Masimo SedLine Operator's Manual
SedLine
Operator's Manual
®
Sedation Monitor
These operating instructions intend to provide the necessary information for proper
operation of the SedLine® Sedation Monitor (SedLine).
General knowledge of electroencephalograph (EEG) monitoring and an understanding of the
features and functions of SedLine are prerequisites for proper use.
Do not operate SedLine without completely reading and understanding these instructions.
Notice
Purchase or possession of this device does not carry any express or implied license to use with
replacement parts which would, alone or in combination with this device, fall within the
scope of one of the relating patents.
Caution: Federal law restricts this device to sale by or on the order of a physician.
For professional use. See instructions for use for full prescribing information, including
indications, contraindications, warnings, and precautions.
This Operator's Manual describes how SedLine information is displayed when used with
®
, including display details as well as accessing and changing user-configurable settings.
Root
For additional information related to Root, refer to the Operator's Manual for Root.
For further information contact:
Masimo Corporation
40 Parker
Irvine, CA 92618, USA
Tel.: 949-297-7000
Fax.: 949-297-7001
www.masimo.com
EU authorized representative for Masimo Corporation:
MDSS GmbH
Schiffgraben 41
D-30175 Hannover, Germany
Patents: www.masimo.com/patents.htm
Root, SedLine, Masimo, and are registered trademarks of Masimo Corporation.
MOC-9 is a trademark of Masimo Corporation.
All other trademarks and registered trademarks are property of their respective owners.
© 2016 Masimo Corporation.
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Contents
About this Manual ------------------------------------------------------------------------------------------ 5
Product Description, Indications, and Contraindications ---------------------------------------------7
Product Description --------------------------------------------------------------------------------------7
Indications for Use ---------------------------------------------------------------------------------------7
Contraindications ----------------------------------------------------------------------------------------7
Warnings and Cautions ------------------------------------------------------------------------------------ 9
Safety Information ------------------------------------------------------------------------------------- 10
Compliance Information ------------------------------------------------------------------------------ 11
General Information ----------------------------------------------------------------------------------- 11
Chapter 1: Technology Overview ------------------------------------------------------------------------ 13
Theory of Operation ------------------------------------------------------------------------------------ 13
Chapter 2: System Descriptions ------------------------------------------------------------------------- 15
Root------------------------------------------------------------------------------------------------------- 15
SedLine Module ---------------------------------------------------------------------------------------- 16
SedLine Patient Cable --------------------------------------------------------------------------------- 16
SedLine Sensor(s) -------------------------------------------------------------------------------------- 16
Chapter 3: Setting Up the System ---------------------------------------------------------------------- 17
Unpacking and Inspecting the System ------------------------------------------------------------- 17
Preparation for Use ------------------------------------------------------------------------------------ 17
Connecting the Module to the Patient Cable ----------------------------------------------------- 18
Connecting the Module to Root --------------------------------------------------------------------- 19
Connecting the SedLine Sensor to the Patient --------------------------------------------------- 19
Chapter 4: Operation -------------------------------------------------------------------------------------- 21
The SedLine Window ---------------------------------------------------------------------------------- 21
EEG Display ---------------------------------------------------------------------------------------------- 22
Parameters Display ------------------------------------------------------------------------------------ 25
DSA (Density Spectral Array) Display --------------------------------------------------------------- 31
View Options ------------------------------------------------------------------------------------------- 33
Chapter 5: Menu Options --------------------------------------------------------------------------------- 37
Parameter Settings ------------------------------------------------------------------------------------ 37
Additional Settings ------------------------------------------------------------------------------------ 45
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SedLine Sedation Monitor Contents
Chapter 6: EEG Download -------------------------------------------------------------------------------- 47
Enable EEG Data Collection -------------------------------------------------------------------------- 47
Download EEG Waveforms---------------------------------------------------------------------------- 48
Import .edf Files ---------------------------------------------------------------------------------------- 48
Chapter 7: Alarms and Messages ----------------------------------------------------------------------- 49
Messages and Indications ---------------------------------------------------------------------------- 49
Alarms and Indications ------------------------------------------------------------------------------- 49
Chapter 8: Troubleshooting ----------------------------------------------------------------------------- 51
