS sync marker

ARR Processing

Resp. monitoring

Color

Alarm limits

Alarm on/off setting

Alarm archive setting

ARR mode

Alarm archive setting

Alarm priority (high, medium, low or off)

Alarm priority

Rate

Count

Parameter Included settings

ST (see page 234)

Temperature (see page 287)

SpO2 (Nellcor) (see page 278)

ST monitoring

ST lead1

ST lead2

ST lead3

ST Mini Trend

TruST 12-lead

Event duration [s]

Selected isoelectric point

Selected ST measuring point

Alarm on/off setting

Alarm limits

Alarm archive setting

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Pulse tone volume

Tone source

Waveform size [%]

SatSeconds alarm

Color

Alarm on/off setting

Alarm limits

Archive setting and alarm priority for SpO2 check sensor alarm

Alarm archive setting

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Operating concept

Parameter Included settings

SpO2 (Masimo SET and Masimo Rainbow SET)

SpO2 Masimo rainbow SET (see page 266)

Non-invasive blood pressure (see page 300)

Pulse tone volume

Tone source

Averaging time

FastSat mode

Waveform size [%]

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Archive setting and alarm priority for SpO2 sensor off alarm

SpHb Averaging time

Pulse CO-Ox mini trend

SpHb Cal

Show parameters

PVI averaging time

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Interval time [min]

Inflation mode

Chime

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Parameter Included settings

Invasive blood pressure

Respiration (see page 240)

Cardiac output (see page 334)

Scale

Filter

Large mean

Min. scale (ICP)

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Resp. lead

Mode

Size [%]

Resp. marker

Resp. monitoring

Coincidence detect

RRi apnea time [s]

Apnea archive

Color

Alarm on/off setting

Alarm limits

Alarm archive setting

Catheter type

Catheter size

Injectate volume [cc]

C.O. mode

Alarm on/off setting (Tblood only)

Alarm limits (Tblood only)

Alarm archive setting (Tblood only)

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Operating concept

Parameter Included settings

2 Scale

RRc apnea time [s]

RRc apnea archive

Color

Airway adapter

Averaging

Alarm on/off setting

Alarm limits

Alarm archive setting

Scio CO

2 CO2 parameter field

configuration

Alarm status

Alarm limits

Alarm archive settings

Apnea settings

Waveform scales

Trend scales

2 color

2 O2 parameter field

Scio O

configuration

2 mini trend configuration

Alarm status

Alarm limits

Alarm archive settings

Waveform scales

Trend scales

Parameter Included settings

Scio Agent (see page 365)

Agent selection (for variants with manual identification only)

Agent parameter field configuration

Agent/xMAC mini trend configuration

Alarm status

Alarm limits

Alarm archive settings

Trend scales

Trends Graphical trend setup

Tabular trend setup

Reports Case summary setup

External device profile settings

External devices – CCO/SvO2 (see page 398)

Parameter 1

Parameter 2

Parameter 3

Mini trends

External devices – Paw (see page 439)

Parameter 1 (paw)

Parameter 2 (paw)

Parameter 3 (paw)

Paw scale

Vol scale

Color

External devices – ventilator (Medibus

- Servo I) (see page 440)

Parameter 1 (vent, paw)

Parameter 2 (vent, paw)

Parameter 3 (vent, paw)

Paw scale

Flow scale

2 Scale

Vol scale

Color (vent, paw, CO2)

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Operating concept

Parameter Included settings

External devices – ventilator (Medibus X) (see page 401)

Vent parameter display

setting (see page 415)

Parameter 1 (vent, paw)

Parameter 2 (vent, paw)

Parameter 3 (vent, paw)

Paw scale

Flow scale

2 Scale

Vol scale

Color (vent, paw, CO2)

All parameters of the Configure show all page (see page 413)

External devices – Anesthesia workstation (see page 401)

External devices –

CO (see page 432)

External devices –

PV Loop

Agent parameter field

O2 parameter field

etCO2 parameter field

2 Scale

Color

Loop draw

Paw scale

Vol scale

External devices –

FV Loop

(see page 437)

External devices –

Loop draw

Flow scale

Vol scale

Loop draw

Loops (see

page 437)

External devices – BIS (see page 379)

External devices –

Scale[uV]

BIS secondary parameter

Display temperature

NMT (see

page 385)

Parameter Included settings

Alarm profile settings

Alarm system settings (see page 458)

