GE B30 User manual

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GE Healthcare

B30 Patient Monitor

User's Guide

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B30 Patient Monitor

User's Guide

Related to software L-DICU08

0459

All specifications are subject to change without notice.

Document no. 2039822-002 A

9th January 2009

GE Medical Systems Information Technologies, Inc. 8200 West Tower Avenue Milwaukee, WI USA Zip: 53223 Tel: 1 414 355 5000 (outside US) 800 558 5102 (US only) Fax: 1 414 355 3790 www.gehealthcare.com

GE Healthcare

3F Building 1, GE Technology Park 1 Huatuo Road Shanghai PRC 201203 Tel: +86 21 3877 7888 Fax: +86 21 3877 7451

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About this guide

This User's Guide describes the features and functions offered by the B30 monitor. Descriptions refer to the software L-DICU08.

This manual is an integral part of the product and describes its intended use. Keep it always close to the equipment. Observance of the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety.

If you are a new user of the monitor, we suggest you begin with sections "Safety precautions", "System introduction" and "Monitoring

basics." The following conventions are used:

− Names of the hard keys on the Command Board and modules

are written in the following way:

ECG.

− Menu items are written in bold italic typeface: ECG Setup.

− Menu access is described from top to bottom. For example, the

selection of the Screen Setup menu item and the Waveform Fields menu item would be shown as Screen Setup - Waveform Fields.

− Messages (alarm messages, informative messages) displayed on

the screen are written inside single quotes: 'Learning.'

− When referring to different sections in this manual, section

names are enclosed in double quotes: "Cleaning and care."

− In this manual, the word "select" means choosing and

confirming.

Trademarks

Dash, Datex, Ohmeda, S/5, D-fend, D-fend+, Mini D-fend, OxyTip+, ComBar, ComWheel, EarSat, FingerSat, FlexSat are trademarks of GE Healthcare. All other product and company names are property of their respective owners.

Product availability

Some of the products mentioned in this manual may not be available in all countries. Please, consult your local representative for the availability.

Service Lifetime

The Service lifetime of this patient monitor is 5 years. At the end of its service lifetime, the product described in this manual, as well as its accessories, must be disposed of in compliance with the guidelines regulating the disposal of such products. If you have questions concerning disposal of the product, please contact GE representatives.

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Intended purpose (Indications for use)

The B30 patient monitor is intended for multiparameter patient monitoring. The B30 monitor is indicated for continuous monitoring of hemodynamic parameters (including arrhythmia and ST segment analysis) and respiratory status and creation of limit alarms. The B30 monitor is intended for all hospital patients and all hospital departments including intra-hospital transport but excluding harsh physical environment like MRI.

The Patient side module E-PSM(P)W and accessories are indicated for monitoring of hemodynamic parameters of all hospital patients. The hemodynamic parameters of the module comprise ECG (including ST-Segment and arrhythmia), impedance respiration, oscillometric NIBP (sys/dia/mean), temperature, SpO

monitoring during conditions of clinical patient motion), and invasive blood pressure. Impedance respiration measurement is indicated for patients ages three years and up. The NIBP measurement is indicated for patients who weight 5kg (11 lb) or up.The E-PSM(P)W is intended for all hospital departments including intra-hospital transport but excluding harsh physical environment like MRI.

The extension module N-FCREC (option N-FCREC or N-FC) is indicated for monitoring of CO

patients. CO2 measurements are indicated for patients who weight over 5 kg (11 lb).

The B30 monitor and N-F(C)(REC) Extension Module and E-PSM(P)W Patient Side Module are indicated for use by qualified medical personnel only.

and respiration rate of all hospital

(including

Classifications In accordance with IEC 60601-1:

−

Class I and internally powered equipment - the type of protection against electric shock.

− Type BF or CF equipment. The degree of protection against

electric shock is indicated by a symbol on each parameter module.

− Equipment is not suitable for use in the presence of a flammable

anesthetic mixture with air or with oxygen or nitrous oxide.

− Continuous operation according to the mode of operation.

− Portable Monitor

In accordance with IEC 60529:

−

IPX1 - degree of protection against harmful ingress of water.

In accordance with EU Medical Device Directive: IIb In accordance with CISPR 11:

Group 1 Class B; see page 3 of this User's Guide.

Responsibility of the manufacturer

GE Medical Systems Information Technologies, Inc. is responsible for the safety, reliability and performance of the equipment only if:

− Assembly, extensions, readjustments, modifications, service and

repairs are carried out by personnel authorized by GE.

− Electrical installation complies with appropriate requirements.

− The equipment is used in accordance with this User's Guide.

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Contents

Safety precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

System introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Monitor introduction . . . . . . . . . . . . . . . . . . . . . . . . . .11

Monitoring basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Setting up the monitor before use . . . . . . . . . . . . . .25

Entering and loading patient data . . . . . . . . . . . . .31

Starting and ending . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Screen setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Printing and recording . . . . . . . . . . . . . . . . . . . . . . . . .41

Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Cleaning and care . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

ECG and ST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Pulse oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Non-invasive blood pressure (NIBP) . . . . . . . . . . . .67

Invasive blood pressure . . . . . . . . . . . . . . . . . . . . . . .71

Airway gas (CO2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81

Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85

Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

ElectroMagnetic Compatibility . . . . . . . . . . . . . . . . .97

End User License Agreement . . . . . . . . . . . . . . . . 105

Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

Impedance respiration . . . . . . . . . . . . . . . . . . . . . . . .59

Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

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Safety precautions

These precautions refer to the entire system. Warnings and cautions specific to parts of the system can be found in the relevant section.

Warnings

A WARNING indicates a situation in which the user or the patient may be in danger of injury or death.

• Connect only one patient to the monitor at a time.

• Do not use the monitor without manufacturer approved mounting attached.

• Use only hospital-grade grounded power outlets and power cord.

• To avoid the risk of electric shock, this equipment must only be connected to a supply mains with protective earth.

• Do not use an additional multiple socket outlet or extension cord.

• After transferring or reinstalling the monitor, always check that it is properly connected and all parts are securely attached. Pay special attention to this in case of stacked mounting.

• If you accidentally drop the monitor or modules, have them checked by authorized service personnel prior to clinical use.

• Vibrations during intrahospital transport may disturb SpO impedance respiration, NIBP and InvBP measurements.

• Some equipment malfunctions may not generate a monitor alarm. Always keep the patient under close surveillance.

• To avoid explosion hazard, do not use the monitor in presence of flammable anesthetics.

• Do not use the monitor in high electromagnetic fields (for example, during MRI.)

• Do not connect any external devices to the system other than those specified.

, ECG,

• Do not touch the patient, table, instruments, modules or the monitor during defibrillation.

• If the integrity of the external protective earth conductor arrangement is in doubt, use the monitor with battery operation.

• When detaching modules, be careful not to drop them. Always support with one hand while pulling out with the other.

• Use only approved accessories, batteries, mounts and defibrillator-proof cables and invasive pressure transducers. For a list of approved supplies and accessories, see the "Supplies and Accessories" catalog delivered with the monitor. Other cables, batteries, transducers and accessories may cause a safety hazard, damage the equipment or the system, result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement. Protection against cardiac defibrillator discharge is due in part to the accessories for pulse oximetry (SpO

(P) measurement.

• Single-use accessories are not designed to be re-used. Re-use may cause a risk of contamination and affect the measurement accuracy.

• Do not incinerate a battery or store at high temperatures, as it will explode.

• The monitor or its components should not be used adjacent to or stacked with other equipment. If adjacent or stacked use is necessary, the monitor and its components should be observed to verify normal operation in the configuration in which it will be used.

• Connecting electrical equipment together or using the same extension cord for more than one device may cause their leakage currents to exceed the limits specified in relevant safety

), temperature (T) and invasive pressure

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standards. Always make sure that the combination complies with the international safety standard IEC 60601-1-1 for medical electrical systems and with the requirements of local authorities.

• Pins of connectors identified with the ESD warning symbol should not be touched. Connections should not be made to these connectors unless ESD precautionary procedures are used. See "Safety precautions: ESD precautionary procedures" in the"User's Reference Manual" for details.

• Other equipment may interfere with the system, even if that other equipment complies with CISPR emission requirements.

• If liquid has accidentally entered the system or its parts, disconnect the power cord from the power supply and have the equipment serviced by authorized service personnel.

• If the unit fails to respond as described, do not use the monitor until tested and repaired by authorized service personnel.

• The system is intended for use by qualified medical personnel only.

• Before cleaning, disconnect the monitor from the power supply.

• Use only an intact power cord. Replace the power cord if it is cracked, frayed, broken or otherwise damaged.

• Do not apply tension to the power cord otherwise the cord may get damaged.

• The power cord may only be connected to a three-wire, grounded, hospital grade receptacle.

• NOTE: The monitor is always internally powered when the batteries are connected.

• The B30 is always energized by the internal batteries. A short circuit may cause internal damage. Do not touch any exposed wiring or conductive surface inside, this may cause an electric shock.

• Make sure that the Pole Mount for PSMW is always used in vertical position to prevent water from entering the E-PSM(P)W module.

Cautions

A CAUTION indicates a situation in which the unit or devices connected to it may be damaged.

• Before connecting the power cord to the power supply, check that the local voltage and frequency correspond with the rating stated on the device plate.

• Leave space for circulation of air to prevent the monitor from overheating.

• Refresh the batteries completely every six months (see "Cleaning

and care").

• Do not store or use the monitor outside the temperature and humidity ranges specified in the "Performance" section of this manual.

• After replacing a battery, always make sure that you close the battery compartment by sliding the lid back to the right until it clicks.

• Perform regular functional testing of each of the parameters and accessories

• The monitor display is fragile. Ensure that it is not placed near a heat source or exposed to mechanical shocks, pressure, moisture or direct sunlight.

• Do not immerse any part of the device in liquids or allow liquid to enter the interior.

• Do not autoclave any part of the system with steam or sterilize with ethylene oxide.

• Do not apply pressurized air to any outlet or tubing connected to the monitor. Pressure may destroy sensitive elements.

• Before use, allow two minutes for warm-up and note any error messages or deviations from normal operation.

• Do not short-circuit the battery terminals, this may produce a very high current, which will damage the battery.

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• Do not store or transport the monitor outside the specified temperature, pressure and humidity ranges.

Disposal

•Dispose of the whole device, parts of it, its packing material and this manual in accordance with local environmental and waste disposal regulations.

Points to note

• This manual is intended for clinical professionals. Clinical professionals are expected to have a working knowledge of medical procedures, practices, and terminology, as required for monitoring of critically ill patients.

• Medical electrical equipment needs special precautions regarding electromagnetic compatibility and needs to be installed and put into service according to the electromagnetic compatibility information provided in the "Technical Reference Manual" by qualified personnel.

• Portable and mobile RF communications equipment can affect the medical electrical equipment.

• The allowed cables, transducers, accessories and mounts for the system are listed in the "Supplies and Accessories" catalog.

• The equipment is suitable for use in the presence of electrosurgery. Please notice the possible limitations in the parameter sections and in the "Performance" section.

• Service and repairs are allowed for authorized service personnel only.

• CISPR 11 classification: Group 1, Class B:

− Group 1 contains all ISM (Industrial, scientific and medical)

equipment in which there is intentionally generated and/or used conductively coupled radio-frequency energy which is necessary for the internal functioning of the equipment itself.

− Class B equipment is suitable for use in domestic

establishments and in establishments directly connected to a low voltage power supply network which supplies buildings used for domestic purposes.

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For your notes:

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Symbols

− Attention, consult accompanying documents.

− On the modules or frames indicates that

modules with identical measurements should not be used in the same monitor. If such modules have been inserted, remove the module that has been most recently connected. You can also remove both modules and reconnect the new module after five second.

− On the E-PSM(P)W module indicates that

protection against cardiac defibrillator discharge is due in part to the accessories for pulse oximetry (SpO2), temperature (T) and

invasive pressure (P) measurement.

− On the N-FC(REC) module indicates that airway

gases should be calibrated every six months in normal use and every two months in continuous use.

− On top of the monitor beside the battery cover:

Use manufacturer recommended batteries only. Follow the regional regulations for disposal.

− On the rear panel this symbol indicates the

following warnings and cautions:

−Electric shock hazard. Do not open the cover or

the back. Refer servicing to qualified personnel.

−For continued protection against fire hazard,

replace the fuse only with one of the same type and rating.

−Disconnect from the power supply before

servicing.

−Do not touch the monitor during defibrillation.

−Do not use the monitor without manufacturer

approved mounting attached.

Type BF (IEC 60601-1) protection against electric shock

Type BF (IEC 60601-1) defibrillator-proof protection against electric shock

Type CF (IEC 60601-1) protection against electric shock

Type CF (IEC 60601-1) defibrillator-proof protection against electric shock

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When displayed in the upper left corner of the screen, indicates that the alarms are silenced. When displayed in the menu or digit fields, indicates that the alarm source has been turned off or alarm does not meet the alarm-specific activation criteria.

Equipotentiality. Monitor can be connected to potential equalization conductor.

Alternating current

Fuse. Replace the fuse only with one of the same type and rating.

In the front panel: battery.

Battery operation and remaining capacity. The height of the green bar indicates the charging level.

Battery (A) charging (white bar)

SN,S/N Serial number

Battery (A) missing

In the front panel: mains/external DC power

ESD warning symbol for electrostatic sensitive devices. Pins of connectors identified with the ESD warning symbol should not be touched. Connections should not be made to these connectors unless ESD precautionary procedures are used. See "Safety precautions: ESD precautionary procedures" in the "User's Reference Manual" for details.