Adjusting Electrodes ---------------------------------------------------------------------------------- 52
Trends Not Available ---------------------------------------------------------------------------------- 54
Chapter 9: Specifications -------------------------------------------------------------------------------- 57
Measurement Range ---------------------------------------------------------------------------------- 57
Resolution ----------------------------------------------------------------------------------------------- 57
Environmental ------------------------------------------------------------------------------------------ 58
SedLine Module Physical Characteristics ---------------------------------------------------------- 58
Regulatory Symbols ----------------------------------------------------------------------------------- 59
Safety Classifications--------------------------------------------------------------------------------- 60
Safety Compliance ------------------------------------------------------------------------------------- 61
EMC Compliance --------------------------------------------------------------------------------------- 61
Chapter 10: Service and Maintenance ----------------------------------------------------------------- 63
Cleaning Procedures ----------------------------------------------------------------------------------- 63
General Maintenance for Module ------------------------------------------------------------------- 63
Service Instructions ----------------------------------------------------------------------------------- 64
Repair Policy -------------------------------------------------------------------------------------------- 64
Return Procedure -------------------------------------------------------------------------------------- 65
Contacting Masimo ------------------------------------------------------------------------------------ 65
Sales & End-User License Agreement -------------------------------------------------------------- 66
Warranty ------------------------------------------------------------------------------------------------- 66
Exclusions ----------------------------------------------------------------------------------------------- 67
End-User License -------------------------------------------------------------------------------------- 67
Restrictions --------------------------------------------------------------------------------------------- 68
No Implied License ------------------------------------------------------------------------------------ 68
Index --------------------------------------------------------------------------------------------------------- 69
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About this Manual
This manual contains setup and operational instructions for the SedLine® Sedation Monitor.
Review it thoroughly before attempting to set up and operate the SedLine® Sedation
Monitor. Keep it in a convenient location for easy reference during operation and
maintenance.
A warning is given when actions may result in a serious outcome (for example, injury, serious
adverse effect, death) to the patient or user. The following is an example of a warning:
Warning: This is an example of a warning statement.
A caution is given when any special care is to be exercised by the patient or user to avoid
injury to the patient, damage to this instrument or damage to other property. The following is
an example of a caution:
Caution: This is an example of a caution statement.
A note is given when additional general information is applicable. The following is an
example of a note:
Note: This is an example of a note.
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Product Description, Indications, and Contraindications
Product Description
SedLine® Sedation Monitor is a patient-connected, 4-channel processed
electroencephalograph (EEG) monitor designed specifically for intraoperative or intensive
care use. It displays electrode status, EEG waveforms, Density Spectral Array (DSA), and
Patient State Index (PSI).
The operator controls the unit using menus and dedicated buttons to select various display
options. The system consists of 4 major components: Root, SedLine Module, SedLine Patient
Cable, and SedLine Sensors.
Indications for Use
The SedLine® Sedation Monitor is indicated for use in the operating room (OR), intensive
care unit (ICU), and clinical research laboratory. It is intended to monitor the state of the
brain by real-time data acquisition and processing of EEG signals. The system includes the
Patient State Index (PSI), a proprietary computed EEG variable that is related to the effect of
anesthetic agents.
Contraindications
This device is not intended for use in children less than 18 years of age.
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Warnings and Cautions
Warning: A complete reading of this manual by personnel in contact with SedLine prior to
use is essential for safety. Improper setup, operation, maintenance, or parts replacement
could result in injury to personnel and damage to SedLine components.
Caution: SedLine is to be operated by, or under the supervision of, qualified personnel only.
The manual, accessories, directions for use, all precautionary information, and specifications
should be read before use.
Caution: Always use SedLine precisely in accordance with the directions in this manual,
including site selection, sensor placement, and subject behavior during testing. Failure to
follow all of the directions in this manual could lead to inaccurate measurements.
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SedLine Sedation Monitor Warnings and Cautions
Safety Information
Warning: Do not start or operate the SedLine Module unless the setup was verified to be
correct.
Warning: Always use the SedLine Module and SedLine Sensor in conjunction with Root. Do
not use parts from other systems. Injury to personnel or equipment damage could occur.
