§ The heart rate is calculated from the ECG signal
§ The lead selection menu allows to choose between the Einthoven
leads I, II or III
§ Remember! The respiration signal is always measured between
red and yellow
Lead IILead III
RALA
Lead I
LL
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VitaGuard
®
VG 3100
Heart Rate
§ The time interval between two consecutive R waves is
used to calculate the heart rate
§ The displayed heart rate is averaged over the number
of RR intervals selected by the user (between 2 and 16
beats in steps of 2)
§ If the number selected is small (e.g. 2 or 4 beats), then the heart rate is practically beat-to-
beat. The displayed value, however, may jump about a lot
§ If the number selected is large (e.g. 14 or 16 beats), then the displayed value tends to be
smoother. However, the monitor will take longer to detect a bradycardia alarm
§ Average values for the heart rate over fixed intervals of 1 minute, 1, 6 and 12 hours
are displayed in the INFO windows
§ Furthermore, the monitor has a user selectable average interval for deviation alarms.
This average and the current deviation are also displayed in theINFO windows
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VitaGuard
®
VG 3100
Respiration and Basal Impedance
§ Respiration and basal impedance are always measured between the red and
yellow electrodes (Einthovenlead I)
§ Basal impedance: 500 -1000 W, depending on the electrodes used
§ Impedance due to respiration: 0,3 -2 W
§ Impedance resulting from heart beat: 0,025 -0,5 W, main problem with impedance
method!!
§ Further impedance changes due to movement
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VitaGuard
®
VG 3100
Apnea Detection and Respiration Rate
§ Detection of central apneas
§ The respiration rate is calculated and displayed when the signalamplitude is large
enough. The values displayed is averaged over 10s. If the rate cannot be
calculated, a question mark is displayed instead
§ Apnea detection is independent of the displayed respiration rate. If the rate cannot
be calculated, then the amplitude is too small. In this case, the electrodes should be
repositioned!
§ The setting “minimum respiration rate”4 to 10 per minute determines the maximum
time (15 s to 6 s) to detect the signal
§ Detection of periodic respiration can be switched on or off. However, for proper
detection, the signal amplitude must be large enough and the agegroup “< 2 years“
must be selected
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VitaGuard
®
VG 3100
Open-Lead Detection
§ Open-Lead-Detection
§ The basal impedance between the red and yellow electrodes is measured once
every second
§ If the basal impedance is greater than approx. 2500 Ohm, then a technical alarm
is generated
§ If the black electrode becomes loose, then a technical alarm is only generated
when monitoring is performed using 3 electrodes (menu option)
§ Monitoring can be performed using two electrodes in „electrically clean“
environments
§ Open-lead detection is activated after power-on once plausible signals are
detected. If no cable is connected upon power-on, a remainder tone is
generated every 20s until plausible signals are received
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VitaGuard
®
VG 3100
Pulse Oximeter
§ Sufficient supply of all organs and tissueswith oxygen is vital for survival. Death
can occur within minutes if this supply line is broken or damaged. Therefore, it is
very important to detect disturbances in the O2supply as fast as possible.
§ Haemoglobin (Hb) in the blood is responsible for approx. 98% of the oxygen
transport within the body. O2attaches to the haemoglobin and changes the light
spectrum –the colour of the blood saturated with oxygen turns bright red.Once the
oxygen is deposited within the tissue cells, the colour of the blood changes back to
dark red.
§ A pulse oximetermeasures these colour changes and, using appropriate
algorithms and calibration tables,determines the oxygen saturation.
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VitaGuard
®
VG 3100
Pulse Oximeter
§ The haemoglobin (Hb) in the blood acts like an optical filter. If one shines white
light through the hand, red light is seen on the other side. Theoptical haemoglobin
filter absorbs all other spectral components of the white light and allows only the
red light to pass through.
Whitelight
filtered(red)
light
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VitaGuard
®
Oxygen Saturation
VG 3100
§ VitaGuard®displays the functional oxygen saturation SpO
§ The „p“ in SpO2relates to the fact that the measurement is performed
using a pulse oximeter
§ The functional oxygen saturation is always slightly greater than the
fractional saturatione.g. SaO2
of 98% » SaO2
func
of approx. 96%
frac
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VitaGuard
Oxygen Saturation -MasimoSET Technology
§ DST -Discrete Saturation Transform:
§ DST outputs a function with at least on maximum
§ Noise signals result mostly from venous blood
which has a lower SpO2value than arterial blood
§ The peak with the highest SpO2value, i.e. the
®
VG 3100
Conventional
value
right-hand peak, is always the arterial SpO
§ DST needs a lot of computing power
§ DST operates well with small and/or corrupted
signal e.g. low perfusion or movement artefacts
§ DST does not need a „good“ start-up value as
reference
2
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VitaGuard
®
VG 3100
Oxygen Saturation and Plethysmograph
§ An oxygen saturation value is calculated every 0.4s
§ The displayed value is an average over the time selected by the user (between 4s
and 16s)
§ When 4s or 6s are selected, the displayed SpO2is practically beat-to-beat.
