Getemed VitaGuard 300, VitaGuard 310, VitaGuard 2000, VitaGuard 2100, VitaGuard 3000 Presentation
...
getemed
Medizin-und Informationstechnik AG
Oderstrasse 77
14513 Teltow
Customer Training
VitaGuard®VG 2100 / VG 3100 / VG 310
07.2006
VitaGuard
®
VitaGuard®-Monitors
VG 2100VG 3100VG 310
Pulse Oximeter
Monitor
Heart Rate, Apnea and
Oxygen Saturation
Monitor
Heart Rate and Apnea
Monitor
2
Monitored parameters
VitaGuard
Device Family
®
VG 3100
Pulse
Rate
*
--
VG 3100
VG 2100
ApneaVitaGuard
Heart
Rate
*
SpO2
VG 310
* = either heart rate or pulse rate, user selectable
§ Heart rate und respiration measured using 3 electrodes
§ SpO2und pulse rate using an optical LNOP sensor (Low Noise Optical Probe)
--
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VitaGuard
®
VG 3100
4
VitaGuard
®
VG 3100
General Requirements (I)
§ User-friendly operation ® increases safety
§ All controls must be clearly marked ® standardised symbols
§ All connectors must be protected against false polarity and connection of wrong
cables
§ Operation must be learned within 20 -30 minutes
§ The monitor must be small, light and easy to transport
§ All settings must reappear when the monitor is switched off
§ Operation from the mains supply and batteries
§ Operation for at least 8 hours from fresh batteries
§ Automatic change-over between mains supply and batteries
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VitaGuard
®
VG 3100
General Requirements (II)
§ Warn signal when power failure occurs
§ Variable alarm settings to suit the particular medical situationof the patient
§ Physiological alarm when the physiological parameter is outside the set limits
§ Technical alarm when an electrode or SpO2 sensor falls off patient
§ Other technical alarms when situations detected that inhibit proper operation
e.g. battery voltage too low
§ Compliance memory i.e. is the monitor being used as expected?
§ Alarm data storage for analysis purposes
§ Silent alarm limits for special situations
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VitaGuard
®
VG 3100
Measured Signals
§ Sensors = Electrodes connected to chest
§ Electrocardiograph (ECG)
§ Heart rate
§ Respiration
§ Basal impedance
§ Sensors = Optical probe on finger, foot, toe or ear
§ Plethysmograph
§ Oxygen saturation (SpO2)
§ Pulse rate
§ Perfusion index
§ Signal IQ
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§ ECG = Electrocardiograph
VitaGuard
ECG Leads
®
VG 3100
EinthovenLeads
I YE -RD(yellow -red)
IIBK -RD (black -red)
IIIBK -YE (black -yellow)
§ 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 II Lead III
RA LA
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
HbO
SaO lefunktionel
SaO lefraktionel
O2Hb = Oxyhaemoglobin MetHb= Methaemoglobin
Hb = reduced Haemoglobin COHb = Carboxyhaemoglobin
2
2
frac
func
=
=
2
HbHbO
2
2
+
=
2
SpO
HbO
2
+++
2
COHbMetHbHbHbO
§ 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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