Philips Avalon FM20, Avalon FM30 User manual

Download

INSTRUCTIONS FOR USE

Avalon Fetal Monitor

FM20 / FM30 / FM40 / FM50

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

FETAL MONITORING

Printed in Germany 12/07

*M2703-9001D*

Part Number M2703-9001D

451261025621

M2703-9001D

1Table 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

Tr a n s d u c e r s 17 Operating and Navigating 19

Keys 21

Permanent Keys 21 SmartKeys 21 Pop-Up Keys 22

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 Ad ju st ing Tou ch To ne Volu me 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

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

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 Tes ti ng Toc o Tra ns du ce rs 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

Calibration 111 Troubleshooting 111

16 Monitoring SpO

113

Selecting an SpO2 Sensor 113 Applying the Sensor 113 Connecting SpO2 Cables 114 Measuring SpO

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 SpO

Adjusting the Heart Rate / Pulse Alarm Limits 121 Average Pulse Rate from Noninvasive Blood Pressure 121 Troubleshooting 121 Testing MECG Mode 121

120

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

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 Tr a n s d u c e r s 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 SpO

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

156

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

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.

1Introduction

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 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.

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 (SpO

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.

1 Introduction Introducing the Avalon Family of Fetal Monitors

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.

2Installation

Step Ta sk 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)

❏

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

To c o+ transducer (with belt clip) - 1 - 1

Toco transducer (with belt clip) 1 - 1 -

US transducer (with belt clip) 1111

Patient Module for DECG/MECG/IUP optional

IUP Adapter Cable

DECG reusable legplate adapter cable - 1 - 1

MECG adapter cable - 1 - 1

Event Marker optional optional optional optional

Fetal paper pack (country-specific, installed) 1111

Powercord 1111

Printed Instructions for Use 1111

Documentation DVD-ROM: includes FM20/30 Service Guide, FM40/50 Service Guide, Instructions for Use (including localized versions), and Training Guide

For assessment of maternal heart rate only.

2. Ships with Patient Module.

1111

optional optional

optional

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.

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.

Tes t Bl oc k Test or Inspection to be Performed Te s t B l o c k R eq u i r ed f o 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 “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

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.

Installation

Preventive Maintenance

Installation

Preventive Maintenance

Installation

Preventive Maintenance

2 Installation Safety Tests

Tes t Bl o c k Test or Inspection to be Performed Te s t B l oc k Re q u i re d f o r

Which Events?

Performance Test the transducers (see “Testing Ultrasound

Transducers” on page 75 and “Testing Toco Tr a ns du c er s” o n p a g e 9 6 ) .

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).

For test and inspection information regarding repairs, upgrades and all other service events, refer to your monitor’s Service Guide.

Installation

Preventive Maintenance

Combining system components

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 606011-1) that ensures mechanical fixing of the power cords and covering of any unused power outlets.

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 Basic Operation Supported Measurements

Supported Measurements

The following measurements are supported:

Supported Measurements

Fetal Maternal

Fetal

Monitor

Model

)

Fetal Heart Rate

(FHR) via US

Including Twins

●❍●

● ❍●●●●●❍ ❍

●❍●

● ❍●●●●●● ●

Key: ● = Standard

Triple F H R vi a U S

To co

FHR

via Direct ECG

(DECG)

Intrauterine Pressure

(IUP)

= Optional

❍

Maternal Heart Rate

(MHR) via maternal

ECG electrodes

Maternal ECG

(MECG)

●

Noninvasive Blood Pressure

with Pulse Rate

Pulse Oximetry

❍

●●

- = Not Available

with Pulse Rate

(Maternal SpO

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 optionally, maternal oxygen saturation (SpO

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

transducer or patient module, and

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 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

The Avalon FM50 carries the label, indicating that it is capable of intrapartum monitoring.

transducer or patient module.

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.

3 Basic Operation Getting to Know Your Avalon FM20/FM30

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

Rear

ON/OFF switch

Power connector

6 7

Carrying handle

Built-in stand

Display release

Getting to Know Your Avalon FM20/FM30 3 Basic Operation

Left Side

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

Noninvasive blood pressure

1213

socket (optional)

SpO2 socket (optional, FM30 only)

3 Basic Operation Getting to Know Your Avalon FM40/FM50

Getting to Know Your Avalon FM40/FM50

Front

On/Off/Standby switch1

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 M273160001 interface cable (with red connector).

8 Noninvasive blood pressure socket

9 SpO

socket

Rear

Reserved for future use: protective earth intended for use in system

2 Equipotential grounding point

3 Power cord connector

4 Loudspeaker

5 Slot 01 for optional LAN / RS232

(A)(B)

6 Slot 02 for optional interfaces:

7 Slot 03 reserved for future use

8 Video output (VGA)

9 Telemetry interface. If not using one of

installations.

system interface (for connection to an obstetrical information and surveillance system)

• Either dual PS/2 system interface

(A) for mouse and keyboard connection)

• Or MIB interface (B) for external

touch screen connection

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 3 Basic Operation

Transducers

Transducer Finder LED - lights up on the transducer providing

Toc o Tr a n s d u c er

(M2734A)

the measurement source.

Belt Button

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

Ultrasound Transducer

(M2736A)

Connector - for connecting

ECG/IUP adapter cables

(M2735A Toco only)

transducer

Toco+ Transducer with ECG/IUP capability

(M2735A)

3 Basic Operation Transducers

Butterfly belt clip (shown fitted; for use with belts

without button holes)

Close-up of MECG adapter cable connected to Toco

transducer

Close-up of active Finder LED

Connector - for connecting ECG/IUP adapter cables (same

as for Toco

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

transducer)

Patient module for ECG/IUP

(M2738A)

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.

18 17

324

Toco

Stop

31 Jan

INOP Only

SpO

Paper

Advance

Doe, Jane

20 minNST

FHR1

NBP Auto

Sys.

All Settings restored successfully

Silence

Toco

Baseline

Start/

13:31

Dischrge

FHR2

Admit

Bed 11

Pulse

9, 10

Main

Screen

Screen Elements

Item Description

Monitor Information Line

INOP and alarm status area - shows active alert messages

LAN connection status indicator only. RS232 system connection is not indicated.

Monitor connected to OB Tr a c e V u e

Patient identification

Date and time

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

Fetal heart sound volume adjust/indicator

LAN cable connected, but no connection to OB TraceVue

If no indicator is shown, there is no network connection.

3 Basic Operation Operating and Navigating

Screen Elements

Item Description

Alarm volume adjust/indicator

Other Screen Elements

Numeric/measurement values

Status indicator - for fetal trace recorder

Fetal recorder On

Status indicator - for Avalon CTS system:

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 Stand-by.

