Nihon Kohden BSM-2300 User manual

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Life Scope i

BEDSIDE MONITOR

BSM-2301A/2304A

Life Scope L

BEDSIDE MONITOR

BSM-2351A

0614-006206H

Model: BSM-2301A/2304A/2351A

Manual code no.: 0614-006206H

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CONTENTS

Contents

GENERAL HANDLING PRECAUTIONS ......................................................................... i

WARRANTY POLICY .................................................................................................... ii

EMC RELATED CAUTION ............................................................................................ iii

Conventions Used in this Manual and Instrument ......................................................... v

Warnings, Cautions and Notes ............................................................................v

Explanations of the Symbols in this Manual and Instrument.............................. vi

On panels .......................................................................................................... vi

On screen ......................................................................................................... vii

Others ............................................................................................................... vii

Section 1 General .................................................................................. 1C.1

Introduction .......................................................................................................................... 1.1

Features ............................................................................................................................... 1.2

Composition ......................................................................................................................... 1.4

Network Composition ........................................................................................................... 1.6

Panel Description ................................................................................................................. 1.7

Front Panel ................................................................................................................. 1.7

Left Side Panel ...........................................................................................................1.8

BSM-2301/2351 ............................................................................................... 1.8

BSM-2304 ........................................................................................................ 1.9

Right Side Panel.......................................................................................................1.10

Basic Operating Concepts .................................................................................................. 1.12

Screen Displays .......................................................................................................1.12

Using Touch Screen Keys......................................................................................... 1.16

Keys on the Front Panel ........................................................................................... 1.18

Using the MENU Window ......................................................................................... 1.18

General Safety Information ................................................................................................ 1.19

General ..................................................................................................................... 1.19

Installation ............................................................................................................... 1.20

Using QI-231P/236P Interface ................................................................................. 1.21

Using DZ-230P Hooks ..............................................................................................1.22

Network .................................................................................................................... 1.22

Battery ..................................................................................................................... 1.23

ECG Monitoring ........................................................................................................1.24

Respiration Monitoring .............................................................................................. 1.26

SpO2 Monitoring ....................................................................................................... 1.26

NIBP Monitoring .......................................................................................................1.29

IBP Monitoring ......................................................................................................... 1.30

Temperature Monitoring ............................................................................................ 1.31

CO2 Monitoring ......................................................................................................... 1.31

Maintenance ............................................................................................................ 1.34

Operator's Manual BSM-2300A C.1

CONTENTS

Section 2 Preparations ......................................................................... 2C.1

Preparation Flowchart .......................................................................................................... 2.1

Installation Conditions ..........................................................................................................2.2

Preparing the Optional Recorder Module .............................................................................. 2.4

Installing the Recorder Module ...................................................................................2.4

Loading the Recording Paper......................................................................................2.4

Attaching the Optional Hooks ............................................................................................... 2.6

Connecting an External Instrument to the Monitor ................................................................2.7

Connecting the Monitor to a Network .................................................................................... 2.8

Inserting the Network Card or Network Printer Card ................................................... 2.9

Removing the Network Card or Network Printer Card ............................................... 2.11

Using the QI-210P Wireless LAN station .................................................................. 2.11

Power ................................................................................................................................. 2.12

AC or Battery Power Source Selection .....................................................................2.12

Connecting the Power Cord and Grounding the Monitor ............................................ 2.12

Connecting the Power Cord ............................................................................ 2.12

Grounding the Monitor .................................................................................... 2.13

Turning the Monitor On ............................................................................................. 2.13

Check Before Turning On the Monitor ............................................................. 2.13

Turning the Monitor On ................................................................................... 2.14

Standby Mode ................................................................................................ 2.15

Check After Turning On the Monitor and During Monitoring ............................ 2.15

Turning the Monitor Off ............................................................................................. 2.16

Check After/Before Turning the Monitor Off .................................................... 2.16

Power and Battery Status Indications ...................................................................... 2.16

Battery Handling and Operation ................................................................................ 2.17

Safety Information.......................................................................................... 2.17

Battery Lifetime.............................................................................................. 2.19

Battery Handling Procedures ......................................................................... 2.19

When Using a Battery for the First Time or After Storage .............................. 2.19

When Not Using the Monitor or Battery ..........................................................2.19

When the BATTERY WEAK Message Appears .............................................. 2.20

Installing or Replacing the Battery ................................................................. 2.20

Charging the Battery ...................................................................................... 2.20

Disposal of Battery Pack................................................................................2.21

Section 3 Changing System Setup Settings ...................................... 3C.1

Displaying the SYSTEM SETUP Screen ............................................................................. 3.2

Changing Settings ......................................................................................................3.3

Closing the SYSTEM SETUP Screen and Displaying the Monitoring Screen ............ 3.3

List and Explanation of the SYSTEM SETUP Settings ........................................................ 3.4

List of All Settings ...................................................................................................... 3.4

Site Setting (SITE) .....................................................................................................3.6

Display Settings (DISPLAY SETUP) .......................................................................... 3.7

Bed ID Setting (BED ID SETUP) ............................................................................... 3.8

Parameter and Other Settings (PARAMETER SETUP) .............................................. 3.9

Alarm Settings (ALARM SETUP) .............................................................................3.10

Unit Settings (UNITS SETUP) ................................................................................. 3.14

C.2 Operator's Manual BSM-2300A

CONTENTS

Color Settings (COLOR SETUP) .............................................................................. 3.15

Recording Settings (RECORD SETUP) ....................................................................3.18

Other Settings (OTHER SETUP) .............................................................................. 3.19

Alarm Master Settings (ALARM MASTER) .............................................................. 3.20

Arrhythmia Recall Master Settings (ARRHYTHMIA RECALL MASTER) ................. 3.22

Network Settings (NETWORK SETUP) ....................................................................3.23

Network Printer Settings (PRINTER SETUP) ........................................................... 3.24

External Interface Information (EXT I/F SETUP) ..................................................... 3.26

Initializing the System ........................................................................................................3.27

Section 4 Necessary Settings Before Monitoring ............................. 4C.1

Changing Date and Time ...................................................................................................... 4.1

Changing Sound Settings ..................................................................................................... 4.3

Changing the Screen Brightness .......................................................................................... 4.5

Assigning a Function to the Function Keys .......................................................................... 4.6

Entering Patient Name..........................................................................................................4.8

Displaying the PATIENT INFO Window ....................................................................... 4.9

Entering the Patient Name Using the Keyboard ........................................................4.10

Entering the Patient Name Using Free Function ....................................................... 4.11

Entering the Patient ID ............................................................................................. 4.12

Deleting Data...................................................................................................................... 4.13

Section 5 Monitoring Screen ............................................................... 5C.1

Safety Precautions for Monitoring ........................................................................................ 5.2

Using an Electrosurgery Unit ........................................................................... 5.2

Using a Defibrillator ..........................................................................................5.2

Overview .............................................................................................................................. 5.3

Monitoring Screen ...................................................................................................... 5.3

Review Windows ........................................................................................................ 5.3

Sync Sound ............................................................................................................... 5.4

Adjusting the Sync and Alarm Sound Volume ............................................................ 5.4

Changing Settings and Performing Other Tasks During Monitoring .............................5.4

Interbed Monitoring .....................................................................................................5.4

Monitoring Screen ................................................................................................................ 5.5

Settings for the Monitoring Screen .............................................................................5.6

Waveform Sweep Mode and Speed..................................................................5.6

Trendgraph/PWTT trendgraph/OCRG Display on the Monitoring Screen

On or Off .......................................................................................................... 5.6

Background and Parameter Colors ................................................................... 5.7

Waveform Sensitivity ....................................................................................... 5.7

Displaying Other Windows from the Monitoring Screen .............................................. 5.8

Changing Settings for Monitoring Screen ............................................................................. 5.9

Displaying OCRG ...............................................................................................................5.11

Displaying PWTT Trendgraph ............................................................................................. 5.12

Freezing Waveforms ........................................................................................................... 5.13

Using Sleep Mode .............................................................................................................. 5.14

Turning Sleep Mode On .................................................................................. 5.14

Turning Sleep Mode Off .................................................................................. 5.15

Operator's Manual BSM-2300A C.3

CONTENTS

Displaying the Large Numeric Window ................................................................................5.16

Section 6 Alarm Function ..................................................................... 6C.1

Overview of Alarms .............................................................................................................. 6.2

What is an Alarm........................................................................................................6.2

Alarm Level ................................................................................................................6.2

Alarm Priority ............................................................................................................. 6.3

Silencing an Alarm/Suspending Alarms......................................................................6.3

Alarm Master ............................................................................................................. 6.3

Automatic Recording ..................................................................................................6.4

Alarm Setting ............................................................................................................. 6.4

Adjusting Alarm Sound Volume ..................................................................................6.4

Standby Mode ............................................................................................................6.4

Alarm History Window ................................................................................................ 6.5

Interbed Alarm ............................................................................................................6.5

Alarm Types ......................................................................................................................... 6.6

Vital Signs Alarms .....................................................................................................6.6

Arrhythmia Alarms .....................................................................................................6.6

Parameter Alarms ...................................................................................................... 6.7

ECG Related Alarms ........................................................................................6.7

Respiration Related Alarms ..............................................................................6.7

SpO2 Related Alarms ....................................................................................... 6.7

NIBP Related Alarms .......................................................................................6.7

IBP Related Alarms .........................................................................................6.7

CO2 Related Alarms ......................................................................................... 6.8