Symbol for non-ionizing electromagnetic radiation. Interference may occur in the vicinity of equipment marked with this symbol.

Submenu. Selecting a menu item with this symbol opens a new menu.

The monitor is connected to Network.

Battery (A) failure

Both batteries failed

A blinking heart next to the heart rate or pulse rate value indicates the beats detected.

A lung next to the respiration rate value indicates that respiration rate is calculated from the impedance respiration measurement.

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Date of manufacture

This symbol indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please, contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment.

The separate collection symbol is affixed to a battery, or its packaging, to advise you that the battery must be recycled or disposed of in accordance with local or country laws. To minimize potential effects on the environment and human health, it is important that all marked batteries that you remove from the product are properly recycled or disposed. For information on how the battery may be safely removed from the device, please consult the service manual or equipment instructions. Information on the potential effects on the environment and human health of the substances used in batteries is available at this url: http://www.gehealthcare.com/euen/weeerecycling/index.html

This product consists of devices that may contain mercury, which must be recycled or disposed of in accordance with local, state, or country laws. (Within this system, the backlight lamps in the monitor display contain mercury.)

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For your notes:

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System introduction

(1)

B30 monitor with modules (2) Printer (3) Other monitors in the network

NOTE: You cannot view other monitors on the B30 monitor with L-DICU08 software.

NOTE: The monitor display is fragile. Ensure that it is not placed near a heat source or exposed to mechanical shocks, pressure, moisture, or direct sunlight.

NOTE: Your system may not include all these components. Consult your local representative for the available components.

Optional components

Optional components for the B30 monitor are:

• Patient Side Modules E-PSMW and E-PSMPW

• Extension Modules N-FREC, N-FCREC and N-FC

For details regarding modules, see section "Measurement modules." The monitor provides places for one E-PSM(P)W and/or one N-Fx

module.

Alarms

If the monitor is connected to the network, the alarm limits can also be changed using the Central if this feature has been enabled in the Central configuration.

If the monitor is connected to the network, the bedside alarms can also be silenced using the Central if this feature has been enabled in the Central configuration.

For more information on alarms, see “Alarms“ on page 37.

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WARNING: Connect only one patient to the monitor at a time.

WARNING: Never install the monitor so that it is above the patient.

WARNING: After transferring or reinstalling the monitor, always check that it is properly connected and all parts are securely attached. Pay special attention to this in case of stacked mounting.

WARNING: Do not use the monitor without manufacturer approved mounting attached.

WARNING: Always make sure that the audio alarm volume level is adequate in your care environment.

WARNING: Before starting to use the system, ensure that the whole combination complies with the international standard IEC 60601-1-1 and the requirements of the local authorities. Do not connect any external devices to the system other than those specified.

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Monitor introduction

(1) Battery compartment, see below (2) Transportation handle (3) Alarm light, see page 39

(4) Alarm LEDs, see page 37 (5) Side panel keys, see page 14 (6) The ComWheel (7) Command Board keys, see page 13 (8) Guide rail for GCX mounting (9) Mains power and battery LEDs, see page 15 (10) ON/standby key (11) Defibrillator & IABP synchronization connector (marked with X5)

(12) Measurement modules, see page 19

WARNING: If you accidentally drop the monitor or modules, have them checked by authorized service personnel prior to clinical use.

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Rear panel connections

(1) Battery compartment (2) Slot for infusion pole mount (3) Module connector (marked with X4) (4) Guide rail for GCX mounting (5) Receptacle for power cord (6) Fuse holder (7) Serial port (marked with X9) (8) Network ID connector (marked with X8) (9) Connector for future use (marked with X7) (10) Accessory: multi I/O adapter (with connectors 7 - 9

above) (11) Network connector (12) Equipotential connector

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Command Board keys

Admit/

Discharge

Monitor

Setup

Pt.Data

& Trends

Print/

Record

(1) ON/standby key (2) Mains power ON (lit) or OFF (dark): indicates mains or external DC

power (3) For admitting or discharging a patient; for selecting user modes (4) For viewing trends and alarm history (5) For activating parameter specific menus. NOTE: All modules do

not measure all of these parameters. For more information, see

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Normal Screen

ECG

NIBP

Airway

Gas

Invasive

Pressures

Others

(6) For returning the Normal Screen view to the screen (7) For activating pulse oximetry, impedance respiration and

temperature setup menus

(8) For printing and recording different trends and waveforms (9) For setting up the monitor and for activating the Help menu (10) Battery operation LEDs, see page 15

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Side panel keys

Silence

Alarms

Setup

Invasive Pressu

Zero ALL

NIBP

Alarm LED indicators: see page 37

For silencing the alarms, see page 40

For activating the Alarms Setup menu

For zeroing the invasive pressure channels, see page 71

NOTE: Functional with the E-PSMP module only.

For starting the NIBP autocycling, see page 68

Start

Cancel

Recorder

For starting or stopping the NIBP manual cycling, see page 68

For starting or stopping local recording, see page 41

NOTE: Functional with the N-FREC and N-FCREC modules only.

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Batteries

The B30 monitor allow to use two lithium-ion batteries at most, located in the battery compartment. They can be charged separately, and screen symbols and monitor frame LEDs indicate their charging level and possible failure, see table on the right. You can also check the battery status through Setup.

If you wish to have the battery charge visible at all times, select it in one of the digit fields: Monitor Setup - Screen Setup - Digit Fields - Battery. You can now see how much charging time is left for each battery separately both in numbers and as symbols, and the total charging time in numbers.

Monitor Setup - Battery

Battery indicators

Screen Explanation Front panel battery LEDs

Monitor is battery powered. Batteries are

fully charged; the size of the green bar indicates the charging level.

Monitor is battery powered. Battery A is

empty, battery B charge is ok.

Green lit Orange dark

NOTE: Always use the B30 monitor with battery inserted. Otherwise all trend data and temporary settings are lost if the power cable is detached from the mains.

NOTE: When the monitor is battery powered, the green battery LED is on. When the monitor is mains powered, the green mains LED is on. See also sections "Conditioning the batteries" and "Messages." NOTE: When useable batteries are installed, if the monitor loses AC power, it automatically switches to battery power without interruption of operation.

Monitor is battery powered. Battery A failure, battery B is full.

NOTE: If both batteries fail, the green battery LED is dark.

Monitor is battery powered. Battery A missing, battery B is full.

Monitor is mains powered. Battery A is being charged (white bar), battery B is already charged.

no symbol Monitor is mains powered.

'No battery backup' message on screen. Batteries have failed or they are not inserted.

Green lit Orange flashing

Green dark Orange flashing

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Checking the battery charge when the monitor is turned off

When the monitor is turned off, you can check the battery charging level by pressing the test button on the battery as indicated in the drawing. The charging indicator bar (1) lights up and the number of lit segments indicates the charging level.

WARNING: Do not incinerate a battery or store at high temperatures, as it will explod

CAUTION: Do not dismantle the battery.

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Replacing the batteries

Battery capacity indicators in the upper right corner of the screen tell you when you should replace a battery, and which one is out of charge, missing or not working, see above. You can replace one battery at a time.

CAUTION: After replacing a battery, always make sure to close the battery compartment by sliding the lid back to the right until it clicks.

(1) Open the lid of the battery compartment

located behind the transportation handle

by sliding it to the left.

(2) Lift up the battery you want to change.

Check the indicators and messages on screen to make sure that you change the battery with lower charge.

(3) Push in the new battery. Make sure that

the charging indicator is facing forward and push the battery down all the way. Check the monitor indicators, see above.

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For your notes:

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Measurement modules

There are five modules for the B30 monitor: hemodynamic Patient Side Modules E-PSMW and E-PSMPW, and the B30 monitor specific Extension Modules N-FREC, N-FCREC and N-FC.

You can use simultaneously either one E-PSM(P)W module or one N-Fx module or one of each. See the following pictures and explanations for module features.

Patient Side Modules E-PSMW and E-PSMPW (in the drawing)

(1) Module keys, see below (2) NIBP connector (3) InvBP connector in the E-PSMPW only: 2-channel

(4) Temperature connector: 2-channel measurement (5) SpO

(6) ECG (3/5) and impedance respiration connector (7) Tab for removing the module

measurement

connector

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Module keys Module versions

The Patient Side Modules have the following measurement

Auto

On/Off

Auto On/Off: for starting or stopping the

NIBP automatic cycling, see page 68

capabilities:

E-PSMW:

− Non-invasive blood pressure

Start

Cancel

Start Cancel: for starting or stopping the

NIBP manual cycling, see page 68

− Temperatures

− Pulse oximetry

− ECG and impedance respiration

Zero P1

Zero P2

In E-PSMP only:

Zero P1: for zeroing pressure channel P1

Zero P2: for zeroing pressure channel P2

E-PSMPW (in the drawing above):

− Non-invasive blood pressure

− Invasive blood pressures

− Temperatures

− Pulse oximetry

− ECG and impedance respiration

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Extension Modules N-FREC, N-FCREC (in the drawing) and N-FC

(1) Recorder, in N-FREC and N-FCREC (2) Paper compartment lever (3) CO

(4) Water trap

(5) Tab for removing the module (6) Sample gas inlet (7) Gas outlet

Module versions

The Extension Modules have the following measurement capabilities and features:

N-FREC:

− Built-in strip chart recorder for local recording

N-FCREC (in the drawing):

− Built-in strip chart recorder

− CO

N-FC:

− CO

measurement, in N-FCREC and N-FC

measurement

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Inserting a module

1. Align the module with the insertion guides. E-PSM(P)W and N-Fx

modules are all inserted the same way.

2. Push the module into the monitor frame until it clicks:

Removing a module

1. Pull the module outwards using the tab. Make sure not to drop it

when it comes out.

Using two modules

To install an E-PSM(P)W and an N-Fx module:

1. Insert the N-Fx module first as explained in "Inserting a module."

2. Attach the E-PSM(P)W to the N-Fx.

WARNING: When detaching modules, be careful not to drop them. Always support with one hand while pulling out with the other.

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Monitoring basics

Navigating in menus

A menu is a list of functions or commands. To display a menu, press one of the hard keys. Selections in the menus are made with the ComWheel. For example, to change the ECG display:

•Press the ECG key to open the function menu.

• Turn the ComWheel to select the desired function in the menu.

• Push the ComWheel to open a submenu or an adjustment

window.

• Push the ComWheel to confirm the selection.

Using modes

The B30 monitor has six user modes. These user modes are predefined combinations of settings. They determine, for example, what is displayed on the screen and in trends and what the alarm limits are. In other words, by choosing a specific mode you get suitable settings on the screen without having to choose all features one by one.

Modes can be hospital specific. The monitor starts in start-up mode, which is one of the user modes chosen during configuration. The default modes are STEP-DOWN, ED, PACU, CCU, NEURO and PEDIATRIC. For more information about the default user modes, see the "Default Configuration Worksheet" delivered with the monitor.

For more information about the installation settings and user modes, see the "User's Reference Manual."

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For your notes:

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Setting up the monitor before use

Before starting to use the monitor, check the monitor installation settings and what is configured in different user modes, and make the necessary changes. The user modes can be hospital-specific. Default modes are STEP-DOWN, ED, PACU, CCU, NEURO and PEDIATRIC. For more information about the factory default user modes, see the "Default Configuration Worksheet" For more information about the installation settings and user modes, see the "User's Reference Manual."

Passwords

NOTE: If you want to make changes that require a password, we recommend you contact the system administrator.

• The default password for entering the Install/Service menu is

16 4 34.

• The default password for entering the Save Modes menu is

13 20 31.

Setting time and date

NOTE: If the monitor is connected to the Central, it follows the Central's time settings and the Time and Date menu is not available.

NOTE: You cannot change the monitor's time settings after the patient has been admitted.

1. Press

2. Turn and push the ComWheel to set the time and date.

Monitor Setup and select Time and Date

Battery setup

Through this menu, you can check the battery status:

1. Press the

2. Select Battery Setup. Battery information is now available.

Monitor Setup key.

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Changing the monitor installation settings

The monitor installation settings are the same in all user modes. The changes are preserved until changed again. Press Monitor Setup, enter the password and select Install/Service - Installation.

Units

Change units for height, weight and blood pressure.

You can change temperature units through and CO

permanent.

units through Airway Gas - CO2 Setup. The changes are

Others - Temp Setup

Alarm options

Show Limits: Select YES to show alarm limits in digit fields. Show Audio ON/OFF: Select YES to enable alarm silencing. Selecting NO (default) disables silencing options in the Audio ON/OFF menu in Alarms Setup.

NOTE: The Show Audio ON/OFF setting should be changed only by the system administrator.

Alarm Light Select NO to disable the alarm light. Latching Alarms: Select YES to keep alarm messages on screen until

Silence Alarms key is pressed.

Reminder Volume: Adjust volume of audible alarm reminder tone. Alarm Tones: Select ISO 9703-2 standard tones or general tones.

Printer

ECG Printout Type: Select 2x6-25, 2x6-50 or 3x4-25. Printer Connection: Select printer connection (default: None). Paper Size: Select A4 or Letter.

NOTE: Network printer only.

Monitor settings

Parameter Settings: Set CO2 humidity compensation.

Page 33

Changing the user modes

NOTE: If you want to make changes in user modes, we recommend you contact the person responsible for the configuration. When new settings are saved, they should be marked in the "Default Configuration Worksheet" See below for instructions on how to change the modes permanently.

1. Select the user mode you wish to change through Admit/

Discharge

2. Make necessary changes (sweep speeds, parameter colors,

report contents, Normal Screen layout, screen setup, trendsetc.).

