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Avalon FM20
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Philips Avalon FM20, Avalon FM30, Avalon FM40, Avalon FM50 User manual (2011)

Instructions for Use
Avalon Fetal Monitor
FM20/30, FM40/50
Release G.0 with Software Revision G.02.xx
Patient Monitoring
1Table of Contents
1 Introduction 9
2 Installation 13
3 Basic Operation 19
4 Using Batteries (with FM20/30 Battery Option) 57
3
5 Alarms 63
6 Patient Alarms and INOPs 73
7 Admitting and Discharging 83
8 Non-Stress Test Timer 87
9 Non-Stress Test Report 91
10 Monitoring FHR and FMP Using Ultrasound 95
4
Fetal Movement Profile 100 Troubleshooting 102 Additional Information 103 Testing Ultrasound Transducers 112
11 Monitoring Twin FHRs 113
Important Considerations 113 Monitoring Twins Externally 114 Monitoring Twins Internally 115 Cross-Channel Verification 115 Separating FHR Traces 116 Troubleshooting 119
12 Monitoring Triple FHRs 121
Important Considerations 121 Monitoring Triplets 122 Cross-Channel Verification 122 Separating FHR Traces 123 "Standard" Separation Order 123 "Classic" Separation Order 123 When Trace Separation is Off 124 Troubleshooting 125
13 Fetal Heart Rate Alarms 127
Changing Alarm Settings 127 Changing Signal Loss Delay 128
14 Monitoring Uterine Activity Externally 129
What You Need 129 External Toco Monitoring 130 Toco Sensitivity 130 Troubleshooting 131 Testing Toco Transducers 132
15 Monitoring Uterine Activity Internally 133
What You Need 133 Internal (IUP) Monitoring 134 Troubleshooting 135
16 Monitoring FHR Using DECG 137
Misidentification of MHR as FHR 137 What You Need 137 Making Connections 139 Monitoring DECG 139 Suppressing Artifacts 140 Troubleshooting 141
5
Testing DECG Mode 142
17 Monitoring Noninvasive Blood Pressure 143
Introducing the Oscillometric Noninvasive Blood Pressure Measurement 143 Preparing to Measure Noninvasive Blood Pressure 144 Starting and Stopping Measurements 146 Enabling Automatic Mode and Setting Repetition Time 146 Choosing the Alarm Source 147 Assisting Venous Puncture 147 Calibration 148 Troubleshooting 148
18 Monitoring SpO2 149
Selecting an SpO2 Sensor 149 Applying the Sensor 149 Connecting SpO2 Cables 150 Measuring SpO2 151 SpO2 Signal Quality Indicator 152 Assessing a Suspicious SpO2 Reading 152 Understanding SpO2 Alarms 152 Setting Up Tone Modulation 153 Setting the QRS Volume 153
19 Monitoring Maternal Heart / Pulse Rate 155
Priority for Maternal Heart / Pulse Rate 155 Cross-Channel Verification 155 MHR from MECG Electrodes 156 Monitoring MECG Wave 158 Pulse Rate from SpO2 159 Pulse Rate from Toco MP 159 Adjusting the Heart Rate / Pulse Alarm Limits 160 Average Pulse Rate from Noninvasive Blood Pressure 160 Troubleshooting 160 Testing MECG Mode 160
20 Printing the ECG Waveform 161
21 Paper Save Mode for Maternal Measurements 165
22 Recovering Data 167
Recovering Traces on Paper 167 Recovering Traces on an OB TraceVue System 168 Recording Stored Data 168
23 Care and Cleaning 171
General Points 171
6
Cleaning and Disinfecting 172 Cleaning and Disinfecting Monitoring Accessories 173 Sterilizing 173
24 Maintenance 175
Inspecting the Equipment and Accessories 175 Inspecting the Cables and Cords 175 Maintenance Task and Test Schedule 176 Storing Recorder Paper 176 Cleaning the Printhead 177 Disposing of the Monitor 177
25 Accessories and Supplies 179
Information on Latex 179 Transducers 179 Fetal Accessories 180 DECG Accessories: Component Compatibility 181 MECG Accessories 181 Noninvasive Blood Pressure Accessories 181 SpO2 Accessories 183 Recorder Paper 187
26 Specifications and Standards Compliance 189
Environmental Specifications 189 Physical Specifications 190 Performance Specifications 191 Recorder Specifications 201 Battery Specifications 203 Alarm Defaults 204 Compatible External Displays: FM40/FM50 Only 204 Manufacturer's Information 205 Trademark Acknowledgement 205 Regulatory and Standards Compliance 205 Environment 212 Monitoring After a Loss of Power 212 ESU, MRI and Defibrillation 213 Cardiac Pacemakers and Electrical Stimulators 213 Fast Transients/Bursts 213 Symbols on the System 214
Index 217
7
8

