MDE Escort User manual

ESCORT Prism™ & Prism SE

Patient Monitor

Reference Manual

Prism Model	Prism SE Model
20401	20411
20403	20412
	20413
	20414

ESCORT Prism™ & Prism SE

Patient Monitor

Reference Manual

Prism Model	Prism SE Model
20401	20411
20403	20412
	20413
	20414

Federal law restricts this device to sale by or on the order of a physician.

E9030-33R Rev F

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 or implied, 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:

Technical Service	Tel:	(818) 768-6411
Technical Service	FAX:	(818) 768-2899
Email	technicalsupport@emailmde.com

Trademarks and Acknowledgments

ESCORT® and the MDE logo are registered trademarks of MDE. ESCORT GuardianTM, and ESCORT PrismTM are trademarks of MDE. MASIMO® is a registered trademark of Masimo Corp.

C-Lock® and NELLCOR® are registered trademarks of Nellcor, Inc. SureTemp® is a registered trademark of Welch AllynTM Inc. Medico2 is a trademark of Oridion Systems Ltd.

Mircrostream® and FilterLine® are registered trademarks of Oridion Systems Ltd.

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.

Single patient use only.

Table of Contents

Chapter 1 – Physical Description...........................................................................................................	1-1
Prism & Prism SE Front Panel .....................................................................................................	1-1
Fixed Function Keys (USA and International).............................................................................	1-2
ON/STBY ..............................................................................................................................	1-2
ALARM SUSPEND ..............................................................................................................	1-2
ALARM SETUP....................................................................................................................	1-3
FREEZE.................................................................................................................................	1-3
NIBP START/STOP..............................................................................................................	1-3
PATIENT TYPE....................................................................................................................	1-3
SYSTEM SETUP ..................................................................................................................	1-3
PAGE HOME ........................................................................................................................	1-3
RECORD ...............................................................................................................................	1-4
Parameter Softkeys.......................................................................................................................	1-4
WAVEFORM SOFTKEYS ...................................................................................................	1-4
SYSTEM SOFTKEYS...........................................................................................................	1-4
Indicators......................................................................................................................................	1-5
AC ON INDICATOR ............................................................................................................	1-5
BATTERY CHARGING INDICATOR ................................................................................	1-5
ALARM INDICATORS........................................................................................................	1-5
Prism & Prism SE Display Screen ...............................................................................................	1-6
ECG Lead in Use ...................................................................................................................	1-7
Softkey Labels for Parameters Displayed in the Waveform Display Zone (WDZ)...............	1-7
Alarm Status for Parameters in the Waveform Display Zone................................................	1-7
Alarm Status for Parameters in the NODZ ............................................................................	1-7
Numeric-Only Display Zone (NODZ)...................................................................................	1-7
Message Area for Parameters in the NODZ ..........................................................................	1-7
System Message Area ............................................................................................................	1-8
Message Area for Parameters in the WDZ ............................................................................	1-8
Waveform Display Zone with Associated Numerics.............................................................	1-8
Current Monitoring Mode (Patient Type selected)................................................................	1-8
Prism SE Rear Panel.....................................................................................................................	1-9
External DC Input (12 - 28V) Connector ............................................................................	1-10
Fuse Holder and Fuse Replacement.....................................................................................	1-10
AC Power Cord Input Connector and Optional Power Cord Mounting Bracket.................	1-10
Battery Compartment...........................................................................................................	1-11
Model & Serial Number Label.............................................................................................	1-11
Add-On Module Interface....................................................................................................	1-11
Auxiliary Output Connector ................................................................................................	1-11
VGA Output Connector .......................................................................................................	1-11
Serial Interface (ISP Port)....................................................................................................	1-11
Equipotential Connector (Grounding Terminal)..................................................................	1-11
Prism Rear Panel ........................................................................................................................	1-12
External DC Input (12 - 28V) Connector ............................................................................	1-13
Equipotential Connector (Grounding Terminal)..................................................................	1-13
Batteries ...............................................................................................................................	1-13
Defibrillator/Pacer Interface ................................................................................................	1-13
Fuse Holder/Voltage Selector and Fuse Replacement .........................................................	1-13

