Philips Intellivue MP5 User manual

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INSTRUCTIONS FOR USE

IntelliVue Patient Monitor

MP5

Release G.0 with Software Revision G.0x.xx

Patient Monitoring

Part Number M8105-9001C Printed in Germany 09/08 4512 610 29031

*M8105-9001C*

M8105-9001C

1Table Of Contents

1 Installation 1

Installation Checklist 1 Unpacking and Checking the Shipment 2 Mounting the Monitor 3 Connecting the Monitor to AC Mains 3 Checking Out The Monitor 3 Loading Paper 4 Operating the Monitor 5 Setting the Date and Time 6 Checking Country-Specific Default Settings 6 Handing Over the Monitor 6

2 Basic Operation 9

Introducing the Monitor 9 Operating and Navigating 13 Operating Modes 19 Understanding Screens 20 Using the XDS Remote Display (not MP5T) 21 Using the Visitor Screen 21 Understanding Profiles 22 Understanding Settings 24 Adjusting a Measurement Wave 25 Freezing Waves 26 Using Labels 27 Entering Measurements Manually 29 Changing Monitor Settings 29 Checking Your Monitor Revision 30 Getting Started 30 Disconnecting from Power 32 Networked Monitoring 32 Using the MP5 with a Host Monitor 33

3 What’s New? 35

What’s New in Release G.0? 35 What’s New in Release F.0? 36

4 Alarms 39

Visual Alarm Indicators 40 Audible Alarm Indicators 41 Acknowledging Alarms 43 Pausing or Switching Off Alarms 44 Alarm Limits 45 Reviewing Alarms 50

Latching Alarms 52 Testing Alarms 52 Alarm Behavior at On/Off 53 Alarm Recordings 53

5 Patient Alarms and INOPs 55

Patient Alarm Messages 55 Technical Alarm Messages (INOPs) 61

6 Managing Patients 85

Admitting a Patient 85 Quick Admitting a Patient 87 Editing Patient Information 87 Discharging a Patient 88 Transferring Patients 89 Care Groups 92

7 ECG, Arrhythmia, ST and QT Monitoring 99

Skin Preparation for Electrode Placement 99 Connecting ECG Cables 99 Selecting the Primary and Secondary ECG Leads 100 Checking Paced Status 100 Understanding the ECG Display 100 Monitoring Paced Patients 101 Changing the Size of the ECG Wave 103 Changing the Volume of the QRS Tone 103 Changing the ECG Filter Settings 104 Selecting Positions of Va and Vb Chest Leads (for 6-lead placement) 104 Choosing EASI or Standard Lead Placement 105 About ECG Leads 105 ECG Lead Fallback 106 ECG Lead Placements 106 Capture 12-Lead 110 EASI ECG Lead Placement 111 ECG and Arrhythmia Alarm Overview 112 Using ECG Alarms 113 ECG Safety Information 114 About Arrhythmia Monitoring 115 Switching Arrhythmia Analysis On and Off 116 Choosing an ECG Lead for Arrhythmia Monitoring 116 Understanding the Arrhythmia Display 117 Arrhythmia Relearning 120 Arrhythmia Alarms 121 About ST Monitoring 127 Switching ST On and Off 127 Understanding the ST Display 128

Updating ST Baseline Snippets 129 Recording ST Segments 130 About the ST Measurement Points 130 ST Alarms 132 Viewing ST Maps 133 About QT/QTc Interval Monitoring 137 QT Alarms 140 Switching QT Monitoring On and Off 141

8 Monitoring Pulse Rate 143

Entering the Setup Pulse Menu 143 System Pulse Source 143 Switching Pulse On and Off 144 Using Pulse Alarms 144

9 Monitoring Respiration Rate (Resp) 147

Lead Placement for Monitoring Resp 147 Understanding the Resp Display 148 Changing Resp Detection Modes 148 Changing the Size of the Respiration Wave 149 Changing the Speed of the Respiration Wave 150 Using Resp Alarms 150 Changing the Apnea Alarm Delay 150 Resp Safety Information 150

10 Monitoring SpO

SpO2 Sensors 153 Applying the Sensor 153 Connecting SpO2 Cables 154 Measuring SpO SpO2 Signal Quality Indicator (Fast SpO2 only) 155 Assessing a Suspicious SpO2 Reading 155 Changing the Averaging Time 156 Setting the Measurement Mode 156 Understanding SpO2 Alarms 156 Pleth Wave 157 Perfusion Numeric 158 Perfusion Change Indicator 158 Setting SpO2/Pleth as Pulse Source 158 Setting Up Tone Modulation 158 Setting the QRS Volume 159

154

11 Monitoring NBP 161

Introducing the Oscillometric NBP Measurement 161 Preparing to Measure NBP 162 Starting and Stopping Measurements 164

153

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Enabling Automatic Mode and Setting Repetition Time 165 Enabling Sequence Mode and Setting Up The Sequence 165 Choosing the NBP Alarm Source 166 Switching Pulse from NBP On/Off 166 Assisting Venous Puncture 167 Calibrating NBP 167

12 Measuring Predictive Temperature 169

Making a Temperature Measurement 169

13 Monitoring Temperature 173

Making a Temp Measurement 173 Calculating Temp Difference 174

14 Monitoring Invasive Pressure 175

Setting up the Pressure Measurement 175 Zeroing the Pressure Transducer 176 Adjusting the Calibration Factor 178 Displaying a Mean Pressure Value Only 178 Changing the Pressure Wave Scale 178 Optimizing the Waveform 179 Using the Wave Cursor 179 Non-Physiological Artifact Suppression 179 Choosing the Pressure Alarm Source 179 Calibrating Reusable Transducer CPJ840J6 181 Calculating Cerebral Perfusion 182 Calculating Pulse Pressure Variation 182

15 Monitoring Carbon Dioxide 185

Using the CO2 Measurement 186 Measuring Microstream CO Setting up all CO2 Measurements 190

189

16 Assigning Two Devices to One Patient 195

How Can You Combine Devices? 195 Functions Available When the Telemetry Data Window is Displayed 199 Functions Available For Devices Connected Via SRR 200 General Telemetry-related Functions 201 Use Models With Telemetry 202

17 Enhancing Telemetry Monitoring with the Monitor 205

18 Tre nd s 207

Viewing Trends 207 Setting Up Trends 210 Documenting Trends 213

Trends Databases 214 Screen Trends 215

19 High Resolution Trend Waves 219

OxyCRG 219 Printing Hi-Res Trend Wave Reports 219 Hi-Res Trend Wave Recordings 220

20 Event Surveillance 221

Event Episodes 221 Events Pop-Up Keys 222 Event Triggers 222 The Events Database 224 Viewing Events 224 Annotating Events 226 Documenting Events 226

21 ProtocolWatch 231

Severe Sepsis Screening 231

22 Recording 237

Starting and Stopping Recordings 237 Overview of Recording Types 238 All ECG Waves Recordings 239 Creating and Changing Recordings Templates 239 Changing ECG Wave Gain 240 Recording Priorities 241 Sample Recording Strip 241 Reloading Paper 243 Recorder Status Messages 243

23 Printing Patient Reports 245

Starting Report Printouts 245 Stopping Reports Printouts 246 Setting Up Reports 246 Setting Up Individual Print Jobs 248 Checking Printer Settings 249 Printing a Test Report 249 Switching Printers On Or Off for Reports 249 Dashed Lines on Reports 249 Unavailable Printer: Re-routing Reports 249 Checking Report Status and Printing Manually 250 Printer Status Messages 251 Sample Report Printouts 252

24 Using the Drug Calculator 257

Accessing the Drug Calculator 257 Performing Drug Calculations 258 Charting Infusion Progress 260 Using the Titration Table 260 Documenting Drug Calculations 260

25 Using the Timer 261

Viewing the Timer 261 Timer Setup Pop-up Keys 261 Setting Up Timers 262 Displaying a Timer On The Main Screen 263 Displaying A Clock On The Main Screen 264

26 Laboratory Data 265

Viewing Received Data 265

27 Care and Cleaning 267

General Points 267 Cleaning the Monitor 268 Disinfecting the Monitor 268 Sterilizing the Monitor 268 Cleaning, Sterilizing and Disinfecting Monitoring Accessories 269 Cleaning and Disinfecting the Predictive Temperature Accessories 269 Cleaning Batteries and the Battery Compartment 269

28 Using Batteries 271

Battery Power Indicators 271 Checking Battery Charge 274 Replacing a Battery 274 Optimizing Battery Performance 274 Battery Safety Information 275

29 Maintenance and Troubleshooting 277

Inspecting the Equipment and Accessories 277 Inspecting the Cables and Cords 277 Maintenance Task and Test Schedule 278 Troubleshooting 279 Disposing of the Monitor 279 Disposing of Empty Calibration Gas Cylinders 279

30 Accessories 281

ECG/Resp Accessories 281 NBP Accessories 285 Invasive Pressure Accessories 286 SpO2 Accessories 287

Temperature Accessories 291 Predictive Temperature Accessories 291 Mainstream CO2 Accessories 292 Sidestream CO2 Accessories 292 Microstream CO2 Accessories 292 Recorder Accessories 293 Cable for Direct Connection of a Telemetry Device 294 Battery Accessories 294

31 Installation and Specifications 295

Intended Use 295 Manufacturer’s Information 296 Symbols 296 Installation Safety Information 298 Altitude Setting 300 Monitor Safety Specifications 300 EMC And Radio Regulatory Compliance 301 Out-Of-Hospital Transport - Standards Compliance 302 Monitor Performance Specifications 304 M4605A Battery Specifications 308 Measurement Specifications 309 Safety and Performance Tests 321

32 Default Settings Appendix 327

Country-Specific Default Settings 327 Alarm and Measurement Default Settings 333 Alarm Default Settings 333 ECG, Arrhythmia, ST and QT Default Settings 334 Pulse Default Settings 337 Respiration Default Settings 337 SpO2 Default Settings 338 NBP Default Settings 339 Temperature Default Settings 339 Predictive Temperature Default Settings 340 Invasive Pressure Default Settings 340 CO2 Default Settings 342

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1Installation

Installation should be carried out by qualified service personnel, either by the hospital’s biomedical department, or by Philips Support.

If you have purchased a “customer-installable bundle”, it is assumed that your own hospital personnel will install and, if necessary, configure the monitor. You can contact Philips Support for assistance if required; any assistance will be associated with additional costs.

For mechanical and electrical installation, you need technically qualified personnel with a knowledge of english. Additionally, for monitor configuration, you need clinically qualified personnel with a knowledge of the use environment. For further information on Installation, refer to the Service Guide.

WARNING • Monitor configuration settings must be specified by authorized hospital personnel.