Temperature Related Alarms ............................................................................ 6.8

Other Alarms .............................................................................................................. 6.8

Messages...................................................................................................................6.8

ECG Related Messages ................................................................................... 6.8

Respiration Related Messages.........................................................................6.8

SpO2 Related Messages .................................................................................. 6.9

NIBP Related Messages ..................................................................................6.9

IBP Related Message ...................................................................................... 6.9

Temperature Related Message ......................................................................... 6.9

CO2 Related Messages .................................................................................. 6.10

Other Messages ............................................................................................ 6.10

INTERBED ALARM message ........................................................................ 6.10

Alarm Indications ............................................................................................................... 6.11

Overview .................................................................................................................. 6.11

Individual Alarm Indications ..................................................................................... 6.11

Vital Signs Alarms ......................................................................................... 6.11

Arrhythmia Alarms ......................................................................................... 6.13

Parameter Alarms .......................................................................................... 6.13

Other Alarms.................................................................................................. 6.15

Alarm Control Marks ................................................................................................ 6.16

Alarm Silence Mark ........................................................................................ 6.16

Alarm Recording Off Mark .............................................................................. 6.16

Priority of Alarm Control Marks ......................................................................6.16

C.4 Operator's Manual BSM-2300A

CONTENTS

Individual Vital Signs Alarm Setting Indication ............................................... 6.16

Adjusting the Alarm Sound Volume .......................................................................... 6.16

Silencing/Suspending Alarms ............................................................................................. 6.17

Overview .................................................................................................................. 6.17

Silencing Alarms After Alarm Occurrence ................................................................ 6.18

Silencing Alarm .............................................................................................. 6.18

Canceling Alarm Silence ................................................................................ 6.18

Suspending Alarms Before Alarm Occurrence ......................................................... 6.18

Suspending Alarms for Two Minutes .............................................................. 6.18

Suspending All Alarms and NIBP STAT and Automatic Measurements

Indefinitely ..................................................................................................... 6.19

Suspending All Alarms Indefinitely ................................................................. 6.21

Turning Automatic Alarm Recording On/Off ........................................................................6.23

Setting Alarm ..................................................................................................................... 6.25

Overview .................................................................................................................. 6.25

Alarm Limits Ranges ................................................................................................ 6.25

Vital Signs Alarms ......................................................................................... 6.25

Arrhythmia Alarms ......................................................................................... 6.26

Setting Vital Signs Alarm Individually ....................................................................... 6.27

Setting All Vital Signs Alarms to a Preset Pattern (Alarm Master) ........................... 6.28

Setting Arrhythmia Alarms Individually ..................................................................... 6.29

Setting All Arrhythmia Alarms to a Preset Pattern (Alarm Master) ........................... 6.30

Section 7 Review Windows .................................................................. 7C.1

General ................................................................................................................................. 7.1

Trend Window ....................................................................................................................... 7.2

Overview .................................................................................................................... 7.2

Displaying the TREND Window...................................................................................7.3

Changing the Time Threshold for Apnea Trendgraph ................................................... 7.5

Recording the Trendgraph ........................................................................................... 7.6

Printing the Trendgraph ............................................................................................... 7.6

List Window .......................................................................................................................... 7.8

Overview .................................................................................................................... 7.8

Displaying the LIST Window ....................................................................................... 7.9

Setting the Data Sampling Interval for the Periodic Vital Signs List ......................... 7.10

Selecting Parameters to be Displayed on the LIST Window ..................................... 7.11

Recording the List .................................................................................................... 7.12

Printing the List ........................................................................................................7.12

Arrhythmia Recall Window ..................................................................................................7.14

Overview .................................................................................................................. 7.14

Arrhythmia List ............................................................................................... 7.14

Arrhythmia Waveform Annotation ................................................................... 7.15

Displaying the Arrhythmia Recall Window ................................................................. 7.15

Recording the Arrhythmia Recall Waveform ............................................................. 7.16

Printing the Arrhythmia Recall Waveform ................................................................. 7.17

Selecting the Arrhythmia Types to be Saved as a Recall File .................................. 7.19

Alarm History Window ........................................................................................................ 7.20

Displaying the ALARM HISTORY Window ................................................................ 7.20

Recording the Alarm History Data ............................................................................ 7.21

Operator's Manual BSM-2300A C.5

CONTENTS

Section 8 Recording ............................................................................. 8C.1

Overview of Recording ......................................................................................................... 8.1

Recording Modes ....................................................................................................... 8.2

Manual Recording/Printing on the Monitoring Screen (Real Time/Delayed

Recording) ........................................................................................................8.3

Manually Recording OCRG on the Monitoring Screen ......................................8.3

Manually Recording PWTT trendgraph on the Monitoring Screen.....................8.3

Manually Recording/Printing on the Review Windows ...................................... 8.3

Periodic Recording ........................................................................................... 8.3

Alarm Recording .............................................................................................. 8.4

Recording Mode Annotations .....................................................................................8.5

Recording Priority ....................................................................................................... 8.6

Recording Sensitivity ................................................................................................. 8.6

Recording Speed ........................................................................................................8.6

Recording Related Message ...................................................................................... 8.6

Recorded/Printed Data ............................................................................................... 8.7

Changing the Recording Pattern ........................................................................................... 8.8

Changing the Recording Sweep Speed .................................................................................8.9

Manually Recording/Printing Waveforms.............................................................................8.10

Recording Waveforms on the Optional Recorder ...................................................... 8.10

Recording OCRG on the Optional Recorder .............................................................. 8.10

Recording PWTT Trendgraph on the Optional Recorder ............................................ 8.10

Manual Printing on the Network Printer .................................................................... 8.11

Setting Periodic Recording ................................................................................................. 8.12

Changing Settings for Automatic Periodic Recording ............................................... 8.13

Printing on a Network Printer .............................................................................................. 8.14

Section 9 Interbed Window................................................................... 9C.1

Registering Interbed Beds .................................................................................................... 9.2

Removing an Interbed Bed ...............................................................................9.3

Displaying the Interbed Bed Data .........................................................................................9.4

Interbed Alarm ...................................................................................................................... 9.6

Setting Interbed Alarm On or Off......................................................................9.6

Section 10 ECG Monitoring .................................................................. 10C.1

General ............................................................................................................................... 10.1

Preparing for ECG Monitoring ............................................................................................. 10.2

Preparation Flowchart .............................................................................................. 10.2

Selecting a Lead ...................................................................................................... 10.2

Number of Electrodes and Measuring Leads ............................................................10.3

Electrode Position .................................................................................................... 10.3

3 Electrode Leads .......................................................................................... 10.3

6 Electrode Leads .......................................................................................... 10.4

Selecting Electrodes and Lead ................................................................................. 10.5

Types of Leads and Connection Cord ............................................................. 10.5

Connecting Cables and Attaching Disposable Electrodes ........................................ 10.6

Connecting the Electrode Cable to the Monitor .............................................. 10.6

C.6 Operator's Manual BSM-2300A

CONTENTS

Attaching Disposable Electrodes to the Patient ............................................. 10.7

Monitoring ECG .................................................................................................................. 10.8

ECG Information on the Monitoring Screen ..............................................................10.8

Measuring ST Level ................................................................................................. 10.9

Monitoring Arrhythmia ............................................................................................ 10.10

Arrhythmia Analysis Classification Messages ............................................. 10.10

Turning Arrhythmia Analysis On/Off ............................................................. 10.11

Learning the ECG Waveform for Arrhythmia Detection (VPC Learning) ........ 10.12

Changing the Dominant QRS ....................................................................... 10.14

Noise Detection and Display .................................................................................. 10.15

Detached Electrode Detection and Display ............................................................ 10.16

Changing ECG Settings ................................................................................................... 10.17

Changing the Monitoring Lead ................................................................................ 10.17

Changing the ECG Sensitivity ................................................................................ 10.20

Changing the Heart Rate or Pulse Rate and ST Alarm Limits ................................ 10.21

Changing the Arrhythmia Alarm Setting.................................................................. 10.22

Changing the Type of Electrode Cable and Leads................................................... 10.24

Changing the Sync Source ..................................................................................... 10.26

Turning the Filters On/Off ....................................................................................... 10.27

Selecting the Mode for Updating the Heart Rate .................................................... 10.29

Turning Pacing Spike Detection On/Off .................................................................. 10.30

Displaying the Pacing Mark on the ECG ................................................................ 10.32

Use with an Electrosurgical Unit ....................................................................................... 10.33

Section 11 Respiration Monitoring...................................................... 11C.1

General ............................................................................................................................... 11.1

Measurement Method ............................................................................................... 11.1

Impedance Method ........................................................................................ 11.1

Thermistor Method ......................................................................................... 11.2

Preparing for Respiration Monitoring in Impedance Method ................................................ 11.3

Preparation Flowchart .............................................................................................. 11.3

Electrode Position and Waveform Examples ............................................................11.4

Connecting Cables and Attaching Disposable Electrodes ........................................ 11.6

Preparing for Respiration Monitoring in Thermistor Method ................................................ 11.7

Preparation Flowchart .............................................................................................. 11.7

Respiration Pickups ................................................................................................. 11.7

Connecting the Cable to the Monitor ........................................................................ 11.8

Attaching the Respiration Pickup ............................................................................. 11.8

When Using Respiration Pickup for Airway ....................................................11.8

When Using Respiration Pickup for Nose ....................................................... 11.9

Monitoring Respiration ...................................................................................................... 11.10

Respiration Information on the Monitoring Screen .................................................. 11.10

