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BSM- 5105A
BSM- 5106A
BSM- 5135A
BSM- 5136A
WS- 510P
QI- 101P
QI- 111P
Life Scope A
BEDSIDE MONITOR
BSM-5100A
0614-007099C
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Model: BSM-5100A
Manual code no.: 0614-007099C
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Page 3
CONTENTS
Contents
GENERAL HANDLING PRECAUTIONS.........................................................................i
WARRANTY POLICY....................................................................................................ii
EMC RELA TED CA UTION............................................................................................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 panel .......................................................................................................vi
On screen .................................................................................................... vii
Others .......................................................................................................... vii
Section 1 General.................................................................................. 1C.1
Introduction ..........................................................................................................................1.2
Features ...............................................................................................................................1.3
Composition .........................................................................................................................1.5
Network Composition ...........................................................................................................1.6
Panel Description .................................................................................................................1.7
Front P anel.................................................................................................................1.7
Left Side Panel...........................................................................................................1.8
BSM-5105/5135 ...............................................................................................1.8
BSM-5106/5136 ...............................................................................................1.8
Right Side Panel.......................................................................................................1.10
Rear Panel ...............................................................................................................1.10
Basic Operating Concepts..................................................................................................1.11
Screen Displays.......................................................................................................1.11
Using T ouch Screen Keys.........................................................................................1.17
Keys on the Front Panel ...........................................................................................1.18
Using Function Dials ................................................................................................1.19
Using MENU Window ...............................................................................................1.19
General Safety Information ................................................................................................ 1.20
General.....................................................................................................................1.20
Installation ...............................................................................................................1.22
Network....................................................................................................................1.22
Battery .....................................................................................................................1.23
12 Lead ECG Interpretation......................................................................................1.24
ECG Monitoring........................................................................................................1.24
Respiration Monitoring.............................................................................................. 1.26
SpO2 Monitoring .......................................................................................................1.26
NIBP Monitoring.......................................................................................................1.28
IBP Monitoring .........................................................................................................1.30
T emperature Monitoring ............................................................................................1.30
CO Monitoring ..........................................................................................................1.31
CO2 Monitoring .........................................................................................................1.31
FiO2 Monitoring ........................................................................................................1.33
Anesthesia Gas Monitoring ......................................................................................1.33
Maintenance ............................................................................................................1.34
Operator's Manual BSM-5100A C.1
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CONTENTS
Section 2 Preparations ......................................................................... 2C.1
Preparation Flowchart ..........................................................................................................2.1
Installation Conditions ..........................................................................................................2.2
Preparing the Optional Recorder...........................................................................................2.4
Installing the Recorder Module ...................................................................................2.4
Loading the Recording Paper......................................................................................2.4
Attaching the Optional Touch Pen.........................................................................................2.6
Connecting an External Instrument to the Monitor................................................................2.7
Connecting the Monitor to a Network....................................................................................2.8
Installing the Optional Network Card or Network Printer Card.....................................2.9
Power .................................................................................................................................2.11
General.....................................................................................................................2.11
Connecting the Pow er Cord and Grounding the Monitor............................................2.11
Connecting the Pow er Cord............................................................................2.11
Grounding the Monitor ....................................................................................2.12
Turning the Pow er On ...............................................................................................2.12
Check Before Turning On the Power...............................................................2.12
Turning the P ower On .....................................................................................2.13
Standby Mode................................................................................................2.13
Check After Turning On the Power and During Monitoring...............................2.13
Turning the P ower Off...............................................................................................2.14
Check After/Before Turning the Power Off......................................................2. 1 4
Po wer and Battery Status Indications ......................................................................2.15
Battery Handling and Operation................................................................................2.16
Safety Information..........................................................................................2.16
Battery Handling Procedures .........................................................................2.16
When Not Using the Monitor or Battery ..........................................................2.16
When the BATTERY WEAK Message Appears ..............................................2.17
Inserting or Replacing the Battery..................................................................2.17
Charging the Battery ......................................................................................2.17
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) ..........................................................................3.6
Bed ID Setting (BED ID SETUP) ...............................................................................3. 8
Parameter and Other Settings (PARAMETER SETUP) ..............................................3.8
NIBP Settings (NIBP SETUP) .................................................................................3.10
Alarm Settings (ALARM SETUP).............................................................................3.11
Unit Settings (UNITS SETUP) .................................................................................3.14
Color Settings (COLOR SETUP) ..............................................................................3.15
Recording Settings (RECORD SETUP)....................................................................3.16
Other Settings (OTHER SETUP)..............................................................................3.17
Alarm Master Settings (ALARM MASTER) ..............................................................3.18
C.2 Operator's Manual BSM-5100A
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CONTENTS
Arrhythmia Recall Master Settings (ARRHYTHMIA RECALL MASTER).................3.20
Network Settings (NETWORK SETUP).................................................................... 3.20
Network Printer Settings (PRINTER SETUP)...........................................................3.22
External Interface Information (EXT I/F SETUP) .....................................................3.24
Initializing the System........................................................................................................3.25
Factory Default Settings.....................................................................................................3.26
SYSTEM SETUP Screen.........................................................................................3.26
ECG Window ............................................................................................................3.26
RESP/CO2 Window...................................................................................................3.27
SpO2 Window............................................................................................................3.27
NIBP Window ........................................................................................................... 3.27
PRESS Window .......................................................................................................3.27
TEMP Window..........................................................................................................3.28
CO Window ..............................................................................................................3.28
GAS Window ............................................................................................................3.28
TREND Window........................................................................................................3.29
ARRHYTH RECALL Window ....................................................................................3.30
FULL DISC Window..................................................................................................3.30
ST Window...............................................................................................................3.30
DATE & TIME Window..............................................................................................3.31
SOUND & BRIGHT Window .....................................................................................3.31
DISPLA Y Window.....................................................................................................3.31
RECORDING Window...............................................................................................3.31
FUNCTION KEY Window .........................................................................................3.31
VITAL ALARM Window .............................................................................................3.32
ARRHYTH ALARM Window......................................................................................3.33
INTERBED Window..................................................................................................3.33
DRUG CALCULA TE Window .....................................................................................3.34
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 Functions to Function Keys .................................................................................4.6
Entering Patient Information .................................................................................................4.8
Displaying the PA TIENT INFO Windo w.......................................................................4.8
Entering the Patient Information .................................................................................4.9
Entering the Patient Name ...............................................................................4.9
Entering the Date of Birth and Age ................................................................4.11
Entering the Height and Weight......................................................................4.12
Entering the Sex ............................................................................................4.12
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
Operator's Manual BSM-5100A C.3
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CONTENTS
Using a Defibrillator ..........................................................................................5.2
Overview ..............................................................................................................................5.3
Monitoring Screen ......................................................................................................5.3
Review Windo ws ........................................................................................................5.3
Sync Sound ...............................................................................................................5.4
Adjusting the Sync and Alarm Sound Volume ............................................................5.4
Changing Settings and Perf orming Other Tasks During Monitoring .............................5.4
Interbed Monitoring.....................................................................................................5.4
Monitoring Screen ................................................................................................................5.5
Settings for the Monitoring Screen .............................................................................5.6
Wav ef orm Sweep Mode and Speed..................................................................5.6
Trendgraph/PWTT trendgraph/OCRG Display on the Monitoring Screen
On or Off..........................................................................................................5.6
Blood Pressure W av ef orm Display Mode..........................................................5.6
Parameter Colors .............................................................................................5.6
Waveform Sensitivity .......................................................................................5.6
Displaying Other Windo ws from the Monitoring Screen ..............................................5.7
Changing Settings for Monitoring Screen .............................................................................5.8
Displaying PWTT Trendgraph .............................................................................................5.10
Displaying OCRG ...............................................................................................................5.11
Freezing W aveforms ...........................................................................................................5.12
Calibrating Wa veforms ........................................................................................................5.13
Using Sleep Mode .............................................................................................................. 5.14
Turning Sleep Mode On ..................................................................................5.14
Turning Sleep Mode Off..................................................................................5.15
Displaying the Large Numeric Window................................................................................5.16
12 Lead ECG Window.........................................................................................................5.18
Displaying the 12 LEAD Window ..............................................................................5.18
Recording ECG W av ef orms on the 12 Lead Window ................................................5.19
Perf orming 12 Lead ECG Interpretation ....................................................................5.21
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 .....................................................................................................6.3
Alarm Master .............................................................................................................6.3
Automatic Recording ..................................................................................................6.3
Alarm Setting .............................................................................................................6.4
Adjusting Alarm Sound Volume ..................................................................................6.4
Standby Mode............................................................................................................6.4
Site Mode and Stage..................................................................................................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 ......................................................................................................6.6
C.4 Operator's Manual BSM-5100A
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CONTENTS
ECG Related Alarms........................................................................................6.6
SpO2 Related Alarms .......................................................................................6.7
NIBP Related Alarms .......................................................................................6.7
IBP Related Alarms .........................................................................................6.7
CO2 Related Alarms .........................................................................................6.7
T emper ature Related Alarms ............................................................................6.8
FiO2 Related Alarms.........................................................................................6.8
CO Related Alarms ..........................................................................................6.8
Gas Related Alarms.........................................................................................6.8
Other Alarms..............................................................................................................6.9
Messages...................................................................................................................6.9
ECG Related Messages...................................................................................6.9
Respiration Related Messages.........................................................................6.9
CO2 Related Messages ....................................................................................6.9
SpO2 Related Messages ..................................................................................6.9
NIBP Related Messages................................................................................6.10
IBP Related Message ....................................................................................6.10
CO Related Messages ...................................................................................6.10
FiO2 Related Messages .................................................................................6.11
Gas Related Messages..................................................................................6.11
Other Messages ............................................................................................6.11
Alarm Indications ...............................................................................................................6.12
Overview ..................................................................................................................6.12
Individual Alarm Indications .....................................................................................6.12
Vital Signs Alarms .........................................................................................6.13
Arrhythmia Alarms .........................................................................................6.14
Parameter Alarms ..........................................................................................6.14
Other Alarms..................................................................................................6.16
Interbed Alarms..............................................................................................6.16
Alarm Control Marks ................................................................................................6.17
Alarm Suspend Mark......................................................................................6.17
Alarm Recording Off Mark..............................................................................6.17
Priority of Alarm Control Marks ......................................................................6.17
Individual Vital Signs Alarm Off Marks...........................................................6.17
Adjusting the Alarm Sound Volume ..........................................................................6.17
Temporarily Silencing/Suspending Alarms..........................................................................6.18
Overview ..................................................................................................................6.18
Silencing Alarms After Alarm Occurrence ................................................................6.18
Silencing an Alarm .........................................................................................6.19
Canceling Alarm Silence ................................................................................6.19
Suspending Alarms ..................................................................................................6.19
Suspending Alarms for Two Minutes ..............................................................6.19
Suspending Alarms Indefinitely......................................................................6.19
Turning Automatic Alarm Recording On/Off........................................................................6.22
Setting Alarms ...................................................................................................................6.24
Overview ..................................................................................................................6.24
Alarm Limits Ranges ................................................................................................6.24
Vital Signs Alarms .........................................................................................6.24
Arrhythmia Alarms .........................................................................................6.26
Operator's Manual BSM-5100A C.5
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CONTENTS
Setting Vital Signs Alarms Individually.....................................................................6.2 6
Setting All Vital Signs Alarms to a Preset Pattern (Alarm Master) ...........................6.27
Setting Arrhythmia Alarms Individually.....................................................................6.28
Setting All Arrhythmia Alarms to a Preset Pattern (Alarm Master) ........................... 6.29
Section 7 Review Windows .................................................................. 7C.1
General.................................................................................................................................7.1
T rend Window .......................................................................................................................7.2
Overview ....................................................................................................................7.2
TREND GRAPH Window ............................................................................................7.2
General ............................................................................................................7.2
Displaying the TREND Window.........................................................................7.3
Changing the Scale ..........................................................................................7.4
Scrolling the Trendgraphs .................................................................................7.4
Selecting Parameters f or the Trendgraph Display .............................................7.4
Recording the Trendgraph .................................................................................7.6
Printing the Trendgraph .....................................................................................7.7
TREND LIST Window .................................................................................................7.7
Overview ..........................................................................................................7.7
Displaying the LIST Window.............................................................................7.8
Selecting Parameters and List Interval for the LIST Windo w............................7.9
Recording the List ..........................................................................................7.10
Printing the List..............................................................................................7.11
Arrhythmia Recall Window ..................................................................................................7.12
General.....................................................................................................................7.12
Arrhythmia List...............................................................................................7.12
Arrhythmia W avefo rm Annotation ...................................................................7.13
Displaying the Arrhythmia Recall Windo w.................................................................7.13
Selecting the Arrhythmia Types to be Saved as a Recall File ..................................7.15
Recording the Arrhythmia Recall W avef orm .............................................................7.16
Printing the Arrhythmia Recall Waveform .................................................................7.16
Full Disclosure Window.......................................................................................................7.18
Displaying the FULL DISC Window ..........................................................................7.19
Selecting the Parameters to be Saved for Full Disclosure .......................................7.2 0
Recording the Full Disclosure W av eform ..................................................................7.22
Recording the Full Disclosure Data ................................................................7.22
Recording the Actual Size ECG W a v ef orm.....................................................7.22
Printing the Full Disclosure Wav efo rm ......................................................................7.2 3
Printing the Compressed Full Disclosure Data ...............................................7.24
Printing the Actual Size ECG Waveform ........................................................7.26
ST Level Recall Window .....................................................................................................7.27
Displaying the ST Window........................................................................................7.27
Changing the Displaying Interval....................................................................7.28
Changing the ST Level Measurement Condition.......................................................7.28
Changing ST Alarm Limits........................................................................................7.29
Printing ST Level Recall...........................................................................................7.30
Alarm History Window ........................................................................................................7.31
Displaying the ALARM HISTORY Window ................................................................7.31
C.6 Operator's Manual BSM-5100A
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CONTENTS
Recording the Alarm History Data ............................................................................7.32
Hemodynamics Window .....................................................................................................7.33
Overview ..................................................................................................................7.33
Displaying the HEMO LIST Window .........................................................................7.33
Explanation of the Hemodynamics List ..........................................................7.34
Recording the Hemodynamics List...........................................................................7.35
Printing the Hemodynamics List ..............................................................................7.35
Section 8 Recording ............................................................................. 8C.1
Overview of Recording .........................................................................................................8.1
Recording Modes .......................................................................................................8.2
Manual Wav eform Recording/Printing...............................................................8.3
Recording/Printing on the 12 LEAD Window.....................................................8.3
Recording/Printing on the Review Windows .....................................................8.3
Recording on the CO Window...........................................................................8.3
Periodic Recording ...........................................................................................8.4
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 Speed ............................................................................................8.8
Changing the Recording Pattern ...........................................................................................8.9
Manually Recording/Printing W aveforms.............................................................................8.10
Recording Wav eforms on the Optional Recorder ......................................................8.10
Recording Wav eforms on the Bedside Monitor with No Recorder .............................8.10
Manual Printing on the Network Printer ....................................................................8.11
Setting Periodic Recording .................................................................................................8.12
Changing Settings for Automatic Periodic Recording ...............................................8.12
Printing on a Network Printer..............................................................................................8.14
Section 9 Drug Window ......................................................................... 9C.1
General.................................................................................................................................9.1
Drug Titration Initial Settings ......................................................................................9.2