• For installation of the monitor as part of a system, always refer to the Service Guide.

• As the first step in preparing the monitor for use, follow the installation instructions given in this chapter.

Installation Checklist

Use this checklist to document your installation.

Step Ta s k Check Box

1 Perform initial inspection of delivery, unpack and check the shipment (see

“Unpacking and Checking the Shipment” on page 2)

2 Mount the monitor as appropriate for your installation (see “Mounting the

Monitor” on page 3)

3 Connect the monitor to AC mains using the supplied power cord (see

“Connecting the Monitor to AC Mains” on page 3)

4 Perform Visual, Power On and Functional test blocks (see “Checking Out

The Monitor” on page 3)

5 Perform Safety Tests, if required by local laws and regulations (see “Checking

Out The Monitor” on page 3)

6 Load paper into the recorder, if present (see “Loading Paper” on page 4) ❏

when Task

Done

❏

1 Installation Unpacking and Checking the Shipment

Step Ta s k Check Box

when Task

Done

7 Check/set the time and date (see “Setting the Date and Time” on page 6) ❏ 8 Check that the country-specific default settings are appropriate (see

“Checking Country-Specific Default Settings” on page 6)

9 Perform System Test as necessary (see the Service Guide) ❏

❏

Unpacking and Checking the Shipment

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

Initial Inspection

Before unpacking, check the packaging and ensure that there are no signs of mishandling or damage. Open the package carefully and remove the monitor and accessories.

Check that the contents are complete and that the correct options and accessories have been delivered.

System Components, Accessories and Supplies Comments

Monitor with options as ordered 1 ECG accessories optional NBP accessories 1 SpO2 accessories optional Pressure accessories optional Temperature accessories optional Predictive Temperature accessories optional CO2 Accessories optional Recorder paper optional Powercord 1 Telemetry Interface cable optional Measurement Link (MSL) cable optional Instructions for Use 1 Quick Guide 1 Documentation CD-ROM (includes Service Guide and Instructions

for Use)

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.

Mounting the Monitor 1 Installation

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, hung on the bed rail, or mounted on a wall. See the Service Guide for details.

Connecting the Monitor to AC Mains

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 to 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.

• Do not use AC mains extension cords or multiple portable socket-outlets. If a multiple portable socket-outlet without an approved isolation transformer is used, the interruption of its protective earthing may result in enclosure leakage currents equal to the sum of the individual earth leakage currents, so exceeding allowable limits.

• Do not connect any devices that are not supported as part of a system.

• Any non-medical device placed and operated in the patient’s vicinity must be powered via an approved isolation transformer that ensures mechanical fixing of the power cords and covering of any unused power outlets.

Checking Out The Monitor

The following table defines which tests and inspections need to be performed, and when they are required.

Te s t Test or Inspection to be Performed

Visual Inspect the monitor, measurement accessories and cables for any damage.

Are they free of damage?

Power On Power on the monitor. Does it start up successfully without errors? Do all alarm

lamps light up during power up? After start up the monitor sounds a tone, and you can see the monitoring main screen (normally with measurement wave channels and numeric positions).

Functionality Test After power up, touch the blue Main Screen key at the bottom right of the

screen to test the Touchscreen. The key should turn light blue then after several seconds return to its standard blue color.

1 Installation Loading Paper

Te s t Test or Inspection to be Performed

Safety Tests (1) to (4) Perform safety tests (1) to (4), as described in the Service Guide, for standalone

devices if required by local laws and regulations, and each time you combine equipment to form a system, or exchange system components.

safety tests and procedures are described in the Service Guide. These safety tests are derived from international standards but may not always be sufficient to meet local requirements.

System Perform the system test according to IEC 60601-1-1, if applicable, after

combining equipment to form a system (see the Service Guide).

For test and inspection information regarding repairs, upgrades and all other service events, refer to the Service Guide.

Details of the

Loading Paper

1 Use the latch on the right side of the recorder door to pull the door open.

2 Remove the empty core.

3 Insert a new roll and secure it in place on the paper holder. The paper

feeds from the bottom of the roll and over the top of the recorder door. Recommended paper: M4816A and M4817A.

4 With at least one inch of paper extending beyond the edge of the door,

swing the recorder door up and push it firmly closed.

5 To test if paper is loaded correctly, start a recording. If no printing appears, paper may be loaded

backwards. Try reloading the paper.

Operating the Monitor 1 Installation

Operating the Monitor

To complete installation you will need to operate the monitor. Here is a short introduction for those not experienced with IntelliVue monitors.

1 Switch on the monitor. After start-up the

monitor display will become active. You operate the monitor using the touch screen.

3 Touch again to select an item on the menu and

work through the menu activities.

2 Touch something on the screen to enter a

menu. Touching the time, as shown here, brings you to the date and time menu needed for the next section.

4 You can touch numerics, waves and any

item on the screen, to get you to the corresponding menu.

5 If you cannot find a menu by touching the

screen you can always use the Main Setup key which will get you to all menus on the monitor

1 Installation Setting the Date and Time

Setting the Date and Time

To set 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, only) and Minute as

necessary. Select the correct values from the pop-up list.

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

If your monitor is connected to an Information Center, the date and time are automatically taken from this.

Once it is set, the internal clock retains the setting even when you switch off the monitor.

Checking Country-Specific Default Settings

Some settings are made in the factory to match the typical requirements in a specific country. Line frequency, units for weight and height, and ECG cable colors (AAMI or IEC) have been set to appropriate values. If you suspect that these settings may not match your institution’s requirements, check the settings and change them if necessary as described in the Configuration Guide.

WARNING Before starting monitoring, check that the current configuration meets your requirements, especially

patient category, alarm limits and paced setting.

If you need to enter configuration mode:

1 In the Main Setup menu, select Operating Modes. 2 Select Config and enter the passcode.

The passcode for configuration mode is given in the monitor’s service documentation.

The monitor displays Config at the right hand side of the status line and in the center of the Screen while you are in configuration mode.

Before you leave configuration mode, always be sure to store any changes you made. You must store changes made to each Settings Block and to each Profile, individually. As it may be difficult to remember whether the settings you changed belong to a Monitor Settings block or a Measurement Settings block, we recommend that you store each block before you leave configuration mode.

To leave configuration mode:

♦ In the Main Setup menu, select Operating Modes and then select Monitoring.

Handing Over the Monitor

If you are handing over the monitor to the end-users directly after configuration, make sure that it is in Monitoring mode.

Ensure that the users have access to the following documentation delivered with the monitor:

• Instructions for Use (this book) - for more detailed questions during use

• Quick Guide - for quick reminders during use

Handing Over the Monitor 1 Installation

Additionally, we recommend working through the Training Guide for self-training on the monitor before use (not available in all languages). The part number is M8105-944XB, where X is a digit dependent on the language. The English training guide is M8105-9441B. An English training video, M8000-9451E, is also available.

1 Installation Handing Over the Monitor

2Basic Operation

These Instructions for Use are for clinical professionals using the IntelliVue MP5 and MP5T (M8105A and M8105AT) patient monitors.

This basic operation section 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 and off, setting up and adjusting wave speeds, working with profiles). 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.

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 care and cleaning that is not repeated here.

This guide describes all features and options. Your monitor may not have all of them; they are not all available in all geographies. Your monitor is highly configurable. What you see on the screen, how the menus appear and so forth, depends on the way it has been tailored for your hospital and may not be exactly as shown here. In particular for the MP5T, refer to the table on the following page to see which sections of this guide are applicable to your monitor.

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 patient monitor. Display refers to the physical display unit. Display Screen and Screen refer to everything you see on monitor’s display, such as measurements, alarms, patient data and so forth.

Introducing the Monitor

The MP5 monitor provides a comprehensive set of basic physiological measurements: NBP, SpO2, and optionally ECG, invasive blood pressure, predictive temperature, standard temperature and CO Through networking it provides information integration, documentation and information access. The MP5 can be used with adult, pediatric and neonatal patients in a hospital and transport environment.

2 Basic Operation Introducing the Monitor

The monitor stores data in trend and event databases. You can see tabular trends (vital signs) and document them on a central printer. You can view measurement trend graphs, with up to three measurements combined in each graph, to help you identify changes in the patient’s physiological condition. You can view fast-changing measurement trends with beat to beat resolution and see up to four high resolution trend segments.

The MP5 monitor can also be connected to another IntelliVue patient monitor (MP20 to MP90), where it acts as a multi-measurement module (MMS), acquiring measurements for the host monitor. When connected to a host monitor, the host controls the MP5 including all alarm functionality. No alarms are available on the MP5, and the alarm lamps are controlled by the host. You can recognize when an MP5 is connected to a host monitor by the following indication on the screen:

Companion Mode

No Alarm Display

When the MP5 is disconnected from the original host monitor, it continues to monitor the patient as a stand-alone monitor with all settings and data. On connection to a new host monitor, the MP5 resumes its role as MMS, transferring all settings and data, ensuring fully continuous monitoring. When the MP5 is connected to a host monitor it still requires batteries or AC power; it also cannot charge its batteries via the host monitor’s AC connection.

The MP5T monitor is intended for use together with a telemetry device. It has no ECG measurement of its own but does have NBP and optionally SpO

and predictive temperature. When the telemetry

device is directly connected to the MP5T, the measurements from the MP5T are transmitted with those from the telemetry device (ECG and optionally SpO

) to the Information Center. The MP5T

alone has no network capability (no direct wired or wireless connection to the Information Center).

The following comparison table shows in detail the differences between MP5 and MP5T:

Functionality (including optional features) MP5 MP5T

ECG 3 SpO

NBP 33 Predictive Temperature 33 Te m p e r at u r e 3 Invasive Pressure 3 Carbon Dioxide 3 Direct Telemetry Connection 33 ECG Output signal 3 LAN networking capability 3 WLAN networking capability 3 Short range radio interface 3 IntelliVue Instrument Telemetry networking capability 3 Severe Sepsis Screening 3 OxyCRG high resolution trend 3 Neonatal event review 3 Integrated recorder 33 Drug Calculator 33

Introducing the Monitor 2 Basic Operation

Functionality (including optional features) MP5 MP5T

Gas monitor support 3 Connection to a host monitor (companion mode) 3 Connection to an external display 3 Nurse call capability 3

1.MP5 options without ECG do not have an ECG output signal

The MP5/MP5T patient monitor has an 8.4-inch TFT LCD flat panel SVGA display. You operate the monitor with the Touchscreen. There is an optional built-in recorder.