1Introduction

Who this Book is For

This book is for trained healthcare professionals using the Avalon FM20, FM30, FM40 and FM50 fetal/maternal monitors. It describes how to set up and use the monitor and transducers. Familiarize yourself with all instructions including warnings and cautions before starting to monitor patients. Read and keep the Instructions for Use that come with any accessories, as these contain important information about application and care and cleaning that is not repeated in this book.
You should be:
• Trained in the use of fetal heart rate (FHR) monitors.
• Trained in the interpretation of FHR traces.
• Familiar with using medical devices and with standard fetal monitoring procedures.
1
For information on how to configure and service the monitor, refer to the Service Guide, or contact your authorized service provider.
Your monitor may not have all of the features and options described in this guide. The exact appearance of the monitor may differ slightly from that shown in the illustrations.
In this guide:
•A warning alerts you to a potential serious outcome, adverse event or safety hazard. Failure to observe a warning may result in death or serious injury to the user or patient.
•A caution alerts you to where special care is necessary for the safe and effective use of the product. Failure to observe a caution may result in minor or moderate personal injury or damage to the product or other property, and possibly in a remote risk of more serious injury.
• Monitor refers to the entire fetal/maternal monitor. Display refers to the physical display unit. Screen refers to everything you see on the monitor's display, such as measurements, alarms, patient data and so forth.
FM30 • Whenever a monitor’s identifier appears to the left of a heading or paragraph, it means that the
information applies to that monitor only. Where the information applies to all models, no distinction is made.
9
1Introduction

Confirm Fetal Life Before Using the Monitor

Fetal monitoring technology available today is not always able to differentiate a fetal heart rate (FHR) signal source from a maternal heart rate (MHR) source in all situations. Therefore, you should confirm fetal life by independent means before starting to use the fetal monitor, for example, by palpation of fetal movement or auscultation of fetal heart sounds using a fetoscope, stethoscope, or Pinard stethoscope. If you cannot hear the fetal heart sounds, and you cannot confirm fetal movement by palpation, confirm fetal life using obstetric ultrasonography. Continue to confirm that the fetus is the signal source for the FHR during monitoring.
Be aware that:
• a MHR trace can exhibit features that are very similar to those of a FHR trace, even including accelerations and decelerations. Do not rely solely on trace pattern features to identify a fetal source.
• Fetal Movement Profile (FMP) annotations on a fetal trace alone may not always indicate that the fetus is alive. The body of a deceased fetus can move and cause the monitor to annotate fetal body movements.
Here are some examples where the MHR can be misidentified as the FHR.
• When using an ultrasound transducer: – It is possible to pick up maternal signal sources, such as the aorta or other large vessels. – Misidentification may occur when the MHR is higher than normal (especially when it is over
100 bpm).
• When using a fetal scalp electrode: – Electrical impulses from the maternal heart can sometimes be transmitted to the fetal monitor
through a recently deceased fetus via the spiral scalp electrode cable, appearing to be a fetal signal source.
– The recorded MHR (and any artifact) can be misinterpreted as a FHR (especially when it is
over 100 bpm).
• When Fetal Movement Profile (FMP) is enabled: FMP annotations in the absence of fetal life may be a result of: – Movement of the deceased fetus during or following maternal movement. – Movement of the deceased fetus during or following manual palpation of fetal movement
(especially if the pressure applied is too forceful). – Movement of the ultrasound transducer. – The ultrasound transducer detecting a maternal movement source, such as the mother
coughing.
See also the chapters “Monitoring FHR and FMP Using Ultrasound” on page 95 and “Monitoring FHR Using DECG” on page 137.
To reduce the possibility of mistaking the MHR for FHR, it is recommended that you monitor both maternal and fetal heart rates. The monitor's cross-channel verification (CCV) facility can help by automatically detecting when a MHR coincides with a FHR. For further details, see “Cross-Channel Verification” on page 97.
10
1 Introduction

