Philips SRRBV1 User Manual

Instructions for Use

IntelliVue Patient Monitor

MX600/MX700/MX800

Release H.0 with Software Revision H.1x.xx

Patient Monitoring

Part Number 453564260091

Printed in Germany 05/11

*453564260091*

Table of Contents

	1 Introduction	13
Introducing the Monitor		13
Devices for Acquiring Measurements		15
Operating and Navigating		24
Operating Modes		31
Understanding Screens		32
Connecting Additional Displays to the Monitor		33
Using the XDS Remote Display		34
Using the Visitor Screen		34
Understanding Profiles		34
Understanding Settings		36
Changing Wave Speeds		37
Freezing Waves		38
Using Labels		39
Entering Measurements Manually		42
Changing Monitor Settings		42
Checking Your Monitor Revision		43
Getting Started		43
Disconnecting from Power		45
Networked Monitoring		45
Using the Integrated PC		46
Using the X2 or MP5 with a Host Monitor		47
	2 Alarms	49
Visual Alarm Indicators		50
Audible Alarm Indicators		51
Acknowledging Alarms		53
Pausing or Switching Off Alarms		54
Alarm Limits		56
Reviewing Alarms		60
Latching Alarms		61
Testing Alarms		62
Alarm Behavior at Power On		62
Alarm Recordings		63
	3 Patient Alarms and INOPs	65
Patient Alarm Messages		65
Technical Alarm Messages (INOPs)		70

3

	4 Managing Patients	95
Admitting a Patient		95
Quick Admitting a Patient		96
Editing Patient Information		97
Discharging a Patient		97
Transferring Patients		98
Data Upload from an MMS		102
Care Groups		105
	5 ECG, Arrhythmia, ST and QT Monitoring	111
Skin Preparation for Electrode Placement		111
Connecting ECG Cables		111
Selecting the Primary and Secondary ECG Leads		112
Checking Paced Status		112
Understanding the ECG Display		112
Monitoring Paced Patients		113
Changing the Size of the ECG Wave		114
Changing the Volume of the QRS Tone		115
Changing the ECG Filter Settings		115
Selecting Positions of Va and Vb Chest Leads (for 6-lead placement)		116
Choosing EASI or Standard Lead Placement		116
About ECG Leads		116
ECG Lead Fallback		117
ECG Lead Placements		117
Capture 12-Lead		123
EASI ECG Lead Placement		125
ECG and Arrhythmia Alarm Overview		126
Using ECG Alarms		127
ECG Safety Information		128
About Arrhythmia Monitoring		129
Switching Arrhythmia Analysis On and Off		130
Choosing an ECG Lead for Arrhythmia Monitoring		130
Understanding the Arrhythmia Display		132
Arrhythmia Relearning		134
Arrhythmia Alarms		135
About ST Monitoring		139
Switching ST On and Off		140
Understanding the ST Display		141
Updating ST Baseline Snippets		142
Recording ST Segments		142
About the ST Measurement Points		143
ST Alarms		145
Viewing ST Maps		146
About QT/QTc Interval Monitoring		149
QT Alarms		152
Switching QT Monitoring On and Off		153

4

	6 Monitoring Pulse Rate	155
Entering the Setup Pulse Menu		155
System Pulse Source		155
Switching Pulse On and Off		156
Using Pulse Alarms		156
	7 Monitoring Respiration Rate (Resp)	159
Lead Placement for Monitoring Resp		159
Understanding the Resp Display		160
Changing Resp Detection Modes		160
Changing the Size of the Respiration Wave		161
Changing the Speed of the Respiration Wave		162
Using Resp Alarms		162
Changing the Apnea Alarm Delay		162
Resp Safety Information		162
	8 Monitoring SpO2	165
SpO2 Sensors		165
Applying the Sensor		165
Connecting SpO2 Cables		166
Measuring SpO2		166
SpO2 Signal Quality Indicator (Fast SpO2 only)		167
Assessing a Suspicious SpO2 Reading		168
Changing the Averaging Time		168
Understanding SpO2 Alarms		168
Pleth Wave		171
Perfusion Numeric		171
Perfusion Change Indicator		171
Setting SpO2/Pleth as Pulse Source		172
Setting Up Tone Modulation		172
Setting the QRS Volume		172
Calculating SpO2 Difference		172
	9 Monitoring NBP	173
Introducing the Oscillometric NBP Measurement		173
Preparing to Measure NBP		175
Starting and Stopping Measurements		176
Enabling Automatic Mode and Setting Repetition Time		178
Enabling Sequence Mode and Setting Up The Sequence		178
Choosing the NBP Alarm Source		178
Switching Pulse from NBP On/Off		179
Assisting Venous Puncture		179
Calibrating NBP		179
10 Monitoring Temperature		181
Making a Temp Measurement		181

