Philips MP40-50 IntelliVue User manual

Page 1

M8000-9001F

1Table Of Contents

1 Basic Operation 1

Introducing the IntelliVue Family 1

IntelliVue MP20/MP20Junior/MP30 2 MP20/MP30 Major Parts and Keys 2 IntelliVue MP40/MP50 3 MP40/MP50 Major Parts and Keys 4 IntelliVue MP60/MP70 5 MP60/MP70 Major Parts and Keys 5 MP80/MP90 Major Parts and Keys 6 Remote Alarm Device 6 Docking Station 7

1Basic Operation

These Instructions for Use are for clinical professionals using the IntelliVue MP20/MP30 (M8001A/ M8002A), MP40/50 (M8003A/M8004A) and MP60/70/80/90 (M8005A/M8007A/M8008A/ M8010A) patient monitors.Unless otherwise specified, the information here is valid for all the above IntelliVue patient monitors.

The basic operation section gives you an overview of the monitor and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching a measurement on and off, setting up and adjusting wave speeds, working with profiles). The alarms section gives an overview of alarms. The remaining sections tell you how to perform individual measurements, and how to care for and maintain the equipment.

Familiarize yourself with all instructions including warnings and cautions before starting to monitor patients. Read and keep the Instructions for Use that come with any accessories, as these contain important information about care and cleaning that is not repeated in this book.

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

In this guide:

•A warning alerts you to a potential serious outcome, adverse event or safety hazard. Failure to

observe a warning may result in death or serious injury to the user or patient.

•A caution alerts you to where special care is necessary for the safe and effective use of the product.

Failure to observe a caution may result in minor or moderate personal injury or damage to the product or other property, and possibly in a remote risk of more serious injury.

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

Introducing the IntelliVue Family

The Philips IntelliVue family of patient monitors offers a monitoring solution optimized for the surgical, cardiac, medical and neonatal care environments. Combining patient surveillance and data management, it allows multi-measurement monitoring by linking separate modules with “plug-andplay” convenience.

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1 Basic Operation Introducing the IntelliVue Family

6 7

Your monitor stores data in trend, event, and calculation databases. You can see tabular trends (vital signs) and document them on a local or remote printer. You can view measurement trend graphs, with up to three measurements combined in each graph, to help you identify changes in the patient’s physiological condition. You can view fast-changing measurement trends with beat to beat resolution and see up to four high resolution trend segments. Event surveillance enhances documentation and review of physiologically significant events by automatically detecting and storing up to 50 userdefined clinical events over a 24 hour period.

There is a choice of monitor configurations, as explained below. All models can also use computer devices such as a mouse, a trackball and a keyboard.

IntelliVue MP20/MP20

The IntelliVue MP20/MP20Junior/MP30 (M8001A/ M8002A) patient monitor has a 10-inch TFT LCD flat panel SVGA display. The standard input devices for the MP30 are the Touchscreen and integrated navigation point; the MP20 is supplied with an integrated navigation point only. Up to six waves can be shown on MP20/MP30 Screens (USA - up to four waves, MP20Junior - up to 3 waves). 12 ECG traces can be shown on the 12-Lead ECG Screen.

The MP20/MP30 can be connected to one MultiMeasurement Server (MMS) and any one of the measurement server extensions. There is an optional built-in recorder. The Flexible Module Server (M8048A) and all plug-in modules cannot be used with the MP20/MP30. With an optional Interface board Bispectral Index (BIS) monitoring is possible.

MP20Junior is an option of MP20 (M8001A) and is not referred to separately in these Instructions for Use.

Junior

/MP30

MP20/MP30 Major Parts and Keys

MP20/MP30 left side

1 Color-coded alarm lamps

2 Alarms off lamp

3 Model indicator

4 ECG out

5 Navigation Point

6 Part number and serial number

7 Mounting quick-release lever

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Introducing the IntelliVue Family 1 Basic Operation

MP20/MP30 front panel

On/Standby switch

On/Standby LED

Error LED

Battery status LED

AC power operation LED

6 “read the documentation”

symbol

Mounting quick-release lever

123 4 5 67

MP20/MP30 LED Colors and their Meanings

On/Standby LED

Error LED

Battery LED

AC Power LED

IntelliVue MP40/MP50

The IntelliVue MP40/MP50 (M8003A/M8004A) patient monitor has a 12-inch TFT LCD flat panel SVGA display. The standard input devices for the MP50 are the Touchscreen and integrated navigation point; the MP40 is supplied with an integrated navigation point only. Up to six waves can be shown on MP40/MP50 Screens, 12 ECG traces can be shown on the 12-Lead ECG Screen.

The MP40/MP50 can be connected to one MultiMeasurement Server (MMS) and any one of the measurement server extensions. The IntelliVue family plug-in measurement modules can be connected to its four integrated plug-in module slots with plug-and-play convenience (the only exception is the SvO module, M1021A, which cannot be used with the MP40/MP50). The Flexible Module Server (M8048A) cannot be used with the MP40/MP50.

Green when monitor is switched on

Red if there is a problem with the monitor

Green, yellow, and red. See the section on Using the Batteries for details

Green while the monitor is connected to AC power (mains)

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1 Basic Operation Introducing the IntelliVue Family

MP40/MP50 Major Parts and Keys

MP40/MP50 left side

1 Color-coded alarm lamps

2 Alarms off lamp

3 Model indicator

4 ECG out

5 Navigation Point

6 Part number and serial number

7 Mounting quick-release lever

8 Plug-in module slots

MP40/MP50 front panel

456 7

MP40/MP50 LED Colors and their Meanings

On/Standby LED

Error LED

Battery LED

AC Power LED

Green when monitor is switched on

Red if there is a problem with the monitor

Green, yellow, and red. See the section on Using the Batteries for details

Green while the monitor is connected to AC power (mains)

On/Standby switch

On/Standby LED

Error LED

Battery status LED

AC power operation LED

6 “read the documentation”

symbol

Mounting quick-release lever

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Introducing the IntelliVue Family 1 Basic Operation

IntelliVue MP60/MP70

The IntelliVue MP60/MP70 (M8005A/M8007A) patient monitors integrate the display unit, with a 15” color LCD display, and the data processing unit into one. Up to eight waves can be shown on the screens, as well as the 12-Lead ECG Screen. The MP60 uses the SpeedPoint as its primary input device while the MP70 uses touch screen operation but may have an optional SpeedPoint.

The monitors can be connected to the Multi-Measurement Server (MMS) and any one of the measurement server extensions, and to the Flexible Module Server (M8048A). The IntelliVue family plug-in measurement modules can be connected to its FMS module slots with plug-and-play convenience.

The MP60/MP70 has two integrated slots for plug-in modules. You can combine one each of the following modules in these slots: Pressure, Temperature, C.O., SpO the two-slot recorder module in the integrated slots.

and VueLink. You can also use

MP60/MP70 Major Parts and Keys

1 Color coded alarm lamps

891011 7

2 Alarms Off lamp

3Display

4Model indicator

5 SpeedPoint (optional for MP70)

6 Part number and serial number

7 Mounting quick-release lever

8AC power LED

9Error LED

10 Power on/standby switch

11 Power on LED

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1 Basic Operation Introducing the IntelliVue Family

MP80/MP90 Major Parts and Keys

In the MP80 and MP90, the display and the processing unit are separate components. They offer both touchscreen and the Remote SpeedPoint as standard input devices.

AC Power LED

Power on LED

Display Unit

Remote Alarm Device

The Remote Alarm Device provides audio and visual indicators of alarms, in addition to those shown on the display.

Error LED

Processing Unit

1 Two color coded alarm lamps (right-hand lamp flashes

red or yellow for patient alarms, left-hand lamp flashes light blue for INOPs)

2 Alarms off lamp - when illuminated it indicates that all

alarms are deactivated.

3 Speaker - for alarm prompts, QRS tones and so forth

4 Monitor power on /standby switch. Press to switch

monitor on remotely. Press and hold for one second to turn monitor off.

5 Power on LED - green when monitor is on

Power on Switch

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Related Products 1 Basic Operation

M3014A Capnography

M3016A Mainstream

Pressure connectors (red)

Temperature connector (brown)

Mainstream connector CO2 (optional)

Cardiac Output connector

M3015A Microstream

Inlet

Microstream

Gas sample outlet

connector CO

M3012A Hemodynamic Measurement Server Extension

Connection to MMS

The M3012A Hemodynamic Measurement Server Extension (HMSE) can be connected to the M3001A Multi-Measurement Server to provide the following additional measurements: Temperature, Pressure, an additional Pressure or Temperature, and C.O. and CCO measurements.

Cardiac Output (orange; optional)

Pressure connectors (red)

Temperature connectors (brown)

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1 Basic Operation Operating and Navigating

Operating and Navigating

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

The configurability of the monitor means that often you can access the same element in different ways. For example, you might be able to access an item through its on-screen setup menu, via a hard key, or via a SmartKey. These Instructions for Use always describe how to access items via an on-screen menu. You may use whichever way you find most convenient.

ABP Zero done at 11 Nov 02 7:31 am

18 16

67 8

Monitor information line Other screen elements

network connection indicator

(documented in Information Center Instructions for Use)

bed label

patient identification

patient category

paced status

date and time

access the profiles menu

current screen name/enter

change screen menu

adjust alarm volume/level

indicator

alarm status area - shows active alarm messages

status line - shows information messages and prompting you for action

close all open menus and windows and return to main screen

enter Main Setup menu

scroll right to display more SmartKeys

SmartKeys - these change according to your monitor’s configuration

scroll left to display more SmartKeys

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

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

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

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

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Operating and Navigating 1 Basic Operation

Selecting Screen Elements

Select a screen element to tell the monitor to carry out the actions linked to the element. For example, select the Patient Identification element to call up the Patient Demographics window, or select the HR numeric to call up the Setup ECG menu. Select the ECG wave segment to call up the ECG lead menu.

Note that the space between each line of a menu may be configured to wide or narrow to facilitate your most common method of operation, either touch, Speedpoint or navigation point, or mouse.

Using the Setup Menu

MP20/MP30/

MP40/MP50

Only

Setup

Alarm Messages

Alarm Limits

Alarm Volume

My Care Group

Change Screens

Profiles

Admit/Dischrg

Paced No

Network

Bed Information

Date, Time

For the MP20/MP30 and MP40/MP50 monitors, the elements at the top of the Screen are grouped together for ease of navigation. Select any item at the top of the Screen to open the Setup menu; scroll down the menu to highlight the element you want then press the navigation point to select the element.

Using the Touchscreen

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

Disabling Touchscreen Operation

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

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

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

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1 Basic Operation Operating and Navigating

Using the SpeedPoint

integrated SpeedPoint (MP60/MP70 only)

1 Silence - acknowledges all active alarms by switching off audible alarm indicators and lamps. Behavior

follows the Silence permanent key configuration.

2 Alarms Off/Pause Alarms- pauses alarm indicators. Behavior follows the Pause Alarms permanent key

configuration.

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

4 Back - go back one step to the previous menu.

5 SpeedPoint knob - rotate and tilt to highlight elements. Press to select.

6 Function keys on remote SpeedPoint - function identical to the first five SmartKeys configured for a

screen.

7 On/standby key

Remote SpeedPoint (all monitors)

Rotate the SpeedPoint knob left or right. With each click, the highlight jumps to the neighboring screen element. Alternatively, tilt the knob to move it in the direction of a screen element. A cursor moves across the screen, following the direction of the knob. Any screen element under the cursor is highlighted. When you reach the screen element you want, press the knob to select the element.

Using the remote SpeedPoint, you can operate the monitor from a distant location such as at the foot of the bed. The remote SpeedPoint can be used with all monitors.

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Operating and Navigating 1 Basic Operation

Using the Navigation Point

MP20/MP30/

MP40/MP50

Only

1Silence - acknowledges all active alarms by

switching off audible alarm indicators and lamps. Exact behavior depends on permanent key configuration

2Alarms Off/Pause Alarms - pauses alarm

indicators. Exact behavior depends on Pause Alarms permanent key configuration

3 Main Screen -

windows and return to the main screen.

4Back - takes you back one step to the previous

menu.

5 Navigation Point knob

closes all open menus and

To use the navigation point, rotate it left or right. With each click, the highlight jumps to the neighboring screen element. The element under the cursor is highlighted. When you reach the screen element you want, press the knob to select the element.

Using a Mouse or Trackball

If you are using a mouse or trackball, select screen elements by clicking on them (press and release the left mouse button). While you are moving the mouse, a cursor appears and a highlight shows your current position.

Using Keys

The monitor has four different types of keys.

Permanent Keys

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

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

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

Select again to immediately re-enable alarm indicators.

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

lamps.

Alarms Off.

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

Main Setup - enter main setup menu.

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1 Basic Operation Operating and Navigating

SmartKeys

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

enter profile menu change Screen

show BIS Sensor

freeze waves quick admit a patient

set alarm limits

change alarm volume end case to discharge a patient

change QRS volume

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

review beat labels (annotate arrhythmia wave)

previous Screen

enter patient identification menu to admit/discharge/transfer

view information for patients in other beds

change screen brightness (not for independent displays)

re-learn arrhythmia

change amplitude (size) of ECG wave enter cardiac output procedure

- start/stop manual NBP measurement

- start auto series

- stop current automatic measurement within series

start veni puncture (inflate cuff to subdiastolic pressure)

access patient reports zero invasive pressure transducer

start NBP STAT measurement

stop automatic or STAT NBP measurement and measurement series

set the NBP repeat time

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Operating and Navigating 1 Basic Operation

start a delayed recording

set wide automatic alarm limits set narrow automatic alarm limits

access wedge procedure window access the Loops window

review vital signs trend review graph trend

access event surveillance access calculations

access the calculator access the Drug Calculator

gas monitor - exit standby mode suppress <gas measurement> zero

unpair equipment access ST Map application

Realtime Record SmartKey to access popup recording keys

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

access EEG CSA access the EEG montage

display VueLink information access timers

Hardkeys

A hardkey is a physical key on a monitoring device, such as the zero pressure key on the MMS or a setup key on a module.

Pop-Up Keys

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

Using the On-Screen Keyboard

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

Shift and capital Lock keys to access uppercase letters. Use the Back key to delete

access remote applications (if Application Server is connected)

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1 Basic Operation Operating and Navigating

If a conventional keyboard is connected to the monitor, you can use this instead of or in combination with the on-screen keyboard.

Using the On-Screen Calculator

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

♦ To access the on-screen calculator, select the

Calculator SmartKey, or select Main Setup

-> Calculations -> Calculator.

Calculator

M+

√

Back

C/CE

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Operating Modes 1 Basic Operation

Operating Modes

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

1 Select the Main Setup menu.

2 Select Operating Modes and choose the mode you require.

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

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

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

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

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

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

Standby Mode

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

To e n t e r Stan d y m o de ,

♦

♦ select Main Setup, followed by Monitor Standby.