Introducing the Avalon Family of Fetal Monitors

The Avalon family of fetal monitors consists of the Avalon FM20, FM30, FM40 and FM50. While the FM20/FM30 and the FM40/FM50 have different form factors, the method of operation is very similar for all monitors. The Avalon fetal monitors also share the same transducers, accessories, software, and are compatible with the Avalon CTS Cordless Fetal Transducer System (M2720A).

Intended Use

The Philips Avalon FM20 (M2702A), FM30 (M2703A), FM40 (M2704A) and FM50 (M2705A) Fetal/ Maternal Monitors are intended for:
• non-invasive monitoring of fetal heart rates and movements.
• non-invasive monitoring of maternal heart rates, maternal pulse rates, uterine activity, maternal noninvasive blood pressure, and maternal oxygen saturation.
• invasive monitoring of fetal Direct ECG and intrauterine pressure and for displaying and recording of fetal and maternal ECG waves. (FM30 and FM50 only)
• displaying, storing and recording patient data and parameter values and for generating alarms from fetal and maternal parameters.
• transmitting patient data and parameter values to a patient information and surveillance system.
• use by trained health care professionals.
• use in antepartum testing areas, in labor and delivery rooms and during postpartum recovery in the hospital environment. They are not intended for use in intensive care units or operating rooms.
• transport situations in healthcare facilities, for healthcare facilities outside hospitals, such as doctors’ offices, and for use in private households. (FM20 and FM30 only)
WARNING
The fetal/maternal monitors are not intended for:
• use during defibrillation, electro-surgery, or magnetic resonance imaging (MRI).
• ECG measurements on patients connected to electrical stimulators or with cardiac pacemakers.
• use of the invasive measurements IUP and fetal DECG and use of the patient module (M2738A) in domestic establishments and those connected directly to the public low-voltage supply network that supplies buildings used for domestic purposes.
CAUTION
US federal law restricts this device to sale by, or on the order of, a physician.
11
1Introduction

Indications for Use

Avalon Fetal/Maternal Monitor FM20:
Indicated for use by trained health care professionals whenever there is a need for monitoring of the physiological parameters uterine activity, heart rate, oxygen saturation, non-invasive blood pressure, pulse rate of pregnant women and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms, in antepartum testing areas, in private households and during transports in healthcare facilities.
Avalon Fetal/Maternal Monitor FM30:
Indicated for use by trained health care professionals whenever there is a need for monitoring of the physiological parameters uterine activity, heart rate, ECG, oxygen saturation, non-invasive blood pressure, and pulse rate of pregnant women and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms, in antepartum testing areas, in private households and during transports in healthcare facilities.
Avalon Fetal/Maternal Monitor FM40:
Indicated for use by trained health care professionals whenever there is a need for monitoring of the physiological parameters uterine activity, heart rate, oxygen saturation, non-invasive blood pressure, and pulse rate of pregnant women and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms and in antepartum testing areas.
Avalon Fetal/Maternal Monitor FM50:
Indicated for use by trained health care professionals whenever there is a need for monitoring of the physiological parameters uterine activity, heart rate, ECG, oxygen saturation, non-invasive blood pressure, and pulse rate of pregnant women and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms and in antepartum testing areas.
12

2Installation

Installation should be carried out by qualified service personnel, either by the hospital's biomedical department, or by Philips Support.
As the first step in preparing the monitor for use, follow the installation instructions given in this chapter.
For a list of conventions used in this guide, see “Basic Operation” on page 19.
Not all accessories and supplies may be available in all geographies. Please contact your local Philips sales representative for details of availability.