Changing Respiration Settings ......................................................................................... 11.12

Turning Respiration Monitoring On or Off in Impedance Method ............................. 11.12

Changing the Monitoring Lead in Impedance Method ............................................. 11.14

Changing the Respiration Sensitivity ...................................................................... 11.15

Changing the Respiration Waveform Sweep Speed ................................................ 11.16

Changing the Apnea Alarm Limit ............................................................................ 11.17

Operator's Manual BSM-2300A C.7

CONTENTS

Changing the Respiration Alarm Limits ................................................................... 11.18

Section 12 SpO2 Monitoring ................................................................. 12C.1

General ............................................................................................................................... 12.1

Preparing for SpO2 Monitoring ............................................................................................ 12.2

Preparation Flowchart .............................................................................................. 12.2

Selecting a Probe ..................................................................................................... 12.3

Nihon Kohden Reusable Probes .....................................................................12.3

Nihon Kohden Disposable Probes .................................................................. 12.4

Nellcor SpO2 Probes ...................................................................................... 12.5

Connecting Cables ................................................................................................... 12.6

Connecting Cable to the Monitor .................................................................... 12.6

Attaching the Probe to the Patient............................................................................12.7

Monitoring SpO2................................................................................................................. 12.9

SpO2 Information on the Monitoring Screen ............................................................ 12.10

Detection and Display of Measurement Condition .................................................. 12.11

CHECK PROBE Message (When the Finger Probe is Used) ....................... 12.11

DETECTING PULSE Message .................................................................... 12.11

M Message .................................................................................................. 12.11

Changing SpO2 Settings .................................................................................................. 12.12

Changing the Pulse Waveform Sensitivity .............................................................. 12.12

Changing the SpO2 Alarm Limits ............................................................................ 12.14

Changing the Sync Source ..................................................................................... 12.15

Selecting Sync Sound Pitch .................................................................................. 12.16

Selecting the Response Mode ............................................................................... 12.18

Section 13 NIBP Monitoring ................................................................. 13C.1

General ............................................................................................................................... 13.1

Oscillometric Method ..................................................................................... 13.1

Measurement Modes......................................................................................13.1

Preparing for NIBP Measurement .......................................................................................13.2

Preparation Flowchart .............................................................................................. 13.2

Selecting the Cuff .................................................................................................... 13.2

Cuff Width and Arm Circumference ................................................................ 13.3

Types of Cuffs .......................................................................................................... 13.4

Reusable Cuffs .............................................................................................. 13.4

Disposable Cuffs ............................................................................................ 13.6

Disinfecting Disposable Cuffs before Use ......................................................13.7

Connecting Cables and Attaching the Cuff to the Patient......................................... 13.7

Connecting Air Hose and Cuff to the Monitor ................................................. 13.7

Attaching the Cuff to the Patient ....................................................................13.9

Changing NIBP Settings ................................................................................................... 13.11

Selecting the Initial Cuff Inflation Pressure ............................................................ 13.11

Selecting the Measurement Mode and Interval ...................................................... 13.13

Selecting the Measurement Modes for the Mode Selection by the NIBP

INTERVAL Key............................................................................................. 13.14

Measurement Modes.................................................................................... 13.16

C.8 Operator's Manual BSM-2300A

CONTENTS

Changing the NIBP Alarm Settings ........................................................................ 13.19

Changing the PWTT Settings ................................................................................. 13.20

Measuring and Monitoring NIBP ....................................................................................... 13.22

Recommended Patient State.................................................................................. 13.22

Starting and Stopping NIBP Measurement ............................................................. 13.23

Manual Mode ............................................................................................... 13.23

STAT (Continuous) Mode .............................................................................. 13.23

Auto Mode ................................................................................................... 13.23

NIBP Information on the Monitoring Screen ........................................................... 13.24

Dimming and Hiding the NIBP Data ............................................................. 13.24

Section 14 IBP Monitoring .................................................................... 14C.1

General ............................................................................................................................... 14.1

Preparing for Blood Pressure Monitoring ............................................................................ 14.2

Preparation Flowchart .............................................................................................. 14.2

Selecting the Blood Pressure Measuring Device ...................................................... 14.2

Blood Pressure Transducers ........................................................................... 14.3

IBP Connection Cords .................................................................................... 14.4

Installing the Blood Pressure Measuring Device ...................................................... 14.5

Connecting Cables to the Monitor .................................................................. 14.5

Assembling the Infusion Circuit ..................................................................... 14.6

Connecting the Dome to the Infusion Circuit .................................................. 14.7

Connecting the Blood Pressure Transducer to the Dome ................................ 14.8

Adjusting Zero Balance ............................................................................................ 14.9

Adjusting Zero Balance .................................................................................. 14.9

Monitoring IBP ................................................................................................................. 14.12

IBP Information on the Monitoring Screen ............................................................. 14.12

Changing IBP Settings ..................................................................................................... 14.13

Changing the IBP Alarm Limits .............................................................................. 14.13

Changing the IBP Scale ......................................................................................... 14.14

Changing the Sync Source ..................................................................................... 14.16

Selecting Sync Sound Pitch .................................................................................. 14.17

Selecting the Mode for Calculating IBP .................................................................. 14.19

Selecting the Data Display Mode ........................................................................... 14.20

Changing the IBP Waveform Display Mode ............................................................ 14.21

Changing the Label ................................................................................................. 14.23

Types of Labels ............................................................................................ 14.23

Changing the Labels ..................................................................................... 14.23

Section 15 CO2 Monitoring ................................................................... 15C.1

General ............................................................................................................................... 15.1

Mainstream Method.................................................................................................. 15.1

Measurement Error with the TG-900P/TG-920P CO2 Sensor Kit .............................. 15.2

Preparing for CO2 Monitoring .............................................................................................. 15.4

Preparation Flowchart .............................................................................................. 15.4

Types of CO2 Sensor Kit .......................................................................................... 15.4

Using TG-900P CO2 Sensor Kit ................................................................................ 15.4

Operator's Manual BSM-2300A C.9

CONTENTS

Connecting the CO

Connecting the CO2 Adapter to the Respiration Circuit ................................... 15.5

Using TG-950P CO2 Sensor Kit ................................................................................ 15.6

Connecting the CO2 Sensor Kit to the Monitor ............................................... 15.7

Connecting the CO2 Adapter to the Respiration Circuit ................................... 15.7

Performing Zero Calibration ............................................................................15.8

Using TG-920P CO2 Sensor Kit .............................................................................. 15.11

Connecting CO2 Sensor Kit to the Monitor ................................................... 15.12

Attaching the CO2 Sensor Kit to the Patient................................................. 15.12

Monitoring CO2................................................................................................................. 15.13

CO2 Information on the Monitoring Screen ............................................................. 15.14

Changing CO2 Settings..................................................................................................... 15.15

Changing the Respiration Alarm Limits ................................................................... 15.15

Changing the Apnea Alarm Limit ............................................................................ 15.16

Changing the EtCO2 Alarm Limits .......................................................................... 15.17

Changing the FiCO2 Alarm Limits ........................................................................... 15.18

Changing the CO2 Scale ......................................................................................... 15.20

Changing the CO2 Waveform Sweep Speed............................................................ 15.21

Setting the Inspiration Composition ........................................................................ 15.22

Inspection of Measuring Accuracy ................................................................................... 15.24

Daily Inspection of Measuring Accuracy ................................................................ 15.24

Inspection of Measuring Accuracy (Precise Method) ............................................. 15.24

Checking Procedure ..................................................................................... 15.25

Sensor Kit to the Monitor ............................................... 15.5

Section 16 Temperature Monitoring.................................................... 16C.1

General ............................................................................................................................... 16.1

Preparing for Temperature Monitoring ................................................................................. 16.1

Preparation Flowchart .............................................................................................. 16.1

Selecting the Probe .................................................................................................. 16.2

Reusable Probes ............................................................................................16.2

Disposable Probe ........................................................................................... 16.3

Connecting Cables and Attaching the Probe ............................................................ 16.4

Connecting Cable to the Monitor .................................................................... 16.4

Attaching the Probe to the Patient ................................................................. 16.5

Monitoring Temperature ....................................................................................................... 16.7

Temperature Information on the Monitoring Screen .................................................. 16.7

Changing Temperature Settings .......................................................................................... 16.8

Changing the Temperature Alarm Limits ................................................................... 16.8

Section 17 Error Messages and Troubleshooting ............................. 17C.1

Monitoring .......................................................................................................................... 17.1

Messages................................................................................................................. 17.1

Problems ..................................................................................................................17.2

Network .............................................................................................................................. 17.3

Messages................................................................................................................. 17.3

Problems ..................................................................................................................17.4

Recording (When Using an Optional Recorder Module) ...................................................... 17.5

C.10 Operator's Manual BSM-2300A

CONTENTS

Messages................................................................................................................. 17.5

Problems ..................................................................................................................17.5

Printing ...............................................................................................................................17.6

Messages................................................................................................................. 17.6

Problems ..................................................................................................................17.6

ECG Monitoring .................................................................................................................. 17.7

Messages................................................................................................................. 17.7

Problems ..................................................................................................................17.8

Respiration Monitoring ........................................................................................................ 17.9

Messages................................................................................................................. 17.9

Problems in Impedance Method ...............................................................................17.9

Problems in Thermistor Method.............................................................................. 17.10

SpO

Monitoring ............................................................................................................... 17.11

Messages............................................................................................................... 17.11