2 Basic Operation Introducing the Monitor

MP5/MP5T Major Parts and Keys

US measurement connectors

Pressure and Temp

Noninvasive Pressure

SpO

1 Color-coded alarm lamps 2 Alarms off lamp 3 Measurement connectors (see

below)

4 Predictive Temperature Unit 5 ECG out (not MP5T and MP5

options without ECG)

6 On/Standby Switch 7 Indicator LEDs

ECG/ Respiration

Telemetry device

International measurement connectors

Pressure and Temp

Noninvasive Pressure

SpO

MP5(T) front panel

12 3 4

ECG/ Respiration

Telemetry device

On/Standby switch On/Standby/Error LED - green when monitor is

switched on, red if there is a problem with the monitor Battery status LED - green, yellow or red, see Battery

section for details AC power operation LED - green when the monitor is

connected to AC power (mains)

Operating and Navigating 2 Basic Operation

Operating and Navigating

Everything you need to operate the monitor is contained on its screen. Almost every element on the screen is interactive. Screen elements include measurement numerics, waveforms, screen keys, information fields, alarms fields and menus:

678

Bed 3

Doe, John Adult

3 Waves A

ALARMS PAUSED 2:59

1mv

Pleth

Resp

1Ohm

NBP

Sys.

Auto 10 min

NBP

mmHg

SpO

Pulse

Temp

Local Recorder out of paper

Repeat

Time

status line - shows information and messages prompting you for action

close all open menus and windows and return to main screen

enter Main Setup menu

scroll right to display more SmartKeys

SmartKeys - these change according to your monitor’s configuration

scroll left to display more SmartKeys

Pause Alarms - pauses alarm indicators. Pause duration depends on monitor

configuration. If pause duration is infinite, this key is labeled Alarms Off. Select again to immediately re-enable alarm indicators.

Pause

Alarms

Silence

Monitor information line Other screen elements

network connection indicator

(documented in Information Center Instructions for Use)

bed label

patient identification

patient category

paced status

date and time

current screen name/enter

change screen menu

Start/

Stop

15 14

Delayed

Record

Vitals

Trend

Default Profile

End Case

Main

Setup

13 12

hrs

Main

Screen

2 Basic Operation Operating and Navigating

Monitor information line Other screen elements

adjust alarm volume/level

indicator

alarm status area - shows active

alarm messages

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

lamps permanently or temporarily, if alarm reminder (ReAlarm) is configured on.

Selecting Screen Elements

Touch a screen element to get to the actions linked to that element. For example, touch the Patient Identification element to call up the Patient Demographics window, or touch the HR numeric to call up the Setup ECG menu. Touch the ECG wave segment to call up the ECG lead menu.

Using the Setup Menu

Setup

Alarm Messages

Alarm Limits

Alarm Volume

My Care Group

Change Screen

Profiles

Admit/Dischrg

Paced No

Network

Bed Information

Date, Time

Disabling Touchscreen Operation

♦ To temporarily disable touchscreen operation of the monitor, press and hold the

Main Screen permanent key. A padlock will appear on the Main Screen permanent key.

The elements at the top of the Screen are grouped together for ease of navigation. Touch any item at the top of the Screen to open the Setup menu; then touch the element you want.

♦ Press and hold the Main Screen permanent key again to re-enable the touchscreen operation.

Moving Windows

You can move windows and menus using the Touchscreen. To move a window

1 Select the title of the window and keep your finger on the title.

2 Move your finger on the Touchscreen to move the window.

3 Take your finger off the screen to place the window in the final position.

Not all locations on the screen can be a target position, a window cannot overlap the monitor info line, the alarms and INOPs or the status line.

Operating and Navigating 2 Basic Operation

Using Keys

The monitor has three different types of keys.

Perma nent Ke y s

A permanent key is a graphical key that remains on the screen all the time to give you fast access to functions.

SmartKeys

Pause Alarms

configuration. If pause duration is infinite, this key is labeled Alarms Off.

- pauses alarm indicators. Pause duration depends on monitor

Select again to immediately re-enable alarm indicators.

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

and lamps.

Main Screen - close all open menus and windows and return to the main screen.

Main Setup - enter main setup menu.

A SmartKey is a configurable graphical key, located at the bottom of the main screen. It gives you fast access to functions. The selection of SmartKeys available on your monitor depends on your monitor configuration and on the options purchased.

enter profile menu, or revert to default profile

change Screen, or revert to default screen

access timers

freeze waves quick admit a patient

set alarm limits

change alarm volume end case to discharge a patient

change QRS volume

previous Screen

enter patient identification menu to admit/discharge/transfer

view information for patients in other beds

2 Basic Operation Operating and Navigating

enter standby mode - suspends patient monitoring. All waves and numerics disappear from the display. All settings

change screen brightness (not for

independent displays) and patient data information are retained.

review beat labels (annotate arrhythmia wave)

re-learn arrhythmia

change amplitude (size) of ECG wave access wedge procedure window

- start/stop manual NBP measurement

- start auto series

- stop current automatic measurement

start/stop NBP STAT measurement

within series

stop automatic or STAT NBP

measurement and measurement series

start NBP measurement and

stop current NBP measurement measurement series

start veni puncture (inflate cuff to

start NBP STAT measurement subdiastolic pressure)

set the NBP repeat time

start a delayed recording

zero invasive pressure transducer

access pop-up recording keys

access Vital Signs recording key

access Select Waves recording key

set wide automatic alarm limits set narrow automatic alarm limits

switch CO

pump off access neonatal event review

review vital signs trend review graph trend

access the calculator access the Drug Calculator

gas analyzer - exit standby mode suppress zero for all gas measurements

Operating and Navigating 2 Basic Operation

Pop-Up Keys

unpair equipment and continue central monitoring with the monitor

start 12-Lead Capture (only available if Information Center is connected)

set standard or EASI lead placement access patient reports

new lead setup manual data entry

access ProtocolWatch start/stop car seat assessment record

open the histogram window open unit conversion window

unpair equipment and continue central

monitoring with the telemetry device

access ST Map application

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

Using the On-Screen Keyboard

Use this as you would a conventional keyboard. Enter the information by selecting one character after another. Use the Shift and capital Lock keys to access uppercase letters. Use the Back key to delete single characters, or use the Clr key to delete entire entries. Select Enter to confirm what you have entered and close the on-screen keyboard.

2 Basic Operation Operating and Navigating

Using the On-Screen Calculator

You can use the on-screen calculator to perform any of the standard operations for which you would normally use a handheld calculator.

♦ To access the on-screen calculator, select the

Calculator SmartKey, or select Main Setup

-> Calculations -> Calculator.

Calculator

M+ Back

C/CE



Operating Modes 2 Basic Operation

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.

2 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, every day working mode that you use for monitoring patients. You can change elements such as alarm limits, patient category and so forth. When you discharge the patient, these elements return to their default values. Changes can be stored permanently only in Configuration Mode. You may see items, such as some menu options or the altitude setting, that are visible but ‘grayed out’ so that you can neither select nor change them. These are for your information and can be changed only in Configuration Mode.

• Demonstration Mode: Passcode protected, this is for demonstration purposes only. You must not change into Demonstration Mode during monitoring. In Demonstration Mode, all stored trend information is deleted from the monitor’s memory.

• Configuration Mode: Passcode protected, this mode is for personnel trained in configuration tasks. These tasks are described in the Configuration 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, the number of waves you see and so forth.

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

When the monitor is in Demonstration Mode, Configuration Mode, or Service Mode, this is indicated by a box with the mode name in the center of the Screen and a symbol in the bottom right-hand corner. Select this field to change to a different mode.

When an MP5 is connected to a host monitor (Companion Mode is indicated):

• The MP5 will adopt the operating mode of the host monitor:

• You cannot change the operating mode at the MP5.

Standby Mode

Standby mode can be used when you want to temporarily interrupt monitoring. To enter Standby mode,

♦

♦ select Main Setup, followed by Monitor Standby.

The monitor enters Standby mode automatically after the End Case function is used to discharge a patient.

Standby suspends patient monitoring. All waves and numerics disappear from the display but all settings and patient data information are retained. A special Standby screen is displayed. This can be configured to a moving image or a blank screen. If a patient location is entered at the Information Center, this will also be displayed on the Standby screen (availability depends on Information Center revision).

Config

select the Monitor Standby SmartKey or

To resume monitoring,

2 Basic Operation Understanding Screens

♦

Select anything on the screen or press any key.

If you connect an MP5 that is powered on (and not in Standby) to a host monitor in Standby mode, the host will leave Standby mode. When connected to a host monitor, with both the host and the MP5 in Standby mode, leaving Standby on the MP5 will also make the host leave Standby.

Understanding Screens

Your monitor comes with a set of preconfigured Screens, optimized for common monitoring scenarios such as OR adult, or ICU neonatal. A Screen defines the overall selection, size and position of waves, numerics and SmartKeys on the monitor screen when you switch on. You can easily switch between different Screens during monitoring. Screens do NOT affect alarm settings, patient category and so forth.

Switching to a Different Screen

1 To switch to a different Screen, select the monitor info line and then Change

Screen in the Setup Menu, or select the Change Screen SmartKey.

2 Choose the new Screen from the pop-up list.

Changing a Screen’s Content

If you do not want to change the entire Screen content, but only some parts of it, you can substitute individual waves, numerics, high-res waves, or trends. Be aware that these changes cannot be stored permanently in Monitoring Mode.

To change the selection of elements on a Screen,

1 Select the element you want to change. 2 From the menu that appears, select Change Wave, Change Numeric, or

Change HiResTrend, and then select the wave or numeric you want, or select the highresolution trend wave you want from the list of available waves.

If you do not see Change Numeric in the menu, this Screen may be configured to always display the numeric beside its wave. Changing the wave will automatically change the numeric.

The changed Screen is shown with an asterisk in the monitor info line.

Using the XDS Remote Display (not MP5T) 2 Basic Operation

In the Change Screen menu, the changed Screen is shown linked to the original Screen and marked with an asterisk.

Up to three modified Screens can be accessed via the Change Screen menu.

To recall Screens, either

♦ select the name of the Screen in the

Change Screen menu

♦ use the previous/next arrows at the top of the

Change Screen menu to move back and forth in the Screen history. The ten most recently-used Screens including up to three modified Screens can be accessed.

After a patient discharge, the monitor’s default Screen is shown. Modified Screens are still available in the Change Screen menu.

If the monitor is switched off and then on again, modified Screens are erased from the monitor’s memory and cannot be recalled. If a modified Screen was the last active Screen when the monitor was switched off, it is retained (unless Automat. Default is configured to Yes).

Change Screen

3 Waves A

Split Screen A

Graph Trends

Vital Signs B

Vital Signs A

Vital Signs A*

Using the XDS Remote Display (not MP5T)

Using the IntelliVue XDS solution it is possible to view an independent monitor screen on an external display. The XDS solution consists of a medical grade PC-based hardware platform, XDS application software and the XDS connectivity option on the monitor. Depending on the configuration you can also operate the monitor from the external display. The XDS must be connected to the same Local Area Network (LAN) as the monitor.

