Federal law restricts this device to sale by or on the order of a physician.
E9030-33R Rev F
Prism SE Model
20411
20412
20413
20414
Medical Data Electronics • 12723 Wentworth Street • Arleta, California 91331-4330
(818) 768-6411 • FAX (818) 768-0759
Medical Data Electronics • Rembrandtlaan 1B, 3723 BG • Bilthoven, The Netherlands
Tel: +31 (0) 30 2289711 Fax: +31 (0) 30 2286244
Preface
The ESCORT Prism and Prism SE Series monitors are intended only as an adjunct to patient
assessment. They cannot replace skilled nursing care and proper surveillance. Carefully read this
reference manual, all directions for use of monitor accessories, and all precautionary information
before attempting clinical use of any Prism or Prism SE. Always keep high-risk patients under
close surveillance. This monitor is a portable patient monitor intended for monitoring vital signs
of critically ill adult, pediatric and neonatal patients in the hospital environment.
Carefully read the Defibrillator/Pacer section of this manual, all directions for use of the
defibrillator/pacer, and all precautionary information before attempting clinical use of the
defibrillator/pacer.
The information in this document is subject to change without notice.
Warranty
The Prism, Prism SE and the Defibrillator/Pacer are warranted against defects in materials and
workmanship for a period of twelve (12) months from the date of shipment to the original
purchaser. Batteries, cables, cuffs, and sensors are warranted ninety (90) days from date of
shipment. Warranty is valid only to the original buyer. Defective equipment should be returned
freight prepaid to Medical Data Electronics. Equipment returned with defective parts and
assemblies will be either repaired or replaced. This warranty is not applicable if repair has been
attempted, if the instrument has been damaged due to operation outside the environmental and
power specifications for the product, or due to improper handling or use.
The foregoing warranty is in lieu of all other warranties expressed o r imp lied , including but not
limited to any implied warranty or merchantability, fitness or adequacy for any particular purpose or
use. Medical Data Electronics shall not be liable for any incidental or consequential damages.
Technical Service
If you experience any problems with this product, please call:
ESCORT® and the MDE logo are registered trademarks of MDE.
ESCORT Guardian
MASIMO
C-Lock
SureTemp
®
is a registered trademark of Masimo Corp.
®
and NELLCOR® are registered trademarks of Nellcor, Inc.
®
is a registered trademark of Welch AllynTM Inc.
Medico2 is a trademark of Oridion Systems Ltd.
Mircrostream
TM
, and ESCORT PrismTM are trademarks of MDE.
®
and FilterLine® are registered trademarks of Oridion Systems Ltd.
ii
Safety Considerations (Prism & Prism SE)
Read the following sections before using the Prism or Prism SE monitors. These cautions and
warnings are presented to both increase patient safety and prevent damage to the monitor.
WARNING: Shock hazard. Do not remove cover. There are NO user
serviceable parts. Contact qualified service personnel for all service
and repair.
Do not under any circumstances remove grounding conductor from
power plug. If there is any doubt about the integrity of the protective
earth conductor arrangement, operate monitor on internal battery
power until AC power supply protective conductor is fully functional.
To maintain patient electrical isolation, connect only to other
equipment with electronically isolated circuits.
WARNING: As with all electrical equipment, carefully route patient
cabling to reduce possibility of patient entanglement or strangulation.
WARNING: There is a potential fire hazard when used with oxygenemitting equipment, and danger of explosion when used near
flammable anesthetics.
WARNING: Do not use monitor during magnetic resonance imaging
(MRI). Induced current could potentially cause burns. The monitor
may affect MRI image and the MRI unit may affect the accuracy of the
monitor.
WARNING: To avoid shock hazard with RS-232 System
Interconnection, first consult IEC60601-1 for system interconnection
guidance. Specific requirements for system interconnection are
dependent upon device connected to the monitor and relative locations
of each device from patient, and relative location of connected device
to room containing the monitor. In all circumstances, the monitor
must be connected to a grounded AC power supply. The monitor is
referred to as an IEC 601/F device in the Summary of Situations
contained in IEC60601-1.
WARNING: When a remote display monitor is connected to the unit
via the VGA connector on side of unit, it is essential the remote
monitor is powered from a properly rated and approved isolation
transformer. This is required to meet earth leakage limits of 0.5 mA,
as per IEC60601-1, Cl. 19.3 for monitor.
WARNING: When connecting monitor to any other instrument, verify
proper operation before clinical use. Refer to the other instrument’s
operation manual for complete instructions.
WARNING: All input/output interfaces to the patient monitors must
be CSA601.1/UL2601-1, EN 60601-1 approved devices.
WARNING: Do not under any circumstance use replacement parts
and connect devices that are not approved by Medical Data
Electronics.
iii
CAUTION: Always locate the Prism or Prism SE and its power cord
away from any electrosurgery and diathermy equipment and its power
cord and cables.
CAUTION: When operating either the Prism or Prism SE monitor
from an AC power source, the wall receptacle must be a three-wire,
grounded, hospital grade outlet. Use only the monitor’s original
hospital grade AC power plug and cord, or an equivalent hospital
grade plug and cord. If in doubt about integrity of grounding of the
main supply connection, the unit must be operated by battery power.
CAUTION: DO NOT plug the unit into a multiple outlet power strip
to avoid summation of leakage currents.
CAUTION: Do not use in ambient temperatures above 40° C or below
5° C.
CAUTION: When using an external DC power source, the
equipotential connector must be used as a protective ground terminal.
Symbols (Prism & Prism SE)
The following symbols appear on the Prism and Prism SE monitors, and may appear on accessory
items. Familiarize yourself with these symbols and their meaning before using the monitor.
Type CF Defibrillation Protected Equipment: Isolated patient connections
comply with allowable leakage current limits for direct cardiac application
and are protected against effects of defibrillation.
Type CF Applied Part: Isolated Patient connections comply with the
allowable leakage current limits for direct cardiac application.
Attention: Consult accompanying documents.
Replace Fuses as Marked: For protection against fire, replace only with
fuses of same type and rating.
Caution: Dangerous voltage.
Alternating Current: 100-240V @ 50/60 Hz.
Equipotential Connection: When external DC power is used, the
equipotential connection must be used as a protective ground terminal.
Fuse: Voltage and current ratings appear adjacent to symbol.
The CE symbol indicates device conforms to the Medical Device Directive.
This section describes the controls, indicators, and features located on the front, back, and side
panels of the Prism and Prism SE Patient Monitors.
Prism & Prism SE Front Panel
1. Monitor On/Standby Keys
2. Battery Charging Indicator
3. AC Power Indicator
4. Alarm Indicator Lights
When flashing, one or more parameters are alarming
When lit, one or more alarms are suspended, OR all alarms are
turned off
5. Alarm Suspend Key (180 seconds)
6. Alarm Setup Key
7. Softkeys for Parameters in Waveform Display Zone
8. Freeze/Unfreeze All Waveform Traces
9. NIBP Start/Stop Key
1-1
10. Patient Type Selection Key (Adult, Ped, Neo)
11. Start/Stop Manual Recordings
12. Display System Setup Menu
13. Return to Home Page
14. Seven Parameter/System Softkeys
Fixed Function Keys (USA and International)
The Prism & Prism SE monitor includes the following nine (9) fixed functions keys: ON/STBY,
ALARM SUSPEND, ALARM SETUP, FREEZE, NIBP START/STOP, PATIENT TYPE,
SYSTEM SETUP, PAGE HOME, and RECORD. Each of these keys, as the name implies (or
symbol for International), is fixed and performs its intended function regardless of the monitoring
scenario. A brief description of each is provided below.
ON/STBY
Turns the display on and initializes the monitor when ON is pressed. When the monitor is turned
on, you will hear two beeps. The monitor is returned to standby status by pressing STBY. When
in STBY, the batteries continue to be charged if the monitor is connected to AC power, but no
monitoring or storing of data occurs. The Prism SE batteries will also charge when using eternal
DC power.
ALARM SUSPEND
Temporarily suspends alarm tones. The factory defaults for alarm suspend intervals are 180
seconds in adult mode, 90 seconds in pediatric mode, and 60 seconds in neonatal mode. If an
alarm limit is violated, pressing ALARM SUSPEND will silence the alarm tone. Pressing the
key again before the suspend time period has elapsed will reactivate the audible alarm tones if the
alarm condition still exists. While alarms are suspended, the following message will appear on the
monitor screen:
ALARMS SUSPENDED XXX
The XXX will be replaced with the number of seconds remaining until the alarm suspend
condition is removed.
1-2
ALARM SETUP
Displays the alarm status for all vital sign parameters. Alarm ON/OFF status, alarm priority
level, high and low limits, and recording type for each active parameter are displayed.
A bell…… next to the listed parameter indicates that one or more alarms for that parameter
is ON. An X is displayed when all alarms for the associated parameter are OFF.
FREEZE
Freezes all displayed waveforms for evaluation purposes. Pressing FREEZE again releases
waveforms.
NOTE: Waveforms cannot be frozen during recording. Initiating a
recording will also release the frozen waveforms.
NIBP START/STOP
Pressing the NIBP START/STOP key immediately initiates an inflation and measurement. You
can also press the NIBP softkey to access the setup keys for setting automatic measurement
intervals.
PATIENT TYPE
The PATIENT TYPE key is used to select or display the current patient type. The selections are
ADULT, PED, and NEO.
SYSTEM SETUP
SYSTEM SETUP is used to change the monitoring conditions that your monitor is currently set
up for.
PAGE HOME
Returns the monitor display to the HOME PAGE screen (i.e., the screen normally displayed
during patient monitoring).
1-3
RECORD
Initiates a 16-second recording of any one or two parameter waveforms. To stop a recording in
process, press RECORD prior to completion of a manual or alarm recording. To specify the
parameters to be recorded, press the softkey(s) of the desired parameter(s) within two seconds
after pressing the RECORD key. If no parameters are selected after pressing record, a 16-second
strip of ECG waveform will be recorded.
NOTE: Active waveforms (i.e., parameters currently being monitored)
do not need to be displayed in order to acquire a recorded waveform.
Parameter Softkeys
The monitor is equipped with eleven (11) softkeys. Softkey operation changes depending upon
the monitoring mode, parameter, or configuration options being accessed. Four parameter
softkeys are located to the right of the display screen. Seven parameter/system softkeys are
located below the display screen.
WAVEFORM SOFTKEYS
These four softkeys, located on the right side of the front panel, provide access to the function
keys of the parameters displayed in the waveform display zone. ECG is always assigned to the
top waveform trace, and as many as three additional parameters, when available (i.e., installed),
can be assigned to trace 2, 3, 4, or 5 depending upon options.
SYSTEM SOFTKEYS
The function of these seven softkeys, located directly below the display screen, depends on the
label or function key displayed directly above the softkey. In the HOME PAGE state, parameter
labels and associated numeric values may be displayed directly above one or more of the
softkeys. To access the function keys for any of these parameters, press the softkey under the
parameter label and a page of function keys that relates specifically to that parameter will be
displayed.
1-4
Indicators
The monitor includes up to four indicators, which illuminate to notify the operator of a specific
activity or situation. These indicators notify the operator of AC power, battery charging, and
alarm status.
AC ON INDICATOR
The green AC ON LED (Light Emitting Diode) illuminates when the monitor is connected to AC
power.
BATTERY CHARGING INDICATOR
The yellow CHARGING LED illuminates when the monitor’s batteries are charging. The
CHARGING LED will not be illuminated when the batteries are fully charged, or when the
monitor is not connected to AC power.
ALARM INDICATORS
When flashing, one or more parameters are alarming.
When lit, one or more alarms are suspended, OR all alarms are turned off.
1-5
Prism & Prism SE Display Screen
1. ECG Lead in Use
2. Softkey Labels for Parameters Displayed in the Waveform Display Zone (WDZ)
3. Alarm Status for Parameters in the Waveform Display Zone
4. Alarm Status for Parameters in the Numeric Only Display Zone
5. Numeric-Only Display Zone (NODZ)
6. Message Area for Parameters in the Numeric Only Display Zone
7. System Message Area
8. Message Area for Parameters in the Waveform Display Zone
9. Waveform Display Zone with Associated Numerics
10. Current Monitoring Mode (Patient Type selected)
1-6
1. ECG Lead in Use
Indicates the ECG lead displayed in the top trace of the WDZ. Choices include lead I, II, III, or
V LD (and depending on hardware and software, choices may include aVF, aVL, or aVR) (for
“chest lead” in a 5-lead configuration). If heart rate is being derived from SpO2 or Invasive Blood
Pressure, PULSE is displayed.
2. Softkey Labels for Parameters Displayed in the Waveform Display Zone (WDZ)
The labels displayed adjacent to the parameter softkeys specify the parameters displayed in the WDZ.
3. Alarm Status for Parameters in the Waveform Display Zone
Each bell displayed in the WDZ indicates the alarm ON/OFF status for the parameter adjacent to it.
If a solid bell is displayed, one or more alarm for the associated parameter is ON.
If the bell is displayed with an X through it, the alarms for the associated parameter are OFF.
4. Alarm Status for Parameters in the Numeric-Only Display Zone (NODZ)
Each bell displayed in the Numeric-Only Display Zone indicates the alarm ON/OFF status for
the parameter listed below it.
If a solid bell is displayed, one or more alarm for the associated parameter is ON.
If the bell is displayed with an X through it, the alarms for the associated parameter are OFF.
5. Numeric-Only Display Zone (NODZ)
The parameter labels displayed above the softkeys at the bottom of the front panel specify the
parameters associated with each softkey. The numeric data associated with the parameters are
displayed above the parameter labels in the Numeric-Only Display Zone.
NOTE: In the HOME PAGE state, the parameter labels and numeric data are
displayed directly above the softkeys. When a parameter or system setup page is
displayed above the softkeys, the Numeric-Only parameter labels and associated
data are displayed slightly above the setup page.
6. Message Area for Parameters in the NODZ
Messages concerning parameters in the NODZ will be displayed in a reverse-video box on the
left side of the screen, just above the NODZ. Message display is temporarily obscured when a
parameter or system setup page is displayed. In the HOME PAGE state, the message continues
to be displayed as long as the message condition exists.
1-7
7. System Message Area
A message that is not specific to a single parameter, such as “ALARMS SUSPENDED 180”, is
displayed in a reverse-video box, just below the WDZ. Message display is temporarily obscured
when a parameter or system setup page is displayed. In the HOME PAGE state, the message
continues to be displayed as long as the message condition exists.
