Philips V26CT, M1165, M1166, M1167, M1175 User's Reference Manual

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Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and Philips M1205A V24 and V26 Patient Monitor

User’s Reference Manual Volume 1 System Information

PHI

Part Number M1046-9220L Printed 02/2003

Notice

This document contains proprietary information which is protected by copyright. All Rights Reserved. Reproduction, adaptation, or translation without prior written permission is prohibited, except as allowed under the copyright laws.

Philips Medical Systems Cardiac and Monitoring Systems 3000 Minuteman Road Andover, MA 01810

Publication number M1046-9220L

Warranty

The information contained in this document is subject to change without notice.

Philips Medical Systems makes no warranty of any kind with regard to this material, including, but not limited to, the implied warranties or merchantability and fitness for a particular purpose.

Philips Medical Systems shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing, performance, or use of this material.

Important

United States federal law restricts these devices to sale by or on the order of a physician.

The M1165/66/75/76A Systems comply with UL544, CSA 22.2-125, IEC 601-1, EN 60601-1, and EN 60601-1-2 and carries Marking to Council Directive 93/42/EEC, European Medical

0366

Device Directive (MDD).

The M1167/77A Systems comply with UL2601-1, CSA 22.2 No. 601.1-M90, IEC 601-1, EN 60601-1, and EN 60601-1-2 and carries Marking to Council Directive 93/42/EEC,

0366

European Medical Device Directive (MDD).

The M1205A Systems comply with UL2601, IEC 601-1, CSA C22.2 no. 601-1, EN60601-1, and EN60601-1-2 and carries Marking to Council Directive 93/42/EEC, European Medical

0123

Device Directive (MDD).

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Electromagnetic Interference

Anomalies due to electromagnetic interference are not unique to the M1165/66/67/75/76/77A or the M1205A but are characteristic of patient monitors in use today. This performance is due to the very sensitive high gain front end amplifiers used to display the physiological signals. Among the many similarly performing patient monitors already in use by customers, interference from electromagnetic sources is rarely a problem in actual use.

Avoiding Electromagnetic Interference

When electromagnetic interference (EMI) is encountered there are a number of actions that can be taken to mitigate the problem.

• Eliminate the source. Possible sources of EMI can be turned off or moved away to reduce their strength.

• Attenuate the coupling. If the coupling path is through the patient leads, the interference may be reduced by moving and/or rearranging the leads. If the coupling is through the power cord, plugging the patient monitor into a different circuit may help.

• Reduce the sensitivity of the system. In all of the EMC testing the patient monitor was adjusted to maximum sensitivity. For the ECG amplifier the gain was four times what is normally required. By reducing the gain of the system receiving the EMI, the interference can often be eliminated.

• Add external attenuators. If EMI becomes an unusually difficult problem external devices such as an isolation transformer or a transient suppressor may be of help. A Philips Customer Engineer can be of help in determining the need for external devices.

Electromagnetic Compatibility (M1205A Only)

The electromagnetic compatibility (EMC) validation of the M1205A included testing performed according to international standards for EMC with medical devices. See the Manufacturer's Declaration for details.

EMC Testing. During the test program the M1205A was subjected to many EMC tests, both international standard and Philips proprietary tests. There were no anomalies observed during this testing.

Intended Use

Description

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are network connectable bedside patient monitoring devices.

The Philips M1205A Models V24CT and V26CT may powered by either AC line power or by battery power.

Purpose

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors measure and display multiple physiological parameters and waves, and generate alarms and recordings. They exchange information with compatible devices. The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are not therapeutic devices.

Environment

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are intended to be used in a clinical environment by trained healthcare professionals. They are not intended for home use.

They communicate with devices such as a central station through network interface ports and a serial I/O port.

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are prescription devices and will carry the following label, “United States Federal law restricts this device to sale by or on the order of a physician.”

Indications for Use

Condition

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are generally indicated when the clinician decides there is a need to measure and display multiple physiological parameters and waves, to generate alarms and recordings of adult, pediatric, or neonatal patients.

Part of Body or Type of Tissue with Which the Device Interacts

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors do not contact the body or tissue of the patient. Signals are obtained from accessory electrode, transducer, and sensor devices.

Frequency of Use

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are indicated for use when prescribed by a clinician.

Physiological Purpose

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are indicated when the purpose is to gain information for treatment, to assess adequacy of treatment, or to rule out causes of symptoms. The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are well suited for patient monitoring.

Patient Population

Adult, pediatric, and neonatal non-ambulatory patients.

Indications for Use

Prescription Versus Over-the-Counter

The Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors are prescription devices.

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Indications for Use

Warnings, Cautions, and Notes

Warnings, cautions, and notes are used throughout this User's Manual to give you additional information about the Philips M1165/66/67/75/76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors. The warnings and cautions included in this safety section refer to the equipment in general.

WarningWarning

A “warning” calls attention to the user of imminent hazard to people if proper procedures are not followed.

• For continued safe use of this equipment, it is necessary that the listed instructions are followed. Instructions in this manual in no way supersede established medical procedures.

• Explosion Hazard- Do not use this equipment in the presence of flammable anesthetics.

• Alarms - 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 jeopardy. Remember that the most reliable method of patient monitoring combines close personal surveillance with correct operation of monitoring equipment.

• This equipment is only intended for use in healthcare facilities by trained healthcare professionals.

• The product is not intended for outside hospital use such as a helicopters or ambulances.

• This product is not intended for home use.

• To reduce the risk of electrical shock, do NOT remove any cover. Refer servicing to qualified personnel.

• This equipment may interfere with ultrasound imaging equipment by causing interference on the ultrasound display. Try to keep the instruments as far apart as possible.

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Indications for Use

• Exposure of electrical contacts or connections to saline or other liquids and gels is dangerous. Electrical contacts and connections such as cable connectors, power supplies, parameter module plug-in connections and rack connections must be kept clean and dry. Thoroughly dry any electrical connections that become contaminated with liquids. If additional decontamination is required please contact your biomedical department or Philips Medical Systems Response Center.

• Although this equipment is shielded against Electromagnetic Interference (EMI), it is recommended to avoid the use of electrically radiating devices in close proximity to this equipment.

• Connecting the Philips monitoring network (SDN) cable when the product is powered on is not supported. Error codes and Philips monitoring network (SDN) interface lock-up may occur. Power cycling the product will recover the product. No permanent damage will result. To prevent unintentional disruption in monitoring, be sure the SDN interface cable is properly secured at both ends when connecting to the Philips monitoring network (SDN).

• Do not connect a second rack by a cable when using a module rack docked to the back of the V24CT or V26CT. Using a second rack connected by a cable may disrupt module communication.

Caution

A “caution” calls attention to a condition or possible situation that could cause injury to the user.

• Ventilation Requirements - Failure to meet ventilation requirements may cause equipment failure and, in turn, jeopardize the functions of automated monitoring. Do not locate equipment in an enclosed area which could restrict heat dissipation.

• Maintenance - Failure on the part of the responsible individual, hospital, or institution employing the use of this equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards.

• Do not spray cleaning solutions directly onto the patient monitor. Moisture droplets may enter the internal components and cause equipment malfunction or failure. Cleaning solutions should be applied to a cloth and the cloth used to wipe the monitor clean. The monitor should be turned off during cleaning.

Indications for Use

• Replacement Parts - It is highly recommended that only Philips Medical Systems recommended parts and accessories be used with this equipment. Failure to do so may result in the degradation of performance. Accessories and parts for individual modules and components are listed at the back of the appropriate section in this manual.

Note—A note gives special instructions to highlight an operating procedure or practice. Notes

may precede or follow the applicable text.

At this time, Philips Medical Systems will make available on request, and in English only, such circuit diagrams, component part lists, descriptions, calibration instructions, or other information which will assist the user's appropriate qualified technical personnel to repair those parts of the equipment which are classified by Philips Medical Systems to be repairable. A list of Philips Sales and Support Offices is provided at the end of this manual.

Notice to the User

Although there may be products in your area that look similar to the Philips M1165/66/67/75/ 76/77A CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors, their functionality may not be the same. This User's Reference Manual is intended to be used with the Philips M1165/66/67/75/76/77A CMS Patient Monitoring System, the M1026A Anesthetic Gas Module and the Philips M1205A V24 and V26 Patient Monitors only.

This Manual is only applicable for Release C.1 versions of the CMS monitors and for Release D.0 of the V24 and V26 monitors. A Release C.1 or Release D.0 monitor can be identified by:

a. the Release C.1 or D.0 label on the monitor, or

b. the suffix of the EPROM pack part number. To view this number, press

Monitor Setup

→ → .

Monitor Revision

Show SW Rev

The suffix of the EPROM pack part number on a Release C.1 CMS is E. The Software Revision of a Release D.0 V24 or V26 monitor is M.00.03

Responsibility of the Manufacturer

Philips Medical Systems only considers itself responsible for any effects on safety, reliability and performance of the equipment if:

assembly operations, extensions, re-adjustments, modifications or repairs are carried out by persons authorized by Philips, and

the electrical installation of the relevant room complies with national standards, and

the instrument is used in accordance with the instructions for use.

To ensure optimum usage, we recommend that Philips parts and accessories are used in conjunction with the Philips M1165/66/67/75/76/77A CMS Patient Monitoring System, the Philips M1026A Anesthetic Gas Module and the Philips M1205A V24 and V26 Patient Monitors, wherever available. If non-Philips parts are used, Philips Medical Systems is not liable for any damage that these parts may cause to the Philips equipment.

