Nonin 7600 Operator's Manual

Operator’s Manual
Model 7600
4-Channel
Regional Oximeter with
Equanox™ Technology
and Bluetooth
®
Technology
For Display Software
Revision 11 and Higher
English
0123
Nonin® reserves the right to make changes and improvements to this manual and the products it describes at any time, without notice or obligation.
Nonin Medical, Inc.
13700 1st Av
enue North
Plymouth, Minnesota 55441-5443
USA
+1 (763) 553-9968
(800) 356-8874 (USA and Canada)
Fa
x +1
(763) 553-7807
mail@nonin.com
www.nonin.com
0123
EC
REP
MPS, Medical Product Service GmbH
Borngasse 20
D-35619 Braunfels, Germany
References to “NONIN” in this
manual shall imply Nonin Medical, Inc.
Nonin is a registered trademark of Nonin Medical, Inc.
The Bluetooth word mark and logos are ow
ned by the Bluetoo
th SIG, Inc. and any use of such marks by Nonin Medical, Inc. is under license. Other trademarks and trade names are those of their respective owners.
© 2010 Nonin Medical, Inc.
7839-001-01
CAUTION: Federal law (USA) restricts this device to sale by or on the order of a licensed practitioner.
Consult Instructions for Use.
i
Contents
Indications for Use............................................................. 1
Contraindications ...................................................................... 1
Warnings ................................................................................... 1
Cautions .................................................................................... 2
Declaration of Conformity with FCC and Canadian Ministry
of Health Rules for Electromagnetic Compatibility................... 4
Federal Communications Commission (FCC) Notice................ 5
Guide to Symbols............................................................... 6
Introduction to the Model 7600....................................... 10
Benefits of the Model 7600 Regional Oximetry System.......... 10
Setting Up the Model 7600 Monitor......................................... 11
Sensor Application .................................................................. 12
Bluetooth Technology ............................................................. 13
Battery..................................................................................... 13
Displays, Indicators, and Controls................................. 14
Displays................................................................................... 15
%rSO
2
Displays ..................................................................15
Hemoglobin Index (HbI) Display ........................................ 15
Cumulative Saturation Below Reference Display (AUC) ... 15
Indicators and Controls ........................................................... 16
Using the Model 7600 Regional Oximeter Monitor....... 20
Verifying System Operation .................................................... 20
Connecting Devices with Bluetooth......................................... 20
Event Mark .............................................................................. 21
Operating Modes and Defaults....................................... 22
Limits Mode............................................................................. 22
Reviewing, Setting, or Changing Alarm Limits................... 23
rSO
2
Reference ................................................................. 23
Menu Mode ............................................................................. 24
USER Menu Mode .................................................................. 26
Factory Defaults................................................................. 27
User-Defined Defaults........................................................ 28
Nurse Call Feature............................................................. 29
Language Options.............................................................. 30
Alarms............................................. ... .... ... ... ... .................. 31
High Priority Alarms ................................................................ 31
Medium Priority Alarms ........................................................... 31
Silencing Alarms ..................................................................... 32
Error Codes............................................................................. 32
ii
Memory and Data Output Features ........................... ... .. 33
Patient Data Output................................................................. 33
Memory Features .................................................................... 36
Data Management Software ....................................................36
Care and Maintenance................................................ ... .. 37
Cleaning the Model 7600 and7600B/7600PA ......................... 37
Parts and Accessories..................................................... 38
Troubleshooting............................. ... .... ... ...... .... ... ... ... ... .. 40
Service, Support, and Warranty...................................... 42
Service and Support................................................................ 42
Warranty.................................................................................. 43
Technical Information........................... ... ........................ 44
Manufacturer’s Declaration ..................................................... 44
Testing Summary .................................................................... 48
Principles of Operation....................................................... 48
rSO
2
Accuracy Testing ...................................................... 48
Specifications .......................................................................... 49
Transmitter..........................................................................50
External Monitor Installation Instructions ..................... 51
Philips VueLink........................................................................ 51
Components....................................................................... 51
Connection Specifications...................................................51
Connecting the 7600 to the Philips Monitor ....................... 51
