Mindray BIO Medical electronics TMS6016 User Manual

TMS-6016

Telemetry Monitoring System

Operation Manual

CE Marking

The telemetry monitoring system bears CE mark indicating its conformity with the

provisions of the Council Directive 93/42/EEC concerning medical devices and

fulfils the essential requirements of Annex I of this directive.

The telemetry monitoring system is in radio-interference protection class B in

accordance with EN55011.

The product complies with the requirement of standard EN60601-1-2

“Electromagnetic Compatibility – Medical Electrical Equipment”.

Revision History

This manual has a revision number. This revision number changes whenever the

manual is updated due to software or technical specification change. Contents of this

manual are subject to change without prior notice. Revision 1.0 is the initial release

of the document.

 Version number: 2.1
 Release time: November 2006

© 2005 - 2006 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights

reserved.

WARNING

z Federal Law (USA) restricts this device to sale by or on the order of a

physician.

I

Intellectual Property Statement

SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter

called Mindray) owns the intellectual property rights to this 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 does not assume any liability arising out of any infringements of patents or

other rights of third parties.

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, rent, 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.

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

II

Manufacturer’s Responsibility

All information contained in this manual is believed to be correct. Mindray shall not

be 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 safety, reliability and performance of this product only in

the condition that:

 All installation operations, expansions, changes, modifications and repairs of

this product are conducted by Mindray authorized personnel; and

 The electrical installation of the relevant room complies with the applicable

national and local requirements; and

 This product is operated under strict observance of this manual.

Warranty

This warranty is exclusive and is in lieu of all other warranties, expressed or implied,

including warranties of merchantability or fitness for any particular purpose.

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 shall not extend to

 Any Mindray product which has been subjected to misuse, negligence or

 Any Mindray product from which Mindray's original serial number tag or

 Any product of any other manufacturer.

accident; or

product identification markings have been altered or removed; or

III

Return Policy

In the event that it becomes necessary to return a unit to Mindray, follow the

instructions below.

1. Obtain a return authorization.

Contact the Mindray Service Department and obtain a Mindray Customer Service

Authorization Number. The Mindray Customer Service Authorization Number must

appear on the outside of the shipping container. Return shipments will not be

accepted if the Mindray Customer Service Authorization Number is not clearly

visible. Please provide the model number, serial number, and a brief description of

the reason for return.

2. Freight policy

The customer is responsible for freight charges when this product is shipped to

Mindray for service (including any relevant customs fees or other freight related

charges).

3. Return address

Please send the part(s) or equipment to the address offered by Customer Service

Department.

Contact Information

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

Tel: [phone] [phone]

Fax: [phone] [phone]

Website: www.mindray.com

EC-Representative: Shanghai International Holding Corp. GmbH (Europe)

Address: Eiffestraße 80, 20537 Hamburg Germany

Tel: [phone]

Fax: [phone]

IV

Preface

Manual Purpose

This manual contains the instructions necessary to operate the telemetry monitoring

system 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 telemetry monitoring system. If you have any question, please

contact us.

This manual is an integral part of the product. It should always be kept close to the

equipment so that it can be obtained conveniently when needed.

Intended Audience

This manual is geared for clinical professionals who are expected to have a working

knowledge of medical procedures, practices and terminology as required for

monitoring of critically ill patients.

Illustrations

All illustrations in this manual serve as examples only. They may not necessarily

reflect your monitoring setup or data displayed on your telemetry monitoring

system.

Conventions

 Italic text is used in this manual to quote the referenced chapters or sections.
 The terms danger, warning, and caution are used throughout this manual to

point out hazards and to designate a degree or level or seriousness.

V

FOR YOUR NOTES

VI

Contents

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

1.1 Safety Information ...................................................................................... 1-2

1.1.1 Dangers ......................................................................................... 1-3

1.1.2 Warnings........................................................................................ 1-3

1.1.3 Cautions......................................................................................... 1-4

1.1.4 Notes ............................................................................................. 1-5

1.2 Equipment Symbols .................................................................................... 1-6

1.3 Reference Literature.................................................................................... 1-8

2 Overview.............................................................................................................. 2-1

2.1 General ........................................................................................................ 2-2

2.1.1 Intended Use.................................................................................. 2-2

2.1.2 Contraindications .......................................................................... 2-3

2.1.3 Components................................................................................... 2-3

2.1.4 Functions ....................................................................................... 2-3

2.2 Product Overview........................................................................................ 2-4

2.2.1 Telemetry Transmitter ................................................................... 2-4

2.2.2 Telemetry Receiver ....................................................................... 2-6

2.3 About the CMS ........................................................................................... 2-8

2.3.1 Main Screen .................................................................................. 2-8

2.3.2 Auxiliary Screen in Single-Screen Mode.....................................2-11

2.3.3 ViewBed Screen .......................................................................... 2-12

3 Installation and Maintenance............................................................................. 3-1

3.1 Installation................................................................................................... 3-2

3.1.1 Unpacking and Inspection............................................................. 3-2

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

3.1.3 Power Requirements ..................................................................... 3-3

3.1.4 Computer Requirements................................................................ 3-4

3.1.5 Installation..................................................................................... 3-5

3.1.6 Starting the system ........................................................................ 3-6

3.1.7 Shutting down the system ............................................................. 3-7

3.2 Maintenance ................................................................................................ 3-8

3.2.1 Inspection ...................................................................................... 3-8

3.2.2 Cleaning ........................................................................................ 3-9

3.2.3 Disinfection and Sterilization.......................................................3-11

1

Contents

4 Using T ransmitters.............................................................................................. 4-1

4.1 Installing and replacing batteries................................................................. 4-2

4.2 Switching on/off the transmitter.................................................................. 4-3

4.3 Wearing the transmitter ............................................................................... 4-3

5 Routine CMS Operation..................................................................................... 5-1

5.1 Nurse call .................................................................................................... 5-2

5.2 Event ........................................................................................................... 5-2

5.3 STANDBY mode ........................................................................................ 5-2

5.4 Patient Management.................................................................................... 5-3

5.4.1 Admitting a Patient........................................................................ 5-3

5.4.2 Editing patient information ........................................................... 5-4

5.4.3 Discharging a Patient..................................................................... 5-5

5.5 Alarm Setup ................................................................................................ 5-6

5.5.1 Alarm Setup .................................................................................. 5-6

5.5.2 Alarm Volume ............................................................................... 5-7

5.5.3 Pause alarm ................................................................................... 5-8

5.5.4 Alarm Latching ............................................................................. 5-8

5.5.5 Turning off alarm sound ................................................................ 5-9

5.6 Review ...................................................................................................... 5-10

5.7 Record ....................................................................................................... 5-14

5.8 Print........................................................................................................... 5-15

6 ECG Monitoring.................................................................................................. 6-1

6.1 Preparation .................................................................................................. 6-2

6.2 Electrode Placement.................................................................................... 6-3

6.3 ECG Monitoring.......................................................................................... 6-8

6.3.1 ECG waveform.............................................................................. 6-8

6.3.2 ECG parameter.............................................................................. 6-9

6.3.3 ECG Setup................................................................................... 6-10

6.3.4 ECG lead type ..............................................................................6-11

6.3.5 ECG Primary and Secondary Leads............................................ 6-12

6.3.6 Waveform display settings .......................................................... 6-12

6.3.7 Filter mode .................................................................................. 6-12

6.3.8 Pace Pulse detection.................................................................... 6-13

6.3.9 HR alarm ..................................................................................... 6-13

6.4 ST Analysis ............................................................................................... 6-14

6.4.1 General ........................................................................................ 6-14

6.4.2 ST setup....................................................................................... 6-15

6.4.3 ST measurement points ............................................................... 6-16

6.5 Arrhythmia Analysis ................................................................................. 6-17

6.5.1 Overview ..................................................................................... 6-17

6.5.2 Arrhythmia analysis setup........................................................... 6-18

6.5.3 Arrhythmia alarm setup............................................................... 6-19

2

Contents

6.5.4 Arrhythmia alarm review ............................................................ 6-20

6.5.5 Arrhythmia relearn ...................................................................... 6-21

6.5.6 Arrhythmia troubleshooting ........................................................ 6-22

6.6 Maintenance and Cleaning ........................................................................ 6-22

7 SpO2 Monitoring................................................................................................. 7-1

7.1 Principle of SpO

Measurement.................................................................. 7-2

2

7.2 Monitoring Procedure ................................................................................. 7-2

7.3 SpO

Measurement...................................................................................... 7-3

2

7.3.1 SpO

7.3.2 SpO

parameter area...................................................................... 7-3

2

Setup .................................................................................... 7-4

2

7.4 Measurement Limitations............................................................................ 7-5

7.5 Warnings ..................................................................................................... 7-6

8 Troubleshooting................................................................................................... 8-1

9 Accessories...........................................................................................................9-1

10 Appendices......................................................................................................... 10-1

A. Product Specifications............................................................................... 10-2

A.1 Safety Specifications................................................................... 10-2

A.2 Environmental Specifications...................................................... 10-2

A.3 Power Specifications................................................................... 10-3

A.4 Hardware Specifications ............................................................. 10-4

A.5 Data Display, Recording and Saving........................................... 10-4

A.6 Alarms and Indicators ................................................................. 10-5

A.7 Wireless Transmission................................................................. 10-5

A.8 ECG Specifications ..................................................................... 10-6

A.9 SpO

Specifications..................................................................... 10-8

2

B. EMC........................................................................................................ 10-10

C. Symbols and Abbreviations..................................................................... 10-15

C.1 Units .......................................................................................... 10-15

C.2 Symbols..................................................................................... 10-16

C.3 Abbreviations ............................................................................ 10-17

3

FOR YOUR NOTES

Contents

4

1 Safety

1.1 Safety Information ...................................................................................... 1-2

1.1.1 Dangers ......................................................................................... 1-3

1.1.2 Warnings........................................................................................ 1-3

1.1.3 Cautions......................................................................................... 1-4

1.1.4 Notes ............................................................................................. 1-5

1.2 Equipment Symbols .................................................................................... 1-6

1.3 Reference Literature.................................................................................... 1-8

1-1

Safety

1.1 Safety Information

The safety statements presented in this chapter refer to the basic safety information

that the operator of the Telemetry monitoring system shall pay attention to and abide

by. There are additional safety statements in other chapters or sections, which may

be the same as or similar to the followings, or specific to the operations.