Manufacturer´s Address

For South America, North America and Canada:

Philips Medical Systems, Inc. 3000 Minuteman Road Andover MA 01810-1099

For all other countries:

Philips Medical Systems GmbH Hewlett-Packard Str. 2 71034 Böblingen Germany

Responsibility of the Manufacturer

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Contents

This book is divided into th ree volumes. This volume contains chapters 1 to 13 (see the following table of contents for more details):

1. The CMS and V24 and V26 Patient Monitors

2. Getting Started

3. Setting up your Monitor

4. Other Patients

5. Alarm Functions

6. Recording Functions

7. Admit/Discharge/End Case

8. Trends and Calculations

9. Neonat al Event Review

10. Data Transfer

11. Monitor Installation and Patient Safety

12. Battery Information (V24CT and V26CT only)

13. Maintenance

Volume 2 contai ns ch apters 12 to 22 (see the table of contents of Volume 2 for more details):

14. ECG and ECG/R espiration Mo dule Section

15. Noninvasive Blood Pressure Module S ection

16. SpO2/PLET H Module Section

17. Temperature Module Section

18. CO2 Module and Sidest ream Module Section

19. FIO2 Module Section (CMS only)

20. Pressure Module Section

21. Cardiac Output Module Section

22. VueLink Module Section

Volume 3 contains chapters 23 to 29 and appendices A to E (see the table of contents of Volume 3 for more details):

23. SvO2 Module Section (CMS only))

24. tcpO2/tcpCO2 Module Section

25. Ventilator Interfaces and Respiratory Loops (CMS only)

26. Anesthetic Gas Module Section (Option #A05, #C03)

27. Blood Analysis

28. EEG Module Section (CMS only)

29. BIS“ Module Section A. Summary of Formulas Used in Calculations B. Analog Ou tput Se ction (CMS Only) C. Calibrating the Pressure System D. SpO2 Tr ansducer Information

E. Main Sales and Support Offic es

Contents-1

Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-v

Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-v

Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-v

Environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-v

Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-vi

Condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-vi

Part of Body or Type of Tissue with Which the Device Interacts. . . . . . . . . . . . . . . . . . . . 1-vi

Frequency of Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-vi

Physiological Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-vi

Patient Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-vi

Prescription Versus Over-the-Counter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-vii

Responsibility of the Manufacturer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-xi

Manufacturer´s Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-xi

The CMS and V24 and V26 Patient Monitors 1-1

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2

CMS Patient Monitoring System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

V24 and V26 Patient Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8

The Handheld Keypad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10

External Alarm Device. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-11

Hardkey Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-12

V26CT/V24CT Power Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14

Battery Power Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-14

Parameter Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-16

Symbols to Indicate Key Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-17

Operating Levels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-20

Main Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-21

Selection Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-23

Task Window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 -24

Getting into the Operating Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-25

Touch or Mouse/Trackball Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-27

Main Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-28

Control Panel Task Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-28

General Touch/Mouse/Trackball Operation (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . .1-29

Disabling Touch/Mouse/Trackball Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-32

The CMS Computer Modules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-33

M1046A Computer Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-33

M1046B Computer Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-34

Contents-2

ECG Output and Defibrillator Marker Input . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-34

The V24 and V26 Parameter Module Rack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-35

Operating Rules to Remember. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-36

Performance Specifications of the Philips Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-37

M1095A Flatscreen Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-37

M1094A/B and M1092A CRT Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-37

M1097A #A02 XGA Flatscreen Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-37

Using an ITE Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-38

Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3 8

EMC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-39

Performance Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-39

Getting Started 2-1

Setting up the Monitor (V24 and V26 only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2

Setting up the Parameter Modules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-5

Attaching the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-6

Adjusting Screen Contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-7

Starting Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-8

Screen Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-8

Reserving a Channel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-9

Power Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-10

Patient Information Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-10

Monitor Standby. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-10

Setting up your Monitor 3-1

Changing Display Screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-2

Selecting a Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-3

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-3

Freezing Waves (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-4

What you Can Configure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-5

Changes to the Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-6

Making Changes to the Main Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-7

Assigning Waves to Screen Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-8

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-9

Selecting a Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-10

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-10

Selecting Screen Labels for Realtime Display Screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-11

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-11

Contents-3

Selecting the Number of Waves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-13

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-13

Changing the Wave Overlap. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-14

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-14

Selecting Realtime Wave Speeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-15

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-15

Numerics On/Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-17

Additional Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-19

Selecting an Application Window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-20

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-20

Displaying Split Screen Trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-22

oxyCRG Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-25

Notes on oxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-26

CSA Display (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-28

Notes on CSA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29

Wave Replace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-30

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-30

Trace Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-31

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-31

Configuring a Second Independent Display (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-32

Other Functions You Can Configure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-33

Adjusting the Volume Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-35

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-35

Adjusting the Date and Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-37

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-37

Selecting Waves for Central Recorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-39

Configuring Module, Bedside and Central Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-40

Other Patients Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-41

The Status Log Function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-42

The Monitor Revision Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-43

Changing Default Settings and Patient Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-44

Changing the Patient Category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-45

NBP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-47

NBP Examples. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-47

ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-49

Heart Rate (HR) / Pulse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-51

RESP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-51

Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-51

SpO2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-51

Contents-4

Changing the Configuration Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-53

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-54

Changing Operating Modes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-55

Returning to Monitoring Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-56

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-57

The Test Signals Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-58

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-59

Analog Output (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-59

Parameter Settings Transfer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-61

Parameter Settings Transfer Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-63

Other Patients 4-1

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-2

Philips Patient Care System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-3

The Other Patients Selection Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-3

Automatic Alarm Other Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-4

Configuring the Other Patients Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-7

Using Philips Patient Care System with an Arrhythmia Computer. . . . . . . . . . . . . . . . . . . . . . . .4-8

Extended Overview (CMS only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-15

To View an Extended Other Patients Bed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-16

Alert Notification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-17

Alarm Functions 5-1

Alarm Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2

Alarm Functions on the Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-2

Suspending Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-3

Silencing and Resetting Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-4

Alarm Priorities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-8

Individual Parameter Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-10

When an Alarm Occurs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-11

Alarm Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-12

Getting into the Alarms Selection Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-12

Changing the Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-13

Setting the Volume Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-14

The Nurse Call Relay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5-15

Recording Functions 6-1

General Recorder Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-2

Contents-5

Recorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-2

Controls and Indicators on the Plug-In Recorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Controls and Indicators on the 4-Channel Recorder (CMS only) . . . . . . . . . . . . . . . . . . . . . 6-4

Recorder Capabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-5

Types of Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7

Delayed Recording . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-8

Configuring Delayed Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-9

Making Delayed Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-11

Alarm Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-12

Configuring Alarm Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-13

Alarm Recording Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-14

Procedure Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-16

Configuring Procedure Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-16

Making Procedure Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-17

ST Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-18

Realtime Wave Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-20

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-20

Configuring Preset Recording Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-21

Making Preset Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 -22

Making Non-Preset Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-22

Making Calibrated ECG Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-23

If the Recorder is Busy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-23

Realtime Vital Signs / Blood Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 -25

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-25

Making a Single Vital Signs/Blood Recording . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-27

Making Timed Sequences of Vital Signs/Blood Recordings. . . . . . . . . . . . . . . . . . . . . . . . 6-27

Trended Vital Signs Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-29

Header Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-29

Trend Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-30

Making Trended Vital Signs Recordings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-32

Neonatal Event Review Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-33

Tabular Neonatal Event Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-33

oxyCRG Episode Recordings for Neonatal Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-34

oxyCRG Recordings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-36

oxyCRG Alarm Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-38

Additional Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-39

Annotations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-39

Changing the Recording Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-42

Contents-6

Changing the Recorder Speed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43

Changing the Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43

Continuing a Timed Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-43

Inserting a Calibration Signal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-44

Recording Layouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-44

Recording Status Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-46

Accessories and Ordering Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-48

Loading Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-49

Central Recorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-49

Loading Paper into the Plug-In Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-49

To Replace Paper in the Plug-In Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-50

Cleaning the Print head in the Plug-In Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6-52

Loading Paper into the Four Channel (M1117A) Recorder (CMS only). . . . . . . . . . . . . . .6-53

Cleaning the Roller on the Four Channel (M1117A) Recorder . . . . . . . . . . . . . . . . . . . . . .6-55

Admit/Discharge/End Case 7-1

Admitting a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-2

Changing Patient Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-5

Discharging a Patient/Ending a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-9

Trends and Calculations 8-1

Introduction to Trends & Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2

Viewing Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-3

Trending Priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-5

Viewing Blood Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-5

Viewing Vital Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-9

Selecting Parameters for Graph Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-12

Viewing Graph Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-13

Performing and Reviewing Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-20

Performing Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-21

Changing or Entering an Input Value. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-25

Reviewing Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-25

Printing Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-26

Printing Task Window Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-26

Printing Scheduled Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-26

What to Do If Your Report Does Not Print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-30

Drug Calculator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-32

Contents-7

Neonatal Event Review 9-1

Introduction to Neonatal Event Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2

Viewing Neonatal Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

Manual Event Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4

Graphical Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-5

Operating Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-12

Viewing oxyCRG Episodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-14

Operating Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-16

Adjusting Neonatal Event Review Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-18

Event Criteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-19

Operating Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-21

Data Transfer 10-1

Data Transfer Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-2

Symbols to Indicate Key Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-5

What is Transferred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-5

Types of Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-7

To Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-7

To Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-10

Transferring Blood Analysis Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-11

Combining Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-14

Time Conversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-14

Database Conversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-14

Vital Signs, Blood Review and Graphs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-17

Time Stamp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-17

Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-18

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-19

Performance Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-20

Data Transfer Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10-20

Monitor Installation and Patient Safety 11-1

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-2

Installation Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Power Source Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5

Grounding the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-5

Combining Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-8

Environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9

Condensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-11

Contents-8

Explanation of Symbols used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-12

Maintenance Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-14

Patient Cables and Leads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-16

Controls and Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-17

The Front Panel of the M1046A Computer Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-17

The Front Panel of the M1046B Computer Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-19

The Rear Panel of the M1046A/B Computer Modules . . . . . . . . . . . . . . . . . . . . . . . . . . .11-21

The Rear Panel of the Display Modules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-23

The Rear Panel of the M1109A External Alarm Device . . . . . . . . . . . . . . . . . . . . . . . . . .11-29

The Rear Panel of the M1026A Anesthetic Gas Module . . . . . . . . . . . . . . . . . . . . . . . . . .11-30

Assembling the System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-31

The V24 and V26 Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-34

Assembling the V24 and V26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-36

Accessories and Ordering Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11-37

Battery Information (V24CT and V26CT only) 12-1

AC and DC (Battery) Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-2

Operating Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-3

Battery Indicator and Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-6

External Battery Charger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-8

Battery Care and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-9

Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-9

Care and Handling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-10

Accessories and Ordering Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12-11

Maintenance 13-1

General cleaning of the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-2

General Disinfecting of the System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-4

Monitor Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-6

Inspect the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-8

Perform a Start-up Sequence Test of the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-9

Verify the Integrity of the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-9

Perform a System Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-10

Performance Assurance Checks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-11