Close all open menus and windows and return to main screen

Scroll to display more SmartKeys

SmartKeys - these can vary according to your monitor’s configuration

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

Status line - shows status and prompt messages

Signal quality indicator:

Fetal recorder Off (when Paper Save Mode is off )

Fetal recorder Off (when Paper Save Mode is on)

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.

Good/full

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

NST timer, if configured (default is off)

Acceptable/medium

Poor/no signal

Operating and Navigating 3 Basic Operation

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.

SmartKeys

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.

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

Recorder Start/Stop - turn the trace recorder on or off.

Paper Advance - advance the

paper automatically to the next fold.

Alarms Off.

Select again to immediately re-enable alarm indicators.

Start Recordng - turn the

trace recorder on.

Stop Recordng - turn the trace

recorder off.

Start ECG - start printing the

ECG wave.

Stored Data Rec - print trace

recovery data from the monitor’s memory.

Admit/Dischrge

identification menu to admit/ discharge

Toco Baseline - reset Toco

baseline

- enter patient

Enter Notes - enter notes

Timer - enters NST timer window

Zero IUP - zero IUP measurement Set Marker - mark an event

Start/Stop:

- start/stop manual noninvasive blood pressure measurement

- start auto series

- stop current automatic measurement within series

Stop All - stop all noninvasive blood

pressure measurements

3 Basic Operation Operating Modes

Start NBP

- start manual noninvasive blood pressure measurement

- start auto series

Repeat Time - set the time

interval between two noninvasive blood pressure measurements

Monitor Standby - enter

Stand-by mode, suspends monitoring. All numerics and waves disappear from the display. All settings and patient data information are retained.

Pop-Up Keys

Pop-up keys are context-sensitive graphical keys that appear automatically on the monitor screen when required. For example, the confirm pop-up key appears when you need to confirm a change.

Using the Touchscreen

Select screen elements by pressing them directly on the monitor’s screen.

Stop NBP:

- stop manual noninvasive blood pressure measurement

- stop current automatic measurement within series

Defaults - load User Default

Disabling Touchscreen Operation

To temporarily disable touchscreen operation of the monitor, press and hold the Main Screen permanent key for about three seconds. A red padlock will blink on the Main

Screen permanent key.

Press and hold the Main Screen permanent key again for about three seconds to re-enable the touchscreen operation.

Selecting Screen Elements

Select a screen element to tell the monitor to carry out the actions linked to the element.

You access most screen elements by touching that element directly. For example, select the FHR1 numeric to call up the Setup FHR1 menu, or select the Start/Stop SmartKey to start or stop the fetal trace recorder.

However, some smaller screen elements are grouped together at the top of the screen in the information area. To access one of these elements, touch anywhere in the information area, and select the element from the selection list that appears. For example, to view alarm messages:

1 Touch the alarm status field, or anywhere else in the information area at the top of the screen. The

window with the selection list opens.

2 Select Alarm Messages from the list. This opens the Alarm Messages window, from where

you can proceed to view the alarm messages.

Operating Modes

When you switch the monitor on, it starts up in monitoring mode. To change to a different mode:

1 Select the Main Setup menu.

Automatic Screen Layouts 3 Basic Operation

Select Operating Modes and choose the mode you require.

Your monitor has four operating modes. Some are passcode protected.

• Monitoring Mode: This is the normal mode for monitoring patients. You can change elements such as alarm limits, and so forth. When you discharge the patient, these elements return to their default values. Changes can be stored permanently in Configuration Mode. You may see items, such as some menu options, that are visible but ‘grayed out’ so that you can neither select nor change them. These are for your information and can be changed in Configuration Mode.

• Demo Mode: Passcode protected, this is for demonstration and training purposes. You must not change into Demonstration Mode during monitoring. When transducers are connected to the monitor and the recorder is on, a demo trace is recorded, but this is not transmitted to an information and surveillance system such as OB TraceVue.

• Configuration Mode: Passcode protected, this is for personnel trained in configuration tasks. These tasks are described in the Service Guide. During installation the monitor is configured for use in your environment. This configuration defines the default settings you work with when you switch on.

• Service Mode: Passcode protected, this is for trained service personnel.

Config

When the monitor is in Demonstration Mode, Configuration Mode, or Service Mode, this is indicated by a box containing the mode name. Select this field to change to a different mode.

Automatic Screen Layouts

Your monitor’s preconfigured screen layouts define how measurement information is arranged on screen. The monitor automatically applies the correct screen layout for the measurements you are monitoring. No user action is required.

Connecting or disconnecting transducers, or switching the noninvasive blood pressure measurement on or off, results in an automatic adjustment of the screen layout. When a measurement is off, its numerics are removed from the monitor’s screen. The monitor stops acquiring data and generating alarms for this measurement. If you disconnect a transducer while it is performing a measurement, the monitor issues a disconnect INOP (and in the case of SpO question marks).

Settings

This section describes the various settings available on the monitor.

Active Settings

What the monitor displays, and the way it operates, is controlled by its settings. They determine screen content, layout, high and low alarm limits and so forth.

The “active settings” are the current settings the monitor uses, including any adjustments made by the last user. Active settings are not permanent, but are retained after a loss of mains power.

, replaces the measurement numeric with

There are also two preconfigured default settings:

•User Default

3 Basic Operation Settings

•Factory Default

User Default

The User Default is a complete configuration stored in the monitor’s long-term memory. You can change individual settings and store them in the User Default. In other words, you can store the active settings, modified to your preference, in the User Default (in configuration mode).

In monitoring mode,

1 Select the Defaults SmartKey .

2 Select Confirm in the dialog box to load the User Default.

To reload the user default settings select Confirm

you can load the User Default settings to return to your preferred settings:

Confirm Cancel

Factory Default

The Factory Default is a complete configuration predefined at the factory. You cannot modify it. In configuration mode, you can load the Factory Default as the active settings.

CAUTION This resets all settings to factory defined values, but be aware that some values may differ from those

with which the monitor was originally shipped from the factory (recorder speed and paper scale type, for instance). After loading the Factory Default, please check the settings and, if necessary, change them to the settings you normally use.

You can use the Factory Default as the basis for producing your User Default. See the Service Guide for details.

Global Settings

General monitor configuration settings are stored in the Global Settings. These include settings for line frequency, QRS type and whether the monitor is automatically reset to the User Default after a power interruption of more than one minute. You can change the Global Settings in Configuration Mode.

Changing Measurement Settings

Each measurement has a setup menu in which you can adjust all of its settings. You can enter a setup menu:

• via the measurement numeric - select the measurement numeric on the screen to enter its setup menu. For example, to enter the Setup FHR1 menu, select the FHR1 (fetal heart rate 1) numeric.