Problems ................................................................................................................ 17.12

NIBP Monitoring ............................................................................................................... 17.13

Messages............................................................................................................... 17.13

Problems ................................................................................................................ 17.14

IBP Monitoring ................................................................................................................. 17.15

Messages............................................................................................................... 17.15

Problems ................................................................................................................ 17.15

Temperature Monitoring .................................................................................................... 17.16

Messages............................................................................................................... 17.16

Problems ................................................................................................................ 17.16

CO2 Monitoring ................................................................................................................. 17.17

Messages............................................................................................................... 17.17

Problems ................................................................................................................ 17.17

Section 18 Maintenance ....................................................................... 18C.1

Calibrating Waveforms ........................................................................................................ 18.2

Calibrating the Touch Screen .............................................................................................. 18.3

Cleaning the Touch Screen ................................................................................................. 18.5

Turning Touch Key Function On or Off ............................................................ 18.5

Cleaning the Touch Screen ............................................................................. 18.6

Handling Accessories After Use ......................................................................................... 18.7

Battery Pack ............................................................................................................ 18.7

Battery Lifetime.............................................................................................. 18.7

Replacing Battery Pack.................................................................................. 18.7

Disposal of Battery Pack................................................................................18.7

ECG and Respiration in Impedance Method .............................................................18.7

Electrode ....................................................................................................... 18.7

Disposing of Electrodes ................................................................................. 18.7

Cleaning and Disinfecting the Electrode Lead and ECG Connection Cord ...... 18.7

Respiration in Thermistor Method .............................................................................18.8

Cleaning and Disinfecting the Respiration Pickup .......................................... 18.8

SpO2......................................................................................................................... 18.8

Expiration of Nihon Kohden Disposable Probes ............................................. 18.8

Disposing of Probes .......................................................................................18.8

Cleaning and Disinfecting the SpO2 Connection Cord .................................... 18.9

Operator's Manual BSM-2300A C.11

CONTENTS

NIBP ........................................................................................................................ 18.9

NIBP Cuff Lifetime .........................................................................................18.9

Cleaning and Disinfecting the YP-950T/951T/952T/953T/954T/955T/960T/961T/

962T/963T/964T/965T Reusable Cuffs ........................................................... 18.9

Cleaning and Disinfecting the YP-900P/901P/902P/903P/904P/905P/906P

Reusable Cuffs ............................................................................................ 18.10

Cleaning and Disinfecting the Air Hose and Extension Hose ....................... 18.10

Disinfecting the Disposable Cuffs ................................................................ 18.11

Disposal of Cuffs ......................................................................................... 18.11

IBP ......................................................................................................................... 18.11

Cleaning, Disinfecting, Sterilizing and Storing the Blood Pressure

Transducer ................................................................................................... 18.11

Disposing of Transducer and Dome .............................................................. 18.13

Cleaning and Disinfecting the IBP Connection Cord ..................................... 18.14

Temperature ........................................................................................................... 18.14

Cleaning, Disinfecting and Sterilizing the Reusable Probe ........................... 18.14

Disposal of Disposable Probe ...................................................................... 18.14

........................................................................................................................ 18.14

Cleaning and Disinfecting the Monitor .............................................................................. 18.15

Cleaning ....................................................................................................... 18.15

Disinfecting .................................................................................................. 18.15

Cleaning the Recorder Module .......................................................................................... 18.16

Cleaning the Thermal Head .......................................................................... 18.16

Cleaning the Sensors ................................................................................... 18.16

Yearly Inspection .............................................................................................................. 18.17

Clock Accuracy ................................................................................................................ 18.18

Periodical Replacement Schedule .................................................................................... 18.19

Repair Parts Availability Policy ......................................................................................... 18.19

Section 19 Reference ............................................................................ 19C.1

Factory Default Settings ..................................................................................................... 19.1

SYSTEM SETUP Screen ......................................................................................... 19.1

ECG Window ............................................................................................................ 19.1

RESP Window .......................................................................................................... 19.1

SpO2 Window ............................................................................................................ 19.2

NIBP Window ........................................................................................................... 19.2

PRESS Window ....................................................................................................... 19.2

CO2 Window .............................................................................................................. 19.3

TREND Window ........................................................................................................ 19.3

LIST Window ............................................................................................................ 19.3

ARRHYTH RECALL Window .................................................................................... 19.4

VITAL ALARM Window ............................................................................................. 19.4

ARRHYTH ALARM Window ...................................................................................... 19.5

RECORDING Window ............................................................................................... 19.5

DATE & TIME Window .............................................................................................. 19.5

SOUND & BRIGHT Window ..................................................................................... 19.5

DISPLAY Window ..................................................................................................... 19.6

FUNCTION KEY Window ......................................................................................... 19.6

INTERBED Window .................................................................................................. 19.6

C.12 Operator's Manual BSM-2300A

CONTENTS

Specifications .................................................................................................................... 19.7

Display ...........................................................................................................19.7

Sound ............................................................................................................. 19.7

Alarm ............................................................................................................. 19.7

ECG ...............................................................................................................19.7

Respiration (Transthoracic impedance pneumography) ...................................19.8

SpO

on BSM-2301/2351 ............................................................................... 19.9

SpO2 on BSM-2304 ........................................................................................ 19.9

Non Invasive Blood pressure, NIBP ............................................................... 19.9

Temperature ................................................................................................. 19.10

Multi-parameter Amplifier .............................................................................19.10

Invasive Blood Pressure, IBP ...................................................................... 19.10

Respiration (Thermistor method) .................................................................. 19.11

Expired Carbon Dioxide Tension, CO2........................................................... 19.11

Trendgraph ................................................................................................... 19.11

Vital Signs List ............................................................................................. 19.11

Recorder Module (optional, WS-231P) ..........................................................19.12

External Output ............................................................................................19.12

Power Requirement ...................................................................................... 19.12

Clock Accuracy............................................................................................ 19.12

Environment ................................................................................................. 19.12

Dimensions and Weight ................................................................................ 19.13

Electromagnetic Compatibility...................................................................... 19.13

Safety Standard ........................................................................................... 19.13

Input/Output Socket Pin Assignment ............................................................................... 19.14

AUX Socket ........................................................................................................... 19.14

General Requirements for Connecting Medical Electrical System .................................... 19.15

Standard Accessories ...................................................................................................... 19.17

Options and Consumables ............................................................................................... 19.18

Options for the Monitor ........................................................................................... 19.18

For ECG and Respiration (Impedance Method) Monitoring ..................................... 19.18

For Respiration Monitoring (Thermistor method) ..................................................... 19.18

For SpO2 Monitoring ............................................................................................... 19.19

For NIBP Monitoring ............................................................................................... 19.20

For IBP Measurement ............................................................................................ 19.21

For Temperature Monitoring .................................................................................... 19.23

For CO2 Monitoring (Mainstream Method) ............................................................... 19.23

For WS-231P Recorder Module .............................................................................. 19.23

Operator's Manual BSM-2300A C.13

GENERAL HANDLING PRECAUTIONS

This device is intended for use only by qualified medical personnel. Use only Nihon Kohden approved products with this device. Use of non-approved products or in a non-approved manner may affect the performance specifications of the device. This includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode leads, input boxes and AC power.

Please read these precautions thoroughly before attempting to operate the instrument.

1. To safely and effectively use the instrument, its operation must be fully understood.

2. When installing or storing the instrument, take the following precautions:

(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive humidity and temperatures, poorly

ventilated areas, and dust, saline or sulphuric air.

(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport.

(3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage.

(4) The power line source to be applied to the instrument must correspond in frequency and voltage to product

specifications, and have sufficient current capacity.

(5) Choose a room where a proper grounding facility is available.

3. Before Operation

(1) Check that the instrument is in perfect operating order.

(2) Check that the instrument is grounded properly.

(3) Check that all cords are connected properly.

(4) Pay extra attention when the instrument is combined with other instruments to avoid misdiagnosis or other

problems.

(5) All circuitry used for direct patient connection must be doubly checked.

(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.

4. During Operation

(1) Both the instrument and the patient must receive continual, careful attention.

(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety.

(3) Avoid direct contact between the instrument housing and the patient.

5. To Shutdown After Use

(1) Turn power off with all controls returned to their original positions.

(2) Remove the cords gently; do not use force to remove them.

(3) Clean the instrument together with all accessories for their next use.

6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is not

functioning properly, it should be clearly marked to avoid operation while it is out of order.

7. The instrument must not be altered or modified in any way.

8. Maintenance and Inspection:

(1) The instrument and parts must undergo regular maintenance inspection at least every 6 months.

(2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect

operating condition.

Operator's Manual BSM-2300A i

(3) Technical information such as parts list, descriptions, calibration instructions or other information is available for

qualified user technical personnel upon request from your Nihon Kohden distributor.

9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or

location of electrodes and/or transducers to avoid possible burn to the patient.

10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator

discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.

WARRANTY POLICY

Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year

from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded from

the warranty.

NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period,

provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals.

No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any other

warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by

someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding this warranty.

Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure.

Shipping costs must be pre-paid.

This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon

Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism,

water or other casualty, improper installation or application, or on which the original identification marks have been

removed.

In the USA and Canada other warranty policies may apply.