Installation Checklist

Use this checklist to document your installation.
2
Step Task Check Box
when Task Done
1 Perform initial inspection of delivery, unpack and check the shipment
(see “Unpacking and Checking the Shipment” on page 14)
2 Mount the monitor as appropriate for your installation (see “Mounting
the Monitor” on page 15)
3 Connect the fetal monitor to AC mains using the supplied power cord.
This configuration varies, depending whether an external power supply/battery option is used. (see “External Power Supply M8023A” on page 58)
4 Perform Safety Tests (see “Safety Tests” on page 18)
5 Check that default settings (including the line frequency) are
appropriate for your institution
6 Check/set the paper scale (see “Checking/Setting Paper Scale” on
page 42)
7 Load paper into the recorder (see “Loading Paper: FM20/FM30” on
page 44 or “Loading Paper: FM40/FM50” on page 45, depending on your monitor)
8 Check/set the time and date (see “Setting the Date and Time” on
page 35)
13
2 Installation
Step Task Check Box
9 Check/set paper speed (see “Choosing Paper Speed” on page 48)
10 Perform System Test as necessary (see the Service Guide)
11 For monitors with the battery option (#E25) chosen, confirm that the
battery can be charged, and that the monitor can be powered by the battery.
12 Test Transducers (see “Testing Ultrasound Transducers” on page 112
and “Testing Toco Transducers” on page 132)

Unpacking and Checking the Shipment

The monitor and any supporting options ordered are supplied packed in protective shipping cartons.

Initial Inspection

Before unpacking, visually check the packaging and ensure that there are no signs of mishandling or damage.
when Task Done
Open the package carefully and remove the instrument and accessories.
Check that the contents are complete and that the correct options and accessories have been delivered.
System Components, Accessories and Supplies FM20 FM30 FM40 FM50
Toco+ Transducer (with belt clip) - optional - optional
Toco MP Transducer (with belt clip) 1111
US Transducer (with belt clip) 1111
Patient Module for DECG/MECG/IUP optional
DECG Reusable Legplate Adapter Cable - 1 - 1
MECG Adapter Cable - 1 - 1
IUP Adapter Cable
External Power Supply and MSL Cable optional optional - -
Event Marker optional optional optional optional
Fetal Paper Pack (country-specific, installed) 1111
Powercord 1111
Printed Instructions for Use 1111
Documentation DVD: includes FM20/30 Service Guide, FM40/50 Service Guide, Instructions for Use (including localized versions), and Training Guide
2
1
optional optional
- optional - optional
1111
1
optional
14
1
For assessment of maternal heart rate only.
2
Ships with Patient Module (K03).
2 Installation

Claims for Damage

If the shipping cartons are damaged, contact the carrier.
If any of the equipment is damaged, contact both the carrier and your local Philips service organization for repair or replacement arrangements.

Repacking

Retain the original packing carton and material, in case you need to return equipment to Philips for service. If you no longer have the original packing materials, Philips can advise you on alternatives.

Mounting the Monitor

FM20/30 The monitor can be rested on a flat surface, set at an angle using the built-in stand, or mounted on a
wall, on a cart or on a rollstand. See the Service Guide for details.
FM40/50 The monitor can be rested on a flat surface, or on a cart. See your monitor's Service Guide for details.

Mounting the External Power Supply (M8023A)

The external power supply (M8023A option #E25) can be rested on its rubber feet on a flat, level surface, or mounted as described in the Service Guide.
The following pictures show examples of correct and incorrect ways to mount the power supply.
15
2 Installation

Connecting the Monitor to AC Mains

FM20/30 The monitor is an electrical Class II device in which the protection against electric shock does not rely
on basic insulation and a protective earth conductor but on double and/or reinforced insulation.
FM40/50 The monitor is an electrical Class I device. Protection against electric shock is provided by a protective
earth conductor.
The monitor has a wide-range power supply that allows you to operate the monitor from an AC (alternating current) power source of 100 V to 240 V (± 10%) and 50 or 60 Hz (± 5%).
WARNING
• Always use the supplied power cord with the earthed mains plug to connect the monitor to an earthed AC mains socket. Never adapt the mains plug from the power supply to fit an unearthed AC mains socket.
• Check that the line frequency is correctly set for your institution (50 Hz or 60 Hz) before putting the monitor into service.
• FM20/FM30 only: The protective earth conductor is required for EMC purposes. It has no protective function against electric shock! The protection against electric shock in this device is provided by double and/or reinforced insulation.
• Do not use AC mains extension cords or multiple portable socket-outlets.
16
2 Installation