•via the Main Setup SmartKey - if you want to setup a measurement when the measurement is switched off, use the Main Setup SmartKey and select Measurements. Then select the measurement name from the popup list. With this SmartKey you can access any setup menu in the monitor.

This guide always describes the entry method using the measurement’s setup menu. You can use the method you prefer.

Settings 3 Basic Operation

Switching the Noninvasive Blood Pressure Measurement On and Off

The noninvasive blood pressure measurement is the only measurement for which you can manually switch on and off. To do this:

1 Enter the noninvasive blood pressure measurement’s setup menu.

2 Select NBP to toggle between on and off. The screen display indicates the active setting.

Changing Monitor Settings

To change monitor settings such as brightness, or touch tone volume:

1 Enter the Main Setup menu by selecting the SmartKey .

2 Select the setting you want to change, or select User Interface to enter a submenu where

you can change user interface settings.

Adjusting the Screen Brightness

1 Enter the Main Setup menu by selecting the SmartKey .

2 Select User Interface.

3 Select Brightness.

4 Select the appropriate setting for the screen brightness. 10 is the brightest, 1 is the least bright.

Optimum is suitable for most situations.

Adjusting Touch Tone Volume

The touch tone volume is the tone you hear when you select any field on the monitor screen. To adjust the touch tone volume,

1 Enter the Main Setup menu by selecting the SmartKey .

2 Select User Interface.

3 Select Touch ToneVolume, then select the appropriate setting for the touch tone volume: 10 is

the loudest and 1 is the quietest. Selecting zero switches the touch tone volume off.

Setting the Date and Time

1 Select the Date, Time screen element from the monitor’s info line to enter the Date, Time

menu.

2 Select, in turn, the Year, Month, Day, Hour (in 24 hour format) and Minute as

necessary.

3 Select Store Date, Time to change the date and time.

If connected to a Philips OB TraceVue system, the monitor uses the OB TraceVue system date and time, including daylight saving time changes.

3 Basic Operation Checking Your Monitor Revision

WARNING Changing the date and time while the monitor is connected to an OB TraceVue system can result in a

mismatch in the time and date between the monitor and the OB TraceVue system.

When disconnected from AC power, the monitor retains the date and time setting for at least two months.

Checking Your Monitor Revision

1 Select Main Setup -> Revision to open the Monitor Revision menu.

2 From the Monitor Revision menu, select the monitor component for which you need

revision information.

Preparing to Monitor a Patient 3 Basic Operation

Preparing to Monitor a Patient

Confirm fetal life before you begin fetal monitoring. Familiarize yourself with the basic operation principles before you start to monitor.

Switching On: FM20/FM30

• Connect the monitor to AC mains and switch the monitor on.

• The green power-on LED comes on.

• The monitor performs a self-test as it starts up. “Selftest OK”, the serial number, and revisions for the software and firmware are printed on the fetal trace paper (if recorder Autostart is configured to On).

• The monitor display comes on.

• There is a start-up tone from the loudspeaker.

Switching On: FM40/FM50

• Connect the monitor to AC mains. The green LED comes on.

• Press the power-on switch.

• The monitor display comes on.

• There is a start-up tone from the loudspeaker.

Adjusting the Display Angle (FM20/FM30)

You can tilt the display on the FM20 and FM30 to one of five different positions, or you can fold it completely down. The tilt/fold mechanism works on a one-way ratchet system. You hear a click as each of the five positions is reached. The screen can be folded back down only after tilting the display forwards as far as it will go.

To tilt the display from the folded position:

1 Unlock the display by releasing the catch.

3 Basic Operation Preparing to Monitor a Patient

Lift the display forwards. You hear a click as the first position engages. If you want to tilt the

display further, lift the display further forwards until you reach the desired angle.

To fold the display:

1 Pull the display forwards as far as it will go.

2 Then push it all the way back until it clicks shut.

If your monitor is wall mounted, the display should be folded flat.

Fastening Belts and Transducers

You can use more than one belt if, for example, you are monitoring uterine activity and FHR simultaneously. There are two basic ways to fasten belts and transducers:

Preparing to Monitor a Patient 3 Basic Operation

• Using belts with button fixings.

• Using velcro belts together with the butterfly belt clip.

Using Belts with Button Fixings

1 Place the transducer belt across the bed, ensuring that the fixing button will face away from the

mother when it is fastened.

2 Lie the patient on the bed and arrange the belt around her until it is tight but still comfortable.

3 Fasten the belt by pushing the fixing button through the overlapping section of the belt. Ensure

that the fixing button and the loose ends of the belt are at the patient’s side.

4 When you have positioned a transducer satisfactorily, you can attach it to the belt by pushing the

belt button on the transducer through one of the holes in the belt.

Alternatively, attach the butterfly belt clip to the transducer belt button and use this to attach the transducer to the belt. The clip allows you to slide the transducer for easy repositioning.

3 Basic Operation Preparing to Monitor a Patient

Using Belt with Velcro Fixings

Insert one end of the belt between the belt guides on one side of the butterfly belt clip, and secure with the velcro fixing. Insert the other end of the belt between the belt guides on the other side of the butterfly belt clip, adjust for the correct tension, then secure with the velcro fixing.

Fasten one end with velcro fixing

Belt guides

Pull the other end through, adjust for tension, and secure with velcro fixing

Belt guides

Preparing to Monitor a Patient 3 Basic Operation

Connecting a Transducer to the Monitor

SpO2 socket Noninvasive blood pressure

socket

You can plug a fetal transducer, a ECG/IUP patient module, an Avalon CTS Cordless Fetal Transducer System interface cable (M2731-60001, red connector), or an external event marker into any of the four fetal sensor sockets marked or “Fetal Sensors” connect the sensor to the socket marked or “SpO pressure, connect the cuff to the socket marked or “NBP”

For the FM40 and FM50, you can connect an Avalon CTS Cordless Fetal Transducer System interface cable (M2732-60001, black connector) to one of the two dedicated black sockets marked ‘Tele’ at the rear of the monitor, as an alternative to using one of the fetal sensor sockets at the front.

Fetal sensor sockets

. For measuring maternal SpO2,

”1, and for maternal non-invasive blood

M2732-60001 interface cable to Avalon CTS Cordless Fetal Transducer System.

1.Depending on geography.

Connect the black connector to one of the two black sockets (marked ‘Tele’) on the rear of the monitor.

3 Basic Operation Preparing to Monitor a Patient

When you connect a transducer or sensor:

• The appropriate measurement is shown on the display. For fetal measurements using an Avalon CTS system, the symbol appears additionally next to the measurement label, indicating that the measurement is being made by a cordless transducer.