8. Message Area for Parameters in the WDZ
Messages concerning parameters displayed in the WDZ will be displayed in a video box below
the numeric data for the corresponding waveform parameters. The message is displayed as long
as the message condition exists.
9. Waveform Display Zone with Associated Numerics
The Waveform Display Zone displays waveform traces and associated numeric data for as many
as four different parameters. The top waveform trace is reserved for the ECG waveform;
however, you can assign different parameters to the other three waveform traces.
10. Current Monitoring Mode (Patient Type selected)
The current monitoring mode is displayed at the top of the screen — ADULT, PED, or NEO.
The monitoring mode can be changed through the system function key ADULT/PED/NEO.
Allows an external DC power source to be connected for extended use during transport where AC
power is not available. Batteries are also charged with external DC power.
2. Fuse Holder and Fuse Replacement
The fuse holder contains the fuses for the monitor. Open the door of this holder to replace fuses.
It is recommended that qualified technical service personnel replace fuses when necessary.
WARNING: For protection against fire, replace the fuses only with
those of the same type and rating.
The Prism SE requires two identical slow blow T2.5A / 250V fuses for operation. Ensure that the
AC power cord has been disconnected before replacing fuses. Carefully open the door of the fuse
holder with a short 1/8" flat screwdriver. Replace the blown or defective fuse with one of the
same type and rating. Noting orientation, gently slide the fuse holder back until it locks snugly
into its original place. After the fuse replacement, connect the AC power cord to the Prism SE.
The unit is now ready for operation.
3. AC Power Cord Input Connector and Optional Power Cord Mounting Bracket
Allows connection of the AC power cord to the monitor. In addition, the AC power cord must be
plugged into an AC source before the monitor can operate on AC power and before the batteries
can be charged.
For permanent connection, the MDE power cord bracket should be installed. See the following
figure for instructions on installing the power cord mounting bracket.
1-10
4. Battery Compartment
This compartment houses one battery (or up to two batteries on earlier units) which provide
power in transport situations or when AC power is not available.
5. Model & Serial Number Label
This label contains the model number and serial number of the monitor.
6. Add-On Module Interface
If a transceiver module is connected here, wireless communications between the monitor and an
MDE Central Station can be established.
If a telemetry receiver module is connected, communication between the monitor and an
ambulatory transmitter can be established.
If a CIS module is connected, communication to a hospital information system computer can be
established, or RS232 communications can be established.
7. Auxiliary Output Connector
Provides analog waveform or alarm relay closure interface signals from the Prism SE to other
clinical instruments.
WARNING: When connecting the Prism SE to any other instrument,
verify proper operation before clinical use. Refer to the other
instrument’s operation manual for complete instructions.
8. VGA Output Connector
Allows for an external VGA monitor to be connected. The same information that is displayed on
the Prism SE monitor will display on the external VGA monitor. Output resolution is 640 x 480
pixels.
9. Serial Interface (ISP Port)
This port is used to upload and download software data from external sources.
10. Equipotential Connector (Grounding Terminal)
Provides grounding for the monitor when the monitor is used with other medical equipment. It
must be used as a protective ground terminal when the monitor is operated with external DC
power.
Allows an external DC power source to be connected for extended use during transport where AC
power is not available. Batteries are not charged with external DC power.
2. Equipotential Connector (Grounding Terminal)
Provides grounding for the monitor when the monitor is used with other medical equipment. It
must be used as a protective ground terminal when the monitor is operated with external DC
power.
3. Batteries
These two slots contain modular batteries which provide power in transport situations or when
AC power is not available.
4. Defibrillator/Pacer Interface
Provides connection and communication between the Prism monitor and the ESCORT
Defibrillator/Pacer.
5. Fuse Holder/Voltage Selector and Fuse Replacement
The fuse holder contains the fuses and the voltage selector for the monitor. Open the door of this
holder to replace fuses or to configure the voltage selection block — 115 VAC or 230 VAC. The
present voltage setting can be read through the small rectangular window on the door of the
holder. It is recommended that qualified technical service personnel replace fuses or change the
voltage selection when necessary.
WARNING: For protection against fire, replace the fuses only with
those of the same type and rating.
The Prism requires two identical slow blow 0.5A fuses for 115 VAC operation, or two slow blow
0.25A fuses for 220 VAC operation. Ensure that the AC power cord has been disconnected before
replacing fuses. Carefully open the door of the fuse holder with a short 1/8" flat screwdriver.
Replace the blown or defective fuse with one of the same type and rating. Noting orientation,
gently slide the fuse holder back until it locks snugly into its original place. After the fuse
replacement, connect the AC power cord to the Prism. The unit is now ready for operation.
6. AC Power Cord Input Connector and Optional Power Cord Mounting Bracket
Allows connection of the AC power cord to the monitor. In addition, the AC power cord must be
plugged into an AC source before the monitor can operate on AC power and before the batteries
can be charged.
For permanent connection, the MDE power cord bracket should be installed. See the following
figure for instructions on installing the power cord mounting bracket.
1-13
7. Auxiliary Output Connector
Provides analog waveform or alarm relay closure interface signals from the monitor to other
clinical instruments.
WARNING: When connecting the Prism to any other instrument,
verify proper operation before clinical use. Refer to the other
instrument’s operation manual for complete instructions.
8. Add-On Module Interface
If a transceiver module is connected here, wireless communications between the monitor and an
MDE Central Station can be established.
If a telemetry receiver module is connected, communication between the monitor and an
ambulatory transmitter can be established.
If a CIS module is connected, communication to a hospital information system computer can be
established, or RS232 communications can be established.
9. Recorder Release Lever
Push this lever towards the recorder to release.
10. Model & Serial Number Label
This label contains the model number and serial number of the monitor.
1-14
Prism SE Side Panel
1-15
Connector Panel
The Prism SE can monitor several parameters. They include ECG, SPO2, IBP (Invasive Blood
Pressure), NIBP (Noninvasive Blood Pressure), Respiration, ETCO
, Cardiac Output and
2
Temperature.
Dual Channel Recorder
The Recorder unit provides manual and alarm recordings of any one or two waveforms
simultaneously.
SureTemp Unit
Allows you to take a patient’s temperature with different types of SureTemp probes and
measurements sites.
Prism Side Panel
1-16
1-17
Multiparameter Module
The Multiparameter Module is configured for several parameters; however your Multiparameter
Module may be configured for fewer parameters. The parameters include ECG, SPO
Cardiac Output, Temperature and SureTemp. This module may be interchanged with any
Prism monitor.
Dual Channel Recorder Module
The Recorder module provides manual and alarm recordings of any one or two waveforms
simultaneously.
Serial Interface (ISP Port)
This port is located inside the MPM well and is used to upload and download software data from
external sources. Only Prism LCD models 20403 with CPU Board assembly 403950 has ISP
capability.
VGA Output Connector
The VGA OUTPUT port allows for an external VGA monitor to be connected. The same
information that is displayed on the Prism monitor will display on the external VGA monitor. See
the following.
1-18
Prism’s Modular Components
There are several modular (user-movable) components that can be shared by all Prism monitors.
•Multiparameter Module (MPM) – allows you to share various configurations of parameters
between monitors.
•Dual Channel Recorder Module – provides manual and alarm recordings of any one or two
waveforms simultaneously.
•Modular Batteries – supplies battery power to the Prism monitor for operation in transport
situations, or when AC power is not available.
•Transceiver Module – provides two-way wireless communication to the ESCORT-Link or
ESCORT Vision Central Station, and serves as a repeater for the wireless network.
• Telemetry Module – allows for bedside monitoring of telemetry patients.
• CIS Communication Module – provides serial and Ethernet TCP/IP interface to HIS/CIS
systems for automated charting.
1-19
Prism SE’s Modular Components
There are several modular (user-movable) components that can be shared by all Prism & Prism
SE monitors.
•Transceiver Module – provides two-way wireless communication to the ESCORT-Link or
ESCORT Vision Central Station, and serves as a repeater for the wireless network.
• Telemetry Module – allows for bedside monitoring of telemetry patients.
• CIS Communication Module – provides serial and Ethernet TCP/IP interface to HIS/CIS
systems for automated charting.
1-20
1-21
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1-22
Chapter 2 – General Instructions for Using the Patient Monitor
Determine the Power Source
The Prism and Prism SE can be powered in one of three ways: AC, battery, and external DC
power.
An optional auxiliary DC connector (center pin positive) labeled EXT DC 12-28V, 30VA is
located on rear panel of monitor to allow external DC power source when AC is not available.
NOTE: Monitor should be plugged into AC power at every
opportunity to allow batteries (optional) to charge.
Prism batteries remain at their current power level during external
DC operation, but will not charge until plugged into AC power. Prism
SE batteries charge during DC operation.
To avoid corrosion, remove batteries if the monitor is disconnected
from AC power for an extended period of time.
Prism’s Modular Batteries
The Prism utilizes up to two (2) rechargeable sealed lead-acid batteries.
NOTE: Never discharge batteries completely. To insure long battery
life, always recharge batteries immediately after use. An optional
battery charger (MDE Part Number E2700-12) is recommended.
Batteries should be replaced every two (2) years regardless of test
results. Used batteries should be recycled or disposed of properly.
To install or remove a modular battery:
1. Turn the battery latch on rear of Prism monitor to allow installation or removal of battery.
2. Gently slide battery in/out from battery slot (if installing, latch battery after installing).
Prism SE’s Battery
The Prism SE utilizes one (1) rechargeable sealed lead-acid battery (up to two batteries for earlier
units). Battery or batteries can only be changed or removed by qualified technical service
personnel.
Prism’s Multiparameter Module
Vital sign parameters for your Prism monitor are factory configured in a Multiparameter Module
(MPM). The MPM is removable, allowing you to move it from one monitor to another.
NOTE: Not all parameters and options are available for CE marked
monitors. Consult your sales representative for more information.
2-1
To install the Multiparameter Module:
1. Align the Multiparameter Module’s front panel with the parameter labels facing you and
right-side up. Insure the edges of module are square with the edges of monitor housing.
2. Push the Multiparameter Module into monitor until it clicks into place.
To remove the Multiparameter Module:
1. Turn power OFF by pressing the STBY key or unplugging the power cord.
2. Release the Multiparameter Module by squeezing the side handles toward center of module.
3. While squeezing handles, pull module straight out.
Prism SE’s Connector Panel
Vital sign parameters for your Prism SE monitor, are factory configured in the Connector Panel.
The Connector Panel is not removable.
Turning Monitor ON and OFF
• Press the ON key to turn monitor on.
• Press the STBY key to turn monitor off.
Vital Sign Setup Menus
All vital signs have setup menus to adjust/alter the settings/limits. The following are some of the
typical vital sign setup menu items.
To open vital sign setup menu:
1.Touch softkey next to vital sign label on screen. Pressing the MORE softkey from SETUP
MENU accesses second page of menu. Some common functions are:
2-2
ALARM ON/OFF—Allows alarm to be turned ON/OFF.
ALARM LIMITS—Allows adjustment of limits through use of ↑↓ arrow keys.
SIZE/SCALE—Allows adjustment of waveform in size or sensitivity. In an invasive waveform,
allows adjustment of scale for waveform being displayed.
TONE—Allows audible tone for ECG, SpO2, and Respiration.
WF ON/OFF—Allows waveform for vital sign to be turned ON or OFF.
VITAL SIGN ON/OFF—Alarms for vital sign must be turned off to allow vital sign to be turned
off. Turn off SpO2 and Respiration at completion of their use to eliminate data from these
parameters being stored in Vital Signs Chart.
NEXT
↑↓→
—Allows movement of highlighted cursor.
ADJ ↑↓ —Allows numeric adjustment to highlighted cursor value.
Temporary Suspension of Monitoring
The Prism and Prism SE allow you to temporarily halt all monitoring/vital sign gathering to allow
the patient to be removed from the monitor for procedures, maneuvers, etc. All alarm settings,
automated NIBP measurements, trace settings are “held” by the monitor until monitoring is
resumed.
To halt monitoring:
1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR
DATA
PT
STOREVSDISP
VSCPTSETUP
2. Press the PT SETUP softkey to open the following menu.
SUSP
ALL
MONTR
ENTER
HT/WT
ENTER
NAME
ENTER
ID
CLEAR
NAME/
ID
3. Press the SUSP ALL MONTR softkey.
ENTER
VS
DATA
HR
AUTO
ECG
EXIT
TRACE
SEL
MORE
To resume monitoring:
1. Press any key on faceplate of monitor. All alarm settings, NIBP intervals, and trace settings
will resume.
Basic Configuration Functions
The Prism and Prism SE monitors allow viewing a variety of formats. Waveform and vital sign
displays can be altered via a Trace selection feature. The monitor can be utilized for adult,
pediatric, and neonatal patients. You can also configure the date and time settings.
To assign parameters to waveform areas (Trace 2, Trace 3, Trace 4):
1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
2-3
2. Press the TRACE SEL softkey to open the following menu.
DISP
VSC
DISP
OCRG
TRACE
AUTO
TRACE
2
AUTO
TRACE
3
4
AUTO
MORE
3. Press the softkey under desired TRACE until the parameter to be displayed is highlighted.
Note that the only available parameters are those that are turned ON.
4. Press the PAGE HOME key. The change will occur on the screen. Note that by
selecting AUTO, the monitor will automatically assign parameters to traces according to the
factory-defined hierarchy. In addition, when AUTO is selected, parameters that already
occupy traces are selection choices.
To select patient monitoring mode (Adult/Pediatric/Neonatal):
1. Press the PATIENT TYPE key to open the following menu.
ADULTPEDNEO
2. Press the softkey under desired patient type.
3. Press the PAGE HOME key.
4. Note monitor screen displays current patient type in upper left of screen.
5. The monitor holds present monitoring mode until it is changed again.
To set date and time:
1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
2. Press the MORE softkey to open the following menu.
ADULT
PED
NEO
VOL
DISP
OCRG
REC
SETUP
TIMER CLOCKMORE
3. Press the CLOCK softkey to open the following menu.
SET
SEC
MIN
SEC
↑↑
SEC
↓↓
FORM
D/M/Y
M/D/Y
CLOCK
TIME
OFF
MORE
4. Press the FORM softkey to select the display format.
5. Press the SET softkey to select desired unit to be changed
(SEC, MIN, HOUR, DAY, MONTH, YEAR).
MORE
2-4
6. Use the UP ARROW ↑ ↑ and DOWN ARROW ↓ ↓ softkeys to adjust the date and time
settings.