DANGER

z Indicates an imminent hazard situation that, if not avoided, will result in

death, serious injury or property damage.

WARNING

z Indicates a potential hazard situation or unsafe practice that, if not

avoided, could result in death, serious injury or property damage.

CAUTION

z Indicates a potential hazard or unsafe practice that, if not avoided, could

result in minor personal injury or product/property damage.

NOTE

z Provides application tips or other useful information to ensure that you

get the most from your product.

1-2

Safety

1.1.1 Dangers

There are no dangers that refer to the product in general. Specific “Danger”

statements may be given in the respective sections of this operation manual.

1.1.2 Warnings

WARNING

z The telemetry monitoring system is intended for use by trained clinical

professionals in specific situations. Any operations of the system by
unauthorized or untrained person are prohibited.

z Check the system and accessories each time before use. Make sure they

function properly and safely.

z Possible fire or explosion hazard if used in the presence of flammable

anesthetics.

z Be sure to set the alarm according to the patient’s conditions. Make sure

the system sounds when an alarm is present.

z Opening the receiver housing may present a risk of electric shock. All

servicing and future upgrades to this system must be performed by
personnel trained and authorized by Mindray only.

z Do not come into contact with patients during defibrillation. Otherwise

serious injury or death could result.

z When the system is used in conjunction with electro-surgery unit (ESU),

patient safety must be ensured.

z Dispose of the packaging material, observing the applicable waste

control regulations and keeping it out of children’s reach.

z The telemetry receiver must be connected to a properly installed power

outlet with protective earth contacts only. If the installation does not
provide for a protective earth conductor, disconnect the receiver from
the power line and operate it on battery power, if possible.

z This system generates, uses and radiates radio-frequency energy, and if

is not installed and used in accordance with this manual, may cause
interference to radio communication.

z Operation of this system in a residential area may cause interference, in

which case, at their own expense, must take whatever measures may be
required to correct the interference.

z The telemetry transmitter is an IPX3 device. Never immerse the telemetry

transmitter in water or other liquids such as cleaning solutions.

1-3

Safety

1.1.3 Cautions

CAUTION

z To ensure patient safety, use only parts and accessories specified in this

manual.

z Remove the batteries if you do not intend to use the transmitter for a

long period of time.

z Disposable devices are intended for single use only. They should not be

reused as performance could degrade or contamination could occur.

z At the end or its service life, the product described in this manual, 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 product, please contact us.

z Magnetic and electrical fields are capable of interfering with the proper

performance of the system. For this reason make sure that all external
devices operated in the vicinity of the system 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.

z Before connecting the receiver to the power line, check that the voltage

and frequency ratings of the power line are the same as those indicated
on the unit’s label or in this manual.

z Install or carry the transmitter properly to avoid damage caused by drop,

impact, strong vibration or other mechanical force.

z Signal transmission can be disturbed when the patient pass es concrete

walls or elevator doors.

z High quality alkali batteries are recommended. Remove the batteries

when the transmitter is not in use.

z Although the transmitter and receiver are chemically resistant to most

common hospital cleaners and non-caustic cleaners, different cleaners
are not recommended and may stain the transmitter and receiver. Man y
cleaners must be diluted before use.

1-4

Safety

1.1.4 Notes

NOTE

z Keep this manual close to the Telemetry monitoring sy stem so that it can

be obtained conveniently when necessary.

z For detailed introductions of the central monitoring system, refer to the

accompanying operation manual of the central monitoring system. In
case you find contradicting contents of the two operation manuals, this
manual supercedes that of the central monitoring system.

z Choose a location that affords an unobstructed view of the system and

easy access to the operating controls.

z The instructions of this manual are based on the maximum

configuration. Some of them may not apply to your system.

1-5

Safety

1.2 Equipment Symbols

Attention: Consult accompanying documents (this manual).

Power on

Power off

Alternating current (AC)

Type CF applied part. The unit displaying this symbol

contains an F-type isolated (floating) patient part providing a

high degree of protection against shock, and is suitable for

use during defibrillation.

TYPE BF applied part

Equipotential terminal

Non-ionizing electromagnetic radiation

Network connector

Antenna interface

Communication status

1-6

Safety

Manufacture date

Serial number

European community representative

This mark means that this device is fully in conformance

with the Council Directive Concerning Medical Devices

93/42/EEC. The number adjacent to the CE marking (0123)

is the number of the EU-notified body that certified meeting

the requirements of Annex II of the Directive.

The following definition of the WEEE label applies to EU

member states only.

This symbol indicates that this product should not be treated

as household waste. By ensuring that this product is disposed

of correctly, you will help prevent bringing potential negative

consequences to the environment and human health. For

more detailed information with regard to returning and

recycling this product, please consult the distributor from

whom you purchased it.

* For system products, this label may be attached to the main

unit only.

1-7

Safety

1.3 Reference Literature

1. EN60601-1/IEC60601-1: Medical electrical equipment part 1: General

requirements for safety

2. IEC60601-1-2, Medical electrical equipment part 1-2: General requirements for

safetyCollateral standard: Electromagnetic compatibility-Requirements and

tests

3. Medical Device Directive 93/42/EEC.

1-8

2 Overview

2.1 General ........................................................................................................ 2-2

2.1.1 Intended Use.................................................................................. 2-2

2.1.2 Contraindications .......................................................................... 2-3

2.1.3 Components................................................................................... 2-3

2.1.4 Functions ....................................................................................... 2-3

2.2 Product Overview........................................................................................ 2-4

2.2.1 Telemetry Transmitter ................................................................... 2-4

2.2.2 Telemetry Receiver........................................................................ 2-6

2.3 About the CMS ........................................................................................... 2-8

2.3.1 Main Screen................................................................................... 2-8

2.3.2 Auxiliary Screen in Single-Screen Mode.....................................2-11

2.3.3 ViewBed Screen .......................................................................... 2-12

2-1

2.1 General

The telemetry monitoring system comprises several telemetry transmitters, a

telemetry receiver, an antenna array, the central monitoring system software and

certain accessories. It features:

 Compact size and light weight.
 Long battery life.
 Reliable signal reception.
 Easy expandability.
 Powerful central monitoring system software.

2.1.1 Intended Use

Overview

The intend use of Telemetry Monitoring System is to monitor Electrocardiogram

(ECG), Heart Rate (HR), PR (Pulse Rate), Saturation of Pulse Oxygen (SpO

adult and pediatric patients via radio frequency within a defined coverage area in

health care facility setting. The information can be displayed, stored and printed.

) for

2

WARNING

z If the accuracy of any value displayed on the screen of the Telemetry

monitoring system’s screen is questionable, first determine the patient’s
vital signs by alternative means and then verify that the Telemetry
monitoring system is working correctly.

z The physiological waves, parameters and alarms displayed on the

system screen are for doctor’s reference only to make diagnoses. They
can not be directly used as the basis for clinical treatment.

z The system transmits data through wireless connection. Risk of data

loss is possible. Keep a close eye on the critical patient.

z One transmitter is to be use on one patient only.

2-2

2.1.2 Contraindications

None.

2.1.3 Components

The system comprises several telemetry transmitters, a telemetry receiver, an

antenna array, the central monitoring system software, ECG cable and SpO

2.1.4 Functions

The system provides information on the following parameters.

Overview

module.

2

 ECG

 SpO

In addition, the system provides such functions as alarms, freeze, review and

recording.

Heart rate (HR)

3-channel of ECG waveforms

Arrhythmia and ST segment analysis

Pace analysis (PACE)

Oxygen saturation (SpO

2

Pulse rate (PR)

)

2

2-3

Overview

2.2 Product Overview

2.2.1 Telemetry Transmitter

1

Figure 2-1 Transmitter – front view

2

43

5

6

7

Figure 2-2Transmitter – rear view

8

Figure 2-3 Transmitter – top view

1. ECG connector

Connects the designated ECG cable (3-lead or 5-lead).

2. SpO

Connects the designated SpO

3. Nurse Call Button

To call a nurse during monitoring, press the Nurse Call Button on the transmitter.

This sends the call to the Central Motoring System (hereinafter called as CMS).

connector

2

module or the special configuration cable.

2

2-4

Overview

4. Event Button

Press the Event Button on the transmitter if the patient feel uncomfortable. This

sends the event to the CMS.

5. LED Indicator

 The LED flashes green when the transmitter works correctly.
 The green LED is on when instructions are in transmission.
 The LED flashes red if one of the patient leads has fallen off the patient;
 The LED flashes yellow when batteries in the transmitter are low.
 The red LED is on when the transmitter is conducting a self-test.

6. SN label

The last four digits of the serial number of the transmitter will be used as the

transmitter ID to be displayed in the central monitoring system.

7. Battery door

It covers the battery compartment.

8. Hanging hole

If you want to hang the transmitter, hang it by this hole.

WARNING

z Do not use the patient cable or the power cord to move or lift the

transmitter. It might cause the transmitter to fall, w hich might damage
the transmitter or injure the patient.

2-5

Overview

2.2.2 Telemetry Receiver

3,4,5

1

Figure 2-4 Receiver – front view

7

6

Figure 2-5 Receiver – rear view

1. Communication indicator

2

7

8

A green LED that indicates the communication status.

 It flashes frequently when the communication is normal.
 It stops flashing when the communication is ceased.
 It is off when the initialization failed or something is wrong with the

hardware.

2. Power indicator

A green LED that indicates the power status.

 It is on when the receiver is powered on.
 It is off when the receiver is powered off.

2-6

Overview

3. AC power input connector

You can power on/off the receiver by pressing this button.

4. Power switch

Place the switch in “┃”to switch on the power , in “〇”to switch off the power.

5. Fuse holder

Open the cover to replace the fuse. The fuse shall be 5TT/1.6A.

6. Equipotential Grounding connector

When the telemetry receiver and other equipment are to be used together, their

equipotential grounding terminals should be connected together, eliminating the

potential difference between them.

7. Antenna connector

The receiver has two antenna connectors, respectively marked 1 and 2.

8. Network connector

For network connection through an RJ45 connector.