Measurement label

FHR1

Cordless measurement symbol

Toco

• Fetal heart rate measurements are labeled in the order in which you plug in the transducers for those measurements. It does not matter which fetal sensor socket you use, as the monitor allocates a channel automatically. For instance, when monitoring triplets, the first transducer you connect is automatically allocated a channel, and the measurement is labelled FHR1, the second FHR2, and the third FHR3. See also “Monitoring Twin FHRs” on page 77 and “Monitoring Triple FHRs” on page 87.

• When you touch a measurement numeric on the screen, the setup menu for that measurement opens. The fetal sensor socket to which the transducer for this measurement is connected is identified by the transducer position indicator in the blue setup menu header: for FM20/30; for FM40/50.

FHR1

Doe, Jane

Setup FHR1

Select Audio

23 Jun

8:37 Bed 11

INOP Only

FHR2

Tr a n s d u c e r position indicator (example shows a screen from FM20/30, with

FHR Sound Volume

Fetal Movement:

NBP

SignalLoss Delay:

Sys.

Silence

Toco

Baseline

Start/

Stop

60 sec

Paper

Advance

Admit/

Dischrge

Pulse

Main

Screen

the transducer measuring FHR1 connected to the left-most slot).

• The blue Finder LED on a wired fetal transducer illuminates when you touch the measurement on the screen, allowing you to identify the corresponding transducer.

Preparing to Monitor a Patient 3 Basic Operation

Finder LED

• The recorder prints an annotation showing the date, time, paper speed, and monitoring mode. It repeats this every 10 minutes.

Checking/Setting Paper Scale

You can check the paper Scale Type (US for USA, or Internat’l for other geographies) in the Fetal Recorder menu. In Monitoring Mode, you can see these settings (grayed out), but you cannot change them. They can be changed in Configuration Mode.

1 Enter the Main Setup menu by selecting the SmartKey .

2 Select Fetal Recorder.

3 Check the current setting for Scale Type. If it is not appropriate, change it in the Fetal Recorder

menu in Configuration Mode:

Select Scale Type to toggle between US and Internat’l.

Paper Guide: FM40/FM50

The recorder in the FM40 and FM50 features a transparent paper guide which:

• facilitates correct alignment of the paper, both during loading and while the recorder is running. See the paper loading instructions on page 38.

• incorporates a tear-off edge, which not only allows you to tear off the trace paper where you like (not necessarily at a fold), but also helps to avoid paper misalignment while doing so. See “Tearing Off the Paper: FM40/FM50” on page 39.

• is removable (see “Removing the Paper Guide: FM40/FM50” on page 33).

Removing the Paper Guide: FM40/FM50

The paper guide is removable, and you can use the recorder without it. When not using the paper guide, ALWAYS tear off the paper along the perforation to avoid possible paper misalignment (see “Tearing Off the Paper: FM40/FM50” on page 39).

To remove the paper guide:

3 Basic Operation Preparing to Monitor a Patient

Press the paper eject button to open the paper drawer.

2 Hinge the transparent paper guide forward.

Protrusion holds paper guide in closed position

3 Release the paper guide from one side of the holder...

4 ....then remove the paper guide.

Preparing to Monitor a Patient 3 Basic Operation

Refitting is a reversal of the removal procedure.

Loading Paper: FM20/FM30

CAUTION Using recorder paper that is not approved by Philips can result in accelerated paper fading and can

damage the thermal line printhead. This type of damage is not covered by warranty.

To load a pack of paper:

1 If the recorder is on, press the recorder Start/Stop SmartKey or the Stop

Recordng SmartKey to turn it off before loading a new pack of paper.

2 Press the paper table release to unlock the paper drawer and then pull the table forward to open it

fully.

3 Lift out any remaining paper from the tray.

4 Prepare to place the new pack of paper in the tray with the bottom side down. The bottom side is

indicated by the word STOP printed on the final page of the new pack.

5 Unfold the top page of the pack and position the uterine activity scale on the right.

3 Basic Operation Preparing to Monitor a Patient

6 Slide the pack into the tray.

7 Push the paper drawer back until it “clicks” closed.

Click!

8 Press the recorder Start/Stop SmartKey or the Start Recordng SmartKey to

switch on the recorder.

9 Annotations of trace information are printed on the trace paper (see “Switching the Recorder On

and Off” on page 40 for details).

Loading Paper: FM40/FM50

CAUTION Using recorder paper that is not approved by Philips can result in accelerated paper fading and can

damage the thermal line printhead. This type of damage is not covered by warranty.

To load a pack of paper:

1 If the recorder is on, press the recorder Start/Stop SmartKey or the Stop

Recordng SmartKey to turn it off before loading a new pack of paper.

2 Press the paper eject button to open the paper drawer.

Preparing to Monitor a Patient 3 Basic Operation

Lift out any remaining paper from the tray. Press and hold the paper eject button to partially eject the paper, thus making it easier to remove.

4 Hinge the transparent paper guide forward. It is held in the closed position by a small protrusion

on each side of the holder.

Protrusion holds paper guide in closed position

5 Prepare to place the new pack of paper in the tray with the bottom side down. The bottom side is

indicated by the word STOP printed on the final page of the new pack.

6 Unfold the top page of the pack and position the uterine activity scale on the right.

7 Slide the pack into the tray.

3 Basic Operation Preparing to Monitor a Patient

Feed the paper evenly through the paper guide. Do not close the paper guide yet.

9 Close the paper drawer.

10 Now close the paper guide.

11 Press the recorder Start/Stop SmartKey or the Start Recording SmartKey to

switch on the recorder.

12 Annotations of trace information are printed on the trace paper (see “Switching the Recorder On

and Off” on page 40 for details).

Preparing to Monitor a Patient 3 Basic Operation

Paper-Out Indication

Each pack of paper has 150 pages. The monitor issues a paper-out warning in the status line at the bottom of the screen, when there are five pages to go. If you switch on the recorder or press the paper advance key when there are fewer than five pages remaining, it may take two pages before the alert is activated. Load a new pack in time.

If the recorder runs out of paper, an audible paper-out alert is sounded, if so configured.

Fetal traces continue to be recorded into the monitor’s backup memory, and can be retrieved and printed completely if new paper is loaded within one hour, when the Bridge Paperout setting is enabled in Configuration Mode. See “Recovering Traces on Paper” on page 129 for further information.

Choosing Paper Speed

You can choose a paper speed of 1, 2, or 3 centimeters per minute (cm/min). The default setting is 3 cm/min.

The ACOG technical bulletin on FHR monitoring states that “accurate pattern recognition is difficult if

not impossible at 1 cm/min and that 1 cm/min is only recommended for more economic screening. When FHR abnormalities arise, the faster paper speeds will enhance FHR pattern recognition”.

Additionally, because a change in paper speed results in a change in the appearance of an FHR trace, you are advised to ensure ALL monitors in your institution are set to the same speed.