7. Press the PAGE HOME key.
Monitor Default Settings
If you need to change power-up defaults so that your monitor powers up every time in a
specialized mode or with settings different than the factory defaults, please refer this process to
service personnel.
Setting Up Parameter Display Options
Parameter Availability and ON/OFF Status
The Parameter Availability ON/OFF feature is a default configuration function that allows you to
cease monitoring selected vital sign parameters altogether. When a parameter is turned OFF in
the factory defaults, it will not be available to be monitored until it is turned back ON again. This
feature's default is "ON", permitting all installed vital signs to be monitored. Please consult
service personnel to change the default value.
Parameter ON/OFF
Each parameter has a setting in its setup menu and in the default configuration menu that allows
you to turn it ON or OFF. When turning a parameter OFF, the parameter will cease being
monitored, and the alarm status/alarm bell will not display. Furthermore, if your monitor is
configured with parameter labels "BLANK", and the sensor has been disconnected, no parameter
label will appear. To turn a parameter back ON, you can change the value in default
configuration, or simply plug in the associated connector. Once a parameter is displayed, you can
change the ON/OFF value in its setup menu. This feature's factory default is "OFF". Please
consult service personnel to change the default value.
Parameter Labels ON/BLANK
The Parameter Label ON/BLANK feature is a default configuration function that allows you to
either display all parameter labels for all parameters installed, or display labels for only those
vital signs that are actively being monitored. When parameter labels are set to "BLANK", the
monitor will detect whether or not a connector is plugged in for each installed parameter, and will
only display labels for those parameters that it detects (note that NIBP will always display, and if
CO is available it will also display). This feature's factory default is "BLANK". Please consult
service personnel to change the default value.
Parameter Colors and Tones
On a color Prism or Prism SE, you can change the colors of the parameter numerics and their
associated waveforms in the power-up defaults. You can choose to assign any of 15 different
colors to each parameter. It is recommended that service personnel perform this function.
Many parameters also have a tone associated with them. You can turn the tones ON or OFF in
each respective parameter’s setup menu, and can adjust the tone volume for all parameters by
accessing the VOL key on the second System Setup page.
2-5
To adjust tone volumes for all parameters:
1. Press the SYSTEM SETUP key to open the System Setup menu.
2-6
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
2. Press the MORE softkey to open the following menu.
TRACE
SEL
MORE
ADULT
PED
NEO
VOL
DISP
OCRG
REC
SETUP
TIMER CLOCKMORE
3. Press the VOL softkey to cycle through the 8 volume selections. The menu that displays after
pressing VOL also allows you to set up tone volumes for all parameter alarms.
NOTE: Minimum alarm volume can be defined in the power-up
defaults.
“MORE PRAMS AVAIL”
If you have more than eleven different vital sign parameters being monitored at the same time, or
have traces turned off that could accommodate some of the eleven parameters, you will see a
message that says “MORE PRAMS AVAIL” in the system message area. You can access a
second row of parameters by pressing SYSTEM SETUP, which will move the top row of vital
signs up one level to allow the second row below them. To move back to the first row of vital
signs, press the PAGE HOME key.
Please note that if the “MORE PRAMS AVAIL” message is displayed, you need to press the
SYSTEM SETUP key to get past the second row of parameters before any System Setup menus
can be accessed with the SYSTEM SETUP key.
2-7
2-8
Chapter 3 – Vital Sign Parameter Usage
NOTE: The Prism SE monitor can be used during defibrillation, but
certain parameter readings may be inaccurate for a short time.
ECG
Prism and Prism SE monitors provide clinical viewing of the conduction of electrical impulses
through various parts of the heart (ECG). Limb lead (I, II, and III) measurements are available
when using a 3-lead ECG cable. Precordial leads (V1, V2, V3, V4, V5, and V6) can be viewed by
using a 5-lead cable and selecting VLD (V-lead) on ECG setup page.
In many clinical situations it is necessary to view two ECG leads simultaneously to accurately
assess a patient’s condition. This “dual-lead” capability is an optional feature in MDE monitors.
WARNING: For pacemaker patients, HR may continue to count
pacemaker artifact during cardiac arrest or other arrhythmia. Keep
pacemaker patients under close surveillance.
WARNING: Prism and Prism SE monitors are intended only to be
used with “safety-protected” ECG cables and lead wires. These cables
and lead wires prevent inappropriate connection of ECG lead wires to
a power source, which could potentially result in burns or
electrocution. ECG electrode wires should only be connected to
patient ECG cable.
WARNING: After applying a defibrillator discharge to a patient
being monitored by Prism SE, wait 5 seconds for a valid ECG
indication on the monitor.
NOTE: For pacemaker rhythms, confirm PACE ON/OFF softkey is
ON to enable pacer rejection and flagging. When PACE softkey is ON,
monitor will indicate correct heart rate for all pacer pulse amplitudes
and widths, with and without overshoot/undershoot (per AAMI/ANSI
Standard EC-13, 1992, paragraphs 3.1.4.1 and 3.1.4.2). If PACE
softkey is OFF, cardiotach may erroneously detect pacer artifact.
Pacemaker output pulse detection and rejection vary from patient to
patient and with type of pacemaker and pacing catheter.
3-1
Patient Preparation
When doing any patient monitoring, proper skin prep and electrode placement are critical to
ensuring patient safety as well as accurate ECG, heart rate, and respiration readings. Follow the
steps and diagrams below carefully:
1. Shave areas where electrodes are to be applied if hair is present.
2. For adult patients, rub electrode location briskly with dry gauze until skin is pink. If alcohol
is used to prepare the electrode site, wait until it has completely evaporated before applying
electrodes.
3. Attach lead wires to electrodes before applying the electrodes to patient’s skin.
4. Apply electrodes to the patient’s skin, pressing firmly around entire edge of the adhesive
surface.
5. To help maintain stable ECG baseline, tape each electrode lead wire to skin.
6. When possible, locate positive and negative ECG electrodes at equal distances from
electrosurgical sites.
7. Check that electrodes are placed in proper locations. See the following diagrams:
Adult Electrode Placement
3-2
Neonatal Electrode Placement
This placement is also
good for RESP
monitoring
Alternate Method:
Position RA and LA
electrodes at the 2nd
intercostal space,
midclavicular line
To monitor a patient’s ECG:
1. Open the ECG SETUP menu by pressing the softkey next to the ECG label.
ALM
ON
OFF
ALM
LIM
SIZE
LEAD
SEL
PACE
ON
OFF
MORE
2. Press the ALM LIM softkey to adjust the values for current heart rate alarms.
3. Press the SIZE softkey to allow increase or decrease of QRS display. QRS needs to be at
least 1/2 millivolt.
4. Press the LEAD SEL softkey to select desired cable and lead. This page allows choice of
3-lead or 5-lead cable.
5. Insure cable matches selected lead cable. An error message “CHK LEADS” may indicate
device is looking for a 5-lead cable when a 3-lead cable is in use.
6. Press the PACE ON softkey to activate reject/flag pacer function (if applicable).
7. Press the MORE softkey.
8. Press the FILT softkey to turn filter OFF when ST segment monitoring is to be activated
(if applicable).
3-3
Selecting a Telemetry Patient to Monitor
“Telemetry-monitored” patients must be prepared properly for telemetry functions to work. A
3-lead or 5-lead ECG cable (depending on the type of transmitter used) must be correctly
connected to both the patient and the telemetry transmitter. The transmitter must then be secured
to the patient with an appropriate transmitter pouch.
1. Open the ECG SETUP menu by pressing the softkey next to the ECG label.
ALM
ON
OFF
ALM
LIM
SIZE
LEAD
SEL
PACE
ON
OFF
MORE
2. Press the MORE softkey twice to access the third ECG Setup Page.
TLM
ID
TLM
ID
MODE
CABLE
TLM
3. Press the MODE softkey to select TLM (telemetry) if it is not already selected.
4. Press the TLM ID UP ARROW or DOWN ARROW softkeys until the transmitter
ID of the patient you wish to monitor appears in the ECG numeric display zone, directly
under the heart rate numerics.
NOTE: If you cannot find the transmitter ID of the patient you wish
to monitor, they may not be setup correctly. Contact service personnel
to perform this procedure.
5. Press the PAGE HOME key to activate your selection and return to the main
monitoring screen. Telemetry ECG monitoring will begin automatically.
Correcting CHK Leads (Check Leads) Errors
If a CHK LEADS message is displayed on the screen after connecting the patient cable to the
monitor or anytime during monitoring, check the following:
The ECG cable, lead wires, and electrodes are properly and firmly connected
Electrodes are not excessively dry
The lead selected can be monitored with the ECG cable and lead wires currently connected
(for example, you are trying to monitor a V-lead with a 3-lead cable)
3-4
Respiration
Respiratory monitoring may be done either by impedance pneumography via ECG leads of RA
(right arm) and LA (left arm) or through ETCO2. Location of ECG electrodes may need to be
altered to allow correct count of RESPS. Review lead placement charts for respiratory
monitoring. The monitor can be set to look via an AUTO mode for source of RESPS.
To monitor a patient’s Respiration:
1. Open the RESP SETUP menu by pressing the softkey next to the RESP label.
ALM
ON
OFF
ALM
LIM
SIZE
MM/S
25
12.5
RR
AUTO
LEADS
APNEA
DELAY
20S
MORE
2. Press the ALM ON softkey if respiratory alarms are to be activated.
3. Press the ALM LIM softkey to adjust values for current respiratory high/low alarms. Apnea
delay alarms can be set as needed.
4. Press the SIZE softkey to allow increase or decrease of RESP waveform. Adjusting
“sensitivity” may improve count accuracy.
5. If this parameter is no longer desired or patient is not a good candidate for respiratory count
via impedance pneumography, press the MORE softkey, then press the RESP OFF softkey.
TONE
ON
OFF
CVA
ON
OFF
RESP
ON
OFF
Cardiovascular Artifact Detection (CVA)
MDE’s cardiovascular artifact detection gives you the ability to determine whether or not a
patient’s (typically a neonate’s) heart beat is being interpreted as an inspiration. When ECG leads
are used as a RESP source, artifact can occur because of the relative size of a neonate’s heart, and
the close proximity of the leads to the movement created by the heart. To alert personnel to this
possible occurrence, CVA detection looks for any period when 8 out of 10 RESP’s appear to
occur simultaneous with a heartbeat. If this happens, the monitor will alarm when CVA is ON.
Using CO2 as the RESP Source
When you monitor ETCO2 (CO2) in addition to ECG and your RESP source (RR) is set to
AUTO, the monitor will choose CO2 as the primary RESP source. This can be overridden if
desired in the RESP setup menu.
3-5
Pulse Oximetry (SPO2)
A noninvasive method for continuously measuring oxygen saturation and pulse rate. Hospital
policies, along with the sensor's directions for use, should be followed in care and rotation of
monitored sites. Insure correct sensor is being used for the type of oximetry in your monitor.
To monitor a patient’s SPO2:
1. Apply sensor to appropriate sensor site on patient. SPO2 monitoring commences
automatically.
2. Open the SPO2 menu by pressing softkey next to SPO2 label.
ALM
ON
OFF
ALM
LIM
ALM
DELAY
5
MODE
NORM
FAST
LOCK
ON
OFF
MORE
3. Press the ALM ON softkey if alarms are to be activated.
4. Press the ALM LIM softkey to adjust high and low values for saturation.
5. Press the ALM DELAY softkey to toggle between 5 or 10 seconds.
6. Press the LOCK ON softkey to activate C-LOCK (with Nellcor only).
7. Press the MODE softkey to choose averaging time of data (refer to the following tables,
MODE for Masimo,MODE for Nellcor MP204, or MODE for Nellcor MP405).
8. Press PAGE HOME.
NOTE: To turn SPO2 OFF, press the SPO2 OFF softkey. Turning parameter off eliminates
SEARCH message and halts further SPO2 storage into VSC preventing 00% data storage.
MODE for MasimoAveraging TimeApplication
NORM (standard)8 secondsUse when patient is relatively
inactive.
FAST 6 secondsUse for fast response
situations such as sleep
studies.
SLOW
Note: Pulse rate will be
displayed in all three SpO
monitoring modes.
2
12 secondsUse during periods of
excessive patient motion.
MODE for Nellcor MP204Averaging TimeApplication
NORM (standard, NELLCOR
Mode 1)
FAST (NELLCOR Mode 2)2 to 3 secondsUse for fast response
SLOW (NELLCOR Mode 3)10 to 15 secondsUse during periods of
5 to 7 secondsUse when patient is relatively
inactive.
situations such as sleep
studies.
excessive patient motion.
3-6
MODE for Nellcor MP405Averaging TimeApplication
*NORM (NOT USED)(NOT USED)(NOT USED)
FAST (NELLCOR Mode 2)Typically 7-8 seconds for
average pulse.
Varies + – with pulse quality
and other functions.
*SLOW (NOT USED)(NOT USED)(NOT USED)
All monitoring situations.
*Nellcor OxiSmartXL Technology has eliminated the need for operation in NORM and
SLOW modes. Refer to the following NOTE.
NOTE: Since Nellcor OxiSmartXL technology has eliminated the need
for operation in the SLOW mode, and depending on the version of
main software, the following may occur if the SLOW mode is
accidentally selected:
Pulse waveform will be replaced by dotted lines
Dashed lines will replace pulse rate
Dashed lines will replace saturation values
A“02 WRT ER” message will be posted on the display
Upon returning to NORM or FAST mode, all SPO2 values and
waveform will return, and the “02 WRT ER” message will disappear
from the display.
WARNING: Incorrect sensor application or use may cause tissue
damage or improper operation of the monitor. Follow directions for
use provided with sensor.
NOTE: Regarding use of NELLCOR sensors:
Before use, carefully read NELLCOR sensor directions for use.
Use only NELLCOR oxygen transducers. Use of oxygen transducers
produced by other manufacturers may result in improper
performance.
Do not use damaged NELLCOR sensors or patient cables. Do not
use a NELLCOR sensor with exposed optical components. Do not
immerse sensor or patient cable in water, solvents, or cleaning
solutions (sensors, cable, and connectors are not waterproof). Do
not sterilize by irradiation, steam, or ethylene oxide. See cleaning
instructions in Directions for Use for reusable NELLCOR sensors
and patient cables.
