Novametrix 7100 User manual
CO
SMO
2
User’s Manual
ETCO2/SpO2 Monitor
Model 7100
May 1, 1998
Catalog No. 5758-23-04
Novametrix Medical Systems Inc.
5 Technology Drive, Wallingford, Connecticut, U.S.A. 06492.
Copyright 19 93, 1998. All rights reserved. No part of this manual may be reproduced
without the written permission of Novametrix Medical Systems Inc.
Revision History
23-Jul-93 Revision 00.
27-Apr-93 Revision 01, this manual is based on software version 2.1.
18-Jun-93 Revision 02 (DN-N1247).
21-Sep-94 Revision 03. Includes versions 1.9 and 2.8 software, Disposable Adult Airway
Adapter, and CAPNOSTAT III references.
01-May-98 Revision 04. R-N563
Declaration of Conformity with European Union Dir ecti ve
The authorized representative for Novametrix Equipment is:
D.R.M. Green
European Compliance Services Limited,
Oakdene House,
Oak Road,
W atchfield
Swindon, Wilts SN 6 8TD
United Kingdom
Rev. 04
CO2SMO
Operator’s Guide
iii
[This page intentionally blank.]
iv
CO2SMO
Operator’s Guide Rev. 04
Guarantee
Equipment manufactured or distributed by Novametrix Medical Systems Inc., is fully guaranteed,
covering mater ials and w orkmanship, for a period of one year from the date of shipment, except for
certain disposable products and products with stated guarantees other than one year. Novametrix
reserves the right to perform guarantee service(s) at its factory, at an authorized repair station, or at
the customer’s installation.
Novametrix’ obligations under this guarantee are limited to repairs, or at Novametrix’ option,
replacement of any defecti v e parts of our equipment, except fuses, batteries, and calibration gasses,
without charge, if said defects occur during normal service.
Claims for damages during shipment must be filed promptly with the transportation company. All
correspondence concerning the equipment must specify both the model name and number, and the
serial number as it appears on the equipment.
Improper use, mishandling, tampering with, or operation of the equipment without following
specific operating instructions will void this guarantee and release Novametrix from any further
guarantee obligations.
Service Department
For factory repair service, call toll free
1-800-243-3444
In Connecticut, call Collect (203) 265-7701
Facsimile (203) 284-0753
World Wide Web: http://www.novametrix.com
Internet: techline@novametrix.com
Caution: Federal (U.S.A.) law restricts this device to sale, distribution, or use by or on the order of
a licensed medical practitioner.
Copyright 1993, 1998, Novametrix Medical Systems Inc. This document contains information
which is proprietary and the property of Novametrix Medical Systems Inc., and may not be
reproduced, stored in a retrieval system, translated, transcribed, or transmitted, in any form, or by
any means, without prior explicit written permission from Novametrix Medical Systems Inc.
Rev. 04
CO2SMO
Operator’s Guide
v
Service Policy
Novametrix Medical System s Inc. will provide Warranty Service Support to its customers within 48
hours of receiving a telephone request for technical support. This 48 hour period begins once a
service request is placed through the Factory Technical Support Department in Wallingford,
Connecticut. Novametrix provides factory direct technical support to its customers through a
technical support group located in Wallingford, Connecticut and company service representatives
located throughout the United States. All Technical Support for Novametrix products is provided
“Factory Direct”.
Novametrix pro vides 24 hour a day technical support accessibility via telephone numbers (8 00) 2433444 or (203) 265 -7701. After hours technical suppor t requests (before 8:00 AM and a fter 5 :00 PM
Eastern Time) will be responded to promptly b y the Technical Support On-Call staff. It is suggested
that any person calling in for technical support have the inoperative equipment available for
preliminary troubleshooting as well as product identification. No vametrix reserv es the right to repair
or replace any product found to be defective during the warranty per iod. Repair may be pr o vid ed in
the form of replacement exchange parts or accessories, on-site technical repair assistance or
complete system exchanges. Repairs provided due to product abuse or misuse will be considered
“non-warranty” and invoiced at the prevailing service rate. Any replaced defective material is
expected to be returned to Novametrix within 10 days of being prov ided in order to a v oid ad ditional
charges. Exchanged material should be returned promptly and directly to Novametrix using the
return paperwork a nd shipping la bel(s) provided. Transfe rring return mat erials to local s ales or
dealer representatives does not absolve return responsibility.
Novametrix man ufactures equipm ent that is generally “user serviceable ” and can usually be rep aired
with the replacement of a plug-in electro-mechan ical assembly by the clinical end user. When repair
parts are provided, the recipient can call i nto Novametrix for on-line replacement assistance and
repair assurance. In the event a replacement part requires increased technical capability, Technical
Support may request Biomedical assistance, provide on-site technical support or complete
replacement equipment. If the customer requires the return of their original product, the exchange
material will be considered “loaner material” and exchanged again after the customer equipment is
repaired.
Novametrix pr omotes customer participation in w arranty repairs should th ey become necessary. This
program allows for customer training and a smooth transition into self-maintenance after warranty,
which can provide substantial cost savings on repairs throughout the product’s life.
The Novametrix Technical Support Department c an provide technical product support at a level
appropriate to most customers protocol and budge t requirements. Please contact the Technical
Support Group at Novametrix for additional information.