To set the paper speed (in Configuration Mode):

1 Enter the Main Setup menu using the SmartKey .

2 Select Fetal Recorder.

3 In the Recorder menu, you can see the current speed setting. Select Recorder Speed.

4 Select the desired speed from the given choices: 1, 2 or 3 cm/min.

Tearing Off the Paper: FM20/FM30

CAUTION NEVER pull on the paper to advance it, as this can cause misalignment of the paper. ALWAYS tear off

the paper along the perforation.

To tear off the trace paper after monitoring:

1 If the recorder is running (the “recorder on” status indicator is displayed), turn off the

recorder by selecting the fetal recorder Start/Stop SmartKey or the Stop Recordng SmartKey.

2 Select the Paper Advance SmartKey . This advances the paper automatically to the

next perforation.

3 When the paper stops advancing, tear off the trace paper along the perforation.

Tearing Off the Paper: FM40/FM50

CAUTION NEVER pull on the paper to advance it, as this can cause misalignment of the paper.

3 Basic Operation Preparing to Monitor a Patient

The recorder’s paper guide incorporates a tear-off edge, allowing you to tear off the trace paper cleanly where you like (not necessarily at a fold). When not using the paper guide, ALWAYS tear off the paper along the perforation.

Using the Paper Guide

To tear off the trace paper after monitoring using the paper guide:

1 If the recorder is running (the “recorder on” status indicator is displayed), turn off the

recorder by selecting the fetal recorder Start/Stop SmartKey or the Stop Recordng SmartKey.

2 Tear off the paper as shown in the pictures. To ensure a clean tear, always tear in an upwards

motion, as indicated by the arrows. You can start tearing from the left or right (right-handed user shown).

If you wish to tear off the paper at a fold, select the Paper Advance SmartKey , wait for the paper to stop, then tear off.

Without the Paper Guide

To tear off the trace paper after monitoring without using the paper guide:

1 Turn off the recorder by selecting the fetal recorder Start/Stop SmartKey or the

Stop Recordng SmartKey.

2 Select the Paper Advance SmartKey . This advances the paper automatically to the

next perforation.

3 When the paper stops advancing, tear off the trace paper along the perforation.

Switching the Recorder On and Off

Note that in addition to the normal recording of real-time traces, you will sometimes see a trace recovery printout from the monitor’s internal backup memory at high speed when the recorder is started. For details, see “Recovering Traces on Paper” on page 129.

For an explanation of the various symbols that can appear on the trace recording, see “Recorder Specifications” on page 158.

To switch the recorder on, select Start/Stop from the Fetal Recorder menu, or press one of the

SmartKeys: fetal recorder Start/Stop or Start Recording . When you

switch on:

Preparing to Monitor a Patient 3 Basic Operation

• The “recorder on” status indicator is displayed in the bottom right-hand corner of the

screen.

• The paper advances quickly for 2 cm and then returns to the set speed.

• Whenever the recorder is switched on, a trace header is printed vertically on the trace paper,

FHR1

Hear t rat e label

containing the following:

– “Selftest OK”: confirmation that the monitor’s

self-test completed successfully, and that it is ready to use.

– the software revision and firmware revision

11:47:33, 23 Mar 2006, 3 cm/min

–the serial number

–the time

–the date

Doe, Jane, 123456

Toco

Uterine activity label

– patient name and medical record number (if

entered)

– the paper speed

Vertically printed trace header

• The current monitoring modes (if any transducers are connected to the monitor) are printed.

• Whenever a transducer’s mode is changed the following are printed:

–the time

–the date

– trace identification symbols

– the paper speed

The monitor prints the time, date, paper speed and monitoring modes in the trace header when first switched on, in a periodic time stamp every ten minutes after, and if the monitoring modes change. The time stamp begins with the symbol.

Time stamp printed every ten minutes

11:59, 22 Mar 2006, 3 cm/min

Toco

Maternal parameters are also annotated on the trace. In the case of noninvasive blood pressure, the annotation is made at the end of the measurement. If the noninvasive blood pressure measurement repetition time is short, the noninvasive blood pressure numeric may not be printed.

3 Basic Operation Preparing to Monitor a Patient

The recording of notes (see “Entering Notes” on page 43) or time/date information may be interrupted by connecting or unplugging a transducer or by a change in measurement-related setting (for example, artifact suppression, Toco sensitivity, or alarm settings).

A new patient admission or a change to the paper scale setting stops all annotations, and prompts a new vertical trace header to be printed.

To switch the recorder off:

• Either select Start/Stop from the Fetal Recorder menu.

• Or press one of the SmartKeys (depending on configuration): fetal recorder Start/Stop

or Stop Recordng .

If your recorder is configured with Confirmed Stop On (a Configuration Mode setting), you will need to confirm that you want to stop the recorder, before it will stop.

When the recorder is off, the “recorder off” status indicator is displayed in the bottom right-hand corner of the screen: when Paper Save Mode is off, and when Paper Save Mode is on.

Advancing the Paper

You can advance the paper automatically to the next fold by pressing the Paper Advance

SmartKey at any time except during a stored data recording.

Marking an Event

You can record significant events on the trace paper (for example, when pain medication is administered or when the mother changes position). The mother can use the remote event marker to mark events herself. You connect the remote event marker to any free fetal sensor socket.

To mark an event on the trace paper you can:

•Either select the Set Marker SmartKey .

• Or press the button on the remote event marker. The remote event marker is connected to the monitor via any fetal transducer socket.

A small arrow is printed on the heart rate scale on the trace paper. This reflects exactly when the marker button was first pressed; keeping the button pressed has no influence on the annotation.

Starting Monitoring 3 Basic Operation

Entering Notes

Your monitor has a set of factory pre-configured notes. It is possible to edit the notes in Configuration Mode (please refer to the Service Guide).

To enter a note:

1 Press the Enter Notes SmartKey to open the Enter Note menu.

2 Scroll if necessary, then select the note you wish to enter. A confirmation dialog box opens:

3 Select Confirm to enter the note. The note is then shown in the status line of the display, and is

annotated on the fetal trace if the fetal recorder is on.

By default, notes are printed lengthwise in the direction of the trace, in the space between the FHR grid and the uterine activity grid. If you prefer, you can configure the recorder to print across the trace. You can change this in Configuration Mode by changing the Notes Recording setting in the Fetal Recorder menu from Along (default) to Across (notes print widthwise across the trace).

Up to two notes can be printed directly, and the monitor can temporarily store up to a further two notes, and these are printed after the first two have been recorded. Any further notes are discarded. For example, if you enter six notes in quick succession, the first two notes you entered are recorded straight away, the next two are stored in memory and then printed when the first two have been recorded, and the last two are discarded.

If the printing of two notes happens to coincide with the regular recording of the time stamp that takes place once every ten minutes, the time stamp is delayed until the notes have finished printing.

