GE Dinamap Pro 100-400 User manual

DlNAMAP@

Series 100-400 Monitor

Operation Manual

PRO

NAMAP” PRO Monitor

Operation Manual

This manual is for 200, 300, and

l PRO 100: BP and Pulse l PRO 200: BP, Pulse, and Temp l PRO 300: BP, Pulse, and l PRO 400: BP, Pulse, Temp, and

DINAMAP@

400, all with printers.

PRO Monitor Models 100,

SpO,

The model of the Monitor determines which menu option

buttons appear on the LCD. Please refer to applicable

sections.

Reissues and Updates

Changes occurring between issues are addressed through Change Information Sheets, Addendums, and replacement

pages. If a Change Information Sheet does not accompany

this manual, it is correct as printed.

Errors and Omissions

If errors or omissions are found in this manual, please notify: Critikon Marketing Services 4502 Woodland Corporate Boulevard

Tampa, FL 33614

1-877-274-8456

Part No. 776995C

The content of this document including all figures and

drawings is proprietary information of Critikon, provided solely for purposes of operation, maintenance or repair, and dissemination for other purposes or copying thereof is

prohibited without prior written consent by Critikon, Tampa,

Florida.

Illustrations may show design models; production units may

incorporate changes.

Introduction

About

Product Compliance Symbols

the

......................

Getting Started

Unpacking Power Powering Rear Panel Connections.

Switching the Monitor On Liquid Crystal Display (LCD) Using the Printer

Sources

t.he

Front Panel Controls and

Installing the Paper Printer Alarms Storage

......................................................................................................................

Using the Monitor

Noninvasive Blood Pressure Determination Procedures Manual Mode Auto

Mode

Stat

Mode Predictive Temperature Procedures spa*

........

Procedures Troubleshooting

Using the Menu System

Introduction Liquid Crystal Display

....

Rotor Menu Tree Main Menu Vitals Button

More Button SetBPButton Alarms Button Trend

Print Button

SpO2

Config Button

Pwr

Time

Rotor Display Button Service Button Clinician Menu Error and Warning Messages Alarms

......................................................................................................................

...

Button

...

Button (Models 300 and 400)

Sav

(Sleep

..........................................................................................................................

Button

Appendix A

Technical Specifications

..........................................................................

DINAMAP@

........

..............................................................................................

PRO

Monitor..

......................................................................................

.................................................................

....................................................................

Monitor

the

..........

Monitor

........................................................................................................

and

Accessories

.............................................................................................

........................................................................

.......................................................................................

Indicators

and

...............................................................................

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.................................................................................................

...................................................................

....................................................................

Off

............

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...

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Determination

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.,..,...,................,.............................................,........................,

........

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...........................

All

(UK:

.........................................................................................................

(UK:

.........................................................................................................

............................................................................................................

..............................................................................................................

...........................................................................................................

.........................................................................................................

Mode)

........................................................................................................

.......................................................................................................

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..................................................................................

Obs)

Mode)

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.....

13 13 13 16 17 19 19 20 20 21 21

23 27 29

29 30

3 1

32 34

..........

36 39

43 43 46 46

.__

47 48 48 49

51 53

53 54 54 54 55

56 56 57 58

.62

BP. . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IVAC

Temperature

.,.........,.....

SpOz Mechanical

Power Requirements Environmental

Appendix B

Patient Alarms System Alarms . .

Failsafe Alarm Hierarchy

Appendix C

Principles

Appendix D

Compatibility Table and Reorder Codes

Appendix E

Warranty, Repairs Packing Service Manuals .

Service,

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Instructions

Appendix F

Maintenance Cleaning the

Cuff Cleaning and Disinfection Temperature

SpOz

Sensors

Storage and Battery Care

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fuses

Calibration . .

Leak Testing . . Disposal of Product Waste . . .

Appendix

Connection Host

Port Connector

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

..,......._,._,....,..,.,......,,.........

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

_...........

. . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..*.............

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

_..__...._....,............................................................................................

Alarms

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pressure

Noninvasive

Blood

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..*.*......

Parts

Spare

and

. . . . . . . . . . . . . . .

.._............................,....,.....................

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..*...........................

. . . . . . . . . .

Monitor . . . . . . . . . . . . .

Devices

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.._...._.....

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Details

.._.....................................

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.._..._....._..............................................~...................