Performance Assurance Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-11

Functional Testing Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-13

Performing the ECG Module and ECG/RESP Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . .13-15

Performing the Invasive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-16

Contents-9

Pressure Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-16

Performing the NBP Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-17

Performing the SpO2/Pleth Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-17

Performing the Cardiac Output Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-17

Performing the tcpO2/tcpCO2 Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-18

Performing the CO2 Module Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-19

Performing the Temperature Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-19

Performing the Blood Analysis Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-20

Performing the Recorder Module Self-Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-20

Performing the Data Management Database Self-Test . . . . . . . . . . . . . . . . . . . . . . . . . . .13-20

Tests for VueLink Module and Anesthetic Gas Module . . . . . . . . . . . . . . . . . . . . . . . . . .13-21

Contents-10

The CMS and V24 and V26 Patient

Monitors

This chapter provides an overview of the CMS Patient Monitoring Systems and V24 and V26 Patient Monitor includes the following sections:

• Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

• Parameter Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-16

• V26CT/V24CT Power Supply . . . . . . . . . . . . . . . . . . . . . . . 1-14

• Operating Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-20

• Touch or Mouse/Trackball Operation. . . . . . . . . . . . . . . . 1-27

• The CMS Computer Modules . . . . . . . . . . . . . . . . . . . . . . . 1-33

• The V24 and V26 Parameter Module Rack. . . . . . . . . . . . 1-35

• Operating Rules to Remember. . . . . . . . . . . . . . . . . . . . . . 1-36

s. It

The CMS and V24 and V26 Patient Monitors 1-1

The CMS and V24 and

Introduction

V26 Patient Monitors

The Philips M1165/66/67/75/76/77 CMS Patient Monitoring System and the Philips M1205A V24 and V26 Patient Monitors, hereafter referred to as the “patient monitor”, are modular patient monitors with networking and data management capabilities. All the systems can have modules added or removed at a later time as needed, or you can interchange the modules between systems in your unit.

Note—Some features explained in this manual are not available for both

the CMS and for the V24 and V26 Monitors. The respective sections are marked throughout the manual with either “CMS only” or “V24 and V26 only”.

The following system types are available:

CMS Patient Monitoring System

The CMS Patient Monitoring System is available as a choice of three system types. Each system consists of three individual parts; a display module, a computer module and parameter modules:

1. M1167/77A Color Flatscreen Display and Computer Module with Satellite Module Rack

Note—This system is also available with an External Alarm Device and

an XGA compatible display controller to drive commercially available ITE (Information Technology Equipment) displays (XGA Type).

2. M1165/75A Monochrome CRT Display and Computer Module with Integral Module Rack

3. M1166/76A color CRT Display and Computer Module with Integral Module Rack

1-2 The CMS and V24 and V26 Patient Monitors

M1167/77A System

Display Module M1095A 10.4” Flatscreen Display

Introduction

The CMS and V24 and

V26 Patient Monitors

Computer Module M1046B Computer Module

Parameter Modules Satellite Rack

The CMS and V24 and V26 Patient Monitors 1-3

The CMS and V24 and

Introduction

M1167/77A System with External Alarm Device

V26 Patient Monitors

XGA Display

External Alarm Device

Computer Module

Parameter Modules

Display Module ITE Display of choicea

Computer Module M1046B Computer Module

Parameter Modules Satellite Rack

a. Philips offers the M1167/77A #H05 and #H07 (XGA Touchscreen

display configuration).

b. A 15” flat touchscreen display is also available separately under the

order number M1097A # A02. A 17” C RT touchscreen displa y is als o available separately under the order number M1098A

1-4 The CMS and V24 and V26 Patient Monitors

M1165/75A and M1166/76A System

Display Module M1094A/B/92A 14” CRT Display

Introduction

The CMS and V24 and

V26 Patient Monitors

Computer Module M1046A Computer Module

Parameter Modules Integral and/or Satellite Rack

Model Types All system types are also available as a choice of three different model

types:

Full Title Abbreviation

The Philips CMS Patient Monitoring System CMS

The Philips CMS Patient Monitoring System for

ACMS

Anesthesia Care

The Philips CMS Patient Monitoring System for

NCMS

Neonatal Care

Note—In this manual, the system will be referred to as the CMS, the ACMS

and the NCMS.

The CMS and V24 and V26 Patient Monitors 1-5

Introduction

The CMS and V24 and

Display

Modules

Below are labeled diagrams of the display modules provided by Philips Medical Systems. The control panel is described in more detail in the following sections

V26 Patient Monitors

M1095A Flatscreen Display Module

1-6 The CMS and V24 and V26 Patient Monitors

M1092A / M1094B CRT Display Module

Introduction

V24 and V26 Patient Monitor

Each V24 and V26 Patient Monitor consists of two individual parts.

1. One of two types of Display Modules, depending on the particular model monitor you have purchased—either:

a. A monochrome display with control panel supporting the V24,

b. A color flat panel display with control panel supporting the

V24C, the V24CT, the V26C and the V26CT.

2. The Rack with Parameter Modules

The CMS and V24 and

V26 Patient Monitors

The V24, V24C and V26C are powered by connection to an AC power supply. The V24CT and V26CT can be powered by rechargeable batteries or by connection to an AC power supply. See “V26CT/V24CT Power Supply” on page 1-14.

The CMS and V24 and V26 Patient Monitors 1-7

Introduction

The CMS and V24 and

Control Panel

V26 Patient Monitors

The control panel consists of softkeys, hardkeys and alarm lamps.

Softkeys The softkeys perform multiple functions. Their functions correspond to

the labels displayed at the bottom of the screen. When no softkey labels are on the screen, the softkeys do not function.

Hardkeys The hardkeys have only one function defined by the label on the key.

The hardkeys are labeled in blue. Each one of these keys gets you into a level where adjustments and changes can be made or performs an immediate action. The keys are labeled according to their function, for example, key allows you to start a recording of a

Realtime Record

waveform.

Note—If you are using the M1167/77A system with the External Alarm

Device, the handheld keypad can be used to operate the system and to enter data. It contains all the hardkeys and softkeys available on the control panel of the other systems.

1-8 The CMS and V24 and V26 Patient Monitors

Introduction

Alarm Lamps The alarm lamps are lit when a red or yellow alarm condition exists.

CMS Control Panel

Alarm Lamps

The CMS and V24 and

V26 Patient Monitors

Silence/

Reset Suspend

Alarms Suspended Lamp

Note—Earlier versions of the V24 feature a key instead of the

Trends/Calcs

Main Screen

Other Patients

Monitor Setup

Realtime Record

Procedures

Delayed Record

Trends/

Calcs

Module Alarms Setup

V24 and V26 Patient Monitor Control Panel

Trends

key.

Confirm

The CMS and V24 and V26 Patient Monitors 1-9

Introduction

The CMS and V24 and

The Handheld Keypad

V26 Patient Monitors

(CMS only):

The handheld keypad consists of the same softkeys and hardkeys that are available on the control panel. In addition, the keypad provides data entry keys which enable you to enter letters, numbers, punctuation marks, and arithmetic symbols.

Note—The handheld keypad is the main means of operating the

M1167/77A System with External Alarm Device. Do not remove the keypad from systems with touch or mouse/trackball operation as it is still required to perform certain tasks.

Softkeys and

Hardkeys

The softkeys and hardkeys on the keypad are in the same relative position and operate in the same manner as the keys on the control panel.

Data Entry

The data entry keys are located on the bottom half of the keypad.

Keys

1-10 The CMS and V24 and V26 Patient Monitors

Introduction

• To enter numbers and arithmetic symbols (labeled in white), simply press the keys you want.

• To enter letters and punctuation marks (labeled in blue), press the

key. The lamp in the key lights up and remains on

Shif

until is pressed again. The softkeys and hardkeys work as

Shif

normal.

The CMS and V24 and

V26 Patient Monitors

External Alarm Device

(CMS only):

Since the External Alarm Device is used only with commercially available ITE displays that do not have a control panel, it contains all the alarm lamps, the Alarms Suspended Lamp and the loudspeaker. It does not contain any hardkeys or softkeys and therefore can only be used in conjunction with the Handheld Keypad. The Handheld Keypad can be mounted onto the External Alarm Device as illustrated below.

The CMS and V24 and V26 Patient Monitors 1-11

Introduction

The CMS and V24 and

Hardkey Functions

V26 Patient Monitors

Silence/Reset

- press to silence an alarm or alarms that are sounding

or, if alarms are latching, to reset them.

Suspend

- press to suspend or switch on all alarms. The current state

is indicated by the Alarm Suspend Lamp.

Main Screen

Change Screen

- press to return to the main monitoring screen.

- (CMS only) press to change between screen layouts or to access a 2nd or 3rd display. You can also freeze any wave movement on the screen (INOPs, alarms and numerics are not affected).

Realtime Record

- press to record pre-selected waves onto a system

recorder or a bedside recorder.

Delayed Record

- press to record pre-selected waveforms that are no

longer on the monitor screen.

Alarms

- press to enable you to suspend or switch on alarms, set and

review alarm limits, enter Monitor Standby, or set the alarm volume.

Other Patients

- press to enable you to view data from other beds in

your group.

Monitor Setup

- press to enable you to pre-select certain system

characteristics.

Procedures

- press to enable you to set up and perform procedures such as Cardiac Output, Wedge Pressure (CMS only), ST analysis, Drug Calculations, admit and discharge patients, or end a particular patient case and transfer patient data.

Trends/Calcs

- press to enable you to view vital signs and graphical trends, make and review calculations, print reports and mark events to view in graphs.

Module Setup

- press to enable you to change or adjust parameter settings, switch parameters on or off, or set up parameters.

Arrow

1-12 The CMS and V24 and V26 Patient Monitors

Keys

Introduction

The arrow keys consist of up/down/left/right keys. They only function when illuminated. The arrow keys allow you to move between areas on operating screens to enable you to change or adjust settings, perform procedures, or make changes to the screen display.

The CMS and V24 and

V26 Patient Monitors

Confirm

Key This key functions only when it is illuminated. A prompt message “...press CONFIRM...” appears on the screen when you need to use it.

Airway Gases/Ventilation

- (CMS only) Press to view airway gases or

ventilator waves and numerics.