Signal Quality

During monitoring, if the fetal heart rate signal quality fluctuates, and becomes poor, it does not necessarily mean that the transducer needs repositioning. The fluctuation may be caused by fetal movement. Allow time for the signal to stabilize before deciding whether to reposition the transducer (ultrasound) or apply a new electrode (ECG). For the best trace quality, the signal quality indicator should be full, indicating good signal quality, even though it may be possible to make traces at a lower signal quality level.

To store and record the note select Confirm.

Confirm Cancel

Select cancel to reject the current note

Starting Monitoring

Confirm fetal life before you begin fetal monitoring.

3 Basic Operation Switching the Monitor to Stand-by

After you switch on the monitor:

1 Check that you have the correct patient cables and transducers plugged in for the measurement

you want to monitor.

2 Admit your patient to the monitor (see “Admitting a Patient” on page 61).

3 Check that the alarm limits, alarm and fetal heart rate volumes, patient category and so forth are

appropriate for your patient. Change them if necessary.

4 Refer to the appropriate measurement section for details of how to perform the measurements you

require.

Switching the Monitor to Stand-by

To switch the monitor to stand-by:

Either

Select the Stand-by SmartKey

1 Enter the Main Setup menu using the SmartKey .

2 Select Stand-by.

Touching any screen element automatically restarts the monitor.

After Monitoring

1 Discharge the patient.

2 Remove the transducer from the patient and, using a soft tissue, remove any gel from it. Then

clean the transducer.

3 Tear off the paper at the fold. To avoid misalignment of the recorder mechanism, NEVER pull on

the paper to advance it, or try to tear it other than at a fold (unless using the paper guide with the FM40/FM50).

4 Switch off the monitor.

Disconnecting from Power

To disconnect the monitor from AC power, switch it off using the On/Off switch located on the right side of the device, or unplug the power cord from the AC mains socket.

The On/Stand-by switch does not disconnect the monitor from the AC power source. To disconnect, unplug the power cord from the AC mains socket. Note that if the power cord is unplugged from the AC mains socket before the monitor is put into Stand-by, a beeper is activated. The beeper warns you if the monitor is accidentally disconnected from AC mains.

Troubleshooting 3 Basic Operation

Troubleshooting

Problem Pos sible Causes Solutions

Light or no trace. Wrong paper. Use recommended paper.

Dirty printhead.

FM20/30 only: Paper misaligned due to drawer not being correctly shut.

End of paper noted when pack not finished.

Bad paper feed or wrong paper. Check paper feed and use recommended

Check Paper INOP is displayed. See the chapter “Patient Alarms and

FetRec EQUIP MALF INOP is displayed.

PAPER END INOP is displayed.

WRONG PAPER SCALE INOP is displayed.

Clean printhead. See “Cleaning the Printhead” on page 139.

Shut the drawer fully, pushing evenly with both hands.

paper.

INOPs”.

3 Basic Operation Troubleshooting

4Alarms

The alarm information here applies to all measurements. Measurement-specific alarm information is contained in the sections on individual measurements.

The monitor has three alarm levels: red, yellow, and INOP.

Red and yellow alarms are patient alarms. A red alarm indicates a high priority patient alarm such as a potentially life threatening situation (for example, SpO alarm indicates a lower priority patient alarm (for example, a fetal heart rate alarm limit violation).

INOPs are technical alarms. They indicate that the monitor cannot measure and therefore not detect critical patient conditions reliably. If an INOP interrupts monitoring and alarm detection (for example, LEADS OFF), the monitor places a question mark in place of the measurement numeric and sounds an audible tone. INOPs without this tone indicate that there may be a problem with the reliability of the data, but that monitoring is not interrupted.

below the desaturation alarm limit). A yellow

Alarms are indicated after the specified alarm delay time. This is made up of the system delay time plus the trigger delay time for the individual measurement. See the specifications section for details.

If more than one alarm is active, the alarm messages are shown in the alarm status area in succession. An arrow symbol next to the alarm message informs you that more than one message is active.

The monitor sounds an audible indicator for the highest priority alarm. If more than one alarm condition is active in the same measurement, the monitor announces the most severe.

Alarm Mode

You can configure the alarm mode for your monitor. There are two possible modes:

• All: patient alarms and INOPs are enabled, with all audible and visual indicators active.

• INOP only: only INOPs are enabled, with audible and visual indication active. This is the default alarm mode.

WARNING In INOP only mode, no patient alarms are enabled or indicated.

The alarm status area for yellow and red alarms shows the “INOP only” indication in conjunction with the “Alarms Off” symbol. No alarm limits or alarm off icons are displayed. No patient alarm settings are available in the setup menus.

↑ ** FHR1 HIGH

INOP only

4Alarms Visual Alarm Indicators

Visual Alarm Indicators

Alarm message: An alarm message appears in the alarm status area on the second line at the top of the screen indicating the source of the alarm. If more than one measurement is in an alarm condition, the message changes every two seconds, and has an arrow ( ) at the side. The background color of the alarm message matches the alarm priority: red for red alarms, yellow for yellow alarms, and light blue for INOPs. The asterisk symbols (*) beside the alarm message match the alarm priority: *** for red alarms, ** for yellow alarms. INOPs are displayed without asterisks.

Depending on how your monitor is configured, it may display alarm limit violation messages:

• in text form, for example “**FHR1 LOW” or

• in numeric form, for example “**FHR1 94 < 110”, where the second number shows the currently set alarm limit, and the first number shows the value at which that alarm limit was violated by the widest margin.

Flashing numeric: The numeric of the measurement in alarm flashes.

Bright alarm limits: If the alarm was triggered by an alarm limit violation, the corresponding alarm

limit on the monitor screen is shown more brightly.

Audible Alarm Indicators

The audible alarm indicators configured for your monitor depend on which alarm standard applies in your hospital. Audible alarm indicator patterns are repeated until you acknowledge the alarm by switching it off or pausing it, or until the alarm condition ceases (if audible alarm indication is set to non-latching).

WARNING Do not rely exclusively on the audible alarm system for patient monitoring. Adjustment of alarm

volume to a low level or off during patient monitoring may result in patient danger. Remember that the most reliable method of patient monitoring combines close personal surveillance with correct operation of monitoring equipment.

Alarm Tone Configuration

The audible alarm indicators of your monitor are configurable. In the monitor’s Configuration Mode, you can change the alarm sound to suit the different alarm standards valid in different countries.

Standard Philips Alarms

• Red alarms: A high pitched sound is repeated once a second.

• Yellow alarms: A lower pitched sound is repeated every two seconds.

• INOPs: an INOP tone is repeated every two seconds.

ISO/IEC Standard 9703-2 Audible Alarms

• Red alarms: A high pitched tone is repeated five times, followed by a pause.