3-7
SPO2 Sensor Accessories—Nellcor
Nellcor Sensors – Contact Nellcor
SensorModelPatient size
Oxisensor® II oxygen transducers
(Sterile, Single-use only)
Oxiband oxygen transducer
(reusable with nonsterile adhesive)
OxiCliq oxygen transducers
(sterile, single use only)
Nellcor MP405 SPO2 Ext Cable –
10 Foot, must be used with the
above sensors
WARNING: A pulse oximeter is an early warning device. Use a lab
co-oximeter to completely understand the patient’s condition.
N-25/N-25LF
I-20
D-20
D-25/D25-L
R15
OXI-A/N
OXI-P/I
DS-100A>40Kg
P
N
I
A
E2800-64
<3 or > 40Kg
3 to 20 Kg
10 to 50Kg
>30Kg
>50Kg
<3 or > 40 Kg
<3 to 40Kg
10 to 50 Kg
<3 or > 40Kg
3 to 20 Kg
>30Kg
NOTE: Inaccurate measurements or loss of pulse signal may be
caused by:
Incorrect sensor application or use
Significant levels of dysfunctional hemoglobins (HbCO or MetHb)
Intravascular dyes such as indocyanine green or methylene blue
Darkly pigmented skin
Exposure to excessive illumination, such as surgical lamps
(especially ones with a xenon light source), bilirubin lamps,
fluorescent lights, infrared heating lamps, or direct sunlight
(exposure to excessive illumination can be corrected by covering
sensor with a dark or opaque material)
Excessive patient movement
Venous pulsations
Placement of a sensor on an extremity with a blood pressure cuff,
arterial catheter, or intravascular line
NOTE: Loss of pulse signal can occur in any of the following
situations:
Sensor is too tight
Patient has hypotension, severe vasoconstriction, severe anemia,
LNOP- DC ILNOP - DC I
PC04 Patient Cable: 4 Ft.PC04Adult/Pediatric/Neonatal
PC08 Patient Cable: 8 Ft.PC08Adult/Pediatric/Neonatal
PC12 Patient Cable: 12 Ft.PC12Adult/Pediatric/Neonatal
Adult/Pediatric
WARNING: Incorrect sensor application or use may cause tissue
damage or improper operation of the monitor. Follow directions for
use provided with sensor.
NOTE: Regarding use of LNOP sensors:
Before use, carefully read LNOP sensor directions for use.
Use only Masimo oximetry sensors for SPO2 measurements. Other
oxygen transducers (sensors) may cause improper performance.
Do not use damaged LNOP sensors or patient cables. Do not use
an LNOP
sensor with exposed optical components. Do not
immerse sensor or patient cable in water, solvents, or cleaning
solutions (sensors, cable, and connectors are not waterproof). Do
not sterilize by irradiation, steam, or ethylene oxide. See cleaning
instructions in Directions for Use for reusable Masimo LNOP
sensors and patient cables.
SPO2 Alarm Delay
The SPO2 alarm incorporates a delay to minimize nuisance alarms related to brief erroneous
SPO2 measurements that can be caused by patient artifact or external noise. The factory default
time for this delay is 5 seconds and, if desired, a 10-second delay is also available by accessing
the ALM DELAY softkey under the SPO2 setup menu. The monitor will generate an alarm if the
averaged SPO2 numeric value exceeds the alarm limit for more than 5 or 10 seconds, depending
on the delay selected.
SPO2 Averaging Time
SPO2 measurements are taken every 2 seconds and are averaged over a period of time (the
designated averaging MODE) to display the most accurate oxygenation percentage and pulse
rate. The MODE key in the SPO2 setup page lets you select a mode of measurement averaging to
best fit your clinical needs.
3-9
Temperature Monitoring
The Prism and Prism SE can accommodate a variety of continuous temperature probes, as well as
MDE SureTemp oral/axillary and rectal fast temperature probes. The unit automatically senses
and configures the monitor for the probe type that it detects.
MDE SureTemp temperature measurements can be accomplished in either “normal” or “monitor”
modes. In normal mode, the thermometer “predicts” body temperature in about 4 seconds for oral
readings and 15 seconds for rectal. When in monitor mode, the thermometer measures body
temperature in about 3 minutes, and will continue for as long as the probe remains in place (this is
the only available mode for axillary temperatures).
Measuring a Patient’s Temperature with Continuous Probes
1. Connect the temperature probe to monitor.
2. Press the softkey below the TMP1 or TMP2 label to access setup functions, if necessary.
Note that if your monitor is equipped with both continuous and SureTemp capability,
SureTemp is configured for TMP1.
ALM
ON
OFF
ALM
LIM
UNIT
C
F
MORE
3. Press the PAGE HOME key to activate any new setup functions.
4. Place the probe in the appropriate measurement site to begin continuous monitoring.
Measuring a Patient’s Temperature with SureTemp
®
A temperature methodology that allows predictive or monitored temperatures. Blue top probe is
used for oral or axillary modes with red top probe for rectal temperatures. Only Welch Allyn™
manufactured probe covers are to be used for this device. Probe covers by other manufacturers
cause inaccurate results.
1. Open the SURETEMP menu by pressing the softkey next to the TMP 1 label. Note current
MODE and SITE. Pressing the softkeys allows changes to these settings.
MODE
NORM
MONTR
SITE
ORAL
AXIL
UNIT
C
F
MORE
NOTE: If TMP1 label is not present on monitor screen, remove probe
from probe well and reinsert probe into probe well to display TMP1
label.
2. Once the TMP1 label appears, and MODE and SITE are established as described in Step 1,
remove probe from well and place probe cover onto probe. The message on screen is
3-10
T1 WAIT. DO NOT place probe into position until message reads T1 READY and an
audible tone is heard.
3. When ready, place probe in position. ORAL and RECTAL methods require caregiver to
hold probe in position.
4. An audible tone for NORM mode signals completion of the measurement. A message on
screen displays T1 FINAL. The MONIT mode is continuous monitoring of temperature so
no audible tone will occur to signal a final temperature. The message on screen notes
T1 MONITOR.
5. Probe covers are discarded after use by “ejecting” probe cover off probe via blue/red ejects
button.
6. Replacement of probe into probe well is required to “reset” device.
WARNING: Incorrect insertion of rectal probe can cause bowel
perforation. Read all instructions thoroughly before proceeding with
probe placement.
NOTE: Regarding the use of SureTemp:
Do not initiate a temperature while unit is displaying T1 INIT on
screen (when monitor is first activated)
Correct positioning of probe tip is critical with oral method
NORM mode allows predictive temps of 4 seconds for oral site and
15 seconds for rectal site
Axillary site should be assessed in MONITOR mode
Probe should be reseated in probe well between temperatures to
allow recalibration of parameter
If ambient temperature of monitor is above 90o F, or if the body
temperature is below 94
o
F, then NORMAL mode cannot be used
and the monitor will automatically switch to MONITOR mode
Noninvasive Blood Pressure Measurements (NIBP)
Prism and Prism SE noninvasive blood pressure (NIBP) monitoring can be started at any time by
pressing the NIBP START/STOP key on the monitor’s front panel, or is user-configurable to take
measurements at preset intervals. NIBP measures oscillometric waveforms as the air pressure in a
standard cuff gradually reduces.
Additionally, initial and subsequent cuff inflations are adaptable for different patient types and
blood pressure ranges. Depending on which patient mode is selected (ADULT, PED, or NEO),
initial inflations can be setup anywhere from 60 to 220 mmHg, and subsequent readings will
automatically inflate to only 25 mmHg above the previous systolic reading to increase
measurement speed and patient comfort.
3-11
Each NIBP reading, recording, and trend printout will display an ET (elapsed time) number. This
number indicates the number of minutes that have passed since the start of the last NIBP
measurement.
To manually measure NIBP:
1. Select proper cuff size and patient-monitoring mode for patient.
2. Place cuff snugly on patient with artery indicator over artery to be assessed.
3. Press the NIBP/PNI START/STOP key.
To set automatic intervals:
1. Press the softkey next to the NIBP label to open the NIBP SETUP menu.
ALM
ON
OFF
STARTSTOP
4MIN
5MIN
10MIN
5MIN
AUTO
ON
PROGMORE
2. Press the softkey under timing interval to highlight desired interval (for example, 5MIN).
3. Press softkey to turn AUTO ON.
4. Press the NIBP/PNI START/STOP key.
5. Note display of A:ET indicates auto mode is functioning and time since last reading.
To set programming cycles:
1. Press the softkey next to the NIBP label to open the NIBP SETUP menu.
ALM
ON
OFF
STARTSTOP
4MIN
5MIN
10MIN
5MIN
AUTO
ON
PROGMORE
2. Press softkey under PROG to open the following menu.
PROG
ON
OFF
NEXT
ADJ
ADJ
STARTMORE
3. Press the PROG ON OFF softkey to turn PROG ON.
4. Utilize NEXT softkey to move highlighted cursor after value has been adjusted to
desired setting via the ADJ softkeys.
5. Press the NIBP/PNI START/STOP key.
6. Note display of P:ET indicates programmed mode is functioning.
7. At conclusion of programmed cycle, PROGRAM ENDED is displayed.
3-12
Selecting an Appropriate NIBP Cuff
For patient safety and accurate NIBP readings, it is essential to select an appropriate cuff for
patient type and size being monitored. The following table shows MDE part numbers for a
variety of cuff sizes and types:
WARNING: Excessive tightness of cuff may cause venous congestion.
It may also cause pinching of skin, or bruising of arm, particularly if
patient’s skin folds under cuff, causing uneven distribution of pressure
on arm.
WARNING: Do not place cuff on an extremity being used for IV
infusion, pulse oximetry, or direct (invasive) pressure monitoring.
WARNING: Operators should exercise caution and position distal
edge of inflatable cuffs higher on patient’s arm, away from elbow, to
avoid differential pressure damage to radial nerve.
WARNING: Closely observe patients undergoing thrombolytic or
anticoagulant therapy for bruising or petechiae under or distal to
cuff. Position the arm to minimize any artifact that could prolong
inflation period.
CAUTION: Calibration tubing should be kept dry and free of
particulate matter. Moisture or foreign substances in pneumatic
system can cause damage to unit.
NOTE: Avoid compression or restriction of pressure tubes during
NIBP reading.
3-13
Displaying the NIBP Table
The Prism and Prism SE monitors stores up to 100 NIBP readings, as well as any other
parameters being monitored, with their corresponding time of measurement. When you turn the
NIBP table ON, the most recent readings will be displayed in tabular format in the NIBP trace
(NIBP must be set up in one of the three lower traces in the waveform display zone).
Additionally, tabular information for all other parameters being monitored will also display in
their corresponding times. You can press the RECORD key followed by the NIBP softkey to
print all readings stored in memory.
Invasive Blood Pressure
INVASIVE PRESSURE monitoring allows user to simultaneously derive pressures from up to 3
different transduced lines. The system works with standard pressure transducers having
5 µV/V/mmHg sensitivity. Following placement of invasive lines, evaluate alarms and alarm
limits to insure settings appropriate for patient. Default settings are set to label most commonly
used pressures.
1. For optimum waveform size on screen, connect higher pressures to BP1 and lower pressures
such as pulmonary artery, CVP, or ICP to BP2 and BP3.
2. Connect transducer cable to monitor. Invasive BP automatically activates on screen.
To display IBP in Trace slot:
1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
2. Press the TRACE SEL softkey to open the following menu.
DISP
VSC
DISP
OCRG
TRACE
AUTO
TRACE
2
AUTO
TRACE
3
4
AUTO
MORE
3. Scroll through TRACE 2, 3, or 4 to highlight desired IBP.
4. Press the PAGE HOME key to initiate change.
5. Insure pressure line is level with transduced vessel or its reference point.
6. Open the BP setup menu by pressing the softkey next to the BP label:
ALM
ON
OFF
ALM
LIM
SIZE/
SCALE
SITE
OFF
ART
ZERO
ALL
ZERO
BP1
MORE
7. Press the ALM ON softkey to activate alarms.
8. Press the ALM LIM softkey to set alarms for displayed values.
9. Press the SIZE/SCALE softkey to change displayed scale or to turn scale on/off. A new
scale for the pressure line can be set at any time. Changing scales may be necessary to insure
an appropriate waveform display.
3-14
10. Press the SITE softkey to cycle through site labels for invasive pressure line. Highlight
desired site.
11. Press the MORE softkey to access second page of menu.
SMD
S/D
MEAN
CAL
BP1
ON
OFF
12. Displayed values for SYSTOLIC/MEAN/DIASTOLIC are chosen by pressing the
SMD-S/D-MEAN softkey.
13. Press the CAL softkey to initiate a calibration wave (waveform must be displayed in trace).
14. Press the BP ON/OFF softkey to turn vital sign on/off. Alarm must be OFF to turn parameter
off. Turn parameter off to eliminate technical messages and halt data into VSC.
To zero invasive blood pressure:
1. Press the ALARM SUSPEND key.
2. Turn the stopcock off to patient and open to atmospheric air. WAIT for waveform to flatten.
3. Press the softkey under ZERO. User can zero all invasives simultaneously through ZERO
ALL.
ALM
ON
OFF
ALM
LIM
SIZE/
SCALE
SITE
OFF
ART
ZERO
ALL
ZERO
BP1
MORE
4. Observe for the 00 (± 1) on screen. Turn the stopcock off to atmospheric air and open to
patient.
5. Press the PAGE HOME key.
Pulmonary Artery Monitoring
PULMONARY ARTERY monitoring on the Prism or Prism SE allows additional menu keys
that specifically address functions of pulmonary artery catheter. These menu keys are displayed
when invasive pressure is labeled for PA. Additional key(s) available are PAWP and
SAVE:PAM:CVP.
Measurement of pulmonary artery pressure (PAWP):
1. Press the softkey next to the PA label.
2. Press the PAWP softkey. Note display initiates a background scale and slows speed of PA
display to allow easier visualization of end expiratory phase of respiration.
3. Inflate balloon per manufacturer guidelines and observe for flattening of PA waveform,
indicating balloon is wedged. Allow full-screen display of wedged waveform. The FREEZE
key allows display to be held on screen as user allows passive balloon deflation.
3-15
4. Press the CURSOR softkeys to align cursor bar with end expiration. Note value displayed
on cursor bar and at bottom of screen changes as cursor bar is moved.
5. Press the SAVE PAWP softkey to store PAWP value for hemodynamic calculations. Press
the FREEZE key to release (if FREEZE key was used to hold display).
