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

Table of Contents

	1 Introduction	9
Who this Book is For		9
Confirm Fetal Life Before Using the Monitor		10
Introducing the Avalon Family of Fetal Monitors		11
	2 Installation	13
Installation Checklist		13
Unpacking and Checking the Shipment		14
Mounting the Monitor		15
Mounting the External Power Supply (M8023A)		15
Connecting the Monitor to AC Mains		16
How and When to Carry Out the Test Blocks		17
Safety Tests		18
	3 Basic Operation	19
Supported Measurements		19
Avalon FM20 and FM30		20
Avalon FM40 and FM50		21
Cordless Monitoring		22
Getting to Know Your Avalon FM20/FM30		23
Getting to Know Your Avalon FM40/FM50		24
Operating and Navigating		27
Operating Modes		32
Automatic Screen Layouts		33
Settings		33
Checking Your Monitor Revision		35
Preparing to Monitor		35
Starting Monitoring		53
Switching the Monitor to Standby		54
After Monitoring		54
Disconnecting from Power		54
Troubleshooting		55
	4 Using Batteries (with FM20/30 Battery Option)	57
External Power Supply M8023A		58
Battery Power Indicators		58
Battery Status Window		60
Optimizing Battery Performance		61

3

	5 Alarms	63
Alarm Mode		63
Visual Alarm Indicators		64
Audible Alarm Indicators		64
Acknowledging Alarms		66
Acknowledging Disconnect INOPs		66
Pausing or Switching Off Alarms		66
Alarm Limits		68
Reviewing Alarms		68
Latching Alarms		69
Testing Alarms		71
Alarm Behavior at Power On		71
	6 Patient Alarms and INOPs	73
Alarm Messages		73
Technical Alarm Messages (INOPs)		76
	7 Admitting and Discharging	83
Admit/Discharge on the Monitor		83
New Patient Check		84
OB TraceVue: via LAN		85
OB TraceVue: via RS232		85
	8 Non-Stress Test Timer	87
Setting NST Autostart/Autostop		87
Viewing the NST Timer		87
Timer Expiry Notification		87
Accessing the NST Setup Pop-up Keys		88
	9 Non-Stress Test Report	91
Setting Up an NST Report		91
NST Report Status Window		92
NST Reassurance Criteria		94
Non-Reassuring Report		94
Non-Reactive NST Test		94
10 Monitoring FHR and FMP Using Ultrasound		95
Technical Description		95
Limitations of the Technology		96
Misidentification of MHR as FHR		96
Cross-Channel Verification		97
What You Need		97
Cordless Monitoring - Important Considerations		97
Preparing to Monitor		98
Selecting Fetal Heart Sound		99
Changing the Fetal Heart Sound Volume		99

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

1

Introduction

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.

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

1 Introduction

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

1 Introduction

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

2

Installation

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.

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
		when Task
		Done
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.

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)	1	1	1	1
US Transducer (with belt clip)	1	1	1	1
Patient Module for DECG/MECG/IUP	optional1	optional	optional1	optional
DECG Reusable Legplate Adapter Cable	-	1	-	1
MECG Adapter Cable	-	1	-	1
IUP Adapter Cable2	-	optional	-	optional
External Power Supply and MSL Cable	optional	optional	-	-
Event Marker	optional	optional	optional	optional
Fetal Paper Pack (country-specific, installed)	1	1	1	1
Powercord	1	1	1	1
Printed Instructions for Use	1	1	1	1
Documentation DVD: includes FM20/30 Service Guide,	1	1	1	1
FM40/50 Service Guide, Instructions for Use (including
localized versions), and Training Guide

1For assessment of maternal heart rate only.

2Ships with Patient Module (K03).

14

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 Block	Test or Inspection to be Performed	Test Block Required for
		Which Events?
Visual	Inspect the monitor, transducers and cables for any	Installation
	damage.	Preventive Maintenance
	Are they free of damage?
Power On	Power on the monitor. Does it boot up successfully without	Installation
	errors? After boot up the monitor sounds a tone, and can	Preventive Maintenance
	you see the monitoring main screen.
	If recorder power-on auto-start is configured to On, does
	the recorder print Selftest: OK across the trace paper? (See
	“Switching the Recorder On and Off ” on page 49 for
	details.)
Functionality Test	FM20/30 with Battery Option #E25 Only	Installation
	After power up, touch the battery status indicator in the	Preventive Maintenance
	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 Main Screen key to close
	the window and return to the main screen.
Safety Tests (1) to (4)	Perform safety tests (1) to (4), as described in your	Installation
	monitor's Service Guide, for standalone devices if required by	Preventive Maintenance
	local regulations, and each time you combine equipment to
	form a system, or exchange system components.
Performance	Test the transducers (see “Testing Ultrasound Transducers”	Installation
	on page 112 and “Testing Toco Transducers” on page 132).	Preventive Maintenance
System	Perform the system test according to IEC/EN 60601-1-1/	Combining system
	IEC/EN 62353, if applicable, after combining equipment	components
	to form a system (see your monitor's Service Guide).