How and When to Carry Out the Test Blocks

The following table defines which test and inspection blocks need to be performed, and when they are required.
Test Blo ck Test or Inspection to be Performed Test Blo ck R equire d fo r
Which Events?
Visual Inspect the monitor, transducers and cables for any
damage.
Are they free of damage?
Power On Power on the monitor. Does it boot up successfully without
errors? After boot up the monitor sounds a tone, and can you see the monitoring main screen.
If recorder power-on auto-start is configured to On, does the recorder print “Switching the Recorder On and Off ” on page 49 for details.)
Functionality Test FM20/30 with Battery Option #E25 Only
After power up, touch the battery status indicator in the bottom right of the screen. The battery status window should open. Check to see if there is an exclamation mark flashing in the gauge. Press the the window and return to the main screen.
Safety Tests (1) to (4) Perform safety tests (1) to (4), as described in your
monitor's Service Guide, for standalone devices if required by local regulations, and each time you combine equipment to form a system, or exchange system components.
Performance Test the transducers (see “Testing Ultrasound Transducers”
on page 112 and “Testing Toco Transducers” on page 132).
System Perform the system test according to IEC/EN 60601-1-1/
IEC/EN 62353, if applicable, after combining equipment to form a system (see your monitor's Service Guide).
Selftest: OK across the trace paper? (See
Main Screen key to close
Installation
Preventive Maintenance
Installation
Preventive Maintenance
Installation
Preventive Maintenance
Installation
Preventive Maintenance
Installation
Preventive Maintenance
Combining system components
For test and inspection information regarding repairs, upgrades and all other service events, refer to your monitor's Service Guide.
17
2 Installation

Safety Tests

Details of the safety tests and procedures required after an installation or an exchange of system components are described in your monitor's Service Guide. These safety tests are derived from international standards but may not be sufficient to meet local requirements.
WARNING
• Do not use additional AC mains extension cords or multiple portable socket-outlets. If a multiple portable socket-outlet is used, the resulting system must be compliant with IEC/EN 60601-1-1.
• Do not connect any devices that are not supported as part of a system.
• Do not use a device in the patient vicinity if it does not comply with IEC/EN 60601-1. The whole installation, including devices outside of the patient vicinity, must comply with IEC/EN 60601-1-
1. Any non-medical device, including a PC running an OB TraceVue system, placed and operated in the patient's vicinity must be powered via a separating transformer (compliant with IEC/EN 60601-1-1) that ensures mechanical fixing of the power cords and covering of any unused power outlets.
18

3Basic Operation

This chapter gives you an overview of the monitor and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching a measurement on, changing some monitor settings, and setting up the recorder). The alarms section gives an overview of alarms. The remaining sections tell you how to perform individual measurements, and how to care for and maintain the equipment.
3

Supported Measurements

The following Fetal Measurements are supported:
Fetal Monitor
or Model
FM20 Standard Optional Standard - -
FM30 Standard Optional Standard Standard Standard
FM40 Standard Optional Standard - -
FM50 Standard Optional Standard Standard Standard
Fetal Heart Rate
(FHR) via US
(including Twins)
Triple FHR via
US
Toco FHR via Direct
ECG (DECG)
Intrauterine
Pressure (IUP)
19
3 Basic Operation
The following Maternal Measurements are supported:
Fetal Monitor
or Model
FM20 Standard - Standard Optional -
FM30 Standard Standard Standard Optional Optional
FM40 Standard - Standard Standard Standard
FM50 Standard Standard Standard Standard Standard
Maternal
Heart Rate (MHR) via
Maternal ECG
Electrodes
Maternal
ECG
(MECG)
Maternal Pulse
from Toco
Non-invasive Blood Pressure with Pulse
Rate
Pulse Oximetry
(Maternal SpO
with Pulse Rate