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

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

To resume monitoring,

♦ Select anything on the screen or press any key.

Config

select the Monitor Standby SmartKey or

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1 Basic Operation Understanding Screens

Understanding Screens

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

When you switch from a complex to a less complex Screen layout, some measurements may not be visible but are still monitored in the background. If you switch to a more complex Screen with, for example, four invasive pressure waves but you have only two pressures connected to the monitor, the “missing” two pressures are either left blank or the available space is filled by another measurement.

Switching to a Different Screen

1 To switch to a different Screen, select the current Screen name in the monitor info line,

or select the Change Screen SmartKey.

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

Changing a Screen’s Content

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

To change the selection of elements on a Screen,

1 Select the element you want to change.

2 From the menu that appears, select Change Wave, Change Numeric, or

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

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

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

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Using a Second Display 1 Basic Operation

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

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

To recall Screens, either

♦ select the name of the Screen in the

Change Screen menu

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

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

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

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

Change Screen

6 Waves A

Split Screen A

Loops

Cardiac Output

Vital Signs A

Vital Signs A*

Using a Second Display

A second display, showing the same Screen as the main display, can be connected to any of the monitors, for viewing only.

A second display showing a different Screen can be connected to the MP90. The second display can also be operated using standard input devices. There are two separate modes of operation depending on whether one person is operating both displays or each display has its own operator. This is set in the monitor’s Service Mode. In Service Mode you can also define which display you want windows to appear on, when the setup keys on the modules are pressed or when a window is automatically opened.

The content of each Screen can be changed individually as described in the previous section. If you are operating two displays, you can choose Screens for both displays from one location:

1 Select Profiles in the monitor info line of the first display,

2 Select Display 1, then select the Screen you want to display on the first display from the list of

available Screens.

3 Select Display 2, then select the Screen you want to display on the second display from the list

of available Screens.

The second display Screen may take a few seconds to load.

Using the Visitor Screen

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

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1 Basic Operation Understanding Profiles

To activate this Screen, select the Screen name in the monitor info line to open the Screen

♦

menu, then select the name of the visitor Screen configured for your monitor from the list of available Screens.

♦ Select any element on the Screen to open the Screen menu and select a different Screen to show

waves and numerics again.

Understanding Profiles

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

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

• Display (screens)

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

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

• Monitor Settings

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

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

• Measurement Settings

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

to individual measurements, for example, measurement on/off, measurement color, alarms limits, NBP alarm source, NBP repeat time, temperature unit (

Profiles

Profile : Profile A

Patient Category: Adult

Paced : No

Display : S-014

Meas Settings: Measurement A

Monitor Settings: Monitor A

F or oC) pressure unit (mmHg or kPa).

Measurement A

Measurement B

Measurement C

Measurement D

Profiles Menu, showing current settings Available choices in measurement

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Understanding Profiles 1 Basic Operation

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

You might find it helpful to think of the three categories in terms of a restaurant menu. The Screens are like the first course, offering you a choice of “starters” (many different screen configurations from which you can choose the one that best suits your requirements). The Monitor Settings category is like the main course, offering a choice of different “main dishes” from which you can pick one. The Measurement Settings are like the dessert course. From these you build your meal. You can choose one from the “starters”, one from the main course, then one from the dessert or simply pick one or two courses without having a full meal.

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

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

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

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

Swapping a Complete Profile

1 Select Profiles in the monitor info line, or select the Profiles Smartkey.

2 In the Profiles menu, select Profile.

3 Chose a profile from the pop-up list.

4 Confirm your selection.

Swapping a Settings Block

1 Select Profiles in the monitor info line, or select the Profiles Smartkey.

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

Monitor Settings

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

4 Confirm your selection.

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

Default Profile

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

Locked Profiles

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

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1 Basic Operation Understanding Settings

Understanding Settings

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

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

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

alarm limits

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

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

• when you discharge a patient

•when you load a Profile

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

Changing Measurement Settings

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

• via the measurement numeric - select the measurement numeric to enter its setup menu. For example, to enter the

• via the Setup hardkey (on plug-in modules) - press the Setup hardkey on the module front.

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

• via the Measurement Selection key.

This guide always describes the entry method using the setup menu. But you can use any method you prefer.

Setup ECG menu, select the HR (heart rate) numeric.

Switching a Measurement On and Off

When a measurement is off, its waves and numerics are removed from the monitor’s screen. The monitor stops data acquisition and alarming for this measurement. A measurement automatically switches off if you disconnect its module or measurement server. If you disconnect a transducer, the monitor replaces the measurement numeric with question marks.

1 Enter the measurement’s setup menu and select the measurement.

2 Select the measurement name to toggle between on and off. The screen display indicates the active

setting.

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Changing Wave Speeds 1 Basic Operation

Switching Numerics On and Off

For some measurements, such as EEG, you can choose which numerics to view on the screen.

♦ In the measurement’s setup menu, select the numeric name to toggle between on and off.

For example in the Setup EEG menu, select the EEG numeric name to toggle between on and off.

Adjusting a Measurement Wave

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

measurement wave itself. This displays the measurement related measurement settings.

Wave menu, which has only wave-

Changing Wave Speeds

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

The monitor distinguishes three groups of wave speed settings,

• RespiratorySpeed, for all respiratory waves: CO

• EEG Speed, for all EEG and BIS waves

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

Changing the Wave Group Speed

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

To change the wave speed of a wave speed group,

1 Select Main Setup -> User Interface

2 Select Global Speed, RespiratorySpeed, or EEG Speed as required

3 Select a value from the list of available speeds.

Changing Wave Speed for a Channel

To change the wave speed of an individual wave channel,

1 Enter the Wave menu for a measurement by selecting its wave.

2 Select Change Speed.

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

Global Speed.

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

, Resp. anesthetic agents and O

Page 44

1 Basic Operation Freezing Waves

Freezing Waves

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

Freezing An Individual Wave

To freeze a wave,

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

2 Select Freeze Waves.

The realtime wave is replaced with the frozen wave.

Freezing All Waves

To freeze all waves on the screen,

1 Select the Freeze Waves SmartKey.

All realtime waves are replaced with frozen waves.

Measuring Frozen Waves

To measure a frozen wave,

1 Select the frozen wave.

If you are using touch, this automatically positions the vertical cursor. The cursor can be repositioned by touching the required point on the wave, or

2 Using the Speedpoint or another pointing device or touch: use the right/left arrow keys to move

the vertical cursor.

The vertical cursor moves through the time axis and the current value is displayed next to the cursor.

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

The horizontal cursor measures the wave value, which is displayed above the cursor line.

Changing The Wave Speed

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

To change the wave speed:

1 Select the frozen wave.

2 Select Change Speed.

3 Select a speed from the list.

Updating The Frozen Wave

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

1 Select the frozen wave.

2 Select Freeze Again.

Page 45

Using Labels 1 Basic Operation

Releasing Frozen Waves

To release frozen waves,

1 Select a frozen wave.

2 Select Unfreeze Waves.

All frozen waves are released.

Using Labels

You can measure multiple invasive pressures, temperatures, and SpO2 simultaneously. The monitor uses labels to distinguish between them. The default settings defined in the profile (such as measurement color, wave scale, and alarm settings) are stored within each label. When you assign a label to a measurement, the monitor automatically applies these default settings to the measurement. The labels assigned are used throughout the monitor, in reports, recordings, and in trends.

About Label Sets

Your monitor may be configured to use a Restricted or Full label set. The Full label set provides extra labels for Pressure and Temp. See the sections in this Instructions for Use on Pressure and Temp for more information.

If you connect a measurement server from a monitor using a Full label set to an IntelliVue monitor using a Restricted label set or an M3/M4 monitor, any additional labels switch to labels available in the target monitor. This may cause a label conflict with other monitored measurements.

Be aware that connecting a monitor using the Full label set to an Information Center with certain software revisions may affect the availability of measurement information from the additional labels on the Information Center. See the Information Center documentation and your monitor’s Configuration Guide for information on label set compatibility.

Changing Measurement Labels (e.g. Pressure)

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

1 Enter the Wave menu of the measurement.

2 Select Label.

3 Choose a label from the list.

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

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

Give me an example Let’s imagine you used a Press module to monitor your previous patient’s CVP. Now you want to use the same module to measure ABP with a new patient. You’ve set up your arterial line. When you connect the pressure transducer to the module, the pressure shown on the screen still uses the CVP color and wave scale and is labeled CVP. To rectify this, just change the pressure label to ABP. Now the pressure has the correct color, the wave is shown in the correct scale, and the appropriate alarm limits for ABP are active.

Page 46

1 Basic Operation Using Labels

Resolving Label Conflicts

Each label must be unique, that is, it can only be assigned once. You cannot monitor two pressures labelled “ICP” at the same time. If you need to use two identical pressures, you must assign different labels to them, for example, P and ICP.

Measurement labels are stored in the measurement device (module or measurement server). If you try to use two measurement devices that have identical labels, this causes a label conflict in the monitor.

Depending on your configuration, the monitor will either

• resolve the conflict automatically, by assigning a new, generic label to the most recently connected conflicting label (e.g. a second FAP label could be changed to ABP)

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

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

All the currently available measurement devices are depicted in the Measurement Selection window. Any measurement labels causing a label conflict are shown in red. If a measurement device is connected but currently unavailable, for example, because it was deactivated due to a label conflict, the device is shown “grayed-out”.

measurement selection key with question marks indicating a label conflict

Conflicting measurement

Measurement Selection

labels are shown in red

SpO2

SpO2 BIS

Tskin C.O.

EcgRsp NBP ABP

De-activated labels are grayed-out

CO2

Temp

To resolve a label conflict,

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

to display the Measurement Selection window.

2 Select the device whose label you want to correct.

3 Use the measurement selection pop-up keys to resolve the conflict. Select either:

– Change Label to assign a different label to the conflicting label

– De-activate: to disable the conflicting device. It retains its label for future use but becomes

invisible to the monitor, as though it had been unplugged. When the device has been deactivated the question marks under the measurement selection key will be replaced by XXX.

– Setup <Measurement label>: to enter the Setup menu for the measurement and change

the conflicting device’s label to a different label.

– Modify Driver (VueLink only) - change the VueLink device driver.

Page 47

Changing Monitor Settings 1 Basic Operation

Changing Monitor Settings

♦ To change monitor settings such as date and time, brightness, or QRS tone volume, select the

Main Setup SmartKey and then select the setting you want to change, or select User Interface to enter a submenu where you can change user interface settings.

Adjusting the Screen Brightness

1 Select the Brightness SmartKey.

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

bright.

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

If you are using an MP80 or MP90 with an external display, the Brightness SmartKey does not adjust the brightness of this display. See the instructions supplied with the external display for instructions.

Adjusting Touch Tone Volume

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

1 In the Main Setup menu, select User Interface

2 Select TouchToneVolume, then select the appropriate setting for the touch tone volume: 10 is

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

Setting the Date and Time

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

WARNING Changing the date or time will affect the storage of trends and events.

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

menu.

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

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

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

Checking Your Monitor Revision

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

2 Select the correct device from the device pop-up keys.

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

revision information.

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1 Basic Operation Getting Started

Getting Started

Once you understand the basic operation principles, you can get ready for monitoring.

Inspecting the Monitor

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

monitoring procedure on a patient. Contact your service personnel.

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

all connected Measurement Servers, modules, or measurement server extensions. – Check for any mechanical damage.

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

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

battery has sufficient power for monitoring. When you use a battery for the first time, you must

charge it, following the instructions given in the section on Charging Batteries.

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

instrument is in good working order.

Switching On

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

ready to use. If you see a message such as

starting monitoring that measurement. Connected devices usually take their power from the

monitor. External devices such as gas monitors and those connected via VueLink have their own

power switches.

CO2 Sensor Warmup wait until it disappears before

Setting up the Measurement Servers and Modules

1 Decide which measurements you want to make.

2 Connect the required modules, Measurement Servers, or measurement server extensions.

3 Check that you have the correct patient cables and transducers plugged in. The connectors are

color-coded to the patient cables and transducers for easy identification.

Starting Monitoring

After you switch on the monitor,

1 Admit your patient to the monitor.

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

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

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

require.

Page 49

Disconnecting from Power 1 Basic Operation

Disconnecting from Power

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

Monitoring After a Power Failure

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

Networked Monitoring

If your monitor is connected to a network, a network symbol is displayed in the upper left corner next to the bed label. To see details about the Care Group, the monitoring equipment, and technical information about the network,

♦ MP20/MP30/MP40/MP50 - select the monitor info line to enter the Setup menu, then select

Bed Information.

♦ MP60/MP70/MP80/MP90 - in the monitor info line, select the bed label.

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

Using Remote Applications

If your monitor is connected to a Philips Application Server, you can access applications hosted remotely on the Application Server and display and operate them on the bedside monitor screen. The Application Server provides portal technology to allow information access through a web browser, terminal emulation, or served applications. The applications available depend on the Application Server configuration: see the device documentation for details. A Remote Application window can also be embedded in a monitoring Screen.

To display remote applications on the monitor,

1 In the Main Setup menu, select Remote Applics, or select the

Remote Applications SmartKey.

2 Select the required application from the pop-up list of available applications.

3 Operate the application with your preferred monitor input device: touchscreen, SpeedPoint,

navigation point, keyboard or mouse.

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1 Basic Operation Using Remote Applications

Remote Application Popup Keys

Pop-Up Keys Selecting this pop-up key lets you....

Minimize

minimize the Remote Application window; the session continues running in the background. Select the Remote Application symbol to show the window at full size again.

Keyboard

Refresh

start a keyboard application to show a keyboard on the display. This key is not available if the keyboard application is not installed or not supported on the Philips Application Server.

update the content of the Remote Application window.

close the Remote Application session.

The Remote Application window occupies a pre-defined area on the monitor Screen. The maximum size of the area depends on the resolution of your display. If the pre-defined area for the Remote Application covers the full monitor Screen (on independent second displays only), the pop-up keys are not displayed. In this case a small window appears with two keys: one (with the Remote Application symbol) to display the pop-up keys and another to move the small window if it is obstructing viewing.

If you change the monitor Screen while a Remote Application is running, and the pre-defined area on the second Screen is smaller, the Remote Application cannot be shown at full size. You must select a suitable monitor Screen to display the Remote Application again.

Page 51

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

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

What’s New in Release C.0?

IntelliVue MP80

The MP80 patient monitor is a new addition to the IntelliVue patient monitor family. The functionality is similar to that of the MP70 but with the flexibilty of component modularity as in the MP90.

M3014A Capnography Extension

2What’s New?

The M3014A Capnography Extension offers a new measurement combination - mainstream CO cardiac output, invasive pressure and invasive pressure/temperature.