Masimo‘s FastSAT® -Algorithm is automaticallyactivated in this case
§ Average values for SpO2over fixed intervals of 1 minute, 1, 6 and 12 hours are
displayed in the INFO windows
§ Furthermore, the monitor has a user selectable average interval for deviation
alarms. This average and the current deviation are also displayed in the INFO
windows
§ The displayed plethysmographis an auto-scaled signal derived from the infra-red
signal
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VitaGuard
®
VG 3100
Pulse Rate and Signal IQ
§ The displayed pulse rate is an average calculated over a selectable time (between
4s and 16s in steps of 2s)
§ When 4s or 6s are selected, the displayed pulse rate is practically beat-to-beat
§ Average values for pulse rate over fixed intervals of 1 minute, 1, 6 and 12 hours
are displayed in the INFO windows
§ Furthermore, the monitor has a user selectable average interval for deviation
alarms. This average and the current deviation are also displayed in the INFO
windows
§ When a pulse is detected, a „Signal IQ“ value is simultaneously generated. This is
displayed as a vertical line on the monitor. The height of the line corresponds with
the quality of the signals from the SpO2sensor –the higher the better
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VitaGuard
Perfusion Index
§ The measured light intensity
pulses with each heart beat due to
®
VG 3100
changes in the blood vessel
volume
§ Skin, bones, venous and arterial
blood as well as other tissues
cause a constant absorption
component
§ The perfusion index is the quotient
of the pulsating component (ac)
and the constant component (dc)
§ The displayed value varies
between 0% and 20%
Absorption
Arterial
Pulse
Arterial
Blood
Venous Blood
(Constant)
Tissue, bones
(Constant)
t
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VitaGuard
®
VG 3100
The Latest MasimoTechnology
§Averaging times of 4, 6, 8, 10, 12, 14 and 16 seconds
§When 4s is set, then averaging is between 2s and max. 4s, depending on the
signal quality
§When 6s is set, then averaging is between 4s and max. 6s, depending on the
signal quality
§Masimo‘s FastSAT® -Algorithm can be activated if required
§3 sensitivity settings: MAXIMUM (for very low signals, perfusion>0,02%),
STANDARD and MINIMUM
§When the MINIMUM setting is selected, then the APOD-Algorithm (Adaptive
Probe Off Detection) is activated
§STANDARD is a compromise between MINIMUM and MAXIMUM. MAXIMUM
has the disadvantage that „Probe Off“ detection is less sensitive
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VitaGuard
®
VG 3100
Alarm Priorities (DIN EN 60601-1-8)
Physiological Alarms –Priority = HIGH
§ Physiological alarm messages are displayed with 3 exclamation marks „!!!“
§ SpO
2
§SpO2too low (Hypoxia) (acoustic and optional as silent alarm)
§SpO2too high (Hyperoxia) (acoustic and optional as silent alarm)
§Negative deviation(optional as acoustic alarm)
§ Heart rate or pulse rate
§No ECG signal (Asystolie)(acoustic alarm)
§Heart rate too low (Bradycardia)(acoustic and optional as silent alarm)
§Heart rate too high (Tachycardia)(acoustic and optional as silent alarm)
§Positive deviation(optional as acoustic alarm)
§Negative deviation(optional as acoustic alarm)
§ Respiration
§Central apnoea(acoustic and optional as silent alarm)
§Periodic respiration(optional as silent alarm)
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VitaGuard
®
VG 3100
Alarm Priorities (per prDINEN 60601-1-8)
Technical Alarms -Priority = MEDIUM
§ Technical alarm messages are displayed with 2 exclamation marks „!!“
§ General
§Recharge or replace batteries
§Check mains adapter (when voltage below 8V or above 10 V)
§Incorrect alarm limits
§Hardware failure detected
§ SpO
2
§No sensor or defective sensor
§Interference or too much light
§Cable not connected
§Pulse search
§Hardware failure detected
§ Heart Rate and Respiration
§Electrode loose
§No cable connected
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VitaGuard
Tone Sequences
§Tone sequences from DIN EN 60601-1-8
§Physiological alarms
break
§ 3 short signals, small pause, 2 short signals, long pause, and repeat
®
VG 3100
§Technical alarms
§ 3 longer signals, long pause, and repeat
break
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VitaGuard
®
VG 3100
Informative Messages
§ Informative messages are displayed in the status box –no acoustic warning:
§Heart rate is being calculated
§Internal battery voltage too low
§SpO2: Low perfusion
§SpO2: Low signal IQ
§Heart rate and pulse rate diverge
§Status ok
§ Remainder signal generated every 20 when no cables connected after power-on
§ All messages displayed in the status box at top of display
§ Description of all messages and possible causes (trouble shooting) listed in the user
manual
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VitaGuard
®
VG 3100
Memory Functionality
§ Alarm data (up to 200 episodes, depending on selected pre-and post alarm times)