AC Power Cord Input Connector and Optional Power Cord Mounting Bracket.................	1-13
Auxiliary Output Connector ................................................................................................	1-14
Add-On Module Interface....................................................................................................	1-14
Recorder Release Lever .......................................................................................................	1-14
Model & Serial Number Label.............................................................................................	1-14
Prism SE Side Panel ...................................................................................................................	1-15
Connector Panel...................................................................................................................	1-15
Dual Channel Recorder........................................................................................................	1-15
SureTemp Unit.....................................................................................................................	1-15
Prism Side Panel.........................................................................................................................	1-16
Multiparameter Module .......................................................................................................	1-16
Dual Channel Recorder Module ..........................................................................................	1-16
Serial Interface (ISP Port)....................................................................................................	1-16
VGA Output Connector .......................................................................................................	1-17
Prism’s Modular Components....................................................................................................	1-18
Prism SE’s Modular Components ..............................................................................................	1-19
Chapter 2 – General Instructions for Using the Patient Monitor .......................................................	2-1
Determine the Power Source ........................................................................................................	2-1
Prism’s Modular Batteries............................................................................................................	2-1
Prism SE’s Battery .......................................................................................................................	2-1
Prism’s Multiparameter Module...................................................................................................	2-1
Prism SE’s Connector Panel.........................................................................................................	2-2
Turning Monitor ON and OFF .....................................................................................................	2-2
Vital Sign Setup Menus................................................................................................................	2-2
Temporary Suspension of Monitoring..........................................................................................	2-3
Basic Configuration Functions.....................................................................................................	2-3
Monitor Default Settings ..............................................................................................................	2-5
Setting Up Parameter Display Options.........................................................................................	2-5
Parameter Availability and ON/OFF Status...........................................................................	2-5
Parameter ON/OFF ................................................................................................................	2-5
Parameter Labels ON/BLANK ..............................................................................................	2-5
Parameter Colors and Tones ..................................................................................................	2-5
“MORE PRAMS AVAIL” ....................................................................................................	2-6
Chapter 3 – Vital Sign Parameter Usage...............................................................................................	3-1
ECG..............................................................................................................................................	3-1
Patient Preparation.................................................................................................................	3-2
Selecting a Telemetry Patient to Monitor ..............................................................................	3-4
Correcting CHK Leads (Check Leads) Errors .......................................................................	3-4
Respiration....................................................................................................................................	3-5
Cardiovascular Artifact Detection (CVA) .............................................................................	3-5
Using CO2 as the Resp Source ..............................................................................................	3-5
Pulse Oximetry (SPO2) ................................................................................................................	3-6
SPO2 Sensor Accessories—Nellcor ......................................................................................	3-8
SPO2 Sensor Accessories—Masimo .....................................................................................	3-9
SPO2 Alarm Delay ................................................................................................................	3-9
SPO2 Averaging Time...........................................................................................................	3-9
Temperature Monitoring ............................................................................................................	3-10