The CMS and V24 and V26 Patient Monitors 1-13

The CMS and V24 and

V26CT/V24CT Power Supply

V26 Patient Monitors

The V24CT and V26CT are powered by an external AC (line power) or by their own internal battery power supply. Your monitoring needs will determine which power source is used. We recommend that you plug the monitor into line or AC power whenever the monitor is not being moved or used, or for long term bedside monitoring. When transporting a patient or when monitoring in a remote area, where AC power is not feasible, use battery power.

WarningWarning

Do not disconnect the power cord from the monitor and leave it connected to the AC power source. This could cause damage to the power cord. Instead, keep the power cord connected to the monitor and unplug it from the AC power source.

Battery Power Supply

The power cord must be inspected periodically for cracks or exposed metal parts. Replace immediately if there are any cracks, exposed metal parts, or any other signs of wear and tear.

The V24CT and V26CT can be powered by 1 or 2 sealed 12 Volt lead-acid batteries with capacity. The rate of battery discharge is dependent on temperature and power load. The power load is a function of the number and type of parameter modules as well as parameter settings being used. The battery life for the V24CT and V26CT ranges from approximately 30 minutes for a fully loaded system operating on one new and fully charged battery to:

• approximately 1 hour for a fully loaded system operating on two new and fully charged batteries when loaded with the following parameter modules: ECG/Resp, NBP, SpO

• approximately 1 hour 15 minutes for a minimally loaded system operating on two new and fully charged batteries when loaded with the following parameter modules: ECG/Resp, NBP, SpO

, Pressure, Recorder and

, Pressure.

1-14 The CMS and V24 and V26 Patient Monitors

V26CT/V24CT Power Supply

Battery life includes the time during the low battery alarm (INOP “Recharge Batteries”) until the unit shuts off.

Battery

Specifications

We recommend you use 2 fully charged batteries to get the optimum battery life when using the battery power supply.

• 1 or 2 lead-acid batteries.

•12 Volt.

• Up to 1.25 hours battery capacity typical on two new fully charged batteries at 25°C, depending on modules used in the product.

Note—Charging time is 4 hours to 90% of full capacity if the monitor is off.

16 hours to 90% of full capacity if the monitor is on.

Confirm

Trends/ Calc

Delayed Record

Module

Setup

Battery Charging

Battery Charged

AC Power

The CMS and V24 and

V26 Patient Monitors

Note—When AC is connected and the monitor is on, the Battery Charge

LEDs may take some time to cycle to the appropriate charge indication and may underreport battery capacity during this setting period. Use the fuel gauge rather than the Battery Charge LEDs during this period to estimate battery capacity or turn the monitor off to accelerate the charge setting time.

See Chapter 12, “Battery Information (V24CT and V26CT only)” for additional information on battery operation and Battery Charge LEDs and indicators.

The CMS and V24 and V26 Patient Monitors 1-15

The CMS and V24 and

Parameter Modules

V26 Patient Monitors

The parameter modules have one or more hardkeys on the front. The key labeled with the parameter name is called the Setup key, which gets you directly into the setup screen for that parameter. When you press the Setup key on the front of the module, and get into the parameter setup window or task window, a light appears above the key.

The connector socket on the front of each module is the same color as the corresponding connector plug on the transducer or patient cable.

ECG

M1001B

Light for

setup key

ECG

Parameter

setup key

80x80

Connector for

patient cable

or transducer

Note—If a “T” is present on the front of a module, certain parameter

settings may be transferred with that module when it is moved from one rack to another. This behavior is dependent on a setting made in a

1-16 The CMS and V24 and V26 Patient Monitors

Parameter Modules

special Service Mode, either by your biomedical engineering department or the Philips service engineer. You can find a description of this behavior (called “Parameter Settings Transfer”) in Chapter 3.

The CMS and V24 and

V26 Patient Monitors

Symbols to Indicate Key Functions

As detailed in the table below, some modules used with the M1046A CMS, and M1205A V24/26 patient monitors now use symbols, instead of words, to indicate the function of some keys. If the monitor’s Reference Manual tells you, for example, to select the START key, you should press the key marked with the corresponding “start” symbol.

The design change also means that you will now find the module’s product number (for example M1032A) on the rear of the module’s housing, not on the front. Although the new modules do not show the letter “T” on the housing, all modules retain their capability to transfer parameter settings from one monitor to another.

Symbol Name Function Which Modules?

ZERO zero a pressure transducer Pressure (M1006B), including

option C01

Press

pressure outlet connector Pressure (M1006B) option C01

Out

Monitor initiates transfer from

Data Transfer Module (M1235A)

module to monitor

Module initiates transfer from

monitor to module

START start measurement CCO/C.O. (M1012A)

CCO/C.O. including option C10

Cal calibrate SvO

(M1021A), tcpO2/tcpCO2

(M1018A) Mainstream CO

The CMS and V24 and V26 Patient Monitors 1-17

(M1016A)

Parameter Modules

Parameter modules can be plugged into the following types of rack:

The CMS and V24 and

V26 Patient Monitors

Rack Type Mounting Comments

CMS Patient Monitoring System

Integral Rack This is fitted to the front of

the M1046A computer module.

Cannot be used with the M1167/77A CMS Patient Monitoring System. 8-slot rack.

Satellite Rack You can have one or more

satellite racks attached to an I.V. pole, bedside or wall.

Can be used with all CMS Patient Monitoring System. Available as 6-slot or 8-slot rack.

V24 and V26 Patient Monitor

8-slot Satellite Rack (Standard)

Same as Satellite Rack for CMS.

Only one Satellite Rack can be used with a V24 and V26 Patient Monitor.

6-slot Satellite Rack (Optional)

Same as Satellite Rack for CMS. This can also be mounted to the back of the M1205A V24CT and V26CT Monitors

Caution

When the rack is mounted in close proximity to any intravenous infusion equipment, do not let saline solution get onto the rack or parameter modules. Severe damage to the equipment can result if saline solution leaks into the connectors at the rear of the modules.

You can plug the parameter modules into the rack and remove them as you require them. The number of modules you can plug in depends on the type of rack and the model of monitor you have ordered.

1-18 The CMS and V24 and V26 Patient Monitors

Parameter Modules

For most types of parameter modules, the system allows only one of each type per patient (ECG, for example). Other types of modules allow more than one per patient (Invasive Pressure, for example).

If too many modules or an unsupported module are plugged in, a message detailing where the extra module is, appears in the system message field:

Currently ignored module in rack position R-P

where:

R is the number of the rack

(e.g. 1=integral rack, 2=first satellite rack,... or 1=first satellite rack, 2=second satellite rack,...

P is the slot number in that rack

(counted from left to right)

The message

Unrecognized module in rack position R-P

is displayed if an unknown module is plugged into the rack.

The CMS and V24 and

V26 Patient Monitors

Note—Since the V24 and V26 Patient Monitors only support one module

rack, R will always be 1.

The CMS and V24 and V26 Patient Monitors 1-19

The CMS and V24 and

Operating Levels

V26 Patient Monitors

There are three types of screens which you will see on the display module. The three types of screen and the interconnections between them are shown below.

Standard

Display

Control

Panel

1st Level

2nd Level

Selection

Window

Task

Window

1-20 The CMS and V24 and V26 Patient Monitors

Operating Levels

Main Screen This display shows the waveforms and numerical readouts of the

parameters you have chosen to monitor, alarms, INOP messages, bed label, date and time, and arrhythmia messages (when assigned).

You can configure the number and position of the waveforms on the display screen. The numerics are aligned with the corresponding waves. The numeric information is updated every two seconds. With the color model, the numeric appears in the same color that you have assigned to the corresponding waveform.

The CMS and V24 and

V26 Patient Monitors

The hardkey always returns you directly to the Main

Main Screen

Screen.

Note—The Main Screen of the V24 and V26 Patient Monitors include

Alarm Volume Control and QRS Volume Control Bars (see figure below)

The CMS and V24 and V26 Patient Monitors 1-21

Operating Levels

The CMS and V24 and

ICU Adult 10 JAN 95 20:05

V26 Patient Monitors

CHANNEL #1

LAYOUT: #1 NON-OVERLAP

CHANNEL #2

CHANNEL#3

CHANNEL #4

F HR

ABP

PLETH

1mV

120

SpO

SQI

Alarm Vol 165

QRS Vol 150

ST1 ST2

ABP

135/72 (94)

PAP

0.3

-0.2

PULSE

34/16

(23)

SpO

ETCO

IMCO

AWRR

NBP

19:47

115/65

(81)

NUMERICS

1-22 The CMS and V24 and V26 Patient Monitors

Operating Levels

Selection Window

This is the first operating level where you can choose a specific activity or function.

You get into a Selection Window by pressing one of the blue-labeled hardkeys on the control panel.

When you get into the Selection Window the bottom line is always active. This is indicated by a bar below the keys and the yellow labeling. The selection can be changed within the Selection Window one line at a time. For information on how to change the selection see page 1-25.

There is also an arrow symbol in the Window that moves along the selected line when the cursor keys are pressed. To enter the Task Window to which the arrow is pointing, press .

Confirm

The CMS and V24 and

V26 Patient Monitors

The CMS and V24 and V26 Patient Monitors 1-23

Operating Levels

The CMS and V24 and

Task Window

V26 Patient Monitors

This is the second operating level, which allows you to make changes or adjustments to the parameters and screen displays, or to perform procedures. Each parameter or procedure has a series of Task Windows.

There are two ways to get into the second operating level:

via the Selection Window,

or for parameters:

by pressing the Setup key on the parameter module.

1-24 The CMS and V24 and V26 Patient Monitors

Operating Levels

Getting into the Operating Levels

Before you can start to make adjustments or changes to the parameters or perform a procedure, you need to know how to get into the operating levels and how to navigate through the selections. Follow the procedures below to get into the Selection and Task Windows.

Selection Window

1. Press the blue-labeled hardkey for the function you require.

2. When you get into a Selection Window, the bottom line is always active. Select the line with the parameter or function you require, by pressing the same hard key again that got you into the selection window, or use the arrow keys if they are illuminated.

3. Press either the softkey corresponding to the parameter or function you require or . This gets you into the Task Window.

Confirm

For example, to get into the Noninvasive Blood Pressure (NBP) Task Window:

1. Press the hardkey

Module Setup

2. If it is not already active, select the line containing NBP by pressing

Module Setup

again.