. . . . . . . . . . . . . . . . . .

(rear pane)) . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

,......

Determination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

._..............................................

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . 63

.._..............__......_.......

,.......

.._,.

. . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . 82

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . 86

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

63 64

66 66

69 69

82 82

83 83 84 84 a5

86 86

a9 89

Introduction

About the

DINAMAP@

DINAMAP

PRO Monitors provide noninvasive

PRO Monitor

determination of systolic blood pressure, diastolic blood

pressure, mean arterial pressure, pulse rate, temperature,

and oxygen saturation. These portable AC- and

DC- operated monitors are primarily intended for use in hospital acute care settings such as outpatient surgery, accident and emergency, labor and delivery,

Gl/endoscopy,

and medical/

surgical units.

The PRO

200, 300, and

PRO 100: BP and Pulse

l PRO 200: BP, Pulse, and Temp

. PRO 300: BP, Pulse, and

l PRO 400: BP, Pulse, Temp, and

Monitor comes in four different models: PRO 100,

400, all with printers.

SpO,

All of the main operations of the PRO Monitor are easy to use. Please review the factory default settings and, where applicable, enter settings appropriate for your use. The “Using the Monitor” section of this manual explains how to use the Monitor in its most simple form, while the “Using the Menu System” section explains how to customize measurements by using the menu system.

lndica tions

The PRO Monitor is intended to monitor one patient at the bedside.

Contraindications

This device is not designed, sold, or intended for use except

as indicated.

Federal law (U.S.A.) restricts this device to sale by or on the

order of a clinician.

Warnings

. .

l Do not use the PRO Monitor in the

magnetic resonance imaging (MRI)

presence of

devices. There have been reports of sensors causing patient burns when operating in an MRI environment.

l Do not use the Monitor in the presence of flammable

anesthetics.

l To help prevent unintended current return paths with

the use of high frequency (HF) surgical equipment, ensure that the HF surgical neutral electrode is properly connected.

l To avoid personal injury, do not perform any servicing

unless qualified to do so.

l WARNING: These Monitors should not be used on

patients who are connected to cardiopulmonary bypass machines.

. If powering the Monitor from an external power

adapter or converter, use only Critikon-approved power adapters and converters.

l The Monitor does not include any user-replaceable

fuses. Refer servicing to qualified service personnel.

l To reduce the risk of electric shock, do not remove the

cover or the back. Refer servicing to a qualified service person.

l If the accuracy of any determination reading is

questionable, first check the patient’s vital signs by alternate means and then check the PRO Monitor for

proper functioning.

Cautions

l Do not use replacement batteries other than the type

supplied with the Monitor. Replacement batteries are available from Critikon. See Appendix D.

l The PRO Monitor is designed to conform to

Electromagnetic Compatibility (EMC) standard IEC 601-l -2, 1993 and will operate accurately in conjunction with other medical equipment which also

meets this requirement. To avoid interference

problems affecting the Monitor, do not use the

Monitor in the presence of equipment which does not

conform to these specifications.

Introduction

Place the PRO Monitor on a rigid, secure surface.

Monitor must only be used with mounting hardware, poles, and stands recommended by Critikon. See

Appendix D.

The weight of the accessory basket contents should

not exceed 6.6 lb (3 kg).

Arrange the power cord, air hoses, and all cables

carefully so they do not constitute a hazard.

Verify calibration of BP parameter (temp and pulse

oximeter do not require calibration). Ensure that the display is functioning properly before operating the

PRO Monitor.

Do not immerse the Monitor in water. If the Monitor is splashed with water or becomes wet, wipe it immediately with a dry cloth.

Do not gas sterilize or autoclave.

The PRO Monitor, when used with Critikon-approved

applied parts and accessories, is protected against defibrillator damage.

Notes

l Waveforms may be distorted and readings inaccurate

when electrosurgical cautery equipment is used while

monitoring

The electromagnetic compatibility profile of the PRO

with the PRO Monitor.

Monitor may change if accessories other than those specified for use with the PRO Monitor are used.

l Trend data are retained in the PRO Monitor when it is

turned off, except when the default is overridden by selecting the Trend button under the Service menu.