Measuring a Patient’s Temperature with Continuous Probes..............................................	3-10
Measuring a Patient’s Temperature with SureTemp®..........................................................	3-10
Noninvasive Blood Pressure Measurements (NIBP)..................................................................	3-11
Selecting an appropriate NIBP Cuff ....................................................................................	3-13
Displaying the NIBP Table..................................................................................................	3-13
Invasive Blood Pressure .............................................................................................................	3-14
Pulmonary Artery Monitoring .............................................................................................	3-15
Storage of Invasive Pressure Values to VSC .......................................................................	3-16
5th Trace Option ...................................................................................................................	3-16
Cardiac Output and Hemodynamic Calculations .......................................................................	3-17
Selecting a Thermodilution Catheter ...................................................................................	3-18
End Tidal Carbon Dioxide (ETCO2) (Prism Only)....................................................................	3-19
ETCO2 (CO2) Sensor and Airway Adapter Maintenance (Prism Only).............................	3-21
End Tidal Carbon Dioxide (ETCO2) (Prism SE Only)..............................................................	3-22
Graphical Trends ........................................................................................................................	3-24
Vital Sign Chart (VSC) ..............................................................................................................	3-24
Storing VS Charts in Monitor Memory ...............................................................................	3-26
“Episodic” VS Entries..........................................................................................................	3-26
Clearing Patient Data from VSC (Vital Sign Chart)............................................................	3-26
Oxycardiorespirogram (OxyCRG/CRG)....................................................................................	3-27
Alarms ........................................................................................................................................	3-28
Alarm Bells ..........................................................................................................................	3-30
Alarm Tones.........................................................................................................................	3-30
Latch Alarms........................................................................................................................	3-31
Recorder .....................................................................................................................................	3-31
Chapter 4 – Additional User Infromation.............................................................................................	4-1
Wireless Communication to a Central Station .............................................................................	4-1
Guidelines for Cleaning................................................................................................................	4-1
Maintenance and Calibration........................................................................................................	4-2
Telemetry Monitoring ..................................................................................................................	4-2
CIS Functions...............................................................................................................................	4-2
Storage and Transport ..................................................................................................................	4-2
Chapter 5 – Main Setup Menus .............................................................................................................	5-1
System Setup Menus ....................................................................................................................	5-1
ECG Setup Menus ........................................................................................................................	5-2
Respiration Setup Menus..............................................................................................................	5-2
Pulse Oximetry (SPO2) Setup Menus ..........................................................................................	5-3
Invasive Blood Pressure (IBP) Setup Menus ...............................................................................	5-3
Noninvasive Blood Pressure (NIBP) Setup Menus......................................................................	5-4
Continuous Temperature Setup Menus ........................................................................................	5-5
SureTemp Menu ...........................................................................................................................	5-5
End Tidal Carbon Dioxide (ETCO2) Setup Menus .....................................................................	5-6
Cardiac Outpt Setup Menus..........................................................................................................	5-6
Vital Sign Chart (VSC) Setup Menus ..........................................................................................	5-7

Chapter 6 – Factory Defaults .................................................................................................................

