Philips Avalon FM20, Avalon FM30 User manual

I N S T R U C T I O N S F O R U S E

Avalon Fetal Monitor

FM20 / FM30 / FM40 / FM50

Release F.0 with Software Revision F.01.xx

F E T A L M O N I T O R I N G

Printed in Germany 12/07

*M2703-9001D*

Part Number M2703-9001D 451261025621

S

M2703-9001D

Table Of Contents

1	Introduction	1
	Who this Book is For	1
	Confirm Fetal Life Before Using the Monitor	2
	Introducing the Avalon Family of Fetal Monitors	3
	Intended Use	3
	Contraindications	3
	Indications for Use	3
2	Installation	5
	Installation Checklist	5
	Unpacking and Checking the Shipment	6
	Initial Inspection	6
	Claims for Damage	6
	Repacking	6
	Mounting the Monitor	6
	Connecting the Monitor to AC Mains	7
	How and When to Carry Out the Test Blocks	7
	Safety Tests	8
3	Basic Operation	9
	Supported Measurements	10
	Avalon FM20 and FM30	11
	Avalon FM20	11
	Avalon FM30	11
	Avalon FM40 and FM50	12
	Avalon FM40	12
	Avalon FM50	12
	Cordless Monitoring	13
	Getting to Know Your Avalon FM20/FM30	14
	Overview	14
	Right Side	14
	Rear	14
	Left Side	15
	Getting to Know Your Avalon FM40/FM50	16
	Front	16
	Rear	16
	Transducers	17
	Operating and Navigating	19
	Keys	21
	Permanent Keys	21
	SmartKeys	21
	Pop-Up Keys	22

i

Using the Touchscreen	22
Disabling Touchscreen Operation	22
Selecting Screen Elements	22
Operating Modes	22
Automatic Screen Layouts	23
Settings	23
Active Settings	23
User Default	24
Factory Default	24
Global Settings	24
Changing Measurement Settings	24
Switching the Noninvasive Blood Pressure Measurement On and Off	25
Changing Monitor Settings	25
Adjusting the Screen Brightness	25
Adjusting Touch Tone Volume	25
Setting the Date and Time	25
Checking Your Monitor Revision	26
Preparing to Monitor a Patient	27
Switching On: FM20/FM30	27
Switching On: FM40/FM50	27
Adjusting the Display Angle (FM20/FM30)	27
Fastening Belts and Transducers	28
Using Belts with Button Fixings	29
Using Belt with Velcro Fixings	30
Connecting a Transducer to the Monitor	31
Checking/Setting Paper Scale	33
Paper Guide: FM40/FM50	33
Removing the Paper Guide: FM40/FM50	33
Loading Paper: FM20/FM30	35
Loading Paper: FM40/FM50	36
Paper-Out Indication	39
Choosing Paper Speed	39
Tearing Off the Paper: FM20/FM30	39
Tearing Off the Paper: FM40/FM50	39
Using the Paper Guide	40
Without the Paper Guide	40
Switching the Recorder On and Off	40
Advancing the Paper	42
Marking an Event	42
Entering Notes	43
Signal Quality	43
Starting Monitoring	43
Switching the Monitor to Stand-by	44
After Monitoring	44
Disconnecting from Power	44
Troubleshooting	45

ii

4	Alarms	47
	Alarm Mode	47
	Visual Alarm Indicators	48
	Audible Alarm Indicators	48
	Alarm Tone Configuration	48
	Standard Philips Alarms	48
	ISO/IEC Standard 9703-2 Audible Alarms	48
	Changing the Alarm Tone Volume	49
	Acknowledging Alarms	49
	Acknowledging Disconnect INOPs	49
	Pausing or Switching Off Alarms	50
	To Pause All Alarms	50
	To Switch All Alarms Off	50
	To Switch Individual Measurement Alarms On or Off	50
	While Alarms are Paused or Off	51
	Restarting Paused Alarms	51
	Alarm Limits	51
	Viewing Individual Alarm Limits (Alarm Mode “All” Only)	51
	Changing Alarm Limits	52
	Reviewing Alarms	52
	Alarm Messages Window	52
	Review Alarms Window	52
	Latching Alarms	52
	Viewing the Alarm Latching Settings	53
	Alarm Latching Behavior	53
	Testing Alarms	54
	Alarm Behavior at On/Off	54
5 Patient Alarms and INOPs		55
	Patient Alarm Messages	55
	Technical Alarm Messages (INOPs)	57
6 Admitting and Discharging Patients		61
	Admit/Discharge on the Monitor	61
	Admitting a Patient	61
	Editing Patient Information	62
	Discharging a Patient	62
	New Patient Check	62
	OB TraceVue: via LAN	62
	OB TraceVue: via RS232	63
7	Non-Stress Test Timer	65
	Setting NST Autostart/Autostop	65
	Viewing the NST Timer	65
	Timer Expiry Notification	65