M8045A Docking Station

The docking station provides quick mounting and connections for the MP20/MP30/MP40/MP50 in a one-step operation. By placing the monitor on the docking station and closing the lever you can make the connection to AC power and to a network, if present.

BIS Interface Board

This interface board allows use of Bispectral Index monitoring with the MP20 and MP30.

Timers Application

The new Timers application allows you to set timers to notify you when a specific time period has expired. The timers can have varying characteristics and can be located on the Main screen for easy viewing.

IntelliVue Instrument Telemetry (USA only)

Wireless network capabilities via the IntelliVue Instrument Telemetry network using a built-in interface (MP20/MP30) or an external adapter (MP40/MP50).

Remote Applications

Remote applications can now be embedded in a monitoring Screen. The display colors for remote applications have been enhanced.

Basic Operation

• Selection and order of SmartKeys can now be configured in the monitor’s Configuration mode.

Page 52

2What’s New? What’s New in Release B.1?

• A new SmartKey exits Standby mode at the gas monitor.

• Direct operation of a second independent display with the MP90, using standard input devices.

• Networked monitors can now show Telemetry information for the “Own Bed” in an overview window or embedded in a Screen.

• Overview bed information can be configured to display in the colors used at the Information Center (with Information Center System G or higher).

• Support for Unit-based Care Group model for up to 64 beds (with Information Center System G or higher).

• Battery status information on the main screen now includes estimated monitoring time available during battery charging.

• Barcode reader support during patient admission.

• Direct entry to graphical trends when a limit alarm is selected in alarm review and to the event episode window when an event alarm is selected.

• MP90: screen trends can now also be viewed on the second display.

Trends

• In graphical trends, a segment menu allows direct adjustment of trend scales, automatic scale optimization, expanded view for an individual segment.

• In graphical and horizon Screen Trends a cursor is available.

• In the Vital Signs window, the values can be shown with the parameter color.

Events

• Events can be configured to be signaled as alarms (advanced event surveillance only).

• Deviation triggers can be set which trigger an event when measured values change by a defined amount over a set time (advanced event surveillance only).

• Up to six event groups can be active simultaneously (advanced event surveillance only).

Measurements

• Pulse Pressure Variation is a new derived measurement calculated from beat-to-beat arterial pressure values.

• MAC value calculations

Applications

• Improved Drug Calculator meeting JCAHO requirements.

• The ST Map application shows ST changes over time in two multi-axis spider diagrams.

• Freeze and measure waves on the Main Screen.

What’s New in Release B.1?

IntelliVue MP20/MP30

The MP20/MP30 patient monitor is a new addition to the IntelliVue patient monitor family. It is smaller and lighter than the MP40/MP50 monitors and can be powered by battery. It can be used with the measurement server and server extensions and has a built-in recorder.

Page 53

What’s New in Release B.0? 2What’s New?

Basic Operation

• New Measurement Selection window makes it easier to resolve measurement label conflicts

• New Previous/Next Screen function provides access to the ten most recently modified Screens

• Wave speeds can now be set for individual wave channels

Trends

• Cursor in graphical trend window improves navigation in the trends database

• Vital Signs and Graphical Trend screen elements can be embedded on a Screen

• New band style format for displaying trends of measurements with multiple numerics

• Horizon trend is a new format for screen trends, showing the deviation from a stored baseline

• Aperiodic measurements now stored with a timestamp in Vital Signs

• New symbol representing NBP measurements in Graphical Trends

Measurements

• ST numerics in the Alarm Limits window can be shown and hidden

• ST Point can be set directly by selecting a numeric value

• New NBP countdown timer shows the time remaining until the next NBP measurement in a series

• Networked monitors can now show Other Bed information embedded on Screen

• Additional labels available for Pressure and Temp

• Additional options for SpO

• Suppress Zero function for Microstream CO

Applications

• Drug Calculator can now be configured to include a list of commonly-used drugs

• Cursor in the Loops window improves navigation through the stored loops

• Volume-flow loops added to the list of respiratory loops types

• Loops Report for documentation of stored loops

• EEG CSA can now be called up and viewed in a window over the currently displayed Screen

, support for an extended list of accessories

What’s New in Release B.0?

IntelliVue MP40/MP50 The MP40/MP50 patient monitor is a new addition to the IntelliVue patient monitor family. It uses the same measurement devices as the MP60/MP70/MP90 monitors and shares the same technological platform and user interface, but is more compact in size and can be operated by battery.

M3012A Measurement Server Extension The new Hemodynamic Measurement Server Extension extends measurement capability by adding two additional pressures and Cardiac Output.

M1020B SpO

measurement without the need to use the VueLink module. Two options are available:

– Option A01 for use with Philips reusable and disposable sensors and Nellcor “R-Cal” disposable

sensors.

Module New SpO2 measurement module, M1020B, enables dual SpO2

Page 54

2What’s New? What’s New in Release B.0?

– Option A02 for use with Nellcor OxiMax sensors, including the MAX-FAST forehead sensor.

M1020B Option A02 for use with Nellcor OxiMax sensors may not be available in all countries.

PV Loops: compares graphic representations of airway waves to help detect changes in the patient airway condition.

High-resolution waves per Screen: the number of high-resolution waves that can be shown on a Screen is increased, limited only by the Axx Option purchased.

Alarms symbols: New alarm symbols are introduced, and “short” yellow alarms were renamed “onestar” yellow alarms (yellow arrhythmia alarms).

Aperiodic measurements available as Screen Trends: patient trend information for NBP, C.O., C.I., and Wedge can now be permanently displayed on the Screen in tabular and graphical form.

Page 55

What’s New in Release A.2? 2What’s New?

What’s New in Release A.2?

12-Lead ECG recordings: 12-Lead ECG waves and numerics can be sent to a connected recorder

High-Resolution Trend Report: high-resolution trend report can be sent to a connected printer

ST Snippets ST snippets, showing a one second wave segment for each measured ST lead, can be

permanently displayed on the Screen or called up as required.

EEG Wave Speed: new EEG-specific wave speeds have been added to the list of wave speeds available

Drug Calculator: this new feature helps you to calculate drug dosages for your patients

On-Screen Calculator: a mathematics calculator can be used on the Screen

Visitor Screen: this new Screen is designed to hide sensitive patient information from the Screen.

Monitoring and alarm generation function as usual.

Touch selection volume control: The volume of the audio prompt given when a screen element is selected is now adjustable

VueLin k i nterface : the VueLink on-screen appearance and controls are improved

M3001A: Trend upload from the Multi-Measurement Server (M3001A) improved

Screen Trends: lets you display patient trend information in graphic form permanently on the Screen

Alarm Limits Page: lets you view and control alarm settings for all measurements in one window

New Option for Event Surveillance: a new neonatal event review option #C04 is introduced

Second display To simultaneously show two different Screens, a second display can be connected to

the MP90. The second display is for viewing only.

Page 56

2What’s New? What’s New in Release A.2?

Page 57

3Alarms

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

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

Red and yellow alarms are patient alarms. A red alarm indicates a high priority patient alarm such as a potentially life threatening situation (for example, asystole). A yellow alarm indicates a lower priority patient alarm (for example, a respiration alarm limit violation). Yellow arrhythmia alarms are specific to arrhythmia-related patient conditions (for example, ventricular bigeminy).

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

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

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

The monitor sounds an audible indicator for the highest priority alarm. If more than one alarm condition is active in the same measurement, the monitor announces the most severe. Your monitor may be configured to increase alarm indicator volume automatically during the time when the alarm is not acknowledged.

↑ ** HR HIGH

Page 58

3Alarms Visual Alarm Indicators

Visual Alarm Indicators

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

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

• in text form, for example “**SpO2 LOW” or

• in numeric form, for example “**SpO2 94<96”, where the first number shows the maximum deviation from the alarm limit, and the second number shows the currently set limit.

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

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

limit on the monitor screen is shown more brightly.

Alarm lamp: A lamp on the monitor’s front panel flashes. This has the same color as the alarm priority.

Nurse call systems: Alarm conditions are indicated on any device connected to the nurse call relay, if configured to do so.

Audible Alarm Indicators

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

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

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

Alarm Tone Configuration

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

• increase the alarm volume of unacknowledged alarms at regular intervals

• change the interval between alarm sounds (ISO/IEC Standard 9703-2 alarms only)

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

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

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Audible Alarm Indicators 3Alarms

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

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

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

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

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

ISO/IEC Standard 9703-2 Audible Alarms

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

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

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

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

Changing the Alarm Tone Volume

♦ The alarm volume symbol at the top right of the monitor screen gives you an

indication of the current volume. To change the volume, select the volume symbol and then select the required volume from the pop-up selection.

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

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

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

Minimum Volume for No Central Monitoring INOP

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

Alarm

Page 60

3Alarms Acknowledging Alarms

Acknowledging Alarms

To acknowledge all active alarms and INOPs, select the Silence permanent key. This switches off the audible alarm indicators and alarm lamps. Alternatively, you can acknowledge alarms by pressing the Silence hardkey on the MMS or on the SpeedPoint. The hardkeys follow the behavior configured for the permanent key.

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

Silence

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

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

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

Acknowledging Disconnect INOPs

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

Alarm Reminder (ReAlarm)

If Alarm Reminder is configured on for your monitor, you will get an audible reminder of alarm conditions that remain active after you have acknowledged the alarm. This reminder may take the form of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is the same as a new alarm). There is no alarm reminder for INOPs.

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

APNEA

Pausing or Switching Off Alarms

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

To view the alarm pause setting chosen for your unit,

1 Select Main Setup -> Alarm Settings

2 Check the Alarms Off setting.

This setting can only be changed in Configuration Mode.

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Pausing or Switching Off Alarms 3Alarms

To Pause All Alarms

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

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

♦ Or press the Alarms hardkey on the SpeedPoint or Navigation Point. The hardkey

follows the behavior configured for the permanent key.

Pause Alarms

To Switch All Alarms Off

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

♦ Select the Alarms Off permanent key.

♦ Or press the Alarms hardkey on the SpeedPoint or Navigation Point. The

hardkey follows the behavior configured for the permanent key.

Pausing alarms infinitely is the same as switching them off.

Alarms

Off

To Switch Individual Measurement Alarms On or Off

1 Select the measurement numeric to enter its setup menu.

2 Select Alarms to toggle between On and Off.

The alarms off symbol is shown beside the measurement numeric.

While Alarms are Paused or Off

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

•

In the alarm field, the monitor displays the message

Alarms Paused or Alarms Off, together with the alarms paused symbol and the remaining pause time in minutes and seconds, or alarms off symbol.

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

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

The only exceptions are the INOPs Battery/Batteries Empty, Battery/ Batteries Malfunction, Batt 1/2 Missing, and NBP Cuff Overpressure. These INOPs are sounded even if alarms are paused or off.

ALARMS PAUSED 1:28

ALARMS OFF

• The nurse call relay is not active.

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

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3Alarms Alarm Limits

Restarting Paused Alarms

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

Pause Alarms (or Alarms Off ) again.

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

Resetting Arrhythmia Alarm Timeouts

♦ To reset the arrhythmia alarm timeout period, select the Alarms Off or Pause Alarms

permanent key and then reselect it.

Extending the Alarm Pause Time

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

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

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

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

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

Alarm Limits

The alarm limits you set determine the conditions that trigger yellow and red limit alarms. For some measurements (for example, BIS and SpO alarm limit to 100 switches the high alarm off, and setting the low alarm limit to 0 switches it off. In these cases, the alarms off symbol is not displayed.

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

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

Viewing Individual Alarm Limits

120

Alarm limits

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

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

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

Page 63

Alarm Limits 3Alarms

Viewing All Alarm Limits

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

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

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

Alarm Limits

ST-V4

ST-V5

ST-V6

SpO2

Pulse (SpO2)

NBPs

Graphic view of current yellow and red alarm limits and currently monitored measurement value Off indicates the measurement is switched off

ABPs

PAPd

awRR

Apnea Time

Measurement labels, with alarms off symbol where appropriate

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

Off

sec

Current alarm limits

Selecting Hide ST Limits hides the list again.

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

– All Al. On/All Al. Off,

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

measurements.

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

connected printer or recorder.

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3Alarms Alarm Limits

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

Changing Alarm Limits

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

1 in the measurement’s setup menu, select the alarm limit you want to change. This calls up a list of

available values for the alarm limit.

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

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

High red alarm (view only)

Alarms On/Off

High yellow alarm field

Up/down arrow keys for changing high yellow alarm limits

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

Preview Alarm AutoLimits for a measurement before applying

Select to apply wide AutoLimits

Select to apply narrow AutoLimits

Up/down arrow keys for changing low yellow alarm limits

15-min trend, showing alarm limits and monitored measurement values (MP40/50/60/70/90 only)

Graphic view of alarm limits with currently measured value

Low red alarm (view only)

Low yellow alarm field

To change alarm limits,

1 In the Change Limits window,

– if you are using touch, select the up or down arrow buttons to adjust the high and low alarm

limits as required.

– if you are using a SpeedPoint or Navigation Point, position the cursor in the high yellow alarm

field, then press the knob inwards. Rotate the knob to the left or right to adjust the limit. Press the knob again to set the displayed limit.

2 Repeat to set the low yellow alarm limit.

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Alarm Limits 3Alarms

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

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

About Automatic Alarm Limits (AutoLimits)

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

The defined safe limits never exceed the non-pathological range.

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

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

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

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

Alarm limits

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

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

Documenting Alarm Limits

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

Lower limit clamps

Upper limit clamps

High alarm limit, wide

High alarm limit, narrow

Low alarm limit, narrow

Low alarm limit, wide

Measurement value

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

printer.

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

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3Alarms Reviewing Alarms

Reviewing Alarms

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

Alarm Messages Window

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

The Alarm Messages window pop-up keys appear when the window is opened. If alarm pause extension is disabled, the pause pop-up keys are inactive (“grayed-out”). Selecting the Review

Alarms pop-up key opens the Review Alarms window.

Alarm Limits

Review Alarms Window

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

If you select a high or low limit alarm in the list, the Graphical Trends window will open to provide further data. If you select an alarm resulting from an event alarm notification, the Event Episode window for that event will open. When you close these windows you will return to the Review Alarms window.

The information in the Review Alarms window is deleted when a patient is discharged, when the monitor is switched off for longer than one minute, and when you leave Demonstration Mode.

Review Alarms

Pause Al. 5 Min.

Review Alarms

5 Apr 16:55:18 *** Apnea

5 Apr 16:55:18 ** ABPs HIGH (120 >95)

5 Apr 16:55:18 Alarms On

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

5 Apr 16:44:57 Alarms Off

5 Apr 16:44:46 ** awRR LOW (14<15)

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

5 Apr 16:44:28 ** ABPs HIGH

Pause Al. 10 Min.

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

Alarm Limits

Active Alarms

Pause Al. 5 Min.

Pause Al. 10 Min.