Warning: Do not use the SedLine Module if it appears or is suspected to be damaged.
Warning: Do not adjust, repair, open, disassemble, or modify the SedLine Module. Injury to
personnel or equipment damage could occur. Return the SedLine Module for servicing.
Warning: Do not use SedLine during magnetic resonance imaging (MRI) or in an MRI
environment.
Warning: Explosion hazard: Do not use the SedLine Module in the presence of flammable
anesthetics or other flammable substance in combination with air, oxygen-enriched
environments, or nitrous oxide.
Warning: The SedLine Module may be used during electrocautery, but this may affect the
accuracy or availability of the parameters and measurements.
Warning: The SedLine Module may be used during defibrillation, but this may affect the
accuracy or availability of the parameters and measurements.
Warning: Electrical Shock Hazard: To protect against injury, follow the directions below:
• Avoid placing the device on surfaces with visible liquid spills.
• Do not soak or immerse the device in liquids.
• Use cleaning solutions only as instructed in this operator’s manual.
• Do not attempt to clean the SedLine Module while monitoring patient.
Caution: An operator may only perform maintenance procedures specifically described in the
manual. Otherwise, return the SedLine Module for servicing.
Caution: To ensure that alarm limits are appropriate for the patient being monitored, check
the limits each time SedLine is used.
Caution: As with all medical equipment, carefully route patient cabling to reduce the
possibility of patient entanglement or strangulation.
Caution: To minimize radio interference, other electrical equipment that emits radio
frequency transmissions should not be in close proximity to the SedLine Module.
Caution: Do not place the SedLine Module on electrical equipment that may affect the
instrument, preventing it from working properly.
Caution: Do not submerge the SedLine Module in any cleaning solution or attempt to
sterilize by autoclave, irradiation, steam, gas, ethylene oxide or any other method. This will
seriously damage the SedLine Module.
Caution: Close proximity to high frequency interference may cause display artifacts. As a
mitigation, consider changing Root location or plug Root into a different outlet if potential
artifacts are displayed.
Caution: Continuous Train of Four stimulation on a patient’s face is not recommended. Doing
so may create EEG artifact, preventing calculation of PSI values.
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SedLine Sedation Monitor Warnings and Cautions
Caution: The PSI value may be elevated in the following situations:
• In patients receiving nitrous oxide or ketamine. These agents may result in
increased EEG activity power at higher frequencies, in the band > 12 Hz, and this
may present an EMG-like pattern.
• On patients with non-typical EEG patterns such as seizure activity.
• When there is significant EMG activity interfering with the EEG waveform.
Caution: Inaccurate PSI values may be caused by:
• Elevated artifact and other sources of electromagnetic interferences.
• Patients with neurological disorders such as stroke, tumor, metabolic disease or
traumatic brain injury.
Compliance Information
Warning: Changes or modifications not expressly approved by Masimo shall void the
warranty for this equipment and could void the user’s authority to operate the equipment.
Caution: Disposal of Product: Comply with local laws in the disposal of the instrument and/or
its accessories.
Caution: For FCC compliance information, refer to the Operator's Manual for Root.
General Information
Warning: The SedLine Module is intended only as an adjunct device in patient assessment. It
should not be used as the sole basis for diagnosis or therapy decisions. It must be used in
conjunction with clinical signs and symptoms.
Warning: Patient State Index (PSI) information shall be used in conjunction with other
indicators of patient state in the delivery of anesthetics.
Warning: SedLine performs continuous impedance measurements (at the sensor) in order to
check that the electrodes are firmly in place. The 83.33 Hz and 125 Hz impedance
measurement signals could interfere with other electronic monitoring equipment connected
to the patient.
Warning: Do not use petroleum-based or acetone solutions, or other harsh solvents, to clean
the SedLine Module. These substances affect the device’s materials and instrument failure
can result.
Caution: Impedance monitoring can interfere with other monitoring devices, in particular
evoked potential monitors.
Caution: Disabling impedance monitoring may lead to decreased signal quality and
decreased PSI reliability due to the user not being notified of inadequate electrode contact.
Note: Use and store the SedLine Module in accordance with specifications. See the
Specifications section in this manual.