Product Compliance

DINAMAP@

The

categories for compliance with

l Class l Transportable l For continuous operation

l Not suitable for use in the presence of flammable

anesthetics

l Not for use in the presence of an oxygen-enriched

atmosphere (oxygen tent)

l Type BF applied parts

IPXl,

l Sterilization/Disinfection, see Appendix F

degree of protection against ingress of water

PRO Monitor is classified in the following

IEC

601-l :

internally powered

@ C

DINAMAP@

PRO MONITOR

CLASSIFIED WITH RESPECT TO ELECTRIC SHOCK, FIRE AND MECHANICAL AND OTHER SPECIFIED HAZARDS ONLY IN ACCORDANCE WITH CAN/CSA C22.2 NO.

601

. ALSO EVALUATED TO IEC-601-2-30.

0086

This product conforms with the essential requirements

of the Medical Device Directive. Accessories without the CE mark are not guaranteed to meet the Essential

Requirements of the Medical Device Directive.

Getting Started

Unpacking the Monitor and Accessories

Before attempting to use the PRO Monitor, take a few minutes to accessories. Unpack the against the contents checklist enclosed in one of the accessory boxes. This is also a good

damage or shortage. If there is a problem or shortage, contact Critikon.

become acquainted with the Monitor and its

items carefully, and check them

time to check for any

It is recommended that all the packaging case the Monitor

must be returned for service in the future.

be retained, in

Power Sources

The PRO Monitor is designed to operate from either an

internal lead-acid battery, AC mains or an IEC 601-l compliant DC power source (see Appendix A).

replacement rechargeable batteries, please refer to the

Service

The Monitor contains five fuses. Two AC line input fuses

are mounted internally and are replaceable only by qualified service personnel. The remaining three fuses are resetable and mounted within the Monitor. These fuses protect the low voltage DC input, the battery, and the output on the host port connector.

section of this manual.

For

auto-

Powering the Monitor

Before the PRO Monitor is used for the first time, the battery should be charged in the Monitor for at least 8 hours.

Refer to the illustration of the rear panel connections. Looking at the rear of the PRO Monitor, remove the battery compartment cover. Insert the rechargeable battery into the compartment so that the battery terminals fit into the power

clips at the bottom of the compartment. Then replace the cover. Insert the power cord plug into the mains external power socket (2) and plug into an AC outlet.

Refer to the illustration of the front panel controls and indicators. With mains or the green external power indicator LED (14) will light to indicate that external power is being applied and that the

battery is charging. If the battery is not inserted, the external

externat DC power connected,

power indicator LED will flash (short flash approx. every 4

When the Monitor is running on battery

appears in

LCD area 3 (toggling with the time indicator)

power, a battery icon

set).

indicating the charge status.

During battery-only operation, the yellow battery power indicator LED (17) will light. When the battery becomes discharged beyond the low battery threshold, the indicator will begin to flash, and the Monitor will sound warning beeps every 30 seconds. At this point, the Monitor should be connected to an AC outlet to recharge the battery. If the

Monitor continues to be used without charging the battery, the message WARNING: THE

BAlTERY

IS TOO LOW FOR

MONITOR TO FUNCTION. TURN MONITOR OFF appears.

The Monitor shuts down all functions until it is turned off and the battery is recharged or replaced. To run the Monitor on AC power, it must be powered off and then on again.

Battery charging will take place as long as the Monitor remains

connected to an external AC power source. A battery that is fully discharged can be fully recharged in

1 hour 50 minutes

when the Monitor is switched off or 8 hours if the Monitor is switched on.

.,:

Notes

l To prolong the life of the battery, keep the Monitor

connected to an AC outlet whenever possible. NEVER allow the battery to become completely discharged. A

fully charged battery will power the Monitor for

approximately 2 hours and should survive between and 500 charge/discharge cycles. When it is necessary to replace the battery, refer to the “Compatibility Table and Reorder Codes” listed in Appendix D. To ensure full charge cycles, replace only with a recommended battery.

If the Monitor is to be stored for some time, first charge

the battery and then remove it and store it separately from

the Monitor.

For continued safety, use only a power cord of listed type

SJT, three-conductor, min. No. 18 AWG, terminated in a medical/hospital grade attachment plug, provided with the following cord tag:

“Hospital Grade Plug.” Grounding

200

Getting Started

integrity can only be maintained when equipment is

connected to an equivalent receptacle marked “Hospital Grade.”

l Where the integrity of the external earth conductor in the

installation or its arrangement is in doubt, the Monitor

be operated from its internal battery.