Page 67

Understanding Alarm Messages 3Alarms

Understanding Alarm Messages

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

♦ In the Alarm Messages window, select the INOP message. This calls up a help window with

an explanation of the INOP message and, where appropriate, a suggested solution for the problem.

Alarm Messages

Resp LEADS OFF

LL LEAD OFF

** awRR LOW

The lead LL has become detached from the patient or the lead set has been changed. Attach the missing electrode or select <New Lead Setup> to confirm the new lead set

Latching Alarms

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

Viewing the Alarm Latching Settings

To see the alarm latching setting for your monitor

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

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

settings.

This setting can only be changed in Configuration Mode. You should be aware of the settings chosen for your unit. There are three possible choices each for visual and audible latching, Red, Red and Yellow, and Off. These choices can be combined to give the following settings:

Visual Latching

Audible latching

R = red alarms, Y = yellow alarms

R&Y R&Y R&Y RROff

R&Y ROffROffOff

Page 68

3Alarms Testing Alarms

Alarm Latching Behavior

Red and Yellow Measurement Alarms

Alarm has not been acknowledged.

Alarm has been acknowledged.

Alarm condition still present.

Alarm condition no longer present.

Alarm condition still present.

Alarm condition no longer present.

Non-latching alarms

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

All audible and visual alarm indicators automatically stop.

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

Audible and visual alarm indicators automatically stop.

Visual and audible latching

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

All INOPs except DISCONNECT and UNPLUGGED INOPs from measurement servers and modules are non-latching. See “Yellow Arrhythmia Alarms” on page 111 for information on short yellow arrhythmia alarms latching behavior.

Silencing Latched Alarms from an Information Center

Alarms set to visual latching only cannot be silenced at an Information Center. If you need to be able to silence bedside monitor alarms at an Information Center, you must make sure that the configured latching settings include an audible element.

Visual latching, audible non-latching

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

Testing Alarms

When you switch the monitor on, a selftest is started. You must check that the alarms lamps light, one after the other, and that you hear a single tone. This indicates that the visible and audible alarm indicators are functioning correctly.

Alarm Behavior at On/Off

When you switch alarms on, the settings defined in the currently active Profile are used.

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

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

Page 69

4Patient Alarms and INOPs

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

For information on alarms and INOPs from the gas modules see the Essential Gas Module and Anesthetic Gas Module Instructions for Use.

Patient Alarm Messages

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

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

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

See the Essential Gas Module and Anesthetic Gas Module Instructions for Use for patient alarms and INOPs from the gas modules.

Alarm Message From Condition Indication

***APNEA or ***APNEA xxx sec

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

**awRR HIGH CO2, Resp,

**awRR LOW CO2, Resp,

**BIS HIGH BIS The Bispectral Index value has exceeded

**BIS LOW BIS The Bispectral Index value has dropped

CO2, Resp, AGM

AGM

Respiration has stopped for longer than the preset apnea time. “xxx” denotes the Apnea duration.

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

The airway respiration rate has exceeded the high alarm limit.

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

the high alarm limit.

below the low alarm limit.

numeric flashes, red alarm lamp, alarm tone.

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

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

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

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

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4 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

***BRADY (Pulse) or ***BRADY xxx<yyy

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

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

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

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

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

**et <Agent label> HIGH

**et <Agent label> LOW

**etCO2 HIGH CO2, Resp,

**etCO2 LOW CO2, Resp,

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

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

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

*/**/*** EVENT

at Information center

***EXTREME BRADY ECG The bradycardia limit has been

***EXTREME TACHY ECG The tachycardia limit has been

Press, SpO2The heart rate from the Pulse signal has

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

Index is above the high alarm limit.

Index is below the low alarm limit.

alarm limit.

SpO

AGM The end tidal agent high alarm limit has

AGM The end tidal agent value has fallen

AGM

Event surveillance

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

been exceeded.

below the low alarm limit.

The end tidal CO2 high alarm limit has been exceeded.

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

been exceeded.

the low alarm limit.

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

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

exceeded.

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

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

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

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

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

numeric flashes, red alarm lamp, alarm tone.

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

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

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

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

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

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

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

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

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

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Patient Alarm Messages 4 Patient Alarms and INOPs

Alarm Message From Condition Indication

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

exceeded.

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

alarm limit.

**imCO2 HIGH CO2, Resp,

AGM

**in <Agent label> HIGH

**in <Agent label> LOW

**inN2O HIGH N2O, AGM The inspired N2O high alarm limit has

**inO2 HIGH O2, AGM The inspired O2 high alarm limit has

**inO2 LOW O2, AGM The inspired O2 value has fallen below

***inO2 LOW OXYGEN O2, AGM The inspired O2 value has fallen below

*/**IRREGULAR HR ECG/

*/**MISSED BEAT ECG/

*/**MULTIFORM PVCs ECG/

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

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

AGM The inspired agent high alarm limit has

AGM The inspired agent value has fallen

Arrhythmia

The inspired minimum CO2 high alarm limit has been exceeded.

been exceeded.

below the AGT low alarm limit.

been exceeded.

the low alarm limit.

18 vol.%.

Consistently irregular heart rhythm. numeric flashes, yellow alarm

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

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

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

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

numeric flashes and high limit is highlighted, yellow alarm lamp, alarm tone. The sound switches off after 5 seconds if Arrhythmia is On.

numeric flashes and low limit is highlighted, yellow alarm lamp, alarm tone. The sound switches off after 5 seconds if Arrhythmia is On.

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

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

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

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

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

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

lamp, short yellow audible alarm.

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

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

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

Page 72

4 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

*/**NON-SUSTAIN VT ECG/

Arrhythmia

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

*/**PACER NOT CAPT ECG/

Arrhythmia

A missed beat with a pace pulse was

detected. (paced patients only)

*/**PACER NT PACING

ECG/ Arrhythmia

A missed beat without a pace pulse was

detected. (paced patients only)

*/**PAIR PVCs ECG/

Arrhythmia

A non-ventricular contraction, followed

by two ventricular contractions,

followed by a non-ventricular

contraction has been detected.

*/**PAUSE ECG/

Arrhythmia

***<Pressure>

PRESS The pressure is non-pulsatile and the

DISCONNECT

No beat detected for a period greater

than the pause threshold.

mean pressure is continuously less than

10mmHg (1.3kPa). This alarm occurs

only with arterial pressures (P, ABP,

ART, Ao, BAP, FAP, PAP, UAP).

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

the high alarm limit. s, d, or m after the

label indicates whether the systolic,

diastolic or mean pressure has crossed

the limit.

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

the low alarm limit. s, d, or m after the

label indicates whether the systolic,

diastolic or mean pressure has crossed

the limit.

**PULSE HIGH PRESS

SpO

**PULSE LOW PRESS

SpO

*/**PVCs/min HIGH ECG/

Arrhythmia

The pulse rate has exceeded the high

alarm limit.

The pulse rate has dropped below the

low alarm limit.

More premature ventricular

contractions have been detected in a

minute than the limit.

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

Arrhythmia

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

< 1/3 the average interval followed by a

compensatory pause of 1.25 x average

R-R interval or two such Vs without

compensatory pause occurring within 5

minutes of each other. (When HR

>100, 1/3 R-R interval is too short for

detection.).

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

numeric flashes, red alarm lamp, alarm tone.

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

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

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

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

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

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Patient Alarm Messages 4 Patient Alarms and INOPs

Alarm Message From Condition Indication

**RR HIGH RESP The respiration rate has exceeded the

high alarm limit.

**RR LOW RESP The respiration rate has dropped below

the low alarm limit.

*/**RUN PVCs HIGH ECG/

Arrhythmia

**<SpO2 label>

SpO

HIGH

**<SpO2 label> LOW SpO

A run of PVCs greater than 2 was

detected.

The arterial oxygen saturation has

exceeded the high alarm limit.

The arterial oxygen saturation has fallen

below the low alarm limit.

**ST<n> HIGH ECG/

Arrhythmia

**ST<n> LOW ECG/

Arrhythmia

**ST MULTI <n>,<n> ECG/

Arrhythmia

The ST elevation in lead <n> is higher

than the limit.

The ST depression in lead <n> is lower

than the limit.

The ST depression or elevation is

outside of the limit in two or more leads

**ST MULTI

at Information Center

ECG/ Arrhythmia

The ST depression or elevation is

outside of the limit in two or more

leads. Check on the monitor for more

details about which leads are affected.

**SvO2 HIGH SvO

The SvO2 value has exceeded the high

limit.

**SvO2 LOW SvO

The SvO2 value has fallen below the low

limit.

*/**SVT ECG/

Arrhythmia

A run of supraventricular beats greater

than the SVT run limit has been

detected and the HR has exceeded the

SVT HR limit.

***TACHY (Pulse) or ***TACHY xxx>yyy

Press, SpO2The heart rate from the Pulse signal has

exceeded the tachycardia limit. xxx

denotes the highest measured value; yyy

is the tachycardia limit.

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

exceeded the high alarm limit.

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

below the low alarm limit.

**tcpO2 HIGH/ **tcpCO2 HIGH

tcGas The tcpO2 or tcpCO2 value has

exceeded the high alarm limit.

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

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

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

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

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

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

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

numeric flashes, yellow alarm lamp, alarm tone

(on monitor) numeric flashes, yellow alarm lamp, alarm tone

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

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

numeric flashes, yellow alarm lamp, alarm tone.

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

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

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

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

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4 Patient Alarms and INOPs Patient Alarm Messages

Alarm Message From Condition Indication

**tcpO2 LOW/ **tcpCO2 LOW

**<Temperature label> HIGH

**<Temperature label> LOW

*/**VENT BIGEMINY ECG/

***VENT FIB/TACH ECG A fibrillatory waveform for 4

*/**VENT RHYTHM ECG/

*/**VENT TRIGEMINY ECG/

***VTACH ECG,

**/***VueLink ALARM

at Information Center

tcGas The tcpO2 or tcpCO2 value has fallen

below the low alarm limit.

TEMP The temperature has exceeded the high

alarm limit.

TEMP The temperature has fallen below the

low alarm limit.

A dominant rhythm of N, V, N, V (N = Arrhythmia

Arrhythmia

VueLink A yellow (**) or red (***) patient alarm

supraventricular beat, V = ventricular

beat) was detected.

consecutive seconds was detected.

A dominant rhythm of adjacent Vs >

vent rhythm limit and ventricular HR <

VTach HR limit was detected.

A dominant rhythm of N, N, V, N, N,

V (N = supraventricular beat, V =

ventricular beat) was detected.

Ventricular tachycardia has been

detected (Consecutive PVCs exceed V-

Tach Run limit and HR exceeds V-

Tach HR limit).

is present on the VueLink module.

Check the monitor display for more

detailed alarm information.

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

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

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

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

numeric flashes, red alarm lamp, alarm tone.

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

(on monitor) yellow or red alarm lamp, alarm tone

Page 75

Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

Technical Alarm Messages (INOPs)

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

INOP Message, Indication Source What to do

ABP INOPS PRESS See <Pressure label> INOPS (under Pressure).

ALL ECG ALARMS OFF ECG/

Arrhythmia

Ao INOPS PRESS See <Pressure label> INOPS (under Pressure).

ART INOPS PRESS See <Pressure label> INOPS (under Pressure).

Bad Serverlink

INOP tone

BAP INOPS PRESS See <Pressure label> INOPS (under Pressure).

BATTERIES EMPTY or BATT 1/ BATT 2 EMPTY

INOP tone, battery LED flashes During this INOP, alarms cannot be paused or switched off.

BATTERIES INCOMPAT or BATT 1/BATT 2 INCOMPAT

INOP tone

BATTERIES LOW or BATT 1/ BATT 2 LOW

INOP tone

BATTERIES MALF or BATT 1/ BATT 2 MALFUNCTION

INOP tone, battery LED flashes During this INOP, alarms cannot be paused or switched off unless the monitor is connected to mains power.

BATT 1/BATT 2 MISSING

INOP tone. During this INOP, alarms cannot be paused or switched off.

BIS CABLE INCOMPAT

INOP tone.

BIS CABLE USAGE

INOP tone.

Monitor 1) An MMS with an incompatible software revision is

Batteries The estimated remaining battery-powered operating time of

Batteries The indicated battery or batteries cannot be used with this

Batteries The estimated battery-powered operating time remaining is less

Batteries The monitor cannot determine the battery status. If this INOP

Batteries The monitor requires two batteries but can detect only one

BIS The semi-reusable sensor cable connected is unknown or not

BIS The semi-reusable sensor cable has exceeded the maximum

All ECG alarms have been switched off, or the HR alarm source is not ECG. To resume ECG alarm generation, switch ECG alarms on or select ECG as the alarms source.

connected to the monitor. This combination does not allow monitoring, OR

2) You cannot use this combination of monitor, MMS and cable. Switch off the monitor and contact your service personnel.

the indicated battery or batteries is less than 10 minutes. Replace the batteries immediately.

If the condition persists and the monitor is not connected to mains power, this INOP is re-issued two minutes after you acknowledge it.

monitor. Replace with the correct batteries

than 20 minutes.

persists, replace the faulty battery or batteries. If the condition persists and the monitor is not connected to mains power, this INOP is re-issued two minutes after you acknowledge it.

Place the batteries in a different monitor or in a battery charger. If the same INOP is shown, contact your service personnel.

battery. Insert the missing battery immediately.

supported by your software revision. Replace it with a Philipssupported sensor cable.

number of uses. Replace the cable.

(M4605A).

Page 76

4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

BIS DSC DISCONN

INOP tone

BIS DSC INCOMPT

INOP tone

BIS DSC MALFUNC BIS Electrocautery used during self-test OR malfunction in the

BIS DSC UPDATE

INOP tone

BIS ELECTR. DISC

INOP tone.

BIS ENGINE DISC.

INOP tone

BIS ENGINE INCOMPT

INOP tone

BIS ENGINE MALFUNC

INOP tone

BIS EQUIP MALF

INOP tone

BIS HIGH IMPEDANCE

INOP tone may sound

BIS IMPEDANCE CHCK

INOP tone may sound

BIS DSC is not properly connected OR either DSC or BIS engine

may be faulty. Make sure that the DSC is properly connected to the BIS Engine. If INOP persists, replace DSC with a known good one of the same type. If INOP persists replace BIS engine. Silencing this INOP switches the measurement off.

BIS DSC is not supported by the BIS engine or new DSC

connected to an old BIS engine. A software upgrade may be required. Contact your service personnel.

DSC hardware. Make sure not to use electrocautery during the self-test procedure. Disconnect and reconnect the DSC to the BIS engine. If the INOP persists, replace the DSC or contact your service personnel.

BIS DSC update currently being carried out. This INOP will

disappear when the DSC update is finished. Do not disconnect the DSC during the update. No action is needed.

BIS One or more electrodes are not connected to the semi-reusable

sensor cable. Check all electrode connections.