6-1

vii

System Setup Factory Defaults ....................................................................................................	6-1
Recorder Factory Defaults............................................................................................................	6-2
Vital Signs Chart Factory Defaults...............................................................................................	6-2
ECG Setup Factory Defaults ........................................................................................................	6-3
Respiration Setup Factory Defaults..............................................................................................	6-3
SPO2 Setup Factory Defaults.......................................................................................................	6-4
BP1 Setup Factory Defaults .........................................................................................................	6-5
BP2 Setup Factory Defaults .........................................................................................................	6-6
BP3 Setup Factory Defaults .........................................................................................................	6-7
NIBP Setup Factory Defaults .......................................................................................................	6-8
CO2 Setup Factory Defaults.........................................................................................................	6-9
CO Setup Factory Defaults...........................................................................................................	6-9
Temp1 Setup Factory Defaults...................................................................................................	6-10
Temp2 Setup Factory Defaults...................................................................................................	6-10
Chapter 7 – System & Parameter Messages .........................................................................................	7-1
System Messages..........................................................................................................................	7-1
System Messages ...................................................................................................................	7-1
Battery Messages ...................................................................................................................	7-2
Parameter Messages .....................................................................................................................	7-2
ECG/Respiration Messages ...................................................................................................	7-2
SPO2 Messages......................................................................................................................	7-3
Invasive Blood Pressure (BP1/BP2/BP3) Messages..............................................................	7-3
Noninvasive Blood Pressure (NIBP) Messages.....................................................................	7-4
ETCO2 Messages...................................................................................................................	7-4
SureTemp Messages ..............................................................................................................	7-5
Cardiac Output (CO) Messages .............................................................................................	7-6
Chapter 8 – Defibrillator/Pacer..............................................................................................................	8-1
Introduction ..................................................................................................................................	8-1
Safety Considerations (Defib/Pacer) ............................................................................................	8-1
Symbols (Defib/Pacer) .................................................................................................................	8-2
Cleaning, Maintenance, & Calibration.........................................................................................	8-2
Defibrillator/Pacer Front Overview..............................................................................................	8-3
Defibrillator/Pacer Rear Overview...............................................................................................	8-4
Defibrillator/Pacer Front Panel.....................................................................................................	8-5
Using Defibrillator and Pacer Paddles and Electrodes.................................................................	8-6
External Paddles ....................................................................................................................	8-6
Pediatric Paddles....................................................................................................................	8-6
Disposable Adhesive Electrodes............................................................................................	8-6
To Apply Disposable Adhesive Electrodes to the Patient: ....................................................	8-7
Internal Paddles......................................................................................................................	8-7
Operating the Defibrillator ...........................................................................................................	8-8
Disarming the Defibrillator....................................................................................................	8-9
“Hands-Off” Defibrillation...........................................................................................................	8-9
To Defibrillate Using “Hands-Off” Procedure: .....................................................................	8-9
Synchronized Cardioversion ......................................................................................................	8-11
To Initiate Synchronized Cardioversion Procedure:............................................................	8-11
Operating the Pacer ....................................................................................................................	8-11
To Pace with Dedicated Electrodes: ....................................................................................	8-12
Pacing and Defibrillating with the Same Electrodes............................................................	8-14

viii

Chapter 9 – Clinical Information System..............................................................................................	9-1
Introduction............................................................................................................................	9-1
Operation ...............................................................................................................................	9-1
Accessing the CIS Menu........................................................................................................	9-2
Interacting with the CIS Menu...............................................................................................	9-3
CIS Status Message Zone ......................................................................................................	9-4
Setting up a Patient for Data Collection ................................................................................	9-4
Initializing a New Patient Record: ..................................................................................	9-5
Initiating a Patient Query: ...............................................................................................	9-5
Confirming the Patient: ...................................................................................................	9-7
Filing Vital Signs / Results ....................................................................................................	9-7
Selecting the Appropriate Filing Mode:..........................................................................	9-7
Using the VSC Function to Set Up CIS Charting Intervals ............................................	9-8
Manually Entering Vital Signs Data Using the CIS Menu............................................	9-13
CIS Module Storage Capacity.......................................................................................	9-14
Deleting Vital Signs Entries.................................................................................................	9-14
Viewing the Current Patient Information.............................................................................	9-15
Special Circumstances .........................................................................................................	9-15
Sending Patient Data Stored in the CIS Module After the Fact ....................................	9-15
Using the Temporary Name Feature .............................................................................	9-17
Retrieving Vital Signs from Previous Patients..............................................................	9-18
RS-232 Communication.......................................................................................................	9-19
Parameter Packet ...........................................................................................................	9-19
Waveform Packet ..........................................................................................................	9-20
Additional Waveforms ..................................................................................................	9-23
Wiring Diagrams ...........................................................................................................	9-24
Chapter 10 – Troubleshooting..............................................................................................................	10-1
Chapter 11 – Supplies, Accessories, & Options ..................................................................................	11-1
Chapter 12 – Specifications ..................................................................................................................	12-1

THIS PAGE LEFT BLANK INTENTIONALLY

Chapter 1 – Physical Description

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.

1-8

Prism SE Rear Panel

1.External DC` Input Connector (optional)

2.Fuse Holder

3.AC Power Cord Input Connector

4.Battery Compartment

5.Model & Serial Number Label

6.Add-On Module Interface (MDE Modules)

7.Auxiliary Output Connector (optional)

8.VGA Output Connector (optional)

9.Serial Interface (ISP Port)

10.Equipotential Connector (grounding terminal) (optional)

1-9

1. External DC Input (12 - 28V) Connector

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.