All alarms paused

Show alarm limits

Cardiac bypass

OR Alarms

Alarm bar enabled

Alarm validation

Pacer detection mode

ASY/VF alarms

NIBP/SpO2 interlock

Config. (see

page 458)

Alarm volume and tone settings (see page 461)

Alarm type

Alarm priority (high, medium, low or off)

Pulse tone volume

Attention tone volume

Alarm volume

Alarm attention tones

Show remote alarms

Code settings (see page 464)

Continuous recording

Alarm volume off

Continuous NIBP mode

All alarms off

Screen profile settings

Auto display settings (see page 446)

Auto view mode

Waveforms

Layout (right/left)

Pressure overlap

Parameter boxes

Layout

Split screen

Mini trends

NIBP trend

Toolbar

Selected parameter priority

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Operating concept

Parameter Included settings

Configurable views (see page 451)

Config. buttons (see page 452)

Multi-tab split screen (see

page 455)

Screen system settings (see page 445)

General profile settings

Anesthesia and BIS graphical trend

Open lung tool

Procedures profile settings

Wedge (see page 317)

Analysis tool (see page 169)

Biomed profile settings

Bedside setup (see page 473)

Up to eight available, configurable views

Button setup

Tab 1, Tab 2, or Tab 3

Monitoring sweep speed [mm/s]

Respiratory sweep speed [mm/s]

Show parameter units

Configuration order of parameters

Scale

Sweep speed [mm/s]

Reference waveform

Parameter selection

Duration

Airway adapter

Patient profile selection

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Settings not included in a profile

The following settings are not included in a profile and must be configured separately. These settings remain unchanged until they are manually changed again by the user.

Operating concept

Parameter/system fea-

Setting

ture

Non-invasive blood pressure

(see page 295)

(see page 234)

Arrhythmia

(see page 225)

Respiration

(see page 240)

Invasive blood pressure

(see page 319)

etCO2 (Infinity MCable – Mainstream CO

(see page 345)

Alarm history

(see page 139)

Venous stasis

Continuous mode

ST relearn

Relearn

Selected labels from M540

Atm. pressure

Filter settings (All, Arrhythmia, Highpriority, Mediumpriority, Low-priority, Time, Priority, Message)

System setup... > General settings

(see page 458)

All alarms paused

SpO2 alarm delay

Alarms > Settings Alarm group

Volume/ Tone

(see page 461)

"Audio off" reminder

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Operating concept

System profiles

System profiles are system-wide settings. System profiles are divided into the following two categories:

– Shared settings – these settings can be

exported and imported using a USB flash drive (see page 490 for information).

– Install persist settings – these settings are not

affected by a patient discharge, software upgrade,or by turning the Cockpit off and then on again.

Setting Shared and install persist settings Install persist only settings

Screen layout settings (see page 445)

Brightness X

Night time X

General alarm settings (see page 458)

External device disconnected alarm control

M540 alarm settings (see page 466)

Keep Bed label X

Transport alarm volume X

Transport pulse tone volume

Tone and volume alarm settings (see page 458)

Audio pause: Quiet mode X

Minimum alarm volume X

Audio off X

All alarms off X

Tone set X

Recorder settings (see page 468)

Delay X

Duration X

Speed X

Waveform Selection X

Waveform 1 X

Waveform 2 X

Most system settings can be shared and are also install persist settings. However, some settings are install persist settings only which are identified in the following table. For details on each setting, such as available selections and detailed descriptions of each setting, refer to the cross-referenced pages.

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Operating concept

Setting Shared and install persist settings Install persist only settings

Alarm Waveform X

Primary Recorder X

Secondary Recorder X

Report setup settings (see page 470)

Waveform delay [s] X

Waveform duration [s] X

Trend duration [hr] X

Table interval [min] X

Biomed printer settings (see page 477)

Printer IP address X

HP Universal Print Driver X

Paper Size X

Biomed patient monitor settings (see page 473)

Line frequency X

French NFC mode X

OR Alarms X

HLM/Bypass sync

Biomed country settings (see page 471)

Language X

Time zone X

Daylight savings X

Biomed unit of measurement settings page (see page 472)

Pressure X

etCO2 X

Temperature X

ST X

SpHb X

Agent X

Weight X

Height X

Biomed patient monitor settings page (see page 473)

External display X

Clinical password X

Biomed password X

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Operating concept

Setting Shared and install persist settings Install persist only settings

Biomed Infinity network settings (see page 476)

