Nihon Kohden BSM-5100 User manual

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BSM5105A BSM5106A BSM5135A BSM5136A

WS510P QI101P QI111P

Life Scope A

BEDSIDE MONITOR

BSM-5100A

0614-007099C

line cutting

Model: BSM-5100A

Manual code no.: 0614-007099C

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CONTENTS

 

Contents

 

 

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

i

 

WARRANTY POLICY ....................................................................................................

ii

 

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

iii

 

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

v

 

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

v

 

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

vi

 

On 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 Panel .................................................................................................................

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 Touch 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

 

Temperature 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

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 Power Cord and Grounding the Monitor ............................................

2.11

 

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

2.11

 

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

2.12

 

Turning the Power On ...............................................................................................

2.12

 

Check Before Turning On the Power ...............................................................

2.12

 

Turning the Power On .....................................................................................

2.13

 

Standby Mode ................................................................................................

2.13

 

Check After Turning On the Power and During Monitoring ...............................

2.13

 

Turning the Power Off ...............................................................................................

2.14

 

Check After/Before Turning the Power Off ......................................................

2.14

 

Power 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

 

 

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

 

DISPLAY Window .....................................................................................................

3.31

 

RECORDINGWindow ...............................................................................................

3.31

 

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

3.31

 

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

3.32

 

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

3.33

 

INTERBED Window ..................................................................................................

3.33

 

DRUG CALCULATE 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 PATIENT INFO Window .......................................................................

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

CONTENTS

 

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

5.2

Overview ..............................................................................................................................

5.3

Monitoring Screen ......................................................................................................

5.3

Review Windows ........................................................................................................

5.3

Sync Sound ...............................................................................................................

5.4

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

5.4

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

5.4

Interbed Monitoring .....................................................................................................

5.4

Monitoring Screen ................................................................................................................

5.5

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

5.6

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

5.6

Trendgraph/PWTT trendgraph/OCRG Display on the Monitoring Screen

 

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

5.6

Blood Pressure Waveform Display Mode..........................................................

5.6

Parameter Colors .............................................................................................

5.6

Waveform Sensitivity .......................................................................................

5.6

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

5.7

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

5.8

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

5.10

Displaying OCRG ...............................................................................................................

5.11

Freezing Waveforms ...........................................................................................................

5.12

Calibrating Waveforms ........................................................................................................

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 Waveforms on the 12 Lead Window ................................................

5.19

Performing 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

 

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

Temperature 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

CONTENTS

 

Setting Vital Signs Alarms Individually .....................................................................

6.26

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

 

Trend 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 for 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 Window ............................

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 Waveform Annotation ...................................................................

7.13

 

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

7.13

 

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

7.15

 

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

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 .......................................

7.20

 

Recording the Full Disclosure Waveform ..................................................................

7.22

 

Recording the Full Disclosure Data ................................................................

7.22

 

Recording the Actual Size ECG Waveform .....................................................

7.22

 

Printing the Full Disclosure Waveform ......................................................................

7.23

 

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

 

 

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 Waveform 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 Waveforms .............................................................................

8.10

 

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

8.10

 

Recording Waveforms 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

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

Monitoring Arrhythmia ............................................................................................

11.10

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

11.11

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

11.11

Learning the ECG Waveform for Arrhythmia 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 Electrodes 11.19

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 Spike Detection On/Off ..................................................................

11.30

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

11.31

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

11.33

C.8

Operator's Manual BSM-5100A

 

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 Waveform 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 Waveform Sweep Speed ............................................................

13.19

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

13.21

Operator's Manual BSM-5100A

C.9

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 on the Monitoring Screen .........................................................

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 Waveform 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 on the Monitoring Screen ...........................................................

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 Waveform Sensitivity ...........................................................

14-2.10

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

14-2.11

C.10

Operator's Manual BSM-5100A

 

 

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 Patient .........................................

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

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 Waveform 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 Temperature .......................................................................................................

17.7

 

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

17.7

 

Changing Temperature 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 Temperature 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

 

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 Temperature 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 Value ..................................

19.28

Operator's Manual BSM-5100A

C.13

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

 

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

Temperature 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

Turning Touchkey 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

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

 

CONTENTS

Section 23 Reference ............................................................................

23C.1

Specifications ....................................................................................................................

23.1

Display ...........................................................................................................

23.1

Sound .............................................................................................................

23.1

Alarm .............................................................................................................

23.1

ECG ...............................................................................................................

23.1

Respiration (Transthoracic 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

Power Requirement ........................................................................................

23.8

Environment ...................................................................................................

23.8

Dimensions and Weight (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 Temperature 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

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.

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9.When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or location of electrodes and/or transducers to avoid possible burn to the patient.

10.When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.

WARRANTY POLICY

Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded from the warranty.

NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period, provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals.

No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any other warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding this warranty.

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

This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation or application, or on which the original identification marks have been removed.

In the USA and Canada other warranty policies may apply.

CAUTION

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

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Operator's Manual BSM-5100A

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 electromagnetic 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 performance, you must avoid, identify and resolve the adverse electromagnetic effect before continuing to use the equipment and/or system.

The following describes some common interference sources and remedial actions:

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

Install the equipment and/or system at another location if it is interfered with by an emitter source such as an authorized radio station. Keep the emitter source such as cellular phone away from the equipment and/or system.