WARNING

z Accessory equipment connected to this system must be certified

according to the respective IEC standards (e.g. IEC 60950 for
information technology equipment and IEC 60601-1 for medical
electrical equipment). Furthermore all configurations shall comply with
the valid version of the system standard IEC 60601-1-1. Any person who
connects additional equipment to the signal input port or signal output
port is responsible to ensure that the system complies with the
requirements of the valid version of the system standard IEC 60601- 1-1.
If in doubt, contact our company or customer service.

2-7

2.3 About the CMS

By analyzing and calculating the ECG signals collected from the telemetry

transmitter, the CMS is intended to display the ECG waveforms and the values of

HR, SpO

transmitter and receiver as well as prompt information for the alarms coming from

the transmitter and receiver.

2.3.1 Main Screen

The CMS supports two display modes: single-screen and dual-screen. For the

dual-screen mode, a dual-head card is needed for connecting two displays to the host,

respectively called primary display and secondary display. The figure below shows

the main screen (default screen) under the single-screen mode.

and PR. Besides, the CMS is intended to show status information for the

2

1 2 3 4

Overview

5

1. System name

67

Figure 2-6 Main Screen

2-8

Overview

2. System start time: displays the time when the system starts.

3. System prompt area: Displays the prompts coming from the system itself. If

more than one prompt occur, they will be displayed circularly.

4. Current time: displays the current time.

5. Patient window: displays the waveforms and parammeters coming from a

transmitter.

6. Main menu buttons: contains the functional buttons that enable you to perform

various system setups. For details, see the figure below:

1 2 3 4 5 6

Figure 2-7 Main Menu Buttons

No. Menu name Description

Auto Arrange: Allow you to re-assign patients to patient windows in a

1

2 Admit Patient: Allow you to enter the Admit Patient auxiliary screen.

System Setup: Allow you to enter the System Setup auxiliary screen. For

3

History Review: Allow you to enter the History Review auxiliary screen. For

4

5 Help: Allows you to enter the Help auxiliary screen

6 Main Screen: Allow you to return to the Main Screen.

7. System icons: For details, see the figure below:

top-to-bottom, left-to-right format by order of importance (or

by alarm level).

details, refer to the central monitoring system’s Operation

Manual.

details, refer to the central monitoring system’s Operation

Manual.

12345

Figure 2-8 Icons

2-9

Overview

No Icon name Icon Description

Indicates that the system sound is turned on

1 Sound

2 Printer

3 Recorder

4 Connecting

Indicates that the alarm is silenced.

Indicats that the alarm sound is totally turned off.

Indicates that the printer is normal;

Indicates that no printer is connected;

Indicates a printer error;

Indicates the recorder is normal;

Indicates that the recorder is under self test;

Indicates that no recorder is connected or there is a

communication error;

It flashes when there is a new transmitter trying to connect

the CMS.

Not flash when no new telemetry transmitter is connected;

Indicates that the network is normal;

5 Network

Indicates that the network is interrupted.

Note

z Auto Arrange may change the sequence of current beds.
z Chaning screen layout will trigger Auto Arrange and may change the

sequence of current beds as a result.

2-10

Overview

2.3.2 Auxiliary Screen in Single-Screen Mode

Figure 2-9 Auxiliary Screen in Single-Screen Mode

In the single-screen mode, you can enter an auxiliary screen by clicking on the

“Main menu” button, system icon or patient window. As shown in the figure above,

the auxiliary screen will occupy the lower half part of the main screen and the

system will automatically adjust the size and number of “patient windows”.

Note:

z The waveform data on the monitoring system are not stored by default. If

necessary, select the waveforms you want to store from the Waveform
Saving dialog box of the Display Setup screen.

2-11

2.3.3 ViewBed Screen

In the single screen mode, you can view a single patient through the ViewBed screen

by clicking in its “Patient window”. The ViewBed screen occupies the lower half

part of the Main Screen and presents an enlarged view of the information displayed

in the “Patient window” you have selected.

1

25

Overview

8

43

6

1. Patient information area 2. Physiological alarm area 3. Sound icons

4. Technical alarm area 5. Button area 6. Waveform area

7. Parameter area 8. Telemetry icons

Figure 2-10 Viewbed screen

7

2-12

Overview

Telemetry icons

No. Icon name Icon Function description

1 Nurse call

2 Event

3

4

5

Battery

energy

Signal

strength

Transmitter

ID

TEL

XXXX

The icon flashes if the nurse call button on the transmitter

has been pressed.

The icon flashes if the event button on the transmitter has

been pressed.

This icon indicates the battery status.

Green － The battery energy is normal.

Yellow － The battery energy is low.

Red － The battery energy is about to die and only can

last for 2 to 6 hours (ECG only).

This icon indicates the signal strength.

Green － The received signal is normal.

Yellow － The received signal is weak.

Red － No signal received.

It indicates the ID of the transmitter.

NOTE

z If the battery icon appears red, install new batteries in time. Keeping

using the old battery may lead to communication failure.

2-13

Overview

Button area

No. Icon name Icon Function description

1 Alarm pause Pause the alarm for 2 minutes.

2 STANDBY Entering or exiting the STANDBY mode.

3 Freeze Used to freeze and unfreeze waveforms

4

Show alarm

high/low limits

1 2 3 4 5 6 7 8 9 10 11

Used to show/hide alarm high/low limits for all

physiological parameters, with the alarm high

limits above the alarm low limits to the right of

the physiological parameters

5

Show Dynamic

Short Trend

Used to show/hide the dynamic short trend of

each physiological parameter.

Used to open the Set Module Order window, in

6 Set Module Order

which, you can set the display order of

modules. The default module order is: ECG,

SpO

.

2

Used to open the Record dialog, in which you

7 Record

can select your desired waveforms, record time

span, waveform speed and grid.

8

Show multi-lead

ECG

Enables the simultaneous monitoring of 7-lead

ECG waveforms if you use a 5-lead set.

9 Show OxyCRG Used to show/hide OxyCRG.

Used to show/hide NIBP groups (so far this

10 Show NIBP groups

function is not supported by the Telemetry

monitoring system).

Used to enter the Alarm Setup tab sheet, in

11 Alarm Setup

which you can set parameter alarms and

arrhythmia alarms.

2-14

3 Installation and Maintenance

3.1 Installation................................................................................................... 3-2

3.1.1 Unpacking and Inspection............................................................. 3-2

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

3.1.3 Power Requirements ..................................................................... 3-3

3.1.4 Computer Requirements................................................................ 3-4

3.1.5 Installation..................................................................................... 3-5

3.1.6 Starting the system ........................................................................ 3-6

3.1.7 Shutting down the system ............................................................. 3-7

3.2 Maintenance ................................................................................................ 3-8

3.2.1 Inspection ...................................................................................... 3-8

3.2.2 Cleaning ........................................................................................ 3-9

3.2.3 Disinfection and Sterilization.......................................................3-11

3-1

Installation and Maintenance

3.1 Installation

WARNING

z The Telemetry monitoring system should be installed by Mindray

designated personnel. The copyright of the CMS software is solely
owned by Mindray. No organization or individual shall juggle, copy or
exchange it in any form or by any means without due permission.

3.1.1 Unpacking and Inspection

Before removing the system components from their packaging, inspect the

packaging for signs of damage. In case of any damage, contact the carrier or our

company immediately.

If the packaging is intact, remove the system and accessories from the packaging

carefully and check if every item on the Packing List has been received without

mechanical damage. If you have any question, contact Mindray Customer Service

Department immediately.

CAUTION

z Please save the packaging materials for future transport or storage use.

WARNING

z Dispose of the packaging material, observing the applicable waste

control regulations and keeping it out of children’s reach.

z The system may be contaminated by microorganism during transport,

storage and use. Verify the packaging, especiall y the packaging for the
single use accessories, is intact. In case of any damage, contact the
carrier or our company immediately.

3-2

Installation and Maintenance

3.1.2 Environmental Requirements

The operating environment of this system must meet the requirements specified in

the section A.2 Environmental Specifications.

The environment where the CMS is installed should be reasonably free from noises,

vibration, dust, and corrosive or flammable and explosive substances. Moreover, to

maintain good ventilation, at least 2 inches clearance around the system should be

left.

To ensure reliable communication, do not use radio equipment (e.g. walkie-talkies,

radio controller) or large power electrical equipment (such as paper cutter) around

the system. Keep the system away from the radio or television station. Contact us if

you have any questions regarding the electromagnetic environment.

Before operation, make sure the receiver and transmitter are free from condensation.

This can form when the system is moved from one place to another, and is exposed

to moisture and differences in temperature.

NOTE

z The system transmits data through w ireless connection. External radio

frequency interference may result in missing waveforms occasionally.
Contact us for any questions regarding the electromagnetic
environment.

3.1.3 Power Requirements

The power applied to the system must meet the requirements specified in the section

A.3 Power Specifications.

WARNING

z Make sure the system works in the specified environment and powered

by the required power supply. Incompliance with the environmental and
power requirements may compromise the system performance and even
damage the system.

3-3

Installation and Maintenance

3.1.4 Computer Requirements

If you have only purchased the central monitoring system software from us, you

need to prepare a computer system meeting the following requirements to install the

software.

Computer requirements

Component Requirements

CPU/Memory/Hard disk No less than 2.0G/512M/40G

Display 17 inch LCD; 1280*1024.

Operating system Microsoft Windows 2000 or Microsoft Windows XP。

Printer Windows compatible.

Sound system Sound card/speaker

Built-in speakers (either in the LCD or the computer),

whose volume will not be easily tampered with, are

recommended.

Others CD-ROM, display card(if you have chosen the two-display

configuration, make sure your display card supports two

displays), network card, at least 2 RS232 ports, at least 1

parallel port, at least two USB ports, keyboard and mouse.

3-4

Installation and Maintenance

3.1.5 Installation

To ensure reliable performance, the system is to be installed by authorized personnel

only. To relocate the system, be sure to contact us first.

WARNING

z If the system is connected to another electrical instrument and the

instrument specifications cannot tell whether the instrument
combination is hazardous (e.g. due to summation of leakage currents),
you should consult our company or experts in the field to ensure the
required safety of all instruments concerned.

z Do not use the three wire-to-two wire adaptor.
z To avoid incidental power failure, do not use the outlet controlled by a

wall switch.

z The system can only be updated by the authorized personnel.

