Mindray Passport 12, Passport 8 Operator's Manual

Passport 12/Passport 8

Patient Monitor

Operator’s Manual

Passport 12/Passport 8 Operator’s Manual I

© Copyright 2014 - 2016 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved.

 Release time: 2016-10

 Revision: 4.0

WARNING

 Federal Law (USA) restricts this device to sale by or on the order of a physician or other practitioner

licensed by U.S. state law to use or order the use of this device.

Intellectual Property Statement

SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the intellectual property

rights to this Mindray product and this manual. This manual may refer to information protected by copyrights or patents

and does not convey any license under the patent rights of Mindray, nor the rights of others.

Mindray intends to maintain the contents of this manual as confidential information. Disclosure of the information in

this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden.

Release, amendment, reproduction, distribution, rental, adaption and translation of this manual in any manner

whatsoever without the written permission of Mindray is strictly forbidden.

, , and are the registered trademarks or trademarks owned by Mindray in China

and other countries. All other trademarks that appear in this manual are used only for editorial purposes without the

intention of improperly using them. They are the property of their respective owners.

Please refer to www.mindrayna.com/patents/ for a complete list of applicable patents and trademarks.

II Passport 12/Passport 8 Operator’s Manual

Manufacturer’s Responsibility

Contents of this manual are subject to changes without prior notice.

All information contained in this manual is believed to be correct. Mindray is not liable for errors contained herein nor for

incidental or consequential damages in connection with the furnishing, performance, or use of this manual.

Mindray is responsible for the effects on safety, reliability and performance of this product, only if:

 all installation operations, expansions, changes, modifications and repairs of this product are conducted by Mindray

authorized personnel;

 the electrical installation of the relevant room complies with the applicable national and local requirements;

 the product is used in accordance with the instructions for use.

WARNING

 Only skilled/trained clinical professionals should operate this equipment.

 It is important for the hospital or organization that uses this equipment to perform a recommended

service/maintenance plan. Neglect of this may result in machine breakdown or personal injury.

Warranty

Mindray warrants that components within its products will be free from defects in workmanship and materials for a

period of one year from the date of purchase except that disposable or one-time use products are warranted to be free

from defects in workmanship and materials up to a date one year from the date of purchase or the date of first use,

whichever is sooner.

This warranty does not cover consumable items such as, but not limited to, batteries, external cables, and sensors.

Mindray shall not be liable for any incidental, special, or consequential loss, damage, or expense directly or indirectly

arising from the use of its products. Liability under this warranty and the buyer’s exclusive remedy under this warranty is

limited to servicing or replacing the affected products, at Mindray option, at the factory or at an authorized distributor,

for any product which shall under normal use and service appear to Mindray to have been defective in material or

workmanship. Recommended preventative maintenance, as prescribed in the service manual, is the responsibility of the

user and is not covered by this warranty.

No agent, employee, or representative of Mindray has any authority to bind Mindray to any affirmation, representation,

or warranty concerning its products, and any affirmation, representation or warranty made by any agent, employee, or

representative shall not be enforceable by buyer or user.

THIS WARRANTY IS EXPRESSLY IN LIEU OF, AND MINDRAY EXPRESSLY DISCLAIMS, ANY OTHER EXPRESS OR IMPLIED

WARRANTIES, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY, NON-INFRINGEMENT, OR FITNESS FOR A

PARTICULAR PURPOSE, AND OF ANY OTHER OBLIGATION ON THE PART OF MINDRAY.

Passport 12/Passport 8 Operator’s Manual III

Damage to any product or parts through misuse, neglect, accident, or by affixing any non-standard accessory

attachments, or by any customer modification voids this warranty. Mindray makes no warranty whatsoever in regard to

trade accessories, such being subject to the warranty of their respective manufacturers.

A condition of this warranty is that the equipment or accessories which are claimed to be defective be returned when

authorized, freight prepaid to Mindray DS USA, Inc., Mahwah, New Jersey 07430 or its authorized representative.

Mindray shall not have any responsibility in the event of loss or damage in transit.

Exemptions

Mindray's obligation or liability under this warranty does not include any transportation or other charges or liability for

direct, indirect or consequential damages or delay resulting from the improper use or application of the product or the

use of parts or accessories not approved by Mindray or repairs by people other than Mindray authorized personnel.

This warranty does not extend to

 Malfunction or damage caused by improper use or man-made failure.

 Malfunction or damage caused by unstable or out-of-range power input.

 Malfunction or damage caused by force majeure events, such as (i) flood, fire and earthquake or other similar

elements of nature or acts of God; (ii) riots, war, civil disorders, rebellions, or revolutions in any country; or (iii) any

other cause beyond the reasonable control of Mindray.

 Malfunction or damage caused by improper operation or repair by unqualified or unauthorized service people.

 Malfunction of the instrument or part whose serial number is not legible.

 Others not caused by instrument or part itself.

Service

Mindray maintains a network of service representatives and factory-trained distributors. Prior to requesting service,

perform a complete operational check of the instrument to verify proper control settings. If operational problems

continue to exist,

In North America contact the Service Department at [phone], ext: 8116 for Technical Support or [phone]

for assistance in determining the nearest field service location.

Please include the instrument model number, the serial number, and a description of the problem with all requests for

service.

Any questions regarding the warranty should be directed to your local sales or service representative.

NOTE

 Upon request, Mindray provides circuit diagrams, component part lists, descriptions, calibration

instructions, or other information which assist the user’s appropriately qualified technical personnel to

repair those parts of the equipment which are designated by Mindray DS USA, Inc. as repairable.

IV Passport 12/Passport 8 Operator’s Manual

Company Contact

Manufacturer: Shenzhen Mindray Bio-Medical Electronics Co., Ltd.

Address: Mindray Building, Keji 12th Road South, Hi-tech industrial park, Nanshan,

Shenzhen 518057,P.R.China

Website: www.mindray.com

E-mail Address: [e-mail]

Tel: [phone]

Fax: [phone]

Distributor: Mindray DS USA, Inc.

Address: 800 MacArthur Boulevard, Mahwah, New Jersey, 07430 USA

Tel: [phone]

Website: www.mindray.com

Passport 12/Passport 8 Operator’s Manual V

Preface

Manual Purpose

This manual contains the instructions necessary to operate the product safely and in accordance with its function and

intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and

ensures patient and operator safety.

This manual is based on the maximum configuration and therefore some contents may not apply to your product. If you

have any questions, please contact Mindray.

This manual is an integral part of the product. It should always be kept close to the equipment so that it can be

conveniently referenced when needed.

Intended Audience

This manual is intended for clinical professionals who are expected to have a working knowledge of medical procedures,

practices and terminology as required for monitoring of patients.

Illustrations

All illustrations in this manual serve as examples only. They may not necessarily reflect the setup or data displayed on

your monitor.

Manual Conventions

 Italic text is used to quote the referenced chapters or sections.

 [ ] is used to enclose screen text.

 → is used to indicate operational procedures.

VI Passport 12/Passport 8 Operator’s Manual

FOR YOUR NOTES

Passport 12/Passport 8 Operator’s Manual 1

Contents

1 Safety ................................................................................................................................................................................. 1-1

1.1 Safety Information .......................................................................................................................................................................................... 1-1

1.1.1 Warnings .............................................................................................................................................................................................. 1-1

1.1.2 Cautions ............................................................................................................................................................................................... 1-2

1.1.3 Notes ..................................................................................................................................................................................................... 1-3

1.2 Equipment Symbols ....................................................................................................................................................................................... 1-3

2 The Basics ........................................................................................................................................................................... 2-1

2.1 Intended Use .................................................................................................................................................................................................... 2-1

2.2 Applied Parts .................................................................................................................................................................................................... 2-2

2.3 Main Unit ........................................................................................................................................................................................................... 2-2

2.3.1 Front View ............................................................................................................................................................................................ 2-2

2.3.2 Side View .............................................................................................................................................................................................. 2-4

2.3.3 Rear View .............................................................................................................................................................................................. 2-6

2.4 Modules .............................................................................................................................................................................................................. 2-8

2.5 Display Screen .................................................................................................................................................................................................. 2-9

2.6 QuickKeys ........................................................................................................................................................................................................2-11

3 Basic Operations ................................................................................................................................................................ 3-1

3.1 Installation ......................................................................................................................................................................................................... 3-1

3.1.1 Unpacking and Checking .............................................................................................................................................................. 3-2

3.1.2 Environmental Requirements ...................................................................................................................................................... 3-2

3.2 Getting Started ................................................................................................................................................................................................ 3-3

3.2.1 Connecting to Power Source ........................................................................................................................................................ 3-3

3.2.2 Turning Power On ............................................................................................................................................................................. 3-3

3.2.3 Starting Monitoring ......................................................................................................................................................................... 3-4

3.3 Turning Off the Monitor ............................................................................................................................................................................... 3-4

3.4 Using the Knob ................................................................................................................................................................................................ 3-5

3.5 Using Keys ......................................................................................................................................................................................................... 3-5

3.6 Using the Touchscreen .................................................................................................................................................................................. 3-5

3.7 Using the On-screen Keyboard .................................................................................................................................................................. 3-5

3.8 Using the Main Menu .................................................................................................................................................................................... 3-6

3.9 Setting the Screen .......................................................................................................................................................................................... 3-6

3.10 Displaying the Timer ................................................................................................................................................................................... 3-8

3.11 Changing General Settings ....................................................................................................................................................................... 3-8

3.11.1 Setting up a Monitor ..................................................................................................................................................................... 3-8

3.11.2 Changing Language ...................................................................................................................................................................... 3-8

3.11.3 Adjusting the Screen Brightness .............................................................................................................................................. 3-9

3.11.4 Showing/Hiding Help Text .......................................................................................................................................................... 3-9

3.11.5 Setting the Date and Time .......................................................................................................................................................... 3-9

3.11.6 Adjusting Volume .........................................................................................................................................................................3-10

3.12 Setting Parameters ....................................................................................................................................................................................3-10

3.12.1 Switching the Parameters On/Off ..........................................................................................................................................3-10

2 Passport 12/Passport 8 Operator’s Manual

3.12.2 Accessing the Parameters Menu ............................................................................................................................................ 3-11

3.13 Operating Modes ....................................................................................................................................................................................... 3-11

3.13.1 Monitoring Mode ......................................................................................................................................................................... 3-11

3.13.2 Night Mode .................................................................................................................................................................................... 3-11

3.13.3 Privacy Mode ................................................................................................................................................................................. 3-11

3.13.4 Standby Mode ............................................................................................................................................................................... 3-12

4 Managing Patients ............................................................................................................................................................ 4-1

4.1 Admitting a Patient ........................................................................................................................................................................................ 4-1

4.2 Quick Admitting a Patient ........................................................................................................................................................................... 4-2

4.3 Querying and Obtaining Patient Information ..................................................................................................................................... 4-2

4.4 Associating Patient Information ............................................................................................................................................................... 4-3

4.5 Editing Patient Information ........................................................................................................................................................................ 4-3

4.6 Discharging a Patient .................................................................................................................................................................................... 4-3

4.7 Transferring Patient Data ............................................................................................................................................................................. 4-3

4.7.1 Transferring Data from the Monitor to a USB Drive ............................................................................................................. 4-4

4.7.2 Transferring Data from a USB Drive to the Monitor ............................................................................................................. 4-4

4.8 Connecting to a CMS .................................................................................................................................................................................... 4-5

5 Managing Configurations ................................................................................................................................................. 5-1

5.1 Introduction ..................................................................................................................................................................................................... 5-1

5.2 Entering the [Manage Configuration] Menu ........................................................................................................................................ 5-2

5.3 Changing Department ................................................................................................................................................................................. 5-2

5.4 Setting Default Configuration ................................................................................................................................................................... 5-3

5.5 Saving Current Settings ............................................................................................................................................................................... 5-3

5.6 Editing Configurations.................................................................................................................................................................................. 5-4

5.7 Deleting a Configuration ............................................................................................................................................................................. 5-5

5.8 Transferring a Configuration ...................................................................................................................................................................... 5-5

5.9 Loading a Configuration .............................................................................................................................................................................. 5-6

5.10 Restoring the Latest Configuration Automatically .......................................................................................................................... 5-6

6 User Screens ....................................................................................................................................................................... 6-1

6.1 Configuring Your Screens ............................................................................................................................................................................ 6-1

6.1.1 Changing the Waveform Line Size ............................................................................................................................................. 6-1

6.1.2 Changing Measurement Colors .................................................................................................................................................. 6-1

6.1.3 Changing Screen Layout ................................................................................................................................................................ 6-1

6.2 Viewing Minitrends ........................................................................................................................................................................................ 6-2

6.2.1 Having a Split-Screen View of Minitrends ............................................................................................................................... 6-2

6.2.2 Setting Minitrends ........................................................................................................................................................................... 6-2

6.3 Viewing OxyCRG ............................................................................................................................................................................................. 6-3

6.4 Viewing Other Patients ................................................................................................................................................................................. 6-4

6.4.1 Care Group .......................................................................................................................................................................................... 6-4

6.4.2 Viewing the Care Group Overview Bar ..................................................................................................................................... 6-4

6.4.3 Understanding the View Other Patient Window ................................................................................................................... 6-5

6.5 Understanding the Big Numerics Screen .............................................................................................................................................. 6-6

Passport 12/Passport 8 Operator’s Manual 3

7 Alarms ................................................................................................................................................................................ 7-1

7.1 Alarm Categories ............................................................................................................................................................................................ 7-1

7.2 Alarm Levels ...................................................................................................................................................................................................... 7-2

7.3 Alarm Indicators .............................................................................................................................................................................................. 7-2

7.3.1 Alarm Lamp ......................................................................................................................................................................................... 7-2

7.3.2 Alarm Messages ................................................................................................................................................................................ 7-2

7.3.3 Flashing Numeric .............................................................................................................................................................................. 7-3

7.3.4 Audible Alarm Tones ........................................................................................................................................................................ 7-3

7.3.5 Alarm Status Symbols ..................................................................................................................................................................... 7-3

7.4 Alarm Tone Configuration ........................................................................................................................................................................... 7-4

7.4.1 Setting the Minimum Alarm Volume ......................................................................................................................................... 7-4

7.4.2 Changing the Alarm Volume ........................................................................................................................................................ 7-4

7.4.3 Setting the Interval Between Alarm Sounds .......................................................................................................................... 7-4

7.4.4 Changing the Alarm Tone Pattern .............................................................................................................................................. 7-5

7.4.5 Setting the Reminder Tones .......................................................................................................................................................... 7-5

7.5 Understanding the Alarm Setup Menu .................................................................................................................................................. 7-6

7.5.1 Setting Alarm Properties for All Parameters ........................................................................................................................... 7-6

7.5.2 Adjusting Alarm Limits Automatically ...................................................................................................................................... 7-7

7.5.3 Setting Alarm Delay Time .............................................................................................................................................................. 7-9

7.5.4 Setting SpO2 Technical Alarm Delay ........................................................................................................................................7-10

7.5.5 Setting Recording Length ............................................................................................................................................................7-10

7.5.6 Entering CPB Mode (Cardiopulmonary Bypass Mode) .....................................................................................................7-10

7.6 Pausing Alarms ..............................................................................................................................................................................................7-10

7.7 Switching Off All Alarms .............................................................................................................................................................................7-11

7.8 Resetting Alarms ...........................................................................................................................................................................................7-11

7.9 Latching Alarms .............................................................................................................................................................................................7-12

7.10 Testing Alarms .............................................................................................................................................................................................7-13

7.11 Using Care Group Alarms ........................................................................................................................................................................7-13

7.11.1 Care Group Auto Alarms ............................................................................................................................................................7-13

7.11.2 Setting Care Group Alert Tone .................................................................................................................................................7-13

7.11.3 Resetting Care Group Alarms ...................................................................................................................................................7-13

8 Monitoring ECG ................................................................................................................................................................. 8-1

8.1 Introduction ...................................................................................................................................................................................................... 8-1

8.2 Safety ................................................................................................................................................................................................................... 8-1

8.3 Preparing to Monitor ECG ............................................................................................................................................................................ 8-2

8.3.1 Preparing the Patient and Placing the Electrodes ................................................................................................................ 8-2

8.3.2 Choosing AHA or IEC Lead Placement ...................................................................................................................................... 8-2

8.3.3 ECG Lead Placements ...................................................................................................................................................................... 8-3

8.3.4 Checking Paced Status .................................................................................................................................................................... 8-4

8.4 Understanding the ECG Display ................................................................................................................................................................ 8-5

8.5 Changing ECG Settings ................................................................................................................................................................................. 8-5

8.5.1 Accessing ECG Menus ..................................................................................................................................................................... 8-5

8.5.2 Setting Pacemaker Rate (For Mortara ECG algorithm only) .............................................................................................. 8-5

8.5.3 Choosing the Alarm Source .......................................................................................................................................................... 8-6

8.5.4 Changing ECG Wave Settings ....................................................................................................................................................... 8-6

4 Passport 12/Passport 8 Operator’s Manual

8.5.5 Changing the ECG Filter Settings ............................................................................................................................................... 8-6

8.5.6 Setting Pacemaker Rate (For Mortara only) ............................................................................................................................ 8-7

8.5.7 Setting the ECG Lead Set ............................................................................................................................................................... 8-7

8.5.8 Choosing an ECG Display Screen ................................................................................................................................................ 8-7

8.5.9 Setting the Notch Filter .................................................................................................................................................................. 8-7

8.5.10 Changing the Pacer Reject Settings ........................................................................................................................................ 8-8

8.5.11 Enabling Smart Lead Off ............................................................................................................................................................. 8-8

8.5.12 Setting the Alarm Level for ECG Lead Off Alarms............................................................................................................... 8-8

8.5.13 Adjusting QRS Volume ................................................................................................................................................................. 8-8

8.5.14 Adjusting the Minimum QRS Detection Threshold (For Advanced ECG Algorithm Only) .................................. 8-9

8.5.15 About the Defibrillator Synchronization ............................................................................................................................... 8-9

8.6 About ST Monitoring................................................................................................................................................................................... 8-10

8.6.1 Switching ST Monitoring On and Off ...................................................................................................................................... 8-10

8.6.2 Changing ST Filter Settings ......................................................................................................................................................... 8-10

8.6.3 Understanding the ST Display ................................................................................................................................................... 8-11

8.6.4 Saving the Current ST Segment as Reference ...................................................................................................................... 8-12

8.6.5 Changing the Reference Segment ........................................................................................................................................... 8-12

8.6.6 Deleting a Reference Segment .................................................................................................................................................. 8-12

8.6.7 Recording the ST Segment ......................................................................................................................................................... 8-12

8.6.8 Changing the ST Alarm Limits ................................................................................................................................................... 8-12

8.6.9 Setting the ST Alarm Delay Time .............................................................................................................................................. 8-12

8.6.10 Adjusting ST Measurement Points ......................................................................................................................................... 8-13

8.7 QT/QTc Interval Monitoring (For Advanced ECG Algorithm Only) ............................................................................................. 8-14

8.7.1 QT/QTc Monitoring Limitations ................................................................................................................................................. 8-14

8.7.2 Enabling QT/QTc Monitoring ..................................................................................................................................................... 8-15

8.7.3 Displaying QT/QTc Parameters and Waveform .................................................................................................................... 8-15

8.7.4 Accessing the QT View .................................................................................................................................................................. 8-16

8.7.5 Changing QT Settings ................................................................................................................................................................... 8-17

8.8 About Arrhythmia Monitoring ................................................................................................................................................................ 8-18

8.8.1 Understanding the Arrhythmia Events ................................................................................................................................... 8-18

8.8.2 Changing Arrhythmia Alarm Settings ..................................................................................................................................... 8-20

8.8.3 Changing Arrhythmia Threshold Settings ............................................................................................................................. 8-20

8.8.4 Setting the Extended Arrhythmia (For Advanced ECG Algorithm Only) .................................................................... 8-21