BIS BIS engine not connected OR Module Cable defective.

Make sure that the Module Cable is properly connected. If INOP persists, replace the Module Cable. Silencing this INOP switches the measurement off.

BIS BIS engine software is not supported. A software upgrade may

be required. Contact your service personnel. MP20/30 - BIS engine not supported.

BIS Malfunction in the BIS engine hardware. Disconnect and

reconnect the BIS engine. If the INOP persists, replace BIS engine.

BIS There is a malfunction in the BIS hardware. Unplug and replug

the BIS module. If the INOP persists, contact your service personnel.

BIS Impedance of one or more electrode(s) is above the valid range,

most often caused by bad skin preparation. Check the sensor montage and press the electrode pads firmly. If this INOP persists, replace the sensor(s) in question using correct skin preparation. If INOP persists, contact your service personnel.

BIS The Cyclic Impedance check is running. It will stop

automatically if all impedances are within the valid range. If any electrodes do not pass the impedance test, check the sensor montage and press the electrode pads firmly. To manually stop the Cyclic Impedance Check, select

Cyclic Check Off in the Setup BIS menu.

BIS ISOELECTRC EEG BIS No discernible EEG activity is detected for longer than one

minute. Check the patient. Check that the electrodes are properly connected.

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Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

BIS LEAD OFF

INOP tone may sound

BIS OVERCURRENT

INOP tone

BIS SENSOR DISCONN

INOP tone

BIS SENSOR INCOMPAT

INOP tone

BIS SENSOR MALFUNC

INOP tone

BIS SENSOR USAGE

INOP tone

BIS SQI < 15% (INOP tone)

BIS SQI < 50% (no INOP tone)

BIS UNPLUGGED

INOP tone

BISx DISCONNECTED

INOP tone

BISx INCOMPATIBLE

INOP tone

BIS One or more electrodes have no skin contact and therefore

impedances cannot be measured. Check the sensor montage and press the electrode pads firmly. If this INOP persists, replace the sensor(s) in question, using correct skin preparation.

BIS Unplug and replug the BIS module or, f or the MP20/MP30,

disconnect and reconnect the BISx from the Interface board. If the INOP persists, contact your service personnel.

BIS The sensor is not properly connected to the patient interface

cable (PIC) and/or the PIC is not properly connected to the DSC or BISx, or the sensor or PIC or DSC or BISx may be faulty. Check all the connections. Disconnect and reconnect the sensor, PIC, DSC, BISx. If the INOP persists, replace the sensor. If the INOP persists, replace PIC. If INOP persists, contact your service personnel. Silencing this INOP switches the measurement off.

BIS Unsupported sensor connected or sensor type unknown or not

supported by your software revision. Replace the sensor, using only Philips supported sensors.

BIS Malfunction in the sensor hardware, most often caused by

liquids permeating into the connectors OR patient interface cable (PIC) or DSC or BISx may be faulty. Replace the sensor. Manually initiate a Cyclic Impedance Check. Make sure all electrodes pass the test. Make sure that the both sides of the PIC connector (between PIC and sensor) are dry. If you are not sure that the connector is dry, replace the PIC until it has dried. If this INOP persists, contact your service personnel.

BIS Excessive sensor usage. Replace sensor.

A Cyclic Impedance Check will start automatically.

BIS If the signal quality is below 50%, BIS numerics cannot be

reliably derived. If the signal quality is below 15%, no BIS numerics can be derived. This may occur as a result of artifacts such as those generated from motion or the presence of electrocautery devices. Make sure the sensor is properly attached to the patient. Manually initiate a Cyclic Impedance Check. Make sure all electrodes pass the test. Make sure the patient is completely relaxed (even small motions of the facial muscles affect the signal quality).

BIS Plug in the BIS module. Silencing this INOP switches off the

measurement.

BIS The BISx is not connected to the BIS module or the BIS

interface board. Silencing this INOP switches the measurement off.

BIS The BISx software is not compatible with the BIS module or

with the MP20/MP30 monitor software. A software upgrade may be required. Contact your service personnel.

Page 78

4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

BISx MALFUNCTION

INOP tone

CANNOT ANALYZE ECG ECG/

CANNOT ANALYZE ST ST The ST algorithm cannot generate a valid ST value. Possible

CCI NO BSA

CCI numeric unavailable INOP tone

CCO BAD PRESS SIGN

numeric displays -?INOP tone

CCO NO <Pressure label>

numeric displays -?INOP tone may sound

CCO NO CALIBRATION

numeric displays -?-

CCO NO PRESS

at Information Center

CCO NOT SUPPORTED

numeric displays -?INOP tone

CCO/CCI OVERRANGE

numeric displays -?INOP tone

CCO <Pressure label> INVALID

numeric displays -?INOP tone may sound

BIS The BISx is faulty. Disconnect and reconnect it to the module

or BIS interface board. If the INOP persists, replace the BISx. MP20/MP30 - Malfunction on interface board. If the INOP persists, contact your service personnel.

The arrhythmia algorithm cannot reliably analyze the ECG

Arrhythmia

C.O. CCI cannot be calculated because the patient's body surface

C.O. The arterial pressure wave can currently not be used for pulse

C.O. CCO/CCI cannot be calculated. Make sure that the pressure

C.O. The CCO measurement is currently not calibrated.

C.O. CCO/CCI cannot be calculated. Make sure that the pressure

C.O. A catheter for transpulmonary C.O. measurements has been

C.O. The measured CCO or CCI value is not within the specified

C.O. The arterial pressure selected for pulse contour calculation for

data. Check the ECG signal quality of the selected primary and secondary leads. If necessary, improve lead position or reduce patient motion. If you have arrhythmia analysis on, and you are not getting a reliable HR because the signal is below a minimum amplitude, unstable, or contains artifact, and you have tried to improve the system performance by choosing another lead and changing electrodes, you should consider turning arrhythmia analysis off.

causes are large variations in the measured ST values for consecutive beats, or ventricular paced beats. Review the ECG signal quality and the ST measurement points. If the patient has a ventricular pacemaker, ST analysis is not possible.

area is unknown. Enter the patient weight and height to provide the BSA for CCI calculation.

contour calculation for CCO or CCI measurement. Possible causes are air bubbles in the tubing or a physiological condition, for example severe arrhythmia.

chosen in the matches the pressure measured with the arterial catheter for CCO measurement. A VueLink pressure cannot be used. Select another pressure label, either ABP, Ao, ART, BAP, FAP, or UAP.

unplugged and replaced with a Right Heart C.O. catheter, or the measurement mode has been changed manually. Silencing this INOP switches the measurement off.

range for CCO/CCI measurement.

CCO is available but currently invalid. Make sure the pressure transducer is connected and the zero calibration is valid.

Setup CCO menu under CCO From

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Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

CCO PRESS INVALID

at Information Center

CCO PRESS OVERRANG

numeric displays -?INOP tone

CCO PULSE OVERRANG

numeric displays -?INOP tone

CCO/Tbl NO TRANSD

Numeric displays -?INOP tone

CCO RECALIBRATE

numeric displays -?-

Charge BATT1/BATT2 now

INOP tone

CHARGER MALFUNCT

INOP tone, battery LED may flash

Check Alarm Lamps

INOP tone.

CHECK BATT TEMP

INOP tone

Check Flex Texts

INOP tone

CheckInternVoltage

INOP tone.

Check Keyboard

INOP tone

Check Main Board 2

INOP tone.

Check Monitor Temp

INOP tone

Check Mouse Device

INOP tone.

Check MSL Voltage

INOP tone

Check Network Conf

INOP tone

C.O. The arterial pressure selected for pulse contour calculation for

CCO is available but currently invalid. Make sure the pressure transducer is connected and the zero calibration is valid.

C.O. The mean value of the arterial pressure values used for pulse

contour calculation for CCO is below 0 mmHg or above 300 mmHg.

C.O. The pulse rate of the pressure used for pulse contour

calculation for CCO is below 30 bpm or above 240 bpm.

C.O. No transducer attached to the module or catheter

disconnected.

C.O. The most recent CCO or CCI calibration was made over 8

hours ago. You should recalibrate CCO or CCI with transpulmonary C.O. measurements at least every 8 hours or when the hemodynamic condition of the patient has changed.

Batteries Battery must be charged. Connect the monitor to mains power

or exchange the battery.

Batteries There is a problem with the battery charger in the monitor.

Connect the monitor to mains power and contact your service personnel.

Monitor Perform a visual check of the alarm lamp to establish whether

there is a problem. Contact your service personnel to check the internal connections to the alarm lamps.

Battery The temperature of one or both batteries is too high. Check

that ventilation openings are not blocked and monitor is not exposed to heat.

Monitor Check the names of the monitor menus, for example the labels

for screens, profiles, event or trend group names, before you resume monitoring. If they are unexpected, there may be a problem with the monitor software. Contact your service personnel.

Monitor There is a problem with the voltages (5V,12V) in the monitor.

Contact your service personnel.

Monitor Perform a visual and functional check of the keyboard. Contact

your service personnel.

Monitor There is a problem with the second main board in the monitor.

Contact your service personnel.

Monitor The temperature inside the monitor is too high. Check that the

monitor ventilation is not obstructed. If the situation continues, contact your service personnel.

Monitor Perform a visual and functional check of the mouse input

device. Contact your service personnel.

Monitor/ Measuremt Server

Monitor The monitor is receiving network topology information from

There is a problem with the voltage of the Measurement Server Link (MSL). Contact your service personnel.

more than one source, e.g.the Database Server and an Application Server. Contact your service personnel.

Page 80

4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

Check Nurse Relay

INOP tone

Check Screen Res

INOP tone

Monitor There is a problem with the connection to the nurse relay.

Contact your service personnel.

Monitor The Screen you have selected uses a resolution which is not

supported by the display. The monitor will show a generic Screen instead until you select a different Screen.

Contact your service personnel if you want the Screen deleted from the Profile(s) to avoid this in future.

Check Settings

INOP tone

Monitor If this INOP appears, check the monitor and patient settings

before you resume monitoring. If the settings are unexpected, there may be a problem with the monitor software. Contact your service personnel.

Check Speedpoint

INOP tone.

Monitor Perform a visual and functional check of the SpeedPoint input

device. Contact your service personnel.

Check Touch Input Monitor Perform a visual and functional check of the touch input

device. Contact your service personnel.

Check Waves

INOP tone

Monitor The options purchased with this monitor may not support the

number of waves required to show the selected Screen, so some waves or high resolution trends are missing from the Screen. Select a different Screen with fewer waves.

Contact your service personnel if you want the Screen deleted from the Profile(s) to avoid this in future.

C LEAD OFF

HR numeric is displayed with a -?- for 10 seconds. INOP tone.

ECG The C electrode (AAMI: V electrode) has become detached

from the patient or the lead set has been changed. Reattach the electrode or select

New Lead Setup in the Setup ECG

menu to confirm the new lead set.

CO2 AUTO ZERO

Numeric is replaced by a - ? if the Autozero lasts >15 sec, INOP tone sounds.

CO2 CAL MODE

numeric displays current CO2

value for accuracy check

CO2 CAL RUNNING

The automatic zero calibration is in progress. This typically takes 10 seconds. During this time the CO

values may not be

updated, or they may be replaced by -?-. Wait until the zero calibration is complete to resume monitoring.

Currently no calibration is running. Accuracy can be checked by placing the transducer on the two cells of the calstick and starting calibration. To start monitoring, leave Cal. Mode.

Wait until calibration is finished.

Numeric is replaced by a - ? -

CO2 CHANGE SCALE CO

The CO2 wave is clipped. Select a more appropriate wave scale to display the whole wave.

CO2 CHECK ADAPTER

Numeric is replaced by a - ? INOP tone.

CO2 CHECK CAL

Numeric is replaced by a - ? INOP tone.

C.O. EQUIP MALF

Numeric is replaced by a - ? -

Check that the sensor is connected to the airway adapter, clean the airway adapter, if necessary. Perform a zero calibration. If the INOP persists, contact your service personnel.

The CO2 value is outside the measurement range. Perform an accuracy check for both calstick cells and, if necessary, recalibrate the transducer.

C.O. There is a problem with the C.O. hardware. Contact your

service personnel.

INOP tone.

CO2 EQUIP MALF

Numeric is replaced by - ? INOP tone.

The Measurement Server Extension is faulty. Unplug and replug the Measurement Server with Extension. If you are using the mainstream method, unplug and replug the transducer or try another transducer. If the INOP persists, contact your service personnel.

Page 81

Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

CO2 FAILED CAL

CO Numeric is replaced by -?INOP tone.

CO2 NO SENSOR

CO Numeric is replaced by - ? INOP tone.

CO2 NO TRANSDUC

CO Numeric is replaced by - ? INOP tone.

CO2 NO TUBING

CO Numeric is replaced by - ? INOP tone.

CO2 OCCLUSION

CO Numeric is replaced by a - ? INOP tone.

CO2 OVERRANGE

CO Numeric is replaced by - ? INOP tone.

CO2 PUMP OFF

CO Numeric is replaced by a - ? -.

CO2 PURGING

CO Numeric is replaced by a - ? INOP tone.

CO2 SENSOR WARMUP

CO Numeric is displayed with a - ? Microstream CO2: INOP tone. Mainstream CO

C.O. UNPLUGGED

: no INOP tone

C.O. Plug in the C.O. module. Silencing this INOP switches off the numeric displays -?INOP tone.

CO2 UPDATE FW

CO Numeric is replaced by a - ? INOP tone.

CO2 WAIT CAL2

CO Numeric is replaced by a - ? -

CO2 ZERO FAILED

CO Numeric is replaced by a - ? INOP tone.

CO2 ZERO REQUIRED

CO Numeric is replaced by a - ? INOP tione

CO2 ZERO RUNNING CO

CPP CHK SOURCES

CPP Not all measurements or values required to perform the Numeric is replaced by a - ? -

Make sure that the Cal cell was changed between CAL1 and CAL2. Repeat the calibration. If the INOP reappears, try another transducer. If the INOP persists, contact your service personnel.

There is no CO2 sensor connected. If you silence this INOP the CO

measurement will be switched off.

There is no CO2 transducer connected. If you replace the transducer, the new transducer must be calibrated. If you silence this INOP the CO

Either the FilterLine is disconnected, or an incorrect line is

measurement will be switched off.

attached. Check the connection. If necessary, connect another Microstream

 Filterline (only Microstream accessories can be

used). If you silence this INOP, the measurement will be switched off.

The FilterLine or exhaust tube is blocked. Check the FilterLine and exhaust tube, then disconnect and reconnect the FilterLine. If the INOP persists, connect a new FilterLine.

The CO2 value is higher than the measurement range. If you suspect a false high value, contact your service personnel.

The pump has been switched off for fifteen minutes. To switch it on again, select Pump On in the Setup CO

menu.