Flow Rate Equations ..................................................................................................9.3
Displaying the DRUG CALCULATE Window..........................................................................9.4
Selecting the Drug................................................................................................................9.6
Assigning a Drug Name and Dosage Unit to DRUG A to D...................................................9.7
Changing the Settings ..........................................................................................................9.9
Unit and Setting Range ............................................................................................9.10
Drug Amount, Dosage and Step.....................................................................9.10
Solution Amount, Flow Rate and Weight ........................................................9.11
Operator's Manual BSM-5100A C.7
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CONTENTS
Section 10 Interbed Window................................................................. 10C.1
Registering Interbed Beds ..................................................................................................10.2
Removing an Interbed Bed .............................................................................10.3
Displaying the Interbed Bed Data .......................................................................................10.4
Displaying the Numeric Data of All Interbed Beds..............................................................10.6
Interbed Alarm....................................................................................................................10.7
Setting Interbed Alarm On or Off....................................................................10.7
Section 11 ECG Monitoring.................................................................. 11C.1
General...............................................................................................................................11.1
Preparing for ECG Monitoring.............................................................................................11.3
Preparation Flowchart ..............................................................................................11.3
Number of Electrodes and Measuring Leads............................................................11.3
Electrode Position ....................................................................................................11.3
3 Electrode Leads ..........................................................................................11.3
6 Electrode Leads ..........................................................................................11.4
10 Electrode Leads ........................................................................................11.5
Selecting Electrodes and Lead.................................................................................11.5
Types of Leads and Connection Cords ...........................................................11.6
Connecting Cables and Attaching Disposable Electrodes ........................................11.6
Connecting the Electrode Cable to the Monitor ..............................................11.6
Attaching Disposable Electrodes to the Patient .............................................11.7
Monitoring ECG..................................................................................................................11.8
ECG Information on the Monitoring Screen..............................................................11.9
Measuring ST Level ...............................................................................................11.10
Monitorin g Arrhyt hmia ............................................................................................11.10
Arrhythmia Analysis Classification Messages .............................................11.11
Turning Arrhythmia Analysis On/Off............................................................. 11.11
Learning the ECG Wa vef orm for Arrh ythmia Detection (VPC Learning) ........11.13
Changing the Dominant QRS .......................................................................11.14
Noise Detection and Display ..................................................................................11.16
Detached Electrode Detection and Display ............................................................11.16
Changing ECG Settings ...................................................................................................11.17
Changing the Monitoring Lead ................................................................................ 11.17
Optimum Lead .............................................................................................11.18
Changing a Lead ..........................................................................................11.18
Assigning Va and Vb (Ca and Cb) Leads when Monitoring with 6 Electrodes11.19
Auto Lead Change On or Off........................................................................ 11.20
Changing the ECG Sensitivity................................................................................ 11.21
Changing the Heart Rate or Pulse Rate and ST Alarm Limits ................................11.22
Changing Arrhythmia Alarm Settings......................................................................11.23
Changing the Number of Electrodes.......................................................................11.25
Changing the Sync Source..................................................................................... 11.26
Selecting the Filter Mode .......................................................................................11.27
Selecting the Mode for Updating the Heart Rate ....................................................11.29
Turning Pacing Spik e Detection On/Off ..................................................................11.30
Displaying the P acing Mark on the ECG ................................................................ 11.31
Use with an Electrosurgical Unit.......................................................................................11.33
C.8 Operator's Manual BSM-5100A
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CONTENTS
Section 12 Respiration Monitoring ...................................................... 12C.1
General...............................................................................................................................12.1
Measurement Method...............................................................................................12.1
Impedance Method ........................................................................................12.1
Thermistor Method .........................................................................................12.2
Preparing for Respiration Monitoring in Impedance Method................................................12.3
Preparation Flowchart ..............................................................................................12.3
Electrode Position and Waveform Examples............................................................12.4
Connecting Cables and Attaching Disposable Electrodes ........................................12.6
Preparing for Respiration Monitoring in Thermistor Method ................................................12.7
Preparation Flowchart ..............................................................................................12.7
Respiration Pickups .................................................................................................12.7
Connecting the Cable to the Monitor ........................................................................12.8
Attaching the Respiration Pickup .............................................................................12.8
When Using Respiration Pickup for Airway ....................................................12.8
When Using Respiration Pickup for Nose.......................................................12.8
Monitoring Respiration ........................................................................................................12.9
Respiration Information on the Monitoring Screen ....................................................12.9
Changing Respiration Settings ......................................................................................... 12.11
Turning Respiration Monitoring On or Off in Impedance Method............................. 12.11
Changing the Monitoring Lead in Impedance Method .............................................12.13
Changing the Respiration Sensitivity......................................................................12.13
Changing the Respiration W av ef orm Sweep Speed ................................................ 12.14
Changing the Respiration Rate and Apnea Alarm Limit ..........................................12.15
Section 13 CO2 Monitoring (Mainstream Method) ............................. 13C.1
General...............................................................................................................................13.1
Mainstream Method..................................................................................................13.1
Measurement Error with the TG-900P CO2 Sensor Kit..............................................13.3
CO2 Sensor Kit and Airway Adapter .........................................................................13.4
Preparing for CO2 Monitoring ..............................................................................................13.6
Preparation Flowchart ..............................................................................................13.6
Connecting the CO2 Sensor Kit to the Monitor .........................................................13.6
Connecting the CO2 Adapter to the Respiration Circuit.............................................13.7
Using the TG-900P CO2 Sensor Kit................................................................13.7
Using the TG-950P CO2 Sensor Kit................................................................13.7
Setup Examples ............................................................................................13.9
Performing Zero Calibration .................................................................................... 13.10
Calibrating by Air.......................................................................................... 13.10
Calibrating with N2 Gas.................................................................................13.11
Monitoring CO2.................................................................................................................13.13
CO2 Information on the Monitoring Screen .............................................................13.14
Changing CO2 Settings.....................................................................................................13.15
Changing the CO2 Scale.........................................................................................13.15
Changing the Respiration Rate, Apnea, CO2 and FiCO2 Alarm Limits ....................13.16
Setting the Inspiration Composition........................................................................ 13.17
Changing the CO2 Wav eform Sweep Speed............................................................13.19
Inspection of Measuring Accuracy ...................................................................................13.21
Operator's Manual BSM-5100A C.9
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CONTENTS
Daily Inspection of Measuring Accuracy ................................................................13.21
Inspection of Measuring Accuracy (Precise Method) .............................................13.21
Checking Procedure .....................................................................................13.22
Section 14 SpO2 Monitoring ................................................................. 14C.1
Section 14-1 With Nihon Kohden Probes on BSM-5105A/5135A Monitors.........14-1C.1
General............................................................................................................................ 14-1.1
Preparing for SpO2 Monitoring .........................................................................................14-1.2
Preparation Flowchart ...........................................................................................14-1.2
Selecting a Probe.................................................................................................. 14-1.3
Nihon Kohden Reusable Probes..................................................................14-1.3
Nihon Kohden Disposable Probes ............................................................... 14-1.4
Connecting Cables ................................................................................................14-1.5
Attaching the Probe to the Patient.........................................................................14-1.5
Attaching the TL-201T Finger Probe............................................................14-1.7
Attaching the TL-251T/252T/253T Disposable Probes ................................14-1.7
Attaching the TL-260T Multi-site Y Disposable Probe .................................14-1.9
Monitoring SpO2............................................................................................................14-1.11
SpO2 Information o n the Mo nitori ng Scre en.........................................................14-1.12
Detection and Display of Measurement Condition ............................................... 14-1.13
CHECK PROBE Message (When the Finger Probe is Used) ....................14-1.13
PULSE SEARCH Message .......................................................................14-1.13
M Message ............................................................................................... 14-1.13
Changing SpO2 Settings................................................................................................ 14-1.14
Changing the Pulse W a veform Sensitivity ...........................................................14-1.14
Changing the SpO2 Alarm Limits ......................................................................... 14-1.15
Changing the Sync Source..................................................................................14-1.16
Selecting Sync Sound Pitch ............................................................................... 14-1.18
Changing the Response Mode ............................................................................14-1.19
Section 14-2 With Nellcor Probes on BSM-5106A/5136A Monitors .....................14-2C.1
General............................................................................................................................ 14-2.1
Preparing for SpO2 Monitoring .........................................................................................14-2.2
Preparation Flowchart ...........................................................................................14-2.2
Selecting a Probe.................................................................................................. 14-2.3
Nellcor SpO2 Probes ................................................................................... 14-2.3
Connecting Cables ................................................................................................14-2.4
Attaching the Probe to the Patient.........................................................................14-2.4
Monitoring SpO2..............................................................................................................14-2.7
SpO2 Information o n the Mo nitori ng Scre en...........................................................14-2.8
Detection and Display of Measurement Condition .................................................14-2.9
CHECK PROBE Message (When the Finger Probe is Used) ......................14-2.9
PULSE SEARCH Message .........................................................................14-2.9
M Message .................................................................................................14-2.9
Changing SpO2 Settings................................................................................................ 14-2.10
Changing the Pulse W a veform Sensitivity ...........................................................14-2.10
Changing the SpO2 Alarm Limits ......................................................................... 14-2.11
C.10 Operator's Manual BSM-5100A
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CONTENTS
Changing the Sync Source..................................................................................14-2.12
Selecting Sync Sound Pitch ............................................................................... 14-2.14
Changing the Response Mode ............................................................................14-2.15
Section 15 NIBP Monitoring ................................................................. 15C.1
General...............................................................................................................................15.1
Preparing for NIBP Measurement.......................................................................................15.2
Preparation Flowchart ..............................................................................................15.2
Selecting the Cuff ....................................................................................................15.2
Types of Cuffs ..........................................................................................................15.4
Reusable Cuffs ..............................................................................................15.4
Disposable Cuffs............................................................................................15.6
Disinfecting Disposable Cuffs before Use ......................................................15.7
Connecting Cables and Attaching the Cuff to the P atient.........................................15.7
Connecting Air Hose and Cuff to the Monitor .................................................15.7
Attaching the Cuff to the Patient ....................................................................15.9
Changing NIBP Settings................................................................................................... 15.11
Selecting the Initial Cuff Inflation Pressure ............................................................15.11
Selecting the Measurement Mode and Interval ......................................................15.13
Measurement Modes....................................................................................15.13
Selecting the Measurement Modes for the Mode Selection by the NIBP
INTERVAL Key.............................................................................................15.16
Changing the NIBP Alarm Settings ........................................................................15.18
Changing the PWTT Settings................................................................................. 15.19
Measuring and Monitoring NIBP.......................................................................................15.21
Recommended Patient State..................................................................................15.21
Starting and Stopping NIBP Measurement.............................................................15.22
Manual Mode ............................................................................................... 15.22
STAT Mode...................................................................................................15.22
Auto Mode ................................................................................................... 15.22
NIBP Information on the Monitoring Screen ........................................................... 15.23
Dimming and Hiding the NIBP Data ............................................................. 15.23
Section 16 IBP Monitoring.................................................................... 16C.1
General...............................................................................................................................16.1
Preparing for Blood Pressure Monitoring ............................................................................16.2
Preparation Flowchart ..............................................................................................16.2
Selecting the Blood Pressure Measuring Device......................................................16.2
Blood Pressure Transducers...........................................................................16.3
IBP Connection Cords....................................................................................16.4
JP-940P IBP Connection Box........................................................................16.4
Installing the Blood Pressure Measuring Device ......................................................16.5
Connecting Cables to the Monitor ..................................................................16.5
Assembling the Infusion Circuit .....................................................................16.6
Connecting the Dome to the Infusion Circuit..................................................16.7
Connecting the Blood Pressure Transducer to the Dome................................16.8
Adjusting Zero Balance ............................................................................................16.9
Operator's Manual BSM-5100A C.11
Page 14
CONTENTS
Zero Balance Mode ........................................................................................16.9
Adjusting Zero Balance ..................................................................................16.9
Memorizing the Zero Balance Values ...........................................................16.11
Monitoring IBP ................................................................................................................. 16.12
IBP Information on the Monitoring Screen .............................................................16.12
Changing IBP Settings ..................................................................................................... 16.13
Changing the Label.................................................................................................16.13
List of Labels ............................................................................................... 16.14
Changing the Labels.....................................................................................16.14
Changing the IBP Scale ......................................................................................... 16.16
Changing the IBP Alarm Limits .............................................................................. 16.17
Changing the Sync Source..................................................................................... 16.18
Selecting Sync Sound Pitch .................................................................................. 16.19
Selecting the Mode for Calculating IBP.................................................................. 16.21
Changing the W av ef orm Display Mode ................................................................... 16.22
Selecting the Data Display Mode ...........................................................................16.23
Section 17 Temperature Monitoring.................................................... 17C.1
General...............................................................................................................................17.1
Preparing for Temperature Monitoring .................................................................................17.2
Preparation Flowchart ..............................................................................................17.2
Selecting the Probe.................................................................................................. 17.2
Reusable Probes............................................................................................17.2
Disposable Probes .........................................................................................17.3
Connecting Cables and Attaching the Probe ............................................................17.4
Connecting Cable to the Monitor ....................................................................17.4
Attaching the Probe to the Patient .................................................................17.5
Monitoring T emperature.......................................................................................................17.7
Temperature Information on the Monitoring Screen ..................................................17.7
Changing T emperature Settings ..........................................................................................17.8
Changing the Temperature Display Mode..................................................................17.8
Changing the Temperature Alarm Limits ...................................................................17.9
Changing the Label.................................................................................................17.10
List of Labels ............................................................................................... 17.11
Types of Labels for Blood T emperature Measured Regions .......................... 17.11
Changing the Label ......................................................................................17.11
Section 18 FiO2 Monitoring................................................................... 18C.1
General...............................................................................................................................18.1
Preparing for FiO2 Monitoring .............................................................................................18.2
Preparation Flowchart ..............................................................................................18.2
Connecting the Oxygen Sensor to the Monitor.........................................................18.2
Calibrating the O2 Sensor .........................................................................................18.3
Calibration with Air (Simple method) ..............................................................18.3
Calibration with 100% O2 (Precise Method) ....................................................18.4
Changing the FiO2 Alarm Limits ...............................................................................18. 5
Connecting the Oxygen Sensor to the Inspiration Circuit and Starting Measurement.........18.7
C.12 Operator's Manual BSM-5100A
Page 15
CONTENTS
Principle and Structure of Oxygen Sensor .........................................................................18.9
Structure of Oxygen Sensor.....................................................................................18.9
Life Span of Oxygen Sensor ....................................................................................18.9
Precautions when Using the Oxygen Sensor .........................................................18.10
Section 19 CO Monitoring .................................................................... 19C.1
General...............................................................................................................................19.1
Assembling the Measuring System and Inserting the Catheter into the Patient ................. 19.2
Preparation Flowchart ..............................................................................................19.2
Selecting the Catheter..............................................................................................19.2
Types of Catheter ...........................................................................................19.3
Preparing the Injectate .............................................................................................19.4
Usable Injectate .............................................................................................19.4
Injectate T emperature and Volume..................................................................19.4
Measuring the Injectate Temperature.............................................................. 19.4
Assembling the Measuring System..........................................................................19.7
Connecting Cables to the Monitor ..................................................................19.7
Measuring System Setup Example................................................................19.8
Changing Settings for CO Measurement .......................................................................... 19.10
Setting the Coefficient Value .................................................................................. 19.10
Procedure ....................................................................................................19.10
The Preset Coefficient Value Settings .......................................................... 19.12
Changing the Height and Weight ............................................................................19.14
Changing the Blood Temperature Alarm Limits ....................................................... 19.15
Measuring the Pulmonary Capillary Pressure................................................................... 19.17
Inserting and Retaining the Catheter in the Patient ................................................ 19.17
Insertion Position and Insertion Method .......................................................19.17
Inserting the Catheter into the Patient and Monitoring Blood Pressure.........19.17
Entering the PCWP and Other IBP Values .............................................................19.19
Measuring CO ..................................................................................................................19.21
Before Measurement ..............................................................................................19.21
Measuring CO ........................................................................................................19.21
When Measurements Cannot be Performed Correctly ..................................19.23
Explanation of Hemodynamics Data ............................................................19.24
Deleting Data from the CO Table ............................................................................ 19.25
Recording the Data on the CO MEASURE Window................................................19.25
Adding the Acquired Data to the HEMO LIST Window ........................................... 19.26
CO Value Calculation Equation/Coefficient Value Calculation V alue..................................19.28
Operator's Manual BSM-5100A C.13
Page 16
CONTENTS
Section 20 Gas Monitoring................................................................... 20C.1
General...............................................................................................................................20.1
Overview ..................................................................................................................20.1
Measuring Parameters .............................................................................................20.1
Preparing for Gas Monitoring..............................................................................................20.2
Preparation Flowchart ..............................................................................................20.2
Required Parts .........................................................................................................20.2
Sampling Line ................................................................................................20.3
T-Piece ...........................................................................................................20.3
Dryline (Water trap) ........................................................................................20.4
Exhaust Gas Adapter.....................................................................................20. 4
Connection Cable ...........................................................................................20.4
Guidelines for Selecting Consumables...........................................................20.5
Connecting the Exhaust Outlet to an Anesthetic Machine to Dispose of
Anesthetic Gas ........................................................................................................20.5
Date Label of the Dryline Receptacle .......................................................................20.6
Setting Up the Sampling Line................................................................................... 20.6
Monitoring Gases ...............................................................................................................20.9