1-11

Prism Rear Panel

1.External DC Input Connector (optional)

2.Equipotential Connector (grounding terminal) (optional)

3.Batteries

4.Defibrillator/ Pacer Interface

5.Fuse Holder/Voltage Selector

6.AC Power Cord Input Connector

7.Auxiliary Output Connector

8.Add-On Module Interface (J1 Connector)

9.Recorder Release Lever

10.Model & Serial Number Label

1-12

1. External DC Input (12 - 28V) Connector

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

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, ETCO2, Cardiac Output and 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, SPO2, IBP

(Invasive Blood Pressure), NIBP (Noninvasive Blood Pressure), Respiration, ETCO2, 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

THIS PAGE LEFT BLANK INTENTIONALLY

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:

Press the SYSTEM SETUP key to open the System Setup menu.

CLEAR

STORE

DISP

TRACE

AUTO

VSC

SETUP

SEL

DATA

ECG

Press the PT SETUP softkey to open the following menu.

SUSP

ENTER

CLEAR

ENTER

ALL

NAME/

EXIT

HT/WT

NAME

MONTR

DATA

Press the SUSP ALL MONTR softkey.

To resume monitoring:

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	STORE	DISP	PT	HR	TRACE
PT				AUTO		MORE
	VS	VSC	SETUP		SEL
DATA				ECG

2-3

Press the TRACE SEL softkey to open the following menu.

DISP

TRACE

VSC

OCRG

AUTO

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.

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):

Press the PATIENT TYPE key to open the following menu.

ADULT

PED

NEO

Press the softkey under desired patient type.

Press the PAGE HOME key.

Note monitor screen displays current patient type in upper left of screen.

The monitor holds present monitoring mode until it is changed again.

To set date and time:

Press the SYSTEM SETUP key to open the System Setup menu.

CLEAR

STORE

DISP

TRACE

AUTO

VSC

SETUP

SEL

DATA

ECG

Press the MORE softkey to open the following menu.

ADULT

DISP

REC

PED

VOL

TIMER

CLOCK

OCRG

SETUP

NEO

Press the CLOCK softkey to open the following menu.

SET

SEC

FORM

CLOCK

SEC

D/M/Y

TIME

↑ ↑

↓ ↓

MIN

M/D/Y

OFF

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).

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	STORE	DISP	PT	HR	TRACE
PT				AUTO		MORE
	VS	VSC	SETUP		SEL
DATA				ECG

2. Press the MORE softkey to open the following menu.

ADULT			DISP	REC
	PED	VOL	DISP	REC	TIMER	CLOCK	MORE
	PED	VOL	OCRG	SETUP	TIMER	CLOCK	MORE
	NEO		OCRG	SETUP
	NEO

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
		Alternate Method:
good for RESP
		Position RA and LA
monitoring
		electrodes at the 2nd
		intercostal space,

		midclavicular line

To monitor a patient’s ECG:

Open the ECG SETUP menu by pressing the softkey next to the ECG label.

ALM

LEAD

PACE

SIZE

LIM

SEL

OFF

Press the ALM LIM softkey to adjust the values for current heart rate alarms.

Press the SIZE softkey to allow increase or decrease of QRS display. QRS needs to be at

least 1/2 millivolt.

Press the LEAD SEL softkey to select desired cable and lead. This page allows choice of

3-lead or 5-lead cable.

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.

Press the PACE ON softkey to activate reject/flag pacer function (if applicable).

Press the MORE softkey.

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	ALM		LEAD	PACE
	ALM	SIZE	LEAD		ON	MORE
	LIM	SIZE	SEL		ON	MORE
OFF	LIM		SEL		OFF
OFF					OFF

2. Press the MORE softkey twice to access the third ECG Setup Page.

TLM	TLM	MODE
ID	ID	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:

Open the RESP SETUP menu by pressing the softkey next to the RESP label.