Additional Novametrix Technical Support Programs
• Focus Series Technical Training Seminars
• Test Equipment and Test Kit s
• Service Contract / Part Insurance Plans
• On-Site Technical Support
• 24 hr. telephone support
• “Demand Services”
Flat rate parts-exchange,
Flat rate return for repair
Time and Material,
Full warranty, discounted replacement sensors
vi
CO2SMO
Operator’s Guide Rev. 04
Contents
About This Manual . ...... ............................................. ....... ...... .............................................1
Acknowledgments ......................................................................................................................... 1
Introduction ...................................... ................................................................ ................... 3
CO
Principles of Operation .........................................................................................................3
2
SpO
Principles of Operation ........................................................................................................4
2
Front Panel Controls and Connectors ............................................................................................5
POWER Keys .................................................................................................................6
AC Mains Operation ............................. .................................. ........................................6
Battery Operation ............................................................................................................6
AUDIO Key ...................................................................................................................7
ALERT RESET Key ......................................................................................................7
The Menu SOFTKEYS ...................................................................................................8
EVENT Key ...................................................................................................................8
CONTRAST Key ...........................................................................................................9
WAVEFORM Key ........................................................................................................9
Red Alert Bar ..................................................................................................................9
CAPNOSTAT CO2 Sensor Input Connector .................................................................9
Sampling System Inlet Connector ..................................................................................9
Rear Panel Controls and Connectors ...........................................................................................10
SpO
Input Connector ...................................................................................................10
2
AC Mains Power Module ........................... ..................................................................10
Sampling System Exhaust Connector ...........................................................................10
Data Communications Port ...........................................................................................10
Patient Safety ....................................................................................................................11
Indications and Usage .................................................................................................................11
Warnings .....................................................................................................................................11
Cautions .......................................................................................................................................12
Monitor Power Up .............................................................................................................15
Monitor Power Up .......................................................................................................................15
Monitor Power Down ..................................................................................................................16
AC Mains Operation ................................ ............................................................................ ... ....16
Battery Operation ........................................................................................................................16
CAPNOSTAT CO
Airway Adapter Selection .................. ...... .................................. ............................................ .....17
Adult Airway Adapter ........................................................................... ......................................17
Single Patient Use Adult Airway Adapter ..................................................................................19
Single Patient Use Airway Adapter with Mouthpiece ................................................................20
Neonatal Airway Adapter ............................................................................................................21
Single Patient Use Neonatal Airway Adapter .............................................................................23
Rev. 04
Sensor ................................................................................................17
2
CO2SMO
User’s Manual
vii
Sampling Airway Adapter ..........................................................................................................25
Non-Intubated Patients ................... ...... ...... .............................................................. ....25
Calibration ...................................................................................................................................27
Sensor Calibration ...................................... .............................................................. ....27
Calibration Verification ............................................................................................ ....27
Adapter Calibration ......................................................................................................28
Monitoring CO
and Respiratory Rate ............................................................................ 29
2
Carbon Dioxide ...........................................................................................................................29
End Tidal CO
2 ...........................................................................................................................................29
Oxygen Compensation .................................................................................................29
Nitrous Oxide Compensation .......................................................................................30
Barometric Pressure Compensation ..............................................................................31
ETCO
Inspired CO
Calculation ............................................................................ ...........................31
2
2 ...............................................................................................................................................32
CO2 Display Units ........................................................................................................32
Respiratory Rate ..........................................................................................................................33
Respiratory Interval Alert .............................................................................................33
Selecting the Respiratory Interval Alert Timer Duration .............................................34
Respiratory Rate Editor ................................................................................................34
Capnogram .................................................................................................................................. 35
Capnogram Speed .........................................................................................................35
Capnogram Scale ..........................................................................................................36
Selecting the Instantaneous CO2 Mode ........................................................................36
SpO2 Sensors ..................................... ....... ...... ...... .............................................. ...... .......37
OxySnap Connectors ...................................................................................................................37
Finger Sensor ..............................................................................................................................38
Finger Sensor Quick Check ..........................................................................................38
Y-Sensor ......................................................................................................................................39
Y-Sensor Application using Wrap Style Tapes ............................................................39
Non-Adhesive Foam Wrap ........................... ...... ...... ................................. .................................41
Adhesive Foam Wraps ................................................................................................................43
Y-Sensor Application using Ear Clip ..........................................................................................45
Y-Sensor Quick Check .................................................................................................46
Single Patient Use SpO
Sensors ................................................................................................46
2
Intended Use .................................................................................................................46
Instructions for Use ......................................................................................................47
Sensor Application ............................................................................ ...........................49
Single Patient Use SpO
Sensor Quick Check .............................................................50
2
viii CO
SMO
User’s Manual
2
Monitoring SpO
SpO
Display Averaging .............................................................................................................51
2
and Pulse Rate .................................................................................... 51
2
Pulse Rate Display Averaging ....................................................................................................51
Pulse “Beep” Volume ................................................................................................................. 52
Signal Bar .................................................................................................................................... 52
Plethysmogram Display .............................................................................................................. 52
Waveform Autosize ......................................................................................................52
Using the SIZE softkey .................................................................................................53
SpO
Timers ................................................................................................................................53
2
Display Held Timer ......................................................................................................53
Special Alert Delay .......................................................................................................54
Bad Signal Timer ..........................................................................................................55
Rev. 04
IABP Mode ............................................ .......................................................................... ........... 56
Making IABP Mode Available ..................................................................................... 56
Turning IABP Mode On/Off ........................................................................................57
Using IABP Mode ........................................................................................................ 57
Alerts ..................................................................................................................................59
Overview ..................................................................................................................................... 59
Limit Alerts ................................................................................................................................. 59
Auto Alert Limits ........................................................................................................................ 60
ETCO2 Auto Alert Limits ............................................................................................ 61
Respiratory Rate Auto Alert Limits .............................................................................61
SpO2 Auto Alert Limits ............................................................................................... 61
Pulse Rate Auto Alert Limits ....................................................................................... 62
Setting Alert Limits Manually .................................................................................................... 62
Alert Volume .............................................................................................................................. 63
Audio Mute ................................................................................................................................. 63
Limit Alerts—Latched/Unlatched .............................................................................................. 64