It is also possible to use an existing PC, connected to the same LAN, to host the XDS Application software.

For more details, including limitations and restrictions, refer to the Instructions for Use for the XDS Application.

Using the Visitor Screen

If a visitor Screen is configured for your monitor, you can use it to clear the screen of all waves and numerics but continue to monitor the patient with active alarms and trend storage at the bedside and Information Center. You can change the name of the visitor Screen in Configuration Mode.

To activate this Screen,

1 Select the monitor info line to open the Setup menu

2 Select Change Screen

3 Select the name of the visitor Screen configured for your monitor from the list of available Screens.

To select a Screen with waves and numerics again,

2 Basic Operation Understanding Profiles

♦

Select any element on the Screen to open the Screen menu and select a screen from the list.

Understanding Profiles

Profiles are predefined monitor configurations. They let you change the configuration of the whole monitor so you can adapt it to different monitoring situations. The changes that occur when you change a complete profile are more far reaching than those made when you change a Screen. Screens affect only what is shown on the display. Profiles affect all monitor and measurement settings.

The settings that are defined by Profiles are grouped into three categories. Each category offers a choice of ‘settings blocks’ customized for specific monitoring situations. These categories are:

Display (screens) – Each profile can have a choice of many different predefined screens. If you are using a second

display, each display can have its own individual screen selection. When you change the profile, the screen selection configured for the new profile becomes active.

• Measurement Settings

– Each profile can have a choice of different predefined measurement settings. These relate directly

to individual measurements, for example, measurement on/off, measurement color, alarms limits, NBP alarm source, NBP repeat time, temperature unit (°F or °C), pressure unit (mmHg or kPa).

• Monitor Settings

– Each profile can have a choice of different predefined monitor settings. These relate to the

monitor as a whole; for example, display brightness, alarms off/paused, alarm volume, QRS tone volume, tone modulation, prompt tone volume, wave speed, resp wave speed, pulse source.

Profiles

Profile : Profile A

Patient Category: Adult

Paced : No

Display : S-014

Measmt. Settings:Measurement A

Monitor Settings: Monitor A

Profiles Menu, showing current settings

Measurement A

Measurement B

Measurement C

Measurement D

Available choices in measurement menu

You can change from one complete profile to another or swap individual settings blocks (display screen/monitor settings/measurement settings) to change a subset of a profile. Changes you make to any element within the settings blocks are not saved when you discharge the patient, unless you save them in Configuration Mode.

Depending on your monitor configuration, when you switch on or discharge a patient the monitor either continues with the previous profile, or resets to the default profile configured for that monitor.

Understanding Profiles 2 Basic Operation

WARNING If you switch to a different profile, the patient category and paced status normally change to the setting

specified in the new profile. However some profiles may be setup to leave the patient category and paced status unchanged. Always check the patient category, paced status, and all alarms and settings, when you change profiles.

When you leave Demonstration Mode, the monitor uses the default profile.

2 Basic Operation Understanding Settings

Swapping a Complete Profile

1 Select the monitor info line and then Profiles in the Setup menu, or select the

Profiles SmartKey.

2 In the Profiles menu, select Profile.

3 Chose a profile from the pop-up list.

4 Confirm your selection.

Swapping a Settings Block

1 Select the monitor info line and then Profiles in the Setup menu, or select the

Profiles SmartKey.

2 In the Profiles menu, select Display or Measmnt. Settings or

Monitor Settings to call up a list of the settings blocks in each category.

3 Choose a settings block from the pop-up list.

4 Confirm your selection.

Default Profile

Your monitor has a default profile that it uses when you leave Demonstration, or Service modes, or when you discharge a patient. This profile is indicated by a diamond .

Locked Profiles

Some profiles are locked, so that you cannot change them, even in Configuration Mode. These are indicated by this lock symbol.

Understanding Settings

Each aspect of how the monitor works and looks is defined by a setting. There are a number of different categories of settings, including,

Screen Settings, to define the selection and appearance of elements on each individual Screen

Measurement settings, to define settings unique to each measurement, for example, high and low

alarm limits

Monitor settings, including settings that affect more than one measurement or Screen and define general aspects of how the monitor works, for example, alarm volume, reports and recordings, and display brightness.

You must be aware that, although many settings can be changed in Monitoring Mode, permanent changes to settings can only be done in the monitor’s Configuration Mode. All settings are reset to the stored defaults:

• when you discharge a patient

• when you load a Profile

Adjusting a Measurement Wave 2 Basic Operation

• when the monitor is switched off for more than one minute (if Automat. Default is set to Yes).

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 to enter its setup menu. For example, to enter the Setup ECG menu, select the HR (heart rate) numeric.

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

• via the Measurement Selection key.

Switching a Measurement On and Off

When a measurement is off, its waves and numerics are removed from the monitor’s screen. The monitor stops data acquisition and alarming for this measurement.

1 Enter the measurement’s setup menu and select the measurement. 2 Select the measurement name to toggle between on and off. The screen display indicates the active

setting.

Adjusting a Measurement Wave

♦ To quickly adjust wave-related measurement settings (such as speed or size), select the

measurement wave itself. This displays the measurement Wave menu, which has only wave-related measurement settings.

Changing Wave Speeds

Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the speed expands the waveform, giving you a more detailed view.

The monitor distinguishes two groups of wave speed settings,

• RespiratorySpeed, for all respiratory waves: CO

• Global Speed, for all waves not included in the other group.

Changing the Wave Group Speed

The wave speed group setting defines the speed of all the waves in the group.

, Resp. anesthetic agents and O

To change the wave speed of a wave speed group,

1 Select Main Setup -> User Interface

2 Select Global Speed or RespiratorySpeed, as required

3 Select a value from the list of available speeds.

2 Basic Operation Freezing Waves

Changing Wave Speed for a Channel

To change the wave speed of an individual wave channel,

1 Enter the Wave menu for a measurement by selecting its wave. 2 Select Change Speed.

3 To set the speed to the wave group speed, select RespiratorySpeed or Global Speed.

To set an individual channel speed, select a numeric value from the list of available speeds. This overrides the wave group speed setting and sets the speed for the individual wave channel on the monitor Screen. The wave channel speed is independent of the wave (label) depicted in the channel, if you change the wave, the new wave will retain the set channel speed.

Freezing Waves

You can freeze waves on the screen and measure parts of the wave using cursors. The waves are frozen with a history of 20 seconds so that you can go back and measure what you have seen.

Freezing An Individual Wave

To freeze a wave,

1 Enter the Wave menu for the measurement by selecting the wave on the screen. 2 Select Freeze Wave.

The realtime wave is replaced with the frozen wave.

Freezing All Waves

To freeze all waves on the screen,

1 Select the Freeze Waves SmartKey.

All realtime waves are replaced with frozen waves.

Measuring Frozen Waves

To measure a frozen wave,

1 Select the frozen wave.

This automatically positions the vertical cursor. The cursor can be repositioned by touching the required point on the wave, or

2 Use the up/down arrow keys to activate and move the horizontal cursor.

The horizontal cursor measures the wave value, which is displayed above the cursor line. If the wave is a pressure wave, the cursor value can be stored as a systolic, diastolic or mean pressure value and if the pressure wave is a PAP wave, it can also be stored as a PAWP value. The stored value appears in the trend database as a manually entered value. To return to the vertical cursor use the <> pop-up key.

Changing The Wave Speed

Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the speed expands the waveform, giving you a more detailed view.

Using Labels 2 Basic Operation

To change the wave speed:

1 Select the frozen wave.

2 Select Change Speed.

3 Select a speed from the list.

Updating The Frozen Wave

To update the wave, that is freeze the current wave:

1 Select the frozen wave. 2 Select Freeze Again.

Releasing Frozen Waves

To release frozen waves,

1 Select a frozen wave. 2 Select Unfreeze Waves.

All frozen waves are released.

Using Labels

Depending on the monitor options purchased, you may be able to measure two invasive pressures and temperatures simultaneously. The monitor uses labels to distinguish between them. The default settings defined in the profile (such as measurement color, wave scale, and alarm settings) are stored within each label. When you assign a label to a measurement, the monitor automatically applies these default settings to the measurement. The labels assigned are used throughout the monitor, in reports, recordings, and in trends.

Changing Measurement Labels (e.g. Pressure)

To change a measurement label of a measurement with multiple labels (invasive pressure or temperature),

1 Enter the Wave menu of the measurement.

2 Select Label.

3 Choose a label from the list.

The monitor automatically applies the scale, color, etc. settings stored in the Profile for the label you select. You can change scale settings in Monitoring Mode, but color can only be changed in the monitor’s Configuration Mode.

Any labels already being used in the monitor are shown “grayed-out” in the list and cannot be selected.

Resolving Label Conflicts

Each label must be unique, that is, it can only be assigned once. If you have a gas monitor connected to the monitor there is a potential conflict with the CO

Depending on your configuration, the monitor will either

label.

2 Basic Operation Using Labels

• display the Measurement Selection window automatically for you to resolve the conflict

• take no action, you must enter the Measurement Selection window and resolve the conflict

measurement selection key

All the currently available measurements are depicted in the Measurement Selection window. If a measurement label is causing a label conflict it is shown in red.

WARNING When an MP5 with an active measurement, say SpO

measurement already active, the SpO

measurement on the MP5 is deactivated and the

Meas. DEACTIVATED INOP is displayed. The measurement can only be reactivated if the MP5 is disconnected from the host monitor. The label conflict can be resolved on the host monitor like any other label conflict.

When the MP5 is connected to a host monitor, the Measurement Selection window can be opened, but only the measurement Setup key is functional. Derived measurements are not active and cannot be activated, but become active again when the MP5 is disconnected from the host monitor. Resolve any label conflicts at the host monitor.

To resolve a label conflict,

1 Select the measurement selection key or select Main Setup -> Measurement Selection

to display the Measurement Selection window.

2 Select the measurement to be deactivated.

3 Select the De-activate pop-up key to disable the conflicting measurement. When the

measurement has been deactivated the question marks under the measurement selection key will be replaced by XXX.

Label Compatibility

When a new measurement is introduced, or new labels for an existing measurement, these labels will not be shown on older Information Centers, and consequently not on the Overview screen sourced from the Information Center.

, is connected to a host monitor with the same

When a patient is transferred from a monitor with these new labels to one with an older software revision, the labels will be replaced with a generic label for that measurement. The settings for that generic label will then be used.

Entering Measurements Manually 2 Basic Operation

If it is critical that the measurement labels are available at the Information Center and after transfers, the older monitors and the Information Center must be upgraded to the appropriate software revision.