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

Identify the cause of this interference and if possible remove this interference source. If this is not possible, use a different power supply.

3.Effect of direct or indirect electrostatic discharge:

Make sure all users and patients in contact with the equipment and/or system are free from direct or indirect electrostatic energy before using it.

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

If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or system as far as possible from the radio wave receiver.

If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden Corporation subsidiary or distributor for additional suggestions.

This equipment complies with International Standard 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.

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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, PATIENT COUPLED EQUIPMENT and/or SYSTEMS applicable IMMUNITY test methods are under consideration at SC62A/WG13. The 3 V/m IMMUNITY level may be inappropriate especially when measuring SpO2 because physiological signals can be much smaller than those induced by a 3 V/m electromagnetic field.

When measuring SpO2, various interference may produce false waveforms which look like pulse waveforms. SpO2 value and pulse rate may be measured from these false waveforms, causing the alarm to function improperly.

When installing the monitor, avoid locations where the monitor may receive strong electromagnetic interference such as radio or TV stations, cellular phone or mobile two-way radios.

WARNING

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

The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker may be affected by cardiac monitoring and diagnostic equipment which is connected to the same patient. If this occurs, the pacemaker may pace at its maximum rate and give incorrect data to the monitor or diagnostic equipment. If this occurs, disconnect the monitor or diagnostic equipment from the patient or change the setting on the pacemaker by referring to the pacemaker’s manual. For more details, contact your pacemaker distributor or Nihon Kohden distributor.

*Minute ventilation is sensed in rate-adaptive pacemakers by a technology known as bioelectric impedance measurement (BIM). Many medical devices in addition to pacemakers use this technology. When one of these devices is used on a patient with an active, minute ventilation rate-adaptive pacemaker, the pacemaker may erroneously interpret the mixture of BIM signals created in the patient, resulting in an elevated pacing rate.

For more information, see the FDA web site. http://www.fda.gov/cdrh/safety.html

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Operator's Manual BSM-5100A

Conventions Used in this Manual and Instrument

Warnings, Cautions and Notes

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

WARNING

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

CAUTION

A caution alerts the user to possible injury or problems with the instrument associated with its use or misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other property.

NOTE

A note provides specific information, in the form of recommendations, prerequirements, alternative methods or supplemental information.

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Nihon Kohden BSM-5100 User manual

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

 

Defibrillation-proof type CF applied

 

 

part

 

 

 

 

“Off” only for a part of instrument

 

Defibrillation-proof type BF applied

 

 

part

 

 

 

 

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

 

NIBP interval

 

Year of manufacture

 

NIBP start

 

Serial number

 

NIBP stop

 

Protective earth

 

Menu

 

High voltage

 

Home (monitoring screen)

 

Fuse

 

Attention, consult operator’s

 

 

 

manual

 

 

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Operator's Manual BSM-5100A

On screen

Symbol

Description

Symbol

Description

 

 

 

 

 

 

 

Alarm suspend with remaining

 

 

 

QRS/pulse sync mark

 

minutes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alarm off

 

 

 

Respiration sync mark

 

 

 

 

 

 

 

Alarm recording off

 

 

 

Value out of range

 

 

 

 

 

 

 

 

 

 

 

Recording

 

 

 

Current measuring value

 

 

 

 

 

 

 

Paper magazine open

 

 

 

Adjust setting/Scroll data

 

 

 

 

 

 

 

Out of paper

 

 

 

Touch screen calibration mark

 

 

 

 

 

 

 

Printer (when QI-111P network

 

 

 

Change scale

 

printer card is used)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cascaded waveform

 

 

 

Network communicating (when QI-

 

 

 

 

101P network card is used)

 

 

 

 

 

 

 

 

 

 

 

Others

Symbol

Description

Recycle (On battery pack)

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vii

Section 1 General

Introduction .........................................................................................................................

1.2

Features ..............................................................................................................................

1.3

Composition ........................................................................................................................

1.5

Network Composition ..........................................................................................................

1.6

Panel Description ................................................................................................................

1.7

Front Panel ................................................................................................................

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 Touch 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

Temperature Monitoring ...........................................................................................

1.31

CO Monitoring .........................................................................................................

1.31

CO2 Monitoring ........................................................................................................

1.31

FiO2 Monitoring .......................................................................................................

1.33

Anesthesia Gas Monitoring .....................................................................................

1.33

Maintenance ...........................................................................................................

1.34

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1C.1

1. GENERAL

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

you have not used a BSM-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

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 AC power.

For simplicity, the suffix A will be omitted in this manual. There is no difference in operation among models with different suffixes unless otherwise specified.

NOTE

Use only Nihon Kohden parts and accessories to assure maximum

performance from your instrument.

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Operator's Manual BSM-5100A

1. GENERAL

Features

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 AG-

920R multigas unit can be connected to the bedside monitor to monitor anesthetic gas.

The difference between the monitors are:

Model

BSM-5105

BSM-5106

BSM-5135

BSM-5136

SpO2 probe

Nihon Kohden’s

Nellcor’s

Nihon Kohden’s

Nellcor’s

NIBP PWTT

Yes

No

Yes

No

measurement

 

 

 

 

Integrated

No

No

Yes

Yes

multigas unit

 

 

 

 

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.

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1.3

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