Alert Limit Settings—Retained/Defaults .................................................................................... 64
Limit Alerts—Delayed/Instant ...................................................................................................65
Alert Bar—Latched/Unlatched/Off ............................................................................................ 66
Trend Memory Display ......................................................................................................67
Overview ..................................................................................................................................... 67
Graphical Trend Display ............................................................................................................. 67
Dual Trend Displays ..................................................................................................... 68
ETCO
Dual SpO
and Respiratory Rate Trend Display Scales .................. ...... ............................ 69
2
and Pulse Rate Trend Display Scales ......................................................... 69
2
Histogram Trend Display ............................................................................................................ 70
Trend Data Compression ............................................................................................................70
Erase Trend Memory .................................................................................................................. 71
Trend Print .................................................................................................................................. 71
Trend and NOVACARD Memory Module ................................................................................ 71
Miscellaneous Features .................................. ..................................................................73
Keyclick Volume ........................................................................................................................ 73
Display Brightness ......................................................................................................................73
Display Colors ............................................................................................................................73
Setting the Clock/Calendar .........................................................................................................74
Display Monitor Software Revision Level ................................................................................. 74
Menu Tree ..........................................................................................................................75
Status Messages ...............................................................................................................81
Using a Printer ...................................................................................................................85
Selecting a Specific Printer ......................................................................................................... 85
Connecting the Seiko DPU-414 Thermal Printer ......................................................... 85
Configuring the Seiko DPU-414 Printer ...................................................................... 86
Connecting the Seiko DPU-411 Printer .......................................................................87
Connecting the Hewlett-Packard ThinkJet Printer ....................................................... 89
Print Formats ............................................................................................................................... 89
Displayed Trend Printout ............................... ...... ..... ................................................... 89
Tabular Mode Text Printout ......................................................................................... 90
Rev. 04
CO2SMO
User’s Manual
ix
Capnogram or Plethysmogram Waveform Printout .....................................................90
Zoom Trend Printout ....................................................................................................90
Compressed Trend Printout ......................................... .................................................91
Interpreting Printer Output ..........................................................................................................92
Header ........................................................................................................................... 92
Graphical Data ..............................................................................................................94
Histogram Data .............................................................................................................94
Tabular Data Format .....................................................................................................94
Capnogram or Plethysmogram Waveform Format ......................................................95
External Devices .............................................. ...... ....... ...... ....... .......................................99
NOVACOM1 Interface ...............................................................................................................99
Mode 1 — Real Time ...................................................................................................99
Mode 3 — CO2 Waveform ........................................................................................100
Mode 4 — SpO2 Waveform .......................................................................................101
Mode 5 — Dual Waveform ........................................................................................102
Mode 6 — Trend Dump .............................................................................................102
Mode d — Date and Time ..........................................................................................104
Mode c — Clear Trends .............................................................................................105
Selecting NOVACOM1 Interface .............................................................................................105
Selecting Analog Module Interface ..........................................................................................105
Connecting the Analog Module ..................................................................................106
Calibrating External Recorder ....................................................................................106
The NOVACARD Memory Module .........................................................................................107
Selecting NOVACARD Interface ..............................................................................107
Connecting the NOVACARD Module ....................................................................... 107
Selecting TeleCap Interface ...................................................................................................... 107
Selecting TeleSat Interface ....................................................................................................... 108
Rear Panel RS232C Pinout .......................................................................................................108
Maintenance ..................... .......................................................... .....................................109
Cleaning and Sterilization ............................. .............................................................. ..............109
Monitor ....................................................................................................................... 109
SpO
Finger Sensor ....................................................................................................109
2
SpO
Y-Sensor ...........................................................................................................109
2
SpO
Y-Strip Tapes and Foam Wraps ........................................................................110
2
Ear Clip .......................................................................................................................110
Capnostat CO
Sensor ................................................................................................110
2
Reusable Adult Airway Adapter .................................................................................110
Reusable Neonatal Airway Adapter ...........................................................................110
External Sampling System Components ....................................................................111
Single Patient Use Airway Adapters ..........................................................................1 11
Internal Sampling System Components .....................................................................111
Maintenance Schedules ............................................................................................................. 112
Battery Maintenance ................................................................................................................. 112
Mains Voltage Configuration ....................................................................................................113
Fuse Replacement .......................................................................................................113
Specifications .................................................................................................................115
General ...................................................................................................................................... 115
Capnograph ............................................................................................................................... 115
Oximeter ....................................................................................................................................116
Monitor Specifications .............................................................................................................. 116
x CO
SMO
User’s Manual
2
Rev. 04
Additional Features ................................................................................................................... 116
Accessories ............... ................................................................ ......................................117
CO2SMO Capnograph and Pulse Oximeter ................. .................................. ..........................117
Typical Capnogram Waveforms ....................................................................................123
Normal Waveform ....................................................................................................................123
Cardiogenic Oscillations ........................................................................................................... 123
Hypoventilation ........................................................................................................................ 124
Hyperventilation ....................................................................................................................... 124
Muscle Relaxants ...................................................................................................................... 125
Rebreathing ............................................................................................................................... 125
Obstruction in Breathing Circuit or Airway .............................................................................126
Endotracheal Tube Kinked .......................................................................................................126
Inadequate Seal Around Endothracheal Tube .......................................................................... 127
Endotracheal Tube in Esophagus ..............................................................................................127
Faulty Ventilator Circuit Valve ................................................................................................127
Rev. 04
CO2SMO
User’s Manual
xi
xii CO
SMO
User’s Manual
2
Rev. 04
About This Manu al
The “CO2SMO ETCO2/SpO2 Monitor U ser’s Manual” describes the op eratio n an d use o f the N ov am etrix
CO
SMO ETCO2/SpO2 Monitor, Model 7100. The manual is divided into the sections described below .
2
• “Introduction” on page 3 provides descri ptions of the monitor, its controls, conn ectors and dis plays.
• “Patient Safety” on page 11 lists important safety information including indications and usage,
warnings, and cautions.
• “Monitor Power Up” on page 15 explains how to turn
and Battery operation are also explained here.
• “CAPNOSTAT CO
and other accessories.
• “Monitoring CO
related to monitoring ETCO
• “SpO2 Sensors” on page 37 describes the Finger Sensor, the Y-Sensor™ and their accessories.
• “Monitoring SpO
monitoring SpO
• “Alerts” on page 59 provides information on the various monitor alerts.
• “Trend Memory Display” on page 67 details
• “Miscellaneous Features” on page 73 describes features not directly linked to specific sections of
this manual.
• “Menu Tree” on page 75 diagrams the menu flow of the
• “Status Messages” on page 81 lists the various messages that may appear on the
and lists possible causes.
• “Using a Printer” on page 85 describes the various printers
the various printing modes.
• “External Devices” on page 99 describes the various externally conected options available that
operate with the
• “Maintenance” on page 109 lists monitor, sensor and accessory cleaning and sterilization
instructions.
• “Specifications” on page 115 detail the
• “Accessories” on page 117 lists
• “Typical Capnogram Waveforms” on page 123 provides additional capnogram-related
information.