Anesthetic Information on the Monitoring Screen................................................... 20.10
Anesthetic Information on the GAS Window........................................................... 20.10
Changing Gas Settings.....................................................................................................20.11
Selecting the Type of Unit on which Gas is Sampled .............................................20.11
Changing the Scale ................................................................................................ 20.12
Changing the Sampling Rate..................................................................................20.14
Changing the Gas Alarm Limits..............................................................................20.15
Performing Zero Calibration .................................................................................... 20.16
Inspection of Measuring Accuracy ...................................................................................20.18
Required Items....................................................................................................... 20.18
Calibration Procedure .............................................................................................20.19
Section 21 Error Messages and Troubleshooting ............................. 21C.1
Monitoring .......................................................................................................................... 21.1
Messages.................................................................................................................21.1
Problems..................................................................................................................21.2
Network ..............................................................................................................................21.3
Messages.................................................................................................................21.3
Problems..................................................................................................................21.3
Recording ...........................................................................................................................21.4
Messages.................................................................................................................21.4
Problems..................................................................................................................21.4
ECG Monitoring..................................................................................................................21.5
Messages.................................................................................................................21.5
Problems..................................................................................................................21.6
Respiration Monitoring ........................................................................................................21.7
Messages.................................................................................................................21.7
Problems in Impedance Method...............................................................................21.7
Problems in Thermistor Method................................................................................21.8
CO2 Monitoring ...................................................................................................................21.9
C.14 Operator's Manual BSM-5100A
Page 17
CONTENTS
Messages.................................................................................................................21.9
Problems..................................................................................................................21.9
When Using TG-900P CO2 Sensor Kit............................................................21.9
When Using TG-950P CO2 Sensor Kit............................................................21.9
SpO2 Monitoring ............................................................................................................... 21.10
Messages...............................................................................................................21.10
Problems................................................................................................................21.11
NIBP Monitoring ............................................................................................................... 21.12
Messages...............................................................................................................21.12
Problems................................................................................................................21.13
IBP Monitoring .................................................................................................................21.14
Messages...............................................................................................................21.14
Problems................................................................................................................21.14
T emperature Monitoring ....................................................................................................21.15
Messages...............................................................................................................21.15
Problems................................................................................................................21.15
FiO2 Monitoring.................................................................................................................21.16
Messages...............................................................................................................21.16
Problems................................................................................................................21.16
CO Monitoring ..................................................................................................................21.17
Messages...............................................................................................................21.17
Problems................................................................................................................21.18
Gas Monitoring .................................................................................................................21.19
Messages...............................................................................................................21.19
Section 22 Maintenance ....................................................................... 22C.1
Calibrating the Touch Screen ..............................................................................................22.2
Cleaning the Touch Screen .................................................................................................22.4
T urning T ouchk ey Function On or Off .............................................................22.4
Cleaning the Touch Screen.............................................................................22.5
Handling Accessories After Use.........................................................................................22.6
Battery Pack ............................................................................................................22.6
Battery Lifetime..............................................................................................22.6
Replacing Battery Pack..................................................................................22.6
Disposal of Battery Pack................................................................................22.6
ECG and Respiration in Impedance Method.............................................................22.6
Electrode Lifetime ..........................................................................................22.6
Disposing of Electrodes .................................................................................22.6
Cleaning and Disinfecting the Electrode Lead and ECG Connection Cord......22.6
Respiration in Thermistor Method.............................................................................22.7
Cleaning and Disinfecting the Respiration Pickup ..........................................22.7
SpO2.........................................................................................................................22.7
Expiration of Probes.......................................................................................22.7
Disposing of Probes.......................................................................................22.8
Cleaning, Disinfecting and Sterilizing the TL-201T Finger Probe ....................22.8
Sterilizing the Disposable Probe .................................................................... 22.9
Cleaning and Disinfecting the SpO2 Connection Cord ..................................22.10
NIBP ......................................................................................................................22.10
Operator's Manual BSM-5100A C.15
Page 18
CONTENTS
NIBP Cuff Lifetime ....................................................................................... 22.10
Cleaning and Disinfecting the YP-950T/951T/952T/953T/954T/955T
/960T/961T/962T/963T/964T/965T Reusable Cuffs...................................... 22.10
Cleaning and Disinfecting the YP-900P/901P/902P/903P/904P/905P
/906P Reusable Cuffs ..................................................................................22.11
Cleaning and Disinfecting the Air Hose and Extension Hose .......................22.11
Disinfecting the Disposable Cuffs ................................................................22.12
Disposal of Disposable Cuffs .......................................................................22.12
IBP.........................................................................................................................22.12
Cleaning, Disinfecting, Sterilizing and Storing the Blood Pressure
Transducer ...................................................................................................22.12
Disposing of Transducer and Dome ..............................................................22.15
Cleaning and Disinfecting the IBP Connection Cord.....................................22.15
Temperature ...........................................................................................................22.15
Cleaning, Disinfecting and Sterilizing the Reusable Probe ........................... 22.15
Disposal of Disposable Probe ......................................................................22.15
Cleaning and Disinfecting the Temperature Connection Cord........................22.15
CO .........................................................................................................................22.16
Cleaning and Disinfecting the Catheter and Measuring System ...................22.16
Cleaning and Disinfecting the CO Connection Cord .....................................22.16
Disposing of Catheter................................................................................... 22.17
CO2........................................................................................................................22.17
Expiration and Replacement of the Airway Adapter .....................................22.17
Disposing of the Airway Adapter .................................................................. 22.17
Replacing the CO2 Sensor and Adapter of the CO2 Sensor Kit.....................22.17
Cleaning and Disinfecting the CO2 Sensor ................................................... 22.18
Cleaning and Disinfecting the CO2 Sensor Cable .........................................22.18
FiO2........................................................................................................................22.19
Lifetime and Replacement of Oxygen Sensor .............................................. 22.19
Cleaning, Disinfecting and Sterilizing the Oxygen Sensor............................22.19
Storing the Oxygen Sensor..........................................................................22.19
Disposal of the Oxygen Sensor ...................................................................22.20
Cleaning, Disinfecting and Sterilizing the T-shaped Adapter.........................22.20
Cleaning and Disinfecting the FiO2 Connection Cord....................................22.20
Gas ........................................................................................................................ 22.21
Handling the Dryline .....................................................................................22.21
Disposing of the Sampling Line and T -Piece ................................................22.22
Replacing the Dryline Receptacle ................................................................22.22
Cleaning and Disinfecting the Monitor .............................................................................. 22.23
Cleaning .......................................................................................................22.23
Disinfecting ..................................................................................................22.23
Cleaning the Optional Recorder ........................................................................................ 22.24
Cleaning the Thermal Head ..........................................................................22.24
Cleaning the Sensors ................................................................................... 22.24
Yearly Inspection .............................................................................................................. 22.25
Clock Accuracy................................................................................................................22.26
Periodical Replacement Schedule .................................................................................... 22.27
Repair Parts Availability Policy......................................................................................... 22.27
C.16 Operator's Manual BSM-5100A
Page 19
CONTENTS
Section 23 Reference............................................................................ 23C.1
Specifications ....................................................................................................................23.1
Display ...........................................................................................................23.1
Sound.............................................................................................................23.1
Alarm .............................................................................................................23.1
ECG...............................................................................................................23.1
Respiration (T r ansthoracic impedance pneumography)...................................23.2
SpO2..............................................................................................................23.3
Non Invasive Blood pressure, NIBP...............................................................23.3
Invasive Blood Pressure, IBP........................................................................23.3
Temperature ...................................................................................................23.4
Cardiac Output, CO........................................................................................23.4
Respiration (Thermistor method) ....................................................................23.4
Inspired Oxygen Fractional Concentration, FiO2.............................................23.5
Expired Carbon Dioxide Tension, CO2.............................................................23.5
Gas (BSM-5135/5136 or when AG-920R multigas unit is connected).............23.6
Trendgraph .....................................................................................................23.7
Vital Signs List...............................................................................................23.7
Full Disclosure ...............................................................................................23.7
Alarm History .................................................................................................23.7
Hemodynamics List .......................................................................................23.7
ECG/BP Output .............................................................................................23.7
Recorder (option)............................................................................................23.8
External Output..............................................................................................23.8
Clock Accuracy..............................................................................................23.8
Pow er Requirement ........................................................................................23.8
Environment...................................................................................................23.8
Dimensions and W eight (approximate) ........................................................... 23.8
Electromagnetic Compatibility........................................................................23.9
Safety Standard .............................................................................................23.9
Input/Output Socket Pin Assignment ...............................................................................23.10
ECG/BP OUT Socket.............................................................................................23.10
AUX Socket ...........................................................................................................23.11
General Requirements for Connecting Medical Electrical System.................................... 23.12
Standard Accessories ......................................................................................................23.14
Options and Consumables ...............................................................................................23.15
Options for the Monitor........................................................................................... 23.15
For ECG and Respiration (Impedance Method) Monitoring.....................................23.16
For Respiration Monitoring (Thermistor method)..................................................... 23.16
For SpO2 Monitoring ............................................................................................... 23.16
For NIBP Monitoring............................................................................................... 23.17
For IBP Measurement ............................................................................................ 23.18
For T emperature Monitoring .................................................................................... 23.20
For CO2 Monitoring (Mainstream Method)...............................................................23.20
For FiO2 Monitoring ................................................................................................ 23.21
For CO Monitoring ..................................................................................................23.21
For Gas Monitoring.................................................................................................23.22
For WS-510P Recorder Module .............................................................................. 23.22
Operator's Manual BSM-5100A C.17
Page 20
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.
(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.
Operator's Manual BSM-5100A i
Page 21
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.
W ARRANTY 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-5100A
Page 22
EMC RELATED CAUTION
This equipment and/or system complies with the International Standard IEC60601-1-2 for electromagnetic
compatibility for medical electrical equipment and/or system. However, an electr omagnetic environment
that exceeds the limits or levels stipulated in the IEC60601-1-2, 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 perf ormance, you must avoid, identify and
resolve the adverse electromagnetic eff ect 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 suc h 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 sour ce. 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.
4. Electromagnetic interference with an y 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 IEC60601-1-2 (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-5100A iii
Page 23
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 radiofrequency electromagnetic fields, PA TIENT COUPLED EQ UIPMENT 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 interf erence 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-5100A
Page 24
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 inf ormation, in the form of recommendations, prerequirements, alternative
methods or supplemental information.
Operator's Manual BSM-5100A v
Page 25
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
Standby Output
“On” only for a part of instrument
“Off” only for a part of instrument
Battery Type CF applied part
Battery charging Data input/output
Record start/stop Input/output terminal
Out of paper Alternating current
Alarm suspend Equipotential terminal
NIBP Remote terminal
Defibrillation-proof type CF applied
part
Defibrillation-proof type BF applied
part
NIBP interval Year of manufacture
NIBP start Serial number
NIBP stop Protective earth
Menu High voltage
Home (monit oring screen) Fuse
Attention, consult operator’s
manual
vi Operator's Manual BSM-5100A
Page 26
On screen
Symbol Description Symbol Description
Alarm suspend with remaining
minutes
Alarm off Respiration sync mark
Alarm rec ording off Value out of range
Recording Current measuring value
Paper magazine ope n Adjust setti ng/ Sc roll data
Out of paper Touch screen calibration mark
Printer (whe n QI-111P network
printer card is used)
Cascaded waveform
QRS/pulse sync mark
Change scale
Network communicating (when QI101P network car d is used)
Others
Symbol Description
Recycle (On ba ttery pack)
Operator's Manual BSM-5100A vii
Page 27
Section 1 General
Introduction .........................................................................................................................1.2
Features ..............................................................................................................................1.3
Composition ........................................................................................................................1.5
Network Composition ..........................................................................................................1.6
Panel Description ................................................................................................................1.7
Front P anel................................................................................................................1.7
Left Side Panel..........................................................................................................1.8
BSM-5105/5135 ..............................................................................................1.8
BSM-5106/5136 ..............................................................................................1.8
Right Side Panel......................................................................................................1.10
Rear Panel ..............................................................................................................1.10
Basic Operating Concepts.................................................................................................1.11
Screen Displays......................................................................................................1.11
Using T ouch Screen Keys........................................................................................1.17
Keys on the Front Panel ..........................................................................................1.18
Using Function Dials ...............................................................................................1.19
Using MENU Window ..............................................................................................1.19
General Safety Information ...............................................................................................1.20
General....................................................................................................................1.20
Installation ..............................................................................................................1.22
Network...................................................................................................................1.22
Battery ....................................................................................................................1.23
12 Lead ECG Interpretation.....................................................................................1.24
ECG Monitoring.......................................................................................................1.24
Respiration Monitoring.............................................................................................1.26
SpO2 Monitoring ......................................................................................................1.26
NIBP Monitoring......................................................................................................1.28
IBP Monitoring ........................................................................................................1.30
T emperature Monitoring ...........................................................................................1.31
CO Monitoring .........................................................................................................1.31
CO2 Monitoring ........................................................................................................1.31
FiO2 Monitoring .......................................................................................................1.33
Anesthesia Gas Monitoring .....................................................................................1.33
Maintenance ...........................................................................................................1.34
Operator's Manual BSM-5100A 1C.1
Page 28
1. GENERAL
Section 1 provides a general overview of the equipment and how to operate it. If
you have not used a BSM-5100A bedside monitor before, read this section first.
• Features
• Components in the system
• Panel descriptions
• Screen displays
• Basic operation concepts
• Important safety information
Operator's Manual BSM-5100A 1.1
Page 29
1. GENERAL
Introduction
The Life Scope A BSM-5105A, BSM-5106A, BSM-5135A and BSM-5136A
hardwired bedside monitors have several connectors for ECG, impedance method
respiration, SpO2, NIBP and temperature monitoring and multi-parameter sockets
for IBP, temperature, thermistor method respiration, CO, CO2 and FiO2 monitoring.
The BSM-5135A/5136A bedside monitor has an integrated multigas unit function
for monitoring anesthetic gas. Its easy operation and compact lightweight design
let you use this bedside monitor in the general ward, ICU, CCU, operating room
and for patient transportation. For portability, it can operate on battery power as
well as A C po wer.
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.
1.2 Operator's Manual BSM-5100A
Page 30
Features
1. GENERAL
• Hardwired system
Monitors ECG, impedance method respiration, SpO2, NIBP and temperature.
With the multi-parameter sockets, IBP, temperature, thermistor method
respiration, CO, CO2 or FiO2 can be monitored. The BSM-5135/5136 bedside
monitor has an integrated multigas unit for monitoring anesthetic gas. An AG920R multigas unit can be connected to the bedside monitor to monitor
anesthetic gas.
The difference between the monitors are:
Model
SpO2 probe
NIBP PWTT
measurement
Integrated
multigas unit
BSM-5105 BSM-5106 BSM-5135 BSM-5136
Nihon Kohden’s Nellcor’s Nihon Kohden’s Nellcor’s
Yes No Yes No
No No Yes Yes
• AC or battery operation
The monitor can operate on AC power or battery for up to 15 minutes.
• Color data display
Detailed information is displayed on the wide angle, 12.1 inch color LCD.
Monitoring parameters are automatically identified.
• Easy operation by 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, and
measuring condition for ST level can be changed. When monitoring with 10
electrodes, 12 leads can be displayed on the screen and 12 lead ECG
interpretation can be performed on these ECG waveforms.
• Review windows for viewing saved data
Saved data can be displayed on the trend graph window, trend list window,
arrhythmia recall window, full disclosure window and ST level recall window.
Hemodynamics list window is available for CO measurement. The alarm history
window is also available for saving numeric data at an alarm occurrence.
• 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 or displaying the
MENU window .
Operator's Manual BSM-5100A 1.3
Page 31
1. GENERAL
• 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-510P recorder module. Up to
three channels can be recorded.
• Central monitor connection (option)
When the optional QI-101P network card is inserted into the bedside monitor,
the bedside monitor can be connected to the central monitor in the network.
Waveforms and data of the bedside monitor can be sent to the central monitor.
An interbed alarm of any patient in the same network can be displayed on the
bedside monitor.
• Wireless LAN system (option)
When the optional QI-510P 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.
• 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, 12 lead ECG interpretation data and
waveforms and numeric data of the monitoring parameters can be printed on a
network printer.
• Anesthesia monitoring (option)
The BSM-5135/5136 bedside monitor has an integrated multigas unit inside the
monitor for anesthetic gas monitoring. Or, the optional AG-920R multigas unit
can be connected to the BSM-5105/5106 monitor. To connect the multigas unit,
the optional YJ-921P connection cable or QI-401P interface is required. For
details, refer to the AG-920RA/RK multigas unit manual.
• Sidestream CO2 monitoring (option)
When the optional AG-400R CO2 unit is connected to the monitor, the CO2 by
sidestream method can be monitored. To connect the CO2 unit, the optional YJ921P connection cable or QI-401P interface is required. For details, refer to the
AG-400RA/RK CO2 unit manual.
• Continuous NIBP monitoring (option)
When the optional AP-400R non-invasive blood pressure unit is connected to
the monitor, continuous NIBP can be measured. To connect the non-invasive
blood pressure unit, the optional YJ-921P connection cable or QI-401P interface
is required. For details, refer to the AP-400RA/RK non-invasive blood pressure
unit manual. The CNIBP data cannot be sent to the central monitor when it is
connected to the central monitor network.
1.4 Operator's Manual BSM-5100A
Page 32
Composition
1. GENERAL
Cart (option), KC-005P
Interface for connecting display and optional unit, QI-401P (option)
Interface for connecting BIS monitor, QI-402P (option)
Interface f or connecting Drager v entilator , QI-403P (option)
Interface for connecting Siemens ventilator Servo300, QI-404P (option)
Life Scope A Bedside Monitor
BSM-5105
BSM-5106
BSM-5135
BSM-5136
Network Card (option) QI-101P
Interface for connecting Oridion Microcap capnograph monitor, QI-405P
(option)
Interface for connecting Puritan Bennett v entilator, QI-406P (option)
Interface for connecting Siemens ventilator Servo i, QI-408P (option)
Interface f or connecting Abbott Laboratories CCO/SvO2 monitor, QI-501P
(option)
Interface for connecting Edw ards Lif esciences CCO/SvO2 monitor, QI-502P
(option)
Holder for attaching the interface, DI-540P (option)
Network Printer Card (option) QI-111P
Recorder Unit (option) WS-510P
Battery Pack (option) NKB-101
Multigas Unit (option) AG-920R CO2 Unit (option) AG-400R
Operator's Manual BSM-5100A 1.5
Wireless LAN Station (option) QI-510P
Non-invasive Blood Pressure Unit (option)
AP-400R
Page 33
1. GENERAL
Network Composition
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
Network group
e.g. ICU
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
Printer
Network group
e.g. CCU
Multiple patient receiver
Transmitter
Transmitter
Transmitter
Bedside monitor
BSM-4100 series
BSM-2300 series
BSM-1100 series
Bedside monitor
BSM-5100 series
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 the y
••
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-5100A
Page 34
Panel Description
1. GENERAL
Front Panel
1
SILENCE
ALARMS
2
3
NIBP
INTERVAL
START/STOP
MENU
HOME
4
5
6
7
8
9
16
10
11
12
13
14
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 SILENCE ALARMS key Silences the alarm sound.