General Caution

Do not touch either the pin of the DC input connector (3) or the terminals within the battery compartment (1) and the patient at the same time.

must

**a

.:::::t:.

a**me*oe

53’

***e :gg::gp

Rear Panel

Battery compartment cover: Retains and protects

internal battery Mains input: Used to connect to AC power supply

External power

Critikon

Inactive temperature cable storage: Inactive temperature

probe cable attaches here (Models

Pole clamp: Used to clamp monitor to

Data interface connector: Host communications port

(15

way D-type RS-232 serial port) for use only with

Connections

socket: To be used with approved

AC-DC power converter ONLY

200

and

pole or stand

400)

equipment conforming to IEC 601-1, configured to comply with IEC 601-l-l

Getting Started

15 16

17 18

Front Panel Controls and Indicators

Systolic pressure display:

measured systolic BP in

Active temperature probe holster: Temperature probe that is being used stored here (Models 200 and

Diastolic pressure display: 3-digit red LED indicates

measured diastolic BP

10 Temperature probe cover storage: Box of probe covers

stored here (Models 200 and 400)

11 Inactive temperature probe holster: Extra temperature

probe can be stored here (Models 200 and 400)

12 Temperature display: 4-digit red LED indicates measured

temperature (Models 200 and 400)

“F

display: Indicates whether temperature is being

“C

displayed in degrees Celsius or Fahrenheit (Models

400)

and

3-digit red LED indicates

mmHg

400)

200

14 External power indicator: Green LED indicates external

power status and battery charging status of monitor

15 Temperature probe connector: Temperature probe cable

attaches here (Models 200 and 400)

ON/OFF switch: Controls on/off state of monitor; push

for power on and push again for power off

17 Battery power indicator: Yellow LED indicates operation

and charge status of internal battery

SpOz

sensor connector:

SpOz sensor extension cable

attaches here (Models 300 and 400)

19 Mean arterial pressure display:

measured MAP in

mmHg

and shows instantaneous cuff

3-digit red LED indicates

pressure during BP determination

SpOz

pulse indicator: Yellow LED in heart symbol flashes to indicate that real-time pulse rate measurements are being derived from

SpOz

signals (Models 300 and 400)

21 Rotor: Used to highlight and select items in LCD

menus; if monitor is off, pressing rotor will switch monitor on

22 Pulse BPM display: 3-digit yellow LED shows pulse rate

in beats per minute

SpOz

display: in

% (Models 300 and 400)

SpOz

artifact indicator LED: Illuminates when motion

3-digit red LED indicates oxygen saturation

artifact is detected (Models 300 and 400)

25 LCD (liquid crystal display): Displays all alarms, user

interface messages, and configuration options

26 Alarm silence switch: Alternately mutes and enables

audible alarms; when pushed once after alarm sounds (silence

on), switch lights to indicate that audible alarms

have been silenced for 2 minutes

27 AUTO BP key: Press to start Auto BP mode 28 Light sensor: Automatically measures ambient light to set

LED display intensity

29 START/STOP BP key: Press to start or stop a BP, Auto,

Stat, or Vitals determination

30 Cuff connector: BP cuff hose attaches here

-18

.s>

Getting Started

Switching the Monitor On and Off

To switch the

ON/OFF

As the Monitor powers up, it will run a short self-test

routine, which will flash all the indicator lights and then

beep the warning speaker. After a few seconds the system

will be ready for operation, as indicated by the appearance

of the main menu on the

To switch the Monitor off, push the power ON/OFF switch

(16) again. This will terminate any measurements that may

be in progress and automatically deflate the cuff.

When the Monitor is operating on the internal battery only, battery life is enhanced by the use of the sleep

However, the PRO Monitor will not enter sleep mode if an alarm is active. If no controls are used and no determinations are being made, the Monitor will enter sleep mode after a time which can be preset by the operator. All LED displays will be blanked except for a dash in the far-left systolic position, and any existing readings will be transferred to the LCD, which displays the message “Sleep Mode Active.” Moving the rotor or pressing a key will “wake up” the Monitor.

DINAMAP

switch (16) or press the rotor (21).

PRO Monitor on, push the power

LCD (25).

mode.

liquid Crystal Display (LCD)

MENU AREA

Menu Area

This area displays the name of the menu that has option

buttons available for selection. Normal text in the menu

area appears dark on a light background, while the text of

selected buttons appears light on a dark background.