Avalon FM20 and FM30

This section outlines the capabilities of your monitor.
)
2

Avalon FM20

The Avalon FM20 fetal/maternal monitor provides a solution for external fetal monitoring applications, and optional non-invasive maternal vital signs.
You can monitor fetal heart rates (FHRs) externally using ultrasound, uterine activity and maternal pulse using an external Toco transducer, and the maternal heart rate (MHR) via maternal ECG electrodes, and optionally, non-invasive blood pressure.
Measurements are displayed on a 6.5-inch color display as numerics. The display is a touchscreen, and you operate the monitor using this touchscreen interface. The integrated recorder documents fetal and maternal measurements as well as user defined annotations.
You can connect the monitor to an OB TraceVue system via the RS232 connection, or over a LAN connection (with OB TraceVue Revision E.00.00 and later).
20

Avalon FM30

The Avalon FM30 fetal/maternal monitor offers a solution for both external and internal fetal monitoring applications, and optional non-invasive maternal vital signs.
The Avalon FM30 shares all the features and capabilities of the Avalon FM20. In addition, you can monitor one FHR internally via direct fetal electrocardiogram (DECG), uterine activity internally using
an intra-uterine pressure (IUP) catheter together with a Toco optionally, maternal oxygen saturation (SpO
The Avalon FM30 carries the label, indicating that it is capable of intrapartum monitoring.
3 Basic Operation
+
transducer or patient module, and
).
2
FM20/30
Battery
Option
#E25 Only
The battery option for the FM20/30 provides support for the in-transport monitoring of all measurements when disconnected from a power supply. Existing data storage is automatically
with
uploaded to OB TraceVue after reconnecting to the system. Trace printing during transport is also possible.

Avalon FM40 and FM50

This section outlines the capabilities of your monitor.

Avalon FM40

The Avalon FM40 fetal/maternal monitor provides a solution for external fetal monitoring applications, and non-invasive maternal vital signs.
You can monitor fetal heart rates (FHRs) externally using ultrasound, uterine activity using an external Toco transducer, and the maternal heart rate (MHR) via maternal ECG electrodes, and non-invasive blood pressure and maternal oxygen saturation (SpO
Measurements are displayed on a 6.5-inch color display as numerics. The display is a touchscreen, and you operate the monitor using this touchscreen interface. The integrated recorder documents fetal and maternal measurements as well as user defined annotations.
You can connect the monitor to an OB TraceVue obstetrical documentation and surveillance system via the RS232 connection, or over a LAN connection (with OB TraceVue Revision E.00.00 and later).
).
2
21
3 Basic Operation

Avalon FM50

The Avalon FM50 fetal/maternal monitor offers a solution for both external and internal fetal monitoring applications, and non-invasive maternal vital signs.
The Avalon FM50 shares all the features and capabilities of the Avalon FM40. In addition, you can monitor one FHR internally via direct fetal electrocardiogram (DECG), and uterine activity internally
using an intra-uterine pressure (IUP) catheter together with a Toco
The Avalon FM50 carries the label, indicating that it is capable of intrapartum monitoring.