8.8.5 Reviewing Arrhythmia Events .................................................................................................................................................... 8-21

8.9 ECG Relearning .............................................................................................................................................................................................. 8-22

8.9.1 Initiating an ECG Relearning Manually ................................................................................................................................... 8-22

8.9.2 Automatic ECG Relearning .......................................................................................................................................................... 8-22

8.10 Troubleshooting ......................................................................................................................................................................................... 8-23

9 Monitoring Respiration (Resp) ......................................................................................................................................... 9-1

9.1 Introduction ..................................................................................................................................................................................................... 9-1

9.2 Safety Information ......................................................................................................................................................................................... 9-1

9.3 Understanding the Resp Display .............................................................................................................................................................. 9-1

9.4 Placing Resp Electrodes ............................................................................................................................................................................... 9-2

9.4.1 Optimizing Lead Placement for Resp ........................................................................................................................................ 9-2

9.4.2 Cardiac Overlay ................................................................................................................................................................................. 9-2

Passport 12/Passport 8 Operator’s Manual 5

9.4.3 Abdominal Breathing ...................................................................................................................................................................... 9-3

9.4.4 Lateral Chest Expansion ................................................................................................................................................................. 9-3

9.5 Choosing the Respiration Lead .................................................................................................................................................................. 9-3

9.6 Changing the Apnea Alarm Delay ............................................................................................................................................................ 9-3

9.7 Changing Resp Detection Mode ............................................................................................................................................................... 9-3

9.8 Changing Resp Wave Settings ................................................................................................................................................................... 9-4

9.9 Setting Respiration Rate Source ................................................................................................................................................................ 9-4

9.10 Setting Alarm Properties ........................................................................................................................................................................... 9-5

10 Monitoring PR ............................................................................................................................................................... 10-1

10.1 Introduction .................................................................................................................................................................................................10-1

10.2 Setting the PR Source ...............................................................................................................................................................................10-1

10.3 Selecting the Active Alarm Source .......................................................................................................................................................10-2

10.4 QRS Tone ........................................................................................................................................................................................................10-2

11 Monitoring SpO2 ............................................................................................................................................................ 11-1

11.1 Introduction .................................................................................................................................................................................................11-1

11.2 Safety ..............................................................................................................................................................................................................11-2

11.3 Identifying SpO2 Modules .......................................................................................................................................................................11-2

11.4 Applying the Sensor ..................................................................................................................................................................................11-2

11.5 Changing SpO2 Settings ..........................................................................................................................................................................11-3

11.5.1 Accessing SpO2 Menus ...............................................................................................................................................................11-3

11.5.2 Adjusting the Desat Alarm ........................................................................................................................................................11-3

11.5.3 Setting SpO2 Sensitivity .............................................................................................................................................................11-3

11.5.4 Changing Averaging Time ........................................................................................................................................................11-3

11.5.5 Monitoring SpO2 and NIBP Simultaneously .......................................................................................................................11-3

11.5.6 Sat-Seconds Alarm Management ...........................................................................................................................................11-4

11.5.7 Changing the Speed of the Pleth Wave ...............................................................................................................................11-5

11.5.8 Zooming PI Value .........................................................................................................................................................................11-5

11.5.9 Setting the Alarm Level for SpO2 Sensor Off Alarm .........................................................................................................11-5

11.5.10 Setting the SpO2 Tone Mode .................................................................................................................................................11-5

11.6 Measurement Limitations .......................................................................................................................................................................11-6

11.7 Masimo Information ..................................................................................................................................................................................11-6

11.8 Nellcor Information ...................................................................................................................................................................................11-7

11.9 Troubleshooting .........................................................................................................................................................................................11-7

12 Monitoring NIBP ............................................................................................................................................................ 12-1

12.1 Introduction .................................................................................................................................................................................................12-1

12.2 Safety ..............................................................................................................................................................................................................12-2

12.3 Measurement Limitations .......................................................................................................................................................................12-2

12.4 Measurement Methods ............................................................................................................................................................................12-2

12.5 Setting Up the NIBP Measurement ......................................................................................................................................................12-3

12.5.1 Preparing the Patient ..................................................................................................................................................................12-3

12.5.2 Preparing to Measure NIBP .......................................................................................................................................................12-3

12.5.3 Starting and Stopping Measurements .................................................................................................................................12-4

12.5.4 Correcting the Measurement if Limb is not at Heart Level ...........................................................................................12-4

6 Passport 12/Passport 8 Operator’s Manual

12.5.5 Enabling NIBP Auto Cycling and Setting the Interval ..................................................................................................... 12-4

12.5.6 Enabling Measurement on Clock ........................................................................................................................................... 12-4

12.5.7 Starting a STAT Measurement ................................................................................................................................................. 12-5

12.6 Understanding the NIBP Numerics ..................................................................................................................................................... 12-5

12.7 Changing NIBP Settings........................................................................................................................................................................... 12-6

12.7.1 Setting the Initial Cuff Inflation Pressure ............................................................................................................................. 12-6

12.7.2 Setting NIBP Alarm Properties ................................................................................................................................................ 12-6

12.7.3 Displaying NIBP List..................................................................................................................................................................... 12-6

12.7.4 Setting the Pressure Unit .......................................................................................................................................................... 12-6

12.7.5 Switching On NIBP End Tone ................................................................................................................................................... 12-6

12.8 Assisting Venous Puncture ..................................................................................................................................................................... 12-7

13 Monitoring Temp ........................................................................................................................................................... 13-1

13.1 Introduction ................................................................................................................................................................................................. 13-1

13.2 Safety .............................................................................................................................................................................................................. 13-1

13.3 Making a Temp Measurement ............................................................................................................................................................... 13-1

13.4 Understanding the Temp Display ........................................................................................................................................................ 13-1

13.5 Setting the Temperature Unit ................................................................................................................................................................ 13-2

14 Monitoring IBP .............................................................................................................................................................. 14-1

14.1 Introduction ................................................................................................................................................................................................. 14-1

14.2 Safety .............................................................................................................................................................................................................. 14-1

14.3 Zeroing the Transducer ............................................................................................................................................................................ 14-1

14.4 Setting Up the Pressure Measurement .............................................................................................................................................. 14-2

14.5 Understanding the IBP Display ............................................................................................................................................................. 14-3

14.6 Changing IBP Settings .............................................................................................................................................................................. 14-4

14.6.1 Changing a Pressure for Monitoring ..................................................................................................................................... 14-4

14.6.2 Setting Alarm Properties ........................................................................................................................................................... 14-5

14.6.3 Changing Averaging Time ........................................................................................................................................................ 14-5

14.6.4 Setting Up the IBP Wave ............................................................................................................................................................ 14-5

14.6.5 Setting the Pressure Unit .......................................................................................................................................................... 14-5

14.6.6 Enabling PPV Measurement and Setting PPV Source ..................................................................................................... 14-5

14.7 Overlapping IBP Waveforms .................................................................................................................................................................. 14-6

14.8 Measuring PAWP ........................................................................................................................................................................................ 14-7

14.8.1 Preparing to Measure PAWP ..................................................................................................................................................... 14-8

14.8.2 Setting Up the PAWP Measurement ...................................................................................................................................... 14-8

14.8.3 Understanding the PAWP Setup Menu ................................................................................................................................ 14-9

14.9 Troubleshooting ......................................................................................................................................................................................... 14-9

15 Monitoring Cardiac Output .......................................................................................................................................... 15-1

15.1 Introduction ................................................................................................................................................................................................. 15-1

15.2 Understanding the C.O. Display ........................................................................................................................................................... 15-1

15.3 Influencing Factors .................................................................................................................................................................................... 15-2

15.4 Setting Up the C.O. Measurement ....................................................................................................................................................... 15-2

15.5 Measuring the Blood Temperature ...................................................................................................................................................... 15-5

15.6 Changing C.O. Settings ............................................................................................................................................................................ 15-6

Passport 12/Passport 8 Operator’s Manual 7

15.6.1 Setting the Temperature Unit ..................................................................................................................................................15-6

15.6.2 Setting Alarm Properties ...........................................................................................................................................................15-6

16 Monitoring CO2 .............................................................................................................................................................. 16-1

16.1 Introduction .................................................................................................................................................................................................16-1

16.2 CO2 Module...................................................................................................................................................................................................16-2

16.3 Preparing to Measure CO2 .......................................................................................................................................................................16-2

16.3.1 Making a Sidestream CO2 Measurement .............................................................................................................................16-3

16.3.2 Making a Microstream CO2 Measurement ..........................................................................................................................16-4

16.4 Changing CO2 Settings .............................................................................................................................................................................16-4

16.4.1 Accessing CO2 Menus .................................................................................................................................................................16-4

16.4.2 Entering the Standby Mode .....................................................................................................................................................16-4

16.4.3 Setting the CO2 Unit ....................................................................................................................................................................16-5

16.4.4 Setting up Gas Compensations ...............................................................................................................................................16-5

16.4.5 Setting up Humidity Compensation .....................................................................................................................................16-5

16.4.6 Setting the Apnea Alarm Delay ...............................................................................................................................................16-6

16.4.7 Choosing a Time Interval for Peak-Picking ..........................................................................................................................16-6

16.4.8 Setting the Flow Rate ..................................................................................................................................................................16-6

16.4.9 Setting up the CO2 Wave ............................................................................................................................................................16-7

16.5 Setting RR Source .......................................................................................................................................................................................16-7

16.6 Barometric Pressure Compensation ....................................................................................................................................................16-7

16.7 Measurement Limitations .......................................................................................................................................................................16-8

16.8 Leakage test .................................................................................................................................................................................................16-8

16.9 Troubleshooting the Sidestream CO2 Sampling System ..............................................................................................................16-8

16.10 Removing Exhaust Gases from the System ....................................................................................................................................16-9

16.11 Zeroing the Sensor ..................................................................................................................................................................................16-9

16.12 Calibrating the Sensor ......................................................................................................................................................................... 16-10

16.13 Oridion Information ............................................................................................................................................................................. 16-10

17 Monitoring AG ............................................................................................................................................................... 17-1

17.1 Introduction .................................................................................................................................................................................................17-1

17.2 Understanding the AG Display ..............................................................................................................................................................17-2

17.3 MAC Values ...................................................................................................................................................................................................17-3

17.4 Preparing to Measure AG ........................................................................................................................................................................17-4

17.5 Changing AG Settings ..............................................................................................................................................................................17-5

17.5.1 Setting Gas Unit ............................................................................................................................................................................17-5

17.5.2 Setting the Apnea Alarm Delay ...............................................................................................................................................17-5

17.5.3 Changing the Sample Flow Rate ............................................................................................................................................17-5

17.5.4 Setting up the O2 Compensation ...........................................................................................................................................17-5

17.5.5 Entering the Standby Mode .....................................................................................................................................................17-6

17.5.6 Setting up the AG Wave .............................................................................................................................................................17-6

17.5.7 Setting RR Source .........................................................................................................................................................................17-6

17.6 Changing the Anesthetic Agent ...........................................................................................................................................................17-6

17.7 Measurement Limitations .......................................................................................................................................................................17-7

17.8 Troubleshooting .........................................................................................................................................................................................17-7

17.8.1 When the Gas Inlet is Blocked ..................................................................................................................................................17-7

8 Passport 12/Passport 8 Operator’s Manual

17.8.2 When an Internal Occlusion Occurs ...................................................................................................................................... 17-7

17.9 Removing Exhaust Gases from the System ...................................................................................................................................... 17-7

18 Freezing Waveforms ...................................................................................................................................................... 18-1

18.1 Freezing Waveforms .................................................................................................................................................................................. 18-1

18.2 Viewing Frozen Waveforms .................................................................................................................................................................... 18-1

18.3 Unfreezing Waveforms ............................................................................................................................................................................. 18-2

18.4 Recording Frozen Waveforms ................................................................................................................................................................ 18-2

19 Review ............................................................................................................................................................................ 19-1

19.1 Accessing Respective Review Windows ............................................................................................................................................ 19-1

19.2 Reviewing Graphic Trends ...................................................................................................................................................................... 19-1

19.3 Reviewing Tabular Trends ....................................................................................................................................................................... 19-2

19.4 Reviewing Events ....................................................................................................................................................................................... 19-3

19.4.1 Marking Events ............................................................................................................................................................................. 19-3

19.4.2 Reviewing Events ......................................................................................................................................................................... 19-4

19.5 Reviewing Waveforms .............................................................................................................................................................................. 19-6

20 Calculations ................................................................................................................................................................... 20-1

20.1 Introduction ................................................................................................................................................................................................. 20-1

20.2 Dose Calculations ...................................................................................................................................................................................... 20-2

20.2.1 Performing Calculations ............................................................................................................................................................ 20-2

20.2.2 Selecting the Proper Drug Unit ............................................................................................................................................... 20-2

20.2.3 Titration Table ................................................................................................................................................................................ 20-3

20.2.4 Drug Calculation Formulas ....................................................................................................................................................... 20-3

20.3 Oxygenation Calculations ....................................................................................................................................................................... 20-3

20.3.1 Performing Calculations ............................................................................................................................................................ 20-3

20.3.2 Entered Parameters ..................................................................................................................................................................... 20-4

20.3.3 Calculated Parameters and Formulas ................................................................................................................................... 20-4

20.4 Ventilation Calculations ........................................................................................................................................................................... 20-5

20.4.1 Performing Calculations ............................................................................................................................................................ 20-5

20.4.2 Entered Parameters ..................................................................................................................................................................... 20-5

20.4.3 Calculated Parameters and Formulas ................................................................................................................................... 20-6

20.5 Hemodynamic Calculations ................................................................................................................................................................... 20-6

20.5.1 Performing Calculations ............................................................................................................................................................ 20-6

20.5.2 Entered Parameters ..................................................................................................................................................................... 20-7

20.5.3 Calculated Parameters and Formulas ................................................................................................................................... 20-7

20.6 Renal Calculations...................................................................................................................................................................................... 20-8

20.6.1 Performing Calculations ............................................................................................................................................................ 20-8

20.6.2 Entered Parameters ..................................................................................................................................................................... 20-8

20.6.3 Calculated Parameters and Formulas ................................................................................................................................... 20-9

20.7 Understanding the Review Window ................................................................................................................................................... 20-9

21 Recording ....................................................................................................................................................................... 21-1

21.1 Using a Recorder ........................................................................................................................................................................................ 21-1

21.2 Overview of Recording Types ................................................................................................................................................................ 21-1

Passport 12/Passport 8 Operator’s Manual 9

21.3 Starting and Stopping Recordings ......................................................................................................................................................21-2

21.4 Setting up the Recorder ...........................................................................................................................................................................21-2

21.4.1 Accessing the Record Setup Menu ........................................................................................................................................21-2

21.4.2 Selecting Waveforms for Recording ......................................................................................................................................21-2

21.4.3 Setting the Realtime Recording Length ...............................................................................................................................21-3

21.4.4 Setting the Interval between Timed Recordings ..............................................................................................................21-3

21.4.5 Changing the Recording Speed ..............................................................................................................................................21-3

21.4.6 Clearing Recording Tasks ...........................................................................................................................................................21-3

21.5 Loading Paper ..............................................................................................................................................................................................21-3

21.6 Removing Paper Jam ................................................................................................................................................................................21-4

21.7 Cleaning the Recorder Printhead .........................................................................................................................................................21-4

22 Printing .......................................................................................................................................................................... 22-1

22.1 Printer .............................................................................................................................................................................................................22-1

22.2 Connecting a printer .................................................................................................................................................................................22-1

22.3 Setting Up the Printer ...............................................................................................................................................................................22-2

22.4 Starting Report Printouts ........................................................................................................................................................................22-2

22.5 Stopping Report Printouts ......................................................................................................................................................................22-3

22.6 Setting Up Reports ....................................................................................................................................................................................22-3

22.6.1 Setting Up ECG Reports .............................................................................................................................................................22-3

22.6.2 Setting Up Tabular Trends Reports ........................................................................................................................................22-3

22.6.3 Setting Up Graphic Trends Reports .......................................................................................................................................22-4

22.6.4 Setting Up Realtime Reports ....................................................................................................................................................22-4

22.7 End Case Reports ........................................................................................................................................................................................22-4

22.8 Printer Statuses ...........................................................................................................................................................................................22-4

22.8.1 Printer Out of Paper .....................................................................................................................................................................22-4

22.8.2 Printer Status Messages .............................................................................................................................................................22-4

23 Other Functions ............................................................................................................................................................. 23-1

23.1 Analog Output.............................................................................................................................................................................................23-1

23.2 Setting DIAP Baud Rate ............................................................................................................................................................................23-1

23.3 Exporting the Log ......................................................................................................................................................................................23-1

23.4 Transferring Data ........................................................................................................................................................................................23-1

23.4.1 Data Export System .....................................................................................................................................................................23-2

23.4.2 Transferring Data by Different Means ...................................................................................................................................23-2

23.5 Nurse Call ......................................................................................................................................................................................................23-3

23.6 Network Setup ............................................................................................................................................................................................23-4

23.6.1 Setting the Network Type ..........................................................................................................................................................23-4

23.6.2 Wireless Network Connection .................................................................................................................................................23-4

23.6.3 Certificates Maintenance ...........................................................................................................................................................23-6

23.6.4 Setting the Central Stations......................................................................................................................................................23-6

23.6.5 Setting the Network Service Quality Level .........................................................................................................................23-7

23.6.6 Setting the Multicast Parameters ...........................................................................................................................................23-7

24 Batteries ......................................................................................................................................................................... 24-1

24.1 Overview .......................................................................................................................................................................................................24-1

10 Passport 12/Passport 8 Operator’s Manual

24.2 Safety .............................................................................................................................................................................................................. 24-2

24.3 Battery Guidelines ..................................................................................................................................................................................... 24-2

24.4 Installing or Replacing a Battery ........................................................................................................................................................... 24-3

24.5 Charging a Battery ..................................................................................................................................................................................... 24-3

24.6 Conditioning a Battery ............................................................................................................................................................................. 24-4

24.7 Checking Battery Performance ............................................................................................................................................................. 24-5

24.8 Storing a Battery ......................................................................................................................................................................................... 24-5

24.9 Recycling a Battery .................................................................................................................................................................................... 24-6

25 Care and Cleaning ......................................................................................................................................................... 25-1

25.1 General Points ............................................................................................................................................................................................. 25-1

25.2 Cleaning ........................................................................................................................................................................................................ 25-2

25.3 Disinfecting .................................................................................................................................................................................................. 25-3

25.4 Sterilization .................................................................................................................................................................................................. 25-3

26 User Maintenance ......................................................................................................................................................... 26-1

26.1 General Inspection .................................................................................................................................................................................... 26-1

26.2 Maintenance and Testing Schedule .................................................................................................................................................... 26-2

26.3 Checking Monitor and Module Information .................................................................................................................................... 26-3

26.4 ECG Verification .......................................................................................................................................................................................... 26-3

26.5 NIBP Leakage Test ...................................................................................................................................................................................... 26-3

26.6 CO2 Leakage Test ........................................................................................................................................................................................ 26-4

26.7 AG Tests.......................................................................................................................................................................................................... 26-5

26.7.1 AG Leakage Test ............................................................................................................................................................................ 26-5

26.8 Calibrating the Touchscreen .................................................................................................................................................................. 26-5

26.9 Entering/Exiting Demo Mode ............................................................................................................................................................... 26-5

27 Accessories ..................................................................................................................................................................... 27-1

27.1 ECG Accessories .......................................................................................................................................................................................... 27-1

27.2 SpO2 Accessories ........................................................................................................................................................................................ 27-4

27.3 NIBP Accessories ......................................................................................................................................................................................... 27-4

27.4 Temp Accessories ....................................................................................................................................................................................... 27-5

27.5 IBP/ICP Accessories.................................................................................................................................................................................... 27-6

27.6 C.O. Accessories .......................................................................................................................................................................................... 27-7

27.7 CO2 Accessories........................................................................................................................................................................................... 27-7

27.8 AG Accessories (for Passport 12 only) ................................................................................................................................................. 27-8

27.9 Micellaneous Accessories ....................................................................................................................................................................... 27-8

A Product Specifications ...................................................................................................................................................... A-1

A.1 Monitor Safety Specifications .................................................................................................................................................................... A-1

A.2 Power Supply Specifications ...................................................................................................................................................................... A-2

A.3 Physical Specifications ................................................................................................................................................................................. A-2

A.4 Hardware Specifications .............................................................................................................................................................................. A-3

A.5 Data Storage .................................................................................................................................................................................................... A-5

A.6 Wireless Network ............................................................................................................................................................................................ A-5

A.7 Measurement Specifications ..................................................................................................................................................................... A-6

Passport 12/Passport 8 Operator’s Manual 11

B EMC and Radio Regulatory Compliance .......................................................................................................................... B-1

B.1 EMC ...................................................................................................................................................................................................................... B-1

B.2 Radio Regulatory Compliance ................................................................................................................................................................... B-5

C Default Configurations ..................................................................................................................................................... C-1

C.1 Parameters Configuration ........................................................................................................................................................................... C-1

C.2 Routine Configuration ............................................................................................................................................................................... C-12

C.3 User Maintenance Items ........................................................................................................................................................................... C-16

D Alarm Messages ............................................................................................................................................................... D-1

D.1 Physiological Alarm Messages ................................................................................................................................................................. D-1

D.2 Technical Alarm Messages ......................................................................................................................................................................... D-3

E Symbols and Abbreviations ............................................................................................................................................. E-1

E.1 Symbols .............................................................................................................................................................................................................. E-1

E.2 Abbreviations ................................................................................................................................................................................................... E-2

12 Passport 12/Passport 8 Operator’s Manual

FOR YOUR NOTES

Passport 12/Passport 8 Operator’s Manual 1-1

1 Safety

1.1 Safety Information

WARNING

 Indicates a potential hazard or unsafe practice that, if not avoided, could result in death or serious injury.