3 Functi on dial 1 and 2
Used for setting alarm limits and scrolling list or trendgraphs. When the
function dial lamp lights, the function dial is available .
4 NIBP INTERVAL key Selects NIBP measurement mode. Pressing this key changes the mode.
5 NIBP START/STOP key
Starts NIBP measurement in selected mode. Pressing the key during
measurement stops measurement.
6 MENU key Displays the MENU window.
7 HOME key Closes all opened windows and displays the monitoring screen.
8Touch screen
Displays m onitoring data. Touching a key or data on the screen change s the
displayed scr e en and se ttings.
9 Speaker For alarm and sync sound.
10 Power switch Press and hold for more than one second to turn the monitor power on or off.
11 Power lamp Lights when the monitor power is turned on.
12 AC power lamp
Lights when the power cord is connected between the AC SOURCE socket
and AC outlet.
13 Battery power lamp Lights when operating on battery power.
15
14 Battery charging lamp Lights or slowly blinks when charging.
15 Record key (option) Press to start or stop recording.
16 Out of paper lamp (option) Blinks when out of paper. Lights whe n the recorder door is open.
Operator's Manual BSM-5100A 1.7
Page 35
1. GENERAL
Left Side Panel
BSM-5105/5135
Multi-parameter sockets
Connects to the connection cord of the parameter to
be monitored (IBP, temperature, CO, CO
respiration by thermistor method). The type of
parameter is automatically recognized.
socket
SpO
2
Connects to the Nihon
Kohden SpO2 connection
cord.
ECG/RESP socket
Connects to the ECG
connection cord.
Dryline receptacle
(on BSM-5135 only)
For attaching the dryline.
Sampling gas exhaust outlet
(on BSM-5135 only)
Connects to an anesthetic
machine to exhaust gas.
ECG/BP OUT socket
Outputs 100 mmHg/V IBP waveform of the IBP connected
to the multi-parameter 1 socket, 1 mV/V ECG waveform
and heart rate trigger by using the YJ-910P or YJ-920P ECG/BP
output cable. These analog signals can be used as the
synchronization signal for other equipment, such as IABP.
Refer to the warning and note on the next page.
, FiO2 or
2
TEMP sockets
Connects to the temperature probe cord.
PC card eject button
PC card slot
For an optional QI-101P network card or
a QI-111P network printer card.
AUX socket
For connecting a display monitor with a
YS-072P5 connection cable, an optional
unit with a YJ-921P connection cable or
QI-400P/500P series interface.
REMOTE socket
Not available.
NIBP socket
Connects to the air hose.
CAUTION
Use only the Nihon Kohden card.
BSM-5106/5136
Multi-parameter sockets
Connects to the connection cord of the parameter to
be monitored (IBP, temperature, CO, CO
respiration by thermistor method). The type of
parameter is automatically recognized.
socket
SpO
2
Connects to the Nellcor
SpO2 connection cord.
ECG/RESP socket
Connects to the ECG
connection cord.
Dryline receptacle
(on BSM-5136 only)
For attaching the dryline.
Sampling gas exhaust outlet
(on BSM-5136 only)
Connects to an anesthetic
machine to exhaust gas.
ECG/BP OUT socket
Outputs 100 mmHg/V IBP waveform of the IBP connected
to the multi-parameter 1 socket, 1 mV/V ECG waveform
and heart rate trigger by using the YJ-910P or YJ-920P ECG/BP
output cable. These analog signals can be used as the
synchronization signal for other equipment, such as IABP.
Refer to the warning and note on the next page.
, FiO2 or
2
NELLCOR
OxiMax
TEMP sockets
Connects to the temperature probe cord.
PC card eject button
PC card slot
For an optional QI-101P network card or
a QI-111P network printer card.
AUX socket
For connecting a display monitor with a
YS-072P5 connection cable, an optional
TM
unit with a YJ-921P connection cable or
QI-400P/500P series interface.
REMOTE socket
Not available.
NIBP socket
Connects to the air hose.
1.8 Operator's Manual BSM-5100A
Page 36
1. GENERAL
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.
••
• Connect the network as specified. Otherwise patient and operator ma y get electrical shock or other injury.
••
For connecting the network, contact y our Nihon K ohden distrib utor.
Using the Output Signal from the ECG/BP OUT Socket
WARNING
When using the output signal from the monitor 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 monitoring screen.
••
••
• 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 (heart rate trigger 64 ms maximum) is within the range of the
••
connected equipment.
••
• Do not use the heart rate trigger as the synchronization signal for defibrillator .
••
NOTE
The output signal from the ECG/BP OUT socket may become unstable in the following conditions.
••
• Electrode is dry or detached.
••
••
• Electrode lead is damaged or disconnected from the electrode.
••
••
• Electrode lead is pulled.
••
••
• AC interference or EMG noise superimposed.
••
••
• Air bubbles or blood clog in the circuit for monitoring IBP.
••
••
• Cord or cable is disconnected or damaged.
••
The Delay Time of the Output Signal
Output Signal Filter Setting Delay Time
ECG
IBP Filter 20 Hz 30 to 35 ms
Heart rate t rigger 32 to 64 ms
Using Multi-parameter Sockets for CO Monitoring
Hum filter OFF 2 ms
Hum filter ON 10 ms
WARNING
When performing defibrillation during CO monitoring, never touch the CO connection cord. Otherwise the
discharged energy may cause serious electrical burn, shock or other injury .
NOTE
CO monitoring using the multi-parameter socket does not comply with the Defibrillator proof type CF.
Operator's Manual BSM-5100A 1.9
Page 37
1. GENERAL
Right Side Panel
For the WS-510P recorder module
Rear Panel
ZS socket
Not available.
Battery pack holder
Fuse holder
AC SOURCE power
cord socket
For the AC power cord.
Equipotential grounding terminal
For an equipotential grounding lead.
1.10 Operator's Manual BSM-5100A
Refer to "Connecting the Power
Cord and Grounding the Monitor"
in Section 2.
Page 38
1. GENERAL
Basic Operating Concepts
Screen Displays Following are the screens and windows available on the Life Scope A bedside
monitor. 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.
Monitoring screen
HOME
• 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 changing patient information.
• Touching the parameter data displays the parameter
setting window.
MENU window
MENU
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.
Operator's Manual BSM-5100A 1.11
Page 39
1. GENERAL
Other windows for monitoring
ENLARGED window
for displaying numeric
data
12 LEAD window for
displaying
simultaneous 12 lead
ECG. 12 lead ECG
interpretation can be
performed.
SLEEP MODE
window for turning
sleep mode on
Review windows
TREND window for
displaying 36 hour
trendgraphs of up to 4
selected parameters
1.12 Operator's Manual BSM-5100A
Page 40
1. GENERAL
LIST window for
displaying list of
parameter data.
ARRHYTH RECALL
window for displaying
arrhythmia recall file
data.
FULL DISC window for
displaying full
disclosure. Up to 5
parameters can be
saved.
ST window for
displaying ST level
recall waveforms. ST
measurement condition
can be changed.
Operator's Manual BSM-5100A 1.13
Page 41
1. GENERAL
ALARM HISTOR Y
window for displaying
vital sign data at alarm
occurrence
HEMO LIST window
for displaying
hemodynamics data
when CO is measured
Patient information window
Alarm setting window
P ATIENT INFO window
for entering patient
name and other
information. Data can
be deleted on this
window.
VIT AL ALARM
window for setting vital
signs alarm and
ARRHYTH ALARM
window for setting
arrhythmia alarms.
1.14 Operator's Manual BSM-5100A
Page 42
Parameter setting windows
For changing parameter monitoring settings.
Interbed window
For displaying interbed beds when the monitor is connected to a network.
1. GENERAL
ECG window
Drug calculation window
Operator's Manual BSM-5100A 1.15
Page 43
1. GENERAL
Setup and other windows
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 display settings for the monitoring screen
RECORDING window for changing recording setting
FUNCTION window for assigning a function to a function key
TOUCHKEY OFF window for turning touch screen function off
SYSTEM SETUP screen
SILENCE
ALARMS
For changing system settings.
Displaying the SYSTEM SETUP
screen interrupts monitoring.
1.16 Operator's Manual BSM-5100A
Page 44
1. GENERAL
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.
Touching the key on the screen displays the window.
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
Cursor
Touch the desired position on the screen to
move the cursor
Scroll bar and buttons for scrolling data
Scroll buttons
Operator's Manual BSM-5100A 1.17
Page 45
1. GENERAL
The time width of the trendgraph on the monitoring screen can be adjusted by touching the right edge of the trendgraph and
moving it left or right.
Keys on the Front Panel
Turns the monitor
power on or off
Starts and stops recording (option)
SILENCE
ALARMS
NIBP
INTERVAL
START/STOP
MENU
HOME
Silences alarm sound
Function dials
Selects NIBP measurement mode
Starts and stops NIBP measurement
Displays the MENU window
Displays the monitoring screen
1.18 Operator's Manual BSM-5100A
Page 46
1. GENERAL
Using Function Dials
When the function dial lamp is lit, the function dial can be used for changing
setting and scrolling data.
When lit, function dial is available
Using MENU 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
MENU
Section 7
Section 4
Section 5
monitoring screen.
For details on each window, refer to the section specified below.
Section 20
Section 16
Section 11
Section 12 and 13
Section 14
Refer to the manual of
the connected unit
Section 15
Section 19
Section 18
Section 17
Section 9
Section 10
Section 6
Operator's Manual BSM-5100A 1.19
Section 4
Section 5
Section 8
Section 4
Section 6
Section 22
Page 47
1. GENERAL
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 electr odes are attached. Ref er to the
instruction manual for the ESU.
••
• 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 .
••
• T o a void 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.
••
• When performing MRI tests, remove the electrodes and transducers
••
from the patient. The heat generated from the induced
electromagnetic field may b urn the patient’s skin. For details, ref er to
the instruction manual for the MRI.
••
• When using the output signal from the monitor 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
· Check the condition of the bedside monitor at all times. The output
· Check that the delay time of the output signal (heart rate trigger 64
· Do not use the heart rate trigger as the synchronization signal for
••
• When performing defibrillation during CO monitoring, never touch the
••
CO connection cord. Otherwise the discharged energy may cause
serious electrical burn, shoc k or other injury.
••
• When performing defibrillation during CO2 monitoring with the CO
••
sensor kit, remove the sensor fr om the patient. When the sensor
WARNING
the monitoring screen.
signal may become unstable.
ms maximum) is within the range of the connected equipment.
defibrillator.
2
1.20 Operator's Manual BSM-5100A
Page 48
1. GENERAL
cannot be removed, do not touch the sensor cable because the
discharged energy may cause serious electrical burn, shock or other
injury.
••
• During alarm suspension (“ALARMS SUSPENDED” message
••
displayed), all current alarms are temporarily turned off.
••
• When EXIT SLEEP MODE ON ALARM is set NO, the bedside monitor
••
alarm cannot be seen or heard on the bedside monitor during sleep
mode. Monitor the bedside monitor alarm on the central monitor or
telemetry system. Otherwise, the bedside monitor alarm may be
overlooked.
••
• When admitting a new patient, chec k 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 DATA 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.
••
••
• T urn off the po wer 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 “CONNECT OR OFF” messa ge appears on the screen, check
••
that the connection cords are connected to the sockets properl y.
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.
Operator's Manual BSM-5100A 1.21
Page 49
1. GENERAL
Installation
WARNING
••
• For patient safety , equipotential grounding of all instruments must be
••
performed. Consult with a qualified biomedical engineer.
••
• 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 .
••
• Only use the provided power cord. Using other power cords may
••
result in electrical shock or other injury to the patient and operator .
CAUTION
••
• Before connecting instruments, make sure that the power is turned off.
••
••
• Use only the KC-005P cart for the BSM-5100 series bedside monitor. If
••
another cart is used, it may tip over or the monitor may fall off.
••
• When not using the KC-005P cart, make sure that the monitor is placed
••
and fastened so that it does not tip over .
••
• Disconnect the power cord from the A C socket bef ore connecting the
••
instruments.
••
• 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 properl y.
••
• After the power on, chec k that one “bong” sounds and the red and
••
orange alarm lamps blink once to show that the alarm functions
properly.
Network
Also read the warning and caution in “Selecting a Suitable Location” in Section 2.
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 distrib utor.
••
• Install the printer and hubs outside the patient environment. If the y
••
are installed inside the patient environment, the patient or operator
may receive electrical shock.
••
• 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. For details, refer to the Network and System Installation
Guide.
1.22 Operator's Manual BSM-5100A
Page 50
1. GENERAL
CAUTION
••
• The network must be managed by the netw ork administrator. Make
••
sure that each monitor in the network has a different IP address.
Otherwise, data communication cannot be performed pr operl y. 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/network printer 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.
••
••
• Keep the battery pack away from children.
••
••
• Never short-circuit the + and – terminals on the battery pack.
••
••
• Never disassemble the battery pack.
••
••
• Do not use the battery which is damaged, such as from falling.
••
••
• If the battery pack is damaged and substance inside the battery
••
(potassium hydroxide) contacts the skin or clothes, wash immediately
and thoroughly with water.
CAUTION
••
• Do not subject the battery pack to a strong mechanical shock.
••
••
• Use the battery pack between 10°C (50°F) and 40°C (104°F).
••
Temperatures out of this range affect the w orking of the battery.
••
• Do not use a battery which is over the expiration date written on the
••
label.
••
• 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 recyclable. 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.
Operator's Manual BSM-5100A 1.23
Page 51
1. GENERAL
12 Lead ECG Interpretation
CAUTION
••
• The 12 lead ECG interpretation is performed for acquired ECG
••
waveforms only and does not reflect all conditions of the patient. The
results of the analysis may not correspond to the judgement of a
physician.
••
• Overall judgement must be performed by the physician, referring to
••
the analysis result, clinical findings and other examination results.
After the physician’ s o verall judgement, the analysis results should be
signed or initialed by the physician.
••
• When the patient sex is not specified, the analysis is performed with
••
the patient as male.
••
• When the patient’s date of birth or age is not entered, the anal ysis is
••
performed with the patient as 35 years old.
ECG Monitoring
WARNING
Interaction Between Minute V entilation Rate-Adaptive P acemakers 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 man ual. For more details, contact y our pacemaker
distributor or Nihon Kohden distrib utor.
* 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
1.24 Operator's Manual BSM-5100A
Page 52
1. GENERAL
WARNING
••
• When using a defibrillator together with the monitor, use Ag/AgCl
••
electrodes. Other types of electr odes, 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.
••
••
• When the “CHECK ELECTR ODE” message is displayed, ECG is not
••
monitored properly. Check the electr ode 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 11 and ground the instruments properl y. 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
••
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.
••
• T urn 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.
••
• QRS of a waveform which has been expanded after being compressed
••
may be distorted. When reading the expanded ECG waveforms, be
aware of this distortion.
••
• When the alarm is turned OFF for an arrhythmia, there will be no
••
alarm for that arrhythmia type.
Operator's Manual BSM-5100A 1.25
Page 53
1. GENERAL
Respiration Monitoring
WARNING
Interaction Between Minute V entilation Rate-Adaptive P acemakers 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 man ual. For more details, contact y our pacemaker
distributor or Nihon Kohden distrib utor.
* 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.
SpO2 Monitoring
For more information, see the FDA web site.
http://www.fda.gov/cdrh/safety.html
WARNING
••
• Measurement may be incorrect in the following cases.
••
· When the patient’s carbo xyhemoglobin or methemoglobin increases
abnormally.
· When dye is injected in the blood.
· When using an electrical surgery unit.
· During CPR.
· When there is body movement.
· When there is vibration.
· When measuring at a site with venous pulse.
· When the pulse wave is small (insufficient peripheral circulation).
· When using an IABP (intra-aortic balloon pump).
••
• Check the circulation condition by observing the skin color of the
••
measuring site and pulse waveform. Change the measuring site every
8 hours for disposable probes and every 4 hours for reusable probes.
The skin temperature may increase at the attached site by 2 or 3°C (4
or 5°F) and cause a burn or pressure necrosis. When using the probe
on the following patients, take extreme care and change the
measurement site more frequently according to symptoms and
degree.
1.26 Operator's Manual BSM-5100A
Page 54
1. GENERAL
• A patient with a fever
• A patient with peripheral circulation insufficiency
• Neonate or low birth weight infant with delicate skin
••
• T o a void poor circulation, do not wrap the tape too tight. Chec k the
••
blood circulation condition by observing the skin color and
congestion at the skin peripheral to the probe attachment site. Even
for short-term monitoring, there may be burn or pressure necrosis
from poor blood circulation, especially on neonates or low birth
weight infants whose skin is delicate. Accurate measurement cannot
be performed on a site with poor peripheral circulation.
••
• When not monitoring SpO2, disconnect the SpO2 connection cord from
••
the bedside monitor. Otherwise, noise may interfere from the pr obe
sensor and displays incorrect data on the screen.
••
• Do not use the probe during MRI examination because it may cause
••
skinburn on the probe attachment area. For details, follow the MRI
operator’s man ual.