iii

	Accessing the NST Setup Pop-up Keys	65
	Via the Timer SmartKey (Route 1)	66
	Via the Main Setup SmartKey (Route 2)	66
	Via the NST Field (Route 3)	66
	Pop-up Keys for NST Timer Setup	66
	Run Time	66
8	Monitoring FHR and FMP Using Ultrasound	69
	Misidentification of MHR as FHR	69
	Cross-Channel Verification	70
	What You Need	70
	Cordless Monitoring - Important Considerations	70
	Preparing to Monitor	71
	Selecting Fetal Heart Sound	72
	Changing the Fetal Heart Sound Volume	72
	Fetal Movement Profile	72
	FMP Statistics	73
	Switching FMP On and Off	74
	Troubleshooting	74
	Testing Ultrasound Transducers	75
9	Monitoring Twin FHRs	77
	Important Considerations	77
	Monitoring Twins Externally	78
	Monitoring Internally	79
	Cross-Channel Verification	80
	Separating FHR Traces	80
	Switching Trace Separation On and Off	80
	Determining the Separation Order	81
	When Trace Separation is On	81
	‘Standard’ Separation Order	81
	‘Classic’ Separation Order	82
	When Trace Separation is Off	82
	Troubleshooting	83
10	Fetal Heart Rate Alarms	85
	Changing Alarm Settings	85
	Turning Alarms On or Off	85
	Changing Alarm Limits	85
	Changing Alarm Delays	85
	Changing Signal Loss Delay	86
11	Monitoring Triple FHRs	87
	Important Considerations	87
	Monitoring Triplets	88
	Cross-Channel Verification	88

iv

Separating FHR Traces	89
Switching Trace Separation On and Off	89
When Trace Separation is On	89
‘Standard’ Separation Order	89
‘Classic’ Separation Order	90
When Trace Separation is Off	90
Troubleshooting	91
12 Monitoring Uterine Activity Externally	93
What You Need	93
External Toco Monitoring	93
Resetting the Toco Baseline	94
Automatic Baseline Adjustment	94
Toco Sensitivity	94
Troubleshooting	95
Testing Toco Transducers	96
13 Monitoring Uterine Activity Internally	97
What You Need	97
Internal (IUP) Monitoring	98
Zeroing the Monitor	98
Selecting the IUP Scale	98
Troubleshooting	99
14 Monitoring FHR Using DECG	101
Misidentification of MHR as FHR	101
What You Need	101
Making Connections	103
Monitoring DECG	103
Suppressing Artifacts	104
Printing the Waveform	105
Troubleshooting	105
Testing DECG Mode	106
15 Monitoring Noninvasive Blood Pressure	107
Introducing the Oscillometric Noninvasive Blood Pressure Measurement	107
Measurement Limitations	108
Measurement Methods	108
Reference Method	108
Preparing to Measure Noninvasive Blood Pressure	108
Correcting the Measurement if Limb is not at Heart Level	109
Understanding the Numerics	109
Starting and Stopping Measurements	109
Enabling Automatic Mode and Setting Repetition Time	110
Choosing the Alarm Source	110
Assisting Venous Puncture	111

v

Calibration	111
Troubleshooting	111

16 Monitoring SpO2	113
Selecting an SpO2 Sensor	113
Applying the Sensor	113
Connecting SpO2 Cables	114
Measuring SpO2	114
Assessing a Suspicious SpO2 Reading	115
Understanding SpO2 Alarms	115
Alarm Delays	115
Adjusting the SpO2 Alarm Limits	115
Adjusting the Desat Limit Alarm	116
Adjusting the Pulse Alarm Limits	116
Setting Up Tone Modulation	116
Setting the QRS Volume	116
17 Monitoring Maternal Heart / Pulse Rate	117
Priority for Maternal Heart / Pulse Rate	117
Cross-Channel Verification	117
MHR from MECG Electrodes	117
Applying Electrodes	118
Making Connections	119
Monitoring MHR	119
Monitoring MECG	119
Applying Electrodes	120
Viewing the Waveform on the Screen	120
Printing the Waveform	120
Pulse Rate from SpO2	120
Adjusting the Heart Rate / Pulse Alarm Limits	121
Average Pulse Rate from Noninvasive Blood Pressure	121
Troubleshooting	121
Testing MECG Mode	121
18 Printing the ECG Waveform	123
19 Paper Save Mode for Maternal Measurements	127
20 Recovering Data	129
Recovering Traces on Paper	129
Recovering Traces on an OB TraceVue System	130
Recording Stored Data	130
21 Care and Cleaning	133
General Points	133
Cleaning and Disinfecting	134