The CMS and V24 and

V26 Patient Monitors

3. Press the softkey to get into the Noninvasive Blood Pressure

NBP

Task Window.

Task Window

There are two ways to get into a parameter Task Window, either:

via the Selection Window,

by pressing the Setup key on the parameter module which gets you directly into the Task Window.

Getting into other Task Windows for functions like Other Patients or Monitor Setup is only possible via the Selection Window. In the Task Window there are separate keys. The selections that are currently active for the parameter or function you have chosen are indicated by yellow labeling. In addition the selected keys appear to be “pushed in” on the screen.

The CMS and V24 and V26 Patient Monitors 1-25

The CMS and V24 and

Operating Levels

V26 Patient Monitors

There are two reasons for changing the selection in the Task Windows: you will either want to move to the next Task Window, or make an adjustment to a setting.

1. To move to the next Task Window, press the softkey for the function you require, for example . This gets you

Filter/Mon/Diag

into the Filter/Mon/Diag Task Window where you can make any necessary adjustments.

2. To make an adjustment, change the selection by pressing the softkey for that window again, until the adjustment or change you want is active, or use the arrow keys if they are illuminated.

1-26 The CMS and V24 and V26 Patient Monitors

Touch or Mouse/Trackball Operation

The M1167A/77A systems also allow connection of XGA displays, enabling touch (requires touchscreen displays), mouse or trackball operation of the monitor. Since these displays do not contain a control panel, there are slight differences in operating the system. The following sections contain the instructions specific to touch, mouse or trackball operation.

V24C and V26C monitors with option T01 allow touch operation in addition to the standard operation. Mouse and Trackball operation is not available for the V24 and V26 monitors.

Touch or Mouse/Trackball Operation

The CMS and V24 and

V26 Patient Monitors

The CMS and V24 and V26 Patient Monitors 1-27

The CMS and V24 and

Touch or M ouse/Trackball Operation

Main Screen The layout of the main screen is basically the same as with other CMS,

V24 and V26 Patient Monitoring Systems, with the only exception that it contains three additional buttons: the Silence/Reset button, the Suspend

V26 Patient Monitors

button (both in the upper right corner of the display) and the Control Panel button (in the lower right corner of the display).These buttons are touch-responsive and can be used alternatively to the hardkeys of the control panel or the handheld keypad.

Silence/ Reset

Suspend

Control Panel Task Window

Control Panel

Note—Do not remove the keypad from systems with touch or mouse/

trackball operation as it is still required to perform certain tasks.

The Control Panel Task Window contains most of the hardkeys found on the control panel of non-touch systems. See “Hardkey Functions” on page 1-12 for detailed descriptions of these keys. You can access the Control Panel Task Window by touching the Control Panel symbol in the lower right corner of the main screen display.

1-28 The CMS and V24 and V26 Patient Monitors

Touch or Mouse/Trackball Operation

Control Panel Task Window

The CMS and V24 and

V26 Patient Monitors

General Touch/ Mouse/ Trackball Operation (CMS only)

If a touch-responsive object or area of the screen is selected (either by touch or by mouse-click), a white ‘+’ appears and the area is surrounded by a white frame. In addition, an audible click is issued. The white frame disappears automatically when the object is released. If an object or area of the screen that is not touch-responsive is touched, a white ‘x’ appears in the selected area.

Note—When using a mouse/trackball, the white ‘+’ and ‘x’ signs appear,

wherever the mouse/trackball pointer is currently located. This indicates touch-responsive areas before they are actually selected by mouse-click.

The CMS and V24 and V26 Patient Monitors 1-29

Touch or M ouse/Trackball Operation

The CMS and V24 and

Touch-

Touch-responsive objects and areas of the screen include:

Responsive

Objects

V26 Patient Monitors

• Numerics and Waves - When a numeric or wave is selected, the respective parameter setup window opens up.

• Alarms/INOP messages - Selecting an Alarm or INOP Message opens the alarm messages window.

• Task Windows/Selection Windows - All softkeys displayed in Task Windows and Selection Windows are touch-responsive. When a Task Window/Selection Window is open, a selection of any area outside this window (except the Silence/Reset and Suspend keys) will close the task window. Selecting the black x in the corner of the Task Window label also closes the Window. Closing a Task Window returns you to the Main Screen.

• Items/Selections - All Items and all Selections within Task Windows can be directly selected by touch or mouse-click without the Select Item softkey or the arrow keys.

• Arrow Keys - Depending on the application, buttons are provided to perform the task of the arrow keys.

• Confirm Button - A confirm button is displayed in the lower right corner of the task window every time a confirm is required.

• Application Windows - Split Screen, oxyCRG and CSA Display contain touch-responsive areas which lead to the respective task windows. Please refer to Chapter 3 of this manual for further details.

• Application-specific buttons - Touch/Mouse/Trackball Operation has special implications for the Vital Signs, Graph Trends and Calculation Task Windows (see Chapter 8 Trends and Calculations for details), for the Patient Admit Task Window (see Chapter 7 Admit/Discharge/End Case for details), for the ST Analysis Task Window (see Chapter 14 ECG and ECG/Respiration Module Section for details) and for defining screen labels and adjusting the date and time (see Chapter 3 Setting up your Monitor for details).

1-30 The CMS and V24 and V26 Patient Monitors

Touch or Mouse/Trackball Operation

Alphanumeric

Entries

A Touchboard can be accessed when alphanumerical data needs to be entered. This is an alternative to the entry of data with the handheld keypad. The Touchboard can be activated with the “Touch Board” softkey e.g. from the Patient Admit Task Window.

The CMS and V24 and

V26 Patient Monitors

The Touchboard Task Window contains a subtitle which references the Task Window from which the Touchboard was accessed. Data entry can be performed for one item at a time. Press to save edited data. Press or to navigate through the editable

Next Item

Previous Item

items of the Task Window the Touchboard was accessed from.

Press to return to the Task Window the Touchboard was accessed

Back

from.

The CMS and V24 and V26 Patient Monitors 1-31

Touch or M ouse/Trackball Operation

The CMS and V24 and

Disabling Touch/ Mouse/

V26 Patient Monitors

Trackball Operation

In order to prevent unintended or uncontrolled operations of the monitor, touch operation must be disabled while cleaning the touchscreen. To disable touch and mouse/trackball operation press and hold or click and hold the control panel button in the lower right corner of the main screen for at least four seconds. A padlock icon over the control panel button indicates when touch and mouse/trackball operation is disabled. To re-enable touch and mouse/trackball operation press and hold or click and hold the padlock icon for at least two seconds. The control panel button will reappear.

Note—If a task window is opened or the monitor is put in standby mode

via the handheld keypad while touch and mouse/trackball operation is disabled, touch any area of the screen to return to the main screen. The padlock icon will be displayed.

1-32 The CMS and V24 and V26 Patient Monitors

The CMS Computer Modules

The signals from the parameters being monitored are transmitted to the computer module, where they are processed and then displayed on the screen as waveforms and numerical readouts.

The CMS Computer Modules

The CMS and V24 and

V26 Patient Monitors

M1046A Computer Module

The M1046A Computer Module is for use with the Philips M1165/66A and the Philips M1175/76A CMS Patient Monitoring System.

Maximum Voltages

ECG Output and Defib. Marker Input 3.2 V p-p Connector for satellite rack 60 V

The parameter module rack can be attached to the computer module, or a blank panel can be fitted to the computer module if you want to use a satellite parameter module rack.

The CMS and V24 and V26 Patient Monitors 1-33

The CMS Computer Modules

The CMS and V24 and

M1046B Computer Module

V26 Patient Monitors

The M1046B Computer Module is for use with the Philips M1167/77A CMS.

Maximum Volt age

ECG Output and Defib. Marker Input 3.2 V p-p

The parameter modules are inserted into one or several satellite racks. They cannot be attached to the front of the computer module.

ECG Output

Applies to both the M1046A and M1046B Computer Modules.

and Defibrillator Marker Input

1-34 The CMS and V24 and V26 Patient Monitors

The ECG output and defibrillator marker input connector on the computer module is used during cardioversion to provide an ECG waveform for synchronizing a defibrillator. It is also used to receive a marker pulse from the defibrillator for indicating the defibrillator discharge in the ECG waveform on the monitor display.

If you are using a Philips defibrillator without a built-in recorder, the marker pulse from the defibrillator is returned to the monitor. If the Philips defibrillator has a built-in recorder, then the marker pulse is returned to that recorder rather than to the monitor. The ECG output can also be used for other applications, such as synchronizing intraaortic balloon pump systems.

The V24 and V26 Parameter Module Rack

The V24 and V26 parameter module rack is attached to the display module by a cable to a connector on the left side of the display module. In addition, the V24CT and V26CT allow you to dock a 6-slot rack directly to the mainframe.

WarningWarning

Do not connect a second rack by a cable when using the V24CT or V26CT with a 6 wide rack docked to the mainframe. Docking a second rack by a cable may disrupt module communication.

The signals from the parameters being monitored are transmitted to the internal computer, where they are processed and then displayed on the screen as waveforms and numerical readouts.

The CMS and V24 and

V26 Patient Monitors

The CMS and V24 and V26 Patient Monitors 1-35

The CMS and V24 and

Operating Rules to Remember

V26 Patient Monitors

• Pressing key always returns you to the Main Screen.

• To get into a Selection Window press a hardkey.

• What is labeled in yellow and appears “pushed in” is active.

• Softkeys function only in the Selection and Task Windows (with the exception of the Alarm Volume Control and the QRS Tone Volume Control on the V24 and V26 Patient Monitors).

• The parameter module Setup key gets you directly into a Task Window.

Main Screen

• The arrow keys and key are illuminated when available

Confirm

for use.