CAUTION
••
• When using Nellcor probes, read the instructions provided with the
••
probe. (BSM-5106/5136 only)
••
• When using Nellcor probes, do not touch the SpO2 socket pins on the
••
monitor with your finger when connecting or disconnecting the
connection cord from the monitor. The monitor may malfunction or
get damaged. (BSM-5106/5136 only)
••
• On the BSM-5106/5136 monitors, when a large amount of static
••
electricity (more than 3 kV) is applied to the SpO2 socket, monitoring
may be interrupted. Be careful when connecting or disconnecting a
cable to the SpO2 socket.
••
• T urn off the po wer 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.
••
• Only use the specified probes. Otherwise SpO2 cannot be monitored
••
properly.
••
• Do not use a damaged or disassembled probe. It causes incorrect
••
measurement and may hurt the patient.
••
• Do not use the probe over its stated lifetime. Otherwise the SpO
••
measurement accuracy cannot be guaranteed.
••
• If the skin gets irritated or redness appears on the skin from the
••
probe, change the attachment site or stop using the probe.
••
• Do not attach the probe to the same limb that is used for NIBP
••
measurement or an IBP catheter.
••
• Normally external light does not affect monitoring, ho wever, intense
••
light such as an operating lamp or sunlight may affect monitoring. If
affected, cover the measuring site with a blanket.
••
• When attached, make sure that the light emitter and the photo detector
••
2
Operator's Manual BSM-5100A 1.27
Page 55
1. GENERAL
of the probe face each other . Otherwise, SpO2 cannot be measured
properly.
••
• Do not reuse the disposable probes for another patient because it
••
causes cross infection.
••
• Disposable probes are not sterilized. To sterilize the probe, ref er to
••
the “Sterilizing the Disposable Probe” in Section 22. (Nihon Kohden
probes only)
••
• When the probe is attached on an appropriate site with sufficient
••
circulation and the error message confirming the probe attachment
repeatedly appears, the probe may be deteriorated. Replace it with a
new one.
••
• When the probe or SpO2 connection cord failure message appears on
••
the screen, replace it with a new one. Otherwise SpO2 data may not be
accurate.
••
• If the attachment site is dirty with blood, clean the attachment site
••
before attaching the probe. If there is nail polish on the attachment
site, remove the polish. Otherwise, the amount of transmitted light
decreases, and measured value may be incorrect or measurement
cannot be performed.
••
• T o minimize bod y mo vement f or stable SpO2 monitoring, fasten the
••
cable with the provided adhesive tape.
••
• Do not pull or bend the probe cable, and do not run over the probe
••
cable with caster feet. Do not immerse the probe cable in detergents
or water. Failure to follow these cautions ma y cause cable
discontinuity , short circuit, skin burn on the patient and incorrect
measurement data. Replace a broken probe with a new one.
••
• Be careful when removing the probe or foam tape from neonatal skin.
••
••
• When removing a probe that is taped to the skin, do not pull the cable
••
part of the probe because this can damage the probe’ s cable
connection.
••
• While a patient is on medication which causes vasodilation, the pulse
••
waveform may change and in rare cases the SpO2 value may not be
displayed.
••
• Refer to the probe instruction manual for details.
••
NIBP Monitoring
WARNING
••
• NIBP measurement on a sickle cell anemia patient may cause a
••
thrombus.
••
• When attaching the cuff to a premature infant at an early stage after
••
birth, periodically change the cuff position to avoid possible skin
erosion and fissure.
••
• While performing continuous measurements many times without a
••
pause, periodically check the blood vessels and limb for adequate
circulation.
1.28 Operator's Manual BSM-5100A
Page 56
1. GENERAL
••
• When performing long term measurements at intervals less than 2.5
••
minutes, periodically check the state of the patient, blood vessels and
limb for adequate circulation.
CAUTION
••
• Only use the specified cuff. Otherwise NIBP monitoring cannot be
••
performed properly or the monitor may be damaged.
••
• Select the cuff which fits each patient. If the cuff size is not correct,
••
measurement may not be completed or the result may be erroneous
due to the different deflation speed of the cuff.
••
• The YP-950T/951T/952T/953T/954T/955T reusable cuffs contain natural
••
rubber latex which may cause allergic reactions.
••
• Do not reuse the disposable cuff.
••
••
• Disposable cuffs are not sterilized. If necessary, sterilize the cuff
••
using glutaraldehyde solution.
••
• The non-sterilized disposable cuffs for neonates cannot be sterilized.
••
If necessary , use the sterilized disposable cuffs for neonates.
••
• Never sterilize the disposable cuff for neonates.
••
••
• Do not wrap the cuff on an arm or thigh which is used for injection.
••
NIBP measurement on an arm or thigh which is used for injection may
cause reflux of blood and stop injection.
••
• Confirm that the air hoses are firmly connected between the sockets
••
and hoses of the cuff. If not connected properly (the air hose
connector clicks when properly inserted into the socket), the cuff
cannot be correctly identified and air leakage will cause incorrect
NIBP data or no data.
••
• If the hose is folded or squeezed, it will cause incorrect NIBP data due
••
to the air pressure noise.
••
• When too much pressure is applied to the cuff, or the hose is folded,
••
the “NIBP SAFETY CIRCUIT R UNNING” message appears on the
screen and NIBP monitoring may be stopped. Remove the cause, wait
for 40 seconds, check that the message disappears, then measure
again.
••
• Do not rely only on the PWTT* to monitor blood pressure changes.
••
When it is necessary to monitor critical blood pressure change, set
the appropriate interval for NIBP measurement.
••
• When the delta PWTT* threshold is too short for a patient, NIBP
••
measurement may be performed too frequently. If this occurs, change
the delta PWTT* threshold to a longer time.
••
• The PWTT* may be incorrect when there is too much arrhythmia or
••
noise.
••
• In the following cases, PWTT* may trigger too many or no NIBP
••
measurements. Check the patient condition. If necessary, change the
delta PWTT* threshold or set the PWTT* to Off.
• Rapid blood pressure change with vasoreflex due to vasoactive
drugs, such as phenylephrine and nicardipine.
Operator's Manual BSM-5100A 1.29
Page 57
1. GENERAL
IBP Monitoring
• Unstable pulse wave due to poor peripheral circulation.
• T oo many arrh ythmias.
• Patient movement.
• Noise on ECG due to ESU.
• SpO2 measurement on foot of a child.
••
• Do not measure NIBP with PWTT* on a neonate because circulation of
••
a neonate changes rapidly .
* PWTT is only available on the BSM-5105/5135 monitors.
WARNING
••
• All parts, except for transducers, must be non conductive. Otherwise,
••
the discharged energy may cause electrical shock to the operator
during defibrillation.
••
• Do not use an expired saline pack.
••
••
• Do not use a blood pressure monitoring kit from a torn package.
••
••
• Vent out any air inside the saline pack by squeezing the saline pack.
••
Otherwise, the air will cause an error in the blood pressure data and
can enter the patient’s b lood vessel.
CAUTION
••
• T urn off the po wer of cell telephones and small wireless de vices, or
••
other devices which produce strong electromagnetic interference.
Otherwise, the waveforms and measurements are affected by such
interference and the displayed data may be incorrect.
••
• Check that there are no scratches on the catheter balloon before use.
••
••
• Do not reuse disposable parts and accessories.
••
••
• Do not leave bubbles in the flushed dome and extension tube because
••
they will distort the blood pressure waveform.
••
• Carefully flush the tube joints because bubbles tend to remain in the
••
joints.
••
• Do not pressurize the pressure bag until bubbles are removed from
••
both the dome and the extension tubes.
1.30 Operator's Manual BSM-5100A
Page 58
T emperature Monitoring
CO Monitoring
1. GENERAL
CAUTION
••
• Select the appropriate probe for the patient. Using adult probes on
••
premature infants and children may injure the mucous membrane.
••
• Do not reuse disposable probes on other patients.
••
••
• The insulation pad may irritate the skin. In long term monitoring,
••
change the attachment site.
WARNING
When performing defibrillation during CO monitoring, never touch the
CO connection cord. Otherwise the discharged energy may cause
serious electrical burn, shoc k or other injury.
CO2 Monitoring
CAUTION
••
• Check that there are no scratches on the catheter balloon before use.
••
••
• Do not reuse disposable products.
••
••
• Insert or extract the catheter from the pulmonary artery as quickly as
••
possible. If it takes a long time (about longer than 10 seconds),
pulmonary infarction, pulmonary hemorrhage or pulmonary artery
perforation may occur .
••
• Insert or extract the catheter by referring to the blood pressure
••
waveform on the monitor, X-ray unit images, and other equipment. Do
not depend on the insertion or extraction messages displayed on the
monitor.
••
• Do not measure the cardiac output repeatedly at short intervals.
••
Frequently injecting the injectate affects the measuring accuracy.
WARNING
••
• Do not use the airway adapter on neonates because the dead space
••
volume of the airway adapter is about 5 cc.
••
• When using the airway adapter on children or patients with low
••
ventilatory amount, the CO2 may mix in the inspiration due to the
airway adapter’ s dead space v olume (5 cc), resulting in inaccurate
measured values or difficulty in detecting apnea.
••
• Before MRI examination, remove the CO2 sensor kit from the patient.
••
Failure to follow this warning may cause serious electrical burn on
Operator's Manual BSM-5100A 1.31
Page 59
1. GENERAL
the patient due to local heating caused by dielectric electromotive
force. For details, refer to the MRI operator’s manual.
••
• With the TG-900P CO2 sensor kit, this monitor cannot monitor CO2 of
••
patients younger than 3 years old or weighing less than 10 kg (22 lbs).
••
• With the TG-950P CO2 sensor kit, select the airway adapter taking the
••
patient ventilation volume into consideration. If an inappropriate
airway adapter is used, the resistance in the respiration circuit
increases or the measurement value is incorrect.
CAUTION
••
• When monitoring CO2 of a patient under anesthesia, make sure that
••
the gas composition is entered. Otherwise the measurement result
may be inaccurate.
••
• When using an anesthetic instrument with volatile anesthetic agent,
••
the CO2 measurement may become inaccurate.
••
• With the TG-900P CO2 sensor kit, measurements are based on the
••
assumption of no CO2 gas in the inspiration. The CO2 concentration in
the respiration is calculated by taking the CO2 concentration in the
inspiration as 0 mmHg. Therefore, measuring CO2 by connecting the
CO2 sensor kit to a Jackson Rees circuit or Mapleson D circuit where
CO2 gas may be present during inspiration may result in the acquired
data being lower than the actual value.
••
• With the TG-950P CO2 sensor kit, measured value ma y be incorrect
••
when the operating temperature changes greatly. In this case, wait for
about 30 minutes to acquire stable measurement.
••
• The CO2 data may not be accurate when monitoring a patient with an
••
extremely high respiration rate or irregular respiration.
••
• T urn off the po wer 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.
••
• The measurement may be inaccurate when electromagnetic noise
••
from another instrument interferes with the CO2 waveform.
••
• We recommend using another method or using a shielded room for
••
monitoring CO2 when respiration monitoring is important.
••
• The airway adapter is non-sterilized and disposable. Use only for
••
single patient and single use. Failure to follow this instruction causes
cross infection.
••
• Do not sterilize the airway adapter more than once. The safety cannot
••
be guaranteed.
••
• Use the Nihon Kohden specified airway adapter.
••
••
• Secure the CO2 sensor cable to the respiration circuit so that it is
••
parallel to the floor. If the cable is perpendicular to the floor, water
droplets may get onto the transparent film of the airway adapter, and
affect the measurement accuracy .
••
• When the “CHANGE ADAPTER” or “CHECK SENSOR” message is
••
displayed, check the CO2 sensor kit and replace with a new one when
1.32 Operator's Manual BSM-5100A
Page 60
1. GENERAL
necessary . CO2 cannot be monitored while the message is displayed.
••
• The transparent film of the airway adapter is coated with the anti-
••
fogging material to prevent the moisture of the expiration and
inspiration from making the inside of the airway adapter fogg y. Under
the operating environment specified in the specifications, the antifogging material works for about 24 hours. For the optimum
performance of the anti-fogging material and correct measurement,
follow the instructions below .
• Do not use the airway adapter more than 24 hours.
• Replace the airway adapter if blood, sputum or mucus adheres to
the transparent film of the airway adapter .
• Do not damage the transparent film, and do not let dust or chemical
solutions contact the transparent film. Do not touch the transparent
film with your fingers, do not wipe it, and do not wash it with
alcohol or other detergents.
••
• Replace the airway adapter with a new one every 24 hours. Using the
••
airway adapter for longer than 24 hours affects measurement accuracy.
••
• Obey the CAUTION label on the CO2 gas cylinder .
••
••
• After the lifetime of the CO2 gas cylinder expires, the measurement
••
accuracy cannot be guaranteed.
FiO2 Monitoring
Anesthesia Gas Monitoring
CAUTION
The oxygen sensor must be stored with the detector facing down
because the detector gets dried and FiO2 monitoring cannot be
performed properly. If the detector is dry , the oxygen sensor must be
left with the detector facing down for 1 or 2 minutes or, when the filter is
completely dry, more than 12 hours.
WARNING
••
• Nitrous oxide (N2O) used as an anesthetic gas is not flammable at
••
room temperature, but it may pyrolyze and cause fire at high
temperature. Therefore, do not use it at high temperature.
••
• The sampling line and T-piece are non-sterilized and disposable. They
••
can only be used once on a single patient. Do not reuse them for
another patient. Failure to follow this warning causes infection for
another patient.
••
• Handle the contents of the dryline as you would handle any bodily
••
fluid. Failure to follow this warning causes infection.
Operator's Manual BSM-5100A 1.33
Page 61
1. GENERAL
CAUTION
••
• Only use the specified parts. Otherwise, the measurement accuracy
••
cannot be guaranteed.
••
• Discharge the gas from the sampling gas exhaust outlet of the monitor
••
to the scavenging system of the anesthetic machine. Discharging the
gas into the atmosphere releases anesthetic gas into the room.
••
• Do not bend or squeeze the exhaust gas adapter tube. The monitor
••
may be damaged.
••
• The gas is sampled at a fixed rate (selected from 70 to 200 mL/min)
••
from the patient’ s respiration cir cuit. Do not monitor gas on a patient
from whom gas cannot be acquired at the selected sampling rate.
••
• Use the dryline and sampling line of the appropriate type (e.g. connect
••
dryline for adult to the sampling line for adult). Otherwise gas may be
aspirated at more than the selected sampling rate.
••
• Connect the T-piece to the respiration circuit properly. Otherwise, gas
••
cannot be monitored properly.
••
• Connect the T-piece to the respiration circuit so that the sampling port
••
of the T-piece is upward. If the sampling port is do wnward, water
droplets in the respiration circuit may flow into the sampling line and
clog it so measurement cannot be continued.
••
• Do not directly connect an aspirator to the sampling gas exhaust
••
outlet on the monitor. Otherwise gas may be aspirated at more than
the selected sampling rate.
••
• Before intratracheal aspiration or spraying chemicals, remove the
••
sampling line from the respiration circuit. Otherwise, the sampling
line may be clogged and monitoring cannot be continued.
••
• When ethanol or methane is present in the respiration circuit, the
••
measurement result may be inaccurate.
••
• When the monitoring value is not appropriate, always perform gas
••
calibration. Always perform gas calibration once a year for stable
measuring accuracy .
••
• Obey the CAUTION label on the gas c ylinder.
••
Maintenance
CAUTION
••
• Do not disassemble the monitor . Disassembly must be performed by
••
a qualified service personnel.
••
• Fuses must be replaced by a qualified service personnel.
••
••
• Do not use volatile liquids such as thinner or benzine, because these
••
will cause the materials to melt or crack.
••
• Before cleaning the monitor, turn the monitor power off and
••
disconnect the power cord from the A C SOURCE po wer cord soc ket
on the rear panel. Otherwise the operator may receive electrical shock
or the monitor may malfunction.
1.34 Operator's Manual BSM-5100A
Page 62
1. GENERAL
••
• After cleaning, make sure that the monitor is completely dried.
••
••
• Wipe the monitor thoroughly after disinfecting it with spra y.
••
••
• The bedside monitor is not waterproof. Be careful not to let any water
••
get inside the monitor.
••
• Never sterilize the monitor because the materials may deform, crack or
••
discolor.
Operator's Manual BSM-5100A 1.35
Page 63
Section 2 Preparations
Preparation Flowchart .........................................................................................................2.1
Installation Conditions .........................................................................................................2.2
Preparing the Optional Recorder..........................................................................................2.4
Installing the Recorder Module ..................................................................................2.4
Loading the Recording Paper.....................................................................................2.4
Attaching the Optional Touch Pen........................................................................................2.6
Connecting an External Instrument to the Monitor...............................................................2.7
Connecting the Monitor to a Network...................................................................................2.8
Installing the Optional Network Card or Network Printer Card....................................2.9
Power ................................................................................................................................2.11
General....................................................................................................................2.11
Connecting the Pow er Cord and Grounding the Monitor...........................................2.11
Connecting the Pow er Cord...........................................................................2.11
Grounding the Monitor ...................................................................................2.12
Turning the P ower On ..............................................................................................2.12
Check Before Turning On the Power..............................................................2.12
Turning the P ower On ....................................................................................2.13
Standby Mode...............................................................................................2.13
Check After Turning On the Power and During Monitoring..............................2.13
Turning the P ower Off..............................................................................................2.14
Check After/Before Turning the Power Off.....................................................2.14
Po wer and Battery Status Indications .....................................................................2.15
Battery Handling and Operation...............................................................................2.16
Safety Information.........................................................................................2.16
Battery Handling Procedures ........................................................................2.16
When Not Using the Monitor or Battery .........................................................2.16
When the BATTERY WEAK Message Appears .............................................2.17
Inserting or Replacing the Battery.................................................................2.17
Charging the Battery .....................................................................................2.17
Operator's Manual BSM-5100A 2C.1
Page 64
Preparation Flowchart
You may not need to do all these.