Alerts.................................................................................. 56
Figures
Figure 1. Model 7600 Regional Oximeter Monitor .................. 11
Figure 2. Setting Up the Monitor (Two-Channel Trunk
Cable Shown) ....................................................................... 12
Figure 3. Model 7600 Controls and Indicators with
Two-Channel Display............................................................ 14
Figure 4. Four-Channel Display .............................................. 14
Figure 5. Model 7600 Main Menu Screen Buttons.................. 18
Figure 6. Model 7600 Limits Menu Screen Buttons ................ 19
Figure 7. Bluetooth Screen ..................................................... 20
Figure 8. Model 7600 Limits Screen ....................................... 22
Figure 9. Model 7600 Menu Mode Screen.............................. 24
Figure 10. USER Menu Mode Options.................................... 26
Figure 11. RS-232 Serial Data Port .........................................33
Figure 12. 7600 Connection to Philips Monitor ........................52
Figure 13. Philips Indicator on 7600 Display............................54
iii
Tables
Table 1. Labeling Icons ............................................................. 6
Table 2. Display Icons............................................................... 7
Table 3. Button Icons ................................................................ 8
Table 4. Soft Button Icons......................................................... 9
Table 5. Display Indicators and Icons ..................................... 16
Table 6. Front Panel Buttons .................................................. 17
Table 7. Main Menu Buttons ................................................... 18
Table 8. Limits Menu Buttons.................................................. 19
Table 9. Alarm Limit Setting Options....................................... 23
Table 10. Factory Default Alarm Limit Settings .................... 27
Table 11. Nurse Call Setup Options........................................ 29
Table 12. Error Codes............................................................. 32
Table 13. Data Output Format .................................................34
Table 14. Electromagnetic Emissions ..................................... 44
Table 15. Electromagnetic Immunity....................................... 45
Table 16. Guidance and Manufacturer’s Declaration—
Electromagnetic Immunity.................................................... 46
Table 17. Recommended Separation Distances..................... 47
Table 18. Philips Monitor Patient Alarms .................................57
Table 19. Philips Monitor Equipment Alarms ...........................58
1
Indications for Use
Indications for Use
Nonin’s non-invasive Model 7600 4-Channel Regional Oximeter system is intended for use as an absolute real-time adjunct monitor of regional hemoglobin oxygen saturation of blood underneath the sensor. It is intended for spot-checking or continuous monitoring of adult or pediatric patients weighing greater than 40 kilograms (88 pounds). It is intended for use in environments including the operating room, surgical recovery, critical care, emergency room, long-term care, and mobile environments.
Contraindications
Do not use this device in an MR environment.
Explosion Hazard: Do not use in an explosive atmosphere or in the presence of flammable anesthetics or gasses.
Warnings
This device is intended only as an adjunct device in patient assessment. It should not be used as the sole basis for diagnosis or therapy decisions. It must be used in conjunction with other methods of assessing clinical signs and symptoms.
Use only Nonin-branded oximeter pods, sensors, and accessories. These sensors are manufactured to meet the accuracy specifications for Nonin oximeters. Using other manufacturers’ sensors can result in improper oximeter performance.
Always inspect the device before use. Do not use a damaged device or sensor. Before using any sensor, carefully read the sensor Instructions for Use, which contains sensor application information for each sensor.
Protect from exposure to water or any other liquid, with or without AC power.
Use the Model 7600 only with power adapters supplied by Nonin Medical.
As with all medical equipment, carefully route patient cables and connections to reduce the possibility of entanglement or strangulation.
Use the Model 7600 Monitor only within its designated range (approximately 100 meters (300 feet) spherical radius from 7600 monitor to remote location). Moving outside this range may cause missing or lost data at the remote monitoring location.
Memory is cleared if error code E06 appears on the display screen.
This device turns off after approximately 30 minutes when in low battery condition.
2
Indications for Use
If this device is used adjacent to or stacked with other equipment, the device should be observed carefully to verify normal operation.
The battery pack must be installed at all times while the device is operating— even when operating on AC power. Do NOT use the device without batteries.
The use of pods, sensors, accessories, and cables other than those listed in this manual may result in increased electromagnetic emission and/or decreased immunity of this device.
The device Nurse Call and Bluetooth features should not be used as the primary source of alarm notification.
The user must verify the device Bluetooth pairing to ensure the correct patient is remotely monitored.
Ensure all alarm volumes are set appropriately and are audible in all situations. Do not cover or otherwise block any speaker openings.
This device is a precision electronic instrument and must be repaired by qualified technical professionals. Field repair of the device is not possible. Do not attempt to open the case or repair the electronics. Opening the case may damage the device and void the warranty.
Cautions
The value of data from the system has not been demonstrated in specific disease states.
When using this device in an operating room, it must remain outside the sterile field.