The Filterline is being purged to remove an occlusion in the line or airway adapter. If the occlusion is removed, the INOP will disappear. If not, the INOP CO2 OCCLUSION is displayed.

Wait until the sensor reaches operating temperature and the INOP disappears.

measurement.

The software in the Measurement Server Extension does not match the software in the MMS. Contact your service personnel.

Calibration on the first calstick cell is complete. Place the transducer on the other calstick cell and start the CAL2 calibration cycle.

An error occurred during the last zero calibration. Check the airway adapter and clean, if necessary. Perform another zero calibration. If the INOP persists, contact your service personnel.

Perform zero calibration for the CO2 sensor. If the INOP persists, contact your service personnel.

Wait until zero calibration is finished.

calculation are available. Check the measurement sources.

Page 82

4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

CPP CHK UNITS

Numeric is replaced by a - ? -

CUFF NOT DEFLATED

Numeric is displayed with a - ? INOP tone.

During this INOP, alarms cannot be paused or switched off.

CVP INOPS PRESS See <Pressure label> INOPS (under Pressure).

ECG EQUIP MALF

Numeric is displayed with a - ? INOP tone.

<ECG LEAD> LEAD OFF

Numeric is displayed with a - ? INOP tone.

ECG EL. NOISY <ECG LEAD> ECG The ECG signal from the named ECG electrodes [RA, LA, LL,

ECG NOISY SIGN.

INOP tone.

EcgOut EQUIP MALF

INOP tone

EEG EQUIP MALFUNC

INOP tone

EEG IMPEDANCE HIGH or EEG1 and/or EEG2 IMPED. HIGH

EEG<X> LEAD OFF <n>

[X = channel, n = electrode]

EEG<X> LEAD OFF

[X = channel] at Information Center

EEG<X> LEADS OFF

[X = channel]

EEG LINE NOISE

EEG 1 or 2 LINE NOISE

CPP The monitor has detected a conflict in the units used for this

calculation. Check the unit settings.

NBP Remove the cuff from the patient. Make sure that the tubing is

not kinked or twisted and that the correct patient category is selected. Try repeating the measurement. You can silence the INOP, but the INOP message remains visible until the next NBP measurement is started or the Stop All SmartKey is selected. [Adult or pediatric patients: The NBP cuff pressure has exceeded 15mmHg (2kPa) for more than 3 minutes. Neonatal patients: The NBP cuff pressure has exceeded 5mmHg (0.7kPa) for more than 90 seconds.]

ECG Contact your service personnel.

The ECG hardware is faulty.

ECG Not all the required leads for ECG monitoring are connected.

Check the ECG connections and make sure that the electrode indicated by <ECG lead> [RA, LA, LL, RL, V or C] electrodes is attached. In EASI mode, all 5 electrodes must be connected.

RL, V (or C)] is noisy. Check the ECG connections and make sure that the electrode indicated is attached.

ECG The ECG signal is too noisy. Check that the electrodes are

properly placed and have not dried out. Remove any possible sources of signal noise (such as power cords) from the area around the cable and the patient. The ECG signal may be saturated or overloaded.

ECG Check that the ECG out cable is securely connected. Contact

your service personnel.

EEG The EEG hardware is faulty. Contact your service personnel.

EEG The signal electrode in one or both channels exceeds the user-

selected impedance limit, or the impedance of a single electrode exceeds the limit. Check the impedance. If the impedance is too high, reconnect the electrodes according to the EEG monitoring setup guidelines.If the INOP persists, contact your service personnel.

EEG Reconnect specified electrode.

EEG One or more electrodes are not connected. Check in the EEG

Impedance/Montage window on the monitor which electrode(s) are affected and reconnect the electrodes.

EEG Two or more electrodes are not connected. Check in the EEG

Impedance/Montage window which electrodes are affected and reconnect the electrodes.

EEG Excessive line noise has been detected in either channel EEG1

or EEG2, or in both EEG channels. Keep all cables together and away from metallic bodies, other cables & radiated fields.

Page 83

Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

EEG MUSCLE NOISE

EEG 1 or 2 MUSCLE NOISE

EEG NO TRANSDUCER

INOP tone

EEG UNPLUGGED

INOP tone

EEG OVERRANGE, or

EEG<X> OVERRANGE

FAP INOPS PRESS See <Pressure label> INOPS (under Pressure).

FMS UNPLUGGED

INOP tone.

FMS UNSUPPORTED

INOP tone.

IC1/IC2INOPS PRESS See <Pressure label> INOPS (under Pressure).

ICP INOPs PRESS See <Pressure label> INOPS (under Pressure).

Indep.Dsp Malfunc.

INOP tone

Internal.Comm.Malf

INOP tone

LA LEAD OFF

Numeric is displayed with a -?- for 10 seconds; INOP tone.

LAP INOPs PRESS See <Pressure label> INOPS (under Pressure).

LEADS OFF

Numeric is displayed with a -?- for 10 seconds; INOP tone.

LL LEAD OFF

Numeric is displayed with a -?- for 10 seconds; INOP tone.

Measserv Unsupportd Monitor The measurement server is not supported by the monitor.

MMS UNPLUGGED

INOP tone.

MMS UNSUPPORTED INOP tone.

MSL Power High Monitor The power consumption of the devices connected to the

EEG Too much power above 30 Hz has been detected in channel

EEG1 or EEG2, or both. Check the Electrode-to-Skin Impedance and reposition the electrode away from possible muscle activity, if necessary.

EEG The trunk cable is disconnected from the EEG plug-in module.

Reconnect the trunk cable.Silencing this INOP switches the measurement off.

EEG Plug in module. Silencing this INOP switches off the

measurement.

EEG Input signal is too high in one or both channels. This is usually

caused by interfering signals such as line noise or electrosurgery. X denotes the EEG channel.

FMS Make sure that the Flexible Module Server is connected to the

monitor. All FMS measurements are off while the FMS is unplugged.

FMS The Flexible Module Server is not supported by your monitor.

Contact your service personnel.

Display There is a problem with the independent display. Contact your

service personnel.

Monitor There is a problem with I2C Bus communication in the

monitor. Contact your service personnel.

ECG The LA electrode has become detached from the patient or the

lead set has been changed. Reattach the electrode or select

Lead Setup

new lead set.

ECG Check that all of the required ECG leads are attached, and that

none of the electrodes have been displaced.

ECG The LL electrode has become detached from the patient or the

lead set has been changed. Reattach the electrode or select

Lead Setup

new lead set.

Contact your service personnel.

MMS Make sure that the Multi-Measurement Server is connected to

the monitor. All MMS measurements are off while the MMS is unplugged.

MMS The Multi-measurement Server is not supported by your

monitor. Contact your service personnel.

Measurement Server Link (MSL) cable is too high. If this situation continues, the MSL will be switched off. Contact your service personnel.

in the Setup ECG menu to confirm the

New

Page 84

4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

MSL Power Off

INOP tone.

MSL Power Overload

INOP tone.

NBP CUFF OVERPRESS

Numeric displayed with -?- ; INOP tone. During this INOP, alarms cannot be paused or switched off.

NBP EQUIP MALF

Numeric is displayed with a -?INOP tone.

NBP INTERRUPTED

Numeric is displayed with a -?INOP tone.

NBP MEASURE FAILED

Numeric may be displayed with a -?INOP tone.

No Central Monit.

INOP tone

NO PPV FROM MeasSrv

at Information Center

NO PPV FROM <Server> MMS or

P/P1/P2/P3/P4 INOPS PRESS See <Pressure label> INOPS (under Pressure).

PAP INOPS PRESS See <Pressure label> INOPS (under Pressure).

PPV BAD <Pressure Label> SIGNAL

Monitor The power consumption of the devices connected to the

Measurement Server Link (MSL) cable was too high for too long and the MSL has been switched off. Contact your service personnel.

Monitor The power consumption of the devices connected to the

Measurement Server Link (MSL) cable is much too high or there has been a short circuit. The MSL has been switched off. Contact your service personnel.

NBP The NBP cuff pressure exceeds the overpressure safety limits.

Remove the cuff from the patient. Make sure that the tubing is not kinked or twisted and that the correct patient category is selected. Try restarting the measurement. You can silence this INOP, but the INOP message remains visible until the next measurement is started or the Stop All SmartKey is selected.

NBP Remove the cuff from the patient. The NBP hardware is faulty.

Contact your service personnel. You can silence this INOP, but the INOP message remains visible until the next measurement is started or the Stop All SmartKey is selected.

NBP Check the tubing and cuff for leakages or kinks. Check that

you are using the correct cuff size and placement, and that the correct patient category is selected. Try restarting the measurement. If the INOP occurs repeatedly, contact your service personnel. You can silence this INOP, but the INOP message remains visible until the next measurement is started or the Stop All SmartKey is selected. This INOP arises when the measurement needed longer than the maximum time for inflation, deflation or the total measurement.

NBP Check that you are using the correct cuff size and placement,

and that the correct patient category is selected. Try restarting the measurement. If numerics are displayed, the monitor is able to measure mean only and the alarm source is set to S, D or S&D. You can silence this INOP, but the INOP message remains visible until the next measurement is started or the Stop All SmartKey is selected. Check the condition and suitability of the patient for NBP monitoring. Use another cuff to continue measuring.

Monitor There is a problem with the communication to the network.

Central monitoring is currently not possible (no patient alarms or information). Check the connection. Contact your service personnel.

MMS or

FMS

PRESS The arterial pressure source selected for PPV is not providing a

The measurement server does not supply a beat-to-beat arterial pressure value. Contact your service personnel.

pulsatile signal.

Page 85

Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

PPV BAD SIGNAL

at Information Center

PPV CHK SOURCES PRESS The arterial pressure source selected for PPV is unplugged or

<Pressure label> ARTIFACT

Numeric displayed with -?-

<Pressure label> DEACTIVATED

INOP tone

<Pressure label> EQUIP MALF

Numeric displayed with -?INOP tone.

<Pressure label> NO TRANSDUCER

Numeric is displayed with a -?INOP tone.

<Pressure label> NOISY SIGNAL

Pulse numeric is displayed with a -?INOP tone.

<Pressure label> NONPULSATILE

Pulse numeric is displayed with a -?INOP tone.

<Pressure label> OVERRANGE

Numeric is displayed with a -?INOP tone.

<Pressure label> REDUCE SIZE

<Pressure label> TRANSDUC MALF

Numeric is displayed with a -?INOP tone.

<Pressure label> UNPLUGGED

PRESS The arterial pressure source selected for PPV is not providing a

pulsatile signal.

switched off. When this INOP has displayed for 1 minute PPV will be switched off.

PRESS A non-physiological event is detected (for example, a flush or

blood sample). A resulting high limit alarm will be suppressed.

PRESS A Pressure measurement label in the measurement server or

extension has been deactivated, either by connecting a Temp transducer in the shared Press/Temp socket, or by deactivating the label in the Measurement Selection window.

The measurement automatically disappears from the display.

To switch the measurement on again, either reconnect a Pressure transducer or reactivate the measurement label in the Measurement Selection window.

PRESS Contact your service personnel.

The pressure hardware is faulty.

PRESS Make sure that the pressure transducer is connected to the

measurement server or module server. If you silence this INOP, the measurement will be switched off.

PRESS This INOP can only arise when a pressure is selected as the

pulse source. It occurs when the pulse detector finds a pulse rate above 350bpm. This is usually caused by movement artifact or electrical interference.

PRESS This INOP can only arise when a pressure is selected as the

pulse source. It occurs when the pulse rate being measured is less than 25 beats per minute or the amplitude is less than three mmHg. Check the catheter and connections to the patient.

PRESS Make sure that the measurement has been properly prepared

and zeroed, and that the transducer is level with the heart. If this INOP persists, try another transducer. Possible causes are a measured pressure outside the allowed pressure range, or a broken wire to the transducer.

PRESS Increase the scale for the pressure wave.

PRESS Contact your service personnel.

The transducer is faulty.

PRESS A Pressure measurement label has been deactivated, either by

unplugging a module, or by deactivating the label in the Measurement Selection window.

The measurement automatically disappears from the display.

To switch the measurement on again, either replug the module or reactivate the measurement label in the Measurement Selection window.

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4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

PRESS Perform a zero and check the calibration of the transducer.

ZERO+CHECK CAL

Numeric is displayed with a -?-

RA LEAD OFF

Numeric is displayed with a -?INOP tone.

ECG The RA electrode has become detached from the patient or the

lead set has been changed. Reattach the electrode or select

Lead Setup

in the Setup ECG menu to confirm the

New

new lead set.

RAP INOPS PRESS See <Pressure label> INOPS (under Pressure).

Rem.Alarmdev.Malf

INOP tone

RESP EQUIP MALF

Monitor There is a problem with the connection to the remote alert

device. Contact your service personnel to check the remote alert device and its connections.

RESP Contact your service personnel. The RESP hardware is faulty. Numeric is displayed with a -?INOP tone.

RESP ERRATIC

Numeric is displayed with a -?-

RESP The monitor has detected too many artifacts in the measured

Resp signal. Check that the RA and LL electrodes are correctly attached and have not dried out.

RESP LEADS OFF

Numeric is displayed with a -?-

RESP Not all the required leads for Resp monitoring are attached.

Make sure that the RA and LL leads are attached.

INOP tone.

RL LEAD OFF

Numeric is displayed with a -?- for 10 seconds; INOP tone.

ECG The RL electrode has become detached from the patient or the

lead set has been changed. Reattach the electrode or select

Lead Setup

in the Setup ECG menu to confirm the

New

new lead set.

Settings Malfunc.

INOP tone.

Monitor The monitor cannot use the predefined settings for

monitoring. Contact your service personnel.

SOME ECG ALARMS OFF Arrhythmia This message appears (if configured to do so) when the on/off

settings of the yellow arrhythmia alarms differ from the current Profile.

Speaker Malfunct.

INOP tone

∆SpO

CHK SOURCES

Numeric is displayed with a -?-

∆SpO

CHK UNITS

Numeric is displayed with a -?-

<SpO2 label> DEACTIVATED

INOP tone

Monitor Contact your service personnel to check the speaker and the

connection to the speaker.

SpO

Difference

SpO

Difference

SpO

Not all measurements or values required to perform the calculation are available. Check measurement sources.

The monitor has detected a conflict in the units used for this calculation. Check the unit settings.

You have connected a measurement server that uses a label the monitor has already assigned to a different source. To activate the new source, choose a new label in the Measurement Selection window.

<SpO2 label> EQUIP MALF

Numeric is replaced by a -?-

SpO

The MMS is faulty. Unplug and replug the MMS. If the INOP persists, contact your service personnel.

INOP tone.

<SpO2 label> ERRATIC

Numeric is replaced by a -?-

SpO

Check the sensor placement. Try another adapter cable and sensor. If the INOP persists, contact your service personnel.

INOP tone.