5

Calculating Temp Difference		182
11 Monitoring Invasive Pressure		183
Setting up the Pressure Measurement		183
Zeroing the Pressure Transducer		184
Adjusting the Calibration Factor		186
Displaying a Mean Pressure Value Only		187
Changing the Pressure Wave Scale		187
Optimizing the Waveform		187
Using the Wave Cursor		187
Non-Physiological Artifact Suppression		188
Choosing the Pressure Alarm Source		188
Calibrating Reusable Transducer CPJ840J6		189
Calculating Cerebral Perfusion Pressure		191
Calculating Pulse Pressure Variation		191
Measuring Pulmonary Artery Wedge Pressure		192
Editing the Wedge		193
Identifying the Pressure Analog Output Connector		193
12 Monitoring Cardiac Output		195
Hemodynamic Parameters		195
Using the C.O. Procedure Window		196
Accessing the Setup C.O. and Setup CCO Menus		197
Entering the HemoCalc Window		198
Measuring C. O. Using the PiCCO Method		198
Measuring C.O. Using the Right Heart Thermodilution Method		203
Documenting C.O. Measurements		206
C.O. Injectate Guidelines		206
C.O./CCO Curve Alert Messages		207
C.O./CCO Prompt Messages		209
C.O./CCO Warning Messages		209
C.O./CCO Safety Information		210
13 Monitoring Carbon Dioxide		213
Measurement Principles		214
Measuring CO2 using M3014A or X2		214
Measuring Mainstream CO2 using M3016A		218
Measuring Microstream CO2 using M3015A/B		220
Setting up all CO2 Measurements		222
14 Monitoring Airway Flow, Volume and Pressure		225
Attaching the Flow Sensor		226
Zero Calibration		228
Automatic Purging		228
Manual Purging		229
Gas Compensation		229

6

Setting up Spirometry			230
15 Monitoring tcGas			233
Identifying tcGas Module Components			233
Setting the tcGas Sensor Temperature			233
Using the tcGas Site Timer			234
Setting the tcGas Barometric Pressure			235
Remembraning the tcGas Transducer			235
Calibrating the tcGas Transducer			235
Applying the tcGas Transducer			237
Finishing tcGas Monitoring			238
TcGas Corrections			238
16 Monitoring Intravascular Oxygen Saturation			241
Selecting a Measurement Label			242
Preparing to Monitor with the M1021A Wide Module			242
Preparing to Monitor with the M1011A Narrow Module			246
Further Information for Both Modules			247
17 Monitoring EEG			249
EEG Monitoring Setup			249
Using the EEG Impedance/Montage Window			250
About Compressed Spectral Arrays (CSA)			252
Changing EEG Settings			253
EEG Reports			254
EEG Safety Information			254
EEG and Electrical Interference			255
18 Monitoring BIS			257
BIS Monitoring Setup			257
BIS Continuous Impedance Check			259
BIS Cyclic Impedance Check			260
BIS Window			260
Changing the BIS Smoothing Rate			261
Switching BIS and Individual Numerics On and Off			262
Changing the Scale of the EEG Wave			262
Switching BIS Filters On or Off			262
BIS Safety Information			262
19 Assigning a Telemetry Device and a Monitor to One Patient			265
How Can You Combine Devices?			265
Functions Available When the Telemetry Data Window is Displayed			267
General Telemetry-related Functions			268
Use Models With Telemetry			269

7

20 Trends		271
Viewing Trends		271
Setting Up Trends		274
Documenting Trends		278
Trends Databases		278
Screen Trends		279
21 Calculations		283
Viewing Calculations		284
Reviewing Calculations		285
Performing Calculations		285
Entering Values for Calculations		286
Documenting Calculations		287
22 High Resolution Trend Waves		289
Changing the Hi-Res Trend Waves Displayed		289
Hi-Res Trend Wave Scales		289
Hi-Res Trend Waves and OxyCRG		289
Printing Hi-Res Trend Wave Reports		290
Hi-Res Trend Wave Recordings		290
23 Event Surveillance		291
Levels of Event Surveillance		291
Event Groups		292
Event Episodes		292
Events Pop-Up Keys		293
Event Triggers		294
The Events Database		298
Viewing Events		298
Annotating Events		301
Documenting Events		301
24 ProtocolWatch		309
SSC Sepsis Protocol		309
25 Recording		317
Central Recording		317
Starting and Stopping Recordings		317
Overview of Recording Types		319
All ECG Waves Recordings		319
Creating and Changing Recordings Templates		320
Changing ECG Wave Gain		321
Recording Priorities		321
Recording Strip		321
Reloading Paper		323
Recorder Status Messages		323

8

26 Printing Patient Reports		325
Starting Report Printouts		325
Stopping Reports Printouts		326
Setting Up Reports		327
Setting Up Individual Print Jobs		328
Checking Printer Settings		329
Printing a Test Report		329
Switching Printers On Or Off for Reports		329
Dashed Lines on Reports		329
Unavailable Printer: Re-routing Reports		330
Checking Report Status and Printing Manually		330
Printer Status Messages		331
Sample Report Printouts		332
27 Using the Drug Calculator		337
Accessing the Drug Calculator		338
Performing Drug Calculations		338
Charting Infusion Progress		340
Using the Titration Table		341
Documenting Drug Calculations		341
28 IntelliBridge EC10 Module		343
Connecting an External Device		343
Changing Waves and Numerics Displayed		344
Viewing the IntelliBridge Device Data Window		344
Using Screens with External Device Data		344
Alarms/INOPs from External Devices		345
Language Conflict with External Device Drivers		345
29 VueLink Modules		347
Connecting an External Device		348
Changing VueLink Waves and Numerics Displayed		348
Viewing the VueLink Device Data Window		349
Using VueLink Screens		349
Switching VueLink On and Off		349
Alarms/INOPs From External Devices		350
Language Conflict with External Device Drivers		350
30 Using Timers		351
Viewing Timers		351
Timer Setup Pop-up Keys		352
Setting Up Timers		352
Displaying a Timer On The Main Screen		353
Displaying A Clock On The Main Screen		354