This equipment complies with IEC 60601-1-2 for electromagnetic compatibility (EMC) for medical electrical equipment and/or systems. This standard is designed to provide reasonable protection against harmful interference in a typical medical installation. However, because of the proliferation of radio-frequency transmitting equipment and other sources of electrical noise in healthcare and other environments, it is possible that high levels of such interference due to close proximity or strength of a source might disrupt the performance of this device. Medical electrical equipment needs special precautions regarding EMC, and all equipment must be installed and put into service according to the EMC information specified in this manual.
Warnings (Continued)
!
3
Indications for Use
Exposure to Radio Frequency Radiation. The radiated output power of the display device is far below FCC radio frequency exposure limits. Nevertheless, the device must be used in such a way that the potential for human contact during normal operation is minimized. To avoid the possibility of exceeding FCC radio frequency exposure limits, remain at least 20 cm (8 in.) away from the display unit’s internal antenna during normal operation. The monitor has been tested and meets allowed limits for exposure.
Portable and mobile RF communications equipment can affect medical electrical equipment.
Radios and cell phones or similar devices can affect the equipment and must be kept at least 2 meters (6.5 feet) away from the equipment.
Readings of this device may be affected by the use of an electrosurgical unit (ESU). Keep electrosurgical/electrocautery instruments away from the sensors and oximetry pod, as they may cause damage or result in erroneous readings.
This device is designed to determine regional hemoglobin oxygen saturation of blood underneath the sensor. Factors that may degrade performance or affect the accuracy of the measurement include the following:
- excessive ambient light or direct sunlight
- excessive motion
- electrosurgical interference
- metal plate or other foreign object in sensor path
- moisture on the skin
- improperly applied sensor
- incorrect sensor type
- anemia or low hemoglobin concentrations
- cardiogreen and other intravascular dyes
- methemoglobin and other dyshemoglobins
- hemoglobinopathies
- performance has not been verified in the presence of elevated carboxyhemoglobin or bilirubin
- non-normocapnic conditions or other conditions that affect blood volume
Batteries are a fire hazard if damaged. Do not damage, mishandle, or disassemble.
Inspect the sensor application sites at least every 2 to 4 hours to ensure correct sensor alignment and skin integrity. Patient sensitivity to the sensor’s adhesive may vary due to medical status or skin condition.
Do not autoclave, sterilize, or immerse this device in liquid or use caustic or abrasive cleaning agents. Do not use cleaning agents or cleaning products that contain ammonium chloride.
Cautions (Continued)
!
4
Indications for Use
Declaration of Conformity with FCC and Canadian Ministry of Health Rules for Electromagnetic Compatibility
• Nonin Medical, Inc., of 13700 1st Avenue North, Plymouth, Minnesota, 55441, declares under its sole responsibility that the Model 7600, to which this declaration relates, comply with part 15 of the FCC Rules. Operation is subject to the following two conditions: (1) this device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation.
Follow local, state and national governing ordinances and recycling instructions regarding disposal or recycling of the device and device components, including batteries. Use only Nonin-approved battery packs.
In compliance with the European Directive on Waste Electrical and Electronic Equipment (WEEE) 2002/96/EC, do not dispose of this product as unsorted municipal waste. This device contains WEEE materials; please contact your distributor regarding take-back or recycling of the device. If you are unsure how to reach your distributor, please call Nonin for your distributor’s contact information.
Data is written continuously when the device is on. If the entire memory is filled, portions of the oldest record will be overwritten when a new record begins.
Verify all alarm settings and limits during system startup to ensure that they are set as intended.
A 2-minute alarm silence is automatically engaged at startup.
A functional tester cannot be used to assess the accuracy of the oximeter monitor or sensor.
When running on battery power, pairing must be initiated within 2 minutes of turning the device on or within 2 minutes of pressing the Bluetooth button. After 2 minutes, the Bluetooth portion of the device turns off to conserve power.
If this device fails to respond as described, discontinue use until the situation is corrected by qualified technical professionals.
Cautions (Continued)
!
5
Indications for Use
• Ministry of Health (Canada), Safety Code 6: standards include a substantial safety margin designed to ensure the safety of all persons, regardless of age and health. The exposure standard for wireless mobile phones employs a unit of measurement known as the Specific Absorption Rate, or SAR. The SAR limit set by the FCC is 1.6W/kg.