To change a parameter setup, press a parameter key and go to

the setup menu. For instructions, see relevant parameter

sections. To change alarm limits and volume, press the Alarms

Setup

3. Confirm changes through

Save Modes - Save. You can save the changes also in other

modes. If you do not save the changes in the modes, they are

temporary and valid only until you discharge a patienor change

the mode or until more than 15 minutes has elapsed from the

turn-off of the monitor. Entering Save Modes requires a

password, see "Passwords" above.

- Select Mode.

side panel key. For instructions, see "Alarms."

Monitor Setup - Install/Service -

Changing the startup mode

1. Select Monitor Setup - Install/Service - Save Modes.

2. Select Startup Mode - 1, 2, 3, 4, 5 or 6.

Renaming a mode

1. Select Monitor Setup - Install/Service - Save Modes.

2. Select the mode, select Name and give a new name.

Loading modes

1. Select Monitor Setup - Install/Service - Save Modes.

2. Select Load Modes and load to/from network.

Page 34

Changing the waveform sweep speeds

1. Select Monitor Setup - Sweep Speeds.

2. Select the parameters and adjust the values. Slow waveforms

show the amplitude changes better.

Changing the parameter colors

To change colors for parameter waveforms, digits and trends:

1. Select

2. Select Colors.

3. Select colors for parameters.

Monitor Setup - Install/Service.

Changing the recorder settings

1. Press Print/Record.

2. Select Record Waveforms and select the recorded waveforms,

delay, paper speed and length, and select if you wish to record

waveforms on alarms.

3. Select Record Trends and set the numerical trend resolution and

trend type and select the graphical trend recorded in upper and

lower field.

Changing the printer settings

1. Press Print/Record.

2. Select Print Graphical.

3. Select the pages to print and how many hours to print on one page.

Changing the Normal Screen layout

1. Press Monitor Setup.

2. Select Screen Setup:

• Waveform Fields: Select the displayed waveforms.

• Digit Fields: Change the contents of a field or turn it off.

• Split Screen: Select what you wish to display with the

waveforms (Trend or None).

• Minitrend Length: Select the length of the minitrend. NOTE:

Minitrend is displayed if you choose the Split Screen option Trend.

Changing the display brightness

1. Press Monitor Setup.

2. Select Display brightness.

3. Select from 10 to 100 %.

Page 35

Setting the default trend

You can select graphical or numerical trends to be displayed by default.

1. Press Monitor Setup and select Install/Service.

2. Select Trends.

3. Select Default Trend and Graph or Num.

Configuring trend pages

To select the parameters that are displayed on the graphical trend pages:

1. Press

2. Select Trends - Graphical Trends.

3. Select the graphical trend page you want to change.

4. Select parameters for fields.

Monitor Setup and select Install/Service.

Setting trend lengths and scales

Press Pt.Data & Trends:

•Select Trends - Graphical - Time Scale and select the trend

length.

•Select Trends - Graphical - Trend Scales and adjust the

scales.

Page 36

For your notes:

Page 37

Entering and loading patient data

Entering patient data

When you admit a patient, you must enter all relevant data:

1. Press the

2. Enter patient data by pushing and turning the ComWheel.

Admit/Discharge and select Admit Patient.

Loading patient data

If the patient has already been admitted on the same monitor, press

Admit/Discharge and select:

•Contin. Previous

Select this to load the most recent patient trends from the monitor memory when less than 15 minutes has elapsed from the turn-off. NOTE: This selection is available if the patient case is already admitted on this monitor.

Saving data

The monitor continuously saves patient data, such as trends. Saving is activated once the patient is admitted. The monitor saves automatically:

− In the monitor memory the most recent patient data up to 72

hours if the network is not in use.

− In the network the most recent patient data up to 72 hours from

2 to 90 days depending on the configuration.

Page 38

For your notes:

Page 39

Starting and ending

Preparations

NOTE: Before using the monitor for the first time with batteries, charge the batteries to their full capacity (charging time 2 hours per battery pack).

1. Plug in the measurement modules.

2. Turn on the monitor from the ON/standby key. The monitor performs a self-test to ensure correct functioning.

3. If necessary, change the user mode: Press the

Discharge

Modes are preconfigured but if desired, they can be changed. Changing the modes is described briefly in "Screen setup."

NOTE: Changing the mode also changes settings, such as the alarm limits. For details, see the "Default Configuration Worksheet"

The monitor automatically reconfigures the display when modules are inserted. Reconfiguration of the display may take up to five seconds.

key and select Select Mode.

Admit/

WARNING: Connect only one patient to the monitor at a time.

WARNING: Always make sure that necessary alarm limits are active and set according to the patient's clinical condition when you start monitoring.

Starting monitoring

1. Prepare the patient connections according to the setup picture in the measurement section. Use only approved supplies and accessories, see the "Supplies and Accessories" catalog. The alarms and parameter settings become active.

2. If necessary, adjust the waveform and digit fields; see "Screen

setup."

3. Zero invasive pressure lines; see "Invasive blood pressure."

4. Check the alarm limits; press the Change them, if necessary; see "Alarms."

5. Start the measurement according to the instructions in the measurement section.

6. Enter or load patient data by pressing the Admit/Discharge key; see "Entering and loading patient data."

The patient admission happens through Admit Patient selection or automatically when the monitor receives a patient's vital signs.

Always observe the monitor and the patient carefully during startup periods and when inserting modules.

Alarms Setup side panel key.

Page 40

Ending monitoring

1. Print necessary data: press the Print/Record key.

2. Wait until the printing is finished. Then clear the patient data and return the settings, including alarm limits, to their defaults through Admit/Discharge - Discharge - YES

3. Turn off the monitor from the ON/standby key if the monitor will not be used.

4. Clean the monitor according to the instructions.

Automatic discharge of the patient

The monitor discharges a patient automatically after 24 hours when vital signs for some parameters (ECG, Art, NIBP, SpO

(with N-FCREC and N-FC)) are not available. When this happens, all trend data will be cleared and alarm limits set to default values.

, Resp and CO2

Page 41

Screen setup

Modifying the screen temporarily

•Press the Monitor Setup key and select Screen Setup.

• Change the waveform and digit field measurements, split screen option, minitrend length and sweep speeds.

• To make other setup changes, such as scale changes, press a parameter key and select its setup menu. For example, press the

ECG key and select ECG Setup.

Changes are valid until the monitor is turned off (+15 minutes) or until you discharge the patient from the monitor. Only time and date settings are stored permanently.

Modifying the screen permanently

You can make permanent changes in the screen setup. This is described briefly in section “Setting up the monitor before use." For information on default configuration, refer to the "Default Configuration Worksheet"

Changing the split screen contents

You can split the Normal Screen page into two parts. The other half of the split screen shows trend data.

1. Press the

2. Select Screen Setup.

3. Select Split Screen and choose from the options.

• Trend shows minitrends beside waveforms.

• None shows no split screen.

Monitor Setup key.

Page 42

Changing waveform and digit fields

Up to six waveforms and four digit fields can be displayed simultaneously.

1. Press the Monitor Setup key.

2. Select Screen Setup.

3. Select Waveform Fields or Digit Fields.

Note that:

− Waveforms are always evenly spread to fill the entire waveform

area. When 3 or fewer waveforms are configured on the screen, they are displayed in an enlarged format.

− Selecting Combine Pressures displays invasive pressures in the

same waveform field with the same zero line, but with individual scales.

− If 5-lead ECG is measured, up to three different ECG leads can be

displayed simultaneously in different fields.

Page 43

Alarms

Enabling the alarms

To enable the alarms, connect patient cables. If the alarm source is selected, the alarms are operative also when the measurement is not displayed (except the impedance respiration measurement alarms).

WARNING: Always make sure that necessary alarm limits are active and set according to the patient's clinical condition when you start monitoring. A potential hazard can exist if different default alarm settings are used for the same or similar equipment in any single area.

CAUTION: Setting alarm limits to extreme values may render the alarm system useless

Alarm indications

When the monitor is turned on, you will hear a beep: this tells you that the alarm audio signal is working. Also, the alarm LED indicators light up for a few seconds. To check them, see "Cleaning and care:

Functioning of the alarms." You can also check the functioning of the

audio signal and alarm light through Alarms Setup - Alarm Volume or Alarm Light.

When an alarm becomes active, messages appear in the order of priority. The alarming measurement value flashes (except for low priority alarms) and the color indicates the alarm category; see the table below. In some cases, there may be a message on the screen giving more detailed information. An audible alarm is also triggered, and the alarm LEDs on the monitor side panel indicate the alarm level. If enabled, also the alarm light flashes red or yellow according to alarm levels, see below.

NOTE: If the monitor is connected to the network, it also sends alarms to the Central.

Page 44

Alarm categories

The priority depends primarily on the cause and alarm duration. The priority increasing with the duration and according to the physiological significance.

Visual Meaning Tone pattern (selected

when the system is

Side panel LED indicators

Alarm light (if enabled)

configured)

Red For life threatening situations: HIGH

PRIORITY ALARM

Yellow For serious but not life threatening

problems: MEDIUM PRIORITY ALARM

White Advisory: LOW PRIORITY ALARM Single beep - yellow LED lit dark

Adjusting limits

1. Press the Alarms Setup side panel key and select Adjust Limits.

2. Highlight the measurement.

3. Push the ComWheel to open an adjustment window.

4. Turn the ComWheel to change limits and accept them by pushing it. Move between selections by turning the ComWheel.

NOTE: If the monitor is connected to the network, the alarm limits can also be changed using the Central if this feature has been enabled in the Central configuration.

Triple + double beep every 5 seconds or continuous beep

--- -- 5 --- --/ -----

Triple beep every 19 seconds or double beep every 5 seconds

--- 19 --- / -- 5 -- 5 --

Adjusting volume

1. Press the Alarms Setup side panel key.

2. Select Alarm Volume and adjust.

WARNING: Always make sure that the audio alarm volume level is adequate in your care environment.

red LED flashing flashing red

yellow LED flashing flashing yellow

Page 45

Alarm light

The B30 monitor has an alarm light, located in the upper right corner of the monitor frame, see page 11. The alarm light can be enabled (default) or disabled through Monitor Setup - Install/Service Installation - Alarm Options - Alarm Light When enabled, it flashes red (high priority) or yellow (medium priority) according to the currently active highest priority alarm.

To adjust the brightness of the light:

1. Press the

2. Select Alarm Light and adjust with the ComWheel. During adjustment the red light is on to help you determine a suitable brightness level.

Alarms Setup key.

Alarm activation

To enable the alarms, connect patient cables. If the alarm source is selected, the alarms are active also when the measurement is not displayed (except the impedance respiration alarms). When an alarm becomes active, messages appear in order of priority. See default settings presented in the "Default Configuration Worksheet." NOTE: Limit alarms are active after one minute from turning on the monitor or after discharging the patient. Individual alarms have their own specific requirements before they become active, for example:

− Apnea requires five breaths to be activated.

− Invasive pressures need to be within alarm limits for 20 seconds

after zeroing.

Changing source

For NIBP, P1 and P2 (with E-PSMPW), you can select which measured values trigger the alarm. One or several alarm sources may be active at a time.

1. Press the

Limits.

2. Select the measurement.

3. If the highlight is in the adjustment window, push the ComWheel until you get to the menu selections.

4. Select the desired alarm source ON.

Alarms Setup side panel key and select Adjust

Showing alarm history

1. Press the Pt.Data & Trends key.

2. Select Alarm History A list of the last 20 alarms is displayed.

Page 46

Silencing audible alarms temporarily

To silence alarms for two minutes, press the Silence Alarms side panel key. To silence them for five minutes, press the key for more than five seconds.

If the alarms are not active when you press the side panel key, they are pre-silenced for two or five minutes.

During silencing, all new alarms for the same reason and all alarms for a different reason are indicated visually.

To silence the individual alarm that is currently active, press the

Silence Alarms

Silence Alarms side panel key twice. This does not pre-silence the

upcoming alarms.

NOTE: If the monitor is connected to the network and the network connection is lost, the silenced alarms are reactivated and the volume level is automatically set to 7.

Reactivating silenced alarms

•Press the Silence Alarms side panel key during the silencing

period.

The alarm sounds of new alarms are activated. Silenced alarms are active after a two-minute period. Apnea alarm is activated after three breaths.

Silencing audible alarms permanently

1. Press the Alarms Setup side panel key and select Audio ON/ OFF. If this option is not selectable, see “Alarm options.”

2. Select Silence Apnea, Silence ECG, Silence Apn&ECG or Silence ALL.

If an active alarm is silenced, the monitor gives a reminder beep every two minutes. By default, silencing alarms is set unselectable and can only be activated through the Installation menu. For more information, see "Setting up the monitor before use" or the "User's Reference Manual."

Reactivating alarms

•In Alarms Setup menu, select Audio ON/OFF and select Activate Alarms.

NOTE: If the monitor is connected to the network, the bedside alarms can also be silenced using the Central if this feature has been enabled in the Central configuration.

WARNING: When the alarms are silenced, observe the patient frequently.

Page 47

Printing and recording

You need

− Laser printer for printouts (PCL5 compatible, min. 2Mb memory)

NOTE: Network printer only.

− Optional N-FREC or N-FCREC module for recording

− Thermal paper for the recorder

NOTE: Before you start printing, check that the printer is operational.

NOTE: Recordings on thermal paper may be destroyed when exposed to light, heat, alcohol, etc. Take a photocopy for your archives.

Side panel key

Use the side panel key to start and stop recording immediately.