<SpO2 label> EXTD. UPDATE

Label is displayed with a -?(questionable numeric)

SpO

The update period of displayed values is extended due to an NBP measurement on the same limb or an excessively noisy signal.

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Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

<SpO2 label> INTERFERNCE

Numeric is replaced by a -?INOP tone.

<SpO2 label> LOW PERF

Label is displayed with a -?(questionable numeric)

<SpO2 label> NOISY SIGN.

Numeric is replaced by a -?INOP tone.

<SpO2 label> NON-PULSAT.

Numeric is replaced by a -?INOP tone.

<SpO2 label> NO SENSOR

Numeric is replaced by a -?INOP tone.

<SpO2 LABEL> POOR SIGNAL

Label is displayed with a - ? (questionable numeric)

<SpO2 LABEL> PULSE?

Numeric is replaced by -?INOP tone

<SpO2 LABEL> SEARCHING

Numeric unavailable

<SpO2 label> SENSOR MALF

Numeric is replaced by a -?INOP tone.

<SpO2 LABEL> SENSOR OFF

Numeric is replaced by -?INOP tone

<SpO2 LABEL> UNKN.SENSOR

Numeric is replaced by a - ? -

<SpO2 LABEL> UPGRADE

Label is displayed with a -?-, numeric is unavailable

Sp - vO2 CHK SOURCES

Numeric is displayed with a -?-

Sp - vO2 CHK UNITS

Numeric is displayed with a -?-

SvO2 CAL FAILED

O2 numeric is displayed with ?

SvO2 CAL MODE

O2 numeric displays -?-

SpO

There is too much interference, caused by a high level of ambient light and/or electrical interference. Cover the sensor to minimize ambient light. If the INOP persists, make sure that the sensor cable is not damaged or positioned too close to power cables.

SpO

Accuracy may be compromised due to very low perfusion. Stimulate circulation at sensor site. If INOP persists, change the measurement site.

SpO

Excessive patient movement or electrical interference is causing irregular pulse patterns. Try to reduce patient movement or to relieve the cable strain on the sensor.

SpO

Check the perfusion at measurement site. If necessary, stimulate circulation or change measurement site. If the INOP is due to NBP measurement on the same limb, wait until the NBP measurement is finished.

SpO

Make sure the SpO2 sensor is connected. If the INOP persists, try another adapter cable and sensor. If you silence this INOP, the measurement will be switched off.

SpO

The signal condition of the SpO2 measurement is poor and measurement accuracy may be compromised.

SpO

The detectable pulsations of the SpO2 signal are outside the specified pulse rate range.

SpO

SpO2 is analyzing the patient signal to derive Pulse, SpO2 and Perf values. Please wait until the search analysis is complete.

SpO

The SpO2 sensor or adapter cable is faulty. Try another adapter cable and sensor. If the INOP persists, contact your service personnel.

SpO

The SpO2 sensor is not properly applied to the patient. Apply the sensor following the instructions supplied by the manufacturer.

SpO

The connected sensor or adapter cable is not supported by the SpO

measurement. Use only specified sensors and cables.

The SpO2 measurement is currently in UPGRADE mode. Monitoring is not possible in this mode.

Sp - vO2Not all measurements or values required to perform the

calculation are available. Check measurement sources.

Sp - vO2The monitor has detected a conflict in the units used for this

calculation. Check the unit settings.

The calibration failed. Check the catheter-to-Optical-Module connection. Manually restart the calibration. Try another catheter and Optical Module. If the catheter is already inserted, perform an in-vivo calibration.

Pre-insertion calibration is complete, but the catheter tip is still inside the optical reference. The catheter is now ready for insertion.

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4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

SvO2 CAL REQUIRED

O2 numeric displays -?-.

INOP tone may sound

SvO2 CONFIGURATION

O2 numeric displays -?-.

INOP tone

SvO2 CONNCT OPTMOD

O2 numeric displays -?-.

INOP tone

SvO2 EQUIP MALF

O2 numeric displays -?-.

INOP tone

SvO2 IN-VIVO CALIB

O2 numeric displays -?-.

SvO2 LIGHT INTENS

O2 numeric displays -?- or numeric

is displayed with ? INOP tone with -?- display

SvO2 LOW LIGHT

O2 numeric displays -?- or numeric

is displayed with ? INOP tone may sound

SvO2 NO OPTMOD

O2 numeric displays -?-.

INOP tone

SvO2 OPTMOD DEFECT SvO

SvO2 OPTMOD WARMUP

O2 numeric is displayed with ?

SvO2 PRE-INS CALIB

O2 numeric displays -?-

INOP tone

SvO2 UNABL TO MEAS

O2 numeric displays -?-.

INOP tone

SvO2 UNPLUGGED

O2 numeric displays -?-.

INOP tone

SVR/SVRI CHK SOURCES

SVR/SVRI Not all measurements or values required to perform the Numeric is displayed with a -?-

SVR/SVRI CHK UNITS

SVR/SVRI The monitor has detected a conflict in the units used for this Numeric is displayed with a -?-

SVR/SVRI SET CVP USED

SVR/SVRI A CVP value is required for this calculation, but is not numeric displays - ? -

There is no valid calibration data in the Optical Module. Perform either a pre-insertion or an in-vivo calibration.

The Optical Module has been configured to SaO2 Mode. Use

Change to SvO2 in the Setup SvO2 menu to

reconfigure to SvO

The Optical Module was disconnected during data storage.

Mode.

Reconnect the Optical Module for at least 20 seconds.

The SvO2 Module or Optical Module is faulty. Unplug and replug the Optical Module and SvO

module. Exchange the

modules. If the INOP persists, contact your service personnel.

The in-vivo calibration is not yet complete. Lab values must be stored to the Optical Module to complete the calibration. Either continue with the next steps of the current calibration or recall the previous calibration.

The intensity changed considerably since the last light intensity calibration. This may indicate that the catheter tip is positioned against a blood vessel wall or that there is low blood flow. Reposition the catheter and perform a light intensity calibration.

The optical signal levels are too low. Check that the catheter is either in the optical reference or inserted into the patient. Check the catheter-to-Optical Module connection. If INOP persists, try another catheter and Optical Module.

Connect the Optical Module. If the INOP persists, try another Optical Module. Silencing this INOP switches the measurement off.

The Optical Module memory is faulty, and calibration data cannot be stored for transport or during power failure. If this feature is needed, use another Optical Module.

The Optical Module has not yet reached the operating temperature. Wait a few minutes until warm-up is finished.

The pre-insertion calibration is running. This typically takes one minute. During this time Sv

O2 alarms are switched off.

Wait until the calibration is complete.

The signal is out of the normal range, and no SvO2 value can be derived. Perform an in-vivo calibration. If the INOP persists, try another Optical Module and catheter.

Measurement switched on and SvO2 module unplugged from the rack.

The measurement automatically disappears from the display. Silencing this INOP switches off the measurement.

calculation are available. Check measurement sources.

calculation. Check the unit settings.

currently being measured. The monitor is using the CVP value preset in the

Setup SVR menu.

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Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

T/T1/T2/T3/T4 INOPs TEMP See <Temp label> INOPs (under Temp)

Tamb INOPs TEMP See <Temp label> INOPs (under Temp)

Tart INOPs TEMP See <Temp label> INOPs (under Temp)

Tblood NO TRANSDUC

Numeric displays -?INOP tone

Tblood OVERRANGE

Numeric displays -?-

Tcereb INOPS TEMP See <Temp label> INOPs (under Temp)

Tcore INOPs TEMP See <Temp label> INOPs (under Temp).

tcpO2 (or tcpCO2 or tcGas) CAL FAILED

Numeric displays -?INOP tone.

tcpO2 (or tcpCO2 or tcGas) CAL REQUIRD

Numeric displays -?INOP tone.

tcpO2 (or tcpCO2 or tcGas) CAL RUNNING

Numeric displays first -?- , then numeric is displayed with a ?

tcpO2 (or tcpCO2 or tcGas) CHECK TIME

tcpO2 (or tcpCO2 or tcGas) CHANGE SITE

If Heat Switch Off is configured to Yes, numeric displays -?INOP tone.

tcpO2 (or tcpCO2 or tcGas) EQUIP MALF

Numeric displays -?INOP tone.

tcpO2 (or tcpCO2 or tcGas) NO TRANSDUC

Numeric displays -?INOP tone.

tcpO2 (or tcpCO2 or tcGas) STABILIZING

Numeric is displayed with a ?

tcpO2 (or tcpCO2 or tcGas) UNPLUGGED

Numeric displays -?INOP tone.

<∆Temp> CHK SOURCES

Numeric is displayed with a -?-

C.O. No transducer attached to the module or catheter

disconnected.

C.O. Tblood out of range 17°C - 43°C.

tcGas A calibration failed. Check the cal. unit, gas pressure, and

tubing connections, then restart the cal. If the cal. has failed more than once, remembrane the transducer and restart the calibration. If this INOP persists, contact your service personnel.

tcGas Calibration is required before applying the transducer to the

patient. Insert a membraned transducer into the cal. chamber on the module, connect the cal. unit to the cal. chamber, open the gas valve and start the calibration. If this INOP occurs during a calibration, there may be a module or transducer malfunction: contact your service personnel.

tcGas Wait until the tcpO2/tcpCO2 calibration is finished.

tcGas Site Timer due to time out in 15 minutes or less.

tcGas Site Timer has timed out. Change the application site to avoid

skin burns. To reset the Site Timer, either calibrate and change the measurement site, or change the measurement site and reset the Site Timer manually by selecting the appropriate site time from the

tcGas There is a malfunction in the transducer or module. Connect

another transducer. If this INOP persists, contact your service personnel.

tcGas No transducer is connected to the tcpO2/tcpCO2 module.

Silencing the alarm switches off the measurement.

tcGas The transducer has not yet reached the selected temperature

and/or skin hyperemization is not yet finished. This INOP will disappear within three minutes.

tcGas The measurement is switched on but the module is unplugged.

The measurement automatically disappears from the display. Silencing this INOP switches off the measurement.

TEMP

Difference

Not all measurements or values required to perform the calculation are available. Check measurement sources.

Setup TCGas menu.

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4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

INOP Message, Indication Source What to do

<∆Temp> CHK UNITS

Numeric is displayed with a -?-

<Temp label> DEACTIVATED

INOP tone

<Temp label> EQUIP MALF

Numeric is displayed with a -?INOP tone.

<Temp label> NO TRANSDUCER

Numeric is displayed with a -?INOP tone.

<Temp label> UNPLUGGED

INOP tone

<Temp label> OVERRANGE

Numeric is displayed with a -?INOP tone.

Tesoph INOPS TEMP See <Temp label> INOPs (under Temp).

TimeExpired:<timer label>

INOP tone

Tnaso INOPS TEMP See <Temp label> INOPs (under Temp).

Trect INOPS TEMP See <Temp label> INOPs (under Temp).

Tskin INOPS TEMP See <Temp label> INOPs (under Temp).

Ttymp INOPS TEMP See <Temp label> INOPs (under Temp)

Tven INOPS TEMP See <Temp label> INOPs (under Temp).

Tvesic INOPS TEMP See <Temp label> INOPs (under Temp)

UAP INOPS PRESS See <Pressure label> INOPS (under Pressure).

Unsupported LAN

INOP tone

User I/F Malfunct. INOP tone.

UVP INOPS PRESS See <Pressure label> INOPS (under Pressure).

V LEAD OFF

Numeric is displayed with a -?- for 10 seconds; INOP tone.

TEMP

Difference

TEMP A Temp measurement label in the measurement server or

TEMP Contact your service personnel.

TEMP Make sure the TEMP probe is connected to the MMS or

TEMP A Temp measurement label has been deactivated, either by

TEMP Try changing the application site of the transducer.

Monitor The time has expired for the timer indicated in the INOP text.

Monitor There is a problem with the communication to the network

Monitor Perform a visual and functional check of all the monitor input

ECG The V electrode (IEC: C electrode) has become detached from

The monitor has detected a conflict in the units used for this calculation. Check the unit settings.

extension has been deactivated, either by connecting a Pressure transducer in the shared Press/Temp socket, or by deactivating the label in the Measurement Selection window.

The measurement automatically disappears from the display.

To switch the measurement on again, either reconnect a Temp transducer or reactivate the measurement label in the Measurement Selection window.

The temperature hardware is faulty.

module. If you silence this INOP, the measurement will be switched off.

unplugging a module, or by deactivating the label in the Measurement Selection window.

The measurement automatically disappears from the display.

To switch the measurement on again, either replug the module or reactivate the measurement label in the Measurement Selection window.

[The temperature is less than -1

Clearing the timer clears the INOP.

and central monitoring is currently not possible. Check the connection.If the INOP persists, switch off the monitor and contact your service personnel.

devices. Contact your service personnel.

the patient or the lead set has been changed. Reattach the electrode or select menu to confirm the new lead set.

New Lead Setup in the Setup ECG

°C, or greater than 45°C.]

Page 91

Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs

INOP Message, Indication Source What to do

<VueLink option> CHK CABLE

INOP tone.

<VueLink option> CHK CONF.

INOP tone.

<VueLink option> CHECK SETUP

INOP tone.

VueLnk EQUIP MALF

INOP tone.

VueLnk NO CONFIG

INOP tone.

VueLnk UNPLUGGED

INOP tone.

VueLink No cable or the wrong cable connected to the VueLink

module, or incorrect device selected. Silencing this INOP switches the measurement off. VueLink INOP abbreviations may differ slightly depending on the device category.

VueLink The wrong external device has been selected on the VueLink

module, or the external device has not been correctly setup, or the wrong cable has been used to connect the device to the VueL i nk m odul e . VueLink INOP abbreviations may differ slightly depending on the device category.

VueLink No information was received from the external device. The

device may be switched off or disconnected. VueLink INOP abbreviations may differ slightly depending on the device category.

VueLink Malfunction in the VueLink module. If this message appears

repeatedly, the module must be replaced. Contact your service personnel. VueLink INOP abbreviations may differ slightly depending on the device category.

VueLink The VueLink module has not been configured during

installation. The installation process should be completed by either your biomedical engineering department or the Philips service engineer. VueLink INOP abbreviations may differ slightly depending on the device category.

VueLink The VueLink module has been unplugged from the rack, or the

whole rack has been disconnected. The measurement automatically disappears from the display. Silencing this INOP switches off the measurement. VueLink INOP abbreviations may differ slightly depending on the device category.

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4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)

Page 93

Use the Patient Demographics window and its associated pop-up keys to admit, discharge, and transfer (ADT) patients.

All patient demographic and ADT information is shared between the patient monitor and the Information Center, for example, patients admitted to the monitor are automatically admitted to a connected Information Center.

Admitting a Patient

The monitor displays physiological data and stores it in the trends as soon as a patient is connected. This lets you monitor a patient who is not yet admitted. It is however important to admit patients properly so that you can identify your patient on recordings, reports, and networked devices.