Federal Communications Commission (FCC) Notice
This equipment has been tested and found to comply with the limits for a class A digital device, pursuant to part 15 of the FCC Rules. These limits are designed to provide reasonable protection against harmful interference in a residential installation. This equipment generates, uses, and can radiate radio frequency energy. If not installed and used in accordance with the instructions, it may cause harmful interference to radio or television reception, which can be determined by turning the equipment off and on. The user is encouraged to try to correct the interference by one or more of the following measures: (1) Reorient or relocate the receiving antenna, (2) Increase the distance between the equipment and the receiver, (3) Connect the equipment to an outlet on a circuit different from the outlet where the receiver is connected, or (4) Consult the dealer or an experienced radio/TV technician for assistance.
The Model 7600 is designed and manufactured not to exceed the e
mission limits for exposure to radio frequency (RF) energy set by the Federal Communications Commission of the U.S. Government. These limits are part of comprehensive guidelines and establish permitted levels of RF energy for the general populatio
n. The guidelines are based on the safety standards previously set by both U.S. and international standards bodies. This EUT has been shown to be capable of compliance for localized specific absorption rate (SAR) for uncontrolled environment/ general population exposure limits specified in ANSI/IEEE Std. C95.1-
2005.
The FCC requires the user to be notified that any changes or mod
ifications to this device that are not expressly approved by Nonin
Medical, Inc. may void the user’s authority to operate the equipment.
NOTE: No modifications to this device are allowed that in any way affect
or alter its antenna or antenna configuration.
6
Guide to Symbols
Guide to Symbols
This chapter describes the symbols that are found on the Model 7600 system or packaging. Detailed information about functional symbols can be found in “Displays, Indicators, and Controls.”
Table 1: Labeling Icons
Symbol Description
Caution!
Consult instructions for use.
Defibrillation-Proof Type BF Applied Part (Patient isolation from electrical shock).
UL Mark for Canada and the United States with respect to electric shock, fire, and mechanical hazards only in accordance with UL 60601-1 30EM and CAN/CSA C22.2 No. 601.1.
Non-ionizing electromagnetic radiation. Equipment includes RF transmitters; interference may occur in the vicinity of equipment marked with this symbol.
CE Marking indicating conformance to all applicable directives, including EC Directive No. 93/42/EEC concerning medical devices.
Serial Number
Lot Number
Indicates separate collection for waste electrical and electronic equipment (WEEE).
Authorized Representative in the European Community.
IP32
Protected against vertically falling water drops when enclosure is tilted up to 15 degrees, per IEC 60529.
Storage/shipping temperature range of -30 °C to 70 °C (-22 °F to 158 °F).
!
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7
Guide to Symbols
Tabl e 2: Display Icons
Symbol Description
%rSO
2
Regional Hemoglobin Oxygen Saturation
HbI
Hemoglobin Index
AUC
Cumulative Saturation Below Reference (Area Under the Curve)
Sensor Alarm
AC Power Adapter LED
Poor Signal
Pod Communication Lost
Alarm Silence
Low Battery
Adjustable Upper Limit
Adjustable Lower Limit
Reference
Trend
Alarm Volume
Brightness
8
Guide to Symbols
Table 3:
Symbol Description
Button Icons
Table 2: Display Icons (Continued)
Symbol Description
Clear Memory
Factory Defaults
User
Defaults
Nurse Call
ON/STANDBY
Alarm Sile
nce
9
Guide to Symbols
Table 4:
Symbol Description
Soft Button Icons
Limits Menu
Menu
Event Mark
Blu
etooth
Plus
Minus
Next
Save
10
Introduction to the Model 7600
Introduction to the Model 7600
Benefits of the Model 7600 Regional Oximetry System
The Model 7600 Regional Oximetry System with Equanox™ Technology is a fully integrated, digital, Bluetooth-enabled system for measuring regional hemoglobin oxygen saturation (rSO
2
) underneath the sensor. It can be used in virtually any common clinical environment where rSO2 measurements might improve patient outcomes. The following features and user-defined parameters allow the clinical team to adjust the system for the needs of the operating environment.
• 4.5-meter (15-foot) trunk cable and monitor mounting features allow
the
system to be conveniently located for viewing without interfering
with surgical and anesthesiology operations.
• Weighing only 1 kg (2 lbs), this highly mobile system has a 3-hour
battery life and 69 hours of memory, which allows for operational flexibility.
• Trend graph timescale is adjustable from 7.5 minutes to 24 hours,
making it ideal for virtually all clinical application timeframes, and allowing the clinical team to track relative saturation changes from baseline.
• Saturation value trends can be read from across the room, and reflect
the actual percentage of oxygen saturation at that moment.