Cordless Monitoring

All monitors are compatible with the Avalon CTS Cordless Fetal Transducer System (M2720A). Note the following points regarding cordless monitoring:
• One Avalon CTS Cordless Fetal Transducer System can be connected to a monitor at a time.
• Monitoring multiple pregnancies using cordless transducers is not supported.
• Using a mixture of wired and cordless fetal transducers is not supported. You can use either wired or cordless fetal transducers. If sufficient signal quality cannot be achieved using cordless fetal transducers, then switching to wired transducers is recommended.
+
transducer or patient module.
• When the monitor recognizes an Avalon CTS interface cable M2731-60001 (red connector) or M2732-60001 (black connector, for rear connection on FM40/FM50 only), it gives confirmation by showing the following status indicator in the lower right-hand corner of the screen:
Indicator Meaning
Avalon CTS interface cable is connected to the monitor, but the Avalon CTS base station is not connected to the interface cable, disconnected from AC mains, or is in Standby.
Avalon CTS interface cable is connected to the monitor, Avalon CTS base station is connected, powered on, and cordless transducers are ready to use, but no cordless transducers are currently active (all are still docked in the base station).
Avalon CTS interface cable is connected to the monitor, Avalon CTS base station is connected, powered on, and at least one cordless transducer has been taken out of the base station and is active. As cordless transducers have priority over wired transducers, any connected wired transducers are disabled.
• Cordless transducers have priority over wired transducers. When an Avalon CTS base station is connected via the appropriate interface cable to the fetal monitor, and there are also wired transducers connected to the monitor, the wired transducers are disabled whenever a cordless transducer is active. To change back to using wired transducers, dock the cordless transducers in the Avalon CTS base station or switch the base station to Standby, and continue monitoring with the wired transducers. Note that if a sufficient ultrasound signal quality cannot be achieved by transducer repositioning, change to wired transducers.
22
• When using a cordless ultrasound transducer from an Avalon CTS system, the monitor automatically sets the Fetal Movement Profile ( you wish, (see “Switching FMP On and Off ” on page 101), but you should refer to the sections “Cordless Monitoring - Important Considerations” on page 97 and “Fetal Movement Profile” on page 100.
FMP) to Off. You can enable the FMP again should

Getting to Know Your Avalon FM20/FM30

Overview

1 Touchscreen Display (tilt and
fold)
2 Power LED 3 Paper Drawer 4 Paper Drawer release 5 Connectors (see Left Side view)

Right Side

6 On/Off Switch 7 Power Connector
3 Basic Operation
with
Battery
Option
8 On/Standby Switch 9 MSL Connector
23
3 Basic Operation

Rear

Left Side

10 Display Release 11 Carrying Handle 12 Built-in Stand
13 SpO 14 Noninvasive Blood Pressure
15 Fetal Sensor Sockets - each
Socket (optional)
2
Socket (optional)
socket accepts any fetal transducer, an Avalon CTS Cordless Fetal Transducer System base station (connected via the interface cable M2731-
60001), or event marker

Getting to Know Your Avalon FM40/FM50

Front

1 On/Standby Switch 2 Power LED 3 Recorder Paper Table 4 Touchscreen Color Display 5 Transparent Paper Guide with
tear-off edge
6 Paper Eject Button. Press to
open paper drawer. Press again and hold when removing paper.
7 Fetal Sensor Sockets. Connect
any fetal sensor or patient module here, including Avalon CTS via M2731-60001 interface cable (with red connector).
8 Noninvasive Blood Pressure
Socket
9 SpO
Socket
2
24

Rear

3 Basic Operation
1 Reserved for future use:
protective earth intended for use in system installations.
2 Equipotential Grounding Point 3 Power Cord Connector 4 Loudspeaker 5 Slot 01 for optional LAN /
RS232 system interface (for connection to an obstetrical information and surveillance system)
6 Slot 02 for optional interfaces:
Either dual PS/2 system interface (A) for mouse and keyboard connection) Or MIB interface (B) for external touch screen connection
7 Slot 03 reserved for future use 8 Video Output (VGA) 9 Telemetry Interface. If not using
one of the fetal sensor sockets, one Avalon CTS can be connected at a time to either socket using the M2732-60001 interface cable (with black connector).

Transducers

Toco and Toco MP Transducer (M2734A, M2734B)
1 Transducer Finder LED - lights up on the transducer providing the measurement source. 2 Belt Button 3 "MP" for M2734B "Toco MP" transducers (additionally capable of providing the maternal pulse
measurement)
25
3 Basic Operation
Ultrasound Transducer (M2736A)
4 Cable - connects to any of the four Fetal Sensor Sockets on the monitor
Note that the The M2736AA US transducer is identical to the M2736A US transducer, including all specifications.
26
+
Transducer with ECG/IUP capability (M2735A)
Toco
5 Connector - for connecting ECG/IUP adapter cables (M2735A Toco
6 Butterfly Belt Clip (shown
fitted; for use with belts without button holes)
7 Close-up of MECG adapter
cable connected to Toco transducer
8 Close-up of active Finder LED
+
transducer only)
+
3 Basic Operation
Patient Module for ECG/IUP (M2738A)
+
9 Connector - for connecting ECG/IUP adapter cables (same as for Toco 10 Cable - connects to any of the four Fetal Sensor Sockets on the monitor
transducer)