IP address X

Subnet mask X

Gateway X

Offline detection X

Primary DNS X

Duplicate IP check X

IP check interval [s] X

Biomed hospital network settings (see page 476)

DHCP X

IP address X

Subnet mask X

Gateway X

Primary DNS X

Biomed network settings (see page 475)

Monitoring unit ID X

Monitoring unit label X

Care unit label X

Bed label X

Hospital name X

Enable Central Station X

Enable Remote Control X

Enable Remote Silence X

Biomed IT tab settings (see page 482)

(identical for the Innovian, PatientWatch, Symphony, Web browser, and Application pages)

IT tabs X

Name X

URL X

Block Popups X

Full Trust X

Tab visible X

Biomed Citrix settings (see page 481)

Name of up to 32

applications

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Operating concept

Setting Shared and install persist settings Install persist only settings

Value of up to 32 applications

Auto logoff X

Tab visible X

Graphical trend settings (see page 164)

View X

Graphs X

Grids X

Tabular trend settings (see page 164)

View X

Calculation parameters (see the ’Calculations’ chapter starting on page 184)

All hemodynamic parameters

All oxygenation/ventilation parameters

Laboratory calculation parameter selections (see page 186)

PaCO2 X

PaO2 X

SaO2 X

Hgb X

Body size calculations selections (see page 182)

BSA X

Wt (weight) X

Ht (height) X

Drug profile settings (see page 193)

For all 40 pre-configured drug profiles, the following settings are stored as part of each individual drug profile:

Name of the drug:

Amount X

Volume X

Dose units X

Concentration X

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Operating concept

Managing profiles and views

Each patient category (adult, pediatric, neonatal) has its own unique profile. For example, if the neonatal patient category is activated, only the profiles defined for the neonatal patient category are selectable. This is unlike views which can be shared among all patient categories.

The following profile functions are available (for detailed instructions, see "Profile setup" on page 484):

– Selecting a profile

– Saving a profile (password-protected)

– Transferring a profile (password-protected)

– Deleting a profile

– Entering a profile name and description

– Assigning a profile to a default view (default

profiles are automatically activated after a restart or a patient discharge).

Transferring profiles

Profiles can be transferred to other Cockpits in the password-protected Profile transfer page. This transfer eliminates time-consuming duplicate setup tasks. Profiles can be transferred either over the network or with a USB flash drive (see page 490).

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Standby mode

Operating concept

Temporarily interrupt patient monitoring by placing the Cockpit and the M540 in standby mode. Selecting standby mode on the Cockpit automatically activates standby mode on the M540 and vice versa. Likewise, taking a patient out of standby on one device does the same at the other device.

Standby mode has the following effect:

– All patient data are removed from display on the

Cockpit and the M540.

– All monitoring (including acoustic and optical

alarm signals) are suppressed.

– Active alarms are considered acknowledged.

– All recordings are canceled.

– The message Standby –Touch Screen to

resume monitoring is displayed in the center of the screen.

To place the Cockpit in standby mode

1 Select the symbol next to the

Start/Standby... button on the main menu bar to display the Standby toolbar.

2 Select the Standby button on the toolbar.

1 Select the Start/Standby... button on the main

menu bar to display the Standby dialog.

2 Select the Start tab if it is not already selected.

3 Select the Standby button next to the menu

selection Monitor.

NOTE

If configured to appear on the main menu bar, the Standby button is also accessible on the main menu bar. For more information, see page 452.

The message Standby – Touch Screen to resume monitoring appears in the center of the Cockpit screen.

To take the Cockpit out of standby mode

 Touch the screen to resume monitoring the vital

signs of the patient.

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Operating concept

Privacy mode

Privacy mode is possible only when the patient is admitted at the Infinity CentralStation (ICS). In privacy mode, patient monitoring continues but the patient data are removed from the Cockpit and the M540 and only appears on the ICS.

Selecting privacy mode on the Cockpit automatically activates privacy mode on the M540 and vice versa. Likewise, taking a patient out of privacy mode on one device does the same at the other device. Privacy mode is canceled automatically when the connection to the Infinity network is disrupted.

Activating privacy mode has the following effect:

– All patient data are removed from the Cockpit

and the M540 displays, but continue to be displayed at the ICS.

– The alarm bar is deactivated.

– Acoustic alarm signals are only provided at the

ICS.

– The message Privacy Touch Screen to

resume monitoring is displayed in the center of the screen.