CAUTION

z To avoid sudden power failure, UPS is recommended.

NOTE

z The provided network cable is for connection with the PC only. For

connection with the hub, please use the parallel network cable.

3-5

Installation and Maintenance

3.1.6 Starting the system

Follow the procedure below to start the system.

1. Switch on the UPS, if any.

2. Switch on the printer and speakers.

3. Switch on the computer and display.

4. Enter the password to log on the central monitoring system.

5. The central monitoring system will run a self-test and beeps if the test result is

normal. The central monitoring system will then enter the main screen.

6. Press the power switch on the back of the receiver to switch it on. The receiver

will beep and the status indicator and power indicator will be lit.

7. Check the central monitoring system to make sure the receiver is on line.

8. Install batteries into the transmitters and connect the accessories (ECG cable,

SpO

module). When data transmission begins, the status indicator on the

2

receiver will flash.

9. Check the central monitoring system to make sure the transmitters are on line.

10. Now the system has been started and you can monitor the patients as instructed

by this operation manual.

NOTE

z If the computer beeps during the st artup of the computer or the operating

system, refer to the instructions for use of the computer for solutions.

3-6

Installation and Maintenance

3.1.7 Shutting down the system

Follow the procedure below to shut down the system.

1. Make sure you do not want to monitor the patients any more

2. Save or delete the patient data as prompted by the central monitoring system.

3. Click on the “System Setup” button.

4. Click on the “General Setup” tab and then click on the “Shutdown” button.

5. The system will check if any patient is being monitored

 If no patients are being monitored, it enters the next step
 If there are still patients being monitored, it will pop up a message box to ask

you to confirm the operation. You can either click on “Yes” enter the next step,
or click on “No” to s save data and discharge the patients and then repeat the
above procedures.

6. The system will pop up a message box to confirm the operation. Click on “Yes”

and then enter the password, if any, to shut down the system.

7. Switch off the computer and the peripheral devices.

8. Switch off the transmitters and reciver.

9. Switch off the UPS, if any.

CAUTION

z The hospital without a stable pow er supply should use a UPS to supply

power to the CMS. The UPS must not be turned off by force. In case of a
power failure, the system should be shut down by following the above
shutdown procedure before the UPS is depleted. If the system has a
sudden power interruption, system failure may occur, the system may
be unable to work normally next time, or even serious result may result.

3-7

Installation and Maintenance

3.2 Maintenance

WARNING

z Failure on the part of the responsible hospital or institution emplo ying

the use of the central monitoring system to implement a satisfactory
maintenance schedule may cause undue system failure and possible
health hazard.

3.2.1 Inspection

Regular maintenance

To ensure reliable system performance, the system shall be inspected by qualified

personnel when the system

 Has not been used yet.
 Has been running continuously for 6 to 12 months
 Has been repaired or updated.

The inspection shall cover

 Whether the envrionment and power meet the requirements.
 Whether the power system is properly grounded.
 Whether the insulation of the power cable isfine.
 Whether the electromagnetic envrionment meets the requriements.
 Whether the battery contacts of the transmitters are fine.
 Whether there are phsical damages on the housing, buttons, connectors and

accessories.

 Whether only the specified accessories are being used.
 Whether the system clock is accurate.
 Whether the sound/visual alarms can function properly.
 Whether the transmitter frequecy is accurate.
 Whether the antenna array is well connected.

If you find any damage or problem, do not use the system. Contact engineers of your

hospital or our service engineers immediately.

3-8

Installation and Maintenance

3.2.2 Cleaning

WARNING

z Be sure to shut down the system and disconnect all power cords from

the outlet before cleaning the system.

The system should be cleaned on a regular basis. If there is heavy pollution in your

place or your place is very dusty and sandy, the system should be cleaned more

frequently. Before cleaning the system, consult your hospital’s regulations for

cleaning, disinfecting and sterilizing system.

The exterior surfaces of the system may be cleaned with a clean and soft cloth,

sponge or cotton ball, dampened with a non-erosive cleaning solution. Drying off

excess cleaning solution before cleaning the system is recommended. Following are

examples of cleaning solutions:

 Diluted soap water
 Diluted ammonia water, diluted sodium hyoichlo (bleaching agent)
 Hydrogen peroxide (3%)
 Ethanol, Isopropanol.

NOTE

z The above-recommended reagents are for general cleaning only. We

make no guarantee of its effectiveness for use as a means to control
contagious diseases.

To avoid damage to the system, follow these rules:

 ALWAYS dilute the solutions according to the manufacturer’s suggestions;
 ALWAYS wipe off all the cleaning solution with a dry cloth after cleaning;
 NEVER SUBMERGE the system into water or any cleaning solution, or

POUR or SPRAY water or any cleaning solution on the system;

 NEVER permit fluid run into the casing, switches, connectors, or any

ventilation openings in the system;

 NEVER use abrasive materials (such as steel wool or silverpolish) and strong

solutions such as acetone and acetone–based cleaners.

3-9

Installation and Maintenance

CAUTION

z Failure to follow these rules may melt, distort, or dull the finish of the

case, blur lettering on the labels, or cause system failures

NOTE

z Consult relevant instructions before cleaning the accessories.

3-10

Installation and Maintenance

3.2.3 Disinfection and Sterilization

WARNING

z Disinfection or sterilization may cause damage to the system; therefore,

when preparing to disinfect or sterilize the system, consult your
hospital’s infection controllers or professionals.

Sterilization or disinfection may cause damage to the transmitter and receiver. We

recommend that you sterilize and disinfect them only when necessary as determined

by your hospital’s policy. We also recommend that the products being sterilized and

disinfected be cleaned first

Use these recommended disinfecting agents are alcohol based (ethanol 70%,

isopropanol 70%) or aldehyde based materials.

CAUTION

z ALWAYS dilute the solutions according to the manufacturer’s

suggestions or use the lowest possible concentration.

z NEVER pour liquid onto the system and its accessories during cleaning,

or NEVER submerge any part of the system.

z NEVER allow any disinfecting agent to remain on the surfaces of the

system and its accessories—wipe it off immediately with a dry cloth.

z NEVER use EtO or formaldehyde disinfecting agents.
z NEVER use the autoclave method or high-temperature disinfection of the

system and its accessories.

3-11

FOR YOUR NOTES

Installation and Maintenance

3-12

4 Using Transmitters

4.1 Installing and replacing batteries................................................................. 4-2

4.2 Switching on/off the transmitter.................................................................. 4-3

4.3 Wearing the transmitter ............................................................................... 4-3

4-1

Using Transmitters

4.1 Installing and replacing batteries

The transmitter is powered by two AA batteries. To install the batteries:

1. Pull the battery door backwards until it clicks. Then lift the door to expose the

battery compartment.

2. Follow the marked polarities to install two AA batteries.

3. Lower the battery door and push it forward until it clicks.

4. The transmitter will beep a moment later and the LED will be lit (first green

and then red).

WARNING

z Do not use batteries with physical damages.
z Follow governmental requirements to dispose of batteries. Do not

disassemble, burn or short circuit the batteries.

NOTE

z When the CMS give alarms for low battery energy, install new batteries in

time. Keeping using the old batteries may result in repeated re-start of
the transmitter.

4-2

Using Transmitters

4.2 Switching on/off the transmitter

Controlled by the software, the transmitter can be switched on/off automatically.

When the batteries are installed, the transmitter runs a self test and gives one beep.

The LED is illuminated green and red alternatively and then extinguished. Now the

transmitter is ready for use.

If all ECG leads are off and the SpO

be automaticcly shut down after 10 minutes. In such state, the transmitter sends no

data and the battery life can be as long as over 10 days.

To return to normal operating state, you can do any of the following:

 Connect any ECG lead
 Insert the SpO
 Press any key
 Reinstall the batteries

Be sure to remove the batteries if the transmitter is not to be used for a long time.

module

2

module is not connected, the transmiiter will

2

4.3 Wearing the transmitter

You can wear the transmitter using either a rope or a non-fabric cloth bag.

 To use the rope, make sure the rope can bear a continuous pulling force of 1

Kg.

 To use the non-fabric cloth bag, be sure to tie the bag to your body. Movement

of the bag may result in lost connection of the ECG cable.

Be sure to disinfect the bag timely and adequately. A bag shall not be repeatly used

for too many times.

4-3

FOR YOUR NOTES

Using Transmitters

4-4

5 Routine CMS Operation

5.1 Nurse call .................................................................................................... 5-2

5.2 Event ........................................................................................................... 5-2

5.3 STANDBY mode ........................................................................................ 5-2

5.4 Patient Management.................................................................................... 5-3

5.4.1 Admitting a Patient........................................................................ 5-3

5.4.2 Editing patient information ........................................................... 5-4

5.4.3 Discharging a Patient..................................................................... 5-5

5.5 Alarm Setup ................................................................................................ 5-6

5.5.1 Alarm Setup .................................................................................. 5-6

5.5.2 Alarm Volume ............................................................................... 5-7

5.5.3 Pause alarm ................................................................................... 5-8

5.5.4 Alarm Latching ............................................................................. 5-8

5.5.5 Turning off alarm sound ................................................................ 5-9

5.6 Review ...................................................................................................... 5-10

5.7 Record ....................................................................................................... 5-14

5.8 Print........................................................................................................... 5-15

5-1

5.1 Nurse call

The CMS shows graphic nurse call acknowledge buttons for individual patients. The

Routine CMS Operation

Nurse Call Acknowledge Button is: “

 Once the “Nurse Call” button has been pressed, the icon will flash and the

system will ring for a certain period.

 If you click on the icon, it will be cleared and the ring will be interrupted.
 If the “Nurse Call” option at the “Alarm Setup” screen has been activated, the

current call will be recorded by the recorder.

 Besides, this call will be stored in the “Alarm Review”. For details about

alarm review, refer to the central monitoring system’s Operation Manual.

5.2 Event

The CMS shows graphic Event Buttons for individual patients. The Event Button is

”

“

 Once the “Event Button” has been pressed, the icon will flash and the system

will sound a ring.

 If you click on the icon, it will be cleared.
 If the “Event” option at the “Alarm Setup” screen has been activated, the

current call will be recorded by the recorder.