1. Install the monitor and do the procedures in Section 2.
2. Check or change any initial settings on the SYSTEM SETUP screen. These
3. Check or change the necessary settings before monitoring in Section 4.
4. Enter the information of the new patient. Refer to “Entering Patient
2. PREPARATIONS
items usually do not need to be changed. Refer to Section 3.
• Date and time
• Sound volume
• Screen brightness
• Assign function to the function keys
Information” in Section 4.
5. Check or change all alarm items for the patient. Alarm settings return to the
default settings 30 minutes after the monitor is turned off. Refer to Section 6.
6. Check or change settings for the trend graphs, list and arrhythmia recall files.
Refer to Section 7.
7. Check or change recording settings. Refer to Section 8.
8. Prepare the equipment (electrodes, transducers, probes, etc.) for monitoring
individual parameters and check or change the settings for each parameter.
Refer to Sections 11 to 20.
Operator's Manual BSM-5100A 2.1
Page 65
2. PREPARATIONS
Installation Conditions
Put the monitor on a stable and flat stand or on an optional KC-005P cart in a
suitable location where the screen is easy to see and does not reflect light. Follow
the cautions below.
For installing the monitor on the KC-005P cart, refer to the KC-005P cart
installation guide.
WARNING
••
• 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.
••
• Connect only the specified instruments to the connector or sockets
••
marked with by following the specified procedure. Otherwise,
electrical leakage current may harm the patient and operator .
CAUTION
••
• Av oid collision when moving the monitor on a cart. Strong impact
••
may damage the monitor .
••
• The display screen is made of glass. Strong impact may damage it.
••
••
• Av oid a location where the monitor is sprinkled with liquids.
••
Avoid direct sprinkling, spray or moist air from a neb ulizer or a
humidifier.
••
• If fluids are accidentally spilled on the monitor , take the monitor out of
••
service and check for damage.
••
• Avoid locations where the monitor ma y receive str ong electroma gnetic
••
interference such as radio or TV stations, cellular phones or mobile
two-way radios.
••
• Do not use the monitor in an ambulance. The monitor may not
••
function properly in a moving vehicle.
••
• Av oid exposing the monitor to direct sunlight.
••
••
• Do not place the monitor in a dusty area.
••
••
• Do not place blankets or cloth over the monitor. It may affect
••
monitoring.
••
• Connect the power cord to an A C outlet which can suppl y enough A C
••
current to the monitor. The monitor cannot function properly with low
current.
••
• Do not place the monitor in an MRI examination room. The monitor
••
may not function properly, or noise from the monitor may interfere
with the MRI.
••
• Do not use an electrical blanket. It may affect monitoring.
••
2.2 Operator's Manual BSM-5100A
Page 66
2. PREPARATIONS
••
• Make sure that there is more than 5 cm of space between the monitor
••
and the wall for adequate ventilation. When the monitor is
surrounded, make sure that there is about 10 cm of space above the
monitor for ventilation so that the operating temperature does not
exceed 40°C (104°F).
10 cm
Rear
5 cm
5 cm
Side
Av oid placing the monitor near a heater or humidifier.
••
• When there is any problem on the monitor, turn off the power
••
immediately and disconnect the power cord fr om the A C outlet. Take
the monitor out of service and check for damage.
Operator's Manual BSM-5100A 2.3
Page 67
2. PREPARATIONS
Preparing the Optional Recorder
Installing the Recorder
Module
Loading the Recording
Paper
Install the optional WS-510P recorder module in the monitor by referring to the
WS-510P recorder module installation guide.
CAUTION for Handling the Recording Paper
••
• Do not allow paper to contact pastes, adhesive agents, oil-based felt
••
pen tips or diazo process (ditto/spirit) copying paper. These discolor
the paper surface.
••
• Do not allow paper to contact any materials made of vinyl chloride,
••
plastic eraser , adhesive tape, fluorescent felt tip pen, or cinnabar seal
ink because these discolor the recorded waveforms and data.
••
• Do not apply strong pressure to the paper. Rubbing or scratching
••
discolors the paper surface.
••
• Do not allow paper to contact saline solution. The paper discolors
••
and if the saline solution gets on the thermal head, there will be dots
missing from the recorded data.
••
• Av oid high humidity, high temperature, direct sunlight and direct
••
fluorescent light when storing recording paper . Otherwise the paper
may discolor. Store the recording paper in a dry, cool place.
••
• When using glue on the recording paper , use glue which consists of
••
starch, polyvinyl alcohol, gum arabic, or carboxymethyl.
CAUTION for Loading the Recording Paper
••
• Correctly load the recording paper as specified. Otherwise, recording
••
may not be performed properl y.
••
• Do not touch the recording head with any hard material. When the
••
head is tapped with hard material, the head may crack and the heater
element wire may short-circuit.
••
• Clean the head surface with the provided head cleaner pen before
••
loading new paper . After a period of usage, paper dust may
accumulate between the paper and the head surface, and good
printing cannot be obtained.
NOTE
Only use the specified recording paper , FQW50-3-100.
The out of paper lamp on the front panel lights and the out of paper mark
appears on the screen when there is no paper.
Out of paper lamp
2.4 Operator's Manual BSM-5100A
Page 68
Recorder door release lever
2. PREPARATIONS
1. Move the recorder door release lever in the direction of the arrow ( ) to
release the lock.
2. Open the recorder door.
Black square
3. Set the recording paper (FQW50-3-100) inside the recorder so that the
detection mark (small black square on corner) of the paper is on the right side.
4. Draw out one page of paper toward you and close the recorder door.
If the out of paper lamp is still lit, the recorder door is not closed properly.
Operator's Manual BSM-5100A 2.5
Page 69
2. PREPARATIONS
Attaching the Optional Touch Pen
Hook the spring catch of the touch pen string to the hook on the rear of the key
panel.
When not using the touch pen, put it through the ring on the touch pen string as
shown below.
2.6 Operator's Manual BSM-5100A
Page 70
Connecting an External Instrument to the Monitor
An external instrument, such as a display monitor, can be connected to the AUX
socket on the left side panel. For details, contact your Nihon Kohden distributor.
Using the optional QI series interface, the following instrument can be connected
to the monitor.
• QI-401P: Display monitor, AG-920R multigas unit, etc
• QI-402P: Aspect BIS monitor
• QI-403P: Drager ventilator
• QI-404P: Servo300 ventilator
• QI-405P: Oridion Microcap capnograph monitor
• QI-406P Puritan Bennett ventilator
• QI-408P Servo i ventilator
• QI-501P Abbott Laboratories CCO/Sv-O2 monitor
• QI-502P Edwards Lifesciences CCO/Sv-O2 monitor
2. PREPARATIONS
The QI-401P interface can be mounted on the KC-005P cart. To mount the
interface on the monitor, an optional DI-540P holder is required. To connect the
interface to the monitor, refer to the interface operator’s manual.
WARNING
For patient safety , equipotential grounding of all instruments must be
performed. Consult with a qualified biomedical engineer.
When more than one electrical instrument is used, there may be electrical potential
difference between the instruments. Potential difference between instruments may
cause current to flow to the patient connected to the instruments, resulting in
electrical shock (micro shock). Never use any medical equipment in patient
treatment without proper grounding.
Always perform equipotential grounding as specified in IEC60601-1-1 when
required. It is often required in the operating room, ICU room, CCU room, cardiac
catheterization room and X-ray room. Consult with a biomedical engineer to
determine if it is required. Refer to the reference “General Requirements for
Connecting Medical Electrical System” in Section 23.
WARNING
Connect only the specified instruments to the connector or sockets
marked with by following the specified procedure. Otherwise,
electrical leakage current may harm the patient and operator .
CAUTION
Disconnect the power cord from the A C SOURCE soc ket before
connecting the instruments.
Operator's Manual BSM-5100A 2.7
Page 71
2. PREPARATIONS
Connecting the Monitor to a Network
Either a QI-101P network card or a QI-111P network printer card can be inserted
into the bedside monitor. These two cards cannot be used at the same time.
The optional QI-101P network card allows connection to a central monitor
network*. Bedside monitor data can be sent to the central monitor. When the
monitor has no recorder, waveforms and data can be recorded manually on the
central monitor recorder from the bedside monitor.
The optional QI-111P network printer card allows connection to a bedside monitor
network with no central monitor*. Monitor data can be printed on a printer
connected to the network. The review window data, 12 lead ECG interpretation
and manual printing can be performed.
* For details about the central monitor network and bedside monitor network, refer
to the Network and System Installation Guide.
WARNING
For patient safety , equipotential grounding of all instruments must be
performed. Consult with a qualified biomedical engineer.
When more than one electrical instrument is used, there may be electrical potential
difference between the instruments. Potential difference between instruments may
cause current to flow to the patient connected to the instruments, resulting in
electrical shock (micro shock). Never use any medical equipment in patient
treatment without proper grounding.
Always perform equipotential grounding as specified in IEC60601-1-1 when
required. It is often required in the operating room, ICU room, CCU room, cardiac
catheterization room and X-ray room. Consult with a biomedical engineer to
determine if it is required.
Refer to the reference “General Requirements for Connecting Medical Electrical
System” in Section 23.
WARNING
••
• 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. For details, refer to the Network and System Installation
Guide.
2.8 Operator's Manual BSM-5100A
Page 72
2. PREPARATIONS
••
• Connect only the specified instruments to the connector or sockets
••
marked with by following the specified procedure. Otherwise,
electrical leakage current may harm the patient and operator .
CAUTION
Before connecting instruments, make sure that the power is turned off.
NOTE
The time on this monitor is automatically adjusted to match the time of
the network as long as the monitor is connected to the network. The
date and time on all monitors in the network are set to the same setting.
Installing the Optional
Network Card or Network
Printer Card
The network card or network printer card can be installed while the monitor power
is on.
For details on handling the network card/network printer card, refer to the QI-101P
network card or QI-111P network printer card operator’s manual.
WARNING
••
• Connect the network as specified. Otherwise the patient and operator
••
may get electrical shock or other injury. For connecting the network,
contact your Nihon Kohden distrib utor.
••
• Do not use the damaged network cable. Otherwise the patient or
••
operator may get an electrical shock when the damaged part is
touched.
NOTE
••
• Use only the shielded network cable with the resin plug for the HUB
••
connector.
••
• Use only a hub which complies with IEC60950 or UL1950.
••
1. Connect the network cable to the socket on the network card/network printer
card. Insert the cable connector until it clicks.
Network card
Network cable
Operator's Manual BSM-5100A 2.9
Do not push in the network cable with too much force. Otherwise the
network card/network printer card or bedside monitor may get
damaged.
CAUTION
Page 73
2. PREPARATIONS
PC card slot
2. Insert the network card/network printer card with the metal side facing front
into the PC card slot on the left side panel.
3. Attach the ferrite core to the network cable.
NOTE
A ferrite core must be attached to every network cable.
Ferrite core
PC card eject button
When removing the network card/network printer card from the monitor, press the
PC card eject button.
NOTE
The network card/network printer card may get hot after long term use,
but this does not mean that the card is damaged.
2.10 Operator's Manual BSM-5100A
Page 74
P ower
2. PREPARATIONS
General
The monitor can operate on either battery or AC power.
When the power cord is plugged into an AC outlet and the power switch on the
front panel is turned on, the monitor operates on AC power.
When a battery is inserted and the power cord is disconnected or there is a sudden
power failure, the monitor automatically switches to battery power.
The battery is charged when the power cord is plugged into an AC outlet and the
AC current is supplied to the monitor. The battery is also charged during
monitoring.
When the monitor is operated on battery power, the brightness of the screen can be
reduced to save battery power. Refer to Section 3.
The monitor can operate for about 15 minutes with a fully charged battery pack
when:
• Used in normal temperature
• Recorder is not used
• No alarm occurs
• No NIBP measurement
• POWER SAVE MODE on the SYSTEM SETUP screen is set to ON.
Connecting the Po wer
Cord and Grounding the
Monitor
Lights
Connecting the Power Cor d
WARNING
Only use the provided power cord. Using other power cords may result
in electrical shock or other injury to the patient and operator .
Connect the provided power cord to the AC SOURCE socket on the side panel of
the monitor and plug the cord into a 3-prong AC outlet.
When the AC power is supplied to the monitor, the AC power lamp on the front
panel lights and a buzzer sounds.
NOTE
If the AC power lamp does not light or there is no b uzzer sound, check
the power cord connection.
Operator's Manual BSM-5100A 2.11
Page 75
2. PREPARATIONS
Grounding the Monitor
WARNING
For patient safety , equipotential grounding of all instruments must be
performed. Consult with a qualified biomedical engineer.
When more than one electrical instrument is used, there may be electrical potential
difference between the instruments. The potential difference between the
instruments may cause current to flow to the patient connected to the instruments,
resulting in electrical shock (micro shock).
Always perform equipotential grounding when required. It is often required in the
operating room, ICU room, CCU room, cardiac catheterization room and X-ray
room. Consult with a biomedical engineer to determine if it is required.
Turning the Po wer On
When equipotential grounding is required, connect the equipotential ground
terminal on the instrument to the equipotential ground terminal on the wall
(equipotential grounding system) with the equipotential grounding lead (potential
equalization conductor).
Check Before Turning On the Power
Check the following items before turning on the power.
• Enough electrodes and electrode leads are ready.
• Cleaned and sterilized sensors and transducers are ready.
• Power cord is connected properly.
• Equipotential grounding lead is connected properly when equipotential
grounding is required.
• All cables are connected properly.
• Enough recording paper in the recorder (when using an optional recorder).
• Fully charged battery is installed in the monitor in case of a sudden power
failure.
• No scratches, damage or dirt on the monitor.
• No damage to the keys, dials and panels.
• No damage to the power cord.
• No damage to the electrode leads, transducers, probes and cables.
• The monitor is not in a wet place.
2.12 Operator's Manual BSM-5100A
Page 76
2. PREPARATIONS
T urning the Power On
CAUTION
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.
NOTE
••
• It takes a few minutes for the LCD screen to reach full brightness.
••
••
• The shadow of the previous screen may remain for a few minutes after
••
changing screens.
••
• There may be some dots on the LCD screen which are always on or
••
always off, but it does not affect monitoring. This is normal for all
LCD screens.
After grounding and connecting the power cord, press the power switch on the
front panel to ON. The power lamp and the AC power lamp light and the “CHECK
PROGRAM R UNNING” message appears on the screen.
If the power lamp does not light, check the power cord connection.
At the power on, check that one “bong” sounds and the red alarm lamp and yellow
alarm lamp blink once to show that the alarm functions properly.
Standby Mode
When the monitor power is turned on, it enters “standby mode” while the monitor
is waiting for the electrodes and probe to be attached to the patient. “CHECK
ELECTRODES”, “NO PULSE” and “CHECK PR OBE” alarms will not be activated.
“CHECK PROBE SITE” and “PULSE SEARCH” messages will not be displayed.
The monitor changes from standby mode to normal monitoring when the ECG or
SpO2 monitoring starts. The monitoring starts when the connection cord is
connected to the socket on the monitor and electrodes or probe is attached to the
patient.
If the monitor power is turned off and on again within 10 seconds, the monitor
skips standby mode.
Check After Turning On the P ower and During Monitoring
To start monitoring safely and properly, check the following items after turning on
the power. If any problem is detected, take the proper countermeasure according to
the troubleshooting and maintenance sections.
• There is no fire, smoke or smell.
• The monitor is not too hot.
Operator's Manual BSM-5100A 2.13
Page 77
2. PREPARATIONS
• The power lamp and standby lamp light.
• Alarm indicators blink once and a bong sounds.
• The start up screen appears and the monitoring screen appears.
• No error message is displayed on the screen.
• The time on the screen is correct.
• The monitor does not affect surrounding equipment.
• The data and waveforms are displayed properly.
• Keys, switch and function dials operate properly.
• The touch keys function properly.
• Alarm functions properly.
• There is no trouble in recording (when using an optional recorder).
NOTE
After turning the monitor on and when admitting a patient on the
monitor, make sure that the time displayed at the upper right of the
screen is correct. When the date or time is changed during monitoring,
the date and time of all stored data is also changed and may not match
the date and time on the printout.
Turning the Po wer Off
When the monitor is connected to a network
The time on this monitor is automatically adjusted to match the time of
the network as long as the monitor is connected to the network. The
date and time on all monitors in the network are set to the same setting.
Press the power switch on the front panel for more than one second to turn the
power off. The screen becomes dark and the power lamp on the front panel turns
off.
Check After/Before Turning the P ower Off
Check the following items for the next use.
• Previous patient data is deleted.
• Temporarily changed settings are changed back to the previous settings.
• There is no dirt, damage or scratches on the monitor.
• The sensors, probes, transducers, and cables are cleaned and sterilized.
• Accessories are cleaned and stored properly.
• There are enough consumables, such as recording paper, and disposable
electrodes for the next use.