CAUTION

 Indicates a potential hazard or unsafe practice that, if not avoided, could result in minor personal injury or

product/property damage.

NOTE

 Provides application tips or other useful information to ensure that you get the most from your product.

1.1.1 Warnings

WARNINGS

 Before putting the system into operation, the operator must verify that the equipment, connecting cables

and accessories are in correct working order and operating condition.

 To avoid risk of electric shock, this equipment must only be connected to a supply mains with protective

earth. If a properly grounded power outlet is not available, operate the monitor on battery power.

 The equipment is not intended to be used within the Magnetic Resonance (MR) environment.

 To avoid an explosion hazard, do not use the equipment in the presence of oxygen-rich atmospheres,

flammable anesthetics, or other flammable agents (such as gasoline).

 Before connecting the equipment to the power line, check that the voltage and frequency ratings of the

power line are the same as those indicated on the equipment’s label or in this manual.

 Do not open the equipment housings. All servicing or future upgrades must be carried out by Mindray

trained and authorized personnel.

 Do not come into contact with patients during defibrillation. Otherwise serious injury or death could result.

 Do not rely exclusively on the audible alarm system for patient monitoring. Adjustment of alarm volume to

a low level or off may result in a hazard to the patient. Remember that alarm settings should be customized

according to different patient situations and always keeping the patient under close surveillance is the most

reliable way for safe patient monitoring.

1-2 Passport 12/Passport 8 Operator’s Manual

WARNINGS

 PATIENTS WITH A PACEMAKER – On ventricular paced patients, episodes of Ventricular Tachycardia may not

always be detected. Do not rely entirely upon the system’s automated arrhythmia detection algorithm.

Keep pacemaker patients under close surveillance.

 The physiological data and alarm messages displayed on the equipment should be reviewed by a clinician

before being used for diagnostic interpretation and treatment.

 To avoid inadvertent disconnection, route all cables in a way to prevent a stumbling hazard. Wrap and

secure excess cabling to reduce risk of entanglement by patients or personnel.

 Do not touch the equipment’s metal parts or connectors when in contact with the patient; otherwise patient

injury may result.

 Never mix patient electrode types or brands. Dissimilar metals or other incompatibilities may cause

considerable baseline drift and may increase trace recovery time after defibrillation.

 To reduce the hazard of burns during high-frequency surgical procedure, ensure that the monitor’s cables

and transducers never come into contact with the electro-surgery unit (ESU).

 The neutral electrode of the electro-surgery unit (ESU) shall properly contact the patient. Otherwise, burns

may result.

 Magnetic and electrical fields are capable of interfering with the proper performance of the equipment. For

this reason make sure that all external devices operated in the vicinity of the equipment comply with the

relevant EMC requirements. Mobile phone, X-ray equipment or MRI devices are a possible source of

interference as they may emit higher levels of electromagnetic radiation.

1.1.2 Cautions

CAUTIONS

 Only use parts and accessories specified in this manual.

 Disposable accessories are not designed to be reused. Reuse may cause a risk of contamination and affect

the measurement accuracy.

 Always install or carry the equipment properly to avoid damage caused by drop, impact, strong vibration or

other mechanical force.

 Dry the equipment immediately in case of rain or water spray.

 Ensure that the patient monitor is supplied with continuous electric power during work. Sudden power

failure may lead to data loss.

 This equipment is intended for single patient use.

 Store and use the equipment in specified environmental condition. The monitor and accessories may not

meet the performance specification due to aging, stored or used outside the specified temperature and

humidity range.

Passport 12/Passport 8 Operator’s Manual 1-3

1.1.3 Notes

NOTES

 Put the equipment in a location where you can easily view and operate the equipment.

 During normal use, the operator is expected to face the front of the equipment.

 The equipment uses a mains plug as a means of isolation to the mains power supply. Do not position the

equipment in a place difficult to operate the mains plug.

 Remove the battery before shipping the monitor or if it will not be used for an extended period of time.

 Keep this manual in the vicinity of the equipment so that it can be conveniently referenced when needed.

 The software was developed in compliance with IEC60601-1-4. The possibility of hazards arising from

software errors is minimized.

 This manual describes all features and options. Your equipment may not have all of them. They are not

available in all geographies.

 At the end of its service life, the equipment, as well as its accessories, must be disposed of in compliance

with the guidelines regulating the disposal of such products. If you have any questions concerning disposal

of the equipment, please contact Mindray.

 When disposing of the packaging material, be sure to observe the applicable waste control regulations and

keep it out of children’s reach.

1.2 Equipment Symbols

Some symbols may not appear on your equipment.

Caution

Refer to instruction manual/ booklet

Power ON/OFF (for a part of the

equipment)

Battery indicator

Alternating current

VGA output

Equipotentiality

Graphical record

USB connector

Network connector

Zero key Input/Output

Check sensor

Calibrate key

Measure/standby

Inserted direction

Gas outlet

Serial number

1-4 Passport 12/Passport 8 Operator’s Manual

DATE OF MANUAFACTURE

Symbol for “MANUFACTURER”

Catalog number

Protected against vertically falling

water drops per IEC 60529

Electrostatic sensitive devices

DEFIBRILLATION-PROOF TYPE CF APPLIED PART

DEFIBRILLATION-PROOF TYPE BF APPLIED PART

The presence of this label indicates the machine was certified by ETL with the statement:

Conforms to AAMI Std ES 60601-1, IEC Std 60601-1-6, IEC Std 60601-1-8, IEC Std 60601-2-25, IEC Std

60601-2-26, IEC Std 60601-2-27, IEC Std 60601-2-34, IEC Std 60601-2-49, IEC Std 80601-2-30, ISO Std

80601-2-55, ISO Std 80601-2-56, ISO Std 80601-2-61

Certified to CSA Std C22.2 NO. 60601-1, NO. 60601-6, NO. 60601-1-8, NO. 60601-2-25, NO.

60601-2-26,NO. 60601-2-27, NO. 60601-2-34, NO. 60601-2-49, NO. 80601-2-30, NO. 80601-2-55, NO.

80601-2-56, NO. 80601-2-61

Passport 12/Passport 8 Operator’s Manual 2-1

2 The Basics

2.1 Intended Use

The Passport Series Patient Monitor ( Passport 8 and Passport 12) are intended to be used for monitoring, displaying,

reviewing, storing and alarming of multiple physiological parameters including ECG (3-lead, or 5-lead, or 12-lead

selectable), arrhythmia detection and ST Segment analysis, QT analysis, heart rate (HR), respiration (Resp), temperature

(Temp), pulse oxygen saturation (SpO

2

), pulse rate (PR), non-invasive blood pressure (NIBP), invasive blood pressure

(IBP), cardiac output (C.O.), carbon dioxide (CO

2

), and anesthetic gas (AG).

All the parameters can be applied to single adult, pediatric or neonatal patients with the exception of the following:

 C.O. monitoring is restricted to adult patients only;
 PAWP monitoring is not intended for neonatal patients;
 The Mortara ECG Algorithm arrhythmia detection and ST Segment analysis is intended for adult and

pediatric patients. The Mindray ECG Algorithm arrhythmia detection is intended for adult and pediatric

patients, and the Mindray ECG Algorithm ST Segment analysis is intended for adult patients only.

 12-lead monitoring and AG monitoring are available for Passport 12 Patient Monitor only.

The monitors are to be used in healthcare facilities by clinical physicians or appropriate medical staff under the

direction of physicians.

WARNING

 This patient monitor is intended for use only by clinical professionals or under their guidance. It must only

be used by persons who have received adequate training in its use. Anyone unauthorized or untrained must

not perform any operation on it.

NOTE

 Mindray ECG algorithm is hereinafter referred as the Advanced ECG algorithm.

2-2 Passport 12/Passport 8 Operator’s Manual

2.2 Applied Parts

The applied parts of the Passport 8/12 patient monitors are:

 ECG electrodes and leadwires,

 SpO2 sensor

 NIBP cuff

 Temp probes

 IBP transducer

 C.O. sensor

 CO

2

sampling line/nasal sampling cannula, and water trap

 AG sampling line, water trap, and airway adapter

2.3 Main Unit

2.3.1 Front View

1

2

3

4

5

6

7

8

910

11

12

Passport 12/Passport 8 Operator’s Manual 2-3

1. Alarm lamp

When a physiological alarm or technical alarm occurs, this lamp flashes as defined below.

 High level alarms: the lamp quickly flashes red.
 Medium level alarms: the lamp slowly flashes yellow.
 Low level alarms: the lamp lights yellow without flashing.

2. Display Screen

3. AC power LED

4. Power On/Off Switch

 Pressing this switch turns the monitor on.
 When the monitor is on, pressing and holding this switch turns the monitor off.

An indicator is built into this switch. It turns on when the monitor is on and turns off when the monitor is off.

5. Battery LED

 On: when the battery is installed and the AC source is connected.
 Off: when no battery is installed or the installed battery is malfunctioning, or no AC source is connected

when the monitor is powered off.

 Flashing: when the monitor operates on battery power.

6. Alarm Reset: Press to reset the alarms.

7. Alarm Pause: Press to pause or restore alarms.

8. Freeze: Press to freeze or unfreeze waveforms.

9. Record: When a recording task is not started, pressing this button starts recording. When a recording task is in

progress, pressing this button stops recording.

10. NIBP: Press to start or stop NIBP measurements.

11. Menu

If no menu is currently displayed on the screen, pressing it enters the main menu. If a menu is currently displayed

on the screen, pressing it closes that menu.

12. Knob

 Rotate the knob clockwise or counter-clockwise to move the cursor.
 Press the knob to select one item, such as accessing a menu or confirming the selection.

2-4 Passport 12/Passport 8 Operator’s Manual

2.3.2 Side View

Passport 12

1. Handle 2. Battery compartment

3. Recorder 4. Parameter module slot

5. Temp probe 1 connector 6. Temp probe 2 connector

7. IBP cable connector 8. SpO2 cable connector

9. ECG cable connector 10. NIBP cuff connector

2

3

4

5

6

7

8

9

10

1

1

Passport 12/Passport 8 Operator’s Manual 2-5

Passport 8

1. Handle 2. Battery compartment

3. Recorder 4. Parameter module slot

5. Temp probe 1 connector 6. Temp probe 2 connector

7. SpO

2

cable connector for 8. ECG cable connector

9. NIBP cuff connector

1

3

5

6

7

8

4

9

1

2

2-6 Passport 12/Passport 8 Operator’s Manual

2.3.3 Rear View

Passport 12

1. AC Power Input

2. Equipotential Grounding Terminal

When using the monitor together with other devices, connect their equipotential grounding terminals together

to eliminate the potential differences between them.

3. Parameter Module Slot

Used for connecting the parameter modules.

4. USB Connectors

Connects a USB drive for data or configuration transfer.

5. Multifunctional Connector:

 Connects the monitor to external devices and outputs defibrillator synchronization signals, nurse call signals,

analog output signals, measurement numerics, and alarm limits of parameter modules.

 Communicates with external devices via Datascope Improved ASCII Protocol (DIAP) protocol.

1 2

4

6

5

7

3

Passport 12/Passport 8 Operator’s Manual 2-7

6. Network Connector

A standard RJ45 connector which connects the monitor to the central station (CMS) or other monitor for remote

viewing. It also connects the monitor to a PC for a system upgrade.

7. VGA Connector

Connects a secondary display, which extends the display capability of your monitor. The contents displayed on

the secondary display screen matches what displays on the monitor screen.

Passport 8

1. Equipotential Grounding Terminal

When using the monitor together with other devices, connect their equipotential grounding terminals together

to eliminate the potential differences between them.

2. AC Power Input

3. Parameter Module Slot

Used for connecting the parameter modules.

2

1

4

5

6

7

3

2-8 Passport 12/Passport 8 Operator’s Manual

4. Multifunctional Connector

 Connects the monitor to external devices and outputs defibrillator synchronization signals, nurse call signals,

analog output signals, measurement numerics, and alarm limits of parameter modules.

 Communicates with external devices via Datascope Improved ASCII Protocol (DIAP) protocol.

5. USB Connectors

Connects a USB disk for data or configuration transfer.

6. Network Connector

A standard RJ45 connector which connects the monitor to CMS or other monitor for remote view. It also connects

the monitor to PC for system upgrade.

7. VGA Connector

Connects a secondary display, which extends the display capability of your monitor. The contents displayed on

the secondary display screen accords with those displayed on the monitor screen.

2.4 Modules

1 2 3 4 5 6

1. IBP module: contains IBP cable connector

2. Sidestream CO

2

module: contains CO2 watertrap connector, and CO2 gas outlet.

3. IBP+C.O. module: contains IBP cable connector and C.O. cable connector.

4. IBP+C.O. + sidestream CO2 module: contains IBP cable connector, C.O. cable connector, CO2 watertrap

connector, and CO

2

gas outlet.

5. IBP+C.O. + microstream CO

2

module: contains IBP cable connector, C.O. cable connector, CO2 sampling

line connector, and CO

2

gas outlet.

6. IBP+C.O.+AG module (with O

2

): contains IBP cable connector, C.O. cable connector, AG watertrap

slot, and AG gas outlet. This module is for Passport 12 only.

NOTE

 The above modules with IBP connectors support two invasive blood pressures through an IBP extended

cable (PN: 040-001029-00).

Passport 12/Passport 8 Operator’s Manual 2-9

2.5 Display Screen

This patient monitor adopts a high-resolution LED screen to display patient parameters and waveforms. A typical

display screen is shown below.

1. Patient Information Area

 This area shows date, time, and the patient information such as department, bed number, patient name and

patient category.

indicates that no patient is admitted or the patient information is incomplete. If no

patient is admitted, selecting this area enters the [Patient Setup] menu. For admitted patients, selecting

this area enters the [Patient Demographics] menu.

2. Alarm Symbols

 indicates alarms are paused.

 indicates alarms are reset.

 indicates alarm sounds are turned off.

 indicates the system is in alarm off status.

1

23 4

5

6

8

9

7

2-10 Passport 12/Passport 8 Operator’s Manual

3. Technical Alarm Area

This area shows technical alarm messages and prompt messages. When multiple messages occur, the messages

scroll. Select this area and the technical alarm list displays.

4. Physiological Alarm Area

This area shows physiological alarm messages. When multiple alarms occur, the messages scroll. Select this area

and the physiological alarm list displays.

5. Waveform Area

This area shows measurement waveforms. The waveform name displays at the upper left corner of the waveform.

Select this area and the corresponding measurement setup menu displays.

6. Parameter Area A

This area shows measurement parameters. Each monitored parameter has a parameter window and the

parameter name displays at the upper left corner. The corresponding waveform of each parameter displays in the

same row in the waveform area. Select this area and the corresponding measurement setup menu displays.

7. Parameter Area B

For the digital parameters displayed in this area, their corresponding waveforms are not displayed.

8. Prompt Message Area

This area shows the current configuration name, prompt messages, network status icons, and battery status icons,

etc. For details about battery status symbols, refer to chapter 24 Batteries.

 indicates the monitor is successfully connected to a wired network.

 indicates the monitor has failed to connect to a wired network.

 indicates the wireless function (optional) is working.

 indicates the wireless function (optional) is not working.

 indicates a USB drive is inserted.

9. QuickKeys Area

This area contains QuickKeys that provide quick access to functions.

Passport 12/Passport 8 Operator’s Manual 2-11

2.6 QuickKeys

A QuickKey is a configurable graphical key, located at the bottom of the main screen. They give you fast access to

functions. Their availability, and the order in which they appear on your screen, depend on your monitor

configuration.

The following QuickKeys are available:

Display more QuickKeys

Hide the QuickKeys

[Main Menu] QuickKey

Enter the [Main Menu]

[Standby] QuickKey

Enter Standby mode

[Alarm Setup] QuickKey

Change alarm settings

[Review] QuickKey

Review the patient’s data

[NIBP Measure] QuickKey

Enter the [NIBP Measurement] menu

[Stop All] QuickKey

Stop all NIBP Measurements

[Zero IBP] QuickKey

Zero IBP

[Realtime Print] QuickKey

Start the realtime print

[Print Setup] QuickKey

Print Setup

[Alarm Reset] QuickKey

Reset the alarms

[Alarm Pause] QuickKey

Pause or restore alarms

[Screens]

Change screen

[Patient Setup] QuickKey

Enter the [Patient Setup] menu

[Manual Event] QuickKey

Trigger a manual event

[Minitrends] QuickKey

Have a split-screen view of minitrends

[Volume Setup] QuickKey

Enter the [Volume Setup] menu

2-12 Passport 12/Passport 8 Operator’s Manual

[Load Config.] QuickKey

Default configurations

[Start C.O.] QuickKey

Start cardiac output procedure

[Calculations] QuickKey

Perform calculations

[Others] QuickKey

Have a split-screen view of another patient’s conditions

[OxyCRG] QuickKey

Have a split-screen view of OxyCRG trends

[7-Lead ECG] QuickKey

Enter the full-screen 7-lead ECG screen

[Parameters] QuickKey

Enter the [Parameters] menu

[NIBP STAT] QuickKey

Start NIBP STAT measurement

[Unit Setup] QuickKey

Enter the [Unit Setup] menu

[PAWP] QuickKey

Enter the PAWP measurement screen

[CPB Mode] QuickKey

Enter the CPB mode

[Privacy Mode] QuickKey

Enter the Privacy mode

[Night Mode] QuickKey

Enter the Night mode

You can configure up to four QuickKeys on the screen. To select your desired QuickKeys:

1. Select [Main Menu]→[Maintenance >>]→[Manage Configuration >>]→enter the required password→[Ok].

2. In the [Manage Configuration] menu, select [Edit Config.>>].

3. In the pop-up menu, select the desired configuration and then select [Edit].

4. In the pop-up menu, select [Screen Setup >>].

5. Select the [Select QuickKeys] tab, and then configure your desired QuickKeys and the order of them.

Passport 12/Passport 8 Operator’s Manual 3-1

3 Basic Operations

3.1 Installation

WARNING

 Connect only approved devices to this equipment. Devices connected to the equipment must meet the

requirements of the applicable IEC standards (e.g. IEC 60950 safety standards for information technology

equipment and IEC 60601-1 safety standards for medical electrical equipment). The system configuration

must meet the requirements of the IEC 60601-1 medical electrical systems standard. Any personnel who

connect devices to the equipment’s signal input/output port is responsible for providing evidence that the

safety certification of the devices has been performed in accordance to the IEC 60601-1. If you have any

questions, please contact Mindray.