6. For a PA catheter that is not to be wedged, the monitor can store pulmonary artery diastolic
value in place of PAWP. Press the PAWP=CURSOR/PAD softkey to select PAD.
7. If a separate CVP line is not present, CVP can be temporarily measured by “bridging PA
line” to determine CVP value. Press the PA softkey, press MORE, then press SAVEPAM;CVP softkey.
NOTE: Storage of PAWP and CVP values requires initiation of
Cardiac Output injections within 30 minutes for these values to be
used for hemodynamic calculations.
Storgae of Invasive Pressure Values to VSC
STORAGE OF INVASIVE PRESSURE VALUES TO VSC: Invasive pressure values are
dynamic values that store into VSC any time a static value such as NIBP or SureTemp is stored.
A single set can be stored into VSC through STORE VS function. These dynamic values can be
stored at a timed interval as follows:
1. Press the softkey next to the VSC label to open the VSC SETUP menu.
VSC
SETUP
STOREVSTABLE
TABLE
TABLE
TEXT
SIZE
MORE
2. Press the VSC SETUP softkey to display the following menu.
AUTO
1MIN
OFF
STORE
ALM
SETUP
STORE
NIBP
ON
STORE
TMP1
ON
STORE
COONMORE
3. Press the AUTO softkey to highlight the desired storage interval.
4. Press the PAGE HOME key. Timed storage continues until monitor is turned off or
until user returns to this menu and makes another selection.
5th Trace Option
If the Prism or Prism SE is configured with the 5th Trace Option, TRACE 4 (Waveform Zone 4)
can be split to display 2 Invasive Blood Pressures. The selections for displaying a 5
th
waveform in
TRACE 4 are BP1 & 2, BP1 & BP3, and BP2 & BP3. The waveform label for TRACE 4 will
display as IBP.
1. To access the individual BP menu, press the IBP softkey, a submenu will appear. Press the
desired BP to access the associated BP menu.
2. To record, press the appropriate BP softkey during the tab recording to designate that
parameter for recording.
3-16
If a BP in TRACE 4 or 5 is turned OFF, that BP will be removed from the waveform zone.
The remaining BP will be expanded into the full Trace 4 area. The 5
then be terminated. Turning BP ON again will not restore it as the 5
th
TRACE Mode will
th
TRACE.
Cardiac Output and Hemodynamic Calculations
The monitor allows cardiac output injections and hemodynamic calculations. Use only a Swan-
Ganz
(or equivalent catheter).
Follow hospital policy/procedure for assembling cardiac output setup. Connect system after
attaching bifurcated CO cable to port on monitor. To allow appropriate data acquisition for
hemodynamics, insure invasive pressure lines are labeled correctly. The recommended procedure
prior to completing cardiac outputs/hemodynamic profile is:
To monitor a patient’s cardiac output:
1. Insure a MAP (mean arterial pressure) value is available via an arterial pressure or from
NIBP.
2. Zero all lines.
3. Obtain the PAWP/PAD and CVP values.
4. Open the menu for Cardiac Output by pressing softkey next to the CO label. CO display is
temporarily displayed on screen.
COMP
CONST
.470
STARTAVG
VIEW
RUN
1
DEL
RUN
1
ENTER
HTWTMORE
5. On initial use of CO, press the ENTER HT/WT softkey to enter values utilizing softkeys.
6. Once these values are complete, press the SAVE HT/WT softkey. Height and weight are
required for indexed values.
7. Verify displayed COEFFICIENT is correct. If value needs to be changed, press softkey under
COEF and use softkeys to change values.
8. Press the MORE softkey to return to prior menu.
9. Prepare to inject by obtaining needed injection volume.
10. Press the START softkey to initiate cardiac output measurement. Injection must be started
within 10 seconds of pressing START. Cardiac output injections should be a smooth, swift
injection completed within 4 seconds of starting injection.
3-17
Injections are labeled as RUN 1, 2, etc. Subsequent injections are completed once START is
redisplayed. A total of 6 RUNS can be displayed. Further RUNS require deletion of one of
the 6.
11. Press the VIEW RUN 1 (2-6) softkey to view injection. To delete the run, press DEL RUN 1
(2-6) softkey and press the YES softkey.
12. Press the AVG CO softkey after all runs to be computed in the average are present. The
preliminary hemodynamic table is displayed.
NOTE: Injectate temperature (Ti), and blood temperature (Tb) are
displayed in the CO trace. There must be at least a 12° C difference
between Ti and Tb. When using iced solution or a CO-SET
®
—due to
remaining fluid in the line— the Ti measured by the in-line probe will
be more than 12° C cooler than Tb at the time of the injection
regardless of the value of Ti displayed prior to the injection.
13. Vital sign parameter data that may require editing is displayed in right hand column. Review
these values.
To edit these values:
Press the EDIT VS softkey
Press the ADJ softkeys to adjust highlighted value
Press the NEXT softkeys to move cursor to next vital sign for editing
14. Press the RUN CALCS softkey to display altered preliminary hemodynamic table.
15. Press the STORE CALCS softkey to display completed hemodynamic table.
16. Press the INDEX ON/OFF softkey to toggle between indexed and nonindexed values.
17. Hemodynamic table can be recorded with a bedside recorder. While hemodynamic table is
displayed on monitor screen, press the RECORD key and within 2 seconds press the softkey
next to CO label.
CO allows 22 sets of hemodynamic data to be stored.
18. To view hemodynamic table at a later time, press the CO softkey, press the MORE softkey,
and press HEMOCALCS. Use softkey arrows to scroll table information.
Selecting a Thermodilution Catheter
The following Baxter-Edwards models of thermodilution catheters or their equivalent are
recommended. “H” in part number refers to Heparin coating, and can be ordered without Heparin
by excluding the “H” from part number.
Part NumberApplication
131HF7Standard, non-REF capable
831HF75Standard, non-REF capable with venous infusion port
93A-931H-7.5FNon-REF capable, infusion and pacing
93A-439H-7.5FREF capable, volumetric
3-18
End Tidal Carbon Dioxide (ETCO2) (Prism Only)
End tidal carbon dioxide (ETCO2) monitoring can show early indications of circulatory and
pulmonary problems. In order to have a “normal” ETCO2 (CO2) reading a patient must have
active cellular metabolism that produces CO2, a functional cardiovascular system to transport
CO2 to the lungs and a normal intrinsic pulmonary function or proper ventilator-assist function.
The Prism monitor uses infrared absorption spectroscopy to measure CO2. MDE’s selfcalibrating sensor directs a single infrared beam through both a sampling chamber containing
patient exhaled CO2, and a reference chamber containing a known concentration of CO2. Based
on a comparison of these two values, the monitor calculates the patient’s CO2 concentration for
each exhaled breath.
Both the mainstream and sidestream sensor continuously measures the level of CO2 during
inspiration and expiration, and detects changes of CO2 levels during the respiratory cycle. These
changes are shown on the CO2 capnogram waveform, with numeric values reflecting the highest
level of CO
respiration rate (if CO2 is selected as the respiration source), measures inspired CO2 (ICO2) to
compare to an adjustable ICO2 alarm limit, and provides the ability to compensate for oxygen
(O2) and nitrous oxide (N2O) greater than 50%.
ETCO2 setup:
1. Press the softkey next to ETCO2 label to open the ETCO2 Setup menu.
detected at the end of expiration. Additionally, the monitor senses and displays
2
ALM
ON
OFF
ALM
LIM
SCALE
50
75
MM/S
12.5
6.25
CO2
ON
OFF
MORE
2. Press the ALM ON/OFF softkey to set patient alarms.
3. Press the ALM LIM softkey to adjust alarm values.
4. Press the SCALE softkey to chose appropriate scale.
5. Press the CO2 OFF to turn off ETCO2 function. Turn ETCO2 off after conclusion of
monitoring to prevent technical messages on screen.
6. Press the MORE softkey to view and select the UNIT softkey (% or mmHg), O2 ON/OFF
compensation softkey, or N2O ON/OFF compensation softkey.
UNIT
%
mmHg
O2
ON
OFF
N2O
ON
OFF
ETCO2 allows numeric information and waveform to be displayed. ETCO2 waveform can be
placed in a trace slot. Refer to configuration instructions.
3-19
WARNING: Do not allow CO2 sensor to come in contact with
patient’s skin for prolonged period of time. CO2 sensor heats to
prevent fogging of airway adapter windows.
WARNING: Do not use damaged sensor or one with exposed
electrical contacts. Refer any servicing to qualified personnel.
CAUTION: Do not apply tension to sensor cable.
CAUTION: CO2 sensor is for use with approved airway adapters
only.
CAUTION: CO2 airway adapter is non-sterile and intended for single
patient use only.
CAUTION: Do not re-circulate exhaust gas back into closed loop
breathing system.
Mainstream:
MDE’s mainstream CO2 sensor attaches to a disposable airway adapter, which is installed in the
ventilator circuit tubing.
3-20
1. Inspect circular window on airway adapter for cracks or blemishes. Replace if necessary.
2. Attach airway adapter and sensor in line proximally to patient between endotracheal,
nasotracheal or tracheal tube and ventilator circuit, T-tube setup or bag/valve setup.
3. Carefully press sensor down onto airway adapter being careful not to damage glass window.
4. Connect ETCO2 cable to port on monitor. Function automatically activates.
5. Allow device to warm up for 45-60 seconds. The message WARM-UP is present on screen.
6. Support under sensor housing may be necessary to prevent excess traction on airway tube. Do
not allow sensor housing to set on patient’s skin.
Sidestream:
The sidestream CO2 sensor attaches to a nasal cannula or in-line airway sampling system (for
intubated patients). It can even attach to a divided oxygen delivery CO2 sampling nasal cannula if
you need to deliver O2 while monitoring sidestream CO2.
1. Connect ETCO2 cable to monitor connector.
2. Insert fresh watertrap into sidestream motor port with a gentle twisting motion.
3. Place respiratory device (nasal cannula, facemask, airway tubing) to patient and attach
sampling port line from respiratory device to watertrap.
4. Allow device to warm up for 45-60 seconds. The message WARM-UP is present on screen.
3-21
ETCO2 (CO2) Sensor and Airway Adapter Maintenance (Prism Only)
CO2 sensor is a precision instrument, which requires proper maintenance to verify accuracy and
durability. Great care must be exercised in handling the CO2
sensor. There are no user serviceable
parts inside sensor. The following precautions will help protect sensor and patients:
Do not autoclave airway adapter or sensor
Do not immerse sensor or cable in liquid
Avoid damaging mainstream adapter glass window
Connect mainstream adapter to sensor away from patient
Mainstream airway adapter is non-sterile and intended for single patient use only
Always use mainstream neonatal adapter (MDE part #E2900-21) for neonatal patients.
After use, clean sensor with cloth moistened with green soap/green soap tincture
(V34 or equivalent)
Always replace sensor and cable in its protective foam-lined case when not in use
End Tidal Carbon Dioxide (ETCO2) (Prism SE Only)
End tidal carbon dioxide (ETCO2) monitoring can show early indications of circulatory and
pulmonary problems. In order to have a “normal” ETCO2 (CO2) reading a patient must have
active cellular metabolism that produces CO2, a functional cardiovascular system to transport
CO2 to the lungs and a normal intrinsic pulmonary function or proper ventilator-assist function.
Prism SE uses molecular comparison spectroscopy to measure CO2. Prism SE’s sensor directs a
single laser beam specific to CO2 through a sampling chamber containing patient exhaled CO2.
The monitor calculates patient’s CO2 concentration for each exhaled breath.
Both intubated and nonintubated techniques continuously measure level of CO2 during
inspiration and expiration, and detect changes of CO2 levels during respiratory cycle. These
changes are shown on CO2 capnogram waveform, with numeric values reflecting highest level of
CO2 detected at end of expiration. Additionally, Prism SE senses and displays respiration rate (if
CO2 is selected as respiration source), and measures inspired CO2 (ICO2) to compare to an
adjustable ICO2 alarm limit.
ETCO2 setup:
1. Press the softkey next to ETCO2 label to open the ETCO2 Setup menu.
ALM
ON
OFF
ALM
LIM
SCALE
50
75
MM/S
12.5
6.25
CO2
ON
OFF
MORE
2. Press the ALM ON/OFF softkey to set patient alarms.
3. Press the ALM LIM softkey to adjust alarm values.
4. Press the SCALE softkey to chose appropriate scale.
5. Press the CO2 OFF to turn off ETCO2 function. Turn ETCO2 off after conclusion of
monitoring to prevent technical messages on screen.
6. Press the MORE softkey to view and select the UNIT softkey (% or mmHg), O2 ON/OFF
compensation softkey, or N2O ON/OFF compensation softkey.
3-22
UNIT
%
mmHg
O2
ON
OFF
N2O
ON
OFF
ETCO2 allows numeric information and waveform to be displayed. ETCO2 waveform can be
placed in a trace slot. Refer to configuration instructions.
CAUTION: Do not over tighten FilterLine tubing in connector.
CAUTION: The Microstream CO2 FilterLine tubing is for use with
approved airway adapters only.
CAUTION: CO2 airway adapter and FilterLine are non-sterile and
intended for single patient use only.
CAUTION: Do not re-circulate exhaust gas back into closed loop
breathing system.
WARNING: Do not attempt to clear or “blow out” the FilterLine.
Replace FilterLine when occluded.
To measure a patient’s ETCO2 (intubated):
1. Attach airway adapter proximally to patient between endotracheal, nasotracheal or tracheal
tube and ventilator circuit, T-tube setup or bag/valve setup. CO2 airway adapter is non-sterile
and intended for single patient use only.
2. Connect appropriate end of ETCO2 FilterLine tubing to Prism SE’s connector panel. CO2
airway adapter and FilterLine are non-sterile and intended for single patient use only.
3. Observe WARM UP message on screen (WARM UP appears 5 seconds after a NO
SENSOR message). ETCO2 monitoring will commence approximately 10 seconds following
setup and connection.
To measure a patient’s ETCO2 (nonintubated):
3-23
1. Position nasal cannula on patient.
2. Connect ETCO2 tubing to Prism SE’s connector panel.
3. Observe WARM UP message on screen. ETCO2 monitoring will commence approximately
10 seconds following connection. If an error message appears, check tubing for blockage. If
this does not correct problem, see the Troubleshooting section.
Graphical Trends
Graphical trend allows view of compilation of data collected for given parameter over defined
time period. Time period choices are 1, 8, and 24 hours for each monitored parameter.