Starts and stops recording

Page 48

Printing with a laser printer

Selecting a printer

1. Press the Print/Record key.

2. Select Printer Connection.

3. Select the printer from the list.

Printing graphical trends

To print graphical trends:

1. Press the

2. Select Print Graphical.

3. Select the page(s) to print.

4. Select Print Graphs.

Print/Record key.

Printing currently displayed screen contents

You can print currently displayed trend data.

To print trend data:

•Press the

• Trends - Graphical/Numerical - Print Page

Pt.Data & Trends key and select:

Page 49

Recording with the recorder

NOTE: You need the N-FREC or N-FCREC module with the built-in recorder.

Recording numerical trends

You can record the current values of measured parameters.

1. Press the

2. Select Record Trends - Record Numerical.

3. You can stop recording by selecting Stop Numerical.

Print/Record key.

Selecting the format for the recorded numerical trends

You can select the format for the recorded numerical trend to be either Num. (vertical) or Tab. (horizontal):

1. Press the

2. Select Record Trends - Num Trend Type and Num. or Tab.

Print/Record key.

Recording graphical trends

1. Press the Print/Record key.

2. Select Record Trends - Record Graphical.

3. You can stop recording by selecting Stop Graphical.

Trends are recorded for the time period that corresponds to the time scale of the graphical trends.

To choose the time scale:

1. Press the

2. Select Trends.

3. Select Time Scale - 20 '/1 h/2 h/4 h/6 h/8 h/10 h/12 h/24 h/36 h/ 48 h/72 h.

To select the parameters for the graphical trends:

1. Press the Print/Record key.

2. Select Record Trends.

3. Select Graphic. Trend 1 or Graphic. Trend 2.

4. Select the parameter.

Pt.Data & Trends key.

Page 50

Recording on alarms

1. Press the Print/Record key.

2. Select Record Waveforms.

3. Select Start on Alarms - YES.

Recording is activated when the following alarms reach the red level: Asystole, Tachy/Brady, Art high/Art low, V Fib, V Tachy.

Art and ECG1 waveforms are recorded. Selections are preconfigured.

Recording waveforms

You can record three waveforms to a local recorder, and two to four waveforms to a network recorder:

1. Press the Print/Record key.

2. Select Record Waveforms - Record to Local. If the monitor is connected to the network, you can also use the network recorder by selecting Record to Net. The network recorder uses the settings of the Central.

3. Stop recording by selecting Stop Waveforms.

Changing the paper speed

To see the waveforms more clearly or more generally, change the paper speed:

1. Press the Print/Record key.

2. Select Record Waveforms - Paper Speed.

To select other waveforms for recording, press the key.

Print/Record

Page 51

Trends

Trends view

(1) Measurement trend field (2) Real time ECG (3) Numerical value of a measurement at the trend cursor point (4) Time and marker field (5) Trend page number

Symbols

Trend bar: the gap shows the blood pressure mean

value

NIBP trend bar

Indicator of change -for example, ST relearning or

zeroing of an invasive blood pressure channel/ changing a label

Page 52

Viewing graphical trends

1. Press the Pt.Data & Trends key.

2. Select Trends - Graphical.

• To see more parameters, select Scroll Pages and scroll with

the ComWheel.

• To see more data, select Cursor and scroll the page left and

right with the ComWheel.

Viewing numerical trends

1. Press the Pt.Data & Trends key.

2. Select Trends - Numerical.

• To see more pages, select Scroll Pages and scroll with the

ComWheel.

• To see more data, select Cursor and scroll the page up and

down with the ComWheel.

Graphical trends contain four trend pages each having up to six preconfigured fields with different parameters. Five fields can be displayed, and six fields can be printed. Real-time ECG waveform is always displayed at the top of each page.

The graphical trend time scale varies from 20 minutes to 72 hours and the resolution from 10 seconds to one minute. With the 20 minute trend length, the displayed time period is 30 minutes and the resolution 10 seconds. With trend lengths from one to 72 hours, the displayed time period is 72 hours and the resolution is one minute. For HR, ST, PVC, SpO

select the scale in the Trend Scales menu.

and temperature measurements you can

Numerical trends contain four pages with the maximum of 72 hours of trend data. Real-time ECG waveform is displayed at the top of each page.

Erasing trends

1. Press the Admit/Discharge key.

2. Select Discharge.

If the monitor has been turned off from the ON/standby key but the patient has not been discharged, the trend data will be stored in the memory for 15 minutes.

Page 53

Cleaning and care

Daily and between patients

• Wipe the monitor and module surfaces.

• Wipe the ECG trunk cable, NIBP cuff and cables and SpO2 sensors. Avoid excessive use of liquids.

• Change or sterilize all airway and invasive patient accessories.

• Clean, disinfect or sterilize reusable temperature probes.

• Empty the water trap.

• Check that the accessories, cables and monitor parts are clean and intact.

Every two months

• Change the water trap.

Every six months

• Refresh the batteries, see below.

• Perform gas calibration, see below.

Permitted detergents

−

Mild hospital detergents

Permitted disinfectants

−

Ethanol

− Isopropyl alcohol

− Chlorite compounds

− Glutaraldehyde

Points to note:

−

Do not use hypochlorite, acetone-, phenol- or ammonia based cleaners.

− Do not autoclave the device or its parts.

− Do not immerse any part of the device in liquids or allow liquid to

enter the interior.

− Do not apply pressurized air to any outlet or tubing connected to

the monitor.

For details about cleaning, disinfecting and sterilizing the reusable accessories, see the instructions for use in the accessory package or the "Supplies and Accessories" catalog. Do not reuse single-use disposable accessories.

WARNING: If liquid has accidentally entered the system or its parts, disconnect the power cord from the power supply and have the equipment serviced by authorized service personnel.

CAUTION: Do not use hypoclorite, ammonia-, phenol-, or acetone based cleaners. These cleaners may damage the monitor surface

Page 54

Before cleaning

1. Turn off the monitor from the ON/standby key.

2. Disconnect the power cord.

After cleaning

1. Let dry completely.

2. Reconnect the power cord and turn on the monitor.

More comprehensive checking

See the "Technical Reference Manual."

Pulse oximetry sensors

The GE Healthcare pulse oximetry sensors are latex-free. Take possible patient allergies into account also when selecting the cleaning agent.

1. Detach the sensor from the patient and the monitor.

2. Wipe the sensor with mild detergent solution. Allow it to dry completely before use.

Sensor can be disinfected with chlorite compounds. The sensors may be sterilized using an ethylene oxide mixture at 50 to 60 °C/ 120 to 140 °F. NOTE: After ethylene oxide sterilization, sensors must be well aerated in a ventilated place.

WARNING: A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery.

Page 55

Water trap in the N-FCREC and N-FC modules

• Empty the container whenever half full.

• Change the water trap every two months and when the text 'Replace D-Fend' appears.

• The water trap cartridge is disposable. Do not wash or reuse the cartridge.

WARNING: After cleaning, ensure that every part of the system is dry before reconnecting it to the power supply.

CAUTION: Do not disinfect or open the water trap cartridge. Do not touch the water trap membrane. The hydrophobic membrane is damaged if any cleaning is attempted other than rinsing with water.

Conditioning the batteries

Condition batteries regularly to maintain their useful life. This is best done on an external charger. Condition a battery every six months or when the message 'Replace Battery A' or 'Replace Battery B' appears on the screen. Always observe the messages and symbols on the screen to see the battery status. You can also check the status through information, see "Replacing the batteries", "Symbols" and "Messages."

Detailed instructions for refreshing the batteries can be found in the “User's Reference Manual.”

Monitor Setup - Battery Setup. For more

Power interruption

NOTE: Always use the monitor with batteries inserted. Otherwise all trend data and temporary settings are lost if the power cable is detached from the mains.

If the monitor is turned off, trend data and the latest user-made settings remain in the monitor memory for 15 minutes even if the mains power is interrupted. If not, contact service personnel. After 15 minutes, trend data is lost and the monitor returns to the user default settings (startup mode).

Changing fuses

1. Remove the power cord if used.

2. Remove the fuse holder by pushing the locking pin and pulling the holder gently out.

3. If a fuse is blown, replace it with a fuse of the correct type and rating.

Page 56

Regular checks

When you start monitoring, check that:

• The module is firmly in place.

• Accessories are intact and properly connected.

• You have selected desired parameters to be displayed in the digit and waveform fields.

ECG and impedance respiration

• Check that the message 'Leads off' disappears and waveforms are displayed when the cable is connected to the patient.

Pulse oximetry

• Check that the red light is lit in the sensor.

• Check that the SpO2 value is displayed and the message 'SpO2 probe off' disappears when the sensor is connected to the

patient.

Temperature

• Check that the temperature value is displayed when the probe is connected to the patient.

InvBP

• Check that the monitor recognizes cable connections (activates the display) for all the pressure channels used and the pressure values are shown.

• Make sure that all transducers are zeroed correctly.

NIBP

• Ensure that you are using correct cuff size and have selected correct inflation limits. For children and when using hoses without identification, the inflation limit must be set manually.

• Check that the cuff hose detection works properly.

• Check that the pressure values are displayed.

• Start the Venous Stasis mode and check that the pump is not restarting during the measurement. If it does, the cuff may be leaking.

Airway gas (CO2)

• Check that the water trap is empty.

• Occlude the sampling line and check that the 'Sample line blocked' message appears within 30 seconds and gas waveforms are showing zero at the same time.

Page 57

Functioning of the alarms

• Set a parameter value outside the alarm limits. For example, connect the SpO2 sensor and adjust the SpO2 High limit under

the measured SpO priority according to sequence given in the "Alarm categories"

table on page 38.

• Check that the yellow and red LEDs function as indicated in the table.

• Check that the alarm light functions if it is enabled.

NOTE: Although SpO often OFF by default, it is easy to use for alarm checking.

If the monitor does not work as described, refer to "Troubleshooting".

values. The alarms go from low to high

may not be the best example because it is

Safety checks for software

The GE Healthcare software design controls include performance of a risk analysis using methods consistent with ISO 14971 Medical devices - Application of risk management to medical devices.

The monitor software employs watchdog timers, self-monitoring activities (memory, communication and sensor checks and so on), and power-on self-diagnostics (for example, memory checksums). For example, for SpO

sensor and, if excessive sensor current is detected, the message ‘SpO2 faulty probe’ is displayed both in the SpO

the monitor message field, and the old SpO the display.

the software continuously monitors the SpO2

number field and

data is removed from

Page 58

Calibrating

NOTE: % is used for CO2 regardless of selected units.

NOTE: See the "Supplies and Accessories" catalog for correct regulator and gas.

NOTE: Ensure that the calibration gas and regulator are functioning properly before calibration. Perform annual maintenance on the regulator as required.

NOTE: Use only specified GE Healthcare calibration gas sampling line; wrong line length or diameter can cause incorrect calibration. See the "Supplies and Accessories" catalog.

NOTE: Do not wash or disinfect calibration gas sampling lines.

Starting the calibration

1. Turn on the power. Let the monitor warm up for 30 minutes.

2. Attach a regulator to the calibration gas container.

Calibrating airway gases

Follow the recommended calibration intervals (every six months in normal use and every two months in continuous use) to ensure that the measurement accuracy remains within specifications.

1. Attach a new sampling line to the water trap. Connect the other end of the sampling line to the regulator on the gas container.

2. Press the

3. Wait until the texts 'Zero OK' and then 'Feed gas' appear on the screen, open the regulator and start feeding gas. Push the ComWheel and continue feeding gas until the text 'Adjust' is displayed.

4. Check that the displayed gas values match the values on the calibration gas container. Adjust with the ComWheel if necessary.

NOTE: Calibrate the N-FCREC or N-FC module with calibration gas 755580 only and set the O

Airway Gas key and select Gas Calibration.

concentration to 20%.

Calibration check for temperature, NIBP and invasive blood pressures

Calibration check for temperature, NIBP and invasive blood pressures should be performed at least once a year by qualified service personnel as a part of the Planned Maintenance, see the "Technical Reference Manual."

Page 59

ECG and ST

You need

(1) E-PSMW or E-PSMPW module with ECG measurement capability (2) Multi-Link 5-lead ECG trunk cable, or 3-lead ECG cable with

integrated leadwires

(3) 3 or 5 leadwire set

ECG electrodes (pre-gelled electrodes are recommended). Check the expiration date.

LEAD I

F=GREEN (IEC) LL=RED (AAMI)

L=YELLOW (IEC)

LA=BLACK (AAMI)

L/LAR/RA

D A E L

F/ LL

R=RED (IEC)

RA=WHITE (AAMI)

NOTE: For a comprehensive list of accessories, see the "Supplies and Accessories" catalog.

NOTE: Keep the ECG cable, lead set and module connectors dry. Avoid excessive use of liquids when cleaning cables and connectors.

NOTE: In 5-lead ECG, place the 5th electrode (C/V) in one of the six places indicated, and select the corresponding V lead label.

R=RED (IEC)

RA=WHITE (AAMI)

N=BLACK (IEC) RL=GREEN (AAMI)

L=YELLOW (IEC)

LA=BLACK (AAMI)

C=WHITE (IEC) V=BROWN (AAMI)

F=GREEN (IEC) LL=RED (AAMI)

R A

R L

I I I

Page 60

WARNING: Vibrations during intrahospital transport may disturb ECG measurement.

Connecting ECG leadwire sets to ECG trunk cables

• For 3-lead ECG, use the Multi-Link 3-lead ECG cable with integrated leadwires or connect a 3 leadwire set to the Multi-Link 3- or 5-lead ECG trunk cable.