 If it is not evident from the equipment specifications whether a particular combination with other devices is

hazardous, for example, due to summation of leakage currents, please consult the manufacturers or else an

expert in the field, to ensure the necessary safety of patients and all devices concerned will not be impaired

by the proposed combination.

CAUTION

 The equipment should be installed by authorized Mindray personnel.

NOTE

 The software equipment copyright is solely owned by Mindray. No organization or individual shall resort to

modifying, copying, or exchanging it or to any other infringement on it in any form or by any means without

due permission.

 Many settings in the patient monitor are password protected. It is recommended to change the default

passwords and keep the passwords safe. Passwords should only be changed by authorized personnel.

Contact your department manager or biomedical engineering department for the passwords used at your

facility.

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3.1.1 Unpacking and Checking

Before unpacking, examine the packing case carefully for signs of damage. If any damage is detected, contact the

carrier or Mindray.

If the packing case is intact, open the package and remove the equipment and accessories carefully. Check all

materials against the packing list and check for any mechanical damage. Contact Mindray in case of any problem.

CAUTION

 When disposing of the packaging material, be sure to observe the applicable waste control regulations and

keep it out of children’s reach.

 Before use, please verify whether the packages are intact, especially the packages of single use accessories.

In case of any damage, do not apply it to patients.

NOTE

 Save the packing case and packaging material as they can be used if the equipment must be reshipped.

3.1.2 Environmental Requirements

The equipment operating environment must meet the requirements specified in this manual.

The equipment operating environment should be reasonably free from noises, vibration, dust, corrosive, flammable

and explosive substances. To maintain good ventilation, the equipment should be at least 2 inches (5 cm) away from

surrounding objects.

When the equipment is moved from one place to another, condensation may occur as a result of temperature or

humidity difference. In this case, never start the system before the condensation disappears.

CAUTION

 Make sure that the equipment operating environment meets the specific requirements. Otherwise

unexpected consequences, e.g. damage to the equipment, could result.

 Put the equipment in a location where you can easily see the screen, access the operating controls, and

disconnect the equipment from AC power.

Passport 12/Passport 8 Operator’s Manual 3-3

3.2 Getting Started

3.2.1 Connecting to Power Source

Using AC Power Source

To use the AC power source, connect one end of the power cord with the AC power input on the equipment’s back

panel and the other end with a wall AC mains outlet.

WARNING

 Always use the accompanying power cord with the monitor.

 Use the battery if the integrity of the protective earth conductor or the protective earthing system in the

installation is in doubt.

Using a Battery

This monitor can be equipped with rechargeable lithium-ion battery. If a battery is installed, the monitor system

automatically switches to the battery for power if AC power is interrupted.

NOTE

 When a battery has been stored for a long time, or the battery is depleted, recharge the battery at once.

Otherwise, the low battery may not be sufficient to power the monitor if the AC power is unavailable.

Refer to Chapter 24 Batteries for detail.

Connecting Accessories

Insert the connector of accessory cables necessary for the measurements to be performed by your monitor to the

corresponding connector on the monitor. For details about the parameter connectors, refer to 2.3.2 Side View

3.2.2 Turning Power On

Once the monitor is installed, before beginning measurements:

1. Check the monitor and plug-in modules for any mechanical damage, and make sure that all external cables,

plug-ins and accessories are properly connected.

2. Check the power supply specification is met if mains power is used. Only use a power outlet that is properly

grounded.

3. Plug the power cord into the AC power source. If you run the monitor on battery power, ensure that the battery

is sufficiently charged.

4. Press the power on/off switch on the monitor’s front panel.

The monitor will perform alarm system self-test during start-up. After pressing the power on/off button, the system

shows a “Loading…” screen, sounds a beep and the alarm lamp simultaneously turns yellow, then red, and then turns

off, followed by the start-up screen being shown. Then the start-up screen disappears. The alarm system self-test

succeeds. The monitor enters the normal monitoring screen.

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NOTE

 Carefully check if the system performs the self-test as described above. Contact your service personnel or

Mindray if the self-test is abnormal.

WARNING

 Do not use the monitor on a patient if you suspect it is not working properly, or if it is mechanically

damaged. Contact your service personnel or Mindray.

3.2.3 Starting Monitoring

1. Decide which measurements you want to take.

2. Connect the required modules, patient cables and sensors.

3. Make sure that the patient cables and sensors are correctly connected.

4. Make sure that the patient settings, such as [Patient Cat.], [Paced], etc, are appropriate for your patient.

5. Refer to the appropriate measurement section for details of how to perform the measurements you require.

3.3 Turning Off the Monitor

Before turning off the monitor,:

1. Ensure that the monitoring of the patient has been completed. .

2. Disconnect the cables and sensors from the patient.

3. Make sure to save or clear the patient monitoring data as required.

4. Press and hold the power on/off switch for more than 2seconds to turn off the monitor. “System is shutting

down…” is displayed on the screen and then the monitor shuts down.

CAUTION

 Press and hold the power on/off switch for 10 seconds to forcibly shut down the monitor if it could not be

shut down normally. This may cause loss of patient data.

 The monitor restores the latest configuration if it restarts within 60 seconds after a power failure. The

monitor restores the default configuration, rather than the latest configuration, if it restarts 120 seconds

after a power failure. The monitor may load either the latest configuration or the default configuration if it

restarts from 60-120 seconds after a power failure.

 Power failure may cause data corruption on the SD card. It is recommended to turn off the monitor

according to the normal procedures. Do not directly unplug the power cord, unless a charged battery is

installed, or remove the battery before shutting down the monitor.

Passport 12/Passport 8 Operator’s Manual 3-5

NOTE

 To completely disconnect the power supply, unplug the power cord.

3.4 Using the Knob

 Rotate the knob clockwise or counterclockwise to move the cursor.

 Press the knob to select one item, such as accessing a menu or confirming the selection.

3.5 Using Keys

The monitor has three types of keys:

 Softkey: A softkey is a graphic key on the screen, giving you fast access to certain menus or functions. The

monitor has two types of softkeys:

 Parameter keys: Each parameter area can be seen as a softkey. You can enter a parameter setup menu by

selecting its corresponding parameter or waveform area.

 QuickKeys: QuickKeys are configurable graphical keys, located at the bottom of the main screen. For details,

refer to the section 2.6 QuickKeys.

 Hardkeys: A hardkey is a physical key on a monitoring device, such as the [Main Menu] hardkey on the monitor’s

front panel.

 Pop-up Keys: Pop-up keys are task-related keys that appear automatically on the monitor screen when needed.

For example, the Confirm pop-up key appears only when you need to confirm a change.

3.6 Using the Touchscreen

Select screen items by pressing them directly on the monitor’s screen. You can enable or disable touchscreen

operation by pressing and holding the [Main Menu] QuickKey for 3 seconds. A padlock symbol

displays if

touchscreen operation is disabled.

3.7 Using the On-screen Keyboard

The on-screen keyboard enables you to enter information.

 Use the

key to delete the previously entered character.

 Use the

key to toggle between uppercase and lowercase letters.

 Select

to confirm what you have entered and close the on-screen keyboard.

 Select to access the symbol keyboard.

 Select to exit the symbol keyboard.

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3.8 Using the Main Menu

To enter the [Main Menu], select the [Main Menu] on-screen QuickKey or the [Menu] hardkey on the monitor’s front

panel. Most of monitor operations and settings can be performed through this [Main Menu].

Other menus are similar to the [Main Menu] and contain the following parts:

1. Heading: displays the title for the current menu.

2. Main body: displays options, buttons, prompt messages, etc. The menu buttons with “>>’’ open a secondary

window to reveal more options or information.

3. Online help area: displays help information for the highlighted menu item.

4.

: select to exit the current menu. If changes are made in the menu, they take effect after selecting this button.

3.9 Setting the Screen

You can enter the [Screen Setup] window as shown below by selecting [Main Menu] → [Screen Setup] →

[Screen Layout >>]. In this window, you can arrange the positions of the parameters and waveforms. Unselected

parameters or waveforms will not display.

1

2

4

3

Passport 12/Passport 8 Operator’s Manual 3-7

The ECG parameter and the first ECG waveform always display in the first row. The configurable areas can be classified

as Area A, Area B, and Area C.

 In Area A, you can choose to display the parameter windows and their waveforms (if one exists). Each parameter

and the associated waveform are displayed in the same row.

 In Area B, you can choose to display the parameter windows. But if all parameters in area C are set to [Off], both

the parameter and waveform selected in the first row of area B will be displayed.

 In Area C, you can choose to display the timer and any parameters without associated waveforms.

The screen automatically adjusts to ensure the best view based on your screen setup.

If no corresponding parameter or waveform displays after the module is inserted, perform the following inspections:

 Check the connection between the module and lead, cable, sensor, or external device.

 Enter the [Screen Setup] window for the desired display configuration by selecting [Main Menu] → [Screen

Setup] → [Screen Layout >>].

 Check that the parameter is turned on in [Parameters Switch] window.

CAUTION

 Unallocated parameters in the [Screen Setup] window will not display. However, the monitor still sounds

alarms for these parameters.

Area C

Area B

Area A

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3.10 Displaying the Timer

To display the timer in the main screen:

1. Select [Main Menu]→[Screen Setup>>]→[Screen Layout >>] to access the [Screens] window.

2. Select [Screen Setup] tab.

3. In Area C, select [Timer] from the drop-down list of the desired parameter area. Refer to section 3.9 Setting the

Screen.

4. Select

to exit the window. The main screen will display the timer.

 Select [Start] or [Pause] to start or pause timing.

 Select [Clear] to clear current timing result.

 Select [Setup] to access the [Timer Setup] window, in which you can set the [Direction] to [Up] or [Down]. If you

select [Down], you should set:

 [Run Time(h:min:s)]: The available time range is 0 to 100 hours, and the default time is 5 minutes.

 [Reminder Vol]: During the last 10 seconds of the countdown, the system issues reminder tone. The

available volume range is 0 to 10. 0 means off, and 10 the maximum volume.

3.11 Changing General Settings

This chapter covers only general settings such as language, brightness, date and time, etc. Refer to measurement and

other settings in their respective sections.

3.11.1 Setting up a Monitor

To install a monitor or change its location:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. In the [User Maintenance] menu, set [Monitor Name], [Department] and [Bed No.], or edit their settings.

3.11.2 Changing Language

To change the language:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. In the [User Maintenance] menu, select [Language] and then select the desired language.

3. Restart the monitor.

Passport 12/Passport 8 Operator’s Manual 3-9

NOTE

 The changed language is applied only after the monitor is restarted.

3.11.3 Adjusting the Screen Brightness

To adjust the screen brightness:

1. Select the [Main Menu]→[Screen Setup >>]→[Brightness].

2. Select the appropriate setting for the screen brightness. 10 is the brightest, and 1 is the dimmest.

If the monitor operates on battery power, setting a dimmer screen brightness will prolong the battery operating time.

When the monitor enters Standby mode, the screen automatically changes to the dimmest setting.

3.11.4 Showing/Hiding Help Text

The monitor provides online help information. The user can display or hide the help text as needed.

1. Select [Main Menu]→[Screen Setup >>].

2. Select [Help] and select either [On] or [Off].

3.11.5 Setting the Date and Time

To set the date and time:

1. Select [Main Menu] →[Maintenance >>]→[System Time >>].

2. Set the date and time.

3. Select [Date Format] and select either [yyyy-mm-dd], [mm-dd-yyyy] or [dd-mm-yyyy].

4. Select [Time Format] and select either [24h] or [12h].

If your monitor is connected to a central station (CMS), the date and time are automatically synchronized to that CMS.

In that case, you cannot change the date and time settings on your monitor.

CAUTION

 Changing date and time affects the storage of trends and events and may cause data loss. Save or record

any needed data prior to changing the date and time.

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3.11.6 Adjusting Volume

Alarm Volume

To adjust the alarm volume:

1. Select the [Volume Setup] QuickKey, or [Main Menu]→[Alarm Setup >>]→ [Others].

2. Select [Alm Volume] and then select the appropriate volume: X-10, in which X is the minimum volume,

depending on the set minimum alarm volume (refer to the chapter Alarm), and 10 is the maximum volume.

Key Volume

When you press the navigation knob, the touchscreen, or the hardkeys on the panel, the monitor prompts you by

making a sound of the key volume you have set.

To adjust the key volume:

1. Select the [Volume Setup] QuickKey, or [Main Menu]→[Screen Setup >>].

2. Select [Key Volume] and then select the appropriate volume. 0 means off, and 10 is the maximum volume.

QRS Volume

The QRS tone is derived from either the HR or PR, depending on which is currently selected as the alarm source in

[ECG Setup] or [SpO2 Setup]. When monitoring SpO2, there is a variable pitch tone which changes as the patient’s

saturation level changes. The tone pitch rises as the saturation level increases and falls as the saturation level

decreases. The tone volume is user adjustable.

To adjust the QRS volume

1. Select the [Volume Setup] QuickKey, or the ECG parameter window→[Others >>], or the SpO

2

parameter

window.

2. Select [QRS Volume] or [Beat Vol] and then select the appropriate volume. 0 means off, and 10 is the maximum

volume.

3.12 Setting Parameters

3.12.1 Switching the Parameters On/Off

To switch the parameters on or off, select [Main Menu]→[Screen Setup >>]→[Screen Layout >>]→[Parameters

Switch]. When a parameter is switched off, its corresponding parameter module stops working, and its parameter

value and waveform are not shown on the monitor display.

NOTE

 ECG is always selected, and you can not switch it off.

Passport 12/Passport 8 Operator’s Manual 3-11

3.12.2 Accessing the Parameters Menu

Select [Parameters >>] from the [Main Menu] or select corresponding parameter area or waveform area to access a

parameter setup menu.

3.13 Operating Modes

Your monitor has different operating modes. Some are password protected. This section lists the major operating

modes.

3.13.1 Monitoring Mode

This is the normal, everyday working mode that you use for monitoring patients. Your monitor automatically enters

the Monitoring mode after being turned on.

3.13.2 Night Mode

To avoid disturbing the patient, Night mode may be used.

To activate the Night mode:

1. Select the [Night Mode] QuickKey or [Main Menu]→[Screen Setup >>]→[Night Mode >>].

2. In the pop-up menu, set the desired brightness, alarm volume, QRS volume, key volume, NIBP end tone, or

whether to stop NIBP measurements or not. When [Stop NIBP] is selected, all the NIBP measurements terminate

after entering the Night mode.

3. Select the [Enter Night Mode] button.

To cancel the Night mode:

1. Select the [Night Mode] QuickKey or [Main Menu]→[Screen Setup >>]→[Night Mode >>].

2. Select [Ok] in the pop-up.

CAUTION

 Before entering Night mode, confirm the brightness settings, alarm volume, QRS volume, and key volume.

Consider the potential risk when the setting value is low.

3.13.3 Privacy Mode

Privacy mode is only available when an admitted patient at a monitor is also monitored by the CMS.

To activate the Privacy mode, select [Main Menu]→[Screen Setup >>]→[Privacy Mode].

3-12 Passport 12/Passport 8 Operator’s Manual

The monitor does the following after activating Privacy mode:

 The screen turns blank and the message [Under monitoring. Press any key to exit the privacy mode.] displays.

 Monitoring and data storing continue but patient data is only visible at the CMS.

 Alarms can still be triggered. But all audible alarms are suppressed and the alarm light is deactivated at the

monitor.

 All system sounds are suppressed, including heart beat tone, pulse tone, all prompt tones, etc.

To cancel the Privacy mode, press any key.

The monitor exits the Privacy mode automatically in any of the following situations:

 The monitor disconnects from the CMS.

 The alarm [Battery Too Low] or [System will shut down soon. Please replace the batteries or use the

external power.] is presented.

The touchscreen is locked automatically in the Privacy mode.

WARNING

 In Privacy Mode, all audible alarms are suppressed and the alarm light is deactivated at the monitor. Alarms

sound only at the CMS.

NOTE

 The Privacy mode can be used only when the monitor is connected to a CMS.

3.13.4 Standby Mode

In Standby mode, you can temporarily stop patient monitoring without turning off the monitor. To enter the Standby

mode, select the [Standby] QuickKey .

Passport 12/Passport 8 Operator’s Manual 4-1

4 Managing Patients

4.1 Admitting a Patient

The monitor displays physiological data and stores it in trends as soon as a patient is connected. This allows you to

monitor a patient that is not admitted yet. However, it is recommended that you admit a patient so that you can clearly

identify them on recordings, reports and networking devices.

To admit a patient:

1. Select the [Patient Setup] QuickKey, or [Main Menu]→[Patient Setup >>].

2. Select [Discharge Patient] to clear any previous patient data. If you do not erase data from the previous patient,

the new patient’s data is combined with the previous patient’s data. The monitor makes no distinction between the

old and the new patient data.

3. If [Discharge Patient] button appears dimmed, directly select [Admit Patient] and then select:

 [Yes] to apply the data saved in the monitor to the new patient, or

 [No] to clear the data saved in the monitor.

4. In the [Patient Demographics] menu, enter the demographic details, of which:

 [Patient Cat.] allows the user to select patient size (Neo, Ped, Adu) which will determine the way your monitor

processes and calculates some measurements, and what safety and alarm limits are applied for your patient.

 [Paced] determines whether to show pace pulse marks on the ECG waveform. When the [Paced] is set to [No],

pace pulse marks are not shown in the ECG waveform.

5. Select [Ok].

WARNING

 The [Patient Cat.] and [Paced] fields always contain a value, regardless of whether the patient is fully

admitted or not. If you do not specify settings for these fields, the monitor uses the default settings from the

current configuration, which might not be correct for your patient.

 For paced patients, you must set [Paced] to [Yes]. If it is incorrectly set to [No], the monitor could mistake a

pace pulse for a QRS and fail to alarm when the ECG signal is too weak.

 For non-paced patients, you must set [Paced] to [No].

4-2 Passport 12/Passport 8 Operator’s Manual

4.2 Quick Admitting a Patient

Use [Quick Admit] only if you do not have the time or information to fully admit a patient. Complete the rest of the

patient demographic details later. Otherwise, the

symbol always displays in the patient information area.

1. Select the [Patient Setup] QuickKey, or [Main Menu]→[Patient Setup >>].

2. Select [Quick Admit]. If a patient has been admitted, select [Ok] to discharge the current patient. If no patient is

admitted, you can choose either:

 [Yes] to apply the data in your monitor to the new patient, or

 [No] to clear any previous patient data.

3. Enter the Patient Category and Paced Status for the new patient, and then select [Ok].

4.3 Querying and Obtaining Patient Information

The monitor can obtain patient information from Hospital Information System (hereafter called HIS) through the

eGateway. To query or obtain patient information from the HIS:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password→[Network

Setup >>]→[Gateway Comm Setup >>], and set [IP Address] and [Port]. Set [ADT Query] to [On]. Then select

[Ok]

2. Select the patient information area to enter the [Patient Demographics] menu.

3. Select [Obtain Patient Info. >>] to enter the [Obtain Patient Information] menu.

4. Input a query condition and then select [Query]. The monitor displays the requested patient information.

5. Select a patient and then click [Import] to update the corresponding patient information.

6. Select

to exit the [Obtain Patient Information] menu.