 Besides, the event will be stored in the “Alarm Review”. For details about

alarm review, refer to the central monitoring system’s Operation Manual.

”

5.3 STANDBY mode

In case you want to replace the electrode, replace the batteries, or stop monitoring a

patient for a moment, you may switch the transmitter to the STANDBY mode to

avoid false alarms.

The central monitoring system provides independent STANDBY mode for each

monitor. In the STANDBY mode, all the received patient information will still be

saved and once you have exited the STANDBY mode, you can continue monitoring

the patient without re-admitting the patient.

5-2

Routine CMS Operation

In the STANDBY mode, no waveforms or data will be dsiplayed, analyzed, stored or

recorded and all the audio/visual alarms will be paused. The screen will only display

the nurse call icon, event icon, battery indicator and signal strength indicator. The

waveform area will display “STANDBY”.

To enter the STANDBY mode, click on

at the viewbed screen. Repeat the step to exit the STANDBY mode.

5.4 Patient Management

5.4.1 Admitting a Patient

If a transmitter is powered on but its patient is not list in the connected patient list of

the CMS, you can admit the patient by following these steps:

below the patient window, or click on

1. Click on the “Admit Patient” button. The following “Connected patient”list will

be displayed.。

Figure 5-1 Admitting patients

2. Select the connection record corresponding to that transmitter;

3. Input the office, bed number, medical ID and name of that patient into the

“Patient Info” area at the right side. You can input more patient information by

dragging the vertical scroll bar;

4. Click on the “Admit Patient” button;

5. After the patient has been admitted, the corresponding record will turn gray.

5-3

Routine CMS Operation

5.4.2 Editing patient information

1. Enter the “Patient Management” tab sheet;

To enter the “Patient Management” tab sheet, you can click in the patient window

for a spot patient or on the block in the non-spot patient window for a non-spot
patient, and then select the “Patient Management” tab from the multiple tabs as

shown below.

Figure 5-2 Editing patient information

2. In this tab sheet, you can modify such information:

 Office: Office where the patient receives treatment;
 Bed NO: Patient bed number;
 Medical ID: Patient medical ID;
 Name: Patient name;
 Gender: Patient gender (available options: MALE and FEMALE);
 Patient Type: Patient type (available options: ADU, PED and NEO);
 Birthday: Date of birth (selected from the drop-down timetable);
 Admit Date: Date when the patient is hospitalized;
 PACE: Pace (available options: ON and OFF);
 Address: Patient address;
 Postcode: Patient address’s post code;
 TEL: Patient’s phone number;
 Height: Patient height;
 Weight: Patient weight;
 Blood Type: Patient blood type (available options: A, B, AB, O and NA.

NA represents unknown);

 BSA: Body surface area (automatically calculated by the system);
 Doctor Name: Name of the doctor.

3. Click on the “Modify” button after modifying the patient information.

5-4

Routine CMS Operation

5.4.3 Discharging a Patient

Discharging a patient is to terminate monitoring a patient before admitting a new

patient. You can discharge a patient from the CMS by following these steps:

1. Enter the “Patient Management” tab sheet;

To enter the Patient Management tab sheet, you can click in the patient window for a

spot patient or on the block in the non-spot patient window for a non-spot patient,

and then select the “Patient Management” tab from the multiple tabs as shown

below.

Figure 5-3 Discharging patients

2. Click on the “Discharge” button. The following dialog box will be displayed;

Figure 5-4 Discharge patients

3. Select either Data Items and Data to be saved or Discharge Without Saving

Data;

4. Click on the “Continue Discharging” button. The system will automatically

perform each step shown in the figure below:

5-5

Figure 5-5 Discharging patients

5.5 Alarm Setup

5.5.1 Alarm Setup

Routine CMS Operation

Clicking on the

sheet, in which you can set the parameter alarms and arrhythmia alarms.

button in the ViewBed screen will enter the “Alarm Setup” tab

Figure 5-6 Alarm Setup screen

Take the HR as an example, you can use the keyboard to modify its alarm high/low

limits after clicking on ALM HI or ALM LO, as well as use the mouse to make a

selection after clicking on Alarm Level, Alarm On or Record On-Off.

Besides, you can view Alarm High Limit Max/Min as well as Alarm Low Limit

Max/Min by dragging the horizontal scroll bar. These values are factory-defaulted

values and cannot be modified by the users. Take the HR as an example, its alarm

high limit set by the users must be within the minimum and maximum alarm high

limits.

5-6

Routine CMS Operation

5.5.2 Alarm Volume

By clicking on “System Setup” then “General Setup”, you can enter the following

tab sheet. The CMS provides 10 volumes. You can drag the Volume Control key to

your desired volume. While dragging the Volume Control key, the volume

corresponding to the key location will be displayed below.

Volume

control

key

Figure 5-7 Alarm volume

In the figure above, you can enable or disable silencing alarms by ticking the

“Silence check” box.

 Indicates that silencing alarms is disabled;
 Indicates that silencing alarms is enabled;

NOTE

z In the silenced status, the system will give the “Alarms Silenced”

message, and the
alarm occurs, the alarms silenced status will be automatically released.

icon will appear on the main screen. If a new

5-7

5.5.3 Pause alarm

To pause alarms, click on

Routine CMS Operation

below the patient widow and then select “Pause

Alarm”, or click on

When the alarms are paused:

 The sound icon will appear .
 All audio alarms will be silenced. No alarm will be responded or saved.
 The remaining alarm pause time will be displayed in the physiological alarm

area.

When the pause times out, all alarms will be reactivated. You can also click on the

“Pause Alarm” icon to reactivate the alarms.

at the viewbed screen to pause all alarms for 2 minutes.

5.5.4 Alarm Latching

You can select the alarm latching function when it is necessary to make the alarm

information of a specific patinent remain on the screen. Click the patient window or

the ECG parameter area in the viewbed window to enter the “Parameter Setup”

screen. Then you can enable or disable the alarm latching function through the

checkbox before “Alarm Latching”.

Enable alarm latching. The system provides the alarm latching

function.

Disable alarm latching. The system fails to provide the alarm

latching function.

When the alarm latching function is enabled, if an alarm occurs, the alarm area

displays the alarm event and the time when the alarm occurs simultaneously. In the

case of multiple alarm events, the alarm information will be displayed circularly.

You can also put the mouse inside the alarm area to display all alarm in a list.

Note

z When “Alarm Pause” is selected, the information of larm latching will be

disabled automatically.

z When alarm latching is enabled, up to 64 alarm events can be displayed

in time order. If there are over 64 alarm events, only the latest 64 alarm
events are displayed. You can view all alarm events on the alarm review
screen.

5-8

Routine CMS Operation

5.5.5 Turning off alarm sound

You can totally turn off the alarm sound as needed. At the “General Setup” screen,

click on “User Setup”. Enter the password as prompted by the message box that

pops up on the screen and then click on “OK” to enter the “User Setup” screen.

Figure 5-8 User setup - Alarm

Click on the “Alarm” tab and then tick the “Audio alm off” check box to turn off the

alarm sound.

 : Alarm sound turned on；
 : Alarm sound turned off.

In the Audio alarm off status, the sound icon

all the alarm sounds only without affecting other alarm manifestations or other

sounds.

To resume the alarm sound, you can also click on the

setup screen and then resume the alarm sound from there.

. will appear The CMS will turn off

icon to enter the volume

5-9

Routine CMS Operation

NOTE

z Pay attention to the icon. When it appears, it means the alarm sound

has been totally turned off. Be careful with this function.

z All the alarm sounds will be resumed after re-boot of the CMS.

5.6 Review

You can review the dynamic short trends, waveforms, trends and alarms of a

currently monitored patient from the CMS.

Dynamic Short Trend

Clicking on the button in the ViewBed screen will show graphic short trends

for each parameter module. The figure below shows the short trends of HR and

, whose colors and order are subject to their respective parameter modules.

SpO

2

Figure 5-9 Dynamic Short Trend

5-10

Routine CMS Operation

Waveform Review

Clicking on the “Wave Review” tab will enter the following tab sheet, through

which you can view up to 72 hours of full-disclosure waveforms. Before reviewing

waveforms, you have to select the waveforms to be saved in the “Display Setup”

screen. Click “Waveform Saving” to enter the waveform saving screen. Select the

desired waveform and then exit. For details, refer to

Operation Manual.

the central monitoring system’s

1 2 5

1. Waveform area 2. Parameter area 3. Current time 4. Caliper 5. Time bar
Figure 5-10 Wave Review Tab Sheet

3

4

Note

z Select the waveform to be saved on the “Display Setup” screen before

performing waveform review. Otherwise, waveform review is disabled.

5-11

Routine CMS Operation

Trend Review

Clicking on the “Trend Review” tab will enter the following tab sheet, through

which you can store and review up to 240 hours of trend data. Change of trends can

be observed through the trend graph and trend table. You can switch between the

trend table and trend graph by simply clicking on their buttons.

Parameter

Figure 5-11 Trend Graph

Figure 5-12 Trend Table

5-12

Routine CMS Operation

Alarm Review

Clicking on the “Alarm Review” tab will enter the following tab sheet, through

which you can view all alarm parameters and waveforms of a patient.

1 2 3

1 Alarm list 2 Alarm parameter area 3 Alarm waveform area

Figure 5-13 Alarm Review Tab Sheet

1. Alarm list: displays alarm status (locked or not), time, message, level, and

description;

2. Alarm parameter area: displays all parameter values for each alarm time;

3. Alarm waveform area: displays relevant parameters’ waveforms within ±8

seconds around the alarm time;

Select an alarm from the Alarm list, and you will view its corresponding parameter

values and waveforms in the Alarm parameter area and Alarm waveform area.

5-13

5.7 Record

The CMS can be equipped with a thermal recorder which, with a separate power

supply, is connected with the host of the CMS via the general interface.

The CMS can print out the following information through the recorder:

Recording Patient Information

1. Enter the “Patient Mgt” tab sheet;

2. Make sure that the patient information is correct;

3. Click on the “Record” button. The patient information will be printed out

through the recorder.