Entering Measurements Manually

You can enter values into the monitor that have been measured with other equipment or manually (for example, manual temperatures, lab values). These values are then stored in the database, included in trends and reports, and passed on to the Information Center and central charting systems. There is no alarm functionality for manually entered measurements.

To enter values,

1 Select the Enter Values SmartKey or select Main Setup -> Enter MeasValues

2 Select the measurement you want to enter values for. The Edit <Measurement> window will

open.

3 If the measurement is switched off, switch it on by selecting the label.

4 Select Value and enter the value.

5 Select Date/Time to enter the date and time for the value. The default is always the current date

and time.

6 For compound labels, for example ABPs, ABPd and ABPm, select the Format field to select

whether all values are required or a single value.

7 Select Confirm.

When a manually entered value has been configured to display as a numeric on the screen, you can also enter a new value for this measurement by selecting the numeric, then selecting Enter MeasValues.

Manually entered measurement values are marked with a * on the display, in trends, and so forth. Each measurement has a defined measurement interval after which a value becomes invalid (no value is then displayed). Values can be entered up to two hours after they have been measured or up to the measurement interval, if this is shorter.

The list of measurement labels which appears in the Manual Entry window is set in Configuration Mode.

No values can be entered manually on the MP5 when it is connected to a host monitor.

Switching Manually Entered Measurements On and Off

To switch a manually entered measurement on or off,

1 Select the Enter Values SmartKey or select Main Setup -> Enter MeasValues

2 Select the measurement you want to switch on or off.

3 Select the measurement label field to switch between On and Off

Changing Monitor Settings

♦ To change monitor settings such as brightness, or QRS tone volume, select the Main Setup

permanent key and then select User Interface to enter a submenu where you can change these settings.

2 Basic Operation Checking Your Monitor Revision

Adjusting the Screen Brightness

1 Select the Brightness SmartKey.

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

bright. Optimum is suitable for most monitoring locations and optimizes power usage for battery powered monitors.

Your monitor may be configured with a lower brightness for Standby mode and also for transport to conserve battery power. These settings can only be changed in the monitor’s Configuration Mode.

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 In the Main Setup menu, select User Interface

2 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

If your monitor is connected to an Information Center, the date and time are automatically taken from this. Once it is set, the internal clock retains the setting even when you switch off the monitor.

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, only) and Minute as

necessary. Select the correct values from the pop-up list.

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

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.

Getting Started

Once you understand the basic operation principles and have completed the Training Program, you can get ready for monitoring.

Inspecting the Monitor

WARNING If the monitor is mechanically damaged, or if it is not working properly, do not use it for any

monitoring procedure on a patient. Contact your service personnel.

1 Before you start to make measurements, carry out the following checks on the monitor.

– Check for any mechanical damage.

Getting Started 2 Basic Operation

– Check all the external cables, plug-ins and accessories.

2 Plug the power cord into the AC power source. If you are using battery power, ensure that the

battery has sufficient power for monitoring. When you use a battery for the first time, you must charge it, following the instructions given in the section on Charging Batteries.

3 Check all the functions of the instrument that you need to monitor the patient, and ensure that the

instrument is in good working order.

Switching On

♦ Press the on/off switch on the monitor for one second. The monitor performs a self test and is then

ready to use. If you see a message such as CO starting monitoring that measurement.

SENSOR WARMUP wait until it disappears before

Power On/Power Off Behavior

The general rules determining the behavior of the monitor when connected to, or disconnected from power are as follows:

• A monitor that was switched on prior to a temporary power loss switches on again when power is restored.

• A monitor that was switched off prior to a temporary power loss remains off when power is restored.

• When AC mains power is lost, a battery powered monitor continues to run without interruption on battery power.

• The MP5 switches on automatically when connected to a running host monitor.

• When the MP5 is disconnected from a running host monitor, it continues to run without interruption on battery power.

Setting up the Measurements

1 Decide which measurements you want to make. 2 Connect the required patient cables and sensors. The connectors are color-coded to the patient

cables and sensors for easy identification.

WARNING When connecting devices for acquiring measurements, always position cables and tubing carefully to

avoid entanglement or potential strangulation.

Starting Monitoring

After you switch on the monitor,

1 Admit your patient to the monitor.

2 Check that the profile, alarm limits, alarm and QRS volumes, patient category and paced status

and so forth are appropriate for your patient. Change them if necessary.

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

require.

2 Basic Operation Disconnecting from Power

WARNING During MR imaging, remove all transducers, sensors and cables from the patient. Induced currents

could cause burns.

Disconnecting from Power

The On/Standby switch does not disconnect the monitor from the ac power source. To disconnect, unplug the power cable.

Monitoring After a Power Failure

If the monitor is without power for less than one minute, monitoring will resume with all active settings unchanged. If the monitor is without power for more than one minute, the behavior depends on your configuration. If Automat. Default is set to Yes, the default profile will be loaded when power is restored. If Automat. Default is set to No, all active settings are retained, if power is restored within 48 hours. The Automat. Default setting is made in Configuration Mode.

Networked Monitoring

You can connect your monitor to an Information Center on a network. This can be done using one of the optional interfaces:

• Standard wired LAN

• Wireless LAN

• IntelliVue Instrument Telemetry System (IIT)

WARNING Do not connect patient monitors to the standard hospital network.

Additionally, when the MP5 is equipped with IIT and declared at the Information Center as a telemetry device, it allows data continuity when paired to a host monitor. After disconnection from the host monitor, it continues to monitor the patient during transport and provides continuous data to the same sector on the Information Center. (See the Instructions for Use for your host monitor for viewing telemetry data on the host.)

If your monitor is connected to a network, a network symbol is displayed in the upper left corner next to the bed label. To see details about the Care Group, the monitoring equipment, and technical information about the network, select the monitor info line to enter the Setup menu, then select Bed Information.

Be aware that some network-based functions may be limited for monitors on wireless networks in comparison to those on wired networks.

Printout functionality and data export are not guaranteed when using a standard hospital network.

Using the MP5 with a Host Monitor 2 Basic Operation

Using the MP5 with a Host Monitor

Host monitors that can support the MP5 as a multi-measurement module require software revision F.00.00 or higher. When you connect an MP5 to a host monitor, an integrated system is formed for monitoring a single patient. The following general observations and considerations apply to such a system:

• The host monitor is the “master” of the system, and you have full control over all the system’s operation only from the host monitor.

• Functions you can operate on the MP5 are restricted to measurements originating in that device. If you try to operate controls that are disabled, you are prompted by the message “Not available in Companion Mode”.

• Depending on how it is configured, your host monitor can determine whether the user interface of a connected MP5 is completely disabled or not, and what is displayed (a standard main screen, or a blank screen similar to the Standby screen indicating “Companion Mode”).

This is controlled by two monitor settings that are applied to the MP5 on connection. You can change the settings in Configuration Mode.

• Some general settings, such as line frequency, QRS sound, ECG lead colors, from the host monitor are applied to the MP5 on connection. When disconnected from the host, the MP5 applies its own settings again.

• No audible alarms are available on an MP5 when connected to a host monitor. The only visual alarm indication is provided by the alarm lamps which are controlled by the host monitor. Alarms become active again as soon as the MP5 is disconnected from the host monitor.

• The host monitor is the master of all ADT information. ADT operations on the MP5 are disabled, and any pending actions on the MP5 (for example, admit or end case) are cancelled.

• The date and time of the MP5 is synchronized with that of the host monitor.

• Event surveillance in the MP5 is disabled. Main Setup menu operations and SmartKeys are disabled. While connected to host monitor, no new events are detected in the MP5, and no events are deleted. There is no transfer of stored events from the MP5 to the host monitor. After disconnection from the host monitor, event surveillance is enabled again in the MP5, and new events are detected.

The MP5 is connected to the host monitor using the measurement link (MSL) cable:

2 Basic Operation Using the MP5 with a Host Monitor

This section lists the most important new features and improvements to the monitor and its user interface introduced with each release. Further information is provided in other sections of this book.

You may not have all of these features, depending on the monitor configuration purchased by your hospital.

What’s New in Release G.0?

Short Range Radio Interface for MP5

A short range radio interface is now available for the MP5 monitor. This allows a telemetry transceiver with a short range radio adapter to be assigned to the monitor resulting in a direct connection, as an alternative to the cable connection. The measurement data from the telemetry transceiver appear directly on the monitor screen with a minimal delay and are combined with the monitor data in one sector at the Information Center.

3What’s New?

Product Options Without ECG

The monitor now has several options, with varying measurement combinations, without an ECG measurement.

Microstream CO

The Microstream CO

Histogram Trend

Trended values can also be viewed in the form of a histogram. The SpO histograms or realtime histograms with 1 second samples.

Car Seat Assessment Record

In Event Surveillance, in the NER group, you can run a Car Seat Assessment Record (CAR). This is a special period of event surveillance for neonates during a car seat test. During the CAR period a realtime SpO

IntelliVue XDS Solution

It is also possible to use an existing PC, connected to the same LAN, to host the XDS Application software.

in MP5

measurement method is now available in MP 5 monitors.

histogram is also generated with 1 second samples.

histograms can be trend

3What’s New? What’s New in Release F.0?

New Fields in the Admission Form

A Middle Name field is now available in the admission form - whether it appears is configurable. Two additional ID fields, Lifetime Id and Encounter Id, can also be configured to appear and their names can be customized to fit hospital requirements.

Enhancements

SpO

• Additional SpO

• New manual measurement mode when telemetry devices are connected via a short range radio link.

Labels - SpO2pr and SpO2po labels have been added.

• Signal Quality Indicator displayed with the SpO

ECG Enhancements

•New */**Afib yellow alarm when an atrial fibrillation waveform is detected.

• QT View window - shows current wave and baseline wave with Q and T points marked so that you can verify that the QT algorithm detects correct Q and T points.

What’s New in Release F.0?

The SSC Sepsis protocol is now available on the MP5 in the form of the screening option. If a patient has been screened on arrival with an MP5, then transferred to Intensive Care when Sepsis is confirmed, the current state, the settings and the log from the SSC Sepsis Protocol can be transferred from the MP5 by connecting it to the new monitor.

QT/QTc Interval Monitoring

QT interval monitoring is used to assist in the detection of prolonged QT interval syndrome. The QT interval is measured and the heart-rate corrected QT value, QTc, is calculated. The monitor also provides a QTc value which tracks variation in the QT interval in relation to a baseline value. High alarm limits can be set for QTc and QTc enabling alarm notification.

Manual Data Entry

Measurement values (for example lab data or manually measured temperatures) can be entered manually into the monitor and stored in the database. They can then be used for trends, reports and also be displayed as a numeric on screen, if required.

numerics.