NOTE

 The option [Obtain Patient Information] is available in the [Patient Setup] menu only when [ADT Query] is

set to [On].

 When obtaining patient information from the HIS, only patient information is updated on the monitor. The

patient’s physiological data is not changed and the patient is not discharged.

Passport 12/Passport 8 Operator’s Manual 4-3

4.4 Associating Patient Information

After associating patient information with the HIS, the monitor automatically updates the patient information if the

corresponding HIS information changes. The monitor can associate the patient’s MRN (Medical Record Number), first

name, last name, date of birth, and gender with the HIS.

NOTE

 A keyword takes effect only when being defined in the eGateway. Refer to eGateway Integration Manager

Installation Guide (P/N: 046-002447-00) for details.

 The monitor displays corresponding patient information only when all the keywords have been entered.

4.5 Editing Patient Information

To edit the patient information after a patient has been admitted, when the patient information is incomplete, or when

you want to change the patient information:

1. Select the [Patient Setup] QuickKey, or [Main Menu]→[Patient Setup >>].

2. Select [Patient Demographics] and then make the required changes.

3. Select [Ok].

4.6 Discharging a Patient

To discharge a patient:

1. Select the [Patient Setup] QuickKey, or [Main Menu]→[Patient Setup >>].

2. Select [Discharge Patient]. In the pop-up menu, you can either:

 Select [Ok] to discharge the current patient, or

 Select [Standby] then [Ok]. The monitor enters the Standby mode after discharging the current patient, or

 Select [Cancel] to exit without discharging the patient.

NOTE

 After discharging an admitted patient, you can review the history data of this patient by selecting [Main

Menu]→[Patient Data >>]→[History Data >>]. When the SD card is full, the oldest patient data will be

deleted automatically. Therefore, you cannot always view all the history data.

4.7 Transferring Patient Data

You can transfer patient data between monitors with a USB drive without re-entering the patient demographic

information. Transferring of patient data enables you to review the patient’s condition history. The patient data that can

be transferred includes: patient demographics, trend data, alarm events and parameter alarm limits.

From the [User Maintenance] menu, select [Others >>]. In the pop-up menu, you can set [Transferred Data Length].

The default is [4 h]. You can also set [Data Transfer Method]. The default is [Off].

4-4 Passport 12/Passport 8 Operator’s Manual

WARNING

 Do not discharge a patient before the patient is successfully transferred.

 After a patient is successfully transferred, check if the patient settings (especially patient category, paced

status and alarm limits settings, etc) on the monitor are appropriate for this patient.

NOTE

 The system automatically enables the HR alarm and lethal arrhythmia alarm after transferring the patient

data.

4.7.1 Transferring Data from the Monitor to a USB Drive

To transfer data from the monitor to a USB drive:

1. Connect a USB drive into the monitor’s USB port. Select [Main Menu]→[Patient Setup >>].

2. Select [Transfer to Storage Medium]. In the pop-up menu, you can:

 Select [Ok] to transfer the patient data, or

 Select [Cancel] to exit the menu.

3. Wait until the following message appears: [Transfer to storage medium successful. Please remove the USB

drive.].

4. Remove the USB drive from monitor.

4.7.2 Transferring Data from a USB Drive to the Monitor

To transfer data from a USB drive to the monitor:

1. Connect the USB drive to the destination monitor.

2. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password → [Others >>]

→ [Data Transfer Method] →[USB Drive]. Then:

 Select [Transfer] to transfer the patient data to the monitor, or

 Select [Cancel Transfer] to cancel the transfer operation.

 Select [Unload USB Drive] to unload the USB drive without transferring the patient data.

3. After you select [Transfer], in the pop-up menu you can select the patient data contents that need to be

transferred. [Patient Demographics] must be selected. After [Ok] is selected, the monitor compares the patient

information stored in both the storage medium and monitor and manages the patient data based on the following.

 Different

Patient:

The monitor erases all the current patient data, transfers the patient data from the

storage medium, and loads the configuration according to the patient category.

 Same Patient:

In the pop-up dialog box, you can:

 Select [Yes] to merge the patient data in the monitor and storage medium.

 Select [No] to erase all the current patient data in the monitor and transfer the

patient data from the storage medium.

4. Wait until the message [Transfer from storage medium successful.] appears before removing the USB drive.

Passport 12/Passport 8 Operator’s Manual 4-5

CAUTION

 The USB drive you use may be write-protected. In this case, make sure the USB drive is in read/write mode.

 Do not remove the storage medium during data transfer process. Otherwise, data files may be damaged.

 The normal monitoring function will be affected during data export. Do notperform any monitoring activity

during data export.

4.8 Connecting to a CMS

If your monitor is connected to a CMS:

 All patient information, measurement data and settings on the monitor can be transferred to the CMS.

 All patient information, measurement data and settings can be displayed simultaneously on the monitor and CMS.

For some functions such as editing patient information, admitting a patient, discharging a patient,

starting/stopping NIBP measurements, etc., bi-directional control can be achieved between your monitor and the

CMS.

For details, refer to the CMS’s instructions for use (PN: 0070-00-0728-52 for Panorama CMS and 046-005011-00 for DPM

CMS).

4-6 Passport 12/Passport 8 Operator’s Manual

FOR YOUR NOTES

Passport 12/Passport 8 Operator’s Manual 5-1

5 Managing Configurations

5.1 Introduction

When performing continuous patient monitoring, the clinical professional often needs to adjust the monitor’s settings

according to the patient’s condition. The collection of all these settings is called a configuration. Allowing you to

configure the monitor more efficiently, the monitor provides different sets of configurations to accommodate the

varying patient categories and departments. You can change the settings from a default configuration and then save it

as a user configuration.

The default configurations provided for your monitor are department-oriented. You can choose either from:

 General
 OR
 ICU
 NICU
 CCU

Each department has three different sets of configurations: one for each patient category [Neo], [Ped], and [Adu]. For

the important configuration items and their default values and user maintenance items, see Appendix C Default

Configurations.

NOTE

 The configuration management function is password protected. The configuration management tasks must

be performed by authorized personnel. Please contact your department manager or biomedical

engineering department for the password used at your facility.

5-2 Passport 12/Passport 8 Operator’s Manual

5.2 Entering the [Manage Configuration] Menu

To access the [Manage Configuraion] menu:

1. Press the [Menu] hardkey on the monitor’s front panel to enter the [Main Menu].

2. Select [Maintenance >>]→[Manage Configuration >>]. Enter the required password and then select [Ok].

5.3 Changing Department

If the current department configuration is not the one you want to view, you can select [Change Department >>] in the

[Manage Configuration] menu and then choose the one you want for viewing as shown below.

NOTE

 Changing the department will delete all current user configurations.

Passport 12/Passport 8 Operator’s Manual 5-3

5.4 Setting Default Configuration

The monitor will load the pre-set default configuration in the following cases:

 The monitor restarts after being switched off for more than 120 seconds.

 A patient is admitted.

 A patient is discharged.

 Patient data is cleared.

 Patient category is changed.

To set the default configuration:

1. Select [Select Default Config. >>] in the [Manage Configuration] menu.

2. In the [Select Default Config.] menu, select [Load the Latest Config.] or [Load Specified Config.].

When you select [Load Specified Config.], the restored configuration is subject to the patient category (adult, pediatric

or neonate). This configuration can be either factory configuration or a saved user configuration. As an example, select

[Default Adu Config.] and then select [Defaults] or user configuration(s).

When you select [Load the Latest Config], the latest configuration is loaded when the monitor is started or a patient is

admitted.

NOTE

 To identify which configuration is restored when the monitor starts, enter the main screen to check the

prompt information at the lower part of the screen (displayed for about 10 seconds).

5.5 Saving Current Settings

Current settings can be saved as a user configuration. Up to 5 user configurations can be saved.

To save current settings:

1. Select [Save Current Settings As >>] in the [Manage Configuration] menu.

2. In the pop-up dialog box, enter the configuration name and then select [Ok]. The current settings are saved as a

user configuration with the name you entered.

5-4 Passport 12/Passport 8 Operator’s Manual

5.6 Editing Configurations

To edit an existing configuration:

1. Select [Edit Config. >>] in the [Manage Configuration] menu. The following menu appears.

2. The pop-up menu shows the existing monitor configurations. Selecting [Config. on USB drive >>] will show the

existing configurations on the USB drive. Select the desired configuration and then select the [Edit] button. The

following menu appears.

3. Select [Alarm Setup >>], [Screen Setup >>] or [Parameters >>] to enter the corresponding menu in which

settings can be changed. The changed alarm setup items will be marked in red.

4. You can select [Save] or [Save as] to save the changed configuration. Select [Save] to overwrite the original

configuration. Select [Save as] to save the changed configuration as another file with another name.

Passport 12/Passport 8 Operator’s Manual 5-5

5.7 Deleting a Configuration

To delete a configuration:

1. Select [Delete Config. >>] in the [Manage Configuration] menu.

2. The pop-up menu shows the existing monitor’s user configurations. Selecting [Config. on USB drive >>] will show

the existing user configurations on the USB drive. Select the user configurations you want to delete and then select

[Delete].

3. Select [Yes] in the pop-up.

5.8 Transferring a Configuration

When installing several monitors with identical user configurations it is not necessary to set each unit separately. Use a

USB drive to transfer the configuration from monitor to monitor.

To export the current monitor’s configuration:

1. Connect the USB drive to the monitor’s USB port.

2. Select [Export Config. >>] in the [Manage Configuration] menu.

In the [Export Config.] menu, select the configurations and [User Maintenance Settings] to export. Then select

the [Export] button. A status message will report completion of the transfer.

To import the configuration from the USB drive to the monitor:

1. Connect the USB drive to the monitor’s USB port.

2. Select [Import Config. >>] in the [Manage Configuration] menu.

3. In the [Import Config.] menu, select the configurations and [User Maintenance Settings] to import. Then select

the [Import] button. A status message will report completion of the transfer.

5-6 Passport 12/Passport 8 Operator’s Manual

5.9 Loading a Configuration

You may make changes to some settings during operation. However, these changes or the pre-selected configuration

may not be appropriate for the newly admitted patient. Therefore, the monitor allows you to load a desired

configuration to ensure that all the settings are appropriate for your patient.

To load a configuration,

1. Select [Load Configuration >>] from the [Main Menu]. The pop-up menu shows the existing configurations on the

monitor.

2. Selecting [Config. on USB drive >>] to show the existing configurations on the USB drive.

3. Select a desired configuration.

4. Select [View] to see the configuration details. In the pop-up menu, you can select [Alarm Setup >>], [Screen

Setup >>] or [Parameter >>] to view the corresponding contents. The alarm setup items which are different than

those currently used are marked in red.

5. Select [Load].

NOTE

 The monitor may configure some settings by default when you load a configuration of different software

version with the current configuration.

5.10 Restoring the Latest Configuration Automatically

During operation, you may make changes to some settings. However, these changes may not be saved as a user

configuration. To prevent the changes from being lost in case of a sudden power failure, the monitor stores the

configuration in real time. The saved configuration is the latest configuration.

The monitor restores the latest configuration if it restarts within 60 seconds after the power failure. And it will restore the

default configuration rather than the latest configuration if it restarts 120 seconds after the power failure. The monitor

loads either the latest configuration or the default configuration if it restarts from 60-120 seconds after the power failure.

Passport 12/Passport 8 Operator’s Manual 6-1

6 User Screens

6.1 Configuring Your Screens

You can configure your monitor’s screens by setting:

 Waveform line size

 The color in which each measurement’s numerics and waveforms are displayed

 The parameter to monitor.

CAUTION

 Changing some settings may be hazardous. Therefore, those settings are password-protected and can be

modified by authorized personnel only. Once a change is made, notify those who use the monitor.

6.1.1 Changing the Waveform Line Size

To change the waveform line size:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Others >>].

3. Select [Wave Line] and select [Thick], [Med] or [Thin].

6.1.2 Changing Measurement Colors

To c hange t he m easurement colors:

1. Select [Main Menu]→[Screen Setup >>]→[Measurement Color Setup >>].

2. Select the color box next to your desired parameter and then select a color from the pop-up menu.

6.1.3 Changing Screen Layout

Select the [Screens] QuickKey, or [Main Menu]→[Screen Setup >>]→[Screen Layout >>] to enter the [Screens] menu.

 You can choose the desired screen type in the [Choose Screen] window.

 You can select the parameters and waveforms you want to view in the [Screen Setup] window. For details, please

refer to the section 3.9 Setting the Screen.

 You can select the parameters you want to view on the big numerics screen in the [Big Numerics Screen Setup]

window.

 You can switch the connected parameter modules on or off in the [Parameters Switch] window. If a parameter

module is switched off, parameter values and waveforms will not display on the screen.

6-2 Passport 12/Passport 8 Operator’s Manual

6.2 Viewing Minitrends

6.2.1 Having a Split-Screen View of Minitrends

You can split the normal screen so that the left hand side continuously shows graphic minitrends beside waveforms as

shown in the figure below.

To have a split-screen view of minitrends:

 Select the [Minitrends] QuickKey, or

 Select the [Screens→] QuickKey [Choose Screen]→ [Minitrends Screen]

→

, or

 Select [Main Menu→][Screen Setup >>→][Screen Layout >>→][Choose Screen]→ [Minitrends Screen]

→

.

The split-screen view provides minitrends for multiple parameters. In each field, the label and scale are respectively

displayed at the top and left. The time is displayed at the bottom of the minitrends view as shown below.

6.2.2 Setting Minitrends

Select the minitrends area. From the pop-up [Minitrend Setup] menu:

 Select the parameters to be displayed, or

 Select [Minitrend Length] and then select the appropriate setting.

Minitrends View

Time

Passport 12/Passport 8 Operator’s Manual 6-3

6.3 Viewing OxyCRG

To have a split screen view of oxyCRG:

 Select the [OxyCRG] QuickKey;

 Select the [Screens] QuickKey→[Choose Screen]→ [OxyCRG Screen]

→

; or,

 Select [Main Menu]→[Screen Setup >>]→[Screen Layout >>]→[Choose Screen]→ [OxyCRG Screen]→ .

The split-screen view covers the lower part of the waveform area and shows HR trend, SpO

2

trend, RR trend, and a

compressed waveform (Resp or CO

2

waveform). At the bottom, there are controls:

1. Event

You can enter the [Review] menu by selecting the [Event] button.

2. Trend length list box

In the trend length list box, you can select [1 min], [2 min], [4 min], or [8 min].

3. Setup

Select the [Setup] button to enter the [Setup] menu, in which you can select the parameters for display, the time

length to be saved before and after an event, and the scale of the graphic trends and waveform. The trend area can

display two parameter trends, e.g. HR trend and RR trend, simultaneously.

4. Auto Scale

Select the [Auto Scale] button, and the system automatically adjusts the scaling.

5. Print

Select [Print] to print the real-time OxyCRG to a printer.

6. Record

Select [Record] to print the currently displayed OxyCRG trends to the recorder.

2

1

3

4

5

6

6-4 Passport 12/Passport 8 Operator’s Manual

6.4 Viewing Other Patients

6.4.1 Care Group

You can select up to 10 monitors (including telemetry) connected to the sameCMS into a care group. This lets you:

 View information on the monitor screen from another bed in the same Care Group.

 Be notified of physiological and technical alarm conditions at the other beds in the same Care Group.

To have a Care Group:

1. Open the [View Other Patient] window by:

 Selecting [Others] QuickKey, or

 Selecting [Screens

→

] QuickKey [Choose Screen]→ [View Others Screen→] , or

 Selecting [Main Menu

→

][Screen Setup >>→][Screen Layout >>→][Choose Screen]→[View Others

Screen→] .

2. Select [Setup] in the [View Other Patient] window.

3. Select the desired monitors from the [Connected Monitor List], and then select the

button. The selected

monitors constitute a Care Group.

NOTES

 Monitors using software version prior to 05.17.00 cannot view or be viewed by monitors of software version

05.17.00 or later.

6.4.2 Viewing the Care Group Overview Bar

The Care Group overview bar is located at the bottom of the [View Other Patient] window. In the overview bar, the

department and bed label for any Care Group beds are displayed. For telemetry, # is displayed before the department

label. The color in which a Care Group bed appears matches its status:

 Red: indicates the bed is having high-level physiological alarms or the telemetry is in alarm, such as nurse call or

event.

 Yellow: indicates the bed is having medium-level or low-level physiological alarms, or medium-level technical

alarms.

 Blue: indicates the bed is having low-level technical alarms.

 Light grey: indicates the bed fails to be networked.

 Dark grey: indicates the bed is in the Standby mode.

You can view a Care Group bed’s alarms by selecting it from the Care Group, and you can select the [View This Patient]

button to view the bed in the [View Other Patient] window.

For more details about Care Group alarms, refer to the chapter 24 Batteries.

Passport 12/Passport 8 Operator’s Manual 6-5

6.4.3 Understanding the View Other Patient Window

When you first open the [View Other Patient] window, the monitor automatically selects a device from the network to

display in the [View Other Patient] window.

The [View Other Patient] window covers the lower part of the waveform area and consists of:

1. Information Area: shows the patient information (including department, bed number, patient name, etc.), network

status symbol.

2. View Area: shows physiological waveforms and parameters. You can switch a waveform area to a parameter area by

selecting your desired waveform area and then selecting [Switch to Parameter Area], or switch a parameter area

to a waveform area by selecting your desired parameter area and then selecting [Switch to Waveform Area].

3. Care Group Overview Bar. See section 6.4.2 Viewing the Care Group Overview Bar for information.

4. Message Area: shows physiological, technical and prompt messages from the currently viewed monitor. It also

shows the alarm given by the device such as nurse call or event. By selecting this area, you can enter the [Alarm

Information List] to view all physiological, technical and prompt messages coming from the currently viewed

patient.

5. [Alarm Reset] button: resets alarms from the currently viewed bed. Refer to section 7.8 Resetting Alarms.

When the [Reset Other Bed’s Alarms] is disabled, no button will appear here.

Additionally, you can change a waveform or parameter for viewing:

 To change a waveform for viewing, select the waveform segment where you want a new waveform to appear and

then select the waveform you want from the pop-up menu.

 To change a parameter for viewing, select the parameter window where you want a new parameter to appear and

then select the parameter you want from the pop-up menu.

1

2

3

4

5

6-6 Passport 12/Passport 8 Operator’s Manual

WARNING

 The data presented in the [View Other Patient] window has a delay. Do not rely on this window for realtime

data.

 The icon indicates network disconnection. You cannot view other monitors when this icon is

displayed.

6.5 Understanding the Big Numerics Screen

To enter the big numerics screen:

1. Select the [Screens] QuickKey, or [Main Menu]→[Screen Setup >>]→[Screen Layout >>].

2. Select [Big Numerics]→

.

You can select your desired parameters to display in this screen: select the [Screens] QuickKey→[Big Numerics Screen

Setup] and then select the parameters you want to view. For parameters having a waveform, the waveform will also be

displayed.

Passport 12/Passport 8 Operator’s Manual 7-1

7 Alarms

Alarms, triggered by an abnormal vital sign or technical issue with the monitor, as visually and audibly indicated to the

user.

WARNING

 A potential hazard can exist if different alarm presets are used for the same or similar equipment in any

single area, e.g. an intensive care unit or cardiac operating room.

 If your monitor is connected to a CMS, alarms can be controlled remotely. Remote suspension, inhibition,

and reset of monitor alarms via the CMS may cause a potential hazard. For details, refer to the CMS’s

operator’s manual.

For troubleshooting specific alarms, see appendix D Alarm Messages.

7.1 Alarm Categories

The monitor’s alarms can be classified into two categories: physiological alarms and technical alarms.

1. Physiological alarms

Physiological alarms, also called patient status alarms, are triggered by a monitored parameter value that violates

set alarm limits or an abnormal patient condition. Physiological alarm messages are displayed in the physiological

alarm area.