1. Press the SYSTEM SETUP key to open the System Setup menu.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
2. Press the MORE softkey twice to access the TREND softkey.
CONFTRENDTEST
3. Press TREND softkey to display Trend Setup Page. Trend is displayed in TRACE 3.
4. Press the softkeys to alter display for parameter, trend time base, and scales. Use arrows to
move time visible on graph.
HR
RESP
SPO2
1 HR
8HR
24HR
SCALE
250
200
CURS
CURS
5. TREND can be recorded with use of bedside recorder. Press the RECORD key and within
two seconds press the softkey next to TRACE 3 (TREND GRAPH).
6. Press PAGE HOME to remove trend display and return to main monitoring
display.
3-24
Vital Sign Chart (VSC)
VSC is a feature that allows storage, display, documentation and editing of vital signs. The
monitor stores 100 sets of tabular vital signs with most recent visible when VSC is viewed. To
continuously display VSC in a trace slot, refer to configuration page.
1. VSC can be temporarily viewed in trace slot. Press SYSTEM SETUP key, then softkey
under DISP VSC.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
2. To open VSC menu, press the softkey next to the VSC label.
VSC
SETUP
STOREVSTABLE
TABLE
TABLE
TEXT
SIZE
MORE
3. Press the TABLE (or ) softkey to scroll and view vital signs.
4. Press the TEXT SIZE softkey to alter text size of vital signs.
5. Press the STORE VS softkey to manually store all vital signs currently displayed on-screen.
6. Press the VSC SETUP softkey to access the AUTO store key for timed storing of dynamic
vital signs.
AUTO
1MIN
OFF
STORE
ALM
SETUP
STORE
NIBP
ON
STORE
TMP1
ON
STORE
COONMORE
7. Press the MORE softkey to access DEL VSC ENTRY (allows deletion of lines of vital sign
entries). CLEAR VSC TABLE allows deletion of entire VSC.
CLEAR
VSC
TABLE
DEL
VSC
ENTRY
MORE
8. Recording Vital Signs: VSC can be recorded with use of bedside recorder. Press the
RECORD key and within two seconds press softkey next to VSC label.
9. Letter/symbol to left of vital sign entry indicates what prompted data to be stored.
As entries are added to the table, the oldest entries cycle down and off the screen but remain in
memory. However, if a parameter trace below the VS chart is off, the table will automatically
continue to fill downward until it fills the second trace as well.
There are a variety of options that can be selected to determine when vital signs are stored, as
listed below. Each VSC storage option includes a small letter or symbol, which displays to the
left of the time displayed for that entry. Each entry option can be turned ON or OFF depending
on your charting requirements.
(blank)Entry made according to preselected automatic time interval.
3-25
(bell)Entry made when an alarm is violated (alarming vital sign is shown in inverse video).
nEntry made when a user-initiated NIBP reading is completed.
aEntry made when an automatic (timed interval) NIBP reading is completed.
tEntry made when a predictive SureTemp reading is completed.
vEntry made when the user presses the STORE VS key (indicates “validated” entry).
mEntry made when the vital signs are manually entered via the CIS module or
Guardian telemetry transmitter.
pIndicates that the monitor was powered down prior to clearing VSC data. All
entries listed below the “p” entry were stored before the monitor was powered
down.
sIndicates that ALL monitoring was SUSPENDED at this time entry.
rIndicates that monitoring was RESTORED at this time entry.
Storing VS Charts in Monitor Memory
Up to 100 VSC entries remain stored in the monitor’s memory for the entire time the monitor is
turned on. Additionally, you can set power-up defaults for your monitor so that these entries stay
in memory for 5, 15, or 30 mins., or 1, 4, 8, or 24 hours after you shut off the monitor (this
feature can also be turned OFF). This “power down memory” is factory set to 15 minutes. If you
need to change this factory default, please consult service personnel.
“Episodic” VS Entries
Episodic entries are defined as vital sign measurements that are not continuously monitored,
including NIBP and predictive SureTemp. Prism and Prism SE monitors include a VALID TIME
setting in power-up defaults that defines how long episodic measurement numerics display onscreen. The factory default for this valid time is 15 minutes. This setting should only be changed
by service personnel.
Episodic entries can initiate VSC entries if these functions are turned on in the VSC setup menu.
Additionally, episodic measurements that are on-screen (i.e. within the valid time) will post once
to the VS chart when entries are initiated by automatic VSC entry options.
NOTE: Episodic measurements will not post to a VS chart more than
once for all automatic entries, even if they are displayed and within
the Valid Time. There is one exception to this rule: the STORE VS key
will capture ALL measurements displayed on the monitor at a given
time, regardless of their continuous or episodic nature.
Clearing Patient Data from VSC (Vital Sign Chart)
Prism and Prism SE monitors allow power down memory for retention of vital signs/trends and
can be cleared by user. This timeframe is configured as a default setting.
1. Press the SYSTEM SETUP key.
3-26
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
2. Press the CLEAR PT DATA softkey and press YES softkey.
3. Press the PAGE HOME key.
Oxycardiorespirogram (OxyCRG/CRG)
OxyCRG is an optional trend that allows display of compressed respiration waveform (1mm/sec)
correlated with trend data derived from heart rate and SpO2 over most recent two minutes of
monitoring. ECG, Respiration, and SpO2 must be actively monitored for proper monitoring of
OxyCRG. OxyCRG can be temporarily or continually displayed (Trace 2 only).
To temporarily display OxyCRG:
1. Monitor ECG, Respiration, and SpO2.
2. Press the SYSTEM SETUP key.
CLEAR
DATA
PT
STOREVSDISP
VSCPTSETUP
AUTO
3. Press the MORE softkey to display the following menu.
ADULT
PED
NEO
VOL
DISP
OCRG
REC
SETUP
TIMER CLOCKMORE
4. Press the DISP OCRG to display OxyCRG.
3-27
HR
ECG
TRACE
SEL
MORE
5. To remove temporary display, press the PAGE HOME key.
To display OxyCRG in Trace 2:
1. Monitor ECG, Respiration, and SpO2.
2. Press the SYSTEM SETUP key.
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
3. Press the TRACE SEL softkey to display the following menu.
DISP
VSC
DISP
OCRG
TRACE
CRG
TRACE
2
AUTO
TRACE
3
4
AUTO
MORE
4. Press TRACE 2 until CRG is highlighted.
5. Press the PAGE HOME key. OxyCRG information will display in TRACE 2.
To access CRG setup page and available functions:
1. Press softkey next to the CRG label. Available functions are:
SCALE ON softkey to activate parameter scales. Data display is 1.75 minutes if scales
are ON.
CLEAR DATA softkey to clear all stored events from memory.
EVNT SCROL softkey to scroll through stored low alarm events. EVENT 01 is the most
recent.
To record displayed event:
1. Press the RECORD key and within two seconds press softkey next to CRG label. Displayed
EVENT will be recorded to bedside recorder.
3-28
Alarms
Alarm ON/OFF status and limits can be set from individual parameter menus or from ALARM
SETUP page. Do not temporarily silence or disable audible alarm if patient safety would be
compromised. During alarm, bell next to parameter will flash.
To temporarily suspend patient alarms:
1. ALARMS IN CURRENT VIOLATION – Press the ALARM SUSPEND key to temporarily
silence any alarm in violation. Note screen message says ALARM SILENCED. Alarms are
silenced until silence interval on screen has elapsed OR until the alarm in violation falls
within alarm settings.
2. NO CURRENT ALARM VIOLATION – Press the ALARM SUSPEND key to temporarily
suspend all alarms. Note screen message says ALARM SUSPEND and suspend interval on
screen.
3. Alarms can be enabled again by pressing the ALARM SUSPEND key, or by waiting until
the alarm suspend interval has elapsed.
To change alarm ON/OFF status using parameter menu:
1. Press the softkey next to the parameter label.
2. Press the ALM ON/OFF softkey to highlight desired status.
3. Press the PAGE HOME key.
To change alarm limits using parameter menu:
1. Press the softkey next to the parameter label.
2. Press the ALM LIM softkey to access alarm limits menu and adjust accordingly.
To change alarm ON/OFF status and limits using alarm setup page:
1. Press the ALARM SETUP key.
NEXT
NEXT
NEXT
ADJ
ADJ
2. Press the NEXT softkey to select alarm status or limit to be changed.
3. Press the ADJ softkey to alter alarm status or limits.
4. Press the PAGE HOME key.
Alarm settings and limits are user configurable. Alarm criteria can be set for different
environments and patient types. Turn alarms on or off by parameter and specify limits such as
High and Low Heart Rate on Alarm Setup page or from individual parameter menus. Fully
3-29
understand the ramifications of turning alarms off, silencing alarms, suspending alarms, and
resetting alarm criteria from factory defaults. Please read this section carefully.
WARNING: Do not temporarily silence or disable an audible alarm if
patient safety would be compromised. In the event of an adverse
patient condition, the audio alarm will not sound if it has been
temporarily silenced or disabled.
NOTE: During an alarm, bell next to SETUP page will flash, but all
alarm tones are suspended while ALARM SETUP screen is displayed.
Alarm tones are immediately enabled when you exit ALARM SETUP
screen.
Alarm Bells
NOTE: Check alarm limits each time a parameter is used to insure
they are appropriate for patient being monitored.
NOTE: Alarms for some parameters are factory set to default to OFF
setting. This may not be consistent with policies of your institution or
types of patients being monitored by Prism and Prism SE monitors.
If a steady solid bell is displayed, an alarm for associated parameter is turned
ON. Bell will also remain steady during a technical alarm, and an error
message will flash in associated parameter’s waveform display zone. On color
monitor, bell will turn from white to yellow during a technical alarm.
If a bell is displayed with an X through it, alarms for associated parameter are
turned OFF.
3-30
(FLASHING)
y
A solid bell will flash if one or more alarm criteria are violated for associated
parameter, and an alarm message will display in parameter’s message area.
When monitored vital sign has returned within set up alarm limits, or when
alarm is suspended, bell will stop flashing. On color monitor, bell will turn
from white to red when in alarm.
(BLANK)
Alarm Tones
Alarm tone priorities can be assigned to each parameter. Factory defaults are Priority Level 2 for
all parameters. Priority Level Alarms differ in the frequency rate as follows:
Alarm priority levels can be changed on the Alarm Setup page and/or in the deep configuration of
the monitor. It is recommended that you have service personnel perform any factory default/deep
configuration functions, or consult the service manual.
Latch Alarms
The latch alarms function can be enabled in the deep configuration of the monitor. Factory
default is OFF. It is recommended that you have service personnel perform any factory
default/deep configuration functions, or consult the service manual. The alarm will remain
latched after the limit is no longer violated and until manually cleared by the operator by pressing
any key on the monitor.
If there is no bell displayed, associated parameter is not enabled.
The tone, alarm LED, softkey page, output(s), and status to the transponder will continue as if the
limit is still in violation. The alarm page will no longer automatically return to the home page.
The current alarm page is latched on the display. The recorder will stop recording the event (as it
currently does) when the alarm condition disappears. Other alarms will not be recorded while the
last alarm is latched. Other alarms will cause that parameters alarm bell to flash. It will continue
to flash until the latch is cleared.
Recorder
The recorder is an option for the Prism and Prism SE monitors.
Manual recordings:
1. For ECG, press the RECORD key to initiate a 16 second strip.
2. For other parameters, press the RECORD key, and within two seconds press softkey next to
vital sign label.
Dual parameter recordings:
1. Press the RECORD key followed by softkeys next to each of selected parameters within two
seconds.
3-31
Continuous recordings:
1. For ECG, press and hold the RECORD key for approximately three seconds.
2. For all other parameters, press the RECORD key followed by pressing softkey next to
selected parameter for approximately three seconds.
To stop a recording in progress:
1. Press the RECORD key to stop current recording.
To install or remove the dual channel recorder module: (Prism only)
1. Align recorder module so recorder door is facing you, door release is at top, and edges of
module line up with edges of monitor’s housing.
2. Push recorder module straight into monitor until securely in place and it cannot be removed
unless release tab is pressed again.
3. To remove, press recorder release tab inward while pulling recorder module out. See the
“Prism Rear Panel” section for location of recorder release tab.
NOTE: Prism SE recorder is not removable by user.
Manually marking events on recordings:
1. Press the SYSTEM SETUP key.
3-32
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
2. Press the MORE softkey to display the following menu.
SEL
MORE
ADULT
PED
NEO
VOL
DISP
OCRG
REC
SETUP
TIMER CLOCKMORE
3. Press the REC SETUP softkey to access the Recorder Setup page.
REC
ON
OFF
DELAY
ON
OFF
TRACE
SNGL
DUAL
MARK
EVENT
MORE
4. Press MARK EVENT to access the event marker softkeys.
MARK
EVENT
E1
MARK
EVENT
E2
MARK
EVENT
E3
MARK
EVENT
E4
MARK
EVENTE5MORE
5. Begin your recording, then press any of the event marker softkeys (E1-E5) during the
recording at the point where you want the marker to be printed.
Load new roll of paper:
3-33
1. Press the door release to open recorder.
2. Remove the empty spool.
3. Install new roll with paper unrolling from bottom side.
4. Pull out five (5) inches (12.7 cm) of paper.
5. Close the recorder door.
6. Tear excess paper using downward motion.
3-34
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3-35
Chapter 4 – Additional User Information
Wireless Communication to a Central Station
The Prism and Prism SE monitors have the capability to send vital sign data and waveforms
wirelessly to ESCORT-Link and ESCORT Vision central stations via modular transponders
(900 MHz - MDE part #20011 or 20011V, and 2.4 GHz - MDE part #20019 or 20019V) that
attach to the back of monitor. It is recommended service personnel install this if not already
installed.
NOTE: Transponders (both 900 MHz and 2.4 GHz) should be located
in an open area at least 6.30 inches (16 cm) from any metal objects
which could block or distort transmission or reception of signals.
NOTE: Do not route patient monitoring cables near transponder’s
antenna.
WARNING: Make sure main power to monitor is disconnected from
its AC source before attempting to attach or remove transceiver,
telemetry, or CIS module. Refer all servicing to qualified technical
personnel.
Guidelines for Cleaning
WARNING: To avoid electric shock, unplug AC power cord before
cleaning.
CAUTION: Do not immerse instrument, switches, cables, connectors
or accessories in liquids. Do not use isopropyl alcohol, caustic or
abrasive cleaners, or other solvents that will damage housing. If
disinfectants or alcohol must be used, apply sparingly to nonabrasive
cloth first and gently wipe surfaces taking care not to let pool on
plastic surfaces.