Note: Some menus have six option buttons. In these cases,

is no space available to display the menu

title.

Area 2

This area displays

l Source 1:

. Source 2: Last three BP readings

data

from one of three different sources.

SpO,

plethysmograph (Models 300 and 400)

. Source 3: Error and warning messages

Note: Refer to “Display Button” in the “Using the Menu System”

section for instructions on setting Area 2.

Area 3

This area displays the time, the time lapsed since the last Auto

BP determination

(if in Auto BP mode), the battery icon (if

operating on battery power, the time and battery icon toggle), and the BP and Printer

modes.

there

Using the Printer

Installing the Paper

Turn the PRO Monitor so that the side is facing you. While

grasping the side of the Monitor, firmly press the notched

indentations on the printer pop open. With the Monitor powered on, place the roll of paper into the compartment so that the end of the paper comes off the top, and thread it between paper touches the plates, the paper will begin to auto-feed itself into the printer. Feeding the end of the paper strip through the slot in the door, firmly press the notched indentation on the side of the printer door to close it. Use the paper release lever to clear a paper jam or manually feed the paper. Note: Make sure that the roll of paper is tightly wound.

door to open it. The printer door will

the two printer plates. As the

Getting Started

Any time the paper is loaded, the printer automatically prints a test strip with the

visible on the paper, check that the paper roll

installed in the printout, use a slight sideways action to pull the paper sharply up across the serrated edge of the door.

Printer Alarms

If the Monitor is the printer door next to “PRNT” in Area 3 of the LCD. When new paper is installed and the printer door is closed, the message will change to “Manual” for Manual print or “Auto” for Auto print, depending on the status before the paper change.

If the paper runs out during a print request or if an attempt is made to print when no paper is installed, the message “Printer No Paper” will appear in Area 2 of the LCD and an audible alarm will sound. In addition, the message “No Paper” will appear next to “PRNT” in Area 3 of the LCD. To clear the alarm, press the rotor. The message in Area 3 of the LCD will remain until new paper is installed and the printer door is closed. (See “Using the Menu System.“)

the correct position (refer to diagram). To tear off

DINAMAP@

switched on with no paper installed or with

open, the message “No Paper” will appear

PRO name on it. If no print is

has been

Installing new paper will cause the Critikon header to be printed, thereby confirming that the paper is installed correctly and that the printer is operational. The message next to “PRNT” in Area 3 of the LCD will change to “Auto” or “Manual” to identify the operating mode of the printer. After power-off, the operating mode of the printer returns to the previous user-selected setting (Auto or Manual) unless specified otherwise in the Print button under the Service Button.

Storage

Store thermal paper in a cool, dry place. The printed strip (thermal paper recording) should not be

exposed

exposed to temperatures over 100 humidity over

placed in contact with adhesives, adhesive tapes, or plasticizers such as those found in all PVC page protectors.

to direct sunlight,

80%,

DINAMAP

“C

OF/38

PRO

or relative

Note: When in doubt about long-term storage conditions, store a

photocopy of the thermal paper recording.

&ions

l The paper is thermally activated; therefore, do not store it in a

hot place as discoloration may result.

l Use only replacement paper rolls (58 mm) from Critikon.

Using the Monitor

Noninvasive

Blood Pressure Determination

Description

The BP parameter is included in Models 100, 200, 300, and

400. Blood pressure is monitored noninvasively

in the

PRO Monitor by the oscillometric method, which measures

the amplitude of the pressure oscillations within the blood

pressure cuff. Further information about the oscillometric method is in Appendix C.

The PRO Monitor has four BP modes: 1. Manual,

2. Auto, 3. Stat, and 4. Vitals which is selected by the user, is

The

BP measurements are automatic, and once the cycle is complete the LED displays (7, 9, 19, 22) show systolic pressure, diastolic pressure, mean arterial pressure, and pulse rate.

Manual BP determinations are started by pressing the

1. START/STOP BP

key (29). In the Manual mode, the

(UK: All Obs). The mode,

shown on the LCD (25).

blood pressure is determined one time.

Auto BP determinations are started by selecting the

2. AUTO BP key (27) or the Auto button under the Set

(UK: BP

Mode) button in the Main menu.