2. Technical alarms

Technical alarms, also called system status alarms, are triggered by a device malfunction or a patient data distortion

due to improper operation or mechanical problems. Technical alarm messages are displayed in the technical alarm

area.

Apart from the physiological and technical alarm messages, the monitor will show some messages telling the

system status or patient status. Messages of this kind are included in the prompt message category and usually

displayed in the prompt information area. Some prompt messages that indicate the arrhythmia events are

displayed in the physiological alarm area. For some measurements, their related prompt messages are displayed in

their respective parameter windows.

7-2 Passport 12/Passport 8 Operator’s Manual

7.2 Alarm Levels

The monitor’s alarms can be classified into three severity categories: high level, medium level and low level.

Physiological alarms Technical alarms

High level

Indicate that the patient is in a life

threatening situation, such as Asystole,

Vfib/Vtac and so forth, and emergency

treatment is required.

Indicate a severe device malfunction or an improper operation

which could make it possible that the monitor cannot detect

critical patient status and thus threaten the patient’s life.

Medium

level

Indicate that the patient’s vital signs

appear abnormal and immediate

treatment is required.

Indicate a device malfunction or an improper operation, which

may not threaten the patient’s life, but may compromise the

monitoring of vital physiological parameters.

Low level

Indicate that the patient’s vital signs

appear abnormal and immediate

treatment may be required.

Indicate a device malfunction or an improper operation which

may compromise a certain monitoring function, but will not

threaten the patient’s life.

7.3 Alarm Indicators

When an alarm occurs, the monitor will indicate it to the user through visual or audible alarm indications.

 Alarm lamp

 Alarm message

 Flashing numerics

 Audible alarm tones

7.3.1 Alarm Lamp

If a technical alarm or physiological alarm occurs, the alarm lamp will flash. The color and flashing frequency match the

alarm level as follows:

 High level alarms: the lamp quickly flashes red.

 Medium level alarms: the lamp slowly flashes yellow.

 Low level alarms: the lamp lights yellow without flashing.

7.3.2 Alarm Messages

When an alarm occurs, an alarm message will appear in the technical or physiological alarm area. For physiological

alarms, the asterisk symbols (*) before the alarm message match the alarm level as follows:

 High level alarms: ***

 Medium level alarms: **

 Low level alarms: *

Additionally, the alarm message uses different background color to match the alarm level:

 High level alarms: red

 Medium level alarms: yellow

 Low level alarms: yellow

You can view the alarm messages by selecting the physiological or technical alarm area.

Passport 12/Passport 8 Operator’s Manual 7-3

7.3.3 Flashing Numeric

If an alarm triggered by an alarm limit violation occurs, the numeric of the measurement in alarm will flash every second,

and the corresponding alarm limit will also flash at the same frequency indicating the high or low alarm limit is violated.

7.3.4 Audible Alarm Tones

The alarm tone is distinct from heart beat tone, keystroke tone and pulse tone in frequency. This monitor has three alarm

tones and patterns: ISO, Mode 1 and Mode 2. For each pattern, the alarm tones identify the alarm levels as follows:

 ISO pattern:

 High level alarms: triple+double+triple+double beep

 Medium level alarms: triple beep

 Low level alarms: single beep

 Mode 1:

 High level alarms: high-pitched single beep

 Medium level alarms: double beep

 Low level alarms: low-pitched single beep

 Mode 2:

 High level alarms: high-pitched triple beep

 Medium level alarms: double beep

 Low level alarms: low-pitched single beep

7.3.5 Alarm Status Symbols

Apart from the aforementioned alarm indicators, the monitor still uses the following symbols telling the alarm status:

 indicates alarms are paused.



indicates alarm is reset.



indicates the alarm sound is turned off.



indicates individual measurement alarms are turned off or the system is in alarm off status.

NOTE

 When multiple alarms of different levels occur simultaneously, the monitor will select the highest level

alarm, light the alarm lamp and give alarm sounds accordingly, while all the alarm messages are displayed

circularly on the screen.

 Some physiological alarms, such as Asystole, are exclusive. They have identical alarm tones and alarm lights

with normal high level physiological alarms, but their alarm messages are displayed exclusively. That is,

when an exclusive physiological alarm and a normal high level physiological alarm are triggered

simultaneously, only exclusive physiological alarm messages will be displayed.

7-4 Passport 12/Passport 8 Operator’s Manual

7.4 Alarm Tone Configuration

7.4.1 Setting the Minimum Alarm Volume

To set the minimum alarm volume:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu.

3. Select [Minimum Alarm Volume] and then select a value between 0 and 10.

The minimum alarm volume refers to the minimum value you can set for the alarm volume, which is not affected by user

or factory default configurations. The minimum alarm volume setting remains unchanged when the monitor shuts

down and restarts.

7.4.2 Changing the Alarm Volume

To change the alarm volume:

1. Select the [Volume Setup] QuickKey or the [Alarm Setup] QuickKey→[Others], or [Main Menu]→[Alarm

Setup >>]→[Others].

2. Select the appropriate volume from [Alm Volume]: X to 10, in which X is the minimum volume, depending on the

set minimum alarm volume, and 10 the maximum volume.

3. Select [High Alarm Volume] to set the high priority alarm volume as [Alm Volume+0], [Alm Volume+1] or [Alm

Volume+2].

4. Select [Reminder Vol] to set the volume of the reminder tone as [High], [Med] or [Low].

When alarm volume is set to 0, the alarm sound is turned off and a

symbol appears in the alarm symbols area of the

screen.

7.4.3 Setting the Interval Between Alarm Sounds

You cannot change the interval between alarm tones if you choose mode 1 or 2 as your desired alarm tone pattern. For

these two patterns, the interval between alarm tones identifies the alarm levels as follows:

 Mode 1:

 Interval between high level alarm tones: continuously

 Interval between medium level alarm tones: 5 s

 Interval between low level alarm tones: 20 s

 Mode 2:

 Interval between high level alarm tones: 1 s

 Interval between medium level alarm tones: 5 s

 Interval between low level alarm tones: 20 s

Passport 12/Passport 8 Operator’s Manual 7-5

If you choose the ISO pattern, you can change the interval between alarm tones. To change the interval between alarm

tones:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu.

3. Select [High Alarm Interval (s)], [Med Alarm Interval (s)] and [Low Alarm Interval (s)] in order and then select

the appropriate settings.

WARNING

 When the alarm sound is switched off, the monitor will give no audible alarm tones even if a new alarm

occurs. Therefore the user should be very careful about whether to switch off the alarm sound or not.

 Do not rely exclusively on the audible alarm system for monitoring. Adjustment of alarm volume to a low

level may result in a hazard to the patient. Always keep the patient under close surveillance.

7.4.4 Changing the Alarm Tone Pattern

To change the alarm tone pattern:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu.

3. Select [Alarm Sound] and then select [ISO], [Mode 1] or [Mode 2].

7.4.5 Setting the Reminder Tones

When the alarm volume is set to zero, or the alarm tone is silenced or turned off, the monitor issues a periodic reminder

tone.

To set the reminder tones:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu.

 To switch the reminder tones on or off, select [Reminder Tones] and and then select [On] or [Off].

 To set the interval between reminder tones, select [Reminder Interval] and then select [1min], [2min] or

[3min].

In addition, you can set the volume of alarm reminder tones. To set the volume of alarm reminder tones, select [Main

Menu]→[Alarm Setup >>]→[Others] or the [Alarm Setup] QuickKey→[Others]. Then, select [Reminder Vol] and then

select [High], [Medium] or [Low].

NOTE

 User or factory default configurations have no impact on the alarm tone pattern setup. The alarm tone

pattern remains unchanged after the monitor restarts.

7-6 Passport 12/Passport 8 Operator’s Manual

7.5 Understanding the Alarm Setup Menu

Select the [Alarm Setup] QuickKey or [Main Menu]→[Alarm Setup >>] to enter the [Alarm Setup], where you can:

 Set alarm properties for all parameters.

 Change ST alarm settings.

 Change arrhythmia alarm settings.

 Set the threshold for some arrhythmia alarms.

 Change other settings.

NOTE

 The On/Off column is only visible when used with a CMS. This column is not visible with Panorama CMS.

Refer to the chapter 8 Monitoring ECG for how to change ST alarm settings, how to change arrhythmia alarm settings

and how to set the threshold for some arrhythmia alarms.

7.5.1 Setting Alarm Properties for All Parameters

In the [Main Menu], select [Alarm Setup >>]→[Parameters]. You can review and set alarm limits, alarm switches, alarm

level and alarm recordings for all parameters.

When a measurement alarm occurs, automatic recording of all the measurement numerics and related waveforms is

possible when the measurement’s [On/Off] and [Record] are set on.

Passport 12/Passport 8 Operator’s Manual 7-7

WARNING

 Make sure that the alarm limit settings are appropriate for your patient before monitoring.

 Setting alarm limits to extreme values may cause the alarm system to become ineffective. For example, high

oxygen levels may predispose a premature infant to retrolental fibroplasia. If this is a consideration, do NOT

set the high alarm limit to 100%, which is equivalent to switching the alarm off.

 When monitoring patients that are not continuously attended by a clinical operator, properly configure the

alarm system and adjust alarm settings as per the patient's condition.

7.5.2 Adjusting Alarm Limits Automatically

The monitor can automatically adjust alarm limits according to the measured vital signs. When auto limits are selected,

the monitor calculates safe auto limits based on the latest measured values.

To get accurate auto alarm limits, you need to collect a set of measured vital signs as a baseline. Then, in the [Main

Menu], select [Alarm Setup >>]→[Parameters]→[Auto Limits] →[Ok]. The monitor will create new alarm limits based

on the measured values.

Before applying these automatically created alarm limits, confirm if they are appropriate for your patient in the [Alarm

Setup Menu]. If not, you can adjust them manually. These alarm limits will remain unchanged until you select auto limits

again or adjust them manually.

The monitor calculates the auto limits based on the following guidelines:

Module Parameter

Low alarm limit High alarm limit

Auto alarm limits

range

Adult/

pediatric

Neonate

Adult/

pediatric

Neonate

ECG HR/PR

(HR × 0.8) or 40

bpm (whichever is

greater)

(HR – 30) or 90

bpm (whichever is

greater)

(HR × 1.25) or 240

bpm (whichever is

smaller)

(HR + 40) or 200

bpm (whichever is

smaller)

Adult/pediatric: 35 to

240

Neonate: 55 to 225

Resp RR

(RR × 0.5) or 6 rpm

(whichever is

greater)

(RR – 10) or 30 rpm

(whichever is

greater)

(RR × 1.5) or 30

rpm (whichever is

smaller)

(RR + 25) or 85 rpm

(whichever is

smaller)

Adult/pediatric: 6 to

55

Neonate: 10 to 90

SpO2 SpO2

Same as the

default alarm limit

Same as the

default alarm limit

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

NIBP

NIBP-S

(SYS × 0.68 + 10)

mmHg

(SYS – 15) or 45

mmHg (whichever

is greater)

(SYS × 0.86 + 38)

mmHg

(SYS + 15) or 105

mmHg (whichever

is smaller)

Adult: 45 to 270

Pediatric: 45 to 185

Neonate: 35 to 115

NIBP-D

(Dia × 0.68 + 6)

mmHg

(Dia – 15) or 20

mmHg (whichever

is greater)

(Dia × 0.86 + 32)

mmHg

(Dia + 15) or 80

mmHg (whichever

is smaller)

Adult: 25 to 225

Pediatric: 25 to 150

Neonate: 20 to 90

NIBP-M

(Mean × 0.68 + 8)

mmHg

(Mean – 15) or 35

mmHg (whichever

is greater)

(Mean × 0.86 +

35) mmHg

(Mean + 15) or 95

mmHg (whichever

is smaller)

Adult: 30 to 245

Pediatric: 30 to 180

Neonate: 25 to 105

7-8 Passport 12/Passport 8 Operator’s Manual

Module Parameter

Low alarm limit High alarm limit

Auto alarm limits

range

Adult/

pediatric

Neonate

Adult/

pediatric

Neonate

Temp

T1 (T1 – 0.5)°C (T1 – 0.5) °C (T1 + 0.5)°C (T1 + 0.5)°C 1 to 49°C

T2 (T2 – 0.5)°C (T2 – 0.5) °C (T2 + 0.5)°C (T2 + 0.5)°C 1 to 49°C

TD

Same as the

default alarm limit

Same as the

default alarm limit

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

IBP: ART/

Ao/

UAP/

BAP/

FAP/

LV/

P1-P4

(Arterial

pressure)

IBP-S

(SYS × 0.68＋10)

mmHg

(SYS – 15) or 45

mmHg (whichever

is greater)

(SYS × 0.86 + 38)

mmHg

(SYS + 15) or 105

mmHg (whichever

is smaller)

Adult: 45 to 270

Pediatric: 45 to 185

Neonate: 35 to 115

IBP-D

(Dia × 0.68 + 6)

mmHg

(Dia – 15) or 20

mmHg (whichever

is greater)

(Dia × 0.86 + 32)

mmHg

(Dia + 15) or 80

mmHg (whichever

is smaller)

Adult: 25 to 225

Pediatric: 25 to 150

Neonate: 20 to 90

IBP-M

(Mean × 0.68 + 8)

mmHg

(Mean – 15) or 35

mmHg (whichever

is greater)

(Mean × 0.86 +

35) mmHg

(Mean + 15) or 95

mmHg (whichever

is smaller)

Adult: 30 to 245

Pediatric: 30 to 180

Neonate: 25 to 105

PA

IBP-S SYS × 0.75 SYS × 0.75 SYS × 1.25 SYS × 1.25

3 to 120 mmHg IBP-D Dia × 0.75 Dia × 0.75 Dia × 1.25 Dia × 1.25

IBP-M Mean × 0.75 Mean × 0.75 Mean × 1.25 Mean × 1.25

IBP:

CVP/

ICP/

LAP/

RAP/

UVP/

P1-P4

(Venous

pressure)

IBP-M Mean × 0.75 Mean × 0.75 Mean × 1.25 Mean × 1.25 3 to 40mmHg

CO2

EtCO

2

0 to 32 mmHg:

remains the same

0 to 32 mmHg:

remains the same

0 to 32 mmHg:

remains the same

0 to 32 mmHg:

remains the same

Same as the

measurement range

32 to 35 mmHg:

29 mmHg

32 to 35 mmHg:

29 mmHg

32 to 35 mmHg:

41 mmHg

32 to 35 mmHg:

41 mmHg

35 to 45 mmHg:

(etCO

2

-6) mmHg

35 to 45 mmHg:

(etCO2-6) mmHg

35 to 45 mmHg:

(etCO2+6) mmHg

35 to 45 mmHg:

(etCO2+6) mmHg

45 to 48 mmHg:

39 mmHg

45 to 48 mmHg:

39 mmHg

45 to 48 mmHg:

51 mmHg

45 to 48 mmHg:

51 mmHg

> 48 mmHg:

remains the same

> 48 mmHg:

remains the same

> 48 mmHg:

remains the same

> 48 mmHg:

remains the same

FiCO2 N/A N/A

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

awRR

awRR × 0.5 or 6

rpm (whichever is

greater)

(awRR – 10) or 30

rpm (whichever is

greater)

awRR × 1.5 or 30

rpm (whichever is

smaller)

(awRR + 25) or 85

rpm (whichever is

smaller)

Adult/pediatric: 6 to

55

Neonate:10 to 90

Passport 12/Passport 8 Operator’s Manual 7-9

Module Parameter

Low alarm limit High alarm limit

Auto alarm limits

range

Adult/

pediatric

Neonate

Adult/

pediatric

Neonate

AG

EtCO2 (AG)

Same as CO2 module

FiCO2 (AG)

awRR

awRR × 0.5 or 6

rpm (whichever is

greater)

awRR – 10 or 30

rpm (whichever is

greater)

awRR × 1.5 or 30

rpm (whichever is

smaller)

awRR + 25 or 85

rpm (whichever is

smaller)

Adult/pediatric: 6 to

55

Neonate: 10 to 90

FiAA/

EtAA

Same as the

default alarm limit

Same as the

default alarm limit

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

FiO2/

EtCO

2

Same as the

default alarm limit

Same as the

default alarm limit

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

FiN2O/

EtN

2

O

Same as the

default alarm limit

Same as the

default alarm limit

Same as the

default alarm limit

Same as the default

alarm limit

Same as the

measurement range

C.O. BT

Adult:

(BT – 1)°C

N/A

Adult:

(BT – 1)°C

N/A

Same as the

measurement range

7.5.3 Setting Alarm Delay Time

You can set the alarm delay time for alarms of continuously measured parameters. If the alarm condition is resolved

within the delay time, the monitor will not sound the alarm.

To set the alarm delay time:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]. Enter the required password and then select

[Ok].

2. Select [Alarm Setup >>]→[Alarm Delay].

Alarm delay is not applied to the following physiological alarms:

 Apnea

 ST alarms

 Arrhythmia alarms

 ECG Weak Signal

 Resp Artifact

 SpO

2

Desat

 No Pulse

 Nellcor SpO

2

over alarm limits

 FiO2 Shortage

 Measurements of noncontinuous parameters over alarm limits

 HR over alarm limits

 Anesthetic Mixture's MAC > 3

You can set [Apnea Delay] and [ST Alarm Delay] separately.

7-10 Passport 12/Passport 8 Operator’s Manual

7.5.4 Setting SpO2 Technical Alarm Delay

You can set the [Tech. Alarm Delay] in the [Others] tab of the [Alarm Setup] menu. The options are [Off], [5 s], [10 s]

and [15 s]. The delay is effective to the following technical alarms: SpO

2

Sensor Off, SpO2 Too Much Light, SpO2 Low

Signal and SpO

2

Interference.

7.5.5 Setting Recording Length

You can change the length of the recorded waveforms. In the [Others] window of the [Alarm Setup] menu, select

[Recording Length] and then select [8 s], [16 s] or [32 s]:

 [8 s]: 4 seconds respectively before and after the alarm or manual event trigger moment.

 [16 s]: 8 seconds respectively before and after the alarm or manual event trigger moment.

 [32 s]: 16 seconds respectively before and after the alarm or manual event trigger moment.

7.5.6 Entering CPB Mode (Cardiopulmonary Bypass Mode)

When performing CPB, you can put the monitor in CPB mode in order to reduce unnecessary alarms. The CPB mode is

activated only if you set the department to [OR]. To set the department to [OR]:

1. Press the [Menu] hardkey on the monitor’s front panel to enter [Main Menu].

2. Select [Maintenance >>]→[Manage Configuration >>]. Enter the required password and then select [Ok].

3. Select [Change Department >>]→[OR].

In the CPB mode, all the physiological alarms, technical alarms and prompt alarms are switched off.

In the CPB mode, [CPB Mode] is displayed in the physiological alarm area with a red background color.

To enter CPB mode:

1. Select the [CPB Mode] Quickkey or select [Enter CPB Mode] in the [Others] window of the [Alarm Setup] menu.

2. Then select [Ok] in the pop-up dialog box.

7.6 Pausing Alarms

If you want to temporarily prevent alarms from sounding, you can pause alarms by pressing the [Alarm Pause] hardkey

on the monitor’s front panel. When alarms are paused:

 No alarm lamps flash and no alarms are sounded.

 No numerics or alarm limits flash.

 No alarm messages are shown.

 The remaining pause time is displayed in the physiological alarm area.

 The alarms paused symbol

is displayed in the sound symbol area.

Passport 12/Passport 8 Operator’s Manual 7-11

If the time interval of the monitor’s last shutdown from this start-up is greater than 2 minutes, the monitor enters into

the alarm paused status as soon as it is turned on. The alarm pause time is fixed to be 2 minutes.

When the alarm pause time expires, the alarm paused status is automatically cancelled and the alarm tone will sound.

You can also cancel the alarm paused status by pressing the [Alarm Pause] hardkey.