• Battery pack is fully charged.
• The power switch on the monitor is turned off and the power cord is
disconnected from the monitor.
• The monitor is not in a wet place.
• Dead batteries are disposed of properly.
• The medical waste is disposed of properly.
• The monitor is stored properly.
2.14 Operator's Manual BSM-5100A
Page 78
2. PREPARATIONS
Po wer and Battery Status
Indications
Lit
Lit
Lit
Lit
Lit
Slow blinking or lit
Power and battery status are indicated by four lamps on the front panel. A
discharged battery is also indicated by a screen message and alarm.
NOTE
When charging the battery with the monitor power switch turned off,
check that the power lamp and battery charging lamp light. If the lamps
do not light even when the power cord is connected and the battery is
inserted, turn the power switch on, check that the battery charging lamp
is blinking or lit, then turn the power switch off.
• Operating on AC power and battery is fully charged
Power lamp: Lit
AC po wer lamp: Lit
Battery power lamp: Off
Battery charging lamp: Lit
• Operating on AC power and battery is being charged
Power lamp: Lit
AC po wer lamp: Lit
Battery power lamp: Off
Battery charging lamp: Slow blinking (once every 2 seconds) or lit
Lit
Lit
Lit
Lit
Lit
Rapid blinking
Off or rapid blinking
• Operating on AC power with no battery or battery is damaged
Power lamp: Lit
AC po wer lamp: Lit
Battery power lamp: Off
Battery charging lamp: Off or rapid blinking (4 times per second)
• Operating on battery power
Power lamp: Lit
AC po wer lamp: Off
Battery power lamp: Lit
Battery charging lamp: Off
• Operating on battery power and battery needs recharging
Power lamp: Lit
AC po wer lamp: Off
Battery power lamp: Rapid blinking (4 times per second)
Battery charging lamp: Off
Screen indication: “BATTERY WEAK” message
Alarm indication: Continuous “bing bong” sound and blinking
yellow alarm lamp
• No monitoring and charging battery
Power lamp: Off
AC po wer lamp: Lit
Battery power lamp: Off
Lit
Operator's Manual BSM-5100A 2.15
Slow blinking or lit
Battery charging lamp: Slow blinking (once every 2 seconds) or lit
Page 79
2. PREPARATIONS
Battery Handling and
Operation
Safety Information
WARNING
••
• Keep the battery pack away from fire.
••
••
• Keep the battery pack away from children.
••
••
• Never short-circuit the + and – terminals on the battery pack.
••
••
• Never disassemble the battery pack.
••
••
• Do not use the battery which is damaged, such as from falling.
••
••
• If the battery pack is damaged and substance inside the battery
••
(potassium hydroxide) contacts the skin or clothes, wash immediately
and thoroughly with water.
CAUTION
••
• Do not subject the battery pack to a strong mechanical shock.
••
••
• Use the battery pack between 10°C (50°F) and 40°C (104°F).
••
Temperatures out of this range affect the w orking of the battery.
••
• Do not use a battery which is past the expiration date written on the
••
label.
••
• 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 recyclable. 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.
Battery Handling Procedures
• Always place a battery in the monitor. This charges it so that you will always
have a fully charged battery ready.
• Fully recharge the battery before using it for the first time or after storing it for
over a month. When the battery is not used, it self-discharges.
• Replace the battery with a new one every year. This is because the battery is a
chemical product which gradually deteriorates whether or not it is used.
• Store the battery packs under the following conditions.
Temperature: –20 to 25°C (–4 to 77°F)
Humidity: 45 to 85% relative humidity
When Not Using the Monitor or Battery
• When the monitor is not used for a long time, remove the battery. When a
charged or discharged battery is left inside the monitor with the power cord
unplugged, the battery self-discharges and deteriorates.
• When a battery is not used, fully charge it before storage. When a battery is not
used for over one month, fully charge it once a month.
2.16 Operator's Manual BSM-5100A
Page 80
2. PREPARATIONS
When the BATTERY WEAK Message Appears
Operate the monitor on AC power and/or replace the battery when the BATTERY
WEAK message appears.
When the BATTERY WEAK message appears, the battery has approximately 5 to
15 minutes of power left. The yellow alarm lamp lights with a continuous “bing
bong” sound.
If no AC or battery power is supplied to the monitor, there is no measurement or
display but no data is lost.
Inserting or Replacing the Battery
The battery must be installed or replaced by a qualified service personnel. Refer to
the monitor service manual.
Charging the Battery
The battery pack can only be charged by the monitor. It takes about 15 hours to
charge a battery pack on the monitor.
The monitor can operate for about 15 minutes with a fully charged battery pack
when:
• Used in normal temperature
• Recorder is not used
• No alarm occurs
• No NIBP measurement
• POWER SAVE MODE on the SYSTEM SETUP screen is set to ON.
CAUTION
When charging the battery pack, keep the ambient temperature at
approximately 20°C to maintain the optimal battery operation time. If
the battery pack is charged at less than 10°C (50°F) or more than 30°C
(86°F), the maximum battery operation time will be 20% to 30% less than
the optimal operation time.
During AC operation, the battery is automatically charged without interrupting
monitoring. It takes approximately 15 hours of continuous charging to fully
charge the battery pack. After 15 hours of continuous charging, the monitor
automatically switches to trickle charging mode to maintain the battery pack fully
charged. Trickle charging is necessary because the battery pack can self-discharge
even when it is not in use.
NOTE
••
• Do not disconnect the power cord from the monitor during battery
••
charging.
••
• If the 15 hours of continuous normal charging is disrupted for more
••
Operator's Manual BSM-5100A 2.17
Page 81
2. PREPARATIONS
than one hour by power failure in the main power supply or by
temporary removal of the battery pack fr om the monitor, the monitor’s
normal charging circuit is reset, and the battery pack is charged for
another 15 hours regardless of how many hours it was charged before
the disruption. This deteriorates the battery.
1. Connect the power cord to the monitor and the AC outlet.
2. Insert the battery pack into the monitor. The monitor charges the battery pack
regardless of whether the monitor power switch is on or off.
During charging, the battery charging lamp on the front panel blinks.
Lit
Lit
Slow blinking or lit
After 15 hours, the battery charging lamp is continuously lit and the battery
charging is completed.
2.18 Operator's Manual BSM-5100A
Page 82
Section 3 Changing System Setup
Settings
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) .........................................................................3.6
Bed ID Setting (BED ID SETUP) ..............................................................................3. 8
Parameter and Other Settings (PARAMETER SETUP) .............................................3.8
NIBP Settings (NIBP SETUP) ................................................................................3.10
Alarm Settings (ALARM SETUP)............................................................................3.11
Unit Settings (UNITS SETUP) ................................................................................3.14
Color Settings (COLOR SETUP) .............................................................................3.15
Recording Settings (RECORD SETUP)...................................................................3.16
Other Settings (OTHER SETUP).............................................................................3.17
Alarm Master Settings (ALARM MASTER) .............................................................3.18
Arrhythmia Recall Master Settings (ARRHYTHMIA RECALL MASTER)................3.20
Network Settings (NETWORK SETUP)...................................................................3.20
Network Printer Settings (PRINTER SETUP)..........................................................3.22
External Interface Information (EXT I/F SETUP) ....................................................3.24
Initializing the System.......................................................................................................3.25
Factory Default Settings....................................................................................................3.26
SYSTEM SETUP Screen........................................................................................3.26
ECG Window ...........................................................................................................3.26
RESP/CO2 Window..................................................................................................3.27
SpO2 Window...........................................................................................................3.27
NIBP Window ..........................................................................................................3.27
PRESS Window ......................................................................................................3.27
TEMP Window.........................................................................................................3.28
CO Window .............................................................................................................3.28
GAS Window ...........................................................................................................3.28
TREND Window.......................................................................................................3.29
ARRHYTH RECALL Window ...................................................................................3.30
FULL DISC Window.................................................................................................3.30
Operator's Manual BSM-5100A 3C.1
Page 83
ST Window..............................................................................................................3.30
DATE & TIME Window.............................................................................................3.31
SOUND & BRIGHT Window ....................................................................................3.31
DISPLA Y Window....................................................................................................3.31
RECORDING Window..............................................................................................3.31
FUNCTION KEY Window ........................................................................................3.31
VITAL ALARM Window ............................................................................................3.32
ARRHYTH ALARM Window.....................................................................................3.33
INTERBED Window.................................................................................................3.33
DRUG CALCULA TE Window ....................................................................................3.34
3C.2 Operator's Manual BSM-5100A
Page 84
3. CHANGING SYSTEM SETUP SETTINGS
The section explains how to change settings after the monitor is installed and
before monitoring waveforms.
The initial settings on the SYSTEM SETUP screen must be changed before
monitoring. Changing these settings during monitoring interrupts monitoring.
All other settings can be changed any time without interrupting monitoring.
This section also explains how to initialize the system. This procedure returns all
settings to the factory default settings and deletes all stored data in memory.
Operator's Manual BSM-5100A 3.1
Page 85
3. CHANGING SYSTEM SETUP SETTINGS
Displaying the SYSTEM SETUP Screen
This procedure interrupts all monitoring. Only change these settings
before or after monitoring.
1. Turn the monitor power off.
W ARNING
SILENCE
ALARMS
2. Press the power switch while pressing the SILENCE ALARMS key on the
front panel until the DIAGNOSTIC CHECK screen is displayed.
3. Touch the “SYSTEM SETUP” key. The SYSTEM SETUP screen appears.
3.2 Operator's Manual BSM-5100A
Page 86
3. CHANGING SYSTEM SETUP SETTINGS
Changing Settings 1. Touch the desired item on the SYSTEM SETUP screen. A setup screen for that
item appears.
2. Touch a setting key on the screen or use the function dials on the front panel to
Lamp lights
Function dial 1
set the condition. A function dial can be used when its lamp on the front panel
lights.
3. Touch the “RETURN” key to return to the SYSTEM SETUP screen.
4. Repeat steps 1 to 3 to change other setup settings.
Closing the SYSTEM
SETUP Screen and
Displaying the Monitoring
Screen
1. After you change all desired settings, touch the “RETURN” key on the
SYSTEM SETUP screen. The new settings are entered and the screen returns
to the DIAGNOSTIC CHECK screen.
2. Touch the “MONITOR MODE” key. After a few seconds, the monitoring
screen appears.
Operator's Manual BSM-5100A 3.3
Page 87
3. CHANGING SYSTEM SETUP SETTINGS
List and Explanation of the SYSTEM SETUP Settings
List of All Settings The factory default settings are underlined.
SETUP type Item Setting Conditions
SITE OR, ICU, NICU
DISPLAY
SETUP
BED ID SETUP
PARAMETER
SETUP
NIBP SETUP
ALARM
SETUP
UNITS SETUP
WAVE DISPLAY FIXED, MOVING
DISPLAY COLOR MODE PARAMETER, ALARM
POWER SAVE MODE ON, OFF
FILL IN WAVEFORM ON, OFF
SHOW FRAME ON ENLARGED
WINDOW
LINE FREQUENCY AUTO, 50 Hz, 60 Hz
ECG 12 LEAD HUM FILTER OFF, AUTO, 50 Hz, 60 Hz
PRESS FILTER 10 Hz, 20 Hz
ECG ELECTRODE IEC, AHA
NOISE REDUCTION ON
IMPEDANCE RESP
NIBP MODE AFTER STAT MANUAL, 2 min, 2.5 min, 5 min, 10 min, 15 min, 30 min
NIBP COMPLETION SOUND ON, OFF OR: ON ICU, NICU: OFF
NIBP STAT MODE STAT, 1 min
INTERVAL MASTER
OLD NIBP DATA
AFTER
SILENCE TIME 1 min, 2 min
ALARM LIMIT DISPLAY
EXIT SLEEP MODE ON ALARM YES, NO
ALARM
LEVEL
SUSPEND MONITORING ON
DATA DELETION
SUSPEND ALARM TIME 0 min, 1 min, 3 min
PRESSURE UNIT mmHg, kPa
TEMPERATURE UNIT C, F
HEIGHT UNIT cm, inch
WEIGHT UNIT kg, pound
ST UNIT mV, mm
HR CRISIS, WARNING, ADVISORY
SpO2 CRISIS, WARNING, ADVISORY
PRESS CRISIS, WARNING, ADVISORY
NIBP CRISIS, WARNING, ADVISORY
APNEA
EXTERNAL CRISIS, WARNING, ADVISORY
ECG CHECK
ELECTRODES
SpO2 CHECK
PROBE
VPC RUN CRISIS, WARNING, ADVISORY
COUPLET CRISIS, WARNING, ADVISORY
EARLY VPC CRISIS, WARNING, ADVISORY
BIGEMINY CRISIS, WARNING, ADVISORY
FREQ VPC CRISIS, WARNING, ADVISORY
TACHYCARDIA CRISIS, WARNING, ADVISORY
BRADYCARDIA
ON, OFF
Up to 8 alphanumeric characters OR: OR-001, ICU: ICU-001,
NICU: NICU-001
ON, OFF
MANUAL, STAT, 2 min, 2.5 min, 5 min, 10 min, 15 min, 30
min, 1 h, 2 h, 4 h, 8 h
DIM, HIDE
10 min, 30 min, 1h, 24h OR: 10 min ICU, NICU: 30 min
MARK ON, VALUES OR, ICU: MARK ON, NICU:
VALUES
CRISIS, W ARNING, ADVISORY OR, ICU: WARNING,
NICU: CRISIS
WARNING, A DVISORY
WARNING, A DVISORY
CRISIS, W ARNING, ADVISORY OR, ICU: WARNING,
NICU: CRISIS
YES, NO
3.4 Operator's Manual BSM-5100A
Page 88
3. CHANGING SYSTEM SETUP SETTINGS
SETUP type Item Setting Conditions
COLOR
SETUP
RECORD
SETUP
OTHER
SETUP
ALARM
MASTER
ARRHYTHMIA RECALL MASTER See explanation in following pages.
NETWORK
SETUP*
PRINTER
SETUP
EXT I/F SETUP
PARAMETER
PARAMETER (PRE SS)
PARAMETER (TEMP)
PARAMETER (GAS. EXT)
ALARM MODE COLOR Green, scarlet, pink, light blue, purple, pale yellow, pale green,
MANUAL RECORD REAL TIME, DELAY
MANUAL RECORD TIME CONTINUOUS, 10 sec, 20 sec, 30 sec
PERIODIC FREE INTERVAL 1 to 120 min (1 min steps), 15 min
SYNC SOUND PITCH LOW, MIDDLE, HIGH
ALARM INDICATOR QRS SYNC ON, OFF OR, NICU: OFF ICU: ON
FUNCTION DIAL DIRECTION NORMAL, REVERSE
ZS-900P TYPE Not available
TIME ZONE 0 to ±12:00 in 30 min steps, +9:00
VITAL, ST, PRESS1, PRESS2,
TEMP, GAS, ARRHYTHMIA
GROUP GROUP 01 to GROUP 16, GROUP 01
DEFAULT GATEWAY 255.255.255.255, 000.000.000.000
IP ADDRESS SETUP AUTO, MANUAL
MANUAL IP ADDRESS 255.255.255.255, 000.000.000.000
MANUAL SUBNET MASK 255.255.255.255, 000.000.000.000
PRINTER
SETUP
PRINTER NAME Up to 8 alphanumerics, lp
HOSPITAL NAME Up to 32 alphanumerics
PAPER SIZE A4, LETTER
PRINTER TYPE MONOCHROME, COLOR
IP ADDR ESS 255.255.255.255, 000.000.000.000
Green, scarlet, pink, light blue, purple, pale yellow, pale green,
sky blue, whi t e, orange, yellow, red
Default settings
ECG: green RESP/CO2: white NIBP : pink
SpO2: light blue FiO2: green CO: white
PRESS/ART/ART-2/RAD/AO/DORS/FEM/UA/LVP: red
PRESS-2/UV/CVP/RAP: sky blue
PRESS-3/PAP/RVP/LAP: yellow
PRESS-4/ICP/ICP-2/ICP-3/ICP-4: pale yellow
PRESS-5: white
TEMP/ TEMP-3/Tskin/T skin-2/Tskin-3/Tb: orange
TEMP-2/TEMP-4/Trect/Tcore/Tnaso/Teso/Ttymp/Tblad/Taxil/
delta-T: pale yellow Fi/EtCO2: white Fi/EtN2O: sky blue
Fi/EtO2: green Fi/EtHAL: red Fi/EtISO: purple
Fi/EtENF: orange Fi/EtDES:
VENT: white BIS: orange CNIBP: orange
sky blue, whit e
See explanation in following pages.
RS-232C information of the interface connected to the monitor.
Refer to the interface manual.
light blue
Fi/EtSEV:
yellow
* These items can only be set when the optional QI-101P network card or QI-111P network printer card is inserted in
the monitor.
Operator's Manual BSM-5100A 3.5
Page 89
3. CHANGING SYSTEM SETUP SETTINGS
Site Setting (SITE)
SITE: OR, ICU, NICU
Select the site according to the environment. The default settings, including alarm
upper and lower limit settings, differ according to site.
OR: The “BYPASS” key is displayed on the MENU window. Sleep mode
ICU, NICU: The “SUSPEND MONITORING” key is displayed on the MENU
is not available.
window. Sleep mode is available.