CAUTION

United States law restricts this device to sale by or on the order of physician.

ii Operator's Manual BSM-2300A

EMC RELATED CAUTION

This equipment and/or system complies with the International Standard IEC 60601-1-2 for electromagnetic

compatibility for medical electrical equipment and/or system. However, an electromagnetic environment that

exceeds the limits or levels stipulated in the IEC 60601-1-2, can cause harmful interference to the equipment

and/or system or cause the equipment and/or system to fail to perform its intended function or degrade its

intended performance. Therefore, during the operation of the equipment and/or system, if there is any

undesired deviation from its intended operational performance, you must avoid, identify and resolve the

adverse electromagnetic effect before continuing to use the equipment and/or system.

The following describes some common interference sources and remedial actions:

1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station or

cellular phone:

Install the equipment and/or system at another location if it is interfered with by an emitter source such

as an authorized radio station. Keep the emitter source such as cellular phone away from the equipment

and/or system.

2. Radio-frequency interference from other equipment through the AC power supply of the equipment and/

or system:

Identify the cause of this interference and if possible remove this interference source. If this is not

possible, use a different power supply.

3. Effect of direct or indirect electrostatic discharge:

Make sure all users and patients in contact with the equipment and/or system are free from direct or

indirect electrostatic energy before using it. A humid room can help lessen this problem.

4. Electromagnetic interference with any radio wave receiver such as radio or television:

If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or

system as far as possible from the radio wave receiver.

If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden Corporation

subsidiary or distributor for additional suggestions.

This equipment complies with International Standard IEC 60601-1-2 (1993) which requires CISPR11, Group 1,

Class B. Class B EQUIPMENT is equipment suitable for use in domestic establishments and in

establishments directly connected to a low voltage power supply network which supplies buildings used for

domestic purposes.

Operator's Manual BSM-2300A iii

In IEC 60601-1-2 Medical Electronic Equipment, Part 1: General Requirements for Safety, 2. Collateral

Standard: Electromagnetic compatibility-Requirements and test. Section 36. 202. 2 Radiated radio-

frequency electromagnetic fields, PATIENT COUPLED EQUIPMENT and/or SYSTEMS applicable IMMUNITY

test methods are under consideration at SC62A/WG13. The 3 V/m IMMUNITY level may be inappropriate

especially when measuring SpO2 because physiological signals can be much smaller than those induced

by a 3 V/m electromagnetic field.

When measuring SpO2, various interference may produce false waveforms which look like pulse

waveforms. SpO2 value and pulse rate may be measured from these false waveforms, causing the alarm to

function improperly.

When installing the monitor, avoid locations where the monitor may receive strong electromagnetic

interference such as radio or TV stations, cellular phone or mobile two-way radios.

WARNING

Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac Monitoring and Diagnostic

Equipment*

The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker

may be affected by cardiac monitoring and diagnostic equipment which is connected to the same patient. If

this occurs, the pacemaker may pace at its maximum rate and give incorrect data to the monitor or

diagnostic equipment. If this occurs, disconnect the monitor or diagnostic equipment from the patient or

change the setting on the pacemaker by referring to the pacemaker’s manual. For more details, contact your

pacemaker distributor or Nihon Kohden distributor.

* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric impedance measurement

(BIM). Many medical devices in addition to pacemakers use this technology. When one of these devices is used on a

patient with an active, minute ventilation rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture

of BIM signals created in the patient, resulting in an elevated pacing rate.

For more information, see the FDA web site.

http://www.fda.gov/cdrh/safety.html

iv Operator's Manual BSM-2300A

Conventions Used in this Manual and Instrument

Warnings, Cautions and Notes

Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information.

WARNING

A warning alerts the user to possible injury or death associated with the use or misuse of the instrument.

CAUTION

A caution alerts the user to possible injury or problems with the instrument associated with its use or

misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other

property.

NOTE

A note provides specific information, in the form of recommendations, prerequirements, alternative

methods or supplemental information.

Operator's Manual BSM-2300A v

Explanations of the Symbols in this Manual and Instrument

The following symbols found in this manual/instrument bear the respective descriptions as given.

On panels

Symbol Description Symbol Description

AC operation

“On” only for a part of instrument Data input/output

“Off” only for a part of instrument Input/output terminal

Battery operation Output terminal

Battery charging Alternating current

Alarm suspend Equipotential terminal

NIBP Year of manufacture

NIBP interval Serial number

Defibrillation-proof type BF applied part

NIBP start Splash-proof equipment

NIBP stop Watertight equipment

Menu Protective earth

Home (monitoring screen) High voltage

Attention, consult operator’s manual

Defibrillation-proof type CF applied part

CSA mark

IPX4

IPX7

Record start/stop (on the WS-231P recorder module)

Out of paper (on the WS-231P recorder module)

vi Operator's Manual BSM-2300A

On screen

Symbol Description Symbol Description

Alarm silence with remaining minutes

QRS/pulse sync mark

Alarm off Respiration sync mark

Alarm recording off Value out of range

Recording Current measuring value

Paper magazine open Adjust setting/Scroll data

Out of paper Touch screen calibration mark

Network communicating Waveform cascaded

Printer (when QI-111P network printer card is used)

Others

Symbol Description

Recycle (On battery pack)

Ni-MH

Operator's Manual BSM-2300A vii

Section 1 General

Introduction ......................................................................................................................... 1.1

Features ..............................................................................................................................1.2

Composition ........................................................................................................................ 1.4

Network Composition .......................................................................................................... 1.6

Panel Description ................................................................................................................ 1.7

Front Panel ................................................................................................................ 1.7

Left Side Panel ..........................................................................................................1.8

BSM-2301/2351 .............................................................................................. 1.8

BSM-2304 ....................................................................................................... 1.9

Right Side Panel......................................................................................................1.10

Basic Operating Concepts ................................................................................................. 1.12

Screen Displays ......................................................................................................1.12

Using Touch Screen Keys........................................................................................ 1.16

Keys on the Front Panel .......................................................................................... 1.18

Using the MENU Window ........................................................................................ 1.18

General Safety Information ............................................................................................... 1.19

General .................................................................................................................... 1.19

Installation .............................................................................................................. 1.20

Using QI-231P/236P Interface ................................................................................ 1.21

Using DZ-230P Hooks .............................................................................................1.22

Network ................................................................................................................... 1.22

Battery .................................................................................................................... 1.23

ECG Monitoring .......................................................................................................1.24

Respiration Monitoring ............................................................................................. 1.26

SpO2 Monitoring ...................................................................................................... 1.26

NIBP Monitoring ......................................................................................................1.29

IBP Monitoring ........................................................................................................ 1.30

Temperature Monitoring ........................................................................................... 1.31

CO2 Monitoring ........................................................................................................ 1.31

Maintenance ........................................................................................................... 1.34

Operator's Manual BSM-2300A 1C.1

1. GENERAL

Section 1 provides a general overview of the equipment and how to operate it. If

you have not used a BSM-2300A bedside monitor before, read this section first.

• Features

• Components in the system

• Panel descriptions

• Screen displays

• Basic operation concepts

• Important safety information

Introduction

The Life Scope i BSM-2301A/2304A hardwire bedside monitor and The Life

Scope L BSM-2351A hardwire bedside monitor have several connectors for ECG,

respiration in impedance method, SpO

multi-parameter socket for IBP, respiration by thermistor method and CO

, NIBP, IBP and temperature monitoring and

monitoring. Its easy operation and compact lightweight design lets you use this

bedside monitor in the general ward, ER, RR, ICU, NICU, operating room and for

patient transportation. For portability, it can operate on battery power as well as

AC power.

For simplicity, the suffix A will be omitted in this manual. There is no difference in

operation among models with different suffixes unless otherwise specified.

NOTE

Use only Nihon Kohden parts and accessories to assure maximum

performance from your instrument.

Operator's Manual BSM-2300A 1.1

1. GENERAL

Features

• Hardwire system

BSM-2301/2351: Monitors ECG, impedance method respiration, SpO

(Nihon

Kohden probes), NIBP and temperature. With the multi-

parameter socket, IBP, thermistor method respiration or CO

can be monitored.

BSM-2304: Monitors ECG, impedance method respiration, SpO2 (Nellcor

probes), NIBP, IBP and temperature. With the multi-

parameter socket, IBP, thermistor method respiration or CO

can be monitored.

• AC or battery (option) operation

The monitor can operate on AC power or battery for up to 3 hours.

• Color data display

Detailed information is displayed on the wide angle, 8.4 inch color LCD (BSM-

2301/2304) or 10.4 inch color LCD (BSM-2351) . Monitoring parameters are

automatically identified.

• Easy operation by the hard keys and touch screen keys

The monitor can be operated using the touch keys on the screen, as well as the

hard keys on the panel.

• Highly reliable ECG monitoring

Arrhythmia can be analyzed and ST level can be measured. The dominant QRS

can be changed any time for template-matching analysis of arrhythmia.

• Review windows for viewing saved data

Saved data can be displayed on the trend window, list window, arrhythmia recall

window and alarm history window.

• Function keys

There are three function keys at the upper left corner of the screen. A function

can be assigned to each key, for example, freezing waveforms and displaying the

MENU window.

• Thermal array recorder with 50 mm width paper (option)

Waveforms, numeric data, trendgraphs, and vital signs lists can be recorded

manually or automatically on the optional WS-231P recorder module. Up to

three channels can be recorded.

• Central monitor connection (option)

When the optional QI-101P network card is installed in the bedside monitor, the

bedside monitor can be connected to the monitor network or any other bedside

monitor in the network. Waveforms and data of the bedside monitor can be sent

to the central monitor. An interbed data and alarm of any patient in the same

network can be displayed on the bedside monitor.