• For 5-lead ECG, connect a 5 leadwire set to the Multi-Link 5-lead ECG cable.

WARNING: Make sure that the leadwire set clips or snaps do not touch any electrically conductive material including earth.

Preparing the patient and applying the electrodes

1. Prepare the skin properly to ensure optimal signal quality:

• Shave any hair from the electrode sites.

• Gently rub the skin surface to increase capillary blood flow and remove dead skin cells and oil.

• Clean the skin using a mild soap and water solution.

• Dry the skin completely before applying the electrodes.

2. Apply the electrodes (see figures and instructions above). Avoid bones close to the skin, obvious layers of fat and major muscles.

Selecting the ECG filter

1. Press the ECG key.

2. Select ECG Setup - Filter: STfilt filters high-frequency artifacts but catches slow ST changes.

Monit filters high-frequency artifacts and slow ST changes. Diagn catches high-frequency changes and slow ST changes.

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Selecting the number of electrodes for 5-lead ECG

1. Press the ECG key.

2. Select ECG Setup.

3. Select 5-lead Cable - 3elect or 5elect.

Selecting the user leads

1. Press the ECG key.

2. Select a lead for ECG1 Lead, ECG2 Lead or ECG3 Lead.

With 3-lead ECG, you can select only one user lead (ECG1 Lead). With 5-lead ECG, you can select three user leads.

Selecting a label for V Lead

With 5-lead ECG, one V lead is measured according to the placement of the V lead electrode.

To select a label for the lead:

1. Press the

2. Select ECG Setup - V Lead.

ECG key.

Selecting how to view ECG waveforms

• To set the number of ECG waveforms in Normal Screen, press

Monitor Setup and select Screen Setup - Waveform Fields.

With 3-lead ECG, one lead, and with 5-lead ECG, up to three leads can be viewed at the same time.

• To cascade a lead, press ECG and select ECG2 Lead/ECG3 Lead

- Casc.

• To increase ECG amplitude, press

• To change the waveform sweep speed: Speeds. Select Hemodynamics and adjust the value.

NOTE: The module input circuits are protected against the effects of electrosurgery and defibrillation. However, the ECG waveform on the monitor screen may be disturbed during electrosurgery.

ECG and select ECG Size.

Monitor Setup - Sweep

Displaying ECG grid

To view the ECG waveforms over gridlines on the screen:

1. Press the ECG key and select ECG Setup.

2. Select Grid - ON. To view without gridlines, select OFF.

Changing the HR source

1. Press the ECG key.

2. Select ECG Setup - HR Source.

• AUTO selects the first available of ECG, Art, ABP and Pleth.

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Beat sound volume

To adjust the beat sound volume of the monitor:

1. Press the

2. Select ECG Setup.

3. Select Beat Sound Volume.

4. Adjust the volume from 0 to 10. If you select 0, there is no audible

sound.

ECG key.

WARNING: The impedance respiration measurement may cause rate changes in Minute Ventilation Rate Responsive Pacemakers. Set the pacemaker rate responsive mode off or turn off the impedance respiration measurement on the monitor.

Selecting what to display with HR

You can select what is displayed with heart rate:

1. Press the

2. Select ECG Setup.

3. Select Display with HR - PR/PVC/None.

ECG key.

Monitoring pacemaker patients

1. Press the ECG key.

2. Select ECG Setup - Pacemaker and select one of the following:

• Show = Pacemaker spike is displayed on ECG.

• Sensit = Sensitive pacemaker detection; spike displayed on

ECG.

• Hide = Pacemaker spike is not displayed on ECG.

NOTE: If the patient has an atrial pacer, ST calculations can be performed if the pacer does not coincide with the ISO point's adjustment range.

NOTE: Pacemaker detector may not operate correctly during the use of high-frequency (HF) surgical equipment. The disturbance of HF surgical equipment typically causes false positive pacer detection.

WARNING: When using the electrosurgery unit, ensure proper contact of the ESU return electrode to the patient to avoid possible burns at monitor measurement sites.

WARNING: Do not rely entirely upon rate meter alarms when monitoring patients with pacemakers. The monitor may count the pacemaker pulses as heartbeats. In this case, asystole and ventricular fibrillation may go undetected. Always keep these patients under close surveillance and monitor their vital signs carefully.

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Arrhythmia monitoring

NOTE: With the L-DICU08 software only severe analysis is available. It detects asystole, bradycardia, tachycardia, ventricular fibrillation and ventricular tachycardia.

Setting arrhythmia alarm priority

1. Press the ECG key.

2. Select ECG Alarms - Arrh. Alarms - Adjust.

3. Select Red (high priority), Yellow (medium priority) or White (low

priority) with the ComWheel. NOTE: You can only set the priority for V Tachy alarm.

4. Select Exit o confirm the changes and return to menu.

NOTE: Alarm priorities can also be set using the Central if the Central configuration allows it.

Starting relearning manually

When the patient's ECG pattern changes considerably, the monitor should start relearning a new ECG pattern.

You can start relearning manually through

ECG - Relearn - Start.

Selecting leads for the arrhythmia analysis

When measuring 5-lead ECG, you can affect the selection of the two ECG leads used for detecting beats and ventricular fibrillation. The selection of user leads (ECG1, ECG2, ECG3) on the monitor affects the leads used for detection. The first lead used for detection is lead I or II. The algorithm uses the lead appearing first in user leads. The second lead used for detection is one of the precordial leads (V1 V6). The algorithm uses the precordial lead appearing first in the user leads.

To change the user lead:

1. Press the

2. Select a lead for ECG1 Lead, ECG2 Lead, ECG3 Lead.

The monitor starts relearning the new ECG pattern automatically.

NOTE: With a 3 leadwire trunk cable, the algorithm uses the only one available lead ECG1 Lead, which is I, II or III, depending on the selected user lead.

ECG key.

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Detecting arrhythmia alarms

NOTE: Arrhythmia alarms are just for reference, but not for diagnose. A physician must analyze the arrhythmia information in conjunction with other clinical findings. NOTE: Asystole alarm will sound when HR reaches zero. For details about detection performance and test results of the arrhythmia algorithm testing, please refer to "User's Reference Manual: ECG."

Alarm Criteria

Asystole Cardiac arrest, no QRS complexes for five seconds

Bradycardia HR below the HR alarm limit

Tachycardia HR over the HR alarm limit

Ventricular fibrillation Fibrillatory waveform caused by ventricular fibrillation

Ventricular tachycardia Five or more consecutive PVCs and rate of successive beats over 100 bpm

Monitoring ST

The monitor analyzes ST for all measured leads and gives ST trends separately for each lead. The ST analysis starts automatically after the leads have been connected and the QRS detection has started.

ST can be viewed as digits and trends. For details about detection performance and test results of ST segment measurement algorithm testing, see the "User's Reference Manual: ECG."

NOTE: ST segment changes may also be affected by such factors as some drugs or metabolic and conduction disturbances.

NOTE: The significance of the ST segment changes needs to be determined by a physician.

Setting the measurement points

Automatic setting of measurement points

The ST algorithm automatically searches for the J and ISO points. The distance between the ST and J point is set according to the heart rate:

• If the heart rate is less than 120 bpm, the ST point is set at

J + 80 ms.

• If the heart rate is more than 120 bpm, the ST point is set at

J + 60 ms.

Adjusting measurement points manually

You can also set the J, ISO and ST points manually. If any of these is manually set, the other two are set at their current values.

1. Press the ECG key and select Adjust ST.

2. Adjust the points by selecting Set ISO point, Set J point or ST point (where the value is the delay between J-point and ST-point in milliseconds).

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Impedance respiration

You need

Use the same setup as in the ECG measurement, see "ECG and ST."

Starting

1. Select respiration to a waveform or digit field, otherwise respiration data is not included in trends and no alarms are activated.

2. Turn on the measurement:

•Press the

• Select Measurement - ON.

NOTE: Impedance respiration measurement is intended for patients over three years old.

Others key and select Resp Setup.

Improving waveform readability

1. Press the Others key and select Resp Setup.

2. Select Size and adjust the waveform size.

Correcting the respiration number

Normally, the AUTO detection limit is recommended. However, if the respirations are particularly weak or affected by artifacts, they may not be included in the respiration rate. To ensure the correct respiration number, adjust detection limits closer to each other:

1. Press the Others key.

2. Select Resp Setup - Detection Limit.

3. Adjust the limits.

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WARNING: Vibrations during intrahospital transport may disturb impedance respiration measurement.

WARNING: Make sure that the leadwire set clips or snaps do not touch any electrically conductive material including earth.

WARNING: This device is not an apnea monitor system intended to alarm primarily upon the cessation of breathing. In central apnea it indicates an alarm after a pre-determined time since the last breath detection. Do not attempt to use it for detecting obstructive or mixed apneas, since respiration movements and impedance variations may continue in these cases.

WARNING: When using the electrosurgery unit, ensure proper contact of the ESU return electrode to the patient to avoid burns at measurement sites.

WARNING: The impedance respiration measurement is inherently very sensitive as it measures very small physiologic signals (changes of impedance of the patient's chest area). Conducted RF current above 1 Vrms may cause erroneous measurements at various frequencies, for example interference with the signal/ waveform leading to respiration rate readings inconsistent with the patient's true respiration rate. If you notice this, use another form of respiration monitoring. For further information, see the "Technical Reference Manual."

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Temperature

You need

(1) E-PSMW or E-PSMPW module (2) Adapter cable for temperature probes (3) Reusable temperature probe (4) Adapter cable for disposable temperature probes (5) Disposable temperature probe

NOTE: Use only GE Healthcare temperature probes or defibrillatorproof YSI 400 series probes.

NOTE: For a comprehensive list of accessories, see the "Supplies and Accessories" catalog.

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Changing temperature label

Combining different temperatures

1. Press the Others key.

2. Select Temp Setup - T1 Label or T2 Label.

Changing temperature units

You can select the temperature units to be either degrees Celsius or degrees Fahrenheit:

1. Press the

2. Select Temp Setup.

3. Select Unit and then °C or °F with the ComWheel.

Others key.

The monitor displays the difference between different temperatures if they are displayed in the same digit field.

For example, to display T2 - T1:

1. Press the

2. Select Screen Setup.

3. Select Digit Fields.

4. Select T1+T2 to one of the lower fields.

Monitor Setup key.

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Pulse oximetry

You need

(1) E-PSMW or E-PSMPW module (2) OxyTip+ interconnect cable

NOTE: For a comprehensive list of accessories, see the "Supplies and Accessories" catalog.

NOTE: For each SpO2 accessory, refer to the instructions for use in the accessory package for patient weight limits.

OXY-E-UN

OXY-SE-3

OXY-F-UN

OXY-W-UN

OXY-AP

OXY-AF

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Applying sensors

• Use dry and clean sensors only.

• Clean the application site. Remove nail polish, artificial fingernails, earrings etc.

• Clip long fingernails.

• Attach the sensor cable to the wrist or bedclothes to prevent the cable and sensor from moving.

NOTE: GE Healthcare sensors are latex-free. Refer to the introduction of each type of probes, to make sure the materials with which patient or any other person may come into contact.

Displaying pulse rate

The heart rate can originate from various sources. Displaying the pulse rate measured with pulse oximetry:

1. Press the Others key.

2. Select SpO2 Setup.

3. Select HR Source - Pleth.

Adjusting SpO2 settings

You can adjust the volume of the beat sound, the waveform scaling and response averaging time:

1. Press the Others key.

2. Select SpO2 Setup.

3. Select Beat Sound Volume, Pleth Scale or SpO2 Response.

Measurement limitations

−

The pulse oximeter cannot distinguish between oxyhemoglobin and dyshemoglobins, for example, met- or carboxyhemoglobins.

− Poor perfusion may affect the accuracy of measurement when

using the ear probe.

− To avoid erroneous readings, do not use a blood pressure cuff or

arterial blood pressure measurement device in the same limb as the sensor.

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WARNING: Allow sensor and cable to dry completely after cleaning. Moisture and dirt on the connector can affect the measurement accuracy.

WARNING: Vibrations during intrahospital transport may disturb SpO2 measurement.

WARNING: Check the measuring site every four hours (more frequently if the perfusion is poor). Routinely check to ensure adequate circulation distal to the sensor site.

WARNING: To prevent erroneous readings, do not use physically damaged sensors, cables or modules. Discard a damaged sensor or cable immediately. Never repair a damaged sensor or cable; never use a sensor or cable repaired by others. A damaged sensor or a sensor soaked in liquid may cause burns during electrosurgery.

WARNING: Inaccurate SpO2 data can result if a sensor is past its useful life. Therefore, re-evaluate the measurement periodically by performing additional assessment of the patient and equipment, including consideration of use of alternate monitoring methods such as direct measurement of arterial oxyhemoglobin saturation (SaO2).

WARNING: Conditions that may cause inaccurate readings and impact alarms include interfering substances, excessive ambient light, electrical interference, ventricular septal defects (VSD), excessive motion, low perfusion, low signal strength, incorrect sensor placement, poor sensor fit, and/or movement of the sensor on the patient.

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For your notes:

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Non-invasive blood pressure (NIBP)

You need

(1) E-PSMW or E-PSMPW module (2) Cuff hose (3) Cuff of correct size

Place the arrow (4) over the brachial artery. Check that the index line (5) falls within the range markings on the cuff and wrap the cuff around the upper arm.

NOTE: For a comprehensive list of accessories, see the "Supplies and Accessories" catalog.

WARNING: Vibrations during intrahospital transport may disturb NIBP measurement.

WARNING: Non-invasive blood pressure measurement is intended for patients weighing over 5 kg (11 lb).