You can set the alarm pause time to [1 min], [2 min], [3 min], [5 min], [10 min], [15 min], or [Permanent]. The default

alarm pause time is 2 minutes.

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>]→[Alarm Pause Time] and then select the appropriate setting from the pop-up list.

7.7 Switching Off All Alarms

If [Alarm Pause Time] is set to [Permanent], the monitor enters into the alarm off status after the [Alarm Pause]

hardkey is pressed. During the alarm off status:

 For physiological alarms, no alarm lamps flash and no alarms are sounded.

 For physiological alarms, no numerics or alarm limits flash.

 No physiological alarm messages are shown.

 [Alarm Off] is displayed in the physiological alarm area with a red background.

 For technical alarms, no alarms are sounded.

 The

alarm off symbol is displayed in the alarm symbol area.

You can cancel the alarm off status by pressing the [Alarm Pause] hardkey.

WARNING

 Pausing or switching off alarms may result in a hazard to the patient.

7.8 Resetting Alarms

By selecting the QuickKey, you can reset the alarm system to acknowledge the on-going alarms and enable the
alarm system to respond to a subsequent alarm condition.

For physiological alarms, except the NIBP-related alarms, when the alarm system is reset:

 The alarm sound is silenced.

 A √ appears before the alarm message, indicating that the alarm is acknowledged.

 The icon

appears in the alarm symbol area.

 The parameter numeric and alarm limits still flash.

7-12 Passport 12/Passport 8 Operator’s Manual

The indication of alarm lamp for the physiological alarm depends on the alarm light setting.

 When [Alarm Light on Alarm Reset] is set to [On], the alarm lamp remains flashing.

 When [Alarm Light on Alarm Reset] is set to [Off], the alarm lamp stops flashing.

To s et [ Alarm Light on Alarm Reset]:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>] to enter the [Alarm Setup] menu.

3. Select [Alarm Light on Alarm Reset], and then select [On] or [Off].

The default setting for [Alarm Light on Alarm Reset] is [On].

Technical alarms give different alarm indicators when the alarm system is reset:

 For some technical alarms, including the NIBP-related alarms, a √ appears before the alarm message and

appears in the alarm symbol area, indicating that the alarm is acknowledged. The indication of the alarm lamp

depends on the alarm light setting.

 Some technical alarms are changed to the prompt messages.

 Some technical alarms are cleared. The monitor gives no alarm indications.

For details about the indications of technical alarms when the alarm system is reset, refer to appendix D.2 Technical

Alarm Messages.

7.9 Latching Alarms

The alarm latching setting for your monitor defines how the alarm indicators behave when you do not acknowledge

them. When alarms are set to non-latching, their alarm indications end when the alarm condition ends. If you switch

alarm latching on, all visual and audible alarm indications last until you acknowledge the alarms, except that the

measurement numeric and violated alarm limit stop flashing as soon as the initial alarm condition goes away.

To set alarms to latching or non-latching:

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

2. Select [Alarm Setup >>].

3. Select [Latching Alarms] and then select [High only], [Hi&Med], [All] or [Off].

 If you select [High only], only high priority alarms are latched;

 If you select [Hi&Med], both high priority alarms and medium priority alarms are latched;

 If you select [All], all alarms are latched;

 If you select [Off], the alarm latching is turned off.

NOTE

 Changing of alarm priority may affect the latching status of corresponding alarms. Determine if you need to

reset the latching status for the specific alarm after changing its alarm priority.

 When the alarm system is reset, the latched physiological alarms are cleared.

Passport 12/Passport 8 Operator’s Manual 7-13

7.10 Testing Alarms

When the monitor starts up, a self-test is performed. In this case the alarm lamp is lit in yellow and red respectively, and

the system gives a beep. This indicates that the visible and audible alarm indicators are functioning correctly.

For further testing of individual measurement alarms, perform the measurement on yourself (for example, SpO

2

or CO2)

or use a simulator. Then adjust alarm limits and check that appropriate alarm behavior is observed.

7.11 Using Care Group Alarms

7.11.1 Care Group Auto Alarms

When a Care Group is set up on your monitor, a flashing symbol will appear beside the QuickKeys area if any monitor in

your Care Group, which is not currently viewed by your monitor, is alarming. The alarm symbol is shown as below.

When a monitor in the Care Group is disconnected, the flashing symbol is shown as below.

The department and bed label of the alarming monitor appear on the symbol. You can enter the View Other Patient

window by pressing this symbol.

7.11.2 Setting Care Group Alert Tone

When a monitor in the Care Group issues an alarm, your monitor prompts you by sounding an alert tone. To set the alert

tone:

1. In the [Main Menu], select [Screen Setup >>]→[Screen Layout >>]→[Choose Screen].

2. In the [Choose Screen] window, select [View Others Screen].

3. In the view other patient window, select [Setup>>], and set [Alert Tone] to [Repeat], [Once] or [Off].

7.11.3 Resetting Care Group Alarms

You can reset the alarm of the currently viewed bed in the View Other Patient window. This function can be set in the

[Alarm Setup] menu from the [User Maintenance] menu only.

To enable this function:

1. Select [Main Menu]→[Maintenance>>]→[User Maintenance>>]→enter the required password→[Alarm

Setup>>].

2. In the [Alarm Setup] menu, set [Reset Other Bed’s Alarms] to [On].

When your monitor is viewed by other monitors and [Alarm Reset By Other Bed] is switched on, alarms on your

monitor can be reset by other monitors.

7-14 Passport 12/Passport 8 Operator’s Manual

WARNING

 Resetting care group alarms may cause a potential hazard.

Passport 12/Passport 8 Operator’s Manual 8-1

8 Monitoring ECG

8.1 Introduction

The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the monitor as a waveform

and a numeric. This section also tells you about ST monitoring and arrhythmia monitoring. ECG monitoring provides two

algorithms:

 Advanced ECG algorithm

The Advanced ECG algorithm enables 3-lead and 5-lead ECG monitoring, ST-segment analysis, and extended

arrhythmia analysis.

 Mortara ECG algorithm

The Mortara ECG algorithm enables 3-lead and 5-lead ECG monitoring, ST-segment analysis and arrhythmia

analysis.

You can select algorithms at the time of purchase or as upgrades post sale:

 The monitor incorporating the Advanced ECG algorithm is labeled with a ST/ARR label.
 The monitor incorporating the Mortara ECG algorithm is labeled with the Mortara logo.

8.2 Safety

WARNING

 Use only ECG electrodes and cables specified by the manufacturer.
 Make sure the conductive parts of electrodes and associated connectors for applied parts, including the

neutral electrode, should not contact any other conductive parts including earth.

 Periodically inspect the electrode application site to ensure skin quality. If the skin quality changes, replace

the electrodes or change the application site.

 Use defibrillation-proof ECG cables during defibrillation.
 Do not touch the patient, or table, or instruments during defibrillation.
 The neutral electrode of the HF surgical unit shall properly contact the patient. Otherwise, burns may result.
 The equipment is not intended for direct cardiac application.

8-2 Passport 12/Passport 8 Operator’s Manual

CAUTION

 Interference from a non-grounded instrument near the patient and electrosurgery interference can cause

problems with the waveform.

NOTE

 After defibrillation, the screen display recovers within 10 seconds if the correct electrodes are used and

applied in accordance with the manufacturer’s instructions for use.

8.3 Preparing to Monitor ECG

8.3.1 Preparing the Patient and Placing the Electrodes

To prepare the patient and place the electrodes:

1. Prepare the patient’s skin. Proper skin preparation is necessary for good signal quality at the electrode site, as the

skin is a poor conductor of electricity. To properly prepare the skin, choose flat areas and then:

 Shave hair from skin at chosen sites.

 Gently rub skin surface at sites to remove dead skin cells.

 Thoroughly cleanse the site with a mild soap and water solution. We do not recommend using ether or pure

alcohol, because this dries the skin and increases the resistance.

 Dry the skin completely before applying the electrodes.

2. Attach the clips or snaps to the electrodes before placing them.

3. Place the electrodes on the patient.

4. Attach the electrode cable to the patient cable and then plug the patient cable into the ECG connector.

8.3.2 Choosing AHA or IEC Lead Placement

To choose AHA or IEC lead placement:

1. Select the ECG parameter window or waveform area to enter the [ECG Setup] menu.

2. Select [Others]→[Lead Set] and then select [3-lead], [5-lead], or [Auto] according to the applied electrodes.

3. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the required password.

4. Select [Others >>]→[ECG Standard] and then select [AHA] or [IEC] according to the hospital standard.

Passport 12/Passport 8 Operator’s Manual 8-3

8.3.3 ECG Lead Placements

The electrode placement illustrations in this chapter adopt the AHA standard.

3-Leadwire Electrode Placement

Following is an electrode configuration when using 3 leadwires:

 RA placement: directly below the clavicle and near the right shoulder.

 LA placement: directly below the clavicle and near the left shoulder.

 LL placement: on the left lower abdomen.

5-Leadwire Electrode Placement

Following is an electrode configuration when using 5 leadwires:

 RA placement: directly below the clavicle and near the right

shoulder.

 LA placement: directly below the clavicle and near the left shoulder.

 RL placement: on the right lower abdomen.

 LL placement: on the left lower abdomen.

 V placement: on the chest.

The chest (V) electrode can be placed on one of the following positions:

 V1 placement: on the fourth intercostal space at the right sternal border.

 V2 placement: on the fourth intercostal space at the left sternal border.

 V3 placement: midway between the V2 and V4 electrode positions.

 V4 placement: on the fifth intercostal space at the left midclavicular line.

 V5 placement: on the left anterior axillary line, horizontal with the V4

electrode position.

 V6 placement: on the left midaxillary line, horizontal with the V4 electrode

position.

 V3R-V6R placement: on the right side of the chest in positions corresponding to those on the left.

 VE placement: over the xiphoid process.

 V7 placement: on posterior chest at the left posterior axillary line in the fifth intercostal space.

 V7R placement: on posterior chest at the right posterior axillary line in the fifth intercostal space.

Lead Placement for Surgical Patients

The surgical site should be taken into consideration when placing electrodes on a surgical patient. e.g. for open-chest

surgery, the chest electrodes can be placed on the lateral chest or back. To reduce artifacts and interference from

electrosurgical units, you can place the limb electrodes close to the shoulders and lower abdomen and the chest

electrodes on the left side of the mid-chest. Do not place the electrodes on the upper arm. Otherwise, the ECG

waveform will be very small.

8-4 Passport 12/Passport 8 Operator’s Manual

WARNING

 When using electrosurgical units (ESU), patient leads should be placed in a position that is equal distance

from the Electrosurgery electrotome and the grounding plate to avoid burns to the patient. Never entangle

the ESU cable and the ECG cable together.

 When using electrosurgical units (ESU), never place ECG electrodes near to the grounding plate of the ESU,

as this can cause a lot of interference on the ECG signal.

8.3.4 Checking Paced Status

It is important to set the paced status correctly when you start monitoring ECG. The paced symbol is displayed in

the ECG waveform area when the [Paced] status is set to [Ye s ]. The pace pulse markers “|” are shown on the ECG wave

when the patient has a paced signal. If [Paced] is set to [No] or the patient’s paced status is not selected, the symbol
will be shown in the ECG waveform area.

To change the paced status, you can select either:

 the patient information area, or

 [Main Menu→][Patient Setup→][Patient Demographics], or,

 the ECG parameter window or waveform area→[Others >>],

and then, select [Paced] from the pop-up menu and then select [Ye s ] or [No].

If you do not set the paced status, the monitor issues a prompt tone when pace pulse is detected. At the same time, the

paced symbol flashes and the message [Please confirm the pace of patient] appears in the ECG waveform area. Then,

please check and set the paced status of the patient.

WARNING

 For paced patients, you must set [Paced] to [Yes]. If it is incorrectly set to [No], the monitor could mistake a

pace pulse for a QRS and fail to alarm when the ECG signal is too weak.

 On ventricular paced patients, episodes of Ventricular Tachycardia may not always be detected.

 False low heart rate indicators or false Asystole calls may result with certain pacemakers because of

pacemaker artifact such as electrical overshoot of the pacemaker overlapping the true QRS complexes.

 Do not rely entirely upon the system’s automated arrhythmia detection algorithm. Keep pacemaker

patients under close surveillance.

 For non-paced patients, you must set [Paced] to [No].

 The auto pacer recognition function is not applicable to pediatric and neonatal patients.

Passport 12/Passport 8 Operator’s Manual 8-5

8.4 Understanding the ECG Display

Your display may be configured to look slightly different.

1. Lead label of the displayed wave

2. ECG gain

3. ECG filter label

4. Notch filter status

Besides, when a paced signal has been detected, the pace pulse marks “|” are shown on the ECG wave if the [Paced] has

been set to [Ye s ].

1. Current heart rate alarm limits

2. Current heart rate

3. Heart beat symbol

8.5 Changing ECG Settings

8.5.1 Accessing ECG Menus

By selecting the ECG parameter window or waveform area, you can access the [ECG Setup] menu.

8.5.2 Setting Pacemaker Rate (For Mortara ECG algorithm only)

Some pacemaker pulses can be difficult to reject. When this happens, the pulses are counted as a QRS complex and

could result in an incorrect HR and failure to detect some arrhythmias. You can set [Pacemaker Rate] to the pacemaker’s

rate in the [ECG Setup] menu. In this way, the monitor can calculate HR and detect arrhythmias more accurately. When

[Paced] is set to [No], the pacemaker rate cannot be set.

1

1

3

2

3

4

2

8-6 Passport 12/Passport 8 Operator’s Manual

8.5.3 Choosing the Alarm Source

In most cases the HR and PR numerics are identical. In order to avoid simultaneous alarms on HR and PR, the monitor

uses either HR or PR as its active alarm source. To change the alarm source, select [Alm Source] in the [ECG Setup] menu

and then select either:

 [HR]: if you want the HR to be the alarm source for HR/PR.

 [PR]: if you want the PR to be the alarm source for HR/PR.

 [Auto]: If the [Alm Source] is set to [Auto], the monitor will use the heart rate from the ECG measurements as the

alarm source whenever a valid heart rate is available. If the heart rate becomes unavailable, for example the ECG

module is turned off or becomes disconnected, the monitor will automatically switch to PR as the alarm source.

8.5.4 Changing ECG Wave Settings

In the [ECG Setup] menu:

 You can select [ECG], [ECG1], or [ECG2] to select a lead to view. The ECG lead (s) selected is used for analysis (beat

detection, beat classification, and V-Fib detection). The waveform of selected lead should have the following

characteristics:

 The QRS should be either completely above or below the baseline and it should not be biphasic.

 The QRS should be tall and narrow.

 The P-waves and T-waves should be less than 0.2mV.

 If the wave is too small or clipped, you can change its size by selecting an appropriate [Gain] setting. If you select

[Auto] from [Gain], the monitor will automatically adjust the size of the ECG waves. In normal screen, only the

selected ECG wave’s size is adjusted. In other screens, all ECG waves’ size is adjusted simultaneously.

 You can change the wave sweep speed by selecting [Sweep] and then selecting the appropriate setting.

NOTE

 Changing the display gain on the monitor does not affect the amplitude of signal that is used by the

algorithm for beat detection.

8.5.5 Changing the ECG Filter Settings

The ECG filter setting defines how ECG waves are smoothed. To change the filter setting, select [Filter] from [ECG Setup]

and then select the appropriate setting.

 [Monitor]: Use under normal measurement conditions.

 [Diagnostic]: Use when diagnostic quality is required. The unfiltered ECG wave is displayed so that changes such as

R-wave notching or discrete elevation or depression of the ST segment are visible.

 [Surgery]: Use when the signal is distorted by high frequency or low frequency interference. High frequency

interference usually results in large amplitude spikes making the ECG signal look irregular. Low frequency

interference usually leads to wandering or rough baseline. In the operating room, the surgery filter reduces artifacts

and interference from electrosurgical units. Under normal measurement conditions, selecting [Surgery] may

suppress the QRS complexes too much and then interfere with ECG analysis.

 [ST]: Use when ST monitoring is applied.

Passport 12/Passport 8 Operator’s Manual 8-7

CAUTION

 The [Diagnostic] filter is recommended when monitoring a patient in an environment with slight

interference only.

8.5.6 Setting Pacemaker Rate (For Mortara only)

Some pacemaker pulses can be difficult to reject. When this happens, the pulses are counted as a QRS complex and

could result in an incorrect HR and failure to detect some arrhythmias. You can set [Pacemaker Rate] to the pacemaker’s

rate in the [ECG Setup] menu. In this way, the monitor can calculate HR and detect arrhythmias more accurately. When

[Paced] is set to [No], the pacemaker rate cannot be set.

8.5.7 Setting the ECG Lead Set

You can set the [Lead Set] by selecting [ECG Setup]→[Others>>]. You can set the [Lead Set] as [Auto] if the auto lead

detection function is available.

8.5.8 Choosing an ECG Display Screen

When monitoring with a 5-lead set, you can select the [Screens] Quickkey. In the [Choose Screen] window, choose the

screen type as:

 [Normal Screen]: The ECG waveform area shows 2 ECG waveforms.

 [ECG 7-Lead Full-Screen]: The whole waveform area shows 7 ECG waveforms only.

 [ECG 7-Lead Half-Screen]: The upper half part of the whole waveform area displays 7 ECG waveforms.

When the screen type is set to [Normal Screen], cascaded ECG waveforms can be displayed. To cascade ECG waveforms:

1. Select the [Screens] Quickkey→[Screen Setup].

2. Select [ECG1 Casc.] in the second row. A cascaded waveform is displayed in two waveform positions.

8.5.9 Setting the Notch Filter

The notch filter removes the line frequency interference. Only when [Filter] is set to [Diagnostic], the [Notch Filter] is

adjustable.

To set the notch filter:

1. Select the ECG parameter window or waveform area to enter its setup menu. Then select [Others >>].

2. Set [Notch Filter] to:

 [Strong]: when waveform interference is strong (such as spikes).

 [Weak]: when waveform interference is weak.

 [Off]: to turn the notch filter off.

8-8 Passport 12/Passport 8 Operator’s Manual

Set notch frequency according to the electric power frequency of your country. To set notch filter frequency:

1. When [Notch Filter] is turned on, select [Main Menu]→[Maintenance >>]→[User Maintenance >>]→enter the

required password.

2. Select [Others >>]→[Notch Freq.] and then select [50Hz] or [60Hz] according to the power line frequency.

8.5.10 Changing the Pacer Reject Settings

Select [ECG Setup]→[Others>>]→[Pacer Reject], and then select [On] or [Off].

When [Paced] is set to [Ye s ]:

 When [Pacer Reject] is switched on, the pace pulses are not counted as extra QRS complexes.

 The pace pulse marks “|” are shown on the ECG wave when pace pulses are detected.

When [Paced] is set to [No], the pace markers are not shown on the ECG wave, and the options of [Pacer Reject] are

inactivated.

8.5.11 Enabling Smart Lead Off

When the smart lead off function is set on and there is a “lead off” in the lead that has an ECG waveform in filter mode

and notch status, if another lead is available, this available lead automatically becomes that lead. The system will

re-calculate HR and analyze and detect arrhythmia. When the “lead off ” condition is corrected, the leads are

automatically switched back.

To switch on/off the smart lead off function, select [Others >>] from the [ECG Setup] menu; select [Smart Lead Off] and

then select [On] or [Off] from the pop-up menu.

8.5.12 Setting the Alarm Level for ECG Lead Off Alarms

Select [Alarm Setup >>] from the [User Maintenance] menu. You can set [ECGLeadOff Lev.] from the pop-up menu.

8.5.13 Adjusting QRS Volume

QRS sounds are produced based on the alarm source.

To adjust the QRS volume, select [Others >>] from the [ECG Setup] menu; select [QRS Volume] from the pop-up menu

and select the appropriate setting. When a valid SpO2 measured value is available, the system adjusts the pitch tone of

QRS sound based on the SpO

2

value.