1-36 The CMS and V24 and V26 Patient Monitors

Performance Specifications of the Philips Displays

M1095A Flatscreen Display

M1094A/B and M1092A CRT Display

Useful Screen: (±5% unless otherw ise noted)

Pixel Size 0.33 mm x 0.33 mm

Storage Time at 25 mm/sec 5.5 second s Trace Spee ds 6.25, 12.5, 25, 50 mm/sec ±10%

Useful Screen: (±5% unless otherw ise noted)

158 mm x 211 mm (6.2” x 8.3”)

180 mm x 225 mm (7.1” x 8.9”)

The CMS and V24 and

V26 Patient Monitors

M1097A #A02 XGA Flatscreen Display

Pixel Size 0.22 mm x 0.35 mm Storage Time at 25 mm/sec 6 seconds Trace Spee ds 6.25, 12.5, 25, 50 mm/sec ±10%

Useful Screen: (±5% unless otherw ise noted)

Pixel Size 0.297 mm x 0.29 7 mm

304.1 mm x 228. 1mm (12” x 9”)

The CMS and V24 and V26 Patient Monitors 1-37

The CMS and V24 and

Using an ITE Display

V26 Patient Monitors

The M1167A/77A CMS Patient Monitoring System provides means for customers to use ITE displays. There are several restrictions associated with this option. Since the display is used as part of a medical device within the patient vicinity, there are additional requirements to be fulfilled in order to be in compliance with the European Council Directive 93/42/EEC (Medical Device Directive) and with FDA recognized consensus standards:

•Safety

•EMC

• Performance Requirements

Safety 1. The display must either comply with the requirements of the:

EN60601-1 +A1 +A2 {IEC601-1 +A1 +A2}, or

it must conform to the requirements of an IEC XXX electrical safety standard and fulfill specific requirements according to the EN60601-1-1 +A1 {IEC601-1-1 + A1} to provide the same level of safety as EN60601-1 {IEC601-1}:

– The display must be constructed or protected so that spillage

of liquids does not wet parts of the display which may cause a safety hazard (IEC601-1; 44.3).

– The ITE display must be used with an isolation transformer

(e.g. Philips M1389A), if the enclosure leakage current exceeds the requirements of EN60601-1/IEC601-1 (normal and single fault condition). The power cable must be secured so that the transformer cannot be disconnected without the use of a tool.

2. A test of the Enclosure Leakage Current (normal and single fault condition) of the complete system, including the display, has to be performed and documented.

1-38 The CMS and V24 and V26 Patient Monitors

Using an ITE Display

EMC 1. The display must either fulfill the requirements of the EN60601-1-2

{IEC 601-1-2}, or

it must conform to the requirements of the EMC standard for ITE devices, EN50082-1: 1997 and EN50081-1 / CISPR 22.

2. The video cable between M1167A/77A CMS Patient Monitoring System and the ITE display must not exceed a length of 3.0m. For cables exceeding 3.0m EMC testing according to IEC 801-4:1988 has to be done.

Performance Requirements

Specification Requirement or Value Units

Resolution (pixel addressability) 1024 x 768 Dots x lines

Vertical Refresh Rate 60 Hz (non-interlaced)

Red, Green and Blue Video Inputs ~0.7 V p-p

Vertical & Horizontal Multi-Sync Inputs 5 V TTL

Video-Cable Connector HD15male

Philips cannot assure compliance with the ANSI/AAMI EC-13 Standard for Cardiac Monitors, Heart-rate Meters and Alarms when using ITE displays. Compliance with the ECG aspect ration and 25 mm/s specifications can only be assured when using the Philips Displays M1092A, M1094B and M1095A. In addition, the following display specifications are recommended:

±10% sweep-speed

The CMS and V24 and V26 Patient Monitors 1-39

Using an ITE Display

1-40 The CMS and V24 and V26 Patient Monitors

Getting Started

Now that you have been introduced to the monitor you are probably ready to start using it. This chapter will help you get started. It contains the following sections:

• Setting up the Monitor (V24 and V26 only) . . . . . . . . . . . . 2-2

• Setting up the Parameter Modules . . . . . . . . . . . . . . . . . . . 2-5

• Attaching the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-6

Getting Started 2-1

Getting Started

Setting up the Monitor (V24 and V26 only)

1. Attach the parameter module rack to the display module by a cable to the connector on the left side of the display module. If you are using the V24CT or V26CT you can attach the 6-slot rack to the back of the mainframe display without the need for a cable. The two components will snap or dock together.

2-2 Getting Started

Setting up the Monitor (V24 and V26 only)

2. If you are using the V24CT and V26CT and the batteries are not already in place, insert 2 Philips 40488A 12 Volt 2.3 Amp-hour sealed lead-acid batteries into the spring-loaded battery door in the back of the monitor. The batteries should be inserted with the grey Philips battery label facing upwards and the contacts pointing into the monitor. The batteries will snap or click into place when properly inserted.

Getting Started

Caution

Philips Medical Systems recommends you fully charge the batteries before using the V24CT or V26CT for the first time. Plug the monitor into an AC power supply (line power) for an initial charging cycle. When the monitor is plugged in and the power is off, it takes approximately four hours for the batteries to reach a charge of 90% capacity and nine hours for the batteries to be fully charged. If the monitor is plugged in and the power and external battery charger is on, it takes approximately 16 hours to charge the batteries.

3. If using an AC power supply, plug the power cord into the power source.

Getting Started 2-3

Getting Started

Setting up the Monitor (V24 and V26 only)

4. Switch on the system using the power On\Off switch. A self test is then performed.

WarningWarning

Connecting the Philips monitoring network (SDN) cable when the product is powered on is not supported. Error codes and Philips monitoring network (SDN) interface lock-up may occur. Power cycling the product will recover the product. No permanent damage will result. To prevent unintentional disruption in monitoring, be sure the SDN interface cable is properly secured at both ends when connecting to the Philips monitoring network (SDN).

2-4 Getting Started

Setting up the Parameter Modules

1. Decide which parameters you want to monitor.

2. Make sure the appropriate modules are plugged into the rack. If not, insert the module into the rack until the lever on the base of the module clicks into place. To remove a module, press the lever upwards and pull the module out. (See diagram below.)

Setting up the Parameter Modules

Getting Started

3. Check that you have the correct patient cables and transducers plugged into the modules. The module connectors are color-coded to the patient cables and transducers, for easy identification.

Your monitor may have Parameter Settings Transfer set ON. To understand the effect this has when using modules with the “T” label, turn to Parameter Settings Transfer in Chapter 3.

Getting Started 2-5

Getting Started

Attaching the Patient

1. Attach the electrodes, probes, transducers, and insert pressure catheters as required for monitoring the patient.

2. Connect the electrodes, probes and transducers to the appropriate modules.

After less than 10 or 20 seconds you should see a display on the screen similar to the one under “Main Screen” in Section 1. The number of waveforms depends on the waveforms you have selected to have displayed and also on the model of your system.

The numerics are aligned with the corresponding waveform.

2-6 Getting Started

Attaching the Patient

Adjusting Screen Contrast

V24 and V26:

The brightness or contrast of the screen display can be adjusted by using the dial located behind the edge of the display, on the lower right side of the monitor. The V24 uses a contrast control. V24C, V24CT, V26C and V26CT are equipped with a brightness control. Make sure that all of the screen information is visible.

Getting Started

Screen Brightness Control

(Model V24C, V26C

V24CT, V26CT)

Screen Contrast Control

(Model V24)

CMS:

The brightness and contrast of the screen display can be adjusted by means of the two dials underneath the hardkeys. Follow this procedure to achieve the optimum screen display:

1. Turn the brightness and contrast controls to their maximum settings.

2. Slowly turn the brightness and contrast controls down to the lowest acceptable position where the display can still be seen clearly. The most acceptable position will be dependent upon the surrounding light conditions. Please ensure that all the screen information is visible.

Getting Started 2-7

Getting Started

Attaching the Patient

Starting Monitoring

Screen Messages

The patient's vital signs are now appearing on the screen. The preconfigured default settings for the parameters and screen display, that were set up at installation or have been stored in the module (“Parameter Settings Transfer”), are active.

If you want to make changes to the screen display see the section “Configuring the System”. If you want to make changes to the parameter settings see the individual parameter sections.

Switch the system alarms ON (by pressing the key so that the Alarm Suspend lamp goes out). The patient is now being monitored.

Two types of messages appear at the top of the display screen:

• Prompt messages - these instruct the user to perform an action

• Status messages - these give information about the current situation. For instance:

“sync output not available, plug-in ECG module''

Suspend

2-8 Getting Started

Attaching the Patient

this message stays as long as the ECG module is not plugged in.

Prompt and status messages are displayed either in the appropriate Task Window, or at the top of the Main Display screen, depending on the operating level.

On the Main Screen display the prompt and status messages are shown below the alarm and INOP messages.

Prompt messages appear for 3 seconds.

Status message are displayed in rotation for 3 seconds each.

Reserving a Channel

In the Task Window the prompt and status messages remain until the appropriate user action is performed.

A parameter module may be turned OFF, but left in the rack. The empty channel where the waveform should be still appears on the Main Screen. There is no waveform, waveform label, or numeric. Another wave may use its screen channel temporarily, but will be discarded as soon as the assigned wave is reactivated.

This ensures that particular waveforms can always be allocated to the same place on the Main Screen, and avoids inconsistencies in the waveform display of different patients in the same department.

Note—If trend data for this patient is to be collected, old data from a

previous patient should be deleted. The old data will be automatically deleted if the monitor has been shut off for three hours or more. See “Discharging a Patient/Ending a Case” on page 7-9 for more information.

Getting Started

Getting Started 2-9

Attaching the Patient

Getting Started

Power Failure

If a power failure occurs, any alarm conditions that were stored in the monitor will NOT be retained when power is restored. Settings such as alarm limits stored in “T” modules ARE retained - see “Parameter Settings Transfer” on page 3-61.

Caution

You are advised to check all the monitor settings after any power failure.

The monitor reacts according to the length of the power failure:

Less than 60 seconds Patient Data Management data and all

settings retained.

Less than 3 hours Patient Data Management data retained. All

settings revert to user defaults.

More than 3 hours Patient Data Management data not retained.

All settings revert to user defaults. Time setting may be lost if not networked.

Patient Information Center

Monitor Standby

2-10 Getting Started

If the monitor is connected to a Patient Information Center (78504 and

78508) and you select the same lead for ECG channels 1 and 2, the wave is not displayed in channel 2 of the Patient Information Center.

If you want to stop patient monitoring, but keep all settings and Patient Data Management information, you can switch the monitor into “Monitor Standby”:

1. Press or

2. Press .

All waves and numerics disappear from the display, and all monitoring is suspended. The word “Standby” appears in big letters on the screen.