Sensor” on page 17 describes the CO2 sensor, associated airway adapters
2
and Respiratory Rate” on page 29 describes those monitor features directly
2
and Pulse Rate” on page 51 describes those monitor features directly related to
2
and Pulse Rate.
2
CO2SMO.
and Respiratory Rate.
2
CO2SMO’s trend memory features.
CO2SMO ETCO
CO2SMO ETCO
CO2SMO on and off. AC Mains operation
CO2SMO.
CO2SMO display,
CO2SMO supports and the formats of
/SpO2 Monitor, Model 7100.
2
/SpO2 Monitor, Model 7100 accesories.
2
Rev. 04
Acknowledgments
CAPNOST AT is a registered trademark and CO
of Novametrix Medical Systems Inc. Othe r trademarks and registered tradema rks are owned by their
respective companies. U.S.A. and foreign patents pending.
SMO, SuperBright, Y-Sensor and Y-Strip are trademarks
2
CO2SMO
User’s Manual
1
[This page intentionally blank.]
Acknowledgments
2
CO2SMO
User’s Manual Rev. 04
Section 1
Introduction
The Novametrix CO
SMO ETCO
2
/SpO2 Monitor, Mo del 7100, is a lightweight, easy to use, combin ation
2
capnograph and pulse oximeter monitor designed for use in a variety of clinical settings. It provides
reliable measurement, display and alerts for, end tidal carbon dioxide (ETCO
functional pulsatile oxygen saturation (SpO
) and pulse rate. The included sampling sy stem allows CO
2
), respiration rate,
2
monitoring of non-intubated patients.
Numerical and waveform information is presented on a bright Cold Cathode Display (CCD) with user
adjustable contrast to optimize viewing angles. A simple menu system allows user selection of
measurement and display options. Alerts are menu programmable or automatic. Presence of a pulse is
indicated audibly by a user-selectable “beep”.
Separate 24 hour trends for ETCO
, respiration rate, SpO2 and pulse rate are updated every 8 seconds.
2
Trend “e v ents” and audible alarm status (Audio Off ) are also stored in trend memory.
CO2SMO has a serial port (RS232) for interfacing to external equipment. The monitor can be powered
from the AC Mains or from its rechargeable two-hour battery.
CO2 Principles of Operation
CO2SMO measures carbon dioxide and respiratory rate with a unique solid-state device called a
CAPNOSTAT CO
airway adapter is placed in the patient’s airway circuit—typically between the ventilator elbow and the
patient wye (See “CAPNOSTAT CO
“U” shaped sensor and then beamed thro ugh the wind o ws of the airw ay ad apter to a detector in the oth er
leg of the sensor. Carbon dioxide, flowing in the airway adapter as a result of respiration, absorbs some
of this light energy. The monitor relates the amount of detected energy to the amount of CO
sample cell (the airway adapter). This results in a capnogram display and numerical values for CO
respiration rate.
accurate digital filters and adaptive thresholds to cover a wide range of monitoring situations including,
rebreathing, neonatal respirat ory rates and CO
operator having to change monitor settings.
Respiration is calculated by measuring the time interval between detected peaks of the CO
The inverse of this measurement is displayed as respiratory rate. Certain rebreathing circuits, or the
presence of artifact such as cardiogen ic oscillation s, may cause
fluctuations as if they were breaths—this condition affects only the numerical displays, the Capnogram
display continues to provide an accur ate picture of the CO
enabled to make the instrument more selective in its differentiation of waveforms caused by breathing
and those introduced by artifact. As a result, when the editor is in use, the monitor will adapt slowly to
sudden changes in respiratory rate.
Sensor. The CAPNOSTAT CO2 Sensor is placed onto an Airway Adapter and the
2
Sensor” on page 17.) Infrared light is generated in one leg of the
2
CO2SMO uses an adaptive digital detection algorithm system incorporating highly
levels, and adult OR and ICU conditions without the
2
waveform.
2
CO2SMO to react to non-respiratory CO
waveform . A Respiratory Rate Editor can be
2
in the
2
and
2
2
2
Rev. 04
CO2SMO
User’s Manual
3
Section 1
SpO2 Principles of Operation
SpO2 Principles of Operation
CO2SMO measures oxygen saturation and pulse rate with sensors that contain red and infrared light
sources, called LEDs. Since oxygen satur ated blood absorbs different amounts of light at each
wavelength (red and infrared) as compared to unsaturated blood, the amount of light absorbed by the
blood in each pulse can be used to calculate oxygen saturation.
The light energy from red (660 nm) and infrared (940 nm) LEDs is beamed through a sample cell—a
pulsating vascular bed, the patient’s finger or toe for example. The remaining light energy not absorbed
by the sample cell reaches a light receptor, called a photodiode, on the opposing side of the sensor. The
data received at the photodiode is sent back to the monitor where it is split into its red and infrared
components, digitized, processed by a microprocessor chip, and finally displayed as a numerical value
for oxygen saturation and a plethysmogram.
CO2SMO is calibrated to dis play “functional” saturation. This differs from the “fractional” saturation
value displayed by most co-oximeters
HbO
Functional Saturation =
HbO
= Fractional Hemoglobin
2
COHb = Carboxyhemoglobin
METHb = Methemoglobin
100 - (COHb + METHb)
2
Functional saturation represents the amount of oxyhemoglobin as a percentage of the hemoglobin that
can be oxygenated. Dysfunctiona l hemoglobins (COHb and METHb) are not included in the
measurement of functional saturation.
Pulse Rate is calculated by measuring th e time interv al between the peaks of the in frared ligh t wa vefor m.
The inverse of this measurement is displayed as pulse rate.
CO2SMO must be used in conjunction with SuperBright™ saturatio n sensors. An INCOMP SpO2 PROBE
message indicates a non-SuperBright™ Sensor is in use.
4
CO2SMO
User’s Manual Rev. 04
Front Panel Controls and Connectors
Front Panel Controls and Connectors
1
2
3
4
Introduction
13
12
5 6 8 9 10 15 14
1 Press to turn CO2SMO on, or if on, press to turn
off ETCO
with
2
Press to turn CO
off SpO
with
3
AC ON . If illuminated, CO
portion of monitor. Press in combination
2
to turn unit off.