Recording Wavef orms

Routine CMS Operation

1. Enter the “Wave Review” tab sheet;

2. Click on the “Record” button;

3. Select a maximum of 2 waveforms, waveform speed and grid from the pop-up

dialog box;

4. Select “OK”. The selected waveforms will be printed out through the recorder.

Recording Alarms

1. Enter the “Alarm Review” tab sheet;

2. Select an alarm from the alarm list;

3. Click on the “Record” button. From the pop-up dialog box, you can select a

maximum of 2 waveforms and grid;

4. Select “OK”. The selected waveforms will be printed out through the recorder.

Recording Real-time Waveforms

1. Enter the “ViewBed” tab sheet;

2. Click on the Record icon at the upper right corner;

3. Select a maximum of 2 waveforms, record time, waveform speed and grid from

the pop-up dialog box;

4. Click on “OK”. The selected waveforms will be printed out through the

recorder.

Recording Real-time Alarms

If a parameter generates an alarm when its alarm switch is set to “ON”, the central

monitoring system will automatically initiate a real-time alarm recording.

5-14

5.8 Print

For printing reports, the CMS can be equipped with a laser printer, which with a

separate power supply, is connected to the CMS via the general interface. For

instructions about the printer, refer to the accompanying documents provided with

the printer.

Printing Patient Information

1. Enter the “Patient Mgt” tab sheet;

2. Make sure if the patient information is correct. If not, click on the “Modify”

button to correct them;

Routine CMS Operation

3. Click the

print setups as prompted;

4. Click the

the printout;

5. Click on the “Print” button.

Printing T r en d Graph or Trend Table

1. Enter the “Trend Review” tab sheet;

2. Set the resolution and start time;

3. Click the

print setups as prompted;

4. Click the

the printout;

5. Click on the “Print” button.

Printing Waveforms

icon on the “Print” button and select “Print Setup” to complete

icon on the “Print” button and select “Print Preview” to preview

icon on the “Print” button and select “Print Setup” to complete

icon on the “Print” button and select “Print Preview” to preview

1. Enter the “Wave Review” tab sheet;

2. Select the current review time;

3. Click the

print setups as prompted;

4. Click the

the printout;

5. Click on the “Print” button.

icon on the “Print” button and select “Print Setup” to complete

icon on the “Print” button and select “Print Preview” to preview

5-15

Routine CMS Operation

Printing Alarms

1. Enter the “Alarm Review” tab sheet;

2. Select an alarm from the alarm list;

3. Click the

icon on the “Print” button and select “Print Setup” to complete

print setups as prompted;

4. Click the

icon on the “Print” button and select “Print Preview” to preview

the printout;

5. Click on the “Print” button.

5-16

6 ECG Monitoring

6.1 Preparation .................................................................................................. 6-2

6.2 Electrode Placement.................................................................................... 6-3

6.3 ECG Monitoring.......................................................................................... 6-8

6.3.1 ECG waveform.............................................................................. 6-8

6.3.2 ECG parameter.............................................................................. 6-9

6.3.3 ECG Setup................................................................................... 6-10

6.3.4 ECG lead type ..............................................................................6-11

6.3.5 ECG Primary and Secondary Leads............................................ 6-12

6.3.6 Waveform display settings .......................................................... 6-12

6.3.7 Filter mode .................................................................................. 6-12

6.3.8 Pace Pulse detection.................................................................... 6-13

6.3.9 HR alarm ..................................................................................... 6-13

6.4 ST Analysis ............................................................................................... 6-14

6.4.1 General ........................................................................................ 6-14

6.4.2 ST setup....................................................................................... 6-15

6.4.3 ST measurement points ............................................................... 6-16

6.5 Arrhythmia Analysis ................................................................................. 6-17

6.5.1 Overview..................................................................................... 6-17

6.5.2 Arrhythmia analysis setup........................................................... 6-18

6.5.3 Arrhythmia alarm setup............................................................... 6-19

6.5.4 Arrhythmia alarm review ............................................................ 6-20

6.5.5 Arrhythmia relearn ...................................................................... 6-21

6.5.6 Arrhythmia troubleshooting........................................................ 6-22

6.6 Maintenance and Cleaning ........................................................................ 6-22

6-1

6.1 Preparation

1. Skin preparation

The quality of ECG information displayed on the monitor is a direct result of the

quality of the electrical signal received at the electrode. Proper skin preparation is

necessary for good signal quality at the electrode. A good signal at the electrode

provides the monitor with valid information for processing the ECG data. Choose

flat, non-muscular areas to place electrodes. Following is a suggested guideline for

skin preparation:

 Shave hair from sites, if necessary.
 Gently rub skin surfaces at sites to remove dead skin cells
 Wash sites with soap and water (never use ether or pure alcohol, because this

increases skin resistance).

 Dry the skin completely before applying the electrodes.

ECG Monitoring

2. Attach the ECG lead to the electrodes prior to placement;

3. Place the electrodes on the patient. Use electrode gel prior to placement only if

pre-gelled electrodes are not used

4. Make sure the monitor is turned on and is ready for monitoring.

6-2

ECG Monitoring

6.2 Electrode Placement

WARNING

z Use only the specified ECG cable for monitoring.
z When applying electrodes or connecting cables, make sure they are not

connected to any conductive part or the ground. Verify that all ECG
electrodes, including neutral electrodes, are securely attached to the
patient.

z Skin irritation may result from the continuous application of the ECG

electrodes. These should be checked each day. If there is an indication
of excess skin irritation, replace the electrodes or change the location of
the electrodes every 24 hours.

z Do not touch the patient, bed or instrument during defibrillation.

WARNING

z Interference from a non-grounded instrument near the patient and ESU

interference can cause inaccuracy of the ECG waveform.

z Always dispose of, or recycle electrodes properly to prevent from

environment contamination.

z Verify the lead fault detection prior to the start of monitoring. Unplug the

ECG cable from the ECG connector and the screen should display the
error message “ECG LEAD OFF” and an audible alarm should be
activated.

5-Leadwire Electrode Placement

Following is the configuration per the American standard (AHA) when using five

leadwires:

 RA (right arm) electrode — directly below the clavicle and near the right

shoulder;

 LA (left arm) electrode — directly below the clavicle and near the left

shoulder;

 RL (right leg) electrode — on the right lower abdomen;
 LL (left leg) electrode — on the left lower abdomen;
 V (precordial) electrode — on the chest.

6-3

ECG Monitoring

Figure 6-1 5-lead electrode placement

For a 5-lead configuration, place the V electrode at one of the locations shown in

Figure 6-2.

 V1: On the 4th intercostal space at the right sternal border;
 V2: On the 4th intercostal space at the left sternal border;
 V3: Midway between V2 and V4 electrodes;
 V4: On the 5th intercostal space at the mid-clavicular line;
 V5:On the left anterior axillary line, horizontal with V4;
 V6: On the left mid-axillary line, horizontal with V4;
 V3R-V6R: On the right side of the chest in positions corresponding to those

on the left;

 VE: Over the xiphoid process;

6-4

ECG Monitoring

For posterior V electrode placement, place the V electrode at one of the following

locations

 V7: On posterior chest at the left posterior axillary line in the fifth intercostal

space;

 V7R: On posterior chest at the right posterior axillary line in the fifth

intercostal space.

Figure 6-2 V Electrode placement

The chart below shows the label used to identify each leadwire. Included also is its

associated color code per American (AHA) and European (IEC) standards.

American Standard European Standard

Label Color Label Color

RA White R Red

LA Black L Yellow

LL Red F Green

RL Green N Black

V Brown C White

6-5

ECG Monitoring

Electrode Placement with a 3-Lead Set

Following is the configuration per the European standard when using three

leadwires:

 R (right arm) electrode — directly below the clavicle and near the right

shoulder;

 L (left arm) electrode — directly below the clavicle and near the left

shoulder;

 F (left leg) electrode — on the left lower abdomen.

Figure 6-3 Electrode placement

The chart below shows the label used to identify each leadwire. Included also is its

associated color code per American (AHA) and European (IEC) standards.

6-6

ECG Monitoring

Characteristics of a Good Signal

As shown in Figure 6-4, the normal QRS complex should exhibit the following

characteristics.

 Tall and narrow with no notches.
 R-wave should be tall, completely above or below the baseline.
 Pacer pulses should be smaller than the R-wave height.
 T-wave should be less that 1/3 of the R-wave height.
 P-wave should be much smaller than the T-wave.

Figure 6-4 Standard ECG waveform

To display a 1-millivolt calibration pulse on the ECG wave, re-install the transmitter

batteries and then the transmitter will automatically generate the square waveforms

for calibration.

NOTE

z To obtain accurate calibrate waveform, set the filter mode to EXTEND.

See 6.3.7 Filter mode for more information regarding the filter mode.

z When calibrating the system, do not count the overshoot on the

waveform edge.

6-7

ECG Monitoring

6.3 ECG Monitoring

6.3.1 ECG waveform

1 2 3 4

5

6

Figure 6-5 ECG waveform area

1. Channel lead

2. Channel 1 gain

3. Channel 1 operation mode

4. Channel 1 ruler

5. Channel 1 display area

6. Channel 2 display area

7. Channel 3 display area.

7

6-8

6.3.2 ECG parameter

ECG Monitoring

1

Figure 6-6 ECG parameter area

1. Heart rate (HR)

2. Upper limit of HR

2

3

4

8

5

6
7

9

3. Lower limit of HR

4. PACE indicator

5. STII indicator

6. STI indicator

7. PVC indicator

8. ST alarm indicator

9. PVC alarm indicator

6-9

6.3.3 ECG Setup

Click on the “ECG” tab of the viewbed window to enter the “Para Setup” screen.

ECG Monitoring

Figure 6-7 ECG Setup screen

Click on the “Other Setup

Figure 6-8 Other Setup screen

…” button to enter the “Other Setup” screen.

6-10

6.3.4 ECG lead type

The system can automatically recognize the connected ECG cable and the central

monitoring system can display the type accordingly.

When a 3 leadwire cable is connected, the central monitoring system will display the

waveform of lead II.

When a 5 leadwire cable is connected, the central monitoring system will display the

waveforms of leads II, I and V by default. To view the waveform of leads III, aVR,

ECG Monitoring

aVL and aVF, click on

shows.

Figure 6-9 7-lead display mode

To exit the 7 lead display mode, click on again.

to switch to the 7 lead display mode, as the figure below

The leads are displayed in a fixed manner, which cannot be adjusted by the user. See

the table below for details.