1.2 Operator’s Manual BSM-2300A

1. GENERAL

• Printing on a Network Printer (option)

When the optional QI-111P network printer card is inserted into the bedside

monitor, the data on the review windows and numeric data of the monitoring

parameters can be printed on a network printer.

• Wireless LAN system (option)

When the optional QI-210P wireless LAN station is connected to the bedside

monitor and when there are several QI-902R wireless access points installed in

the facility, the signal from the bedside monitor can be received by radio

communication with the wireless LAN access point. The wireless LAN access

point is connected to the central monitor network. For details, contact your

Nihon Kohden distributor.

• Connecting Oridion Microcap capnograph monitor (option)

With the optional QI-235P interface, Oridion Microcap capnograph monitor

can be connected to the monitor to display the data acquired by the Microcap.

For details, refer to the QI-235P interface manual.

• Anesthesia monitoring (option)

When the optional AG-920R multigas unit is connected to the monitor, the

anesthetic gas can be monitored. To connect the multigas unit, the optional YJ-

231P connection cable is required. For details, refer to the AG-920RA/RK

multigas unit manual.

Operator's Manual BSM-2300A 1.3

1. GENERAL

Composition

Bedside Monitor

BSM-2300

Interface for connecting a display and

external instruments (option)

QI-231P

Recorder Module (option)

WS-231P

Adapter for attaching

QI-231P interface (option)

DI-231P

Battery pack (option)

10HR-4/3FAUC-NK

Interface for connecting

Oridion Microcap (option)

QI-235P

Network Card (option)

QI-101P

Interface for connecting a display and

an external instrument (option)

QI-236P

Hooks (option)

DZ-230P

1.4 Operator’s Manual BSM-2300A

Wireless LAN Station (option)

QI-210P

Network Printer Card (option)

QI-111P

Cart (option)

KC-013P

BSM-2300 RGB cable (option)

YS-076P2 (10 m)

YS-080P2 (2 m)

Connection cable for optional units

YJ-231P

Multigas unit (option)

AG-920R

1. GENERAL

Operator's Manual BSM-2300A 1.5

1. GENERAL

Network Composition

Network group e.g. ICU

In a central monitor network, on a central monitor, you can see data of any bed in

the network.

The data that can be displayed on the bedside monitor or central monitor depends

on the type of bedside or central monitor used.

The number of central monitors and bedside monitors that can be connected to a

central monitor network and the network communication method depend on the

type of monitor used. For details, refer to the Network and System Installation

Guide.

Central monitors

CNS-9300 series CNS-9701

Central monitor

CNS-9300 series CNS-9701

Central monitor

Bedside monitors

CNS-9300 series

Central monitor

Multiple patient receiver

ORG-9200 ORG-9700

Printer

Network group e.g. CCU

Multiple patient receiver

Transmitter

Bedside monitor

BSM-5100 series BSM-4100 series BSM-2300 series BSM-1100 seriesTransmitter

Bedside monitor

BSM-2300

Bedside monitors/Transmitters

Central monitor

Bedside monitor

Central monitor

Bedside monitor

Interface

QI-910R

Bedside monitor

Multi-patient receiver

BSM-8000 series ORG-8200

Central monitor

Bedside monitor

WARNING

••

• Install the printer and hubs outside the patient environment. If they are installed inside the patient

••

environment, the patient or operator may receive electrical shock.

••

• Check the software version number of the monitor before connecting it to the network. Different

••

software versions have different communication methods. When there is more than one communication

method in the network, communication may malfunction.

1.6 Operator’s Manual BSM-2300A

Panel Description

Front Panel

1. GENERAL

SILENCE ALARMS

NIBP

INTERVAL

START/STOP

HOME

Without optional WS-231P recorder module

SILENCE ALARMS

NIBP

INTERVAL

START/STOP

HOME

With optional WS-231P recorder module

No. Name Description

1 Alarm indicator

Red or yellow lamp blinks according to the alarm settings. Green lamp blinks in synchronization with the patient’s QRS.

2 Handle For carrying the monitor.

3 SILENCE ALARMS key Silences the alarm sound.

4 NIBP INTERVAL key Selects NIBP measurement mode. Pressing this key changes the mode.

5 NIBPSTART/STOPkey

Starts NIBP measurement in selected mode. Pressing the key during measurement stops measurement.

6 MENU key Displays the MENU window.

7 HOME key Closes any opened window and displays the monitoring screen.

8 Power switch Press and hold for more than one second to turn the monitor power on or off.

9 Power lamp Lights when the monitor power is turned on.

10 AC power lamp

Lights when the power cord is connected between the AC SOURCE socket and AC outlet.

11 Battery power lamp Lights when operating on the battery power.

12 Battery charging lamp Lights or slowly blinks when charging.

13 Touch screen

Displays monitoring data. Touching a key or data on the screen changes displaying screen and settings.

14 Record key Press to start or stop recording.

15 Out of paper lamp Blinks when out of paper. Lights when recorder door is open.

Operator's Manual BSM-2300A 1.7

1. GENERAL

Left Side Panel

BSM-2301/2351

TEMP socket

Connects to the temperature probe cord.

Refer to Warning and Caution in the "General Safety Information" section.

Multi-parameter socket

Connects to the connection cord of the parameter to be monitored (IBP, CO

or respiration by

thermistor method). The type of parameter is automatically recognized.

SpO

socket

Connects to the SpO2 connection cord.

ECG/RESP socket

Connects to the ECG connection cord.

Battery box

For the optional battery pack.

TEMP socket

Connects to the temperature probe cord.

NIBP socket

Connects to the air hose.

Without optional WS-231P recorder module

Refer to Warning and Caution in the "General Safety Information" section.

Multi-parameter socket

Connects to the connection cord of the parameter to be monitored (IBP, CO by thermistor method). The type of parameter is automatically recognized.

SpO

socket

Connects to the SpO

or respiration

connection cord.

ECG/RESP socket

Connects to the ECG connection cord.

NIBP socket

Connects to the air hose.

Battery box

For the optional battery pack.

With optional WS-231P recorder module

1.8 Operator’s Manual BSM-2300A

BSM-2304

TEMP socket

Connects to the temperature probe cord.

PRESS 1 socket

Connects to the IBP connection cord.

NELLCOR

OxiMax

1. GENERAL

Refer to Warning and Caution in the "General Safety Information" section.

Multi-parameter socket

Connects to the connection cord of the parameter to be monitored (IBP (PRESS 2), CO

or respiration

by thermistor method). The type of parameter is automatically recognized.

SpO

socket

Connects to the SpO2 connection cord.

ECG/RESP socket

Connects to the ECG connection cord.

Battery box

For the optional battery pack.

TEMP socket

Connects to the temperature probe cord.

PRESS 1 socket

Connects to the IBP connection cord.

NELLCOR

OxiMax

NIBP socket

Connects to the air hose.

Without optional WS-231P recorder module

Refer to Warning and Caution in the "General Safety Information" section.

Multi-parameter socket

Connects to the connection cord of the parameter to be monitored (IBP (PRESS 2), CO

or respiration

by thermistor method). The type of parameter is automatically recognized.

SpO

socket

Connects to the SpO

connection cord.

ECG/RESP socket

Connects to the ECG connection cord.

NIBP socket

Connects to the air hose.

Battery box

For the optional battery pack.

With optional WS-231P recorder module

Operator's Manual BSM-2300A 1.9

1. GENERAL

Right Side Panel

Handle

PC card eject button

PC card slot For an optional QI-101P network card or QI-111P network printer card.

Equipotential grounding terminal

For an equipotential grounding lead.

Fuse holder

AC SOURCE power cord socket

For the AC power cord.

AUX socket

For connecting a display monitor or optional unit.

ZB socket

Not available.

Without optional WS-231P recorder module

Handle

PC card eject button

PC card slot For an optional QI-101P network card or QI-111P network printer card.

Equipotential grounding terminal

For an equipotential grounding lead.

Fuse holder

AC SOURCE power cord socket

For the AC power cord.

AUX socket

For connecting a display monitor or optional unit.

Recorder door release lever

Pull up the lever to open the recorder door.

1.10 Operator’s Manual BSM-2300A

ZB socket

Not available.

WS-231P recorder module (option)

Paper window

For checking the amount of recording paper.

With optional WS-231P recorder module

1. GENERAL

WARNING

Connect the network as specified. Otherwise patient and

operator may get electrical shock or other injury. For connecting

the network, contact your Nihon Kohden distributor.

CAUTION

Use only the Nihon Kohden card.

WARNING

••

• For patient safety, equipotential grounding of all

••

instruments must be performed. Consult with a

qualified biomedical engineer.

••

• Only use the provided power cord. Using other

••

power cords may result in electrical shock or other

injury to the patient and operator.

CAUTION

When the provided power cord cannot be used, operate

the monitor on battery power.

WARNING

Connect only the specified instrument to the socket marked with by following the specified

procedure. Otherwise, electrical leakage current may harm the patient and operator.

CAUTION

When connecting the monitor to other instruments, the connection must comply with IEC

60601-1-1. Refer to “General Requirements for Connecting Medical Electrical System” in

Section 19.

Operator's Manual BSM-2300A 1.11

1. GENERAL

Basic Operating Concepts

Screen Displays

Monitoring screen

Following are the screens and windows available on the Life Scope i and the Life

Scope L bedside monitors. For details about the individual screens and windows,

see the appropriate section.

The shadow of the previous screen may remain for a few minutes after changing

the screen.