vi

Cleaning Agents	134
Disinfecting Agents	135
Cleaning and Disinfecting Monitoring Accessories	135
Sterilizing	135
22 Maintenance	137
Inspecting the Equipment and Accessories	137
Inspecting the Cables and Cords	137
Maintenance Task and Test Schedule	138
Storing Recorder Paper	138
Cleaning the Printhead	139
Disposing of the Monitor	139
23 Accessories and Supplies	141
Information on Latex	141
Transducers	141
Fetal Accessories	142
DECG Accessories: Component Compatibility	143
MECG Accessories	143
Noninvasive Blood Pressure Accessories	144
Adult/Pediatric Multi-Patient Comfort Cuffs and Disposable Cuffs	144
Adult Antimicrobial Coated Reusable cuffs	144
Adult Soft Single Patient Single-Hose Disposable Cuffs	144
SpO2 Accessories	145
Recorder Paper	147
24 Specifications and Standards Compliance	149
Environmental Specifications	149
Physical Specifications	150
Performance Specifications	151
Fetal / Maternal	151
Noninvasive Blood Pressure	154
SpO2	156
Recorder Specifications	158
Alarm Defaults	160
Compatible External Displays: FM40/FM50 Only	160
Manufacturer’s Information	161
Trademark Acknowledgement	161
Regulatory and Standards Compliance	161
Safety and Performance	161
Electromagnetic Compatibility (EMC)	161
EMC Testing	162
Reducing Electromagnetic Interference	162
System Characteristics	163
Electromagnetic Emissions and Immunity	163
Electromagnetic Immunity	164

vii

Finding Recommended Separation Distances	165
Recommended Separation Distances from Other RF Equipment	167
Environment	167
Monitoring After a Loss of Power	168
ESU, MRI and Defibrillation	168
Cardiac Pacemakers and Electrical Stimulators	168
Fast Transients/Bursts	168
Symbols on the System	168

viii

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.

•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.

1

1 Introduction

Confirm Fetal Life Before Using the Monitor

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 maternal heart, 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’s aorta.

See also the chapters “Monitoring FHR and FMP Using Ultrasound” and “Monitoring FHR Using DECG”.

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 70.

2

Introducing the Avalon Family of Fetal Monitors

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 and accessories, 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 the physiological parameters of pregnant women during antepartum testing and labor and delivery. The FM30 and FM50 are additionally intended for invasive monitoring.

All monitors are intended for monitoring fetal and maternal heart rates, uterine activity, maternal noninvasive blood pressure, and additionally for the FM30, FM40 and FM50, oxygen saturation (SpO2).

All monitors are intended for generating alarms from fetal and maternal parameters, for displaying, storing and recording patient data and related waves, transmitting patient data to a patient information and surveillance system on a network, and for postpartum monitoring of the mother.

All monitors are intended for use by trained health care professionals.

They are intended for use in labor and delivery rooms, antepartum testing areas and during postpartum recovery in the hospital environment. They are not intended for use in intensive care units or operating rooms. The FM20 and FM30 are additionally intended for use in healthcare facilities outside hospitals, for example in doctors’ offices, and for use in private households.

Contraindications

All monitors are NOT intended for:

–use during defibrillation, electro-surgery, or magnetic resonance imaging (MRI).

–ECG measurements on patients connected to external electrical stimulators or with cardiac pacemakers.

–use with the IUP/ECG 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.

Indications for Use

The monitors are indicated for use by health care professionals for monitoring the physiological parameters of pregnant women.

3

1 Introduction

Introducing the Avalon Family of Fetal Monitors

4

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 Chapter 2, “Basic Operation”.