• Yellow alarms: A lower pitched tone is repeated three times, followed by a pause.

Acknowledging Alarms 4Alarms

• INOPs: a lower pitched tone is repeated twice, followed by a pause.

Changing the Alarm Tone Volume

The alarm volume symbol at the top right of the monitor screen gives you an indication of the current volume. To change the volume:

1 Select the volume symbol . The volume scale pops up.

2 Select the required volume from the volume scale.

Alarm Volume

Off

When the alarm volume is set to zero (off), the alarm volume symbol shows this. If you switch the alarm volume off, you will not get any audible indication of alarm conditions.

Acknowledging Alarms

To acknowledge all active alarms and INOPs, select the Silence key. This switches off the audible alarm indicators.

A check mark beside the alarm message indicates that the alarm has been acknowledged.

If the condition that triggered the alarm is still present after the alarm has been acknowledged, the alarm message stays on the screen with a check mark symbol beside it.

If the alarm condition is no longer present, all alarm indicators stop and the alarm is reset.

Switching off the alarms for the measurement in alarm, or switching off the measurement itself, also stops alarm indication.

Acknowledging Disconnect INOPs

Silence

FHR_1_HIGH

Acknowledging an INOP that results from a disconnected transducer switches off the associated measurement.

4Alarms Pausing or Switching Off Alarms

Pausing or Switching Off Alarms

If you want to temporarily prevent alarms from sounding, for example while you are moving a patient, you can pause alarms. Depending on your monitor configuration, alarms are paused for one, two, or three minutes, or infinitely.

To view the alarm pause setting chosen for your unit:

1 Select Main Setup -> Alarm Settings.

2 Check the Alarms Off setting.

This setting can be changed in Configuration Mode.

To Pause All Alarms

If you have configured alarms to be paused for one, two or three minutes, the SmartKey is labelled Pause Alarms.

Select the Pause Alarms SmartKey to pause all alarms.

1 Select Main Setup.

2 Select Alarms.

3 Select Pause Alarms.

To Switch All Alarms Off

You can switch alarms off permanently if your monitor is configured to allow infinite alarms pause and the SmartKey is labelled Alarms Off.

Select the Alarms Off SmartKey.

1 Select Main Setup.

2 Select Alarms.

3 Select Alarms Off.

To Switch Individual Measurement Alarms On or Off

This applies to alarm mode All.

Pause

Alarms

Off

1 Select the measurement numeric to enter its setup menu.

2 Select Alarms to toggle between On and Off.

The alarms off symbol is shown beside the measurement numeric.

Alarm Limits 4Alarms

While Alarms are Paused or Off

• In the alarm field, the monitor displays the message Alarms Paused or Alarms Off, together with the alarms paused symbol and the remaining pause time in minutes and seconds, or alarms off symbol.

• No alarms are sounded and no alarm messages are shown.

• INOP messages are shown but no INOP tones are sounded.

The only exception is the INOP NBP Cuff Overpress. This INOP is issued even if alarms are paused or off.

If a disconnect INOP is present and alarms are paused or switched off, the measurement in question is switched off.

Restarting Paused Alarms

To manually switch on alarm indication again after a pause, select the SmartKey Pause Alarms (or Alarms Off) again.

Alarm indication starts again automatically after the pause period expires. If the monitor is configured to stay paused infinitely, you must select Alarms Off again to restart alarm indication.

ALARMS PAUSED 1:28

ALARMS OFF

Alarm Limits

The alarm limits you set determine the conditions that trigger yellow and red limit alarms.

For the SpO limit to 100 switches the high alarm off, and setting the low alarm limit to 0 switches it off. In this case, the alarms off symbol is not displayed.

WARNING Be aware that the monitors in your care area may each have different alarm settings, to suit different

patients. Always check that the alarm settings are appropriate for your patient before you start monitoring.

Viewing Individual Alarm Limits (Alarm Mode “All” Only)

Alarm limits

measurement (if available), where the value ranges from 100 to 0, setting the high alarm

FHR2

150

110

You can usually see the alarm limits set for each measurement next to the measurement numeric on the main screen.

If your monitor is not configured to show the alarm limits next to the numeric, you can see them in the appropriate measurement setup menu. Select the measurement numeric to enter the menu and check the limits.

4Alarms Reviewing Alarms

Changing Alarm Limits

To change individual measurement alarm limits using the measurement’s Setup Menu:

1 In the measurement’s Setup Menu, select the alarm limit you want to change. This calls up a list of

available values for the alarm limit.

2 Select a value from the list to adjust the alarm limit.

Reviewing Alarms

To review the currently active alarms and INOPs, select any of the alarm status areas on the monitor screen. The Alarm Messages window pops up. All alarms and INOPs are erased from the monitor’s alarm history when you discharge a patient, or if you enter Demonstration Mode.

Alarm Messages Window

The Alarm Messages window shows all the currently active alarms and INOPs in chronological order, beginning at the top with the most recent. INOPs are shown on the left hand side and patient alarms are shown on the right hand side. Any active red alarms are shown first, followed by yellow alarms. Acknowledged alarms or INOPs are shown with the check mark symbol.

The Alarm Messages window pop-up keys appear when the window is opened. Selecting the Review Alarms pop-up key opens the Review Alarms window.

Review Alarms Window

The Review Alarms window contains a list of up to 100 of the most recent alarms and INOPs with date and time information. If configured to do so, each alarm is shown with the alarm limit active when the alarm was triggered and the maximum value measured beyond this limit. The Review Alarms window also shows any changes made to the Alarms On/Off or Silence status.

The information in the Review Alarms window is deleted when a patient is discharged or if you leave Demonstration Mode.

The Review Alarms window pop-up keys appear when the window is opened. Selecting the Active Alarms pop-up key opens the Alarm Messages window.

Latching Alarms

The alarm latching setting for your monitor defines how the alarm indicators behave when you do not acknowledge them. When alarms are set to non-latching, their indicators end when the alarm condition ends. Switching alarm latching on means that visual and/or audible alarm indications are still displayed or announced by the monitor after the alarm condition ends, allowing you to identify what caused the alarm condition. The indication lasts until you acknowledge the alarm.

Review Alarms

5 Apr 16:55:18 Alarms On

5 Apr 16:45:15 ** SpO2 NON-PULSAT.

5 Apr 16:44:57 Alarms Silenced

5 Apr 16:44:46 ** FHR1 HIGH (153>150)

5 Apr 16:44:39 ** SpO2 LOW (95<99)

Latching Alarms 4Alarms

Viewing the Alarm Latching Settings

To see the alarm latching setting for your monitor:

1 In the monitor’s Main Setup menu, select Alarms.

2 Select Alarm Settings, and see the Visual Latching and Audible Latching

settings.