Normally, the monitoring screen is displayed. All screens, except for the SYSTEM

SETUP screen, return to the monitoring screen when there is no key operation for

about 3 minutes.

HOME

MENU window

• The monitoring screen can be displayed anytime by pressing

the HOME key on the front panel.

• Displays waveforms and data of the monitoring parameters.

• Touching the patient name displays the PATIENT INFO

window for entering patient name.

• Touching the parameter data displays the parameter setting

window.

The MENU window can be displayed anytime by pressing the

MENU key on the front panel. From the MENU window, you

can display any window except the monitoring screen.

1.12 Operator’s Manual BSM-2300A

Enlarged window

Review windows

1. GENERAL

ENLARGED window

for displaying

enlarged numeric data

TREND window for

displaying 24 hour

trendgraph

LIST window for

displaying list of

parameter data

ARRHYTH

RECALL window

for displaying

arrhythmia recall file

data

Operator's Manual BSM-2300A 1.13

1. GENERAL

Patient information window

ALARM HISTORY

window for displaying

alarm occurrence

PATIENT INFO

window for entering

patient name. Stored

data can be deleted on

this window.

Alarm setting window

Parameter setting windows

For changing parameter monitoring settings

VITAL ALARM

window for setting

vital signs alarm and

ARRHYTH ALARM

window for setting

arrhythmia alarms

ECG window

1.14 Operator’s Manual BSM-2300A

INTERBED window

For selecting interbed beds and displaying interbed bed data when the monitor is connected to a network

Setup and other windows

RECORDING window

for recording setting

1. GENERAL

DATE & TIME window for changing date and time, SOUND & BRIGHT window for changing alarm and sync sound

volume and screen brightness, DISPLAY window for changing trendgraph display on the monitoring screen and respiration/

CO2 waveform sweep speed, FUNCTION KEY window for assigning a function to a function key and TOUCHKEY OFF

window for turning touch screen function off

SLEEP MODE

window for turning

sleep mode on

Operator's Manual BSM-2300A 1.15

1. GENERAL

SYSTEM SETUP screen

SILENCE

ALARMS

For changing system settings.

Displaying the SYSTEM

SETUP screen interrupts

monitoring.

Using Touch Screen Keys

Any window can be opened and settings can be changed by touching the keys and

items on the screen with your finger or the touch pen (option).

Touching the key on the screen displays the window.

1.16 Operator’s Manual BSM-2300A

1. GENERAL

Tabs for changing displaying window. The

opened window is displayed in light blue.

Selected item is displayed in light blue

Selectable items or keys are displayed in

yellow

Scroll bar and buttons for scrolling data

The time width of the trendgraph on the monitoring screen can be adjusted by touching the position for the right edge of the

trendgraph on the screen.

Operator's Manual BSM-2300A 1.17

1. GENERAL

Keys on the Front Panel

Turns the monitor power on or off

SILENCE ALARMS

NIBP

INTERVAL

START/STOP

HOME

Silences alarm sound

Selects NIBP measurement mode

Starts and stops NIBP measurement

Displays the MENU window

Displays the monitoring screen

Starts and stops recording (when using optional recorder module)

Using the MENU Window

Section 7

Section 5

Section 4

The MENU window can be displayed anytime by pressing the MENU key on the

front panel. From the MENU window, you can display any window except the

monitoring screen.

For details on each window, refer to the section specified below.

Section 14

Section 10

Section 11

Section 12

Section 13

Section 15

Section 16

Section 6

Section 4

Section 5

Section 8

Section 4

Section 18

Section 9

1.18 Operator’s Manual BSM-2300A

General Safety Information

General

••

• Never use this monitor in the presence of any flammable anesthetic

••

gas, concentrated oxygen or hyperbaric oxygen. Failure to follow

this warning may result in explosion.

••

• Never use the monitor in a high-pressure oxygen medical care tank.

••

Failure to follow this warning may cause explosion or fire.

••

• When using this monitor with an electrosurgery unit, its return plate

••

and the electrodes for monitoring must be firmly attached to the

patient. If the return plate is not attached correctly, it may burn the

patient’s skin where the electrodes are attached. Refer to the

instruction manual for the ESU.

••

• When performing MRI tests, remove the electrodes and transducers

••

connected to the patient from this monitor. The heat generated from

the induced electromotive force may burn the patient’s skin. For

details, refer to the instruction manual for the MRI.

••

• When performing defibrillation, discharge as far as possible from

••

electrodes and medicine on the chest of the patient. If there is a

possibility that the defibrillator paddle could touch electrodes and

medicine, remove electrodes and medicine from the patient. If the

defibrillator directly contacts these materials, the discharged energy

may cause serious electrical burn to the patient.

••

• Before performing defibrillation, check that the cords and cables of

••

the electrodes and transducers attached to the patient are properly

connected to the monitor. Touching the metal parts of disconnected

cords and cables may cause serious electrical shock or injury by

discharged energy.

••

• To avoid the risk of serious electrical burn, shock or other injury

••

during defibrillation, all persons must keep clear of the bed and must

not touch the patient or any equipment connected to the patient.

••

• During alarm suspension (the “ALARMS SUSPENDED” or “ALL

••

ALARMS OFF” message displayed), all current alarms are

temporarily turned off.

••

• Before setting ALARMS OFF TYPE, consult the administrator of this

••

monitor in your facility. Before selecting “ALL ALARMS OFF” or

“BYPASS”, all operators must thoroughly understand the function of

the “ALL ALARMS OFF” key and “BYPASS” key which turn all alarms

off for an indefinite period.

••

• Do not turn all alarms off with the ALL ALARMS OFF key when there

••

is no medical staff around the patient or when the patient is

connected to a ventilator.

••

• Do not turn all alarms off with the BYPASS key when there is no

••

medical staff around the patient.

••

• When EXIT SLEEP MODE ON ALARM on the SYSTEM SETUP screen

••

is set NO, the bedside monitor alarm cannot be seen or heard on the

bedside monitor during sleep mode. Monitor the bedside monitor

1. GENERAL

WARNING

Operator's Manual BSM-2300A 1.19

1. GENERAL

alarm on the central monitor or telemetry system. Otherwise, the

bedside monitor alarm may be overlooked.

••

• For arrhythmia monitoring, set ARRHYTHMIA ANALYSIS on the ECG

••

window to ON. Otherwise, there is no sound or indication for

arrhythmia alarms.

••

• When admitting a new patient, check the alarm settings. The alarm

••

settings return to the alarm master settings on the SYSTEM SETUP

screen when all data is deleted on the DELETE ALL window or 30

minutes elapse after monitor power off.

CAUTION

••

• Use only Nihon Kohden specified electrodes, probes, transducers,

••

thermistors and catheters. Otherwise, the maximum performance

from the monitor cannot be guaranteed.

••

• Do not reuse disposable parts.

••

• Turn off the power of cell telephones, small wireless devices and

••

other devices which produce strong electromagnetic interference.

Otherwise, the waveforms and measurements are affected by such

interference and the displayed data may be incorrect.

••

• When admitting a new patient, first delete all data of the previous

••

patient. Otherwise, the data of the previous patient and new patient

will be mixed together.

••

• After the monitor power is turned on, parameter-related alarms do

••

not function until the parameters are monitored (during standby

mode).

••

• Alarm recording is not performed when alarm is suspended or alarm

••

recording is set to off.

••

• If there is any doubt about the arrhythmia analysis, make the monitor

••

relearn the patient’s VPC. Otherwise, an important arrhythmia maybe

overlooked.

••

• When the upper or lower alarm limit is turned off, there will be no

••

upper or lower alarm for that parameter limit.

••

• When the “CONNECTOR OFF” message appears on the screen,

••

check that the connection cords are connected to the sockets

properly. Patient cannot be monitored and the alarm does not

function properly while this message is displayed.

••

• Do not turn the monitor off when the system check screen is

••

displayed. Otherwise the saved data may be damaged or deleted. If

the monitor is turned off during system check, delete all data

because the data is not reliable.

••

• If fluids are accidentally spilled on the monitor, take the bedside

••

monitor out of service and check for damage.

Installation

WARNING

••

• For patient safety, equipotential grounding of all instruments must be

••

1.20 Operator’s Manual BSM-2300A

1. GENERAL

performed. Consult with a qualified biomedical engineer.

••

• Only use the provided power cord. Using other power cords may

••

result in electrical shock or other injury to the patient and operator.

••

• When the provided power cord cannot be used or when equipotential

••

grounding is doubtful (such as in poor grounding facility), operate

the monitor on battery power.

••

• Connect only the specified instrument to the socket marked with

••

by following the specified procedure. Otherwise, electrical leakage

current may harm the patient and operator.

CAUTION

••

• When connecting the monitor to other instruments, the connection

••

must comply with IEC 60601-1-1. Refer to “General Requirements for

Connecting Medical Electrical System” in Section 19.

••

• Disconnect the power cord from the AC socket before connecting the

••

instruments.

••

• Use only the KC-013P cart for the BSM-2300 bedside monitor. If

••

another cart is used, it may tip over or the monitor may fall off.

••

• Avoid locations where the monitor and system may be sprinkled with

••

water or chemical solutions. Otherwise the monitor and system may

be damaged.

••

• When not using the KC-013P cart, make sure that the monitor is

••

placed and fastened so that it does not tip over.

••

• Install the monitor and ESU appropriately and perform equipotential

••

grounding. Otherwise, noise from the ESU may interfere with the

ECG and ECG monitoring may not be performed properly.