ALM

MM/S

APNEA

SIZE

AUTO

DELAY

LIM

OFF

12.5

LEADS

20S

Press the ALM ON softkey if respiratory alarms are to be activated.

Press the ALM LIM softkey to adjust values for current respiratory high/low alarms. Apnea

delay alarms can be set as needed.

Press the SIZE softkey to allow increase or decrease of RESP waveform. Adjusting

“sensitivity” may improve count accuracy.

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

CVA

RESP

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:

Apply sensor to appropriate sensor site on patient. SPO2 monitoring commences

automatically.

Open the SPO2 menu by pressing softkey next to SPO2 label.

ALM

MODE

LOCK

DELAY

NORM

LIM

OFF

FAST

OFF

Press the ALM ON softkey if alarms are to be activated.

Press the ALM LIM softkey to adjust high and low values for saturation.

Press the ALM DELAY softkey to toggle between 5 or 10 seconds.

Press the LOCK ON softkey to activate C-LOCK (with Nellcor only).

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).

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 Masimo	Averaging Time	Application

NORM (standard)	8 seconds	Use when patient is relatively
		inactive.

FAST	6 seconds	Use for fast response
		situations such as sleep
		studies.

SLOW	12 seconds	Use during periods of
Note: Pulse rate will be		excessive patient motion.
Note: Pulse rate will be
displayed in all three SpO2
monitoring modes.

MODE for Nellcor MP204	Averaging Time	Application

NORM (standard, NELLCOR	5 to 7 seconds	Use when patient is relatively
Mode 1)		inactive.

FAST (NELLCOR Mode 2)	2 to 3 seconds	Use for fast response
		situations such as sleep
		studies.

SLOW (NELLCOR Mode 3)	10 to 15 seconds	Use during periods of
		excessive patient motion.

3-6

MODE for Nellcor MP405	Averaging Time	Application

*NORM (NOT USED)	(NOT USED)	(NOT USED)

FAST (NELLCOR Mode 2)	Typically 7-8 seconds for	All monitoring situations.
	average pulse.
	Varies + – with pulse quality
	and other functions.

*SLOW (NOT USED)	(NOT USED)	(NOT USED)

*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

Sensor	Model	Patient size

Oxisensor® II oxygen transducers	N-25/N-25LF	<3 or > 40Kg
(Sterile, Single-use only)	I-20	3 to 20 Kg
	D-20	10 to 50Kg
	D-25/D25-L	>30Kg
	R15	>50Kg

Oxiband® oxygen transducer	OXI-A/N	<3 or > 40 Kg
(reusable with nonsterile adhesive)	OXI-P/I	<3 to 40Kg

Durasensor® oxygen transducer	DS-100A	>40Kg
(Reusable, Nonsterile)

OxiCliq® oxygen transducers	P	10 to 50 Kg
(sterile, single use only)	N	<3 or > 40Kg
	I	3 to 20 Kg
	A	>30Kg

Nellcor MP405 SPO2 Ext Cable –	E2800-64
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.

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, or hypothermia

3-8

•There is arterial occlusion proximal to sensor

•Patient is in cardiac arrest or is in shock

SPO2 Sensor Accessories—Masimo

	Name/Type	Model Number	Application

LNOP®- ADT		LNOP® - ADT	Adult, digit
LNOP®- PDT		LNOP® - PDT	Adult/Pediatric
LNOP®- NEO		LNOP® - NEO	Neonatal < 10 kg
LNOP®- NEO PT		LNOP® - NEO PT	Neonatal < 1 kg

LNOP®- DC I		LNOP® - DC I	Adult/Pediatric
PC04 Patient Cable: 4 Ft.		PC04	Adult/Pediatric/Neonatal

PC08 Patient Cable: 8 Ft.		PC08	Adult/Pediatric/Neonatal

PC12 Patient Cable: 12 Ft.		PC12	Adult/Pediatric/Neonatal

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

+ 121 hidden pages