ECG cable ECG channel ST analysis Collecting lead Calculating lead

3 leadwire ECG Channel 1 STII II －

5 leadwire

ECG Channel 1 STII II

ECG Channel2 STI I

ECG Channel3

－ V

6-11

III, aVR, aVL,

aVF

ECG Monitoring

6.3.5 ECG Primary and Secondary Leads

The system uses ECG primary and secondary leads to calculate heart rate and to

analyze & detect arrhythmia. Secondary lead is set only when the transmitter is

configured with 5-lead measurement. Setting a secondary lead decides which

additional lead is used for arrhythmia analysis.

Choose the primary and secondary leads featuring the following:

 The QRS complex is completely above or below the baseline instead of

biphase.

 The QRS complex is tall and narrow.
 Both P wave and T wave are less than 0.2 mV.

To select a lead for primpary or secondary one, enter the ECG parameter setup

screen and choose the appropriate lead in the “Primary Lad” and “Secondary Lead”

options.

If you are using 3-lead system, the primary lead is II and the secondary lead null by

default. You can not make changes to them.

If you are using 5-lead system, the primary lead is II and the secondary lead I by

default. You can make changes to them when necessary.

6.3.6 Waveform display settings

At the “Other Setup”screen, you can set the sweep speed and gain of the displayed

waveforms.

The system provides two sweep speeds 12.5mm/s and 25mm/s. In the 7 lead display

mode, the sweep speed is fixed to 25mm/s.

The system provides 4 gains for the ECG waveforms, ×0.25 (2.5mm/mV), ×0.5

(5mm/mV), ×1 (10mm/sV), ×2 (20mm/mV). If you want to view the details of the

displayed waveforms, select a large gain; if you find incomplete waveform, select a

small gain.

6.3.7 Filter mode

The system provides 3 filter modes EXTEND, MONITOR (default) and SURGERY.

You can select the desired filter mode at the “Others” window of the “Parameter

Setup” screen. The selected filter mode applies to all channels.

You should select the filter mode according to your own needs.

Patient movement will disturb the waveform signals. To obtain a stable and clear

6-12

ECG Monitoring

waveform, you can select the MONITOR or SURGERY mode. However, certain

significant diagnostic information may be lost during the filtering process.

For ST analysis, you should select the EXTEND to obtain a better low-frequency

response and more accurate ST analysis results.

6.3.8 Pace Pulse detection

You should activate the PACE detection function when monitoring a patient wearing

a pace-maker.

The pace pulse detection function is deactivated by default.

Click on the “Patient Mgt” tab to enter the “Patient Mgt” screen, select “ON” or

“OFF” and then click on “Modify” to activate or deactivate pace detection.

A pace pulse, when detected, is indicated by “

︱

” above the ECG waveform.

WARNING

z Certain pace pulses are hard to reject and those pulses may be counted

as QRS complex, hence leading to wrong HR readings or failure to
diagnose certain arrhythmia symptoms. Be sure to keep a close eye on
the patient wearing a pace-maker.

NOTE

z When PACE is set to ON, the system does not detect PVC-related

arrhythmia (including PVCs) resulting from pacemaker but still analyzes
the normal QRS complex.

z When the patient is not wearing a pacemak er, set PACE to OFF.
z When PACE is set to ON, missed beat (MIS) alarm is reported as pacer

not captured (PNC) or pacer not paced (PNP).

6.3.9 HR alarm

In the HR area of the “ECG Para Setup”screen, you can set alarm switch, alarm

level, alarm limits, etc.

6-13

6.4 ST Analysis

6.4.1 General

 ST analysis is deactivated by default.
 When ST analysis is activated, the system will automatically select the

EXTEND filter mode.

 You can set the monitor to MONITOR or SURGERY mode. However, the ST

numerics might be severely distorted in these modes.

 ST analysis can be conducted by measuring the rising or falling part of the ST

segment. The ST numerics are displayed in STII and STI parameter areas.

 ST-II indicates the result of ST analysis of lead II and ST-I that of lead I.
 You can view the trend graph and data of the ST analysis through the review

function.

 ST measurement unit: mV (milivolt).
 ST numeric: positive numeric means rising and negative numeric means

falling.

 ST measurement range: -2.0 mV to +2.0 mV.

ECG Monitoring

NOTE

z When ST segment monitoring is activated, the filter mode is set to

EXTEND automatically to obtain effective low-frequency response, so as
to ensure the accuracy of ST segment measurement.

6-14

6.4.2 ST setup

In the ST Analysis area of the “Para Setup”screen, you can adjust settings related to

ST analysis. Be sure to select “ON” for the “ST Analysis” option.

ECG Monitoring

Figure 6-10 ST setup screen

6-15

ECG Monitoring

6.4.3 ST measurement points

Selecting “Define ST Point >>” opens the following window.

Figure 6-11 Defining ST points

As shown above, the “Define ST Point” window shows the QRS complex template.

Two vertical lines indicate the positions of the ISO and ST points.

 ISO: It is the base point, used to indicate the baseline point of the ST analysis.
 ST: It is the ST measurement point.

The two measurement points, ISO and ST, should be adjusted if the patient’s HR or

ECG morphology changes significantly. You can select the ISO or the ST option in

the window and then rotate the control knob to adjust its position.

R wave

Pwave

T wave

ST value

As shown above, the peak of the R wave is the reference point for ST measurement.

ISO

Figure 6-12 ST measurement point

ST measurement point

6-16

ECG Monitoring

The ST measurement value for a beat complex is equal to the vertical difference

between the two measurement points.

NOTE

z Abnormal QRS complex is not considered in ST analysis.

6.5 Arrhythmia Analysis

6.5.1 Overview

In clinical application, arrhythmia analysis is used to:

 Detect the change of heart rate and premature ventricular beat.
 Store the arrhythmia events and the alarm information generated.

The medical professionals can use the arrhythmia analysis to evaluate patients’

condition (such as heart rate, PVCs frequency, rhythm and ectopic beat) and give

proper treatment.

The arrhythmia analysis of the system has the following characteristics:

 Up to 14 types of arrhythmia analysis.
 Applicable to the monitoring of either a patient with a pacemaker or without.
 Activated by default.
 Capability of raising the doctor’s attention to the patient’s heart rate, by

measuring and classifying the arrhythmia and the abnormal heartbeat and
triggering the alarm.

6-17

ECG Monitoring

6.5.2 Arrhythmia analysis setup

On the parameter setup screen, you can set arrhythmia analysis and PVC alarm. For

arrhythmia analysis, you must first set “ARR Analysis” to “ON”.

Dual lead analysis mode is used for arrhythmia analysis. You can set the channel for

arrhythmia anlysis on the parameter setup screen. For details, refer to

Primary and Secondary Leads

.

6.3.5 ECG

Figure 6-135 ARR a na lysis setting

6-18

ECG Monitoring

6.5.3 Arrhythmia alarm setup

On the “Alarm Setup” screen, select “ARR Alarm Setup” to enter the screen as

shown below:

Figure 6-146 ARR alarm setup

NOTE

z In default status, the ASYSTOLE, VFIB/VTAC and Ventricular RUN alarms

are ON, while other ARR alarms are OFF.

On the ARR alarm setup screen, you can change alarm level, alarm on-off, record

on-off. When it is necessary to change the alarm threshold, you can make the

relevant settings on the ARR alarm threshold setup screen. Click the ARR alarm

limit setting scrren to pop up the following screen:

Figure 6-1 ARR alarm limit setup

6-19

ECG Monitoring

You can adjust the alarm thresholds and click QUIT after making changes. If the

input threshold exceeds the alarm range, the prompt “XX exceeds the alarm range.

Please input again” displays.

6.5.4 Arrhythmia alarm review

You can view the arrhythmia alarm information on the alarm review screen. On the

auxiliary screen, click the alarm revirew tab sheet to open an alarm review window.

Then you can review all alarm parameters and waveforms of the patient.

By selecting arrhythmia for alarm type and all levels for alarm level, you can view

the arrhythmia alarm information of the patient.

6-20

ECG Monitoring

6.5.5 Arrhythmia relearn

The arrhythmia algorithm generates arrhythmia template through relearning.

To view the arrhythmia waveform template, click the arrhythmia relearn button on

the ECG parameter setup screen to enter the following window:

Figure 6-2 ARR relearn

To start arrhythmia relearn manually, click the arrhythmia relearn button on the

parameter setup screen. During the relarning process, the ECG parameter area

displays “ARR learning”, which disappears automatically when the learning finishes.

The arrhythmia waveform template screen is refreshed.

Arrhythmia relearn is activated automatically if:

 ECG monitoring is switched on.
 The HR calculation channel is changed manually.
 Patient category is changed
 Lead off ends.

NOTE

z Arrhythmia relearn can be activated only when the primary lead is

normal and the ECG waveform is of good quality.

z Arrhythmia relearn can be activated automatically under certain

circumstances.

.

6-21

ECG Monitoring

6.5.6 Arrhythmia troubleshooting

In the case of false heart rate, cardiac arrest, and ventricular fibrillation, do the

following to troubleshoot the problems:

 Check the site where the electrode is placed.
 Check whether the patient skin is well prepared.
 Check the amplitude of the ECG signal. If the signal amplitude is too low,

replace the electrode or adjust the position to place the electrode.

 View the arrhythmia relearn template and start an arrhythmia relearn process

if necessary.

6.6 Maintenance and Cleaning

WARNING

z Before cleaning the ECG cable, be sure to disconnect the monitor from

the ECG cable, or shut down the system and disconnect all power cords
from the outlet.

z If the ECG cable is damaged or aged, replace with a new one.

 Cleaning

The exterior surfaces of the ECG cable may be cleaned with a soft cloth, dampened

with the alcohol, and then be air-dried or dried with a clean dry cloth.

 Disinfection

Disinfection may cause damage to the system. We recommend the disinfection be

contained in the hospital’s servicing schedule only when necessary. The system

should be cleaned prior to disinfection.