••

• At the monitor on, check that one “bong” sounds and the red alarm

••

lamp, yellow lamp and green lamp blink once to show that the alarm

functions properly.

Also read the warning and caution in “Selecting a Suitable Location” in Section 2.

Using QI-231P/236P Interface

If the display does not have an equipotential ground terminal and the

bedside monitor and display cannot be equipotentially grounded, make

sure that the display is grounded to the same AC outlet as the bedside

monitor. Always perform equipotential grounding as specified in IEC

60601-1-1 when required.

WARNING

CAUTION

••

• Before connecting instruments, make sure that the power is turned

••

off. Otherwise electrical current may harm the patient and operator.

Operator's Manual BSM-2300A 1.21

1. GENERAL

However, when using the TRIG output, before connecting the

instrument to the interface, connect the interface cable to the

monitor, display the monitoring screen on the monitor and check that

the TRIG LED on the interface is lit. (Only QI-231P interface has the

TRIG LED.)

••

• Keep the interface and cable out of the way. Otherwise people may

••

trip over it, causing the cable to break or the bedside monitor to fall

and injure the patient and operator.

••

• When using the output signal from the interface as the

••

synchronization signal for other equipment such as IABP (intra-

aortic balloon pump), or defibrillator:

· Set the timing of the other equipment by checking the waveform on

the screen of the equipment.

· Check the condition of the bedside monitor at all times. The output

signal may become unstable.

· Check that the delay time of the output signal (QRS sync 100 ms

(QI-231P) / 20 ms (QI-236P) maximum, ECG analog 20 ms

maximum) is within the range of the connected equipment.

· Do not use the QRS sync signal as the synchronization signal for a

defibrillator.

••

• Only use the DI-231P adapter for attaching the interface to the

••

monitor.

Using DZ-230P Hooks

CAUTION

••

• Use the hooks only for hooking the BSM-2300 series bedside

••

monitors onto a board.

••

• Do not carry the monitor by the hooks.

••

• Hook the monitor onto a board which can support the weight of the

••

monitor.

••

• To prevent the monitor from falling off, periodically check that the

••

hooks are attached to the monitor properly.

••

• Do not put weight on the hooks and monitor.

••

• Make sure that both hooks are properly hooked onto the board.

••

• When moving a bed with a monitor hooked to it, make sure that the

••

monitor does not fall off.

Network

WARNING

••

• Install the printer and hubs outside the patient environment. If they

••

are installed inside the patient environment, the patient or operator

may receive electrical shock.

1.22 Operator’s Manual BSM-2300A

1. GENERAL

••

• Connect the network as specified. Otherwise patient and operator

••

may get electrical shock or other injury. For connecting the network,

contact your Nihon Kohden distributor.

••

• Do not use the damaged network cable. Otherwise patient or

••

operator may get an electrical shock when the damaged part is

touched.

••

• Check the software version number of the monitor before connecting

••

it to the network. Different software versions have different

communication methods. When there is more than one

communication method in the network, communication may

malfunction.

CAUTION

••

• The network must be managed by the network administrator. Make

••

sure that each monitor in the network has a different IP address.

Otherwise, data communication cannot be performed properly. When

adding a unit to an already operating network, set the IP address on

the monitor before connecting the monitor to the network.

••

• Use only the Nihon Kohden network card.

••

• Do not push in the network cable with too much force. Otherwise the

••

network card or bedside monitor may get damaged.

••

• When the monitor is connected to a central monitor network, set the

••

Bed Name (Bed ID) and Group Name on the monitor. Otherwise, the

default settings are used for the bed name and group name and the

bed may be incorrectly identified on the central monitor.

Battery

WARNING

••

• Keep the battery pack away from fire. The battery pack may explode.

••

• Do not heat the battery pack. The battery pack may explode.

••

• Never short-circuit the + and – terminals on the battery pack with a

••

wire or store the battery pack with metals such as necklace or hair

pins. The battery pack may short-circuit, causing the substance

inside the battery to leak or explode.

••

• Never disassemble or modify the battery pack. Never damage or

••

directly solder the sheath tube. The battery pack short-circuits, the

electrolyte comes out and the battery pack explodes.

••

• Do not subject the battery pack to a strong mechanical shock. The

••

battery may leak or explode.

••

• Do not use a battery which is damaged, such as from falling. There is

••

a gas discharge valve inside the battery and if this valve is damaged,

the gas cannot be discharged, causing the battery to explode.

••

• Only use the battery pack on the specified instrument. If the battery

••

Operator's Manual BSM-2300A 1.23

1. GENERAL

is used on an unspecified instrument, large current may flow,

causing the battery to explode.

••

• If the battery pack is damaged and the substance inside the battery

••

(alkaline liquid) contacts the eyes or skin, wash immediately and

thoroughly with water and see your physician. Never rub your eyes,

otherwise you may lose your eyesight.

••

• The battery pack has + and – polarity. Make sure that the battery is

••

installed with the correct polarity direction. Otherwise, the

substance inside the battery may leak and explode.

••

• Do not connect the battery pack to an AC outlet or lighter socket in a

••

car. The battery may explode.

••

• Do not immerse the battery pack in water or seawater. The battery

••

will rust and may heat up.

••

• Never use a battery pack which is damaged, discolored or has

••

leakage. A damaged battery may explode if used.

••

• Do not leave the battery for more than two years unused. The battery

••

may leak.

ECG Monitoring

CAUTION

••

• Do not expose the battery pack to direct sunlight or leave in a high

••

temperature place. The lifetime of the battery pack may be shortened

or the substance inside the battery pack may leak.

••

• Do not leave a used battery pack for a long period of time (more than

••

one year). The substance inside the battery may leak.

••

• The battery pack must be replaced by qualified service personnel.

••

• Keep the battery pack away from children.

••

• Before disposing of the battery, check with your local solid waste

••

officials for details in your area for recycling options or proper

disposal. The battery is recycleable. At the end of its useful life,

under various state and local laws, it may be illegal to dispose of this

battery into the municipal waste stream.

WARNING

Interaction Between Minute Ventilation Rate-Adaptive Pacemakers and

Cardiac Monitoring and Diagnostic Equipment*

The bioelectric impedance measurement sensor of a minute ventilation

rate-adaptive implantable pacemaker may be affected by cardiac

monitoring and diagnostic equipment which is connected to the same

patient. If this occurs, the pacemaker may pace at its maximum rate

and give incorrect data to the monitor or diagnostic equipment. If this

occurs, disconnect the monitor or diagnostic equipment from the

patient or change the setting on the pacemaker by referring to the

1.24 Operator’s Manual BSM-2300A

1. GENERAL

pacemaker’s manual. For more details, contact your pacemaker

distributor or Nihon Kohden distributor.

* Minute ventilation is sensed in rate-adaptive pacemakers by a technology known

as bioelectric impedance measurement (BIM). Many medical devices in addition

to pacemakers use this technology. When one of these devices is used on a

patient with an active, minute ventilation rate-adaptive pacemaker, the pacemaker

may erroneously interpret the mixture of BIM signals created in the patient,

resulting in an elevated pacing rate.

For more information, see the FDA web site.

http://www.fda.gov/cdrh/safety.html

WARNING

••

• When using a defibrillator together with the monitor, use Ag/AgCl

••

electrodes. Other types of electrodes, stainless steel in particular,

will adversely affect the ECG waveform by slowing the baseline

recovery on the monitor and result in no monitoring immediately

following defibrillation.

••

• False heart rate indicators may occur with certain pacemakers

••

because of electrical overshoots.

••

• Pacemaker patients can only be monitored when the pace program is

••

activated.

••

• Keep pacemaker patients under close observation. The pacemaker

••

rate may be counted during cardiac arrest and certain arrhythmias.

Do not rely only on the monitor.

••

• For arrhythmia monitoring, set ARRHYTHMIA ANALYSIS on the ECG

••

window to ON. Otherwise, there is no sound or indication for

arrhythmia alarms.

CAUTION

••

• Use only Nihon Kohden products and specified parts and

••

accessories. When other type of electrodes are used, the “CHECK

ELECTRODES” message may be displayed and monitoring may stop.

••

• Do not reuse disposable electrodes.

••

• If the contact is bad even before the expiration date printed on the

••

package, replace the electrode with a new one.

••

• When the “CHECK ELECTRODES” message is displayed, ECG is not

••

monitored properly. Check the electrode, electrode leads and

connection cord, and if necessary, replace it with a new one.

••

• When using the monitor with an ESU, locate the monitor and ESU

••

following the description in “Use with an Electrosurgical Unit” in

Section 10 and ground the instruments properly. Otherwise noise

from the ESU may interfere with the ECG and the heart rate and

arrhythmia analysis may be incorrect.

••

• At the start of ECG monitoring, check that the dominant QRS is

••

Operator's Manual BSM-2300A 1.25

1. GENERAL

Respiration Monitoring

appropriate. Otherwise arrhythmia monitoring may be inaccurate.

••

• If there is any doubt about the arrhythmia analysis, make the monitor

••

relearn the patient’s VPC and check that the dominant QRS is

appropriate. Otherwise, arrhythmia monitoring may not be accurate.

••

• Changing the dominant QRS must be performed under the

••

physician’s instructions.

••

• When the alarm is turned OFF for an arrhythmia, there will be no

••

alarm for that arrhythmia type.

••

• Turn the pacing spike detection to On when monitoring a pacemaker

••

patient. Otherwise QRS and pacemaker spike may not be

distinguished and pacemaker failure may not be recognized.