Alarms / Volume Alarms

Monitor Standby

Attaching the Patient

If your monitor is connected to a Philips patient care system while the monitor is in standby, no parameter data from your monitor is sent over the system. Instead, a message indicating that your monitor is in “Standby” is sent to other beds in the system, and is displayed at the central station. If your bed is configured to receive alarms, and another bed in the system goes into alarm, the status message “Other Bed in Alarm” is displayed on your monitor. You will hear the overview prompt tone (two double beeps), but the Alarm Bed Task Window will not be displayed.

To resume monitoring, simply press one of the keys (except )

Suspend

on the control panel on the front of the display or on the handheld keypad (CMS only). The changes and adjustments that you made to the settings before going into Monitor Standby are retained. Patient Data Management information collected before going into Monitor Standby is also retained.

As all monitoring is suspended, no patient data is collected while the monitor is in Monitor Standby.

The hardkey operates as usual when you are in Monitor

Suspend

Standby, so you can prepare the monitor alarm capability before you resume monitoring.

Getting Started

Getting Started 2-11

Getting Started

Attaching the Patient

2-12 Getting Started

Setting up your Monitor

This chapter describes the characteristics of your system that can be changed during monitoring, using the key. It includes the following sections:

• Changing Display Screens . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

• Selecting a Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3

• What you Can Configure. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

• Changes to the Configuration . . . . . . . . . . . . . . . . . . . . . . . 3-6

• Assigning Waves to Screen Channels . . . . . . . . . . . . . . . . . 3-8

• Selecting the Number of Waves. . . . . . . . . . . . . . . . . . . . . 3-13

• Changing the Wave Overlap. . . . . . . . . . . . . . . . . . . . . . . . 3-14

• Selecting Realtime Wave Speeds. . . . . . . . . . . . . . . . . . . . 3-15

• Displaying Split Screen Trends . . . . . . . . . . . . . . . . . . . . . 3-22

• oxyCRG Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-25

• CSA Display (CMS only). . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28

• Configuring a Second Independent Display (CMS only) 3-32

• Adjusting the Volume Control . . . . . . . . . . . . . . . . . . . . . . 3-35

• Adjusting the Date and Time . . . . . . . . . . . . . . . . . . . . . . . 3-37

• Selecting Waves for Central Recorders . . . . . . . . . . . . . . 3-39

• Configuring Module, Bedside and Central Recordings . 3-40

• Other Patients Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-41

• The Status Log Function. . . . . . . . . . . . . . . . . . . . . . . . . . . 3-42

• The Monitor Revision Function. . . . . . . . . . . . . . . . . . . . . 3-43

• Changing Default Settings and Patient Category . . . . . . 3-44

• Changing the Patient Category . . . . . . . . . . . . . . . . . . . . . 3-45

• Changing the Configuration Set. . . . . . . . . . . . . . . . . . . . . 3-53

• Changing Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . 3-55

• The Test Signals Function . . . . . . . . . . . . . . . . . . . . . . . . . 3-58

• Parameter Settings Transfer . . . . . . . . . . . . . . . . . . . . . . . 3-61

Monitor Setup

Setting up your Monitor 3-1

Changing Display Scree ns

Next Display

Changing Display Screens

A display screen is a pre-selected arrangement of realtime waveforms, numerics and overlayed application windows. A particular display screen can, for instance, be created to monitor a patient during a specific procedure in a department or unit.

There are five separate display screens which can be configured. The default names of these screens are Screen A, Screen B, Screen C, Screen D and Screen E. You can select additional screen labels (such as Standard, or Surgeon) for these screens.

A softkey corresponding to each screen is available in the Change Screen Task Window (CMS) or the Monitor Setup Task Window (V24 and V26). The display screen which is active is identified by an inactive softkey for that screen.

You can change to one of the other screens at any time, by pressing one of the other softkeys.

Monitor

You can reconfigure only the screen which is currently active. Once a

Setting up your

display screen has been configured, the settings remain either until the user changes them, or the monitor is switched off. When the monitor is switched off, the settings automatically revert to the defaults.

CMS only: If you have a second or third independent display, the

softkey is available in the Change Screen Task Window.

This key is used to configure the second or third display.

3-2 Setting up your Monitor

Selecting a Scre en

If the screen you want to change is not the currently active screen, you must select the required screen (for example, Screen A, Screen B, Screen C, screen D or Screen E).

Selecting a Screen

Procedure 1. Press the hardkey (CMS) or (V24

Change Screen Monitor Setup

and V26).

2. Press the softkey corresponding to the screen you want to change. The Main Display appears for the selected screen.

Monitor

Setting up your

Setting up your Monitor 3-3

Freezing Waves (CMS only)

Freeze Waves

Start Waves

Freezing Waves (CMS only)

You can freeze any wave movement on the screen via the

Change Screen

other key except or to restart the waves.

You can also freeze the waves on your 2nd and 3rd independent display. To restart the waves on an independent display, press

→ keys. Press or any

Suspend Silence/Reset

Monitor

Setting up your

3-4 Setting up your Monitor

What you Can Configure

Changes and adjustments you make to the settings in Monitor Setup screens remain active while the system is switched on. With the exception of changes to the date and time, all settings revert back to their default settings (factory defaults or user defaults) if the system is switched off for longer than 60 seconds. The settings for the date and time are stored by the system when it is switched off.

Note—If necessary, these default settings can also be changed. This is

done in a special configuration mode, either by your biomedical engineering department or the Philips service engineer. See the ““Changing Default Settings and Patient Category” on page 3-44 for more details.

What you C an Configure

Monitor

Setting up your

Setting up your Monitor 3-5

Changes to the Configuration

Display

Changes to the Configuration

To make changes to the settings, you need to get into the Monitor Setup Selection Window. The key sequence to get into the Task Windows is shown above the screen figures in this guide.

The softkeys are indicated in the text like this:

The hardkeys are indicated in the text like this:

Monitor Setup

Monitor

Setting up your

3-6 Setting up your Monitor

Making Changes to the Main Display

The following describes how to change screen A, B, C, D, or E and assign a label. The description includes:

• Assigning Waves to Screen Channels

• Selecting a Screen

• Selecting Screen Labels for Realtime Display Screens

• Selecting the Number of Waves

• Selecting the Wave Overlap Configuration

• Selecting Realtime Wave Speeds

• Numerics On/Off

• Selecting an Application Window

• Wave Replace Mode

•Trace Mode

Making Changes to the Main Disp lay

A description is then given for changing a completely separate display screen.

Monitor

Setting up your

Setting up your Monitor 3-7

Assigning Waves to Screen Channels

Display1 Setup

Assigning Waves to Screen Channels

You can assign realtime waves to positions on the screen. This defines where the waves appear on the Main Screen.

Monitor Setup

Monitor

Setting up your

Notes—

• You can also return to the Display Setup Task Window from the Realtime Speeds Task Window by pressing the softkey Display Setup.

3-8 Setting up your Monitor

Assigning Waves to Screen Chann el s

Select Item

Change Content

Procedure 1. Press repeatedly to select a channel on the

screen.

2. Press to move the selection to the wave you want to place in your selected channel.

3. Repeat steps 1 and 2 for each wave position you want to change.

4. Press to return to the Main Screen screen.

Note—If one of the assigned waves is not available (parameter switched

Main Screen

off or unplugged), then another wave will use its channel until the assigned wave is reactivated, provided Wave Replace Mode is enabled. The channel will only remain blank if:

• It is assigned to ECG or Blank.

• Another wave is available, but numerics aligned to that wave are switched off.

Monitor

Setting up your

Setting up your Monitor 3-9

Selecting a Screen

Display1 Setup

Select Item

Change Content

Selecting a Screen

You can switch between the five available screens (A-E) in the Display Setup Task window.

Monitor Setup

Monitor

Setting up your

Procedure 1. Press until “Screen Choice” is selected on the

screen.

2. Press to select a screen (A-E). The selected screen choice and its screen label will appear at the top of the Task Window. The other items on the screen will change depending on the configuration of the different screens

3. Press to return to the Main Screen.

3-10 Setting up your Monitor

Main Screen

Selecting Screen Labels for Realtime Display Screens

Display1 Setup

Select Item

Change Content

Selecting Screen Labels for Realtime Display Screens

A screen label may be selected for a realtime display screen. There are eleven choices.

Monitor Setup

Procedure 1. Press until “Screen Label” is selected on the

screen.

2. Press to select the key label that you require. The choices are:

a. Neuro b. Cardvasc c. SwanGanz d. Standard e. Ventilat

f. Perfusn

g. Surgeon

Monitor

Setting up your

Setting up your Monitor 3-11

Selecting Screen Labels for Realtime Display Screens

h. Inductn

i. Non Invasive j. OxyCRG3.

k. Blank (No screen label).

l. User Def (user defined screen label - see below)

User Defined

Screen Labels

3. Press to return to the Selection Window or press

Main Screen

In addition to the pre-defined screen labels, you can define your own labels for each screen (A-E). To define a screen label:

Monitor Setup

to return to the Main Screen screen.

1. Select User Def in the Display Setup Task Window.

2. Press .

Confirm

3. Enter new label using either the handheld keypad, the touchboard (CMS only) or the arrow keys (V24 and V26).

4. Press .

Monitor

5. The user defined labels will also appear in the Change Screen Task

Confirm

Window

Setting up your

3-12 Setting up your Monitor

Selecting the Number of Waves

Display1 Setup

Select Item

Change Content

You can select how many waves you want displayed on the screen (within the capabilities of the model you have ordered).

Selecting the Number of Waves

Monitor Setup

Procedure 1. Press until “NumbrOfWaves” is selected on the

screen.

Monitor

Setting up your

2. Press depending on your model.

3. Press to return to the Selection Window or

Monitor Setup

Main Scree

to choose 4, 6, or 8 waves to be displayed

to return to the main screen.

Setting up your Monitor 3-13

Changing the Wave Overlap

Display1 Setup

Select Item

Change Content

Changing the Wave Overl ap

The wave overlap refers to the position of particular waves on the screen. You can select to have overlapping and non-overlapping waves. Overlapping waves allow a larger wave amplitude and you can compare waveforms of various parameters (i.e. pressure waves).