Horizon Trend Enhancements

The trend indicator arrow indicates how the patient trend has developed in a set time period. This period is now configurable and can be set to 10 minutes, 5 minutes or 2 minutes. The horizon (or baseline) can now be set to a range or to a specific value.

Connecting an MP5 to a Monitor (Companion Mode is indicated)

The MP5 monitor can be connected to one of the MP20 to MP90 monitors (then called the host monitor) and used like an MMS. This provides monitoring continuity in transport situations allowing measurement data and patient demographics from the MP5 to be transferred to another monitor. When the MP5 is connected to a host monitor, no alarms will be announced on the MP5.

Pairing MP5 with another IntelliVue Monitor

The MP5 (with IIT) can be declared as a telemetry device at the Information Center and paired with another monitor. The data from the MP5 will then be shown on the same sector on the Information Center as that from the other monitor.

What’s New in Release F.0? 3What’s New?

Sending Data To An Information Center Via A Telemetry Device

For the MP5T monitor, or an MP5 monitor without a connection to an Information Center, a small set of monitoring data can be sent from the monitor to the Information Center via a connected telemetry device.

NBP - Programmable Measurement Sequence

Up to four measurement cycles can be set up which will run consecutively. For each cycle you can set the number of measurements and the interval between them. By setting the last cycle to run continuously you can have regular measurements continue after the sequence has run.

New Printing Options For Reports

Reports can now also be printed via an external PC-based print server or to an internal print database, when no printer is available (for example, during transport). As soon as a printer becomes available, the reports stored in the database will print automatically.

Manual Pairing At Monitor

Previously, devices could only be manually paired at the Information Center. You can now pair devices at the monitor as long as the monitor is already connected to the Information Center.

Moving Windows And Menus

Windows and menus can now be moved on the monitor screen. Using touch or a mouse you can select the title of a window and then “drag” it across the screen. Some positions on the screen are not allowed, such as ones overlapping the alarm field or the monitor info line.

Invasive Pressure Changes

Wave cursor - A cursor is now available on the realtime pressure wave to allow you to define a position

and store the corresponding value.

Reduced alarm limit steps in lower ranges - The alarm limits setting in 2 mmHg steps is now possible in ranges up to 50 mmHg (previously up to 30 mmHg).

New Patient Check

The monitor can be configured to ask you in certain situations: after a specified power-off period, after a specified standby period and when no basic vitals (HR, RR, Pulse, SpO

, NBP) have been measured

for a specified period, whether a new patient is now being monitored. By selecting the Yes pop-up key you can discharge the previous patient and reset settings.

New Smart Keys

A SmartKey is available for New Lead Setup when a new ECG lead set with fewer leads than previously is being used.

Better Visibility Of Gridlines

The brightness of the gridlines on the realtime waves has been increased for better visibility.

3What’s New? What’s New in Release F.0?

4Alarms

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

The monitor has two different types of alarm: patient alarms and INOPs.

Patient Alarms are red and yellow alarms. A red alarm indicates a high priority patient alarm such as a potentially life threatening situation (for example, asystole). A yellow alarm indicates a lower priority patient alarm (for example, a respiration alarm limit violation). Additionally there are short yellow alarms, most of which are specific to arrhythmia-related patient conditions (for example, ventricular bigeminy).

INOPs are technical alarms, they indicate that the monitor cannot measure or detect alarm 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 an audible indicator tone will be sounded. INOPs without this audible indicator indicate that there may a problem with the reliability of the data, but that monitoring is not interrupted.

Most INOPs are light blue, however there are a small number of INOPS which are always yellow or red to indicate a severity corresponding to red and yellow alarms. The following INOPs can also be configured as red or yellow INOPs to provide a severity indication:

• ECG LEADS OFF

• ECG/ARRH ALARM OFF (yellow only, no red INOP)

• CUFF OVERPRESS

• CUFF NOT DEFLATED

• OCCLUSION

• TELE DISCONNECT.

• Replace TeleBatt

All monitors in a unit should have the same severity configured for these INOPs. Alarms are indicated after the 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.

** HR HIGH

4Alarms Visual Alarm Indicators

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. Your monitor may be configured to increase alarm indicator volume automatically during the time when the alarm is not acknowledged.

Visual Alarm Indicators

WARNING • No alarms are available on the MP5 when connected to a host monitor. Alarms become active again

as soon as the MP5 is disconnected from the host monitor.

• Alarm fields and other visual alarm indicators are disabled on the MP5 when connected to a host monitor. The only visual alarm indication is provided by the alarm lamps, which are controlled by the host monitor. No Alarm Display is shown in the field for red alarms, Companion

Mode is shown in the yellow alarms field, and the INOPs field is blacked out.

Companion Mode

Alarm message: An alarm message text appears in the alarm status area 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, light blue for standard INOPs, red for red INOPs and yellow for yellow INOPs. The asterisk symbols (*) beside the alarm message match the alarm priority: *** for red alarms, ** for yellow alarms, * for short yellow alarms. Standard INOPs do not have a symbol, red and yellow INOPs have exclamation marks beside the alarm message: !!! for red INOPs and !! for yellow INOPs.

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

• in text form, for example “**SpO

• in numeric form, for example “**SpO deviation from the alarm limit, and the second number shows the currently set limit.

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 if Show AlarmLimits is enabled and there is sufficient room on the screen.

LOW” or

94<96”, where the first number shows the maximum

No Alarm Display

Alarm lamp: A lamp on the monitor’s front panel flashes. The alarm lamp is divided into two

sections. The right one flashes for a patient alarm, except for short yellow alarms where the lamp will light for approximately six seconds. The color is yellow or red corresponding to the highest priority patient alarm currently present. The left one lights continuously for a light blue INOP and flashes for yellow or red INOPs as follows:

Audible Alarm Indicators 4Alarms

INOP Lamp Color

Yellow 1.0 seconds 1.0 seconds Red 0.25 seconds 0.25 seconds

If only patient alarms are present, and no INOPs, the patient alarms will use both left and right sections to flash (for red and yellow alarms) or light for approximately six seconds (for short yellow alarms). If only INOPs are present, and no patient alarms, red and yellow INOPs will use both left and right sections to flash but light blue INOPs will always light continuously in the left section only.

Nurse call systems: If configured to do so, red, yellow and light blue alarms are indicated on any device connected to the nurse call relay.

Modulation (how long the lamp is on or off while flashing)

On Off

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.

• No alarms are available on the MP5 when connected to a host monitor (Companion Mode is indicated). Alarms become active again as soon as the MP5 is disconnected from the host monitor.

• When connected to a host monitor (Companion Mode is indicated), no alarm tones are available on the MP5.

Alarm Tone Configuration

The audible alarm indicators of your monitor are configurable. In the monitor’s Configuration Mode, you can:

• increase the alarm volume of unacknowledged alarms at regular intervals

• change the interval between alarm sounds (ISO/IEC Standard alarms only)

• change the base volume of the red and yellow alarm tones and the INOP tones

• change the alarm sound to suit the different alarm standards valid in different countries.

Traditional Audible Alarms (HP/Agilent/Philips/Carenet)

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

• Two-star yellow alarms and yellow INOPs: A lower pitched sound is repeated every two seconds.

4Alarms Audible Alarm Indicators

• One-star yellow alarms (short yellow alarms): The audible indicator is the same as for yellow alarms, but of shorter duration.

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

ISO/IEC Standard Audible Alarms

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

• Two-star yellow alarms and yellow INOPs: A lower pitched tone is repeated three times, followed by a configurable pause.

• One-star yellow alarms (short yellow alarms): The audible indicator is the same as for yellow alarms, but of shorter duration.

• Standard 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, select the volume symbol and then select the required volume from the pop-up selection.

♦ If you want to see a numerical indication of the current alarm volume on a scale

from zero to 10, or change the setting, select the Alarm Volume SmartKey. The volume scale pops up. The current setting is indented. To change the setting, select the required number on the scale. Any settings that are inactive (“grayed out”) have been disabled in the monitor’s Configuration Mode.

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

There is no alarm volume indication on the MP5 screen when the MP5 is connected to a host monitor (Companion Mode is indicated).

Minimum Volume for No Central Monitoring INOP

If your monitor is connected to an Information Center, and the connection is interrupted, the INOP message No Central Monit. will appear within 30 seconds, accompanied by an INOP tone. To help ensure that this INOP, and any other active alarm, is not overlooked, the INOP and alarm tones may be configured to have a minimum volume. In this case, INOP and alarm tones will sound even if the monitor alarm volume is set to zero.

Minimum Volume for Severe Yellow or Red INOPs

Severe yellow or red INOPs require action to ensure the well-being of the patient. Therefore the minimum volume for the INOP tone is set to at least alarm volume 8, irrespective of the current alarm volume setting. The INOP tone will sound even if the monitor alarm volume is set to zero.

Alarm

Volume

The severe INOPs for which this applies are:

Cuff Not Deflated (configurable to yellow or red)

Acknowledging Alarms 4Alarms

NBP Cuff Overpress (configurable to yellow or red)

Power Loss Tone

When power is lost - no power is available from the power cable or from a battery - a buzzer will sound, if so configured. The tone can be silenced by pressing the On/Off power switch.

Acknowledging Alarms

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

Silence

A check mark beside the alarm message indicates that the alarm has been acknowledged. If the monitor is configured to re-alarm, a dashed check mark will be shown.

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, except for NBP alarms. When an NBP alarm is acknowledged the alarm message disappears.

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

Acknowledging an INOP that results from a disconnected transducer switches off the associated measurement. The only exception is ECG/Resp: acknowledging a disconnect INOP for ECG leads does not switch off the ECG and Resp measurements. Acknowledging a disconnect INOP at the Information Center switches off the audible INOP indicator but does not switch off the measurement.

Alarm Reminder (ReAlarm)

If Alarm Reminder is configured on for your monitor, you will get an audible reminder of alarm conditions that remain active after you have acknowledged the alarm. This reminder may take the form of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is the same as a new alarm). Alarm reminder is not available for standard, light blue INOPs but for yellow and red INOPs.

In Configuration Mode, you can set the interval between silencing the alarm and sounding the reminder tone to one, two, or three minutes.

APNEA

The alarm reminder behavior at the Information Center is different to that at the monitor. Refer to the Information Center Instructions for Use for further information.

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 -> Alarms -> Alarm Settings

2 Check the Alarms Off setting.

This setting can only be changed in Configuration Mode.

To Pause All Alarms

♦ Select the Pause Alarms permanent key. If your monitor is configured to

infinite pause time, the permanent key is labelled Alarms Off, and selecting it switches alarms off.

Depending on the configuration, you may need to select Confirm to complete the change.

Pause

Alarms

To Switch All Alarms Off

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

♦ Select the Alarms Off permanent key.