Use following guidelines and considerations when cleaning the Prism or Prism SE monitor:
• Clean monitor, cuffs, and hoses as required per hospital procedures. Only use lint free,
nonabrasive cloth that has been slightly dampened with mild detergent.
• Do not spray or pour liquids directly onto monitor or accessories.
• Do not allow any liquid to come into contact with power connector, fuse holder, or switches.
4-1
Maintenance and Calibration
There are no user-serviceable parts in Prism or Prism SE monitors. MDE recommends a yearly
performance check to verify all functions on the Prism and Prism SE monitors. All maintenance
and calibration should be performed by qualified personnel only. Refer to Chapter 9 in the
ESCORT Prism or ESCORT Prism SE Patient Monitor Service Manual for periodic
maintenance and calibration instructions. If returned to MDE, the Prism/Prism SE must be
shipped in packaging specified by MDE.
Telemetry Monitoring
The Prism and Prism SE monitors have the ability to receive ECG plus other data from wireless
telemetry transmitters. Because the monitor can receive signals from approximately 200 different
remote transmitters, it is necessary to first set up all of the transmitter types and ID’s of any
patients you may wish to monitor. This procedure was most likely done upon installation of the
monitors, but if it was not, or transmitters need to be added or removed, it is recommended that
service personnel perform this function because it requires power-up configuration of each
monitor.
CIS functions
Prism and Prism SE monitors equipped with MDE’s CIS Module can share patient data with a
CIS (Clinical Information System). In order to accomplish this, the monitor must be set up with
the patient’s name and ID to match patient data with the correct patient record in the CIS. If your
monitor is not equipped with a CIS Module, you can use this function to display the patient’s
name/ID at the center/top of the screen. The information entered will also print in the tabular area
of a recording strip. Refer to the Clinical Information System section later in this manual.
Storage and Transport
Storage and transport specifications are:
Temperature = -10° C to 40° C
Humidity = 0% to 90%
Pressure = 500 to 1060hpa
4-2
4-3
Chapter 5 – Main Setup Menus
This section describes the main system setup and vital sign menus on the Prism and Prism SE
monitors. The menus are the same for both monitor types.
System Setup Menus
Pressing the System Setup key accesses the following menus:
CLEAR
PT
DATA
STOREVSDISP
VSCPTSETUP
HR
AUTO
ECG
TRACE
SEL
MORE
CLEAR PT DATA—Clears all stored readings (NIBP, Temp) and trended data.
STORE VS—Manually stores a Vital Sign Chart (VSC).
DISP VSC—"Pops up" display of current vital sign chart (VSC).
PT SETUP—Access to patient name and ID, and to Suspend Monitoring key.
HR AUTO ECG—Specifies default parameter for heart rate derivation.
TRACE SEL—Selects parameters displayed in Waveform Display Zone.
MORE—Displays the next menu.
ADULT
PED
NEO
VOL
DISP
OCRG
REC
SETUP
TIMER CLOCKMORE
ADULT PED NEO—Selects the patient type with new alarm limits, etc.
VOL—Adjusts the volume of alarm and parameter tones.
DISP OCRG—Pops-up an Oxycardiorespirogram in Trace 2 (if installed).
REC SETUP—Changes settings for general recording functions.
TIMER—Sets up/displays elapsed time or current time of day.
CLOCK—Sets the system date and time.
MORE—Displays the next menu.
CONFTRENDTEST
CONF—Accesses monitor configurations and power-up defaults.
TREND—Sets up/displays graph of trended vital sign data.
TEST—Displays system test screens for service personnel.
5-1
ECG Setup Menus
ECG function menus are accessed by pressing the softkey adjacent to the ECG label. The menus
are as follows:
ALM
ON
OFF
ALM
LIM
SIZE
LEAD
SEL
PACE
ON
OFF
MORE
ALM ON OFF—Toggles ECG alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
SIZE—Accesses menu to increase/decrease ECG size.
LEAD SEL—Accesses menu to select ECG cable (3/5) and ECG lead (I, II, III, V).
PACE ON OFF—Turn on to reject and flag pacer artifact.
MORE—Displays next menu.
TONE
ON
OFF
FILT
ON
OFF
MM/S
25
12.5
WF
ON
OFF
MORE
TONE ON OFF—Toggles QRS tone ON or OFF.
FILT ON OF—Toggles ECG filtering between norm. (ON) and diag.(OFF) modes.
MM/S 25/12.5—Selects ECG sweep speed.
WF ON OFF—Turns ECG Waveform display ON or OFF.
MORE—Displays next menu (the following menu is only available if the Telemetry option is
installed).
TLM
ID
↑↑
TLM
ID
↓↓
MODE
CABLE
TLM
TLM ID ↑↑—Selects the next higher telemetry transmitter for monitoring.
TLM ID ↓↓—Selects the next lower telemetry transmitter for monitoring.
MODE CABLE TLM—Selects ECG source from the monitor or telemetry receiver.
Respiration Setup Menus
Respiration function menus are accessed by pressing the softkey adjacent to the RESP label. The
menus are as follows:
ALM
ON
OFF
ALM
LIM
SIZE
ALM ON OFF—Toggles RESP alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
SIZE—Accesses menu to increase/decrease RESP waveform size.
MM/S 12.5/25—Selects RESP sweep speed.
MM/S
25
12.5
RR
AUTO
LEADS
APNEA
DELAY
20S
MORE
5-2
RR AUTO LEADS—Selects RESP source, ECG leads, CO2, or AUTO detect.
APNEA DELAY 20S—Selects allowable apnea period before alarming.
MORE—Displays the next menu.
TONE
ON
OFF
CVA
ON
OFF
RESP
ON
OFF
TONE ON OFF—Toggles RESP tone ON or OFF.
CVA ON OFF—Toggles cardiovascular artifact detection ON or OFF.
RESP ON OFF—Turns RESP monitoring ON or OFF.
Pulse Oximetry (SPO2) Setup Menus
SPO2 function menus are accessed by pressing the softkey adjacent to the SPO2 label. The menus
are as follows:
ALM
ON
OFF
ALM
LIM
ALM ON OFF—Toggles SPO2 alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
ALM DELAY—Selects SPO2 delay time.
MODE—Selects SPO2 averaging time (not used for Nellcor MP405).
LOCK ON OFF—Toggles ECG Sychronization (C-LOCK) ON or OFF (Nellcor only).
ALM
DELAY
5
MODE
NORM
FAST
LOCK
ON
OFF
MORE
MORE—Displays the next menu.
WF
ON
OFF
TONE
ON
OFF
SPO2
ON
OFF
WF ON OFF—Turns waveform ON or OFF in Waveform Display Zone.
TONE ON OFF—Toggles saturation tone ON or OFF.
SPO2 ON OFF—Turns SPO2 monitoring ON or OFF.
Invasive Blood Pressure (IBP) Setup Menus
Invasive Blood Pressure function menus are accessed by pressing the softkey adjacent to the BP1,
BP2, BP3, or IBP label. The menus are as follows:
ALM
ON
OFF
ALM
LIM
SIZE/
SCALE
ALM ON OFF—Toggles alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
SIZE/SCALE—Accesses menu to increase/decrease waveform size.
SITE
OFF
ART
ZERO
ALL
ZERO
BP1
MORE
5-3
SITE OFF ART—Adds label next to numeric to identify IBP sites.
ZERO ALL—Zeroes all connected transducers.
ZERO BP1—Zeroes the transducer offset.
MORE—Displays the next menu.
SMD
S/D
MEAN
CAL
BP1
ON
OFF
SMD S/D MEAN—Selects numeric display format.
CAL—Simulates a 100/50 mmHg square wave (hold for 5-10 sec.).
BP1 ON OFF—Turns BP monitoring ON or OFF.
Noninvasive Blood Pressure (NIBP) Setup Menus
Noninvasive Blood Pressure function menus are accessed by pressing the softkey adjacent to the
NIBP label. The menus are as follows:
ALM
ON
OFF
STARTSTOP
ALM ON OFF—Toggles NIBP alarms ON or OFF.
START—Initiates an NIBP measurement.
STOP—Stops an NIBP measurement in progress.
4MIN/5MIN/10MIN—Selects automatic reading interval.
5MIN AUTO ON—Turns AUTO mode ON/OFF and displays current selected interval.
4MIN
5MIN
10MIN
5MIN
AUTO
ON
PROGMORE
PROG—To program an NIBP sequence.
MORE—Displays the next menu.
ALM
ON
OFF
ALM
LIM
1ST
INFL
170
SMD
S/D
MEAN
SITE
OFF
LIST
NIBP
TABLE
MORE
ALM ON OFF—Toggles NIBP alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
1ST INFL 170—Sets default first inflation pressure (mmHg).
SMD S/D MEAN—Sets NIBP numeric display format.
SITE OFF LIST—Adds label next to numeric to identify NIBP site.
NIBP TABLE—Displays NIBP table.
MORE—Displays the next menu.
NIBP
ON
OFF
5-4
NIBP ON OFF—Press the NIBP softkey to turn ON or OFF.
Continuous Temperature Setup Menus
Continuous Temperature menus may be accessed by pressing the softkey adjacent to either of the
Temp labels (TMP1, TMP2). Note that these menus are different for SureTemp (shown later):
ALM
ON
OFF
ALM
LIM
UNIT
°C
°F
MORE
ALM ON OFF—Toggles Temp alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
UNIT °C / °F—Switches between °C and °F for temperature measurement.
MORE—Displays the next menu.
TMP
ON
OFF
TMP ON OFF—Turns Temp monitoring ON or OFF.
SureTemp Menu
If SureTemp is installed, SureTemp menu may be accessed by pressing the softkey adjacent to the
TMP1 label. The menu is as follows:
MODE
NORM
MONTR
SITE
ORAL
AXIL
UNIT
°C
°F
MORE
MODE NORM MONTR—Toggles between predictive and monitored measurements.
SITE ORAL AXIL—Selects oral or axillary measurement site (or rectal for rectal probe).
UNIT °C / °F—Switches between °C and °F for temperature measurement.
MORE—Displays the next menu.
TMP1
ON
OFF
TMP1 ON OFF—Turns Temp monitoring ON or OFF.
End Tidal Carbon Dioxide (ETCO2) Setup Menus
ETCO2 menus may be accessed by pressing the softkey adjacent to the CO2 label. The menus are
as follows:
5-5
ALM
ON
OFF
ALM
LIM
SCALE
50
75
MM/S
12.5
6.25
CO2
ON
OFF
MORE
ALM ON OFF—Toggles CO2 alarms ON or OFF.
ALM LIM—Accesses alarm limits menu.
SCALE 50/75—Selects CO2 waveform scale (50, 75, 100 mmHg).
MM/S 12.5/6.25—Selects CO2 sweep speed.
CO2 ON OFF—Turns CO2 monitoring OFF (alarms must be disabled).
MORE—Displays the next menu.
UNIT
%
mmHg
O2
ON
OFF
N2O
ON
OFF
UNIT % / mmHg—Toggles measurement units (% or mmHg).
O2 ON OFF—Toggles O2 compensation ON or OFF (Prism only).
NO2 ON OFF—Toggles N2O compensation ON or OFF (Prism only).
Cardiac Output Setup Menus
CO menus may be accessed by pressing the softkey adjacent to the CO label. The menus are as
follows:
COMP
CONST
.470
STARTAVG
COMP CONST .470—Adjusts computational constant for catheter and injectate volume.
START—Starts cardiac output measurement run.
AVE—Calculates average of CO, REF, and derived parameter.
VIEW RUN—Allows you to cycle through runs prior to averaging.
DEL RUN—Allows deletion of unwanted runs prior to averaging.
VIEW
RUN
1
DEL
RUN
1
ENTER
HT
WT
MORE
ENTER HT WT—Allows entry of patient height/weight.
MORE—Displays the next menu.
CONST
↑
.470
CONST
.470
↑
CONST
.470
↑
MORE
5-6
CONST .470 (ARROW ON 4)—Use to change the tenths column of the constant.
CONST .470 (ARROW ON 7)—Use to change the hundredths column of the constant.
CONST .470 (ARROW ON 0)—Use to change the thousandths column of the constant.
MORE—Displays the previous menu
Vital Sign Chart (VSC) Setup Menus
VSC menus are accessed by pressing the softkey adjacent to the VSC label. The menus are as
follows:
VSC
SETUP
STOREVSTABLE
→→
TABLE
↑↑
TABLE
↓↓
TEXT
SIZE
MORE
VSC SETUP—Accesses setup options for events that trigger entries.
STORE VS—Manually stores a VSC entry including all VS data on-screen.
TABLE →→—Scrolls to the right to show additional data, if available.
TABLE ↑↑—Scrolls up to show additional data, if available.
TABLE ↓↓—Scrolls down to show additional data, if available.
TEXT SIZE—Decreases/enlarges the VSC table approx. 50%.
MORE—Displays the next menu.
CLEAR
VSC
TABLE
DEL
VSC
ENTRY
MORE
CLEAR VSC TABLE—Clears all VSC data currently stored in memory.
DEL VSC ENTRY—Allows selective deletion of individual VSC entries.
MORE—Returns to the first VSC Setup menu.
5-7
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5-8
Chapter 6 – Factory Defaults
When the Prism & Prism SE monitor is powered on for the first time, it will be in the Neonatal
mode, and all parameters will be set to their factory defaults.
Each parameter has defaults for adult, pediatric, and neonatal modes (ADULT, PED, NEO). All
parameter and system defaults can be user-configured.
It is important to recognize that changes made to these functions determine the status of those
functions upon every subsequent power-up. As a result, default settings should not be changed
unless the setting will be desired on a regular basis.
It is recommended that you have service personnel perform any factory default/deep
configuration functions.
