GE Healthcare 6961-MON, 6960-MON Operators Guide

FHR Gaps Troubleshooting Guide

2.4"/6cm

1"/2-3cm

2.4"/6cm

1"/2-3cm

SKIN PREPARATION GOOD

REPEAT SKIN PREP

REPEAT SKIN PREP DO NOT BYPASS

2.4"/6cm

1"/2-3cm

SKIN PREPARATION GOOD

REPEAT SKIN PREP

REPEAT SKIN PREP DO NOT BYPASS

2.4"/6cm

1"/2-3cm

FHR

MHR

SKIN PREPARATION GOOD

REPEAT SKIN PREP

REPEAT SKIN PREP DO NOT BYPASS

1"/2-3cm

2.4"/6cm

1"/2-3cm

Signal

POSSIBLE CAUSE ACTION & SOLUTION

The patient is ambulating

Patient position/posture

Electrode ‘detached’ or makes

poor contact with skin

l Return patient to bed

l Consider using a maternity belt to support pannus during

ambulation or upright position

HELP/TIP

a) Allow 1015 minutes of monitoring before starting ambulation.

b) The patient should not be encouraged to ambulate unless the FHR trace is good and the signal indicator on the Novii Interface shows 3 green squares.

l Use a pillow behind back or head

to make patient more comfortable

l Return patient to a position where

Novii worked well

l Encourage patient to lie on left or right

l If patient on side, support abdomen with

a pillow/rolled blanket to re-position abdomen so that the Patch is centred over the uterus

l Check electrodes and move or stick back down

l Re-position Patch or electrode to avoid the skin problem

HELP/TIP

a) The Interface will alert user with a visual message, but only when electrode is fully detached.

b) Check electrodes after a shower, clinical procedure, ambulation or position change.

c) Electrode(s) should not be placed over a skin lesion, skin fold, umbilicus, stretch mark, pronounced linea nigra.

d) If necessary use a strip of micropore tape to prevent electrode lifting or detachment.

Lost MHR and UA

as well as FHR

electrode/skin checkscreen

Bypassed red X on

l Check Interface for help message

l Interface is o

HELP/TIP

a) If Interface has lost power Bluetooth pairing with POD is lost.

Remove POD from Patch, place in charging bay and start new monitoring episode when power is returned.

b) Interface does not have a battery back-up.

l Start-Screen is displayed

HELP/TIP

POD has switched o – remove POD from Patch and place in charging well.

Start new monitoring session with other POD.

l Faulty ‘Y’ Connector - replace

l Exfoliate skin under ‘bad’ electrode

HELP/TIP

a) Peel the X electrode back, remove excess gel from skin and inish with alcohol wipe. Wait until skin is dry then exfoliate skin and reapply electrode.

b) May need to use micropore tape to hold in place.

l Restart the monitoring session if location of ‘bad’ electrode not known

HELP/TIP

Remove POD from Patch, place in charging bay and start new monitoring episode.

2.4"/6cm

1"/2-3cm

POSSIBLE CAUSE ACTION & SOLUTION

1"/2-3cm

SKIN PREP

ARATION GOOD

REPEAT SKIN PREP

REPEAT SKIN PREP DO NOT BYPASS

2.4"/6cm

1"/2-3cm

TOCO/IUPC UA –

10 sec

Novii FHR (10 sec delay)

US FHR

Novii MHR (10 sec delay)

Novii UA (10 sec delay)

Novii FHR (10 sec delay)

(10 sec delay)

Lower electrode is not

2.4"/6cm above the symphysis pubis

Lower electrode may not

be optimally placed

l Re-position electrode

HELP/TIP

a) Peel the electrode back, remove excess gel from skin and inish with alcohol wipe.

ait until skin is dry then exfoliate skin again and reapply electrode in correct position.

b) May need to use micropore tape to hold in place.

Pannus covering Symphysis Pubis

l Remove electrode and place it lower or higher on the abdomen

l Alternatively place electrode just below the point where

the surface curves back on itself ensuring that the electrode is not folded

l Plug in US transducer for short

FHR ‘illing’ and reassurance

l Swap back to conventional

monitoring modality

HELP/TIP

WARNING: Novii UA/MHR delayed

10 seconds (5mm) from US FHR - see panels below

Using US FHR with Novii UA could

make a late deceleration appear early

None of the above

US FHR

10 sec

Novii FHR/MHR/UA are synchronised

but all trace 5mm (10 sec) behind US FHR trace.

10 Second Trace Example

Novii MHR

Novii UA

but all trace 3 mm (6 sec) behind TOCO UA trace.

High/Low UA Sensitivity Explained

UA High

8 9 10 11 18171615141312

Selecting UA Low sensitivity from the Novii display will decrease the UA trace amplitude, suppressing unwanted low amplitude UA, but it will also reduce the contraction duration. There will be no change to the location of the peak.

Low amplitude UA is considered to be due to artefact from fetal/maternal movement and unsynchronised myometrial activity.

Notes:

This troubleshooting guide assumes that the patient is supine or semi-supine during Patch placement and Novii set-up.

CAUTION: any intervention will take 10 seconds before its impact will be seen on the trace.

The user is familiar with the placement of Patch and lower mid-line electrode in high BMI patients with a pannus.

UA Low

Data (minutes)

Using TOCO UA with Novii FHR could

make an early deceleration appear late

Novii FHR (6 sec delay)

Novii MHR

10 sec

Novii FHR/MHR/UA are synchronised

(6 sec delay)

real-time

Novii UA (6 sec delay)

6 Second Trace Example

107-PT-008-USRev1