This setting can be changed in Configuration Mode. You should be aware of the settings chosen for your unit. There are three possible choices each for visual and audible latching: Red, Red and Yellow, and Off. The audible latching configuration can never be configured to a higher level than that configured for the visual latching. In other words, the audible latching setting is always the same level, or lower, than the visual latching setting. For example, if visual latching is configured to Red only, then audible latching can only be set to Red or Off. The following table shows the possible combinations for latching settings:

Possible Combinations for Alarm Latching Settings

Visual Latching Setting Audible Latching Setting

Red and Yellow Red and Yellow

Red and Yellow Red

Red and Yellow Off

Red Red

Red Off

Off Off

Alarm Latching Behavior

Alarm Condition Red and Yellow Measurement Alarms

Alarm has not been acknowledged.

Alarm has been acknowledged.

All INOPs except the UNPLUGGED INOPs are non-latching.

Alarm condition still present.

Alarm condition no longer present.

Alarm condition still present.

Alarm condition no longer present.

Non-latching

alarms

Alarm tone on. Alarm message. Flashing numerics.

All audible and visual alarm indicators automatically stop.

Audible alarm acknowledged. Alarm message. Flashing numerics. Audible alarm reminder (if configured).

Audible and visual alarm indicators automatically stop.

Visual and audible

latching

Alarm tone on.

Alarm message.

Flashing numerics.

Visual latching,

audible non-latching

Alarm message. Flashing numerics.

Audible alarm indicators automatically stop.

4Alarms Testing Alarms

Testing Alarms

In general, to test the functioning of visible and audible alarms, do the following:

1 Enable the alarm.

2 Set the alarm limits.

3 Measure or simulate the parameter that is out of range, or signal loss.

4 Verify that the visible and audible alarms are working.

As an example, to test the FHR alarms:

1 Connect the US transducer to a fetal sensor socket.

2 Enable the FHR alerting (see “Turning Alarms On or Off ” on page 85).

3 Set the high alert limit and delay to 150 bpm and 60 seconds respectively, and the low alert limit

and delay to 110 bpm and 60 seconds respectively (see “Changing Alarm Limits” on page 85).

4 Generate a fetal heart rate of approximately 180 bpm (3 beats per second) for more that one

minute.

5 Verify the functioning of the visible and audible alarm.

Alarm Behavior at On/Off

When you switch alarms on, the settings defined in User Defaults are used.

If the monitor is switched off for longer than one minute and then switched on again, or after a loss of power lasting longer than one minute, or when a patient is discharged, the monitor can be configured to restore either the alarm settings from the monitor's User Defaults, or the most recently used alarm settings. After any of these situations, you should check that the alarm settings are appropriate for your patient.

If power is lost for less than one minute, the alarm settings prior to the power loss are restored.

5Patient Alarms and INOPs

This chapter lists patient alarms and technical alarms (INOPs) alphabetically, irrespective of their priority. INOPs start on page 57.

Patient Alarm Messages

Fetal alarms are identified by either “FHR” or “DFHR”. All other alarms without these identifiers refer to maternal parameters.

Alarm Message From Condition Indication

***BRADY (Pulse)

***BRADY xxx < yyy

***DESAT

***DESAT xxx < yyy

**DFHR HIGH

**DFHR xxx > yyy

**DFHR LOW

**DFHR xxx < yyy

***EXTREME BRADY

***BRADY xxx < yyy

***EXTREME TACHY

***TACHY xxx > yyy

SpO

FHR (DECG)

FHR

(DECG)

MECG The maternal heart rate obtained from

The heart rate from the Pulse signal has fallen below the bradycardia limit. xxx denotes the lowest measured value; yyy is the bradycardia limit.

The SpO2 value has fallen below the desaturation alarm limit. xxx denotes the lowest measured value, and yyy is the desaturation limit.

The fetal heart rate obtained from DECG has risen above the high alarm limit. xxx denotes the highest measured value, and yyy is the high alarm limit.

The fetal heart rate obtained from DECG has fallen below the low alarm limit. xxx denotes the lowest measured value, and yyy is the low alarm limit.

the maternal ECG has fallen below the extreme bradycardia limit. xxx denotes the lowest measured value, and yyy is the extreme bradycardia limit.

the maternal ECG has risen above the extreme tachycardia limit. xxx denotes the highest measured value, and yyy is the extreme tachycardia limit.

numeric flashes and alarm limit is highlighted, red alarm lamp, alarm tone.

numeric flashes, red alarm lamp, alarm tone.

numeric flashes and high limit is highlighted, yellow alarm lamp, alarm tone.

numeric flashes and low limit is highlighted, yellow alarm lamp, alarm tone.

numeric flashes, red alarm lamp, alarm tone.

5 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

**FHR1 HIGH or **FHR1 xxx > yyy

FHR

(ultrasound)

**FHR2 HIGH or **FHR2 xxx > yyy

**FHR3 HIGH or **FHR3 xxx > yyy

**FHR1 LOW or **FHR1 xxx < yyy

FHR

(ultrasound)

**FHR2 LOW or **FHR2 xxx < yyy

**FHR3 LOW or **FHR3 xxx < yyy

**HR HIGH

MECG The maternal heart rate obtained from

**HR xxx > yyy

**HR LOW

MECG The maternal heart rate obtained from

**HR xxx < yyy

**NBP HIGH Noninvasive

blood pressure

**NBP LOW Noninvasive

blood pressure

**Pulse HIGH SpO

**Pulse LOW SpO

**SpO2 HIGH SpO

**SpO2 LOW SpO

***TACHY (Pulse)

SpO

***TACHY xxx > yyy

The fetal heart rate obtained from ultrasound has risen above the high alarm limit. xxx denotes the highest measured value, and yyy is the high alarm limit.

The fetal heart rate obtained from ultrasound has fallen below the low alarm limit. xxx denotes the lowest measured value, and yyy is the low alarm limit.

the maternal ECG has risen above the high alarm limit. xxx denotes the highest measured value, and yyy is the high alarm limit.

the maternal ECG has fallen below the low alarm limit. xxx denotes the lowest measured value, and yyy is the low alarm limit.

The measured noninvasive blood pressure value is above the high alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

The measured noninvasive blood pressure value is below the low alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

The pulse rate has exceeded the high alarm limit.

The pulse rate has dropped below the low alarm limit.

The arterial oxygen saturation has exceeded the high alarm limit.

The arterial oxygen saturation has fallen below the low alarm limit.

The heart rate from the Pulse signal has exceeded the tachycardia limit. xxx denotes the highest measured value, and yyy is the tachycardia limit.

Numeric flashes and high limit is highlighted, yellow alarm lamp, alarm tone.

Numeric flashes and low limit is highlighted, yellow alarm lamp, alarm tone.