Depending on the configuration, you may need to select Confirm to complete the change.

Pausing alarms infinitely is the same as switching them off.

To Switch Individual Measurement Alarms On or 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.

While Alarms are Paused or Off

• The red Alarms Paused lamp on the monitor front panel is lit.

•

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.

ALARMS PAUSED 1:28

Alarms

Off

Alarm Limits 4Alarms

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

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

The only exceptions are the INOPs CUFF NOT DEFLATED, CUFF OVERPRESS and INOPs relating to empty, missing and malfunctioning batteries.

These INOPs switch the alarms on, and the INOP tones are sounded, even if alarms are paused or off. You need to remove the INOP condition first before you can switch the alarm tones off again.

• The nurse call relay is not active.

If a NO SENSOR or NO TRANSDUCER INOP is present and alarms are paused or switched off, the measurement in question is switched off.

ALARMS OFF

Restarting Paused Alarms

♦ To manually switch on alarm indication again after a pause, select the permanent key

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.

Resetting Arrhythmia Alarm Timeouts

♦ To reset the arrhythmia alarm timeout period, select the ALARMS OFF or PAUSE ALARMS

permanent key and then reselect it.

Extending the Alarm Pause Time

If your monitor has extended alarm pause enabled, you can extend the alarm pause time. Use this to prevent alarms being indicated, for example, while you are washing a patient or carrying out a procedure. Only extend the alarm pause time when you are sure that clinical personnel are available to monitor the patient’s condition closely.

To extend the alarm pause time to five or 10 minutes,

1 Select one of the alarm fields. This calls up the Alarm Messages window.

2 Select either the pop-up key Pause Al. 5 min or the pop-up key Pause Al. 10 min.

Each time you select one of these pop-up keys, the Alarm Pause Time is reset to five (or 10) minutes.

Alarm Limits

The alarm limits you set determine the conditions that trigger yellow and red limit alarms. For some measurements (for example, SpO to 100 switches the high alarm off. In these cases, the alarms off symbol is not displayed.

), where the value ranges from 100 to 0, setting the high alarm limit

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.

4Alarms Alarm Limits

Viewing Individual Alarm Limits

120

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,

Alarm limits

you can see them in the appropriate measurement setup menu. Select the measurement numeric to enter the menu and check the limits.

Viewing All Alarm Limits

The Alarm Limits overview window lists the currently set alarm limits for all measurements. If an Apnea alarm delay time is set, this is also shown. The ALARMS OFF symbol is shown beside the measurement label of any measurement whose alarm switched off.

To open the Alarm Limits window, either select any alarm field to open the Alarm

Messages window, then select the Alarm Limits pop-up key, or select the Alarm Limits SmartKey, if configured.

ST-V4

Alarm Limits

ST-V5

ST-V6

SpO

Pulse (SpO2)

NBPs

ABPs

PAPd

awRR

Apnea Time

Off

sec

Alarm Limits 4Alarms

1 2 3

Measurement labels, with alarms off symbol where appropriate

Current alarm limits

Graphic view of current yellow and red alarm limits and currently monitored measurement value.

Off indicates the measurement is switched off

Select Show ST Limits to expand the list of ST leads and view the currently set alarm limits.

♦

Selecting Hide ST Limits hides the list again.

You can use the pop-up keys that open with the Alarm Limits window to perform common tasks:

– All Al. On/All Al. Off, – All Lim. Narrow/All Lim. Wide to set narrow or wide alarm AutoLimits for all

measurements.

– Print Limits/Record Limits to print a list of all current alarm limit settings on a

connected printer or recorder.

These pop-up keys are not available in the window for changing individual alarm limits which you access by selecting the measurement label in the Alarm Limits window.

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.

Alternatively, you can use the keys in the measurement Change Limits window, which you access by selecting the measurement label in the Alarm Limits window.

4Alarms Alarm Limits

Alarms On/Off

1 2 3 4 5 6 7 8 9 10

Parameter label

High red alarm (view only)

High yellow alarm field. Select to open a pop-up list of high alarm limits

Alarms On/Off key - select to toggle between alarms on or off

Preview Alarm AutoLimits for a measurement before applying

Select to apply wide AutoLimits

Select to apply narrow AutoLimits

Low yellow alarm field. Select to open a pop-up list of low alarm limits

Low red alarm (view only)

Graphic view of alarm limits with currently measured value

To change alarm limits,

1 Enter the Alarm Limits window.

2 To set the high alarm limit, select the high yellow alarm field to open a pop-up list of high alarm

limits. Select a limit from the list. Repeat to set the low yellow alarm field.

If you set the yellow alarm limit outside the red alarm limit, the monitor will automatically set the red alarm to the yellow alarm limit.

When an ST measurement is in the Change Limits window there are also two pop-up keys available labeled All ST Narrow/All ST Wide. With these keys you can set Auto Limits for all ST Leads.

Alarm Limits 4Alarms

About Automatic Alarm Limits (AutoLimits)

The monitor can automatically set alarm limits suited to your individual patient, using the Automatic Alarm Limits function. This tells the monitor to adapt the alarm limits of selected measurements to the measured vital signs within a defined safe limit. The monitor calculates safe AutoLimits for each patient based on the measured values from the last 12 seconds.

The wide and narrow limits have a fixed relationship to the measured value within the nonpathological range. Outside of this range, no auto limits are calculated. To set values outside of the non-pathological range, limits must be changed manually, based on the clinician’s judgement about the specific patient.

1 Wide alarm limits 2 Narrow alarm limits 3Alarm Limits 4 Measurement value

2 1

Limits Narrow sets limits close to the currently measured values for situations where it is critical for you to be informed about small changes in your patient’s vital signs.

Limits Wide sets limits further away from the currently measured values for situations where small changes are not so critical.

♦ Use the keys in the Change Limits window to apply AutoLimits for individual measurements.

These keys are not available if AutoLimits have been disabled for the measurement in the monitor’s Configuration Mode.

AutoLimits are not available for all measurements. The list of measurements for which AutoLimits can be used is defined in the monitor’s Configuration mode.

Use the Change Limits window to check AutoLimits before you apply them to ensure that they are appropriate for your individual patient and their clinical condition. Once applied, AutoLimits are shown on the monitor screen just like manually-set alarm limits. If the AutoLimits are not appropriate for your patient, you must set alarm limits manually. The limits remain unchanged until you set them again or change them manually.

Documenting Alarm Limits

The alarm limits pop-up keys appear with the Alarm Limits and Change Limits windows.

♦ Select the Print Limits pop-up key to print an overview of all alarm limits on a connected

printer.

4Alarms Reviewing Alarms

♦

Select the Record Limits pop-up key to send a recording of the alarm limits to a recorder.

Reviewing Alarms

You can see which alarms and INOPs are currently active in the respective alarms and INOPs fields at the top of the screen.

To see the currently active alarms and INOPs listed in one place, 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 Review Alarms window when you discharge a patient, or if you change to Demonstration Mode.

Alarm Messages Window

The Alarm Messages window shows all the currently active alarms and INOPs sorted by priority, 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. If alarm pause extension is disabled, the pause pop-up keys are inactive (“grayed-out”). Selecting the Review

Alarms pop-up key opens the Review Alarms window.

Alarm Messages

Resp LEADS OFF

LL LEAD OFF

Alarm Limits

If you do not immediately understand an INOP or alarm message, refer to its help text.

•In the Alarm Messages window, select the INOP message. This calls up a help window with an explanation of the INOP message and, where appropriate, a suggested solution for the problem.

• If the alarm or INOP was generated in a device other than the monitor (for instance, in an MMS or FMS), this source is specified at the end of the help text (Source: FMS).

Review Alarms

** awRR LOW

Pause Al. 5 Min.

Pause Al. 10 Min.

Review Alarms Window

Reviewing Alarms 4Alarms

The Review Alarms window contains a list of the most recent alarms and INOPs with date and time information.

Review Alarms

5 Apr 16:55:18 *** Apnea

5 Apr 16:55:18 ** ABPs HIGH (120 >95) 5 Apr 16:55:18 Alarms On 5 Apr 16:45:15 ** SpO 5 Apr 16:44:57 Alarms Off 5 Apr 16:44:46 ** awRR LOW (14<15) 5 Apr 16:44:39 ** SpO 5 Apr 16:44:28 ** ABPs HIGH (120>95)

NON-PULSAT.

LOW (95<99)

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 when the monitor was switched on (after being switched off for longer than 1 minute) and any changes made to the Alarms On/Off, Standby, Silence or ECG source.

No entries are made in the Review Alarms window of the MP5 while it is connected to a host monitor, except the time when the MP5 was connected to the host (Companion Entered), and when it was disconnected (Companion Left). Alarms can be reviewed on the host monitor.

When you select an item from the list, you can get additional information about that item. If you select a high or low limit alarm in the list, the Graphical Trends window will open to provide further data. If you select an alarm resulting from an event alarm notification, the Event Episode window for that event will open. If you select an alert other than a high or low alarm, a help text window opens with more information. This is the same as the help text window that opens in the Alarm Messages window. Some items in the list are simply log items not related to a patient alert as such (for example, Alarms On or Alarms Off). You cannot see any further information if you select one of these items. When you close these windows you will return to the Review Alarms window.

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

The Review Alarms window pop-up keys appear when the window is opened. If alarm pause extension is disabled, the pause pop-up keys are inactive. Selecting the Active Alarms pop-up key opens the Alarm Messages window.

Alarm Limits

Active Alarms

Pause Al. 5 Min.

Pause Al. 10 Min.

4Alarms Latching Alarms

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. The indication lasts until you acknowledge the alarm.

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 only 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. These choices can be combined to give the following settings:

Visual Latching

Audible latching

R = red alarms, Y = yellow alarms

Alarm Latching Behavior

Red and Yellow Measurement Alarms

Alarm has not been acknowledged.

Alarm has been acknowledged.

All INOPs are non-latching. See “Yellow Arrhythmia Alarms” on page 122 for information on one-star yellow alarms latching behavior.

Alarm condition still present.

Alarm condition no longer present.

Alarm condition still present.

Alarm condition no longer present.

R&Y R&Y R&Y RROff R&Y ROffROffOff

Non-latching alarms

Alarm tone on. Alarm lamp on. Alarm message. Flashing numerics.

All audible and visual alarm indicators automatically stop.

Alarm tone off. Alarm lamp off. Alarm message. Flashing numerics. Audible alarm reminder (if configured).

Audible and visual alarm indicators automatically stop.

Visual and audible latching

Alarm tone on. Alarm lamp on. Alarm message. Flashing numerics.

Visual latching, audible non-latching

Alarm message. Flashing numerics. Audible alarm indicators automatically stop.