Operating and Navigating

Your monitor has a touchscreen. Everything you need to operate the monitor, other than to turn it on and off, is contained on its screen. Most screen elements are interactive. Screen elements include measurement numerics, screen keys, information fields, status indicators, alarms fields and menus.
FM40/50 If an optional external touch display with a MIB interface board are connected to the monitor, you can
operate the monitor using the external touch display.

Screen Elements

Monitor Information Line
1 INOP and alarm status area - shows active alert messages
2 LAN connection status indicator only. RS232 system connection is not indicated. Either the
Monitor is connected to OB TraceVue , the LAN cable is connected but no connection to
OB TraceVue ; or, if no indicator is shown, there is no network connection.
3 Patient identification
27
3 Basic Operation
4
5 Bed label (when connected to a Philips OB TraceVue system)
6 Fetal heart sound volume adjust/indicator
7 Alarm volume adjust/indicator
8 Numeric/measurement values
9 Fetal Trace Recorder - status indicator
Date and time
Fetal recorder is On
Fetal recorder is Off (when Paper Save Mode is off )
Fetal recorder is Off (when Paper Save Mode is on)
There is a Recorder problem that can be solved by the user (for example, paper out, paper jam, wrong paper scale set)
Fetal recorder is defective: call service.
10 Avalon CTS System - status indicator:
Avalon CTS interface cable is connected to the monitor, but Avalon CTS base station is not connected to the interface cable, disconnected from AC mains, or is in Standby.
Avalon CTS interface cable is connected to the monitor, Avalon CTS base station is connected, powered on, and cordless transducers are ready to use, but no cordless transducers are currently active (all are still docked in the base station).
Avalon CTS interface cable is connected to the monitor, Avalon CTS base station is connected, powered on, and at least one cordless transducer has been taken out of the base station and is active. Any connected wired transducers are disabled.
11 Close all open menus and windows and return to main screen
12 Battery Status Indicator
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13 Scroll to display more SmartKeys
14 SmartKeys - these can vary according to your monitor's configuration
15 Silence - key which acknowledges all active alarms by switching off audible alarm indicators

Keys

3 Basic Operation
Status line - shows status and prompt messages
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17 Signal quality indicator
Good / full acceptable / medium Poor / no signal
18 Measurement label (a cordless measurement from a connected Avalon CTS system is indicated by
the symbol)
19 NST timer, if configured (default is Off)
The monitor has three different types of keys.
Permanent Keys
A permanent key is a graphical key that remains permanently on the screen, giving you fast access to functions.
Silence - acknowledges all active alarms by switching off audible alarm indicators.
Main Screen - closes all open menus and windows and returns to the main screen.
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3 Basic Operation
SmartKeys
SmartKeys are configurable graphical keys, located at the bottom of the main screen. They give you fast access to functions. The selection of SmartKeys available on your monitor depends on your monitor configuration and on the options purchased.
Main Setup - enter main setup
menu.
Pause Alarms - pauses alarm
indicators. Pause duration depends on monitor configuration. If pause duration is infinite, this key is labeled
Alarms Off.
Select again to immediately re­enable alarm indicators.
Start Recordng - turn the trace
recorder on.
Start ECG- start printing the
MECG, DECG or both waves, when both are available.
Admit/ Dischrge - enter patient
identification menu to admit/ discharge
Toco Baseline - reset Toco
baseline/whichever is available (see below)
Recorder Start/ Stop - turn the trace recorder on or off.
Paper Advance - advance the paper
automatically to the next fold.
Stop Recordng - turn the trace
recorder off.
Stored Data Rec - print trace data
from the monitor's memory.
Enter Notes - enter notes
Timer - enters NST timer window
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Zero IUP - zero IUP
measurement/whichever is available (see above)
Set Marker - mark an event
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