To place the Cockpit into privacy mode

1 Select the symbol next to the

Start/Standby... button on the main menu bar.

2 Select Privacy on the toolbar.

1 Select the Start/Standby... button on the main

menu bar.

2 Select the Start tab if it is not already selected.

3 Select Privacy next to the menu selection

Display.

NOTE

If configured to appear on the main menu bar, the Privacy button is also accessible on the main menu bar. For more information, see page 452.

The message Privacy Touch Screen to resume monitoring is displayed in the center of the Cockpit screen.

To take the Cockpit out of privacy mode

 Touch the screen to activate the display of the

patient data.

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Screen lock

The screen lock feature allows the user to disable the touchscreen via a Screen lock control. Screen lock enables the user to move or clean the Cockpit without unintentionally triggering changes on the touchscreen.

To activate screen lock

1 Select the Start/Standby... button on the main

menu bar to display the Standby dialog.

2 Select the Start tab if it is not already selected.

3 Select the On button next to the menu selection

Screen lock.When screen lock is activated, the touchscreen does not respond to touch and the rotary knob LED flashes.

Screen lock automatically deactivates after one minute. However, the user can manually deactivate screen lock at any time.

Operating concept

To deactivate screen lock

 Press the rotary knob.

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Assembly and preparation

Assembly overview . . . . . . . . . . . . . . . . . . . . 92

Docking/undocking the M540 . . . . . . . . . . . . 93

Front view of the M500 (M540 docked) . . . . . . 93

Side view of the M500 (M540 undocked) . . . . . 93

Locking/unlocking the M540 . . . . . . . . . . . . . 94

Additional M540 accessories . . . . . . . . . . . . 95

Connecting the system cables . . . . . . . . . . . 95

Connecting the system cable to the PS250 /

P2500 and the Cockpit . . . . . . . . . . . . . . . . . . . 95

Connecting the system cable to the PS250 /

P2500 and the M500 . . . . . . . . . . . . . . . . . . . . 96

Mounting the Infinity MCable – Masimo SET/Masimo rainbow SET/ Nellcor OxiMax .97

Assembly and preparation

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Assembly and preparation

Assembly overview

This chapter describes the following basic assembly tasks:

– Docking/undocking the M540 from the M500

– Locking/unlocking the M540 into the M500

– Connecting/disconnecting the system cables

CAUTION

Avoid mounting solutions that could impede air flow since the M500, PS250 / P2500 require adequate airflow to dissipate heat. In addition, when mounting the PS250 / P2500, always position it vertically for adequate heat dissipation.

IACS components are compatible with commercially available mounting solutions.

Commercially available mounting solutions

Various mounting solutions are available. It is the responsibility of the hospital to install, test, and ensure the proper and safe operation of any mounting solution.

Contact your Dräger representative for specific approved mounting solutions.

CAUTION

Check the weight ratings of the commercially available mounts to avoid injuring the patient or damaging the device.

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Docking/undocking the M540

Assembly and preparation

The following diagram shows the front and side of the M500 which holds the M540 in place.

Front view of the M500 (M540 docked)

Side view of the M500 (M540 undocked)

To dock the M540

1 Align the curved portion of the M540 with the

curved portion of the M500.

2 Press the M540 (C) into the M500 (D) until it

‘clicks’ into place.

3 Push the locking tab (A) of the M500 towards

the front, to the locked position to fasten the M540 into place.

To lock the M540 into place permanently, see 'Locking/unlocking the M540“on page 94.

To undock the M540

1 Push the locking tab (A) of the M500 towards

the back. If the locking tab does not move, it has been permanently locked. See page 94 for information on how to unlock the locking tab.

300305

2 Hold the M540 firmly and press one of the

release buttons (B - see arrow) of the M500.

3 Pull the M540 (C) out of the M500 (D).

A M500 locking tab

B Release buttons for removing the M540

C M540 patient monitor

D M500

E Swivel mount (optional) and mounting clamp

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Assembly and preparation

Top view of the M500

Locking/unlocking the M540

You can lock the M540 in the M500 to prevent anyone from undocking it.

To lock the M540 into place

1 Push the locking tab (D) of the M500 towards

the front. This prevents you from undocking the M540. If you push the locking tab back, you can undock the M540 again.

2 Insert the 2 mm hex wrench tool (A) into the

middle hole (B) on the locking tab and turn it clockwise to the locked position .The locking tab is fixed and you cannot remove the M540 unless you unlock it again using the hex wrench tool.