6-22

7 SpO

7.1 Principle of SpO

7.2 Monitoring Procedure ................................................................................. 7-2

7.3 SpO

7.3.1 SpO

7.3.2 SpO

7.4 Measurement Limitations............................................................................ 7-5

7.5 Warnings ..................................................................................................... 7-6

Monitoring

2

Measurement.................................................................. 7-2

2

Measurement...................................................................................... 7-3

2

parameter area...................................................................... 7-3

2

Setup .................................................................................... 7-4

2

7-1

SpO2 Monitoring

7.1 Principle of SpO2 Measurement

monitoring is a non-invasive technique used to measure the amount of

SpO

2

oxygenated haemoglobin and pulse rate by measuring the absorption of selected

wavelengths of light. The light generated in the probe passes through the tissue and

is converted into electrical signals by the photodetector in the probe. The SpO

module processes the electrical signal and displays on the screen digital values for

and pulse rate.

SpO

2

7.2 Monitoring Procedure

Follow the procedure as below:

2

1. Power on the telemetry monitoring system.

2. Attach the sensor to the proper site on the patient.

3. Plug the connector of the sensor extension cable into the SpO

telemetry transmitter.

The SpO

sensor selection and placement depend on the patient type. When

2

choosing a site for a sensor, refer to the directions for that sensor.

connector on the

2

7-2

SpO2 Monitoring

7.3 SpO2 Measurement

7.3.1 SpO2 parameter area

When the sensor and cable are correctly connected, the SpO2 numeric will be

displayed to the right of the ECG waveform, as the figure below shows.

2

5

1

Figure 7-1 SpO2 parameter area

1. SpO

value

2

2. Upper limit of the SpO

3. Lower limit of the SpO

4. Pulse rate

5. Upper limit of the pulse rate

6. Lower limit of the pulse rate

If the HR source is set to “SpO

area.

6

3

value

2

value

2

” or “All”,SpO2 numeric will be displayed in the HR

2

4

7-3

CAUTION

SpO2 Monitoring

z The following factor may interfere with SpO
z Excessive light (suggestion: cover the sensor with something

measurement:

2

non-transparent.)

z EM interference.
z Excessive patient movement.
z Presence of such substance as Hb-CO, Met-Hb or dye dilution chemicals.

7.3.2 SpO2 Setup

Click on the parameter area of the viewbed screen to enter the parameter setup

screen. Click on “SpO

” to enter the SpO2 setup screen.

2

Figure 7-2 SpO2 setup screen

To obtain more alarm settings, click on “Alarm setup” at the lower left corner of the

screen.

7-4

SpO2 Monitoring

7.4 Measurement Limitations

If the SpO

check the system and SpO

SpO

reading seems incorrect, check the patient with another method, and then

2

module. The following factors may interfere with the

2

measurement:

2

 Use of inappropriate SpO

sensor.

2

 High-frequency interference, or interference from ESU connected to the

system;

 Oximeters and oximetry sensors used during magnetic resonance imaging

(MRI) scanning. Induced current could potentially cause burns;

 Intravascular dye injections;
 Excessive patient movement;.
 Excessive ambient light;
 Improper sensor installation or incorrect sensor placement on the patient
 Sensor temperature (optimal temperature is between 28°C and 42°C);
 The sensor is placed on a limb that is attached to a blood pressure cuff, arterial

catheter, or intravascular line;

 Concentration of dysfunctional hemoglobin such as carboxyhemoglobin and

methemoglobin;

 SpO

too low;

2

 Poor circular perfusion of the applied part;
 Shock, anemia, low temperature and application of vasomotor all reduce the

arterial blood flow and may affect the pulse oximetry measurement

The absorption of oxyhemoglobin (HbO2) and deoxyhemoglobin to the light of

special wavelength may also affect SpO

measurement. If there exist other

2

substances (like carbon hemoglobin, methemoglobin, methylene blue and indigo

carmine) absorbing the light of the same wavelength, they may result in false or low

readings.

SpO

2

7-5

7.5 Warnings

WARNING

SpO2 Monitoring

z The SpO

value might be overestimated in the presence of Hb-CO,

2

Met-Hb or dye dilution chemicals.

z Do not use the SpO

sensor if it’s packaging or the sensor is damaged.

2

Return them to the distributor or manufacturer.

z Verify sensor cable fault detecti on before beginning monitoring. Unplug

the SpO
prompt information “SpO

sensor cable from the connector. The screen displays the

2

SENSOR OFF” and the audible alarm is

2

activated.

z Do not tangle the sensor cable around the ESU cable.
z Do not place the sensor on the limb where an arterial catheter or

intravascular line is already placed.

WARNING

z Do not perform SpO

simultaneously. Obstruction of blood flow during NIBP measurements
may adversely affect the reading of the SpO

and NIBP measurements on the same limb

2

value.

2

z Prolonged and continuous monitoring may increase the risk of burns at

the site of the sensor. It is especially important to check the sensor
placement, and ensure proper attachment on neonates and patients of
poor perfusion or skin sensitive to light. Check the sensor location every
2 to 3 hours and move to another location if the skin deteriorates. More
frequent examinations may be required for different patients.

7-6

8 Troubleshooting

8-1

Troubleshooting

Common Technical Alarms

Alarm meesages Description Recommended action

BAT. VOLTAGE

LOW

The transmitter batteries

are about to die.

RF No Signal The receiver has not

received valid signal in

the past 5 seconds.

RF Interference The receiver has received

3 consecutive wrong

frames.

Wrong ID The received data coming

from a transmitter not

belonging to the system.

Replace the batteries.

Check the transmitter batteries.

Check whether the transmitter is in the

power-saving mode.

Check if the patient is out of the range.

Check if the antenna array is well

connected.

Check if the ECG cable is connected.

Check if the patient is at the edge of

the transmitting range; check if the

patient is in an elevator or behind a

reinforced concrete wall; check if there

is strong RF interference.

Check if there are other telemetry

monitoring system working in the area.

If so, contact the service engineer to

reconfigure the frequency.

Offline The receiver cannot be

connected to the central

monitoring system.

ECG NOISE Noise found on the ECG

waveform.

ECG SIGNAL

SATURATION

Wrong

transmitter

button pressed.

Transmitter

restarting

The receiver found the

ECG signal too large.

The receiver found a

button has been pressed

for 10 seconds.

The receiver batteries are

about to die.

repeatedly.

Check if the receiver is on.

Check if the network cable is well

connected.

Check if the ECG cable tangles with

the cables of other devices.

Check the electrodes of the ECG cable.

Check if the elctrodes are in good

contact with the skin.

Check if the button is pressed by a

foreign object or jammed.

Replace the batteries.

8-2

9 Accessories

WARNING

z Use the accessories specified in this chapter. Use of accessories other

than the specified may lower system performance or damage the
system.

9-1

Accessories

Accessories PN

3-lead AHA leadwire, snap-on 0010-20-12441

3-lead IEC leadwire, snap-on 0010-20-12442

5-lead AHA leadwire, snap-on 0010-20-12443

5-lead ICE leadwire, snap-on 0010-20-12444

Monitoring electrode (10 electrodes per pack) 0010-10-12304

Mindray SpO2 module and extension cable. 0152-30-39939

512D SpO2 Sensor (Finger Clip Sensor)

ES-3212-9/envitec (Ear Clip Sensor)

512D-30-90200

0010-10-12392

Disposable SpO2 Sensor for Adults (>30kg) 0010-10-12202

Disposable SpO2 Sensor for Pediatrics (10 - 30kg) 0010-10-12203

Disposable SpO2 Sensor for Infants (3 - 20kg) 0010-10-12204

Disposable SpO2 Sensor for Adults 0010-10-12333

Power cord (American standard) DA8K-10-14452

Power cord (English standard) DA8K-10-14453

Power cord (Indian standard) 0000-10-10903

Three-wire power cord 509B-10-05996

Transmitter bag 0152-10-39878

Network cable 0000-10-11009

Silica gel plug 0152-20-39707

9-2

10 Appendices

A. Product Specifications............................................................................... 10-2

A.1 Safety Specifications................................................................... 10-2

A.2 Environmental Specifications...................................................... 10-2

A.3 Power Specifications................................................................... 10-3

A.4 Hardware Specifications ............................................................. 10-4

A.5 Data Display, Recording and Saving........................................... 10-4

A.6 Alarms and Indicators ................................................................. 10-5

A.7 Wireless Transmission................................................................. 10-5

A.8 ECG Specifications ..................................................................... 10-6

A.9 SpO

B. EMC........................................................................................................ 10-10

C. Symbols and Abbreviations..................................................................... 10-15

C.1 Units .......................................................................................... 10-15

C.2 Symbols..................................................................................... 10-16

C.3 Abbreviations ............................................................................ 10-17

Specifications..................................................................... 10-8

2

A. Product Specifications

A.1 Safety Specifications

Type of protection against

electric shock

Degree of protection

against electric shock

Mode of operation Continuous

Degree of protection

against hazards of ignition

of flammable anesthetic

mixtures

Degree of protection

against harmful ingress of

water

Transmitter: I

Receiver: Internal power source

Receiver: I

ECG: CF (defibrillation proof)

SpO

: BF

2

Receiver: B

Not suitable

Transmitter: IPX3 (IEC 529)

Receiver: ordinary

A.2 Environmental Specifications

Operating temperature 0 to 40

Operating humidity 15 to 95%, noncondensing

Operating altitude 70.0 to 106.0kP

Storage temperature -20 to 60℃

Storage humidity 10 to 95%, noncondensing

Storage altitude 22.0 to 107.4kPa

℃

P/N: 0152-20-39887 (2.1)

A.3 Power Specifications

Transmitter

Battery voltage range 2 to 3.4VDC

Power type Two AA size, 1.5V alkaline batteries

Switch control

modePower ON/OFF

Continuous battery

operating time (typical)

Receiver

The transmitter is switched on when the batteries are

installed.

If all ECG leads are off and the SpO

module is not

2

connected for 10 minutes, the transmiiter will be

automaticcly shut down. To return to normal operating state,

you can do any of the following:

 Connect any ECG lead
 Insert the SpO

module

2

 Press any key
 Reinstall the batteries

ECG: 96h

ECG+SpO

ECG+SpO

(Mindray): 36h

2

(NONIN): 48h

2

Power-saving: 240h

Input voltage 100 to 240 VAC (±10%)

Frequency Range 50/60 Hz (± 3 Hz)

Power Consumption <60VA

P/N: 0152-20-39887 (2.1)