System Setup Factory Defaults
SYSTEM SETUPADULTPEDNEODESCRIPTION
FACTORY DEFAULTSNONONOTo restore all settings to factory defaults
PWR DN MEMORY15MIN15MIN15MINSelected time for saving VSC settings
ALRM VOLUME777Alarm tone volume setting (1-8)
ALM VOL MIN111
TONE VOLUME444Key tone setting
TRACE 2AUTOAUTOAUTOWaveform or feature for second trace
TRACE 3AUTOAUTOAUTOWaveform or feature for third trace
TRACE 4AUTOAUTOAUTOWaveform or feature for fourth trace
HR SOURCEAUTOAUTOAUTOHeart rate source, ECG, SPO2, BP’s
ALM SUSPND1809060Alarm suspend time
PRAM LABELSBLANKBLANKBLANKTo blank parameters when off
CLOCK DISPLYOFFOFFOFFTime displayed on screen
CABLE / TELMCABLECABLECABLEECG mode - telemetry or cable
REMOTE RECDOFFOFFOFFTelemetry recording
ALARM FLASHONONONFlashing alarm LED
LANGUAGEENGLENGLENGL
LINE FREQ60HZ60HZ60HZ50Hz or 60Hz input line frequency
PATIENT TYPEALLALLALLADULT, PED, NEO, or ALL
ALARM CNTRLONONON
Sets minimum allowable alarm tone
volume setting (1-8)
Sets language (English, French,
German, Spanish, Swedish, or Italian)
When default is set to ON, allows
enabled alarms to be turned OFF
STORE AUTOOFFOFFOFFAuto stores at selected intervals
STORE NIBPONONONStoring NIBP values
STORE TMPONONONStoring Temperature values
STORE COONONONStoring Cardiac Output values
VALID TIME303030
STORE ALARMOFFOFFOFFStoring alarm violations
ALARMSONONONEnables ECG alarms
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the ECG alarms until reset
HIGH LIMIT140180200High alarm limit setting
LOW LIMIT5080100Low alarm limit setting
RCD ON ALARMWFWFWFRecord when ECG alarm enabled
FILTERONONONECG filter enable
SIZE VCTR 1 1.000.800.803 lead select size
SIZE VCTR 21.000.800.805 lead select size
SWEEP SPEED252525Waveform speed
PACE DETECTOFFOFFOFFPacer detection enable
LEAD SELECTIIIIIILead select I, II, III, or V
5 LEADOFFOFFOFF5 lead mode enable
QRS TONEOFFOFFOFFQRS detect tone
WAVEFORM ONONONONECG waveform enable
PRAM COLORGREENGREENGREENSets on-screen color of parameter
LATCH ALARMSOFFOFFOFF
HIGH LIMITOFFOFFOFFHigh alarm limit setting
LOW LIMIT555Low alarm limit setting
PRAM AVAILONONONRespiration enable or disable
PRAM ON/OFFOFFOFFOFFRespiration standby
RCD ON ALARMWFWFWFRecord when Resp alarm enabled
RESP SIZE1.000.770.57Respiration waveform size
SWEEP SPEED12.512.512.5Respiration waveform speed
APNEA DELAY202020Time delay for apnea alarm
APNEA ALM LVL222Sets alarm priority level (1, 2, or 3)
CVAONONONArtifact detection
TONEOFFOFFOFFRespiration Rate tone
CRG SCALESONONONOXYCRG scales enable
PRAM COLORCYANCYANCYANSets on-screen color of parameter
ADULTPEDNEODESCRIPTION
Latches the Respiration alarms until
reset
6-3
SPO2 Setup Factory Defaults
SPO2 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFONONEnables SPO2 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
ALARM DELAY555Delay time for alarm
LATCH ALARMSOFFOFFOFFLatches the SPO2 alarm until reset
ALARM TONESTDSTDSTDTone during alarm
HIGH LIMIT10010095High alarm limit setting
LOW LIMIT858580Low alarm limit setting
PRAM AVAILONONONSPO2 enable or disable
PRAM ON / OFFOFFOFFOFFSPO2 standby
RCD ON ALARMVSVSVSRecord when SPO2 alarm enabled
TONEOFFOFFOFFTone enable for SPO2
TONE RANGEWIDEWIDEWIDESPO2 tone frequency range
MODENORMNORMNORMSPO2 averaging time
C-LOCKOFFOFFOFFECG synchronization
WAVEFORM ONONONONSPO2 waveform enable
PRAM COLORPURPLPURPLPURPLSets on-screen color of parameter
6-4
BP1 Setup Factory Defaults
BP1 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables BP1 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the BP1 alarm until reset
SYS HI LIMIT170130100Systolic high alarm limit setting
SYS LO LIMIT906550Systolic low alarm limit setting
DIA HI LIMIT1009070Diastolic high alarm limit setting
DIA LO LIMIT504030Diastolic low alarm limit setting
MN HI LIMIT12010080Mean high alarm limit setting
MN LO LIMIT605035Mean low alarm limit setting
PRAM AVAILONONONBP1 enable or disable
PRAM ON / OFFOFFOFFOFFBP1 standby
RCD ON ALARMWFWFWFRecord when BP1 alarm enabled
SIZE120120120BP1 waveform size
SCALEOFFOFFOFFBP1 scale enable
DISPD VALUESS/DS/DS/DBP1 numeric display format
SITEOFFOFFOFFBP1 catheter site
PRAM COLORREDREDREDSets on-screen color of parameter
6-5
BP2 Setup Factory Defaults
BP2 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables BP2 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the BP2 alarm until reset
SYS HI LIMIT504020Systolic high alarm limit setting
SYS LO LIMIT2055Systolic low alarm limit setting
DIA HI LIMIT251510Diastolic high alarm limit setting
DIA LO LIMIT50000Diastolic low alarm limit setting
MN HI LIMIT302515Mean high alarm limit setting
MN LO LIMIT1055Mean low alarm limit setting
PRAM AVAILONONONBP2 enable or disable
PRAM ON / OFFOFFOFFOFFBP2 standby
RCD ON ALARMWFWFWFRecord when BP2 alarm enabled
SIZE303030BP2 waveform size
SCALEOFFOFFOFFBP2 scale enable
DISPD VALUESS/DS/DMEANBP2 numeric display format
SITEOFFOFFOFFBP2 catheter site
PRAM COLORYELLWYELLWYELLWSets on-screen color of parameter
6-6
BP3 Setup Factory Defaults
BP3 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables BP3 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the BP3 alarm until reset
SYS HI LIMIT252525Systolic high alarm limit setting
SYS LO LIMIT555Systolic low alarm limit setting
DIA HI LIMIT555Diastolic high alarm limit setting
DIA LO LIMIT000000Diastolic low alarm limit setting
MN HI LIMIT555Mean high alarm limit setting
MN LO LIMIT000000Mean low alarm limit setting
PRAM AVAILONONONBP3 enable or disable
PRAM ON / OFFOFFOFFOFFBP3 standby
RCD ON ALARMWFWFWFRecord when BP3 alarm enabled
SIZE303030BP3 waveform size
SCALEOFFOFFOFFBP3 scale enable
DISPD VALUESMEANMEANMEANBP3 numeric display format
SITEOFFOFFOFFBP3 catheter site
PRAM COLORLTBLULTBLULTBLUSets on-screen color of parameter
6-7
NIBP Setup Factory Defaults
NIBP SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables NIBP alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the NIBP alarm until reset
SYS HI LIMIT170130100Systolic high alarm limit setting
SYS LO LIMIT906550Systolic low alarm limit setting
DIA HI LIMIT1009070Diastolic high alarm limit setting
DIA LO LIMIT504030Diastolic low alarm limit setting
MN HI LIMIT12010080Mean high alarm limit setting
MN LO LIMIT605035Mean low alarm limit setting
PRAM AVAILONONONNIBP enable or disable
PRAM ON/OFFONONONNIBP standby
RCD ON ALARMVSVSVSRecord when NIBP alarm enabled
AUTOOFFOFFOFFAutomatic mode enable
INTERVAL5MIN5MIN5MINAutomatic reading interval
1ST INFLATE17014090First inflation pressure
TABLE DSPLYOFFOFFOFFEnables NIBP table display
DISPD VALUESS/DS/DS/DNIBP numeric disply format
TONEONONONEnables end value tone
SITEOFFOFFOFFNIBP cuff site
PRAM COLORORNGEORNGEORNGESets on-screen color of parameter
6-8
CO2 Setup Factory Defaults
CO2 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables CO2 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the CO2 alarm until reset
HIGH LIMIT505050High alarm limit setting
LOW LIMIT252525Low alarm limit setting
ICO2 LIMIT888Inspired CO2 alarm limit setting
PRAM AVAILONONONCO2 enable or disable
PRAM ON/OFFOFFOFFOFFCO2 standby
RCD ON ALARMWFWFWFRecord when CO2 alarm enabled
SCALE505050CO2 waveform scale size
UNITSmmHgmmHgmmHgMeasurement units % or mmHg
O2 COMPNSATOFFOFFOFFO2 compensation enable
N2O COMPNSATOFFOFFOFFN2O compensation enable
PRAM COLORCYANCYANCYANSets on-screen color of parameter
CO Setup Factory Defaults
CO SETUPADULTPEDNEODESCRIPTION
PRAM AVAILONONONCardiac output enable or disable
CONSTANT.470.470.470
PRAM ON/OFFOFFOFFOFFCardiac output standby
REF ON/OFFONONON
DISP TIMEOUT555Displayed time for CO measurement
UNITSIN/LBIN/LBIN/LBInches/pounds or centimeters/kilograms
PRAM COLORPINKPINKPINKSets on-screen color of parameter
Adjusts computational constant for
catheter and injectate volume
Right ejection fraction measurement
enable
6-9
Temp1 Setup Factory Defaults
TEMP1 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnables Temp1 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the Temp1 alarm until reset
UNITS
ο
C
ο
C
ο
C
Celsius or Fahrenheit
HIGH LIMIT38.038.037.5High alarm limit setting
LOW LIMIT36.036.036.0Low alarm limit setting
PRAM AVAILONONONTemp1 enable or disable
PRAM ON/OFFOFFOFFOFFTemp1 standby
TONEONONONMeasurement update tone enable
PRAM COLORWHITEWHITEWHITESets on-screen color of parameter
Temp2 Setup Factory Defaults
TEMP2 SETUPADULTPEDNEODESCRIPTION
ALARMSOFFOFFOFFEnable Temp2 alarm
ALARM LEVEL222Sets alarm priority level (1, 2, or 3)
LATCH ALARMSOFFOFFOFFLatches the Temp2 alarm until reset
HIGH LIMIT38.038.037.5High alarm limit setting
LOW LIMIT36.036.036.0Low alarm limit setting
PRAM AVAILONONONTemp2 enable or disable
PRAM ON/OFFOFFOFFOFFTemp2 standby
PRAM COLORGRAYGRAYGRAYSets on-screen color of parameter
6-10
Chapter 7 – System & Parameter Messages
System and parameter messages remind, prompt, or warn you about the current condition of the
monitor or its parameters. These messages are displayed in reverse video and may flash on and
off to get your attention.
System Messages
The system messages, explained in the following tables, are displayed in a reverse-video box, just
below the WDZ. They apply to conditions of the monitor that are not specific to any one
parameter. See the “System Message Area” section for more information.
System Messages
SYSTEM MESSAGEMEANING
RECORDER PAPERThe recorder is out of paper, or the paper is not installed
correctly.
REC DISABLE FREEZEYou are trying to freeze waveforms while recording is in
progress. You can only freeze waveforms when they are not
being recorded.
REC IN CONT RUN MODEIndicates that you have pressed and held the RECORD key so
that the recorder will run continuously. Press RECORD again to
end continuous recording.
FREZ RELEASE FREZWaveforms are currently frozen. To release the frozen
waveforms, you must press either the FREEZE or the RECORD
key.
LINK RECORD SENTA record has been sent to the Central Station because the recorder
at PRISM monitor is either not present or out of paper.
ALARM SUSPEND XXXYou have pressed the ALARM SUSPEND key, disabling all
alarm tones for the number of seconds (XXX) displayed. To
enable alarm tones before the suspend time has expired, press the
ALARM SUSPEND key again. The ALARM SUSPEND
function is also enabled at power-up.
7-1
Battery Messages
MONITOR BAT HI> 60% Charge
MONITOR BAT MID20-60% Charge
MONITOR BAT LOW< 20% Charge
MESSAGEBATTERY LEVEL
BATTERY VERY LOW
(Intermittent Alarm Tone Sounds)
Approximately 10 minutes of battery life remains
Parameter Messages
The following tables explain messages that are parameter specific. Messages concerning
parameters displayed in the WDZ will be displayed in a video box below the numeric data for the
corresponding waveform parameters. The message is displayed as long as the message condition
exists. All messages that apply to parameters in the numeric-only zone are displayed in the
numeric display area.
ECG/Respiration Messages
ECG/RESP MESSAGEMEANING
CVACardiovascular artifact (CVA) coincidence has been detected on
respiration. Respiration will reject coincident respiration while
the message is displayed. At least 8 out of 10 coincident
respirations are required to initiate and maintain the CVA
message.
APNEAThe apnea alarm limits have been exceeded.
APN ALM OFFRespiration alarms are ON, but apnea alarm is OFF.
CHK LEADSOne or more electrodes or lead wires may be dry or loose. In
addition to the message, the ECG waveform and respiration
waveform, if it is displayed, become dotted lines.
7-2
SPO2 Messages
SPO2 MESSAGEMEANING
SPO2 SRCH
(Nellcor only)
NO C-LOCK
(Nellcor only)
NO SENSORThe SPO2 parameter is ON, but the sensor and/or sensor cable
SPO2 CALThe monitor is performing automatic self-calibration. The
Invasive Blood Pressure (BP1/BP2/BP3) Messages
BP1/BP2/BP3 MESSAGEMEANING
NO XDUCERThe pressure transducer is not connected to the monitor.
ZERO BP1
ZERO BP2
ZERO BP3
The monitor cannot locate the patient’s pulse. The patient’s
perfusion may be too poor to detect an acceptable pulse. Confirm
proper application of the sensor; make sure the ECG parameter is
available for C-LOCK synchronization; try another sensor site; or
try the OXISENSOR II R-15 sensor.
Indicates loss of synchronization between the ECG and SPO2
pulse waveform. Take steps to eliminate ECG artifact, or if the R-
wave amplitude is less than 4 mm, increase the ECG waveform
size by using the ECG SIZE softkey.
is/are not connected to the monitor.
calibration range is 50 to 100%.
Message flashes until the pressure channel is zeroed as a
reminder that pressures must be zeroed prior to use.
NO ZERO: PULSE DETECTDisplayed over the BP SETUP page to indicate that either a pulse
or electrical noise was detected, which precluded zeroing the
transducer. Confirm that the transducer is vented to air before
pressing the ZERO key.
ZERO OUT OF RANGEDisplayed over the BP SETUP page to indicate that a
transducer’s offset exceeds the zero range (±100 mmHg) of the
monitor. Confirm that the transducer is vented to the air and
attempt to zero again.
7-3
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