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Starting

Note that the measurement unit may be mmHg or kPa. The unit is selected during configuration through Service - Installation - Units.

The monitor automatically sets inflation limit for adults to Adult according to the hose used. For children and when using hoses without identification, the inflation limit must be set manually. To do this:

1. Connect the cuff hose to the NIBP connector.

2. Press the NIBP key.

3. Select NIBP Setup - Inflation Limits. NOTE: When using hoses without identification, the monitor goes

to this selection automatically when you try to start the NIBP measurement using one of the procedures described in the following. With these hoses, AUTO option is not available.

4. Select the limit with the ComWheel. For children, select Child. and for infants, select Infant.

The Monitor beeps once to signal the completion of the determination and values are posted in Digit Fields.

Monitor Setup - Install/

To produce a single measurement

•Press the Start Cancel side panel or module key, or

press the

NIBP key and select Start Manual.

To measure automatically after set intervals

•Press the Auto On/Off side panel or module key, or

press the The possible intervals for autocycling are 1, 2.5, 3, 5, 10, 15, 30 or 60 minutes, 2 or 4 hours.

•Press the NIBP key and select Cycle Time

• Select teh alternative with the ComWheel.

NIBP key and select Start Cycling.

To measure continuously for five minutes

•Press the NIBP key and select Start STAT.

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During measurement

• Observe the cuffed limb frequently. Measurement may impair blood circulation. Intervals below 10 minutes and STAT measurements are not recommended for extended periods of time.

• Make sure that tubes are not bent, pressed or stretched. Measurement may be impaired.

• Blood pressure values may be affected by a change in the patient's position.

When 30 minutes has passed from the latest NIBP measurement, the numeric value digits turn gray. When 245 minutes has passed from the latest NIBP measurement, the gray numeric value digits are replaced by a dashed line.

NOTE: The presence of some arrhythmias during NIBP measurement may increase the time required for the measurement. For details about the test results of the functioning of the NIBP measurement in the presence of arrhythmias, see "User's Reference Manual: NIBP."

Stopping

To release the cuff pressure before the measurement is finished:

•Press the press the

Start Cancel side panel or module key, or NIBP key and select Stop XX.

Setting cycling intervals

1. Press the NIBP key.

2. Select Cycle Time.

3. Select the interval time from the list with the ComWheel.

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Using NIBP cuff for venous stasis

1. Press the NIBP key.

2. Select Start Ven.Stasis.

Inflation limit Maximum venous stasis inflation limit Venous stasis time

Infant 145±5 mmHg (19.3 ±0.7 kPa) 40±5 mmHg (5.3 ±0.7 kPa) 1 minute

Child 200±10 mmHg (26.7 ±1.3 kPa) 60±5 mmHg (8.0 ±0.7 kPa) 2 minutes

Adult 280±10 mmHg (37.3 ±1.3 kPa) 80±5 mmHg (10.7 ±0.7 kPa) 2 minutes

Venous stasis pressure may be lower than the values above if the patient has low blood pressure. The venous stasis pressure adapts to the measured mean pressure being the same as mean pressure but always at least the following: Infant 20 ± 5 mmHg (2.7 ±0.7 kPa) Child 30 ± 5 mmHg (4.0 ±0.7 kPa) Adult 40 ± 5 mmHg (5.3 ±0.7 kPa)

WARNING: The monitor sets the inflation pressure automatically according to the previous measurement. Discharge the patient from the monitor to reset the inflation limit before measuring a new patient.

WARNING: If Luer lock connectors are used in the construction of tubing, there is a possibility that they might be inadvertently connectd to intravascular fluid systems, allowing air to be pumped in to a blood vessel.

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Invasive blood pressure

You need

(1) E-PSMPW module with InvBP measurement capability (2) Heparinized fluid bag with pressure infusor (3) Flushing set (4) Disposable catheter (5) Transducer (6) Adapter cable for the InvBP transducer (7) Adapter cable for dual InvBP measurement

You can monitor up to two pressure channels with the E-PSMPW module by using a dual cable. Note that the measurement unit may be mmHg or kPa. The unit is selected during configuration through

Monitor Setup - Install/Service - Installation - Units.

NOTE: For a comprehensive list of sensors and accessories, see the "Supplies and Accessories" catalog.

Page 78

Starting

1. For the setup, prepare the transducer kit according to the manufacturer's instructions.

2. Ensure that there is no air in the line.

3. Zero the transducer by opening it to air, pressing the Zero ALL side panel key or the selecting Zero Pressures - Zero ALL. You can zero one channel at a time with the module keys channel. NOTE: Selecting Zero ALL does not zero ICP. Zero it separately.

NOTE: The transducer is always leveled to the mid right atrium. Zero the transducer and pressures whenever the patient’s position is changed.

4. Open the line to the patient.

NOTE: Invasive pressures need to be zeroed after reconnecting the pressure transducer or cable, and whenever patient's position is changed. If any channel has not been zeroed, the message 'InvBP's not zeroed' appears. The invasive pressure alarms advance to medium and high priority levels regardless of the zeroing.

Invasive Pressures monitor key and

Zero P1 and Zero P2. Zero each

Labeling channels

The label of the pressure channel sets its display scale, color, filter, alarm source and alarm limits. The label descriptions are preconfigured.

To change the label:

1. Press the

2. Select P1 Setup - Label. For factory default descriptions, see

next page.

Invasive Pressures key.

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Factory default descriptions

The channels have the following factory default descriptions:

LABEL P1, Art, ABP P2, CVP RAP, LAP ICP PA RVP

Scale mmHg/kPa 200/30 20/3 20/3 20/3 60/8 60/8

Color Red Blue White White Yellow White

Alarm source Sys Off Off Off Off Off

Digit format S/D Mean Mean CPP S/D S/D

Filter (Hz) 2299999

Response Normal Normal Normal Normal Normal Normal

Combinining pressures

All invasive pressure waveforms can be displayed together so that they use an area of two normal waveforms, or so that all are combined in the same field with the same zero line.

1. Press the Monitor Setup key.

2. Select Screen Setup.

3. Select Waveform Fields.

• To combine all pressure waveforms in one field, select

Combine Pressures and YES.

Determining pressure values visually

By moving the horizontal cursor across the pressure waveform, you can get accurate pressure values at selected points. This may be useful, for example, if the patient's breathing pattern is irregular. The cursor is not available for pressures shown with a combined scale.

1. Press the Invasive Pressures key.

2. Select P1 Setup - P1 Cursor.

3. Move the cursor up or down by turning the ComWheel. Every time the cursor is moved, the time (hours and minutes) and pressure values appear on the screen. This way you can keep track of the changes made.

4. You can remove the cursor by selecting Remove Cursor. Note that if the cursor is not removed, it remains visible on the Normal Screen.

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WARNING: Vibrations during intrahospital transport may disturb InvBP measurement.

WARNING: All invasive procedures involve risks to the patient. Use aseptic technique. Follow catheter manufacturer's instructions.

WARNING: Make sure that no part of the patient connections touches any electrically conductive material including earth.

WARNING: When using the electrosurgery unit, ensure proper contact of the ESU return electrode to the patient to avoid burns at monitor measurement sites.

WARNING: Use only defibrillator proof transducers and cables.

WARNING: Mechanical shock to the invasive blood pressure transducer may cause severe shifts in zero balance and calibration, and cause erroneous readings.

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Airway gas (CO2)

You need

−

N-FCREC or N-FC module with CO2 measurement capability

− Gas sampling line

− Airway adapter with sampling line connector

− Water trap

You get

Carbon dioxide measurement: EtCO2, FiCO2, capnogram, respiratory rate

NOTE: For a comprehensive list of accessories, see the "Supplies and Accessories" catalog.

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Starting

• Make sure that the water trap container is empty and properly attached.

WARNING: Handle the water trap and its contents as you would any body fluid. Infectious hazard may be present.

• Connect the gas sampling line to the airway adapter and to the module. Check that the connections are tight.

• Turn on the monitor. The monitor performs a self-check.

• Before connecting the patient, wait until the message 'Calibrating gas sensor' disappears.

• Position the adapter with the sampling port upwards. This prevents any condensed water from entering the sampling line.

• If N-FCREC or N-FC is used with O than 40%, make sure that FiO2 Level and N2O Level are set accordingly in N2O compensation.

Airway Gas - CO2 Setup to enable O

During monitoring

• Empty the water trap container when half full.

• Disconnect the airway adapter during nebulization of medications.

NOTE: When the measured CO measurement range, the numeric value is gray.

NOTE: Leak in sampling system will cause too low EtCO

and/or N2O contents higher

and/or

value is outside the specified

value.

Waveform scaling

If EtCO2 is above 6% or the difference between FiO2 and EtO2 is above 6%, change the scale for capnogram:

1. Press the

2. Select CO2 Setup.

3. Select Scale.

Airway Gas key.

Changing the units

You can use %, kPa or mmHg as the CO2 measurement units. The units can be changed in the CO2 Setup menu:

1. Press the

2. Select CO2 Setup - Unit.

3. Choose the option.

Airway Gas key.

Points to note

−

Do not return the sample gas to the patient circuit.

− All accessories including the water trap are for single use only.

− Calibrate the airway gas module every six months in normal use

and every two months in continuous use, see "Cleaning and

care."

Disposal of gases

Connect the exhaust port of the N-FCREC/N-FC to an anaesthetic gas scavenging system. Or follow local hospital’s regulations.

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WARNING: Always test the airway adapter for a tight connection and proper operation before attaching it to the patient.

CAUTION: Do not apply pressurized air to any outlet or tubing connected to the moniotr, Pressure may destroy sensitive elements.

CAUTION: Remove the airway sampling line from the patient’s airway while nebulized medications are being delivered.

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For your notes:

Page 85

Troubleshooting

NOTE: Always check the patient’s condition first in problematic situations or if an alarm is triggered. See also “Messages.” Also note that if the measurement or function does not appear on the screen, check module connections.

Airway gases Values are too low:

• Check the sampling line and connectors for leakage.

Arrhythmia Extra arrhythmias are detected.

• Start relearning manually through ECG - Relearn.

Extra Ventricular Fibrillations are detected:

• Check the patient.

• Check that the amplitude signals are sufficient:

Leads I and II: Select the one with the largest amplitude to ECG 1. After selecting the leads, start relearning manually.

Batteries Battery operation time is markedly shortened:

• Condition the batteries, see “Conditioning the batteries” and

the “User's Reference Manual.”

ECG ECG signal is noisy or no QRS is detected:

• Ensure that the patient is not shivering.

• Select the correct ECG filter through ECG - ECG Setup -

Filter.

• Check the electrode quality and positioning. Do not place them on body hair, bones close to skin, layers of fat and major muscles. Pre-gelled electrodes are recommended.

• Change the ECG lead.

• Remove the ECG cable from the module and reinsert it.

Impedance respiration Measurement fails:

• Check the electrode quality and positioning.

• Adjust the detection limits. During ventilator supported breathing, the respiration calculation may count only ventilator-produced inspirations and expirations.

• Remove other electrical devices from the vicinity of the respiration measurement as they may cause interference.

Invasive pressures Readings seem unstable:

• Make sure that there are no air bubbles in the transducer system: Flush and zero.

• Place the transducer on the patient’s mid-heart level and zero.

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Monitor The monitor does not start:

• Check that the batteries are inserted and sufficiently charged, see page 17.

• Check that the power cord is properly connected.

• Check the fuses and replace them if necessary, see “Cleaning and care.”

Measurements The measured values are not displayed:

• Check that you have selected the desired parameter to a waveform or digit field, see “Screen setup.”

You cannot perform a measurement or a function.

• Check that the measurement module is properly installed.

• Remove the module and reinstall it.

Non-invasive blood pressure Measurement does not work or values seem unstable:

• Check that cuff tubings are not bent, stretched, compressed or loose.

• When using hoses without identification, make sure that you have selected the inflation limits in the NIBP Setup menu, see “Non-invasive blood pressure (NIBP).”

• Prevent motion artifacts.

• Use cuffs of correct size.

Pulse oximetry

signal is poor:

SpO

• Check the sensor and sensor positioning.

• Change the SpO2 Response (averaging time) to Normal.

• Note that skin pigment causes differences.

• Make sure that the patient is not moving.

Printing Printing is not possible:

• Check the printer setting through Print/Record - Printer

Connection.

• Check that the printer is connected to the network.

• Check the network cable.

Recording Recording is not possible:

• Connect an N-FREC or N-FCREC module.

• Check the Central recorder if you are recording through network.

Temperature Measurement fails:

• Check that you are using a correct probe.

• Try another probe.

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Messages

Always check the patient first. If any problem or message persists, contact qualified service personnel. Messages are listed here in alphabetical order.

• Air leakage

− NIBP: Check all connections and test tightness using Venous

Stasis.

• Alarms acknowledged from Central

− If required, turn on the alarms through Alarms Setup -

Audio ON/OFF - Activate Alarms.

•Alarm setup changed from Central

− Check the alarm limits and the arrhythmia alarm priorities,

see “Alarms” and “ECG and ST.”

• Alarms silenced from Central

− If required, turn on the bedside alarms through Alarms Setup

- Audio ON/OFF - Activate Alarms.

•Apnea

− Check the patient status.

− Check the ventilator and breathing circuit.

• Apnea deactivated

− The message will disappear after the monitor detects three

breaths.

•Artifacts

− Calm the patient since patient movements, shivering, deep

breathing, arrhythmia or irregular beats may cause some measurements to fail.

− If applicable, start a new measurement.

• Asystole

− Check the patient status.