To unlock the M540

1 Insert the 2 mm hex wrench tool (A) into the

middle hole (B) on the locking tab and turn it counterclockwise to the unlocked position .

2 Push the locking tab (D) back to unlock the re-

lease buttons (C) on the M500 to undock the M540.

307

A Hex wrench tool (2 mm)

B Center hole on locking tab for locking/unlocking

the M540

C Release buttons for undocking the M540

D Locking tab

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Additional M540 accessories

Bottom view of the PS250

Bottom view of the P2500

Assembly and preparation

The M540 patient monitor supports a variety of accessories that include transport hardware, clamps, cable hooks, trolleys, and so forth. For

more information about these specialized accessories, refer to the Infinity Acute Care System – Monitoring Accessories instructions for use.

Connecting the system cables

Connecting the system cables involves 2 main steps:

– Connecting a system cable to the PS250 /

P2500 and the Cockpit.

– Connecting a system cable to the PS250 /

P2500 and the M500.

Connecting the system cable to the PS250 / P2500 and the Cockpit

1 Connect one end of the system cable to the sys-

tem connector on the back of the Cockpit (refer to the instructions for use Infinity Acute Care System – Medical Cockpit).

2 Connect the other end of the system cable to

one of the two PS250 / P2500 system connectors (A).

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Assembly and preparation

Side view of the M500

Connecting the system cable to the PS250 / P2500 and the M500

1 Connect one end of the system cable (B) to the

M500 system connector.

2 Connect the other end of the system cable to

one of the two PS250 / P2500 system connectors (see diagram on page 95).

306

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Assembly and preparation

Side view (connectors)

Bottom view

Mounting the Infinity MCable – Masimo SET/Masimo rainbow SET/ Nellcor OxiMax

The following diagram shows how a Masimo MCable can be mounted to the M540. The Nellcor OxiMax MCable can be mounted in the same way.

A M540

B Tabs of the MCable mount adapter that lock into

the side of the M540.

C MCable mount

D Cable end of the MCable

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n 97

E Blue SpO2 connector

F Indentations for locking the MCable mount

adapter

G Intermediate cable or reusable SpO2 sensor

which connects directly to MCable

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Page 98

Assembly and preparation

To attach the MCable mount adapter

Follow these steps to attach the MCable to the M540:

1 Make sure the cable end of the MCable (D)

mount adapter (C) points in the same direction as the connector side of the M540.

2 Align the tabs on the mount adapter (B) with the

indentations on the M540 and push firmly until the mount adapter clicks in place.

3 Connect the MCable (D) to the blue SpO2 con-

nector on the M540.

To remove the MCable mount adapter

1 Insert a flat head screwdriver (or equivalent

tool) between the indentations for locking the MCable mount adapter (F).

2 Gently lift to unhinge the adapter.

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Getting started

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Turning the IACS on/off . . . . . . . . . . . . . . . . . 100

Viewing demographic data . . . . . . . . . . . . . .101

Admitting a patient. . . . . . . . . . . . . . . . . . . . .102

Admitting a patient using Get HIS . . . . . . . . . . 103

Discharging a patient . . . . . . . . . . . . . . . . . . . 103

Patient categories. . . . . . . . . . . . . . . . . . . . . . 104

Selecting the patient category . . . . . . . . . . . . . 105

Getting started

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Getting started

Overview

This chapter describes the necessary steps to start monitoring a patient on the IACS.

Turning the IACS on/off

Before monitoring a patient on the IACS, the Cockpit and the M540 must be turned on. The following steps assume that the M540 has been docked in the M500 (for information see, "Docking/undocking the M540" on page 93).

To turn the Cockpit on

 Press the on/off key (B) of the Cockpit.

Specifically, this chapter describes how to:

– Turn the IACS on/off

– Admit/discharge a patient on the Cockpit

– Change the patient category

To turn the M540 on

 Press the on/off key (C) of the M540.

The M540 emits a high-pitched tone followed by two power-up tones, performs a selftest, and displays the New patient prompt. Select Discharge to delete the previous patient data or Cancel to continue monitoring the patient and append the new data to the previous data set. The main screen appears.

C700_withBlueMan

The LEDs (A) and the on/off key light up green. The Cockpit emits a power-up tone and performs a selftest. After a brief moment, the Dräger startup screen appears before the Cockpit main screen appears.

The acoustic alarm signals are paused for 2 minutes.

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