SMO on, or if on, press to turn
2
portion of monitor. Press in combination
2
to turn unit off.
SMO is connected to
2
AC Mains power and charging internal battery.
LOW BAT . Illuminates when approximately 15
4
minutes of battery life remain.
5 (Two Minute Silence). Illuminates when
key is
pressed. Indicates audible alerts are silenced for two
minutes.
6 Press and release to start Two Minute Silence, or
stop Two Minute Silence or Audio Off. Press and hold
three seconds to start Audio Off.
7 (Audio Off).Flashes when key is pressed for
three seconds. Indicates audible alerts have been
disabled.
8 Press to turn off alert indicators. Alerts will
reactivate if still valid.
9 (Alert). Flashes red as soon as an alert occurs.
10 Softkeys (5). Perform the action annotated in the
Message Center above each key.
11
Press to mark an “event” in trend memory. When
pressed while in the Main Menu the waveform is
frozen for sixty seconds. Pressing the
RUN softkey
will return to real time instantly.
167 11
12 (Contrast). Press to adjust display contrast for
optimum viewing.
13
Press to switch between capnogram,
plethysmogram, or dual waveform displays
14 CO
Input Connector. Plug the CAPNOSTAT CO2
2
Sensor in here.
15 Sampling System Inlet Connector. The Sampling
Airway Adapter tubing plugs in here.
16 Red Alert Bar. Flashes red when alert is latched.
Symbols:
Patient isolation: Identifies connection as type BF
Attention: Consult manual for detailed information
Indicates heavy metal content, specifically lead.
Found on the internal battery and monitor enclosure.
Pb
Refer to qualified service personnel when battery
replacement is required.
Recyclable item. Found on the internal battery. Refer
to qualified service personnel when battery
replacement is required.
Mains fuse rating for replacement fuses.
250V
Separate collection. Ensure that spent batteries are
collected separately when disposed of. Found on the
internal battery. Refer to qualified service personnel
when battery replacement is required.
Equipotentiality: Connection to monitor’s chassis
Rev. 04
CO2SMO
User’s Manual
5
Section 1
Front Panel Controls and Connectors
POWER Keys
To turn CO
SMO on, press either the or key. To turn the monitor off, press both the and
2
keys.
NO T E
CO2SMO powers up as a combined ETCO2/SpO2 monitor. If only the capnograph or pul se oximeter
portion is going to be used, th e unused half can be disabled to avoid nuisance alerts and error
messages. With the monitor turned on, press either POWER key to shut down that half of the monitor.
Press the key again turn that half back on. T o turn CO
the power key associated with the active parameter.
Press key
to turn off CO
Press key
to turn off SpO
2
2
SMO off while only one parameter is active, press
2
AC Mains Operation
CO2SMO uses AC Mains ( line cord ) po wer if available and automatically switches to battery operation if
AC Mains power is removed or not present. An illuminated AC ON indicator means the
CO2SMO is
connected to AC Mains power and the internal battery is being charged.
To power
CO2SMO from AC Mains (line cord) power; P lug the line cord into the rear panel AC input
connector . Set the rear panel po wer switch to the “|” (ON) position. Plug the other end of the line cord to
a properly grounded three-wire outlet.
NOTE
Caution: Ensure the AC ON indicator is illuminated w hen operation from AC mains is desired,
otherwise power for the monitor is drawn from the internal battery. This can result in the monitor shutting
itself off if the battery is allowed to drop to the low battery state. See “Battery Operation” on page 6.
Battery Operation
CO2SMO uses battery power if the line cord is disconnected or the rear panel power switch is set to the
“O” (OFF) position.
While on battery power,
indicates a fully charged battery, a half charge, and indicates less than 30 minutes of battery
CO2SMO can operate up to two hours from its internal battery.
CO2SMO displays a battery icon to the right of the numerical Respiration display .
6
CO2SMO
User’s Manual Rev. 04
Front Panel Controls and Connectors
life remain. Note: The battery icon may appear fully ch arged for the first minute after switching to battery
power: wait one minute for the icon to truly reflect battery charge.
When approximately 15 minutes of battery life remains, the front panel
flash. Reconnect the monitor to the AC Mains to rechar ge the battery. The monitor can be operated from
the AC Mains while the battery is being recharged. The battery will be fully recharged in 12-15 hours.
If the monitor continues operating on battery power while in the lo w battery state ( indicator flashing),
the message
continue operation while in the very low battery state, the monitor shuts itself off to prevent damage to
the battery and monitor.
BATTERY VERY LOW PLUG IN AC POWER is displayed. If the monitor is al lowed to
Introduction
LOW BAT indicator starts to
NOTE
This alert cannot be silenced by pressing the key. The monitor must be connected to AC Mains
power to silence the alert condition and recharge the battery. See “A C Mains Operation” on page 6.
AUDIO Key
Audible alarms can be silenced in two ways; temporarily or permanently.
• Two Minute Alarm Silence: Press the key. The (two minute silence) indicator illuminates
and audible alerts are silenced for two minutes. After two minutes, the indicator turns off and
audible alerts are again allowed to sound. To cancel the two minute silence before the two minutes
have elapsed, press the key again and the silence condition will be cancelled.
• Permanent Audio Off: Press and hold the key until the (audio off) indicator starts
flashing
again: it will stop flashing and audible alerts are again allowed to sound.
*
. No audible alerts will be generated. To cancel the audio off condition , press the key
ALERT RESET Key
An alert occurs if ETCO2, respiration rate, SpO2 or pulse rate exceeds the displayed alert limits. Alerts
are also generated by conditions such as NO RESP. When an alert occurs, the (alert) indicator flashes,
and the violated limit displays and the red alert bar may flash and an alarm may sound. Once the alert
condition is fixed, and other flashing displays may continue even though the audible alarms stop.
Press the key to stop an alert condition that is not currently active. Any alert messages, flashing
indicators or audible alerts will be disabled. Currently acti ve alerts will be re set and aga in become acti v e
once any time-out period has elapsed.
In certain conditions such as NO RESP, pressing will reset (silence) the audible alerts until monitoring
is resumed and the monitor again displays end tidal and respiration rate values.