− Check the electrodes.

•Battery low

− Replace the battery, see “Replacing the batteries”, or

connect the monitor to power outlet.

•Brady

− Check the patient status.

• Calibr.error

− Gases: Perform a new calibration.

• Check D-Fend

− Check that the water trap is properly attached to the

module.

•Check NIBP

− Check the patient status.

− Check the measurement setup.

− Check the cuff.

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•Check SpO2 probe

− SpO

• Check sample gas out

: Check the sensor and connections.

− Gases: Remove blockage from the sample gas outlet.

• Identical modules

− You are trying to use two or more E-PSM(P)W modules or two

or more N-Fx modules at the same time. You can only use one E-PSM(P)W and/or one N-Fx module at a time. Remove extra modules.

• Condition Battery A, Condition Battery B

− Condition the battery according to the instructions of the

external charger.

• Cuff loose

− NIBP: Check cuff and hose.

• Cuff occlusion

− NIBP: Check tubes and hose.

• Cuff overpressure

− NIBP: Check cuff, hose and tubes.

− Restart measurement.

• EEPROM error or EPROM error

− Contact authorized service personnel.

• Faulty ECG cable

− Change the ECG cable and the lead set. Change the ECG

module if the module connector is wet. Keep the connectors dry. Avoid excessive use of liquids when cleaning the cables and connectors.

• Gas measurements removed

− Reconnect the N-FREC or N-FCREC module if you want to

restart the CO2 measurement.

• Infl. limits! Check setup

− NIBP: Check cuff and inflation limits.

• InvBP's not zeroed

− Zero the channel indicated or zero both channels.

•Lead changed

− ECG: The monitor automatically switches the ECG1

waveform selection to a measurable ECG Lead (I, II, III, aVR, aVL, aVF or V5) if the current ECG1 waveform is not measurable. Note that the ECG waveform changes according to the lead it is measured from. Check the lead.

•Leads off

− ECG: Reconnect the disconnected trunk cable, electrode or

leadwire. Change the trunk cable, leadset and module.

• Network down: xxx (xxx = network name)

− Check the network cable.

− Check the Central.

•NIBP manual

− Check NIBP setup and restart autocycling.

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• No battery backup

− Replace the batteries, see “Replacing the batteries.”

•Noise

− ECG: Check the patient status. Check the electrodes.

•No xx Transducer

− InvBP: Connect the transducer or the cable.

• No SpO2 probe

− Check connection between the SpO

•No SpO2 pulse

sensor and module.

− Try other measuring sites.

• Printer error

− Printer is not working properly. Check that thenetwork

printer is operational.

• Printing...

− Printing onnetwork printer has been started. Please wait until

the printing is finished.

• Printing ready

− Monitor has completed sending printing data to the printer.

Please wait until the printing is finished.

• Poor signal

− SpO

•RAM error

: Change the measuring site.

− Contact authorized service personnel.

• Recorder module removed

− Reconnect the N-FREC or N-FCREC module if you need a

recorder.

• Replace Battery A, Replace Battery B

− Replace the battery as soon as possible, see “Replacing the

batteries.”

•Replace D-Fend

− Gases: Replace the water trap.

• Sample line blocked

− Gases: Change the sampling line and water trap.

• Select inflation limits

− NIBP: You are using a hose without an automatic

identification. Select appropriate inflation limits. NOTE: AUTO option is not available for these hoses.

•Sensor INOP

− Gases: Contact authorized service personnel.

• SpO2 probe off

− Check connection between sensor and patient.

− Replace the sensor.

•SRAM error

− Contact authorized service personnel.

•Tachy

− Check the patient status.

Page 90

• Temperature error

− Contact authorized service personnel.

• Unable to measure Dia

− Check the patient status.

− Check the NIBP cuff placement.

− Perform a new NIBP measurement.

• Weak pulsation

− Check the patient status.

− Check the NIBP cuff position and attachment.

− Check that the cuff is not damaged.

•x-Lead off

− ECG: Check the leadwires and their connections.

• Unable to measure Sys

− Check the patient status.

− Check the inflation limits.

− Perform a new NIBP measurement.

• Unstable zero pressure

− Calm the patient and retry.

• xxx high/low (xxx = measurement parameter)

− Check the patient status.

− Adjust the alarm limits.

• xx measurement(s) removed

− Reconnect the E-PSM(P) module if you want to restart the

measurement.

• Zero error

− Gases: Repeat the calibration procedure.

Page 91

Abbreviations

/min beats per minute, breaths per minute °C Celsius degree °F Fahrenheit degree µg microgram

Aalveolar A arm (describing location) aarterial a/AO2 arterio-alveolar PO

AA anesthetic agent AaDO2 alveolo-arterial oxygen difference AAMI Association for the Advancement of Medical

Instrumentation ABG arterial blood gases ABP arterial pressure ADU Anesthesia Delivery Unit AEP auditory evoked potential AirW airway temperature Alpha, Al alpha frequency band AM Anesthesia Monitor Amp amplitude Ant. anterior APN apnea Arrh. arrhythmia Art arterial pressure ASY asystole ATMP atmospheric pressure ATPD atmospheric/ambient temperature and pressure,

dry gas ATPS ambient temperature and pressure, saturated

gas aw airway AV atrioventricular aVF left foot augmented lead Avg. average aVL left arm augmented lead aVR right arm augmented lead Axil axillatory temperature

ratio

BAEP brainstem auditory evoked potential Bal balance gas bar 1 atmosphere Beta, BE beta frequency band Bigem. bigeminy BIS bispectral index Blad bladder temperature Blood blood temperature (C.O. measurement) Body body temperature BP blood pressure Brady bradycardia BSA body surface area BSR burst suppression ratio B-TO-B beat-to-beat BTPS body temperature and pressure, saturated gas

c calculated/derived value Cchest C(a-v)O2 arteriovenous oxygen content difference C.I. cardiac index C.O. cardiac output cal. calibration Calc calculated/derived value Calcs calculations CAM Compact Anesthesia Monitor CaO2 arterial oxygen content Casc. cascaded (ECG) cc cubic centimeter CCCM Compact Critical Care Monitor CCM Critical Care Monitor CCO continuous cardiac output CcO2 capillary oxygen content CCU cardiac (coronary) care unit CEL Celsius degree CISPR International Special Committee on Radio

Interference CFI Cardiac Function Index cmH2O centimeter of water

Page 92

CMRR common mode rejection ratio CO carbon monoxide CO2 carbon dioxide COHb carboxyhemoglobin Compl compliance Cont. continuous Contrl controlled ventilation Core core temperature Count count of responses CPB cardiopulmonary bypass CPP cerebral perfusion pressure CSA compressed spectral array CT computer tomography CvO2 (mixed) venous oxygen content CVP central venous pressure

d day dB decibel DBS double burst stimulation (NMT) DEL delete Delta, De delta frequency band depr. depression Des desflurane Dia diastolic pressure Diagn diagnostic (ECG filter) DIFF difference DIS S/5 Device Interfacing Solution DO2 oxygen delivery DO2I oxygen delivery index DSC digital signal converter Dyn. dynamic

eestimated ECG electrocardiogram ECG1 first ECG waveform (top) ECG1/r real-time ECG ECG2 second ECG waveform ECG3 third ECG waveform ED emergency department EDV end-diastolic volume EDVI end-diastolic volume index

EE energy expenditure (kcal/24h) EEG electroencephalogram EEG1 first EEG waveform EEG2 second EEG waveform EEG3 third EEG waveform EEG4 fourth EEG waveform EEMG evoked electromyogram EEtot total energy expenditure elect electrode elev. elevation EMC electromagnetic compatibility EMG electromyogram Enf enflurane Entr entropy EP evoked potential ESD electrostatic discharge Eso esophageal temperature ESV end-systolic volume ESVI end-systolic volume index ET, Et end-tidal concentration EtAA end-tidal anesthetic agent EtBal end-tidal balance gas EtCO2 end-tidal carbon dioxide EtN2O end-tidal nitrous oxide EtO2 end-tidal oxygen ET-tube, ETT endotracheal tube EVLW extravascular lung water EVLWI extravascular lung water index exp expiratory

F foot (describing location) FAH Fahrenheit degree FEMG frontal electromyogram FFT fast Fourier transform FI Fi fraction of inspired gas FiAA fraction of inspired anesthetic agent Fib fibrillation FiBal fraction of inspired balance gas FiCO2 fraction of inspired carbon dioxide FiN2 fraction of inspired N

FiN2O fraction of inspired nitrous oxide

Page 93

FiO2 fraction of inspired oxygen Flow airway gas flow Freq. frequent ft foot, feet FVloop flow volume loop

GGauss ggram Graph. graphical GEDI global enddiastolic volume index GEDV global enddiastolic volume GEF global ejection fraction

H hand (describing location) hhour Hal halothane Hb hemoglobin Hbtot total hemoglobin HCO3- bicarbonate Hemo Calcs hemodynamic calculations Hemo hemodynamic HHb reduced hemoglobin HME heat and moisture exchanger HMEF heat and moisture exchanger with filter hPa hectopascal HR dif heart rate difference HR heart rate ht height HW hardware Hz hertz

I:E inspiratory-expiratory ratio IABP intra-aortic balloon pump IC inspiratory capacity ICP intracranial pressure ICU intensive care unit ID identification IEC International Electrotechnical Comission Imped. impedance; impedance respiration in inch Inf. inferior

Infl. inflation (limit) insp inspiratory Inv. invasive InvBP invasive blood pressure Irreg. irregular ISM Industrial, Scientific and Medical ISO International Standards Organisation Iso isoflurane ITBV intrathoracic blood volume IVR idioventricular rhythm

Jjoule

Kkelvin kcal kilocalorie kJ kilojoule kPa kilopascal

L left (describing location) L leg (describing location) L, l liter l/min liters/minute Lab laboratory LAN local area network LAP left atrial pressure Lat. lateral lb pound LCD liquid crystal display LCW left cardiac work LED light emitting diode LVEDP left ventricular end diastolic pressure LVEDV left ventricular end diastolic volume LVSW left ventricular stroke work LVSWI left ventricular stroke work index

MAC minimum alveolar concentration Max maximum mbar millibar mcg microgram mean mean blood pressure mEq milliequivalent

Page 94

MetHb methemoglobin MF median frequency mg milligram Min minimum min minute ml milliliter MLAEP middle-latency auditory evoked potential mmHg millimeters of mercury mol mole Monit monitoring (ECG filter) MRI magnetic resonance imaging Mult. multiple Multif. PVCs multifocal PVCs MV minute volume MVexp expired minute volume (l/min) MVexp(BTPS) expired minute volume in BTPS conditions MVexp(STPD) expired minute volume in STPD conditions MVinsp inspired minute volume (l/min) MVspont spontaneous minute volume Myo myocardiac temperature

Nneutral N2 nitrogen N2O nitrous oxide Na sodium Naso nasopharyngeal temperature Neo neonate Net network Ni-Cd nickel-cadmium NIBP non-invasive blood pressure NiMH nickel-metal hydride NMT neuromuscular transmission NO nitric oxide NTPD normal temperature and pressure, dry gas Num. numerical

O2 oxygen O2ER oxygen extraction ratio O2Hb oxygenated hemoglobin OR operation room Oxy oxygenation

Oxy. Calcs oxygenation calculations

P partial pressure Ppressure P(BTPS) pressure in BTPS conditions P(g-a)CO2 difference between gastrointestinal carbon

dioxide and arterial blood carbon dioxide

concentration

P(g-ET)CO2 difference between gastrointestinal carbon

dioxide and end tidal carbon dioxide

concentration P(STPD) pressure in STPD conditions P1..6 invasive pressure channel identification on

module PA pulmonary arterial pressure PA pulmonary artery Pa Pascal (unit of pressure) Paced paced beats PaCO2 partial pressure of carbon dioxide in the arteries PAO2 partial pressure of oxygen in the alveoli PaO2 partial pressure of oxygen in the arteries PAOP pulmonary artery occlusion pressure Paw airway pressure Pbaro barometric pressure PCWP pulmonary capillary wedge pressure PE polyethylene Pedi pediatric PEEP positive end-expiratory pressure PEEPe extrinsic positive end expiratory pressure PEEPe+i total positive end expiratory pressure (ICU) PEEPe+PEEPi total positive end expiratory pressure (ICU) PEEPi intrinsic positive end expiratory pressure PEEPtot total positive end expiratory pressure

(anesthesia) PgCO2 gastrointestinal carbon dioxide concentration pH pH pHa arterial pH pHi intramucosal pH pHv (mixed) venous pH PIC patient interface cable

Page 95

Pleth plethysmographic pulse waveform PM non-capt. pacemaker non-capturing PM non-funct. pacemaker non-functioning PM pacemaker Pmax maximum pressure Pmean mean pressure Pmin minimum pressure Ppeak peak pressure Pplat plateau (pause) pressure PR pulse rate Prev previous psi pounds per square per inch pt patient PTC post tetanic count (NMT) pts patients PVC polyvinylchloride PVC premature ventricular contraction PVloop pressure volume loop PvO2 partial pressure of oxygen in (mixed) venous

blood PVR pulmonary vascular resistance PVRI pulmonary vascular resistance index Px standard pressure label, x being 1, 2, 3, 4, 5, or 6

QRS QRS complex Qs/Qt venous admixture

R right (describing location) RAP right atrial pressure Raw airway resistance RCW right cardiac work RCWI right cardiac work index RE response entropy Rect rectal temperature REF right ventricular ejection fraction ref. reference Resp Rate respiration rate (total) (measured) Resp respiration rate (total) (set) RF radio frequency RMS average (root mean square) power Room room temperature