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 6)
2	Mount the monitor as appropriate for your installation
	(see “Mounting the Monitor” on page 6)
3	Connect the fetal monitor to AC mains using the supplied power cord (see
	“Connecting the Monitor to AC Mains” on page 7)
4	Perform Safety Tests (see “Safety Tests” on page 8)
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 33)
7	Load paper into the recorder (see “Loading Paper: FM20/FM30” on page 35
	or “Loading Paper: FM40/FM50” on page 36, depending on your monitor)
8	Check/set the time and date (see “Setting the Date and Time” on page 25)
9	Check/set paper speed (see “Choosing Paper Speed” on page 39)
10	Perform System Test as necessary (see the Service Guide)
11	Test Transducers (see “Testing Ultrasound Transducers” on page 75 and
	“Testing Toco Transducers” on page 96)

5

2 Installation

Unpacking and Checking the Shipment

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)	-	1	-	1
Toco transducer (with belt clip)	1	-	1	-
US transducer (with belt clip)	1	1	1	1
Patient Module for DECG/MECG/IUP	optional1	optional	optional1	optional
IUP Adapter Cable2		1		1
DECG reusable legplate adapter cable	-	1	-	1
MECG adapter cable	-	1	-	1
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-ROM: includes FM20/30 Service	1	1	1	1
Guide, FM40/50 Service Guide, Instructions for Use
(including localized versions), and Training Guide
1. For assessment of maternal heart rate only.
2. Ships with Patient Module.

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

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.

The monitor can be rested on a flat surface, or on a cart. See your monitor’s Service Guide for details.

6

Connecting the Monitor to AC Mains

2 Installation

Connecting the Monitor to AC Mains

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.

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.

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	Installation
	any damage.	Preventive Maintenance
	Are they free of damage?
Power On	Power on the monitor. Does it boot up	Installation
	successfully without errors? After boot up the	Preventive Maintenance
	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 “Selftest OK” across
	the trace paper? (See page 26 for details.)
Safety Tests (1) to (4)	Perform safety tests (1) to (4), as described in your	Installation
	monitor’s Service Guide, for standalone devices if	Preventive Maintenance
	required by local regulations, and each time you
	combine equipment to form a system, or exchange
	system components.

7

2 Installation

Safety Tests

Test Block	Test or Inspection to be Performed	Test Block Required for
		Which Events?
Performance	Test the transducers (see “Testing Ultrasound	Installation
	Transducers” on page 75 and “Testing Toco	Preventive Maintenance
	Transducers” on page 96).
System	Perform the system test according to IEC/EN	Combining system
	60601-1-1/IEC/EN 62353, if applicable, after	components
	combining equipment 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.

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.

8

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.

9

3 Basic Operation

Supported Measurements

Supported Measurements

Fetal

Monitor

Model

Key:

The following measurements are supported:

Supported Measurements

Fetal

Maternal

HeartFetalRate

via(FHR)US

IncludingTwins

FHRTriplevia US

Toco

FHR

DirectviaECG

(DECG)

IntrauterinePressure

(IUP)

MaternalHeart Rate

via(MHR)maternal

electrodesECG

MaternalECG

(MECG)

NoninvasiveBlood Pressure

PulsewithRate

OximetryPulse

(MaternalSpO

PulsewithRate

)

2

●

●

-

-

●

-

-

●

●

●

●

●

●

●

●

-

-

●

-

●

●

●

●

●

●

●

●

●

●

● = Standard

= Optional

- = Not Available

10

Avalon FM20 and FM30

3 Basic Operation

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 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 obstetrical documentation and surveillance system via the RS232 connection, or over a LAN connection (with OB TraceVue Revision E.00.00 and later).

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

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

11

3 Basic Operation

Avalon FM40 and FM50

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 optional 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 optionally, 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).

Avalon FM50

The Avalon FM50 fetal/maternal monitor offers a solution for both external and internal fetal monitoring applications, and optional 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.

12

Cordless Monitoring

3 Basic Operation

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 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.

•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 Stand-by.

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 Stand-by, and continue monitoring with the 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 74), but you should refer to the sections “Cordless Monitoring - Important Considerations” on page 70 and “Fetal Movement Profile” on page 72.

13

3 Basic Operation

Getting to Know Your Avalon FM20/FM30

Getting to Know Your Avalon FM20/FM30

Overview

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

4

5

Right Side

6 ON/OFF switch

7 Power connector

6

7

Rear

			8		Carrying handle
10				9	Built-in stand
			10		Display release
8

9

14

Getting to Know Your Avalon FM20/FM30

3 Basic Operation

Left Side

		11								Fetal sensor sockets - each
										socket accepts any fetal
										transducer, an Avalon CTS
										Cordless Fetal Transducer
										System base station (connected
										via the interface cable M2731-
										60001), or event marker
		12
										Noninvasive blood pressure
		11								socket (optional)
13 12										SpO2 socket (optional, FM30
		13

only)