Monitor Setup

Monitor

Setting up your

Procedure 1. Press until “Overlap” is selected on the screen.

2. Press to choose one of the available numbers (dependent on model). The boxes in the middle of the screen indicate which waves are overlapping.

3. Press to return to the Selection Window or

Main Screen

3-14 Setting up your Monitor

Monitor Setup

to return to the Main Screen.

Selecti n g R e altime Wave Speeds

Display1 Setup

Realtime Speeds

Select Paramete

Select Speed

The same speed can be selected for all the waveforms or different speeds can be chosen for different waveforms. You can select the speed for the waveforms from the following:

50 mm/sec 25 mm/sec

12.5 mm/sec

6.25 mm/sec

Selecting Realtime Wave Speeds

Monitor Setup

Monitor

Setting up your

Procedure To select different speeds for the waveforms:

1. Press the softkey repeatedly to select a parameter to which you want to assign a different speed.

2. Press repeatedly to select the speed you require.

3. Repeat steps 1 and 2 for each parameter speed you want to change.

Setting up your Monitor 3-15

Selecting Realtime Wave Speeds

Display Setup

Global Speed

Display Setup

Global Speed

Press the softkey to return to the Display Setup Window, press to return to the Selection Window or

Main Screen

To select the same speed for all the waveforms:

Monitor Setup

to return to the Main Screen.

1. Press

repeatedly to select the speed you require.

2. Press the softkey to return to the Realtime

Note—

Waves Task Window, press to return to the Selection window or to return to the Main Screen.

Main Screen

Monitor Setup

• The speed of the Resp or CO2 waves and of the AG waves must always be set individually. You cannot alter their speeds by pressing .

• If waves overlap, all the waves travel at the speed of the wave in the first overlapping channel. If the overlap is then changed to

Monitor

non-overlapping waves each wave travels at its assigned speed.

Setting up your

3-16 Setting up your Monitor

Selecting Realtime Wave Speeds

Display1 Setup

Numerics1 On/Off

Select Numeric

On/Off Numeric

All Num On/Off

Numerics On/Off

To tailor the numeric display format to specific needs, individual numerics can be switched on or off. This is possible for each individual screen (A-E) of an independent display. When monitoring many parameters, switching off the numerics for some of the parameters results in more of the remaining numerics being displayed in large digits.

Monitor Setup

1. Press the softkey to highlight the required parameter numeric. To view parameters which are not displayed, press the softkey

2. Press the softkey to set the selected numeric display on or off.

3. Repeat Steps 1 and 2 for each numeric that requires resetting.

4. Press the softkey

to switch ALL numerics on or

off at the same time.

5. Press to return to the Main Screen.

Main Screen

Monitor

Setting up your

Setting up your Monitor 3-17

Selecting Realtime Wave Speeds

If numerics are switched off, the status message “Not all numerics displayed” is displayed. This message can be disabled in

configuration mode by your biomedical engineer or by the Philips service engineer.

Numeric

Positioning

Parameter numerics on the Main Screen screen are shown as aligned numerics - the numerics are next to the corresponding waveforms.

Aligned Numerics:

The monitor controls the position of numerics on the screen, and also controls the size of some numerics.

Numeric Positions:

Numerics are positioned on the screen in the following order:

1. Parameters with waveforms (such as Pressure) are positioned first. The numerics are aligned with the corresponding waveform.

2. Numerics, which are part of a contiguous block (i.e. CO2, AGM, ST, BIS, HR/PULSE) are positioned next.

Monitor

3. Parameters without waveforms which are not part of a contiguous block (such as Temperature) are positioned in the left column if

Setting up your

space is available. Otherwise, they are placed from bottom to top in a column to the right of the waveform numerics according to their priority as shown in the Numerics On/Off Task Window.

3-18 Setting up your Monitor

Selecting Realtime Wave Speeds

Numeric Sizes:

Parameter numerics on the screen are displayed in 2 sizes - big or small.

When there are too many large numerics to be displayed on the Main Screen display, the monitor performs the following actions to make more space available:

• The large numerics decrease in size, starting from bottom to top.

• If more than one temperature is being monitored, the additional temperatures are shown continuously in rotation in the position of the third temperature numeric

Invasive pressures are multi-numeric parameters because each pressure has numerics for systolic, diastolic and mean pressures. They are decreased in size. Pressure 1 (P1) numerics preferably stay big.

Additional Information

• The ST1, ST2, and ST3 values are shown next to the 2nd ECG channel if present.

• The NBP numerics are displayed big next to the 2nd or 3rd ECG channels or a blank channel.

• CO2, AGM, and BIS numerics are each preferably kept together as a block.

Monitor

Setting up your

Setting up your Monitor 3-19

Selecting an Application Wi ndow

Display1 Setup

Select Item

Change Content

Selecting an Application Window

One of three application windows can be selected for display in each screen:

• Split Screen

• oxyCRG

•CSA

They are described in more detail in the following sections.

Monitor Setup

Monitor

Setting up your

Procedure 1. Press until “ApplicWindow” is selected on the

screen.

2. Press to choose Split, OxyCRG, CSA or None (no application window) to be displayed.

3. Press to return to the selection window or

Main Screen

3-20 Setting up your Monitor

Monitor Setup

to return to the Main Screen.

Selecting an Application Window

Note—If you have configured a second or third independent display,

oxyCRG and CSA can only be on one of these displays at a time. Split Screen can be configured for all displays simultaneously.

Special Implications for Touch or Mouse Operation

• If Split Screen is active and a split trend is selected, the Graph Trends Window opens up displaying the selected parameter in combination with the adjacent parameters.

• If the oxyCRG display is active and is selected, the Neonatal Event Review Window opens up. If Neonatal Event Review is not available, the Graph Trends Task Window opens up.

• If the CSA Display is active and is selected, the EEG Setup Window opens up

Monitor

Setting up your

Setting up your Monitor 3-21

Displaying Split Screen Trends

Split Screen trends display the last 30 minutes of the patient's trend data along with any alarm limits that are set. The trend values are updated every minute. The trend value itself is calculated as the average of all the values sampled with the previous minute.

Monitor

Setting up your

With Split Screen trending you can:

• Display the preceding 30 minutes of trend data for all vital signs next to their waves.

• Obtain a clear indication if a patient's vital signs tend towards exceeding the alarm limits.

Note—Split Screen Trends are not available with selected V24 and V26

ICU bundles.

3-22 Setting up your Monitor

Displaying Split Screen Trends

The alarm limits are represented by a rectangle, filled with the parameter’s color at low intensity. When a measurement exceeds an alarm limit, it is clearly visible against the screen’s black background. The limits themselves are displayed on the right side of the trend display, next to their corresponding boundaries.

The alarm-limit values are always displayed within the rectangle defined by alarm limits, if they fit.

Note—Some trends, such as vital signs that are received through VueLink,

do not have alarm limits associated with them. In this case, no rectangle is displayed for the alarm range. Instead, the default range scales are displayed with low intensity on the left side of the trend display, to distinguish them from alarm limits.

Trend data is only displayed for those vital signs that are positioned in the left column of the numeric display.

Viewing Trend

Data for

Invasive Blood

Pressure

Three trend values are displayed for invasive pressure; systolic, diastolic, and mean pressure. These three trends are displayed together as shown in the diagram below.

Monitor

Setting up your

Display of Trend Data for Invasive Blood Pressure - Example

The alarm limits can apply to any of the three pressures, depending on how they are configured. The alarm limits are therefore prefixed with a letter, which identifies the pressure to which they are configured. These letters are:

S Systolic pressure

D Diastolic pressure

M Mean pressure

Setting up your Monitor 3-23

Displaying Split Screen Trends

In addition to this, the trend to which the alarm limits apply is displayed with a thicker line than the other trends.

Viewing Trend

Data for Non-

invasive Blood

Because the NBP is not a continuously measured parameter, a special symbol is used to display the trend values, as shown in the diagram below.

Pressure

Display of Trend Data for Non-invasive Blood Pressure - Example

Monitor

Setting up your

3-24 Setting up your Monitor

oxyCRG Display

The oxyCRG (oxygen CardioRespiroGram) display provides a simultaneous presentation of the following three waveforms overlayed on the Main Screen:

• Beat-to-beat heart-rate trend

• An oxygen parameter trend

• Compressed respiration wave

Approximately the last six minutes of information is displayed for each parameter.

oxyCRG Display

Main Screen Display with oxyCRG

The oxyCRG display can help you to make early detections of respiratory regulation problems in neonates, by comparing trend patterns, or finding interrelationships among the three parameters.

Monitor

Setting up your

Setting up your Monitor 3-25

oxyCRG Display

Freeze Waves

Approximately the bottom two thirds of the Main Screen area are covered with the three oxyCRG waveforms.

The number of realtime waves that you can display simultaneously with oxyCRG is related to the maximum number of realtime waves that your system is capable of displaying. Details are provided in the following table:

Main Screen

Standard Display oxyCRG Display

4 realtime waves oxyCRG + 1 realtime wave

6 realtime waves oxyCRG + 2 realtime waves

8 realtime waves oxyCRG + 3 realtime waves

Notes on oxyCRG

• The oxyCRG information is overlayed on the realtime waves at the bottom of the Main Screen. These realtime waves disappear from the display, but the parameters are still being monitored, and the

Monitor

Setting up your

parameter alarms are still active.

• If oxyCRG covers part of an overlap channel, the entire overlap channel disappears from the display.

•The

softkey has no effect on the oxyCRG section

of the Main Screen, because the display speed is very low.

• The beat-to-beat heart rate (btbHR) in the oxyCRG display will vary from the heart rate (HR) numeric on the Main Screen, since the HR numeric is an averaged value.

• If the monitor is switched off for less than 60 seconds, oxyCRG data is retained. However, when the power is switched back on, you will see gaps in the oxyCRG display. The gaps correspond to the amount of time it takes the monitor to get the first readings after power is restored, not the amount of time that the monitor was switched off. For this reason, you cannot properly measure the time difference between an event which occurs before power

3-26 Setting up your Monitor

Philips V26CT, M1165, M1166, M1167, M1175 User's Reference Manual

Specifications and Main Features

Frequently Asked Questions

User Manual