Display Settings
(DISPLAY SETUP)
When the “BYP ASS” or “SUSPEND MONIT ORING” ke y is pressed,
• Alarm is suspended until the key is released. Refer to Section 6.
• NIBP measurement in STAT and Auto mode is suspended until the NIBP
START/STOP k ey is pressed. Refer to Section 15.
Select the site and touch the “SET” key to change the site.
WAVE DISPLAY: FIXED , MOVING
Select waveform sweep mode on the monitoring screen.
FIXED: Waveform does not sweep; it is refreshed from the left.
MOVING: W aveform sweeps from the right.
3.6 Operator's Manual BSM-5100A
Page 90
3. CHANGING SYSTEM SETUP SETTINGS
DISPLA Y COLOR MODE: PARAMETER, ALARM
There are two color display modes.
PARAMETER: A different color can be set for each parameter. When an alarm
occurs, the alarmed parameter data is highlighted.
ALARM: The same color selected at ALARM MODE COLOR of the
COLOR SETUP is set for all parameters. When an alarm occurs,
the alarmed parameter color changes to red or yellow according to
the alarm level set at ALARM LEVEL of the ALARM SETUP.
CRISIS: red
WARNING: yellow
ADVISORY : yellow
POWER SAVE MODE: ON, OFF
When operating the monitor on battery power, the brightness of the screen can be
adjusted to save battery power.
ON: Dim, longer battery operation time
OFF: Normal screen brightness, shorter battery operation time
FILL IN WA VEFORM: ON, OFF
When set to ON, the respiration, CO2 and gas waveforms are filled in.
The CO2 waveform is filled in
SHOW FRAME ON ENLARGED WINDOW: ON, OFF
Select the format of the ENLARGED window.
ON: Large numeric data are displayed inside a frame. Waveforms are partially
hidden by the frame.
OFF: No frame is displayed. Large numeric data are superimposed over
waveforms.
Operator's Manual BSM-5100A 3.7
Page 91
3. CHANGING SYSTEM SETUP SETTINGS
Bed ID Setting
(BED ID SETUP)
Entered data
Enters space
Enter an identification name for the bed. Up to 8 alphanumeric characters can be
entered.
Moves the cursor
CAUTION
When the monitor is connected to a central network, set the Bed ID on
the monitor to correctly identify the bed on the central monitor .
1. Touch the desired letters and numbers to enter the bed ID.
2. Touch the “SET” key to register the bed ID.
3. Touch the “RETURN” key to return to the SYSTEM SETUP screen.
Parameter and Other
Settings
(PARAMETER SETUP)
3.8 Operator's Manual BSM-5100A
Page 92
3. CHANGING SYSTEM SETUP SETTINGS
LINE FREQUENCY: A UT O , 50 Hz, 60 Hz
Select line frequency. In normal use, set to AUTO.
NOTE
When operating on battery , make sure that the appr opriate line
frequency is selected. Otherwise, noise may interfere on the pulse
waveform.
AUTO: Automatically detects the AC line frequency
50 Hz: Set to 50 when operating on battery only in a 50 Hz area
60 Hz: Set to 60 when operating on battery only in a 60 Hz area
ECG 12 LEAD HUM FIL TER: OFF , AUT O , 50 Hz, 60 Hz
Select the hum filter for 12 lead ECG monitoring. In normal use, set to AUTO.
NOTE
When operating on battery , make sure that the appr opriate line
frequency is selected. Otherwise, noise may interfere on the ECG
waveforms.
OFF: Hum filter is turned off
AUTO: Automatically detects the AC line frequency
50 Hz: Set to 50 when operating on battery only in a 50 Hz area
60 Hz: Set to 60 when operating on battery only in a 60 Hz area
PRESS FILTER: 10 Hz, 20 Hz
Select the noise filter for IBP monitoring. For normal monitoring, set the filter to
20 Hz. To see the IBP waveforms in detail, set the filter to 10 Hz.
ECG ELECTRODE: IEC, AHA
Select the electrode lead type.
IEC: R, L, F, RF , C
AHA: RA, LA, LL, RL, V
NOISE REDUCTION ON IMPEDANCE RESP: ON, OFF
In the impedance method, noise from the heart beat may interfere on the respiration
waveform due to electrode position, and the respiration rate may increase to almost
the same rate as the heart rate. In such a case, set this setting to ON to reduce noise
interference on the respiration waveform.
If the respiration rate is miscounted in the thermistor method, set this item to OFF.
NOTE
When this item is set to ON and the timing of the respiration and heart
beat coincide, respiration rate may not be counted. In such a case, set
this item to OFF or check the patient’ s respiration b y observing the
patient’s c hest mo vement or the respiration wavef orm on the monitoring
screen.
Operator's Manual BSM-5100A 3.9
Page 93
3. CHANGING SYSTEM SETUP SETTINGS
NIBP Settings
(NIBP SETUP)
NIBP MODE AFTER STA T: MANU AL, 2, 2.5, 5, 10, 15 or 30 min
The NIBP measurement mode after completing STAT (continuous) measurement
changes to the Manual mode or Auto mode with the selected interval.
NIBP COMPLETION SOUND: ON, OFF
ON: When NIBP measurement is completed, one “bong” sounds.
OFF: No sound. However, when the STAT mode is selected for the NIBP
measurement, one “bong” sounds after completing STAT measurement.
NIBP STA T MODE: STAT, 1 min
There are two modes for STAT NIBP measurement.
STAT: Measure NIBP as many times as possible over a 15 minute period.
1 min: Measure NIBP every minute for a 15 minute period.
INTERVAL MASTER: MANUAL, STAT, 2, 2.5, 5, 10, 15, 30 min, 1, 2, 4 or 8 h
Select the NIBP measurement mode to be set when the monitor is turned off for
more than 30 minutes or the monitor is initialized.
OLD NIBP DATA: DIM, HIDE
AFTER: 10 min, 30 min, 1h, 24h
Select whether to dim or hide the NIBP data after NIBP measurement and how long
to wait after NIBP measurement to dim or hide it.
3.10 Operator's Manual BSM-5100A
Page 94
Alarm Settings
(ALARM SETUP)
3. CHANGING SYSTEM SETUP SETTINGS
SILENCE TIME: 1 min, 2 min
The interval for suspending an alarm can be selected.
ALARM LIMIT DISPLAY: MARK ON, VALUES
MARK ON: The Vital Signs Alarm Off mark is displayed beside the parameter
value whose vital signs alarm is set to OFF.
VALUES: The upper/lower alarm limits are displayed beside parameter values.
EXIT SLEEP MODE ON ALARM: YES, NO
YES: When an alarm occurs during sleep mode, the sleep mode is exited and the
monitoring screen appears.
NO: The sleep mode continues even when an alarm occurs.
HR ALARM LEVEL: CRISIS, WARNING, ADVISORY
Heart rate alarm level and alarm indicator color can be selected. See “Alarm
Indications” in Section 6.
CRISIS: The heart rate data are highlighted with a continuous “pip” sound
and red blinking lamp.
WARNING: The heart rate data are highlighted with a continuous “bing bong”
sound and yellow blinking lamp.
ADVISORY : The heart rate data are highlighted with a “bong” sound every 20
seconds and yellow lamp lit.
SpO2 ALARM LEVEL: CRISIS, WARNING, ADVISORY
SpO2 alarm level and alarm indicator color can be selected. When the sync sound
is synchronized with the SpO2 pulse, the pulse rate alarm level is also set. See
“Alarm Indications” in Section 6.
CRISIS: The SpO2 and pulse rate data are highlighted with a continuous “pip”
sound and red blinking lamp.
WARNING: The SpO2 and pulse rate data are highlighted with a continuous “bing
bong” sound and yellow blinking lamp.
ADVISORY : The SpO2 and pulse rate data are highlighted with a “bong” sound
every 20 seconds and yellow lamp lit.
Operator's Manual BSM-5100A 3.11
Page 95
3. CHANGING SYSTEM SETUP SETTINGS
PRESS ALARM LEVEL: CRISIS, WARNING, AD VISORY
IBP alarm level and alarm indicator color can be selected. When the sync sound is
synchronized with the blood pressure pulse, the pulse rate alarm level is also set.
See “Alarm Indications” in Section 6.
CRISIS: The IBP and pulse rate data are highlighted with a continuous “pip”
WARNING: The IBP and pulse rate data are highlighted with a continuous “bing
ADVISORY : The IBP and pulse rate data are highlighted with a “bong” sound
NIBP ALARM LEVEL: CRISIS, WARNING, ADVISORY
NIBP alarm level and alarm indicator color can be selected. See “Alarm
Indications” in Section 6.
CRISIS: The NIBP data are highlighted with a continuous “pip” sound and red
WARNING: The NIBP data are highlighted with a continuous “bing bong” sound
ADVISORY : The NIBP data are highlighted with a “bong” sound every 20 seconds
sound and red blinking lamp.
bong” sound and yellow blinking lamp.
every 20 seconds and yellow lamp lit.
blinking lamp.
and yellow blinking lamp.
and yellow lamp lit.
APNEA ALARM LEVEL: CRISIS, W ARNING, AD VISOR Y
APNEA alarm level and alarm indicator color can be selected. See “Alarm
Indications” in Section 6.
CRISIS: The “APNEA” message is highlighted with a continuous “pip” sound
and red blinking lamp.
WARNING: The “APNEA” message is highlighted with a continuous “bing bong”
sound and yellow blinking lamp.
ADVISORY : The “APNEA” message is highlighted with a “bong” sound every 20
seconds and yellow lamp lit.
EXTERNAL ALARM LEVEL: CRISIS, W ARNING, AD VISOR Y
The alarm level and alarm indicator color for the alarm occurring on the external
instrument connected to the monitor can be selected. See “Alarm Indications” in
Section 6.
CRISIS: The external instrument data are highlighted with a continuous “pip”
sound and red blinking lamp.
WARNING: The external instrument data are highlighted with a continuous “bing
bong” sound and yellow blinking lamp.
ADVISORY : The external instrument data are highlighted with a “bong” sound
every 20 seconds and yellow lamp lit.
ECG CHECK ELECTRODES ALARM LEVEL: WARNING, AD VISOR Y
CHECK ELECTRODES alarm le vel and alarm indicator color can be selected. See
“Alarm Indications” in Section 6.
WARNING: The “CHECK ELECTRODES ” message is highlighted with a
continuous “bing bong” sound and yellow blinking lamp.
ADVISORY : The “CHECK ELECTRODES ” message is highlighted with a “bong”
sound every 20 seconds and yellow lamp lit.
3.12 Operator's Manual BSM-5100A
Page 96
3. CHANGING SYSTEM SETUP SETTINGS
SpO2 CHECK PROBE ALARM LEVEL: WARNING, AD VISOR Y
The alarm level and alarm indicator color for the CHECK PROBE and NO PULSE
alarm can be selected. See “Alarm Indications” in Section 6.
WARNING: The SpO2 ALARM message is highlighted with a continuous “bing
bong” sound and yellow blinking lamp.
ADVISORY : The SpO2 ALARM message is highlighted with a “bong” sound
every 20 seconds and yellow lamp lit.
VPC RUN, COUPLET, EARLY VPC, BIGEMINY, FREQ VPC ALARM LEVEL:
CRISIS, W ARNING, ADVISOR Y
The alarm level and alarm indicator color for the VPC RUN, COUPLET, EARL Y
VPC, BIGEMINY and FREQ VPC arrhythmias can be selected individually. See
“Alarm Indications” in Section 6.
CRISIS: The arrhythmia message is highlighted with a continuous “pip”
sound and red blinking lamp.
WARNING: The arrhythmia message is highlighted with a continuous “bing
bong” sound and yellow blinking lamp.
ADVISORY : The arrhythmia message is highlighted with a “bong” sound every 20
seconds and yellow lamp lit.
T ACHYCARDIA, BRAD YCARDIA ALARM LEVEL: CRISIS, WARNING,
ADVISOR Y
The alarm level and alarm indicator color for the TACHYCARDIA and
BRADYCARDIA arrhythmias can be selected. See “Alarm Indications” in Section
6. When the heart rate alarm level and tachycardia or bradycardia alarm level
differ, the higher level is used.
CRISIS: The arrhythmia message is highlighted with a continuous “pip”
sound and red blinking lamp.
WARNING: The arrhythmia message is highlighted with a continuous “bing
bong” sound and yellow blinking lamp.
ADVISORY : The arrhythmia message is highlighted with a “bong” sound every 20
seconds and yellow lamp lit.
SUSPEND MONITORING ON D ATA DELETION
Select whether to suspend monitoring when the YES key is pressed on the
DELETE DATA window. While monitoring is suspended, all alarms are suspended.
YES: Deletes data and suspends monitoring
NO: Deletes data and does not suspend monitoring
SUSPEND MONITORING TIME
Select when to release monitoring suspension and resume alarms.
0 min: Alarms resume immediately when heart rate, SpO2, IBP, Tb, CNIBP or
EtCO2 is monitored or when NIBP is measured.
1 min: Alarms resume when heart rate, SpO2, IBP, Tb, CNIBP or EtCO2 is
monitored properly for 1 minute or when NIBP is measured.
3 min: Alarms resume when heart rate, SpO2, IBP, Tb, CNIBP or EtCO2 is
monitored properly for 3 minutes or when NIBP is measured.
Operator's Manual BSM-5100A 3.13
Page 97
3. CHANGING SYSTEM SETUP SETTINGS
Unit Settings
(UNITS SETUP)
PRESSURE UNIT: mmHg/kPa
Select the unit for NIBP, IBP and CO2.
TEMPERA TURE UNIT : C, F
Select the unit for temperature.
HEIGHT UNIT: cm, inc h
Select the unit for height.
WEIGHT UNIT: kg, pound
Select the unit for weight.
ST UNIT: mV, mm
Select the unit for ST level.
3.14 Operator's Manual BSM-5100A
Page 98
3. CHANGING SYSTEM SETUP SETTINGS
Color Settings
(COLOR SETUP)
P ARAMETER COLOR
The color for each parameter display can be selected. Available colors are: green,
scarlet, pink, light blue, purple, pale yellow, pale green, sky blue, white, orange,
yellow and red.
To display the parameters in different colors, the DISPLAY COLOR MODE of the
DISPLA Y SETUP must be set to PARAMETER.
1. Touch the “PARAMETER” key to change color for ECG, SpO2, NIBP, CO,
RESP/CO2 and FiO2.
Touch the “PARAMETER (PRESS)” k e y to change color for IBP parameters.
Touch the “PARAMETER (TEMP)” key to change color for temperature
parameters.
Touch the “PARAMETER (GAS. EXT)” k ey to change color for the gas
parameters and the parameters monitored by the external instrument.
2. Touch the parameter you want to change the color of.
3. Touch the desired color for the parameter.
4. Repeat steps 1 to 3 to change the color for other parameters.
ALARM MODE COLOR
The color for all parameters display can be selected. When ALARM is selected for
the DISPLAY COLOR MODE of the DISPLAY SETUP, all parameters are displayed
in the same color. Available colors are: green, scarlet, pink, light blue, purple, pale
yellow, pale green, sky blue and white.
Operator's Manual BSM-5100A 3.15
Page 99
3. CHANGING SYSTEM SETUP SETTINGS
When an alarm occurs, the alarmed parameter changes to red or yellow according
to the alarm level set at ALARM LEVEL of the ALARM SETUP.
Recording Settings
(RECORD SETUP)
1. Touch the “ALARM MODE” key.
2. Touch the desired color.
MANUAL RECORD: REAL TIME, DELA Y
There are two manual recording modes.
REAL TIME: The beginning of the recorded waveform is when the “RECORD”
key on the screen is touched or the record key on the front panel is
pressed.
DELAY : The beginning of the recorded waveform is 8 seconds before the
“RECORD” key on the screen is touched or 8 seconds before the
record key on the front panel is pressed.
When manually recording on a central monitor recorder in the central monitor
network from monitor with no optional recorder, this setting is fixed at REAL
TIME.
3.16 Operator's Manual BSM-5100A
Page 100
3. CHANGING SYSTEM SETUP SETTINGS
MANUAL RECORD TIME: CONTINUOUS, 10 sec, 20 sec, 30 sec
Select the length for manual recording. When CONTINUOUS is selected, the
recording starts when the “RECORD” key on the screen is touched or the record
key on the front panel is pressed and stops when the “STOP REC” key on the
screen is touched or the record key on the front panel is pressed.
When manually recording on a central monitor recorder in the central monitor
network from monitor with no optional recorder, this setting is automatically
changed to 30 sec when CONTINUOUS is selected.
PERIODIC FREE INTERVAL: 1 to 120 min
You can select the FREE time interval from 1 to 120 min in 1 min steps for
periodic recording. See “Setting Periodic Recording” in Section 8.
1. Enter the numbers by touching the number keys.
2. Touch the “SET” key to enter the value.
Other Settings
(OTHER SETUP)
SYNC SOUND PITCH: LO W , MIDDLE, HIGH
High, middle, or low pitch synchronized sound can be selected.
ALARM INDICA T OR QRS SYNC: ON, OFF
ON: The green lamp blinks in synchronization with the QRS.
OFF: The alarm indicator does not blink.
FUNCTION DIAL DIRECTION: NORMAL, REVERSE
Selects the direction of the function dials 1 and 2 operation on all screens as below
except for the SYSTEM SETUP screen.
Operator's Manual BSM-5100A 3.17
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