Rev. 04
*If AUDIO OFF DISABLED appears when the user activates AUDIO OFF, refer to “Audio Mute” on page 63.
CO2SMO
User’s Manual
7
Section 1
Front Panel Controls and Connectors
The Menu SOFTKEYS
The Menu Center display area is located just above the five unmarked “softkeys”. Softkeys perform the
action displayed above each key. For example; above the rightmost softkey in the Main (or Base) Menu
is a
MENU key. Press MENU and new menu and softkey functions are displayed. Press RUN to return to
the Main Menu.
NOTE
RUN always displays the Main Menu. NEXT and PREV (previous) move through the menus one level
at a time. The Main Menu will reappear if no key is pressed f or one minute. The time out is e xtended to
five minutes if trends are displayed.
The Main (or Base) Menu is comprised of the following keys
ALRT - Set alert limits, either manually or with Auto Alerts.
•
TRND - Trend page menus and displays.
•
•
SCALE - Capnogram sweep speed and vertical scale controls
•
CAL -Airway Adapter calibration menus
MENU -Access CO2 OPTIONS (O
•
OPTIONS
(audible alert volume, bright/dim display, averaging time) menus.
0 compensation, sampling pump on/off) and SYSTEM
2/N2
:
EVENT Key
Press the key to place an “e ven t” marker into the mon itor’s trend memory. Pressing th e key while
in the Main Menu will freeze the waveform for sixty seconds, the message
appears on the display. To return to the real time display before the sixty second time out press the RUN
softkey. Pressing the EVENT softkey in menus other than the Main Menu will not freeze the waveform,
the event will however be recorded in trend memory. Events are stored in trend memory for use in
printouts and trend data examination. The message
EVENT MARKED is displayed each time an event is
marked.
When the
CO2SMO is configured for operation with a printer and the key is pressed, PRINT
WAVEFORM? will be displayed for approximately 60 seconds. Pressing the
will cause a printout of the waveform. The duration of this printout will be the 10 second interval
immediately preceding the pressing of the key.
When the
CO2SMO is config ured fo r o peration with the NOVACARD memory module and the key is
pressed, STORE WAVEFORM? will be displayed for 60 seconds. Pressing the
WAVE FO R M FROZEN
PRINT key during this time
STORE key will store the
8
CO2SMO
Based on factory default settings.
User’s Manual Rev. 04
Front Panel Controls and Connectors
waveform to the NOVACARD. Pressing ID will bring up the patient ID menu. The ERASE softkey will
erase the card. Pressing
CONTRAST Key
Press the (contrast) key to adjust the display for optimum viewing.
WAVEFORM Key
Press key to display the capnogram, plethysmogram, or dual waveform.
Introduction
RUN will return to real time display.
Red Alert Bar
The Red Alert Bar flashes when an alert occurs. The bar can be set to; “latched”, where the bar flashes
until the presses
inside its limits; or “off”, where the bar will not turn on at all.
ALERT RESET; “unlatched”, the bar stops flashing when the alerting param eter returns
CAPNOSTAT CO2 Sensor Input Connector
The CAPNOSTAT CO2 Sensor plugs into this connector.
CAUTION
Connect only a Novametrix Catalog No. 7167, CAPNOSTAT CO2 Sensor to the CO2SMO CO2 Input
Connector. Do not use other CO
INCOMPATIBLE CO2 SENSOR message indicates a non-compatible sensor is connected.
An
sensors with the CO2SMO.
2
Sampling System Inlet Connector
The Sampling Airway Adapter tubing plugs into this connector.
Rev. 04
CO2SMO
User’s Manual
9
Section 1
Rear Panel Controls and Connectors
Rear Panel Controls and Connectors
SpO2 Input Connector
The SpO2 Sensor plugs into this connector.
CAUTION
Connect only Novametrix SuperBright SpO2 sensors to the CO2SMO SpO2 Input Connector. Do not use
other SpO
INCOMP SpO2 PROBE message indicates a non-compatible sensor is connected.
An
AC Mains Power Module
The AC Ma ins line cor d plugs into the Po wer I nput Module a nd is held in place with the line c ord retaini ng
clip. The monitor’s voltage setting (i.e., 115 VAC) is displayed on the module. When the power switch is
set to the “|” position, AC Mains line voltage will power the monitor and recharge the battery (if the line
cord is connected). If the po wer swit ch is set to the “ O” position , A C Mains li ne vo ltage is pre v ented from
reaching the monitor’s power supply and the monitor must operate from its internal battery.
sensors with CO2SMO.
2
Sampling System Exhaust Connector
This port is provided so that gas analyzed with the Sampling Airway Adapter and tubing can be
scavenged as needed.
Data Communications Port
The “RS232C/Novametrix Accessories” con nector pr ovides an interf ace to ex ternal equipm ent such as a
printer and other external optional accessoriesw
10
CO2SMO
User’s Manual Rev. 04
Section 2
Patient Safety
The CO
ground is limited to less than 10 µA at 120 VAC, 60 Hz. Patient isolation is greater than 10 MΩ, 2500
VAC rms at 60 Hz.
SMO SpO
2
Indications and Usage
The CO
respiration rate, functional oxy gen saturation and pulse rate in all critical monitoring environments
including ventilatory support, patient transport and anesthesia.
patients including adult, pediatric and neonatal.
The following factors can inf luence CO
pressure, water vapor and halogenated agents.
For maximum patient and operator safety, you must follow the following warnings and cautions.
SMO ETCO
2
Warnings
!
Indicates a potentially harmful condition that can lead to personal injury
Input is electrically isolated. Patient leakage current flowing from the instrument to
2
Monitor, Model 7100, is intended to be used for monitoring end tidal C O2,
2
CO2SMO is designed to monitor all
CO2SMO is not intended for any other purpose.
measurement; nitrous oxide, ele vated oxygen le vels, barometric
2
W ARNING
Rev. 04
• Explosion Hazard: Do NOT use CO
instrument in such an environment may present an explosion hazard.
• Electrical Shock Hazard: Always turn
Do NOT use a damaged sensor or one with exposed electrical contacts. Refer servicing to
qualified service personnel.
• Failure of Operation: If the monitor fails to re spond as described, do not use it until the situation
has been corrected by qualified personnel.