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Chapter 1: Technology Overview
Theory of Operation
The Patient State Index (PSI) was constructed based upon multivariate combinations of
quantitative electroencephalogram (QEEG) variables found to be sensitive to changes in the
level of anesthesia but insensitive to the specific substances producing such changes. The
PSI is the result of a complex computation that combines weighted quantitative values
reflecting many dimensions of brain electrical activity, such as: (1) changes in power in
various EEG frequency bands, (2) changes in symmetry and synchronization between critical
brain regions, and (3) the inhibition of regions of the frontal cortex.
The PSI is computed from continuously monitored changes in the QEEG during surgery, using
statistical analysis to estimate the likelihood that the patient is anesthetized. SedLine
performs these computations automatically on the continuously recorded EEG after
automatic removal of data contaminated with artifact from physiological and environmental
signals. The computed PSI is periodically updated, displayed in numeric form, and presented
in a color-coded trend graphic for monitoring the effect of certain anesthetics on the state of
the brain.
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Chapter 2: System Descriptions
The SedLine system is comprised of four (4) components:
• Root
• SedLine Module
• SedLine Patient Cable
• SedLine Sensor(s)
Root
SedLine is displayed on Root for the user. This information includes electrode status, EEG
waveforms, PSI, DSA, electromyograph (EMG), artifacts (ARTF), suppression ratio (SR), and
spectral edge frequency (SEFL for left side and SEFR for right side). The following image
illustrates these features being displayed on Root.
The following image illustrates these features being displayed on Root along with
information from the Radical-7 Pulse CO-Oximeter.
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SedLine Sedation Monitor Chapter 2: System Descriptions
SedLine Module
The SedLine Module computes and calculates PSI and additional parameters using the EEG
signals acquired from the SedLine Sensor. The module connects Root to the SedLine Patient
Cable and receives its power from Root.
SedLine Patient Cable
The SedLine Patient Cable transfers analog EEG signals collected from the SedLine Sensor to
the SedLine Module for processing. The patient cable is reusable and may be used from
patient to patient.
SedLine Sensor(s)
The SedLine Sensor is comprised of six (6) gelled electrodes, including four (4) active
channels (R1, R2, L1, L2), one reference channel (CT), and one ground channel (CB). The
sensor is a single-use, non-sterile product that does not contain natural rubber latex.
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Chapter 3: Setting Up the System
Unpacking and Inspecting the System
To unpack and inspect the system
1. Remove the components from the shipping carton and examine them for signs of
shipping damage.
2. Check all materials against the packing list. Save all packing materials, invoice
and bill of lading. These may be required to process a claim with the carrier.
3. If anything is missing or damaged, contact Masimo Technical Service.
Preparation for Use
Prior to using SedLine for monitoring
1. Confirm that you have all system components:
• Root
• SedLine Module
• SedLine Patient Cable
• SedLine Sensor
2. Confirm that Root holds adequate battery power.
3. Confirm that you have alcohol swabs for sensor application.
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SedLine Sedation Monitor Chapter 3: Setting Up the System
Connecting the Module to the Patient Cable
The image below shows various SedLine system components connected.
To connect the module to the patient cable
1. Identify the module connector end.
2. Align the ridged patient cable connector end with the available module connector
end.
3. Push to insert.
4. For additional details, see the Directions for Use (DFU) for the patient cable.
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SedLine Sedation Monitor Chapter 3: Setting Up the System
Connecting the Module to Root
To connect the module to Root
1. Identify the Masimo Open Connect (MOC-9 TM) end of the module.
2. Insert the MOC-9 end of the module securely into a MOC-9 port on Root.
Connecting the SedLine Sensor to the Patient
For directions on how to connect the SedLine Sensor, see the Directions for Use (DFU) for
SedLine Sensors.
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Chapter 4: Operation
The following sections describe how SedLine information is displayed when used with Root,
including display details and accessing and changing user-configurable settings. For
additional information, see Operator's Manual for Root.
The SedLine Window
When SedLine is connected to Root, parameters and measurements display in a window.
SedLine parameters can display as numeric values and graphical representations of the
information acquired through the SedLine Sensor.
1 EEG Display
2 Parameters Display
3 DSA Display
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