Passport 12/Passport 8 Operator’s Manual 8-9

8.5.14 Adjusting the Minimum QRS Detection Threshold (For Advanced ECG Algorithm
Only)

To avoid false asystole alarms when the R wave amplitude is low and missed asystole alarms during ventricular standstill

(tall P waves, but no QRS), a means to manually adjust the minimum QRS detection threshold is provided.

To adjust the QRS threshold,

1. In the [ECG Setup] menu, set [Filter] to [Monitor].

2. Select [Others >>]→[Minimum QRS Threshold >>] to enter the [Minimum QRS Threshold] menu.

3. Select the up or down arrow to adjust the QRS threshold. Selecting [Default] resets the QRS threshold to the

default value (0.16 mV).

4. Select [Confirm] to make the changes effective.

CAUTION

 The setting of QRS threshold can affect the sensitivity of arrhythmia, ST, QT/QTc detection, and heart rate

calculation.

 If QRS amplitude is low, the monitor might not be able to calculate heart rate and false asystole may occur.

NOTE

 The minimum QRS detection threshold can only be adjusted when the ECG filter is set to [Monitor].

8.5.15 About the Defibrillator Synchronization

A defibrillator synchronization pulse (100 ms, +5V) is output through the Multifunctional connector every time the

monitor detects an R-wave.

To use the defibrillator synchronization function, connect the monitor and the defibrillator with a synchronization cable.

WARNING

 Improper use of a defibrillator may cause injury to the patient. The user should determine whether to

perform defibrillation or not according to the patient’s condition.

8-10 Passport 12/Passport 8 Operator’s Manual

8.6 About ST Monitoring

 ST segment analysis is not intended for neonatal patients.

 ST segment analysis calculates ST segment elevations and depressions for individual leads and then displays them

as numerics in the ST1 and ST2 areas.

 A positive value indicates ST segment elevation; a negative value indicates ST segment depression.

 Measurement unit of the ST segment deviation: mV or mm. You can set the unit in the [Unit Setup] menu from the

[User Maintenance] menu.

 Measurement range of the ST segment deviation: -2.0 mV to +2.0 mV.

NOTE

 The ST algorithm has been tested for accuracy of the ST segment data. The significance of the ST segment

changes need to be determined by a clinician.

8.6.1 Switching ST Monitoring On and Off

To switch ST monitoring on or off:

1. In the [ECG Setup] menu, select [ST Analysis >>].

2. Select [ST Analysis] and then select [On] or [Off].

Reliable ST monitoring can hardly be ensured if:

 You are unable to get a lead that is not noisy.

 Arrhythmias such as atrial fib/flutter cause irregular baseline.

 The patient is continuously ventricularly paced.

 The patient has left bundle branch block.

In these cases, you may consider switching ST monitoring off.

8.6.2 Changing ST Filter Settings

ST-segment analysis can be carried out only when the filter mode is set to [Diagnostic] or [ST]. When ST-segment

analysis is switched on, [Filter] will automatically switch to [ST] if it is not [Diagnostic] or [ST]. When ST-segment

analysis is switched off, the filter mode automatically switches to previous manual setting.

However, if you switch [Filter] to [Monitor] or [Surgery], ST-segment analysis will turn off automatically. If you change

[Monitor] or [Surgery] to [Diagnostic] or [ST], ST-segment analysis remains off, you can turn it on manually.

Passport 12/Passport 8 Operator’s Manual 8-11

8.6.3 Understanding the ST Display

8.6.3.1 ST Numerics

This example shows ST numerics with 5-lead ECG. Your monitor screen may look slightly different from the illustration.

8.6.3.2 ST Segment

ST segment shows a QRS complex segment for each measured ST lead. The current ST segment is drawn in the same

color as the ECG wave, usually green, superimposed over the stored reference segment, drawn in a different color. The

information is updated once every ten seconds.

To display the ST segment on normal screen:

1. Enter the [ST Analysis] menu. Set [ST Analysis] to [On].

2. Enter the [Screen Setup] window from the [Screens] menu. Set [ST Segment] to be displayed.

Select the ST parameter window or ST segment area to enter the [ST Analysis] menu.

8-12 Passport 12/Passport 8 Operator’s Manual

8.6.4 Saving the Current ST Segment as Reference

Select [Save Ref.] in the [ST Analysis] menu to save the current segment as a reference. Up to 20 reference segment

groups can be saved.

NOTE

 If the memory is full and you do not delete a group before saving a new one, the earliest saved group is

deleted automatically.

8.6.5 Changing the Reference Segment

Select the and arrow keys beside the [Change Ref.] to switch between different reference segment groups.

8.6.6 Deleting a Reference Segment

To delete the current ST reference segment, select [Delete Ref.] in the [ST Analysis] menu and then select [Ok] in the

pop-up.

8.6.7 Recording the ST Segment

To record the current ST segment and reference segment, select [Record] in the [ST Analysis] menu.

8.6.8 Changing the ST Alarm Limits

High and low ST alarm limits can be set individually for each ECG lead. Alarm limits can also be set separately for

single-lead and multi-lead ST monitoring. You can select [ST Alarm Setup >>] from [ST Analysis] menu and then

change ST alarm settings for each lead.

8.6.9 Setting the ST Alarm Delay Time

To set the ST alarm delay time,

1. Select [Main Menu]→[Maintenance >>]→[User Maintenance >>]. Enter the required password and then select

[OK].

2. Select [Alarm Setup >>]→[ST Alarm Delay].

Passport 12/Passport 8 Operator’s Manual 8-13

8.6.10 Adjusting ST Measurement Points

As shown in the figure below, the ST measured for each beat complex is the vertical difference between two

measurement points with the R-wave peak as the baseline for the measurement.

The ISO and ST points need to be adjusted when you start monitoring and if the patient’s heart rate or ECG morphology

changes significantly. Exceptional QRS complexes are not considered for ST-segment analysis.

WARNING

 Always ensure that the ST measurement points are appropriate for your patient.

To adjust the ST measurement points:

1. Select the ECG numeric area or waveform area to enter the [ECG Setup] menu.

2. Select [ST Analysis >>].

3. Set [ST Analysis] to [On].

4. Select [Adjust ST Point >>].

In the [Adjust ST Point] window, three vertical lines represent the ISO, J and ST point positions respectively. In this

window, you can:

 Select [Auto] to automatically detect the ISO point and J point, and set ST point. When [Auto] is selected, the

monitor takes a few seconds to finish automatic detection. During this time, the message [Please wait...] is

displayed in the [Adjust ST Point] window.

 Or manually adjust the ISO point, J point, and ST point.

To manually adjust the ST measurement points, follow this procedure:

1. Use the left and right arrows beside [ISO] and [J] to adjust the position of ISO point and J point.

 The ISO-point (isoelectric) position is given relative to the R-wave peak. Position the ISO-point in the middle of

the flattest part of the baseline (between the P and Q waves).

 The J-point position is given relative to the R-wave peak and helps locating the ST-point. Position the J-point at

the end of the QRS complex and the beginning of the ST segment.

2. Set [ST Point]. The ST-point is positioned a fixed distance from the J-point. Move the J-point to position the

ST-point at the midpoint of the ST segment. Position the ST-point relative to the J-point at either [J+60/80ms], [J+40ms],

[J+60ms] or [J+80ms]. When [J+60/80ms] is selected, the ST-point will be positioned 80 ms (heart rate 120 bpm or less)

or 60 ms (heart rate more than 120 bpm) from the J-point.

R-wave peak

P point

ISO electric point

ST measurement point

Difference=ST value

J point

Q

8-14 Passport 12/Passport 8 Operator’s Manual

NOTE

 Only Advanced ECG algorithm has the function of automatic J point detection.

 The ISO point, J point, and ST point displayed in the [Adjust ST Point] window are positioned with reference

to the R-wave peak.

8.7 QT/QTc Interval Monitoring (For Advanced ECG Algorithm Only)

The QT interval is defined as the time between the beginning of the Q-wave and the end of the T-wave. It measures the

total duration of the depolarization (QRS duration) and repolarization (ST-T) phases of the ventricles. QT interval

monitoring can assist in the detection of long QT syndrome.

The QT interval has an inverse relationship to heart rate. As heart rate increases, the QT interval shortens, while at lower

heart rates QT interval gets longer. Several formulas are available to correct QT interval for heart rate. The heart rate

corrected QT interval is abbreviated as QTc.

QT/QTc Interval Monitoring is intended for adult, pediatric, and neonate patients.

CAUTION

 For QT interval monitoring to be effective, basic or enhanced arrhythmia monitoring should be turned on.

8.7.1 QT/QTc Monitoring Limitations

Some conditions may make it difficult to achieve reliable QT monitoring, for example:

 R-wave amplitudes are too low

 The presence of frequent ventricular ectopic beats

 Unstable RR intervals

 P-waves tending to encroach on the end of the previous T-wave at high heart rates

 T-waves are very flat or not well defined

 The end of the T-wave is difficult to delineate because of the presence of U-waves

 QTc measurements are not stable

 In the presence of noise, asystole, ventricular fibrillation, and ECG lead off

Al2

QT interval

Passport 12/Passport 8 Operator’s Manual 8-15

For these cases you should select a lead with good T-wave amplitude and no visible flutter activity, and without a

predominant U-wave or P-wave.

Some conditions such as left or right bundle branch block or hypertrophy can lead to a widened QRS complex. If a long

QTc is observed you should verify it to ensure that it is not caused by QRS widening.

Because normal beats followed by ventricular beats are not included in the analysis, no QT measurement will be

generated in the presence of a bigeminy rhythm.

If the heart rate is extremely high (over 150bpm for adults and over 180bpm for pediatrics and neonates), QT will not be

measured. When the heart rate changes, it can take several minutes for the QT interval to stabilize. For reliable QTc

calculation it is important to avoid the region where the heart rate is changing.

WARNING

 QT/QTc measurements should always be verified by a qualified clinician.

8.7.2 Enabling QT/QTc Monitoring

The QT monitoring function is disabled by default. Before you start QT monitoring, enable the QT function.

To e nable QT/QTc m oni tor ing:

1. In the [ECG Setup] menu, select [QT Analysis>>] to enter the [QT Analysis] menu.

2. Set [QT Analysis] to [On].

8.7.3 Displaying QT/QTc Parameters and Waveform

To display QT numerics and waveform:

1. Select the [Screens] QuickKey or select [Main Menu]→[Screen Setup >>]→[Screen Layout >> to enter the

[Screens] window.

2. Select the [Screen Setup] tab.

3. Select the parameter area where you want to display the QT parameters and select [QT].

The following picture shows the QT numeric area. Your monitor screen may look slightly different:

2

4

5

3

1

8-16 Passport 12/Passport 8 Operator’s Manual

1: QTc alarm limit (if QTc alarm is off, the alarm off symbol is displayed)

2: Parameter label

3: QTc value

4: ΔQTc value (the difference between the current and reference QTc values. If ΔQTc alarm is off, the alarm off symbol

is displayed on the right.)

5: QT value

NOTE

 QTc values are calculated based on the QT-HR, not the ECG HR. To view the QT-HR, open the QT View

window.

8.7.4 Accessing the QT View

QT View shows the current and reference QT parameter values and waveforms.

To accss the QT View:

1. Select the QT parameter area or waveform area to enter the [QT Analysis] menu.

2. Select [QT View>>].

The following picture shows the QT view.

 The current waveform is shown in the upper half in green.
 The reference waveform is shown below in yellow.
 The start of QRS complex and the end of the T wave are marked with vertical lines.
 In some conditions, no QT measurement can be calculated. Then the cause of failed QT measurement is shown at

the bottom of the QT numerics area. Additionally the message “Cannot Analyze QT” is shown in the technical alarm

area.

Passport 12/Passport 8 Operator’s Manual 8-17

In the QT View, you can:

 Select the arrows besides [View Leads] to switch the displayed lead.

 Select [Save Ref.] to save the current QT parameters and waveforms as reference. If no reference has been set

for this patient within the first five minutes after getting valid QT values, the monitor will automatically set a

reference. If you set a new reference, the previous reference will be discarded.

CAUTION

 Updating QTc reference affects ΔQTc value and alarm.

8.7.5 Changing QT Settings

8.7.5.1 Setting QT Alarm Properties

To set QT alarm properties,

1. Select the [Alarm Setup] QuickKey, or select [Alarm Setup>>] from the [QT Analysis] menu.

2. Set QTc and ∆QTc alarm properties.

8.7.5.2 Selecting the QT Analysis Lead

You can select one lead or all leads for QT calculation. To select the QT analysis lead:

1. Select the QT parameter area or waveform area to enter the [QT Analysis] menu.

2. Set [Analysis Lead]. [All] is selected by default. This means all leads are used for QT calculation.

8.7.5.3 Changing QTc Formula

The monitor uses as a default the Hodges correction formula to correct the QT interval for heart rate. To change the QTc

formula:

1. Select the QT parameter area or waveform area to enter the [QT Analysis] menu.

2. Set [QTc Formula].

 Hodges:

()

6075.1 −×+= HeartRateQTQTc

 Bazett:

2

1

60











×=

HeartRate

QTQTc

 Fridericia:

3

1

60











×=

HeartRate

QTQTc

 Framingham:











−×+=

HeartRate

QTQTc

60

1154

8-18 Passport 12/Passport 8 Operator’s Manual

8.8 About Arrhythmia Monitoring

Arrhythmia analysis provides information about the patient's cardiac parameters like heart rate, PVC rate, and rhythm.

WARNING

 Arrhythmia analysis program is intended to detect ventricular arrhythmias and atrial fibrillation. It is not

designed to detect all the atrial or supraventricular arrhythmias. It may incorrectly identify the presence or

absence of an arrhythmia. Therefore, a physician must analyze the arrhythmia information with other

clinical findings.

 The arrhythmia detection is not intended for neonatal patients.

 Heart-rate reading may be affected by cardiac arrhythmias. Do not rely entirely on rate meter alarms when

monitoring patients with arrhythmias. Always keep these patients under close surveillance.

 Atrial fibrillation (Afib) detection function is not intended for pediatric and neonatal patients.

8.8.1 Understanding the Arrhythmia Events

Mortara ECG algorithm

Arrhythmia Message Description Category

Asystole No QRS complex detected within the set time threshold (in absence of

ventricular fibrillation or chaotic signals).

Lethal

arrhythmia

Vfib Ventricular fibrillation occurs and persists for 6 seconds.

Vtac Ventricular HR is greater or equal to the preset threshold and the number of

consecutive PVCs is greater than the preset threshold.

PVCs PVCs/min exceeds high limit Nonlethal

arrhythmia

Pacer Not Pacing No pace pulse detected for (60*1000/pace rate +90) milliseconds following a QRS

complex or a pacer pulse (for paced patients only).

Pacer Not Capture No QRS complex detected for 300 milliseconds following a pace pulse (for paced

patients only).

Multif. PVC More than 2 PVCs of different forms occur in the predefined search window

(3-31).

Couplet Paired PVCs are detected.

Run PVCs Ventricular HR is greater than or equal to the preset threshold and the number of

PVCs is greater than or equal to 3 but less than the preset threshold.

Vent. Rhythm Ventricular HR is less than the preset threshold and the number of PVCs is greater

than or equal to 3.

Bigeminy A dominant rhythm of N, V,N, V, N, V.

Trigeminy A dominant rhythm of N, N, V,N, N, V, N, N, V.

R on T R on T is detected.

Irr. Rhythm Consistently irregular rhythm

Missed Beats No beat detected for 1.75x average R-R interval for HR <120, or

No beat for 1 second with HR >120 (for non-paced patients only), or

No beat detected for more than the set pause threshold.

Passport 12/Passport 8 Operator’s Manual 8-19

Brady The HR is less than the set bradycardia low limit.

Tachy The HR is greater than the set tachycardia high limit.

Advanced ECG algorithm

Arrhythmia message Description Category

Asystole

No QRS detected within the set time threshold in absence of ventricular

fibrillation or chaotic signal.

Lethal

arrhythmia

Vfib/Vtac

A fibrillatory wave for 6 consecutive seconds.

A dominant rhythm of adjacent Vs and a HR > the V-Tac HR limit.

Vtac The consecutive PVCs ≥ Vtac PVCs limit, and the HR ≥ the Vtac rate limit.

Vent. Brady

The consecutive PVCs ≥ the Vbrd threshold and the ventricular HR < the Vbrd

Rate threshold.

Extreme Tachy The heart rate is equal to or greater than the extreme tachycardia limit.

Extreme Brady The heart rate is equal to or less than the extreme bradycardia limit.

PVCs PVCs/min exceeds high limit

Nonlethal

arrhythmia

Pacer Not Pacing

No pace pulse detected for 1.75 x average R-to-R intervals following a QRS

complex (for paced patients only).

Pacer Not Capture

No QRS complex detected for 300 milliseconds following a pace pulse (for

paced patients only).

PVC One PVC detected in normal heartbeats.

Couplet Paired PVCs detected in normal heartbeats.

Run PVCs More than 2 consecutive PVCs within the last minute.

Bigeminy A dominant rhythm of N, V, N, V, N, V.

Trigeminy A dominant rhythm of N, N, V,N, N, V, N, N, V.

R on T R on T detected in normal heartbeats.

Missed Beats

No beat detected for 1.75 x average R-R interval for HR <120, or No beat for 1

second with HR > 120 (for non-paced patients only), or No beat detected for

more than the set pause threshold.

Brady The average heart rate is equal to or less than the bradycardia limit.

Tachy The average heart rate is equal to or greater than the tachycardia limit.

Vent. Rhythm

The consecutive PVCs ≥ the Vbrd PVCs limit, and the HR ≥ Vbrd Rate limit but <

the Vtac Rate limit.

Multif. PVC Multiform PVCs detected in Multif. PVC's Window (which is adjustable).

Nonsus. Vtac

The consecutive PVCs < the Vtac PVCs limit but > 2, and HR ≥ the Vtac Rate

limit.

Pause No QRS detected within the set time threshold of pause.

Irr. Rhythm Consistently irregular rhythm.

Afib Absence of P-waves and/or variable RR intervals between normal beats.

8-20 Passport 12/Passport 8 Operator’s Manual

8.8.2 Changing Arrhythmia Alarm Settings

To change arrhythmia alarm settings, select the ECG parameter area or waveform area →[ECG Setup]→ [Arrh.

Analysis >>]. In the pop-up menu, you can set the [Alm Lev] to [High], [Med], [Low] or [Message], or switch on lethal

arrhythmia analysis alarms only or switch on/off all arrhythmia analysis alarms. In the [Alarm Setup] menu from the

[User Maintenance] menu, you can enable/disable turning off lethal arrhythmia analysis alarms.

WARNING

 If you switch off all arrhythmia analysis alarms, the monitor cannot give any arrhythmia analysis alarm.

Always keep the patient under close surveillance.

NOTE

 The priority of lethal arrhythmia alarms is always high. It is unchangeable.

8.8.3 Changing Arrhythmia Threshold Settings

Select the ECG parameter window or waveform area→[Arrh. Analysis >>]→[Arrh. Threshold], and you can then

change threshold settings for some arrhythmia alarms. When an arrhythmia violates its threshold, an alarm will be

triggered. The asystole delay time relates to ECG relearning. When HR is less than 30 bpm, it is recommended to set the

asystole delay time to 10 seconds.

Mortara ECG algorithm

Arrh. event Range Default Step Unit

PVCs High 1 to 100 10 1 /min

Asys. Delay 2 to 10 5 1 s

Vtac Rate 100 to 200 130 5 bpm

Vtac PVC 3 to 12 6 1 beats

Multif. PVC 3 to 31 15 1 beats

Tachy High

Adult: 100 to 300

Pediatric: 160 to 300

Adult: 100

Pediatric: 160

5 bpm

Brady Low

Adult: 15 to 60

Pediatric: 15 to 80

Adult: 60

Pediatric: 80

5 bpm