• Do not operate
• Do not operate
• Keep
• Never sterilize or immerse the monitor in liquids.
• Connect the line cord only to a grounded hospital-grade outlet.
• Patient Safety: Care should be exercised to assure continued peripheral perfusion distal to the
CO2SMO and its accessories clean.
the same electrical circuit as other equipment in use on the patient. Outlets on the same circuit can
be identified by the hospital’s engineering department.
SpO
sensor site after application.
2
CO2SMO when it is wet due to spills or condensation.
CO2SMO if it appears to have been dropped or damaged.
SMO in the presence of flammable anesthetics. Use of this
2
CO2SMO off, and remove the line cord b efore cleaning it.
CO2SMO should be connected to
CO2SMO
User’s Manual
11
Section 2
Cautions
•The CO
SMO is not intended to be used as a primary diagnostic apnea monitor and/or recording
2
device.
• Inspect the SpO
sensor site often for adequate circulation - at least once every fo ur hour s. When
2
applying sensors take note of the patient’s physiological condition. For example, burn patients
may exhibit more sensitivity to heat and pressure and therefore additional consideration such as
more frequent site checks may be appropriate.
• Data Validity: As with all pulse oximeters, inaccu rate SpO
and Pulse Rate values can be caused
2
by any of the following:
• Incorrect application or use of a sensor
• Significant levels of dysfunctional hemoglobin; carboxyhemoglobin or methemoglobin
• Significant levels of indocyanine green, methylene blue, or other intravascular dyes
• Exposure to excessive illumination such as surgical lamp s—especially ones with a xenon
light source, or direct sunlight
• Excessive patient movement, venous pulsations, electrosurgical interference
• Data Validity: The Pulse Oximeter should not be used as a substitute for an ECG monitor. The
oximeter’s Pulse Rate display reflects the pulsatile flow found at the p atien t extr emity co nnected
to the sensor. This rate can be affected by many factors and may occasionally be “frozen.”
• Do NOT attach an SpO
sensor distal to a blood pressure cuff. Valid data CANNOT be processed
2
when the cuff is inflated. Attach the sensor to the limb opposite to the site used for the blood
pressure cuff.
• A “NO RESPIRATION” alert is not generated when the CAPNOSTAT CO
Sensor is not
2
connected to the monitor.
•
The CO2SMO has no protection against the ingress of water.
Cautions
CAUTION
Indicates a condition that may lead to equipment damage or malfunction.!
• Do not operate CO
• Do not operate
• Never sterilize or immerse the monitor in liquids.
• Do not sterilize or immerse sensors except as directed in this manual.
• Tension should not be applied to the sensor cable.
• Overstretching the pulse oximeter finger sensor can damage the sensor and potentially aff ect pulse
oximeter readings. Do not stretch the finger sensor open beyond the limit for which it was
designed. Overstretching can be prevented: avoid opening the sensor by any means other than
squeezing the grips; Do NOT force the sensor onto large objects such as the bed rail.
• In case of interference with our equipment or another manufacturer’s equipment, notify your
Novametrix representative.
• Do NOT attach an SpO
when the cuff is inflated. Attach the sensor to the limb opposite to the site used for the blood
pressure cuff.
• Care should be exercised to assure continued peripheral perfusion distal to the SpO
after application
SMO when it is wet due to spills or condensation.
2
CO2SMO if it appears to have been dropped or damaged.
sensor distal to a blood pressure cuff. Valid data CANNOT be processed
2
sensor site
2
12
CO2SMO
User’s Manual Rev. 04
Cautions
Patient Safety
• Do not store the monitor or sensors at temperatures less than 14° F (-10° C) or greater than 131°
F (55° C).
• Do not operate the monitor or sensors at temp eratures less than 50 ° F ( 10° C) or greater than 104°
F (40° C).
• Caution: Federal (U.S.A.) law restricts this device to sale, distribution, or use by or on the order
of a licensed medical practitioner.
NOTES
Indicates points of particular interest or emphasis for more efficient or convenient operation.
• Components of this product and its associated accessories which have patient contact are free of
latex.
• After the life cycle of our equipment and all accessories has been met, disposal of the equipment
should be accomplished following the national requirements. Contact the local Novametrix
representative for questions concerning disposal.
Rev. 04
CO2SMO
User’s Manual
13
Section 2
Cautions
[This page intentionally blank.]
14
CO2SMO
User’s Manual Rev. 04
Section 3
Monitor Power Up
This section explains how to turn the CO
operation.
SMO on and off. It also explains AC Mains and battery power
2
Monitor Power Up
1. Verify CAPNOSTAT CO2 and SpO2 Sensor integrity.
Ensure sensors and their extension cables ar e physically intact with no broken, frayed or
damaged components.
2. Plug the CAPNOSTAT CO
Connect only a Novametrix Catalog No. 7067 or 7167, CAPNOSTA T CO2 Sensors to CO2SMO. Do
not use other CO
3. Plug an SpO
Connect only Novametrix SuperBright SpO2 sensors to the CO2SMO. Do not use other SpO
sensors with CO2SMO.
sensors with the CO2SMO.
2
sensor (or extension cable) into the rear panel input connector.
2
Sensor into the front panel input connector.
2
CAUTION
CAUTION
2
Rev. 04
4. To turn
5. Press the (contrast) key to adjust the display for optimum viewing.
6. Press
CO2SMO on, press either the or key.
Ensure all displays and indicators illuminate briefly . En sure a “beep” sounds to indicate that the
audio is working. Verify a “Self Test in progress” appears followed by the main menu.
CO2SMO powers up as a combined ETCO
oximeter portion is going to be used, the unused half can be disabled to avoid nuisance alerts
and error messages. With the monitor turned on, press either power key to shut down that half
of the monitor. Press the key again turn that half back on.
YES to erase or press NO to retain stored trend information.
“ERASE STORED TRENDS?” is briefly displayed after p ower on. Press YES to erase the tren d
data stored during previous monitoring episodes. To keep the stored trend data intact, press the
NO key (or don’t press any key and let the menu time out).
/SpO2 monitor. If only the capnograph or pulse
2
CO2SMO
User’s Manual
15
Section 3
Monitor Power Down
Monitor Power Down
1. To turn CO
SMO off, press both the and keys.