15

3 Basic Operation

Getting to Know Your Avalon FM40/FM50

Getting to Know Your Avalon FM40/FM50

Front

																			1	On/Off/Standby switch
		4									5								2	Power LED
																			3	Recorder paper table
																		6	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.
			3								2							1	7
																				Fetal sensor sockets. Connect any fetal
																				sensor or patient module here,
																				including Avalon CTS via M2731-
																				60001 interface cable (with red
																			8	connector).
																				Noninvasive blood pressure socket
9		8	7
																			9	SpO2 socket

Rear

																		Reserved for future use: protective
																		earth intended for use in system
															1			installations.
															2			Equipotential grounding point
															3			Power cord connector
															4			Loudspeaker
															5			Slot 01 for optional LAN / RS232
1 2									3	4								system interface (for connection to an
																		obstetrical information and
(B)																		surveillance system)
									(A)
			6												6			Slot 02 for optional interfaces:
																5		• Either dual PS/2 system interface
																	7	(A) for mouse and keyboard
																		connection)
																		• Or MIB interface (B) for external
																		touch screen connection
															7			Slot 03 reserved for future use
									9	8
															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).

16

Transducers

Transducers

1

2

Toco Transducer

(M2734A)

3

Ultrasound Transducer

(M2736A)

4

3 Basic Operation

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

2Belt Button

3Cable - connects to any of the four Fetal Sensor Sockets on the monitor

4Connector - for connecting ECG/IUP adapter cables

(M2735A Toco+ transducer only)

Toco+ Transducer with ECG/IUP capability (M2735A)

17

3 Basic Operation

Transducers

	5	Butterfly belt clip (shown
	6	fitted; for use with belts
		without button holes)
	6	Close-up of MECG adapter
		cable connected to Toco+
		transducer
5	7	Close-up of active Finder LED

7

					8	Connector - for connecting
						ECG/IUP adapter cables (same
						as for Toco+ transducer)
8				9	9	Cable - connects to any of the
						four Fetal Sensor Sockets on the
						monitor

Patient module for ECG/IUP (M2738A)

18

Operating and Navigating

3 Basic Operation

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.

If an optional external touch display is connected to the monitor, you can operate the monitor using the external touch display.

	2					3		4	5	6	7
1						Doe, Jane		31 Jan 13:31 Bed 11
								INOP Only
18				NST		20 min
17			FHR1				Toco		FHR2
16											8
			NBP			Auto		SpO2	Pulse
			Sys.
15				All Settings restored successfully									9, 10
							Start/
				Silence Toco				Paper	Admit		Main
						Baseline	Stop	Advance	Dischrge		Screen
	14							13	12		11

Screen Elements

Item		Description
		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.
	Monitor connected to OB	LAN cable connected, but no	If no indicator is shown, there
	TraceVue	connection to OB TraceVue	is no network connection.
3	Patient identification
4	Date and time
5	Bed label (when connected to a Philips OB TraceVue system)
6	Fetal heart sound volume adjust/indicator

19

3 Basic Operation

Operating and Navigating

				Screen Elements
Item				Description
7	Alarm volume adjust/indicator
				Other Screen Elements
8	Numeric/measurement values
9	Status indicator - for fetal trace recorder
	Fetal recorder On	Fetal recorder Off		Fetal recorder Off	Recorder problem that can		Fetal recorder is
		(when Paper Save		(when Paper Save	be solved by the user (for		defective. Call service.
		Mode is off)		Mode is on)	example, paper out, paper
					jam, wrong paper scale set)
10	Status indicator - for Avalon CTS system:
	Avalon CTS interface cable is		Avalon CTS interface cable is			Avalon CTS interface cable is
	connected to the monitor, but		connected to the monitor, Avalon CTS			connected to the monitor, Avalon CTS
	Avalon CTS base station is not		base station is connected, powered on,			base station is connected, powered on,
	connected to the interface cable,		and cordless transducers are ready to			and at least one cordless transducer has
	disconnected from AC mains, or is		use, but no cordless transducers are			been taken out of the base station and
	in Stand-by.		currently active (all are still docked in			is active. Any connected wired
			the base station).			transducers are disabled.
11	Close all open menus and windows and return to main screen
12	Scroll to display more SmartKeys
13	SmartKeys - these can vary according to your monitor’s configuration
14	Silence - key which acknowledges all active alarms by switching off audible alarm indicators
15	Status line - shows status and prompt messages
16	Signal quality indicator:
	Good/full			Acceptable/medium		Poor/no signal
17	Measurement label (a cordless measurement from a connected Avalon CTS system is indicated by the						symbol)
18	NST timer, if configured (default is off)

20