• Saturation event markers identify critical deviations from acceptable
rSO2 trends and include alphabetical sequencing of events and associated saturation values.
• Area Under the Curve (AUC) displays the integrated, cumulative time
and saturation value below a channel’s reference setpoint.
• Display brightness adjusts for the lighting conditions in each potential
clinical environment.
• Alarm thresholds and volumes are also adjustable to signal
in
tervention at the clinician’s discretion, and to compensate for ambient
noise in each unique clinical operating environment.
• The Nurse Call feature integrates into standard hospital systems.
• RS-232 serial data port allows the 7600 to connect to a PC or an
external monitoring system via a serial cable.
11
Introduction to the Model 7600
Setting Up the Model 7600 Monitor
Carefully remove the monitor and accessories from the shipping carton. Save the packaging materials in case the monitor or accessories must be returned. Compare the packing list with the accessories received to make sure the shipment is complete. The monitor includes these non-sterile components:
• 7600, Regional Oximeter Monitor (figure 1)
• 7600TC-1, Two-Channel Trunk Cable
• 7600B or 7600PA, Regional Oximeter Pods (qty 2)
• Operator’s Manual
• 7800 PS, Power Supply, 25W
• eVision Patient Data Management Software The Four-Channel Accessory Kit includes these components:
• 7600TC-2, Four-Channel Trunk Cable
• 7600B or 7600PA, Regional Oximeter Pods (qty 2)
Figure 1: Model 7600 Regional Oximeter Monitor
Detail A: Pod (oximeter) with Sensor
Display Trunk Cable Pods (contain oximeter)
Detail A illustrates sensor to pod connec
12
Introduction to the Model 7600
Figure 2: Setting Up the Monitor (Two-Channel Trunk Cable Shown)
Sensor Application
Refer to the sensor Instructions for Use (IFU) for proper sensor application sites, and sensor application cautions and warnings.
WARNING: This device is intended only as an adjunct device in
patient assessment. It should not be used as the sole basis for diagnosis or therapy decisions. It must be used in conjunctio n with other methods of assessing clinical signs and symptoms .
WARNING: As with all medical equipment, carefully route patient
cables and connections to reduce the possibility of entanglement or strangulation.
13
Introduction to the Model 7600
Bluetooth Technology
Bluetooth allows wireless connections between electronic communications and computing devices. The technology is based on a radio link that offers fast and reliable data transmissions. Bluetooth uses a license-free, globally available frequency range in the ISM band— intended to ensure communication compatibility worldwide.
Nonin’s use of Bluetooth wireless technology allows regional oxygen sa
turation information to be transmitted through a Bluetooth radio to a compatible Bluetooth-enabled device. Nonin’s wireless system removes the connection from the monitor to a remote monitor location, giving increased ability to move the monitor freely. Nonin’s 7600 monitor uses an automatically switchable class I/class II Bluetooth radio with a maximum range of about 100 meters (328 feet) (spherical radius).
The Model 7600 features point-to-point communications, allowing one master de
vice (the remote monitor) to be paired to one slave device (the 7600 monitor). Once connected, the 7600 monitor will not connect with any other Bluetooth-enabled device.
Battery
Battery capacity: 7.2 V Li-ion battery pack, 2.4 Ah when charged with the
Model 7600
Operating life (fully charged battery): 3 h
ours minimum
Storage life: 20 day
minimum
Recharge time to 90% capacity: 2.5 hours
maximum
• Follow local, state and national governing ordinances and recycling instructions regard
ing disposal or recycling of the
device and device components, including batteries.
• Use only Nonin-approved battery packs.
• Batteries are a fire hazard if damaged. Do not damage, mishandle,
or disassemble.
CAUTIONS:
!
14
Displays, Indicators, and Controls
Displays, Indicators, and Controls
This chapter describes the displays, indicators, and controls for the Model 7600.
Figure 3 shows operation when pods are only connected to channels 1 and/or 2. If pods are connected to ch
annels 3
and/or 4, the system will automatically display all four channels (figure 4) (four-channel accessory kit required).
Trunk Connector
%rSO
2
Channel
Displays
On/Standby
Button
rSO2Trendline
Area
rSO2 Channel Displays
Timescale
rSO2 Trendline
Area
AUC
HbI
Channel 1 & 2
Channel 3 & 4
Figure 3: Model 7600 Controls and Indicators with
Tw o-Channel Display
Figure 4: Four-Channel Display
Blue Soft
Buttons
Alarm Silence
Button
rSO
2
Trendline
Areas
Speaker
AC Power
Adapter LED
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