2
T o turn
active parameter.
CO2SMO off while only one parameter is acti ve, press the po wer ke y associated with the
AC Mains Operation
CO2SMO uses AC Mains ( line cord ) po wer if available and automatically switches to battery operation if
AC Mains power is removed or not present. An illuminated
connected to AC Mains power and the internal battery is being charged.
To power
connector . Set the rear panel power switch to the “|” (ON) p osition. Plug the other end o f th e lin e co rd to
a properly grounded three-wire outlet.
CO2SMO from AC Mains (line cord) power; P lug the line cord into the rear panel AC input
AC ON indicator means the CO2SMO is
Battery Operati on
CO2SMO uses battery power if the line cord is disconnected or the rear panel power switch is set to the
“O” (OFF) position.
While on battery power,
indicates a fully charged battery, a half charge, and indicates less than 30 minutes of battery
life remain. Note
power: wait one minute for the icon to truly reflect battery charge.
When approximately 15 minutes of battery life remain, the front panel
flash. Reconnect the monitor to the AC Mains to rechar ge the battery. The monitor can be operated from
the AC Mains while the battery is being recharged. The battery will be fully recharged in 12-15 hours.
If the monitor continues operating on battery power while in the low battery state ( indicator
flashing), the message
to continue operation while in the very low battery state, the monitor will alert, then shut itself off to
prevent damage to the battery and monitor.
CO2SMO can operate up to two hours from its internal battery.
CO2SMO displays a battery icon to the right of the numerical Respiration display .
: The battery icon may appear fully charg ed for the first minute after switching to battery
LOW BAT indicator starts to
BA TTER Y VER Y LOW PL UG IN AC POW ER is displayed. If the mon itor is allowed
16
CO2SMO
NOTE
This alert cannot be silenc ed b y pressi ng the key. The monitor must be connec ted to A C Mai ns
power to si lence the alert condit ion an d recharge the ba ttery. See “AC Mains Oper ation” o n page6.
User’s Manual Rev. 04
Section 4
This section explains how to select an airway adapter based on the patient to be monitored, connect the
airway adapter to the CAPNOSTAT CO
to calibrate the airway adapter and sensor.
Airway Adapter Selection
Select an airway adapter based on the patient and monitoring situation.
• Adult Airway Adapter (Catalog No. 7007)
For patients with Endotracheal Tube diameters greater than 4.0 mm.
• Single Patient Use Adult Airway Adapter (Catalog No. 6063)
For single patient use with Endotracheal Tube diameters greater than 4.0 mm.
• Single Patient Use Adult Airway Adapter with Mouthpiece (Catalog No. 6421)
For single patient use for spot checking CO
• Neonatal Airway Adapter (Catalog No. 7053)
For patients with Endotracheal Tube diameters less than or equal to 4.0 mm.
• Single Patient Use Neonatal Airway Adapter (Cat. No. 6312)
For monitoring intubated patients with an ET tube size of 4.0 or smaller.
• Sampling Airway Adapter with tubing (Catalog No. 5843)
For non-intubated patients when used in conjunction with a nasal sampling cannula.
CAPNOSTAT CO2 Sensor
Sensor and to the patient’s airway circuit, and how and when
2
on non-intubated adult or pediatric patients.
2
Rev. 04
Adult Airway Adapter
The Adult Airway Adapter (Catalog No. 7007) should be used when monitoring patients with
Endotracheal Tube diameters greater than 4.0 mm. Alternatively, the Single Patient Use Adult Airway
Adapter (Catalog No. 6063) may be used. See “Single Patient Use Adult Airway Adapter” on page 19.
1. Verify the windows are clean and dry. Clean or replace the adapter if necessary.
2. Snap the airway adapter into the CAPNOSTAT CO
Align the arrow on the bottom of the airway adapter with the arrow on the bottom of the
CAPNOSTAT C O
3. If necessary, perform an adapter calibration. Otherwise, skip this step.
Adapter Calibration needs to be performed each time you switch airway adapter types—for
example; if you switch from using an Adult to a Neonatal adapter , b ut not if you switch from an
Adult adapter to another Adult adapter. Adapter Calibration should also be performed if the
monitor displays
To perform an Adapter Calibration:
Sensor. Press the sensor and airway adapter together until they “click”.
2
ADAPTER CAL?.
Sensor.
2
CO2SMO
User’s Manual
17
Section 4
Adult Airway Adapter
Press CAL. PLACE ON ADPT IN RM AIR message appears.
Place the sensor and airway adapter away from all sources of CO
(including the patient’ s—
2
and your own—exhaled breath, and ventilator exhaust valves).
Press
START. TIME REMAINING counts down and the Main Menu reappears.
The actual calibration will take typically less than 15 seconds.
NOTE
If the monitor detects changing CO2 levels (breaths) during an adapter calibration, BREATHS
DETECTED? is display ed follow ed by PLA CE ON ADPT IN RM AIR. To continue, remov e the source
, wait 30 seconds, and press START.
of CO
2
4. When using the Adult Airway Adapter, place the CAPNOSTAT CO
Sensor/Airway Adapter assembly
2
at the proximal end of the airway circuit between the elbow and the ventilator circuit wye.
Shown with CAPNOSTAT
Sensor Cat. No. 7167
CO
2
(may also use Cat. No. 7067)
Elbow
Wye
Adult Airway Adapter
(Cat. No. 7007)
To
Patient
(Cat. No. 8751)
To
Ventilator
Cable Clip
18
CO2SMO
NOTE
• For optimal results, do NOT place the airway adapter between the ET tube and the elbow, as this
may allow patient secretions to block the adapter windows.
• Position the Airway Adapter with its windows in a vertical and NOT a horizontal position: This
helps keep patient secretions from “pooling” on the windows. If pooling does occur, the airway
adapter may be removed from the circuit, rinsed with water and reinserted into the circuit.
• To prevent “rain-out” and moisture from draining into the Airway Adapter, do NOT place the
Airway Adapter in a gravity dependent position.
5. Check that the connections ha ve been made correctly by verifying a proper CO
on the monitor display.
6. The sensor cable should face away from the patient.
User’s Manual Rev. 04
wavefo rm (capnogram)
2
Loading...