RQ respiratory quotient RR respiration rate (total) (measured) rtm rhythm RV residual volume RVEDV right ventricular end-diastolic volume RVESV right ventricular end-systolic volume RVP right ventricular pressure RVSW right ventricular stroke work RVSWI right ventricular stroke work index

ssecond SA sinoatrial SaO2 arterial oxygen saturation S.A.R. Specific Absorption Rate SD standard deviation SE state entropy SEF spectral edge frequency SEMG spontaneous electromyogram Sev sevoflurane SI stroke index Skin skin temperature SN, S/N serial number Spiro patient spirometry SpO2 oxygen saturation Spont spontaneous breathing SQI signal quality index SR sinus rhythm SR suppression ratio SSEP somatosensory evoked potentials ST single twitch (NMT) ST ST segment of electrocardiograph STAT continuous NIBP cuff inflation for five minutes stat static STBY standby STfilt ST filter (ECG) STPD standard temperature and pressure, dry gas Surf surface temperature SW software SV stroke volume SVC supraventricular contraction SVI stroke volume index

Page 96

SvO2 (mixed) venous oxygen saturation SVR systemic vascular resistance SVRI systemic vascular resistance index SVV stroke volume variation Sys systolic pressure

Ttesla T corr. temperature correction T inj. injectate temperature T temperature t time (min) T(BTPS) temperature in BTPS conditions T1% first stimulus as % of the reference value (NMT) T1..4 temperature channel identification on module Tab. tabular Tachy tachycardia Tbl, Tblood blood temperature Temp temperature Theta, Th theta frequency band TOF train of four (NMT) TOF% ratio of the 4th to the 1st response (NMT) Trigem. trigeminy TV tidal volume TVexp expired tidal volume (ml) TVinsp inspired tidal volume (ml) Tx temperature label, x being 1, 2, 3, r 4 or one of the

other label choices Tymp tympanic temperature

V Fib ventricular fibrillation V Run ventricular run V Tachy ventricular tachycardia vvenous Vventricular Vvolume V/Q ventilation/perfusion ratio V0.5 volume expired during the first 0.5 seconds V1.0 volume expired during the first second VA alveolar ventilation VC vital capacity VCO2 carbon dioxide production Vd dead space Vd/Vt dead space ventilation Vent. Calcs ventilation calculations VO2 oxygen consumption VO2calc calculated oxygen consumption* VO2I oxygen consumption index VO2Icalc calculated oxygen consumption index* Vol volume

WLAN wireless local area network wt weight

Xextreme

yr year yrs years

* with Fick equation

Page 97

Performance

WARNING: Operation of the monitor outside the specified values may cause inaccurate results.

NOTE: Information in this section may be especially useful to clinicians.

B30 Patient Monitor

Any fluctuations within the specified limits do not affect the performance.

Power supply

Rated voltages and frequencies: 100 to 240 V 50/60 Hz Allowed voltage fluctuations: ±10% Max. power consumption: 150 VA

Battery operation

Batteries: Exchangeable lithium-ion,

2 pcs max. Charging time: 2 hours per battery pack Operation time: Up to 4.5 hours

Environmental conditions

Operating temperature:

normal operation: +5 to +40°C (41 to 104°F)

while charging batteries: +5 to +35°C (41 to 95°F) Storage and transport temperature: -20 to +60°C (-4 to 140°F) Relative humidity: 10 to 90% noncondensing,

in airway 0 to 100% condensing

Atmospheric pressure: 670 to 1060 mbar

(500 to 800 mmHg)

Alarm behavior

The maximum alarm delay of the alarm at the monitor signal output to network: <5 seconds

If the alarm mode is latched, the technical alarms are latched as well. This does not comply with the NIBP (IEC 60601-2-30) and invasive pressure (IEC 60601-2-34) standard requirements. Silencing alarms for 5 minutes does not comply with the SpO

9919) standard requirements.

N-FREC, N-FCREC

Power consumption: 3 W Recorder type: Thermal array Print resolution:

Vertical 8 dots/mm (200 dots/inch) Horizontal 24 dots/mm (600 dots/inch) at a

speed of 25 mm/s and slower Paper width: 50 mm, printing width 48 mm Waveforms: Selectable 1, 2, or 3 waveforms Print speed: 1, 6.25, 12.5, 25 mm/s

(ISO

Page 98

Defibrillator & IABP synchronization connector

Analog output

ECG (Pin 8):

From first user lead (ECG1) Gain: 1 V/mV ±10% Delay: < 15 ms DC offset: ±100 mV max. Frequency response: 0.05 Hz to 40 Hz

Invasive blood pressure (Pin 7):

From pressure labeled ‘Art’ or P1 Gain: 10 mV/mmHg ±2% Delay: < 35 ms‘ DC offset: ±20 mV max.

Frequency response: DC to 30 Hz The pacemaker pulses have been replaced with 2 ms ± 20% fixed digital pulses at the ECG analog output. A device that fulfils the requirements of the IEC 60601-1 standard can be connected to the defibrillator & IABP synchronization connector. There are no other limitations, because the signals of the connector are galvanically isolated from patient applied part of the ECG and invasive blood pressre measurements.

Synchronization pulse (Pin 1)

Pulse width: 10 ms positive pulse Delay: < 35 ms (R-wave peak to leading edge

of pulse)

Amplitude: CMOS compatible

3.5 V min. at 1 mA sourcing

0.5 V max. at 5 mA sinking Output impedance: 50 ohm Current limit: 10 mA

Hemodynamic modules E-PSMW, E-PSMPW

ECG1

Filter modes:

With 50 Hz power supply frequency:

monitoring filter 0.5 to 30 Hz ST filter 0.05 to 30Hz diagnostic filter 0.05 to 150 Hz

With 60 Hz power supply frequency:

monitoring filter 0.5 to 40 Hz ST filter 0.05 to 40 Hz diagnostic filter 0.05 to 150 Hz

QRS minimum detection level:

Minimum level 0.5 mV with duration between 40 and 120 ms. Defibrillation protection: 5000 V, 360 J Recovery time: <5 s according to Heart rate:

Measurement range: 30 to 250 bpm

Measurement accuracy: ±5 % or ±5 bpm, whichever is greater

Displays average of 10-second median values

Display update time: 1 s Maximum response time of heart rate meter to change in heart rate:

Response time 80 to 120 bpm: 6.9 s

Response time 80 to 40 bpm: 8.2 s Maximum Tall T wave amplitude that does not disturb the heart rate calculation time: >1.4 mV Input Impedance: > 2.5 mΩ

1 The isolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a defect in the ESU return electrode

connection.

2 When the heart rate (HR changes rapidly, the averaging is restarted.

Page 99

The heart rate calculation operates with irregular rhythms of IEC 60601-2-27 6.8.2 bb 4 , the heart rate after a 20 second stabilization period is:

Figure 101 A1): 80 bpm Figure 101 A2): 59 bpm Figure 101 A3): 122 bpm Figure 101 A4): 117 bpm

Pacemaker pulse detection:

detection level: 2 to 700 mV pulse duration: 0.5 to 2 ms

Pacer pulse rejection of fast ECG signals: 2.0 V/s

Pacemaker detector may not operate correctly during the use of

high-frequency (HF) surgical equipment. The disturbances of HF surgical equipment typically cause false positive pacer detection. Direct current for leads-off detection through an active patient electrode: <30 nA Direct current for leads-off detection through a reference electrode:<120 nA The normalized respiration sensing current between RA (R) and LL (F)

or RA (R) and LA (L) or LA (L) and LL (L): <5.0 µA Frequency of respiration sensing current: 31.25 kHz Minimizing the effects of the line isolation monitor transients:

Crystal controlled oscillator used as the operating frequency source of the patient isolation power supply.

The average time and time range ( ) to alarm (VFib or VTachy) for tachycardia waveform are as follows (IEC60601-2-27 6.8.2.bb.6): Figure 101 B1 halved amplitude:9.9 s (8.4 to 11.5 s) Figure 101 B1 normal amplitude:7.1 s (5.8 to 8.2 s) Figure 101 B1 doubled amplitude:4.4 s (4.2 to 4.6 s) Figure 101 B2 halved amplitude: 7.0 s (6.1 to 7.5 s) Figure 101 B2 normal amplitude:5.8 s (4.5 to 7.4 s) Figure 101 B2 doubled amplitude:6.1 s (5.1 to 7.0 s) A clinician should always confirm the rhythm from the ECG waveform.

Direct cardiac application:

The display area reserved for the ECG measurement in the monitoring system screen may not be adequate for displaying the complete ECG amplitude when measuring ECG direct from the

surface of the heart. Clipping of the signal can be reduced by adjusting the size of the signal on the screen (for example, from the default 1.0 to 0.2) in the ECG menu.

Impedance respiration

Respiration range: 4 to 120 resp/min Accuracy: ± 5% or ±5 resp/min, whichever is

greater

Alarm limits range: 4 to 80 resp/min The conducted RF immunity of the respiration measurement has

been tested with 1 Vrms. The radiated RF immunity of the respiration measurement has been tested with 1 V/m. The impedance respiration measurement technology has been optimized so that the measurement is not sensitive to electrosurgery equipment which is commonly used in the intended environment for the impedance respiration measurement.

NOTE: Impedance respiration measurement is intended for patients over three years old.

Invasive blood pressure (E-PSMPW)

Measurement range: -40 to 320 mmHg (-5.3 to 42.7 kPa) Measurement accuracy: ±5% or ±2 mmHg, whichever is

greater Pulse rate: Measurement range: 30 to 250 bpm Accuracy: ±5% or ±5 bpm, whichever is greater Transducer sensitivity: 5 µV/V/mmHg

1 The isolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a defect in the ESU return electrode

connection

Page 100

NIBP

Blood pressure measurement range:

adult 25 to 260 mmHg (3.3 to 34.7 kPa) child 25 to 190 mmHg (3.3 to 25.3 kPa)

infant 15 to 140 mmHg (2.0 to 18.7 kPa) Pulse rate range accepted: 30 to 250 bpm Cuff pressure measurement range: -15 to + 350 mmHg (-2.0 to 46.7 kPa) Typical measuring time:

adult Less than 30 s

infant Less than 25 s Overall system accuracy: Meets or exceeds SP10-2002 AAMI

standards.

NOTE: The cuff pressure measurement range is equal to cuff nominal and cuff indication ranges.

The ESU does not cause a burn hazard through the NIBP cuff, because there is no electrical connection between the cuff and the NIBP measuring electronics.

NOTE: NIBP measurement is intended for patients weighing over 5 kg (11 lb).

Temperature

Measurement range: 10 to 45°C (50 to 113°F) Measurement accuracy: ±0.1°C Digital display resolution: 0.1°C at 25 to 45°C with resuable

probles Digital display averaging: median of 5 samples Probe type: Use only GE Healthcare temperature

probes or defibrillator-proof YSI 400

series probes. Temperature self-check: at start-up and then every 10 minutes

Time constant of temperature probes:

Reusable skin temperature probe: 3 s Reusable adult central temperature probe: 6 s Reusable pediatric central temperature probe: 4 s Disposable skin temperature probe: 3 to 6 s Disposable central temperature probe, 12F: 5 to 8 s Disposable central temperature probe, 9F: 5 to 8 s Esophageal stethoscope with temperature probe, 9F: 15 s Esophageal stethoscope with temperature probe, 12F: 16s

Esophageal stethoscope with temperature probe, 18F Esophageal stethoscope with temperature probe, 24F

: 23 s

: 32 s

1 According to SP10-2002 AAMI 4.4.5.2.B, Intra-arterial method as the reference standard, mean difference of the test system and the comparison system shall

be ± 5 mmHg or less with standard deviation of 8 mmHg or less

2 The isolation barrier capacitance in the module has been minimized to reduce the hazard of burns in the event of a defect in the ESU return electrode

connection.

3 Response time of the probe exceeds 150 seconds.

GE B30 User manual

Specifications and Main Features

Frequently Asked Questions

User Manual

B30 Patient Monitor

User's Guide

Related to software L-DICU08

About this guide

Related documentation

Trademarks

Product availability

Service Lifetime

Intended purpose (Indications for use)

Responsibility of the manufacturer

Safety precautions

Warnings

Cautions

Disposal

Points to note

Symbols

System introduction

Optional components

Alarms

Monitor introduction

Rear panel connections

Command Board keys

Side panel keys

Batteries

Replacing the batteries

Measurement modules

Patient Side Modules E-PSMW and E-PSMPW (in the drawing)

Module keys Module versions

Extension Modules N-FREC, N-FCREC (in the drawing) and N-FC

Module versions

Inserting a module

Removing a module

Using two modules

Monitoring basics

Navigating in menus

Using modes

Setting up the monitor before use

Passwords

Setting time and date

Battery setup

Changing the monitor installation settings

Units

Alarm options

Printer

Monitor settings

Changing the user modes

Changing the startup mode

Renaming a mode

Loading modes

Changing the waveform sweep speeds

Changing the parameter colors

Changing the recorder settings

Changing the printer settings

Changing the Normal Screen layout

Changing the display brightness

Setting the default trend

Configuring trend pages

Setting trend lengths and scales

Entering and loading patient data

Entering patient data

Loading patient data

Saving data

Starting and ending

Preparations

Starting monitoring

Ending monitoring

Screen setup

Modifying the screen temporarily

Modifying the screen permanently

Changing the split screen contents

Changing waveform and digit fields

Alarms

Enabling the alarms

Alarm indications

Adjusting limits

Adjusting volume