When Auto mode is selected, a number at the right of

the Auto button indicates the time interval between each

reading. To change the time interval, choose the box around the number and turn the rotor until the desired interval is reached. The interval can be set between and 120 minutes (1, 2, 3, 4, 5, 10, 15, 20, 25, 30, 45, 60,

90, and 120 minutes).

Press the rotor to confirm the

setting.

Stat determinations are started by selecting the Stat

button under the Set BP button

(UK: BP Mode) in the Main menu. In the Stat mode, the blood pressure is determined as many times as possible in

Vitals (UK: All Obs) determinations are started by

minutes.

selecting the Vitals (UK: All Obs) button in the Main menu. (Refer to the “Using the Menu System” section.) Selection of this button initiates a BP determination

?-%

”

SpOz

while allowing

and predictive temperature determinations to be monitored and recorded (depending on Monitor model). In the Vitals (UK:

All

Obs) mode, the blood pressure is determined one time.

Before

to ensure that the cuff pressure

each BP determination, the Monitor performs a test

is below a specified level.

The determination is delayed until this condition is met.

During the delay, the

BP values are displayed as zero.

The Monitor senses the type of hose being used and

automatically uses adult/pediatric monitoring parameters or neonatal monitoring parameters, as appropriate.

Audible and visible alarms occur when a value for systolic pressure, diastolic pressure, mean arterial pressure, or pulse rate is outside the selected high or low limit.

Instructions for cleaning and disinfecting BP cuffs are in

Appendix F.

Genera/ Warnings

l The PRO Monitor will not measure blood pressure

effectively on patients who are experiencing seizures or tremors.

l Arrhythmias will increase the time required by the

PRO Monitor to determine a blood pressure and may extend the time beyond the capabilities of the Monitor.

l In Manual mode, the PRO Monitor displays the results

of the last blood pressure determination for 2 minutes or until another determination is completed. If a patient’s condition changes between one determination and the next, the Monitor will not detect the change or indicate an alarm condition.

Devices that exert pressure on tissue have been

associated with purpura, skin avulsion, compartmental syndrome, ischemia and/or neuropathy. To minimize these potential problems, especially when monitoring

at frequent intervals or over extended periods of time, make sure the cuff is applied appropriately and

-24

Using

the Monitor

examine the cuff site and

the limb distal to the cuff

regularly for signs of impeded blood flow.

Do not apply external pressure against cuff while

monitoring. Doing so may cause inaccurate blood pressure values.

l Use care when placing cuff on extremity used to

monitor other patient parameters.

l The PRO Monitor is designed for use only with

dual-

tube cuffs.

l Use only accessories recommended by Critikon.

Failure to use recommended accessories may result in inaccurate readings. See Appendix D.

l Blood pressure cuffs should be removed from the

patient when the Monitor is powered off. If the extremity remains cuffed under these conditions or if

the interval between blood pressure determinations is

prolonged, the patient’s limb should be observed

frequently and the cuff placement site should be

rotated as needed.

General Cautions

Accuracy of BP measurement depends on using a cuff

of the proper size. It is essential to measure the circumference of the limb and to select the proper size cuff. The air hoses are color-coded according to size of the patient. The gray m or 7.3 m) is required on patients who require cuff sizes from infant through thigh cuffs. The teal green)

neonatal cuff sizes

If it becomes necessary to move the cuff to another

12-foot

hose (3.66 m) is required for the

through

limb, make sure the appropriate size cuff is used.

The pulse rate derived from a BP determination may

differ from the heart rate derived from an EKG

waveform because the PRO Monitor measures actual

peripheral pulses, not electrical signals or contractions from the heart. Differences may occur because electrical signals at the heart occasionally fail

12-

24-foot hose (3.66

#5.

(blue-

to produce a peripheral pulse or the patient may have

poor peripheral perfusion. Also, if a patient’s

beat-to-

beat pulse amplitude varies significantly (e.g., because

atrial

of pulsus alternans,

fibrillation, or the use of a rapid-cycling artificial ventilator), blood pressure and pulse rate readings can be erratic, and an alternate measuring method should be used for confirmation.

General Notes

l A patient’s vital signs may vary dramatically during the

use of cardiovascular agents such as those that raise or

lower blood pressure or those that increase or decrease heart rate.