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

3

Basic 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.

Supported Measurements

The following Fetal Measurements are supported:

Fetal Monitor	Fetal Heart Rate	Triple FHR via	Toco	FHR via Direct	Intrauterine
or Model	(FHR) via US	US		ECG (DECG)	Pressure (IUP)
	(including Twins)
FM20	Standard	Optional	Standard	-	-
FM30	Standard	Optional	Standard	Standard	Standard
FM40	Standard	Optional	Standard	-	-
FM50	Standard	Optional	Standard	Standard	Standard

19

3 Basic Operation

The following Maternal Measurements are supported:

Fetal Monitor	Maternal	Maternal	Maternal Pulse	Non-invasive Blood	Pulse Oximetry
or Model	Heart Rate	ECG	from Toco	Pressure with Pulse	(Maternal SpO2)
	(MHR) via	(MECG)		Rate	with Pulse Rate
	Maternal ECG
	Electrodes
FM20	Standard	-	Standard	Optional	-
FM30	Standard	Standard	Standard	Optional	Optional
FM40	Standard	-	Standard	Standard	Standard
FM50	Standard	Standard	Standard	Standard	Standard

Avalon FM20 and FM30

This section outlines the capabilities of your monitor.

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

3 Basic Operation

Avalon FM30

FM20/30 with Battery Option #E25 Only

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+ transducer or patient module, and optionally, maternal oxygen saturation (SpO2).

The Avalon FM30 carries the label, indicating that it is capable of intrapartum monitoring.

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 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 (SpO2).

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).

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+ transducer or patient module.

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.

•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.

•When using a cordless ultrasound transducer from an Avalon CTS system, the monitor automatically sets the Fetal Movement Profile (FMP) to Off. You can enable the FMP again should 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.

22

3 Basic Operation

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

with Battery Option

8 On/Standby Switch

9 MSL Connector

23

3 Basic Operation

Rear

10 Display Release

11 Carrying Handle

12 Built-in Stand

Left Side

13 SpO2 Socket (optional)

14 Noninvasive Blood Pressure Socket (optional)

15 Fetal Sensor Sockets - each socket accepts any fetal transducer, an Avalon CTS Cordless Fetal Transducer System base station (connected via the interface cable M273160001), 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	SpO2 Socket

24

3 Basic Operation

Rear

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)

1Transducer Finder LED - lights up on the transducer providing the measurement source.

2Belt 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.

Toco+ Transducer with ECG/IUP capability (M2735A)

5 Connector - for connecting ECG/IUP adapter cables (M2735A Toco+ transducer only)

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

26

3 Basic Operation

Patient Module for ECG/IUP (M2738A)

9Connector - for connecting ECG/IUP adapter cables (same as for Toco+ transducer)

10Cable - connects to any of the four Fetal Sensor Sockets on the monitor

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

1INOP and alarm status area - shows active alert messages

2LAN 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.

3Patient identification

27

3 Basic Operation

4Date and time

5Bed label (when connected to a Philips OB TraceVue system)

6Fetal heart sound volume adjust/indicator

7Alarm volume adjust/indicator

8Numeric/measurement values

9Fetal Trace Recorder - status indicator 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.

10Avalon 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.

11Close all open menus and windows and return to main screen

12Battery Status Indicator

13Scroll to display more SmartKeys

14SmartKeys - these can vary according to your monitor's configuration

15Silence - key which acknowledges all active alarms by switching off audible alarm indicators

28

3 Basic Operation

16Status line - shows status and prompt messages

17Signal quality indicator

Good / full

acceptable / medium

Poor / no signal

18Measurement label (a cordless measurement from a connected Avalon CTS system is indicated by the symbol)

19NST timer, if configured (default is Off)

Keys

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.

29

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			Recorder Start/ Stop - turn the trace
		menu.			recorder on or off.
		Pause Alarms - pauses alarm			Paper Advance - advance the paper
		indicators. Pause duration depends			automatically to the next fold.
		on monitor configuration. If pause
		duration is infinite, this key is
		labeled Alarms Off.
		Select again to immediately re-
		enable alarm indicators.
		Start Recordng - turn the trace			Stop Recordng - turn the trace
		recorder on.			recorder off.
		Start ECG- start printing the			Stored Data Rec - print trace data
		MECG, DECG or both waves,			from the monitor's memory.
		when both are available.
		Admit/ Dischrge - enter patient			Enter Notes - enter notes
		identification menu to admit/
		discharge
		Toco Baseline - reset Toco			Timer - enters NST timer window
		baseline/whichever is available
		(see below)
		Zero IUP - zero IUP			Set Marker - mark an event
		measurement/whichever is
		available (see above)

30