During admission you enter data that the monitor needs for safe and accurate operation. For example, the patient category setting determines the algorithm the monitor uses to process and calculate some measurements, the safety limits that apply for some measurements, and the alarm limit ranges.

5Managing Patients

To admit a patient,

1 Select the patient name field or select the

Admit/Dischrge SmartKey to open the

Patient Demographics window.

2 Clear any previous patient data by selecting

Dischrge Patient or End Case

the pop-up key and then Confirm.

If you do not discharge the previous patient, you will not be able to distinguish data from the previous and current patients, for example, in the trend database.

3 Select Admit Patient.

4 Enter the patient information: select each

field and use the on-screen keyboard or choose from the pop-up list of alternatives to input information. If a conventional keyboard or a barcode scanner is connected to the monitor you can use this to enter patient information.

Last name: Enter the patient’s last name (family name), for example Smith.

–

Patient Demographics

Last Name First Name MRN Patient Cat. Paced Height Weight BSA (D) Date of Birth Age Gender Notes (1): Notes (2):

Adult No

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5 Managing Patients Quick Admitting a Patient

– First name: Enter the patient’s first name, for example Joseph.

– MRN: Enter the patient’s medical record number (MRN), for example 12345678.

– Patient Cat: Choose the patient category, either Adult, Pediatric, or Neonatal.

Paced: Choose Yes or No (You must use “Yes” if your patient has a pacemaker).

–

Height: Enter the patient’s height.

–

Weight: Enter the patient’s weight.

–

BSA: The monitor calculates the body surface area automatically.

–

Date Of Birth: Enter the patient’s date of birth. Enter this in the form dd/mm/yyyy.

–

Age: The monitor calculates the patient age automatically.

–

Gender: Choose Male or Female.

–

Notes: Enter any extra information about the patient or treatment.

–

5 Select Confirm. The patient status changes to admitted.

Patient Category and Paced Status

The patient category setting determines the algorithm the monitor uses to process and calculate some measurements, the safety limits that apply for some measurements, and the alarm limit ranges.

The paced setting determines whether the monitor shows pacemaker pulses or not. When Paced is set to No, pace pulses are filtered and therefore do not show in the ECG wave.

WARNING Patient Category and Paced status will always contain a value, regardless of whether the

patient is fully admitted or not. If you do not specify settings for these fields, the monitor uses the default settings from the current profile, which might not be correct for your patient.

Patient category Changing the patient category may change the arrhythmia and NBP alarm limits. Always check alarm limits to make sure that they are appropriate for your patient.

Paced status For paced patients, you must set could mistake a pace pulse for a QRS and fail to alarm during asystole.

Paced to Yes. If it is incorrectly set to No, the monitor

Admitting a Centrally-Monitored Patient

You can admit a patient at either the bedside or the Information Center. When you admit a patient, the patient’s name appears on the bedside monitor and the Information Center.

If you do not fill in all patient information required by the Information Center, the Information Center may reject the admission. Complete all the required fields and try again to admit the patient.

Quick Admitting a Patient

Use Quick Admit only if you do not have the time or information to fully admit a patient. Complete the rest of the patient demographic details later. If you do not, the patient name will not be written on reports and on information stored in the database or sent to an Information Center.

1 Select the Quick Admit SmartKey.

2 Enter the required data (MRN or Last Name depending on configuration) with the keyboard or a

barcode scanner.

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Editing Patient Information 5 Managing Patients

Select Enter.

4 In the confirmation window, select Confirm to discharge the previous patient (if confirmation is

configured).

5 Check that patient category and paced status are correct for the new patient.

If the monitor is connected to an Information Center and only the MRN is entered, the patient name is set to - - - . The patient name field on the monitor shows space on printed reports is blank. To fully admit this patient, select Admit complete all required fields.

Not Admitted and the patient name

Patient again and

Editing Patient Information

To edit the patient information after a patient has been admitted, select the patient name field on the Main Screen to open the

Patient Demographics window, and make the required changes.

Discharging a Patient

You should always perform a discharge even if your previous patient was not admitted. A discharge:

– clears the information in the Patient Demographics window

– erases all patient data (such as trend, event, and calculation data) from the monitor, measurement

servers and Information Center

– resets patient category and paced settings to the settings defined in the default Profile

– resets all monitor and measurement settings as well as the active Screen to the settings defined in

the default Profile

– discharges the patient from the Information Center.

When a patient is discharged from the monitor or from an Information Center, all patient data is deleted. Make sure that you have printed out any required reports before discharging. Check that a functioning local or central printer is available before you use End Case.

To discharge a patient,

1 Select the patient name field to display the Patient Demographics window and associated

pop-up keys.

2 Select the pop-up key for either:

– End Case - to print any configured end case reports or vital signs recording, discharge the

patient and clear the patient database, then enter standby mode. If an End Case SmartKey is configured for your monitor, you can also select this instead and then confirm.

To see which end case reports are set up for your monitor, select Main Setup -> Reports ->

Auto Reports. For each auto report, if End Case Report is set to On, this report will be printed when you select End Case. See the section on AutoReports for information on setting up end case reports.

– Dischrge Patient - to discharge the patient without printing any reports.

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5 Managing Patients Transferring Patients

Transferring Patients

To save you from having to enter the same patient data multiple times and enable patient transfer without loss of data, information can be shared between measurement servers, patient monitors, and Information Centers.

– patient demographic information is shared between connected measurement servers, patient

monitors, and Information Centers

– measurement settings and calibration data can be uploaded from an MMS to a patient monitor, if

configured

– trend information can be uploaded from an MMS to a patient monitor, if configured.

Different sets of patient- and measurement-related data are stored in the monitor and the MultiMeasurement Server. Understanding this will help you to understand what happens to patient data when you transfer patients.

Patient Information Stored in Monitor Stored in MMS and extensions

Patient demographics (name, DOB, MRN)

Monitor settings (alarm pause time, alarm volume)

Measurement settings for all measurements (alarm limits, measurement on/off, etc.)

Trend data

Calculation data (HemoCalc data)

Events data

WARNING If the monitor is not battery-powered, you cannot monitor during transport.

yes yes

yes no

yes yes, for all MMS and extensions

measurements

yes, for all MMS and extensions measurements (up to a maximum of 16 or 32, depending on your database configuration)

yes no

most recent 8 hours of information, for all MMS and extensions measurements

Transferring a Centrally-Monitored Patient

Scenario: A centrally-monitored patient is moved to another monitoring location on the same Information Center database server without interrupting the collection of patient trend information.

1 Before you disconnect the MMS from the monitor, select the patient name in the monitor info line

to enter the Patient Demographics window, then select the Transfer pop-up key. If the patient is not admitted or not monitored by an Information Center, the Transfer key is inactive (“grayed-out”).

This step preserves the patient’s demographic data during the transfer.

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Data Upload from an MMS 5 Managing Patients

Remove the MMS and any connected extensions from the monitor. Do not separate any connected

extensions from the MMS, as this will erase all settings and trend data stored in the MMS for the extension measurements.

3 Connect the MMS to the transfer monitor and monitor your patient during the move.

4 At the new location, connect the MMS to the monitor. If the monitor detects a patient conflict,

the patient selection window will be displayed.

5 Select Continue MMS and Confirm your selection. This re-admits the patient from the

transfer list to the new monitor, completing the transfer. This will upload the patient demographics, and, if configured, the measurement settings and trend data stored in the MMS to the receiving monitor.

6 Verify that the settings for patient category and paced mode are correct.

If you accidentally transfer a patient, use Center. If you are not connected to the network, select patient data remains in the monitor.

Re-admit to restore this patient’s data to the Information

Clear Transfer to leave transfer mode.The

Transferring a Patient with an MMS (no Central Station)

Scenario: A patient is moved to another monitoring location using a transport monitor and readmitted at the new monitor.

1 Disconnect the MMS from the original monitor and silence the resulting MMS UNPLUGGED

INOP. If you are sure that the patient will not be returning to this monitor, you should perform a

discharge or end-case. This prevents data from the next patient accidentally being mixed up with your current patient’s data.

2 Connect the MMS to the transport monitor and move the patient.

3 At the new monitoring location, remove the MMS from the transport monitor and connect it to

the new monitor.

4 If prompted, re-admit the patient to the new monitor: in the Patient Selection window,

select Continue MMS to retain the data in the MMS. This will upload the patient demographics, and, if configured, the measurement settings and trend data stored in the MMS to the monitor. Verify that the settings for patient category and paced mode are correct.

Data Upload from an MMS

The Multi-Measurement Server stores eight hours of patient trend data at one-minute resolution. It also stores patient demographic information and the measurement settings and calibration data for the measurements carried out by the MMS and any connected extensions. This data can be uploaded to an IntelliVue patient monitor, if your monitor is configured to do so and if at least five minutes of trend information is stored in the MMS.

Your monitor’s data upload settings are defined in Configuration Mode to suit your patient transfer use model.

How data is uploaded to the host monitor depends on the configuration mode settings MMS Trend Upload and MMS Settings Upload.

If there is a patient conflict and you select Continue Monitor, no data will be uploaded from the MMS.

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5 Managing Patients Data Exchange Between Information Centers

Data Exchange Between Information Centers

You can transfer demographic data and trend data from one IIC to another by selecting Transfer on the patient monitor. Trend data is not shared between Information Centers and monitors.

Resolving Patient Information Mismatch

When you connect an MMS to a monitor, or a monitor to the network, the monitor compares patient category, paced status, and a unique patient identification number that is internally stored in both the MMS and the monitor. The monitor indicates a mismatch if the information is not identical.

Depending on your monitor’s configuration, this mismatch may be automatically resolved or you may have to resolve it manually. If your monitor is configured to resolve mismatches automatically, depending on the configuration, either the monitor or the Multi-Measurement Server data is automatically retained.

WARNING USA only When a monitor is connected to an Information Center by the wireless IntelliVue

Instrument Telemetry interface, the patient data will automatically be merged in the case of a transfer. This means there is no patient discharge at the monitor and settings and trend data will be retained. You will see a message on the monitor and the Patient Demographics window will automatically appear so that you can check the data and change it if necessary.

Manually Resolving Patient Mismatch

The patient mismatch is indicated by question marks (???) beside the questionable fields in the Monitor Info Line and in the Patient Demographics window. The monitor displays a message such as

Different patients in Central and Monitor. The Patient Selection window

automatically opens so you can decide which patient data to use. You do not have to resolve the mismatch immediately, however, the indicators remain until you do. There can be up to three columns of data in the Patient Selection window if the patient is different in the Information Center, monitor, and MMS.

After you resolve the mismatch, the monitor displays a confirmation window that explains the consequences of your choice, telling you where the patient will be continued/discontinued. Confirm your choice. The monitor automatically displays the Patient Demographics window after confirmation. Verify that the settings shown are correct for the patient.

Gender, date of birth, height, weight, and nursing notes do not generate a mismatch. If these fields are different on different devices, the monitor resolves them itself. For example, it may take date of birth from the Information Center, whilst taking gender from the MMS. Always check the Patient Demographics after combining patients, to ensure that you are satisfied with the results. Change them if necessary.

WARNING After resolving a patient mismatch, check that the monitor settings (especially patient category, paced

status and alarm limits) are correct for the patient.

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Resolving Patient Information Mismatch 5 Managing Patients

Patient Mismatch - If One Set of Patient Data is Correct

♦ If there is a mismatch between an

Information Center and a monitor, choose the data set you want to continue using for this patient, either:

Continue Central: to continue with the patient demographics from the Information Center, discharge the patient in the monitor, and use the default monitor profile.

Continue Monitor: to continue with the patient in the monitor and discharge the patient in the Information Center, permanently deleting all data in the Information Center.

♦ If there is a mismatch between a

monitor and a measurement server, choose the data set you want to continue using for this patient, either:

Continue Monitor: to continue with the patient demographics, trend data, and settings in the monitor. This discharges the patient in the measurement server, and resets all MMS settings to the defaults currently active for the monitor.

Continue MMS: to upload the data

- patient demographics, trend data (if configured), and measurement settings (if configured) - stored in the MMS to the monitor. This clears all data in the monitor, resets the monitor to the default Profile, and discharges the patient in the monitor.

Patient Selection

Central Monitor

Last name DOE MILLER

First name JOHN

MRN 1234HG9556

Patient Cat Adult Neo

Paced No Yes

Continue Central

Patient Selection

Last name MILLER ADAMS

First name PETER

MRN

Patient Cat Neo Neo

Paced Yes No

Continue Monitor

Monitor MeasServ

Continue MMS

New Patient

Same Patient

Patient Mismatch - If Neither Patient Data Set is Correct

A patient mismatch where neither set of patient data is correct might occur if you connect a new MMS to a monitor in order to prepare for a new patient, before you actually start measuring.

♦ Select New Patient if you are sure that none of the information is correct. This discharges all

patients, erases all data in both the monitor and MMS, resets all settings to the default Profile, and lets you admit a new patient.

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5 Managing Patients Care Groups

Patient Mismatch - If Both Patient Data Sets Are Correct

A patient mismatch where both sets of patient data are correct might occur if you admit a new patient at the monitor (or Information Center) before the patient arrives at your unit and then connect the MMS that was used during the patient transport to the monitor.

♦ Select Same Patient if the patient information is different, but you are sure it is the same

patient. This merges the demographics and updates them in the Information Center, monitor, and MMS, according to this table. Be aware that your monitor may be configured to merge trend data from the MMS and the monitor, and to upload measurement settings from the MMS to the monitor.

Patient Information This information is taken from...

Patient name the monitor, if the patient was admitted there. For centrally-admitted

MRN

Screen Notes

Patient Category the Multi-Measurement Server. if connected, otherwise the data is

Date of Birth

Height

Weight

Gender

Paced Status Paced status is always set to Yes where there is a conflict in patient

Trend data if there is newer trend data stored in the MMS, it is uploaded to the

patients, this information is taken from the Information Center.

taken from the monitor.

information.

monitor.

Automatically Resolving Patient Mismatch

Your monitor can be configured to automatically resolve mismatches in one of two ways.

• continue using the patient in the MMS, and delete the old data in the monitor. This is suitable for transport monitors.

• continue with the patient in the monitor, and delete the data in the MMS.

Care Groups

If your monitor is connected to an Information Center, you can group bedside monitors into Care Groups. This lets you:

• view information on the monitor screen from another bed in the same or in a different Care Group.

• be notified of yellow or red alarm conditions at the other beds in the Care Group.

• see the alarm status of all the beds in the Care Group on each monitor screen.

There are two main types of Care Groups:

• standard care group (Bed-based Care Group) - up to 12 patients monitored by up to 4 Information Centers

•unit group (Unit-based Care Group) - for a complete unit with up to 64 patients monitored by up to 4 Information Centers