Because treatment protocols based on the patient’s

blood pressure may

measurement methods,

rely on specific values and differing

such as auscultatory, clinicians

should note a possible variance from values obtained

with the PRO Monitor

management. the oscillometric method of noninvasive blood pressure measurement and correspond to comparisons

inn-a-aortic

The PRO Monitor values are based on

values within ANSI accuracy (a mean difference of standard deviation of

in planning patient care

/AAMI

mmHg).

Standards for

mmHg, and a

+ 5

with

. Several conditions may cause the

calculate and display

only the mean arterial pressure

BP parameter to

(MAP) without a systolic and diastolic reading. These conditions include very low systolic and amplitude

fluctuations, so an accurate calculation for these values

can’t be made (e.g., patient in shock); too small of a difference between systolic and MAP calculations in relationship to the difference between diastolic and MAP; or a leak has occurred in the

(1.

Check all BP connections 2. Monitor may need

PRO Monitor

calibration and leak testing). If only the MAP value is

displayed, the systolic and diastolic will display dashes (-) and an alarm message

displayed.

“N99-BP

FAILED” will be

Using the Monitor

Procedures

Connect the end of the air hose which has quick-release

1. clips to the cuff connector (30) on the front of the Monitor. Make

Note: To

the quick-release clips together and pull the plug from the cuff connector (30). Select the appropriate blood pressure measurement site.

2. Because normative values are generally based on this site and as a matter of convenience, the upper arm is preferred. When upper arm size or shape, the patient’s clinical condition, or other factors prohibit use of the upper arm, the clinician must plan patient care accordingly, taking into account the patient’s cardiovascular status and the effect of an alternative site on blood pressure values, proper cuff size, and comfort. The figure shows the recommended sites

for placing cuffs.

Warning: Do not place the cuff on a limb being used for intravenous infusion or any area where circulation is compromised or has the potential to be

sure that the hose is not kinked or compressed.

disconnect the hose from the Monitor, squeeze

compromised.

mmHg

Neonate

from values for

Adult/Pediatric

3.4.If patient is standing, sitting, or inclined, ensure that cuffed limb is supported to maintain cuff at level of patient’s heart. If cuff is not at heart level, the difference in systolic and diastolic values due to hydrostatic effect must be considered. Add cm) above heart level. Subtract every inch (2.54 cm) below heart level. Select appropriate cuff size. Measure patient’s limb and select appropriately sized cuff according to size marked on

cuff or cuff packaging. When cuff sizes overlap for a

specified circumference, choose the larger size cuff.

Precaution: Accuracy depends on use of proper size cuff.

1.80

mmHg

to values for every inch (2.54

1.80

Inspect cuff for damage. Replace cuff when aging, tearing, or weak closure is apparent. Do not inflate cuff when unwrapped.

Precaution: Do not use cuff if structural integrity is

suspect.

Connect the cuff to the air hose. Thread the cuff connectors onto the hose connectors until finger tight.

Do not overtighten.

Warning: It is mandatory that the appropriate hose and

cuff combination be used. Any attempt to modify the hose will inhibit the Monitor from switching between

the neonatal and adult measurement modes.

Note: In normal use, each cuff will have its own hose, so

it will not usually be necessary to disconnect them. If it is

necessary to do so, carefully unscrew the cuff from the hose. Care should be taken in reconnecting the cuff to a hose, ensuring that threads of the cuff and hose are in alignment and no cross-threading occurs.

Inspect patient’s limb prior to application.

7. Precaution: Do not apply cuff to areas where skin is not

intact or tissue is injured. Palpate artery and place cuff so that patient’s artery is

aligned with cuff arrow marked “artery.”

Squeeze all air from cuff and confirm that connection is

secure and unoccluded and that tubing is not kinked.

1 O.Wrap cuff snugly around the patient’s limb. Cuff index

line must fall within the range markings. Ensure that hook and loop closures are properly engaged so that pressure is evenly distributed throughout cuff. If upper arm is used, place cuff as far proximally as possible.

.Proper cuff wrapping should be snug, but should still

allow space for a finger between patient and cuff. Cuff should not be so tight as to prevent venous return between determinations.

Warning: Using a cuff that is too tight will cause venous congestion and discoloration of the limb, but

using a cuff that is too loose may result in no readings and/or inaccurate readings.

12.Proceed with monitoring in the Manual, Auto, Stat, or Vitals (UK: All Obs) mode.

+ 53 hidden pages

GE Dinamap Pro 100-400 User manual

Contents

Introduction

Getting Started

Using the Monitor