Te s t i n g A l a r m s

When you switch the monitor on, a selftest is started. You must check that the alarms lamps light, one after the other, and that you hear a single tone. This indicates that the visible and audible alarm indicators are functioning correctly. For further testing of individual measurement alarms, perform the measurement on yourself (for example SpO that appropriate alarm behavior is observed.

or CO2) or use a simulator. Adjust alarm limits and check

Alarm Behavior at On/Off 4Alarms

Alarm Behavior at On/Off

When you switch alarms on, the settings defined in the currently active Profile 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 configured default Profile, or the most recently used alarm settings. After any of these situations, you should check that the alarm settings are appropriate for your patient, and if necessary, select the correct Profile and patient category.

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

Alarm Recordings

You can set up your monitor so that it automatically triggers alarm recordings at the Information Center, or if configured, to a printer as a realtime report.

1 Press the Main Setup SmartKey.

2 Select Alarms from the Main Setup menu.

3 Select Alarm Recording from the Alarms menu to open the Alarm Recordings menu.

4 Select a measurement from those listed for which you want to change the alarm condition that

triggers an alarm recording. This opens a pop-up list.

5 For the desired measurement(s), choose the alarm condition to trigger an alarm recording:

Red Only: an alarm recording will automatically be triggered when the measurement enters a red alarm condition.

Red&Yell: both yellow and red alarms will trigger an alarm recording. Off: disables automatic alarm recording.

Refer to the chapter “Recording” for details of how to set up a recording.

4Alarms Alarm Recordings

5Patient Alarms and INOPs

This chapter lists patient alarms and technical alarms (INOPs) alphabetically, irrespective of their priority. INOPs start on page 61. All alarms and INOPs are listed here; the ones which can appear on your monitor will depend on the model and the individual options.

For information on alarms and INOPs from the gas module refer to your Gas Module Instructions for Use.

Patient Alarm Messages

The measurement labels and abbreviations for pressure, temperature, SpO2, and anesthetic agent alarms are explained in the individual chapters.

Some alarms may be shown at the Information Center in shortened form, when transferred through IntelliVue Instrument Telemetry. These shortened alarm texts are included in the list and identified with the note “at Information Center”.

Note that yellow arrhythmia alarms may be shown with one or with two stars, depending on your monitor configuration and the Information Center revision you are using.

Refer to your IntelliBridge Device Driver Instructions for Use for patient alarms from connected external devices.

Refer to your Gas Module Instructions for Use for patient alarms and INOPs from the gas module.

Alarm Message From Condition Indication

*/**AFIB ECG/

Arrhythmia

***APNEA or ***APNEA mm:ss sec

***APNEA >10min

***ASYSTOLE ECG No QRS detected for a period greater

**awRR HIGH CO2, Resp,

**awRR LOW CO2, Resp,

, Resp,

Spirometry

AGM

Atrial fibrillation waveform detected yellow alarm lamp, short

yellow audible alarm.

Respiration has stopped for longer than the preset apnea time. “mm:ss” denotes the Apnea duration in minutes and seconds.

than the asystole threshold (in the absence of Vfib or chaotic ECG).

The airway respiration rate has exceeded the high alarm limit.

The airway respiration rate has dropped below the low alarm limit.

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.

5 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

**BIS HIGH BIS The Bispectral Index value has

exceeded the high alarm limit.

**BIS LOW BIS The Bispectral Index value has dropped

below the low alarm limit.

***BRADY/P xxx<yyy

or ***BRADY xxx<yyy

**CCO/CCI HIGH CCO Continuous Cardiac Output or CC

**CCO/CCI LOW CCO Continuous Cardiac Output or CC

**CPP HIGH CPP The CPP value has exceeded the high

**CPP LOW CPP The CPP value has fallen below the low

***DESAT or ***DESAT xxx<yyy

**etCO2 HIGH CO2, Resp,

**etCO2 LOW CO2, Resp,

**etO2 HIGH O2, AGM The end tidal O2 high alarm limit has

**etO2 LOW O2, AGM The end tidal O2 value has fallen below

*/**/*** EVENT:<GRP>

*/**/*** EVENT

at Information center

***EXTREME BRADY ECG The bradycardia limit has been

***EXTREME TACHY ECG The tachycardia limit has been

Press, SpO2The heart rate from the Pulse signal has

fallen below the bradycardia limit. xxx denotes the lowest measured value; yyy is the bradycardia limit.

Index is above the high alarm limit.

Index is below the low alarm limit.

alarm limit.

SpO

AGM

Event surveillance

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

The end tidal CO2 high alarm limit has been exceeded.

The end tidal CO2 value has fallen below the low alarm limit.

been exceeded.

the low alarm limit.

An event has occurred and the event notification is configured to alarm. <GRP> is the event group

An event has occurred and the event notification is configured to alarm. Check on the monitor for more details on event group.

exceeded.

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

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

numeric flashes and low alarm limit is highlighted, yellow 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.

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

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

event group name flashes, yellow or red alarm lamp and alarm tone

(on monitor) event group name flashes, yellow or red alarm lamp and alarm tone

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

Patient Alarm Messages 5 Patient Alarms and INOPs

Alarm Message From Condition Indication

**HR HIGH ECG The heart rate high alarm limit has

been exceeded.

**HR LOW ECG The heart rate has fallen below the low

alarm limit.

*/**IRREGULAR HR ECG/

Arrhythmia

*/**MISSED BEAT ECG/

Arrhythmia

*/**MULTIFORM PVCs ECG/

Arrhythmia

**NBP HIGH NBP The measured NBP value is above the

**NBP LOW NBP The measured NBP value is below the

*/**NON-SUSTAIN VT ECG/

Arrhythmia

*/**PACER NOT CAPT ECG/

Arrhythmia (paced patients only)

*/**PACER NT PACING ECG/

Arrhythmia (paced patients only)

*/**PAIR PVCs ECG/

Arrhythmia

*/**PAUSE ECG/

Arrhythmia

Consistently irregular heart rhythm. numeric flashes, yellow alarm

No beat detected for 1.75*R-R interval, or if HR>120bpm no beat detected for one second (non-paced patients only).

Two differently shaped Vs detected, each occurring at least twice within the last 300 beats and at least once within the last 60 beats.

high alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

low alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

A run of Vs having a ventricular HR>V-Tach HR limit, but lasting for less than the V-Tach Run limit has been detected.

A missed beat with a pace pulse was detected.

A missed beat without a pace pulse was detected.

A non-ventricular contraction, followed by two ventricular contractions, followed by a non-ventricular contraction has been detected.

No beat detected for a period greater than the pause threshold.

numeric flashes and high limit is highlighted, yellow alarm lamp, alarm tone. If configured to short yellow, the sound switches off after 5 seconds if Arrhythmia is On.

numeric flashes and low limit is highlighted, yellow alarm lamp, alarm tone. If configured to short yellow, the sound switches off after 5 seconds if Arrhythmia is On.

lamp, short yellow audible alarm.

numeric flashes, yellow alarm lamp, short yellow audible alarm.

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, yellow alarm lamp, short yellow audible alarm.

5 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

***<Pressure> DISCONNECT

***<Pressure> HIGH PRESS The measured pressure value is above

**<Pressure> HIGH PRESS The measured pressure value is above

***<Pressure> LOW PRESS The measured pressure value is below

**<Pressure> LOW PRESS The measured pressure value is below

**Pulse HIGH PRESS

**Pulse LOW PRESS

*/**PVCs/min HIGH ECG/

**QTc HIGH ECG/QT QTc value has exceeded the QTc high

**QTc HIGH ECG/QT QTc value has exceeded the QTc

*/**R-ON-T PVCs ECG/

**RR HIGH RESP The respiration rate has exceeded the

PRESS The pressure is non-pulsatile and the

mean pressure is continuously less than 10mmHg (1.3kPa). This alarm occurs only with arterial pressures (P, ABP, ART, Ao, BAP, FAP, PAP, UAP, P1, P2, P3, P4).

the extreme high alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

the high alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

the extreme low alarm limit. s, d, or m after the label indicates whether the systolic, diastolic or mean pressure has crossed the limit.

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

SpO

alarm limit.

The pulse rate has dropped below the

SpO

low alarm limit.

More premature ventricular

Arrhythmia

contractions have been detected in a minute than the limit.

limit for more than 5 minutes

high limit for more than 5 minutes

For HR <100, a PVC with R-R interval

Arrhythmia

< 1/3 the average interval followed by a compensatory pause of 1.25 x average R-R interval or two such Vs without compensatory pause occurring within 5 minutes of each other. (When HR >100, 1/3 R-R interval is too short for detection.).

high alarm limit.

numeric flashes, red alarm lamp, alarm tone.

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

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

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

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

numeric flashes, yellow alarm lamp, alarm tone.

numeric flashes, yellow alarm lamp, short yellow audible alarm.

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

Patient Alarm Messages 5 Patient Alarms and INOPs

Alarm Message From Condition Indication

**RR LOW RESP The respiration rate has dropped below

the low alarm limit.

*/**RUN PVCs HIGH ECG/

Arrhythmia

A run of PVCs greater than 2 was detected.

**<SO2 label> HIGH SvO2/SO2The the measured intravascular oxygen

saturation has exceeded the high limit.

**<SO2 label> LOW SvO2/SO2The measured intravascular oxygen

saturation has fallen below the low limit.

**<SpO2 label> HIGH SpO

The arterial oxygen saturation has exceeded the high alarm limit.

**<SpO2 label> LOW SpO

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

**ST<n> HIGH ECG/ST The ST elevation in lead <n> is higher

than the limit.

**ST<n> LOW ECG/ST The ST depression in lead <n> is lower

than the limit.

**ST MULTI <n>,<n> ECG/ST The ST depression or elevation is

outside of the limit in two or more leads <n> and <n>

**ST MULTI

at Information Center

ECG/ST The ST depression or elevation is

outside of the limit in two or more leads. Check on the monitor for more details about which leads are affected.

*/**SVT ECG/

Arrhythmia

A run of supraventricular beats greater than the SVT run limit has been detected and the HR has exceeded the SVT HR limit.

***TACHY/P xxx>yyy or ***TACHY xxx>yyy

Press, SpO2The heart rate from the Pulse signal has

exceeded the tachycardia limit. xxx denotes the highest measured value; yyy is the tachycardia limit.

**Tblood HIGH C.O. The blood temperature value has

exceeded the high alarm limit.

**Tblood LOW C.O. The blood temperature value has fallen

below the low alarm limit.

**tcpO2 HIGH/ **tcpCO2 HIGH

**tcpO2 LOW/ **tcpCO

LOW

tcGas The tcpO2 or tcpCO2 value has

exceeded the high alarm limit.

tcGas The tcpO

or tcpCO2 value has fallen