9

31 Respiratory Loops		355
Viewing Loops		355
Capturing and Deleting Loops		356
Showing/Hiding Loops		356
Changing Loops Display Size		356
Using the Loops Cursor		356
Changing Loops Type		357
Setting Up Source Device		357
Documenting Loops		357
32 Laboratory Data		359
Viewing Received Data		359
33 Care and Cleaning		361
General Points		361
Cleaning the Monitor		362
Disinfecting the Monitor		362
Sterilizing the Monitor		363
Cleaning, Sterilizing and Disinfecting Monitoring Accessories		363
Cleaning the SO2 Optical Module		363
Cleaning the Recorder Printhead (M1116B only)		363
34 Maintenance and Troubleshooting		365
Inspecting the Equipment and Accessories		365
Inspecting the Cables and Cords		366
Maintenance Task and Test Schedule		366
Troubleshooting		367
Disposing of the Monitor		367
Disposing of Empty Calibration Gas Cylinders		367
35 Accessories		369
ECG/Resp Accessories		369
NBP Accessories		372
Invasive Pressure Accessories		375
SpO2 Accessories		376
Temperature Accessories		380
Cardiac Output (C.O.) Accessories		381
Mainstream CO2 Accessories		382
Sidestream CO2 Accessories		382
Mainstream CO2 Accessories (for M3016A)		383
Microstream CO2 Accessories		383
Spirometry Accessories		384
tcGas Accessories		385
EEG Accessories		385
BIS Accessories		385
SO2 Accessories for M1021A		386

10

SO2 Accessories for M1011A		386
Recorder Accessories		386
Battery Accessories		386
36 Specifications		387
Intended Use		387
Manufacturer's Information		387
Symbols		389
Installation Safety Information		390
Monitor Mounting Precautions		393
Altitude Setting		393
Monitor Safety Specifications		393
EMC And Radio Regulatory Compliance		393
Physical Specifications		395
Environmental Specifications		397
Performance Specifications		399
Interface Specifications		401
Measurement Specifications		405
Safety and Performance Tests		424
37 Default Settings Appendix		429
Country-Specific Default Settings		429
Alarm and Measurement Default Settings		436
Alarm Default Settings		436
ECG, Arrhythmia, ST and QT Default Settings		437
Pulse Default Settings		438
Respiration Default Settings		439
SpO2 Default Settings		439
NBP Default Settings		440
Temperature Default Settings		440
Invasive Pressure Default Settings		441
Cardiac Output Default Settings		443
CO2 Default Settings		444
Spirometry Default Settings		444
tcGas Default Settings		445
Intravascular Oxygen Saturation		445
SvO2 Default Settings		446
ScvO2 Default Settings		446
EEG Default Settings		446
BIS Default Settings		447
VueLink Default Settings		447
	Index	449

11

12

1

Introduction

These Instructions for Use are for clinical professionals using the IntelliVue MX600/MX700/MX800 patient monitor.

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

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

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

In 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.

Introducing the Monitor

The IntelliVue MX600/MX700/MX800 patient monitor offers a monitoring solution optimized for the high-end surgical, cardiac, medical and neonatal care environments. Combining patient surveillance and data management, it allows multi-measurement monitoring by linking separate modules. The MX600 uses the navigation knob as primary input device and the MX700/MX800 use the touch screen as primary input device. All monitors have a remote control for convenient access to the five main keys and numeric data input.

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1 Introduction

The monitor stores data in trend, event, and calculation databases. You can see tabular trends (vital signs) and document them on a 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 user-defined clinical events over a 24 hour period.

With the optional Integrated PC, you have computer functionality directly in the monitor. You can use standard applications (e.g. Web browsers), connect to the hospital network or intranet, and run a second independent display with content from the patient monitor.

An IntelliVue X2 or MP5 can be connected to your monitor, where it acts as a multi-measurement module, acquiring measurements for the host monitor. When the X2 or MP5 is disconnected from the the original host monitor, it continues to monitor the patient as a fully independent, battery powered patient monitor, eliminating the need for a separate transport monitor. On connection to a new host monitor, the X2 or MP5 resumes its role as multi-measurement module, ensuring fully continuous monitoring.

Major Parts and Keys

MX600/700:

1 Color coded alarm lamps

2 Alarms Off lamp

3 Power on/Standby switch with integrated LED: Green - On/ Standby, Red - Error

4 AC power LED

5 Mounting quick-release lever (when this is pressed the monitor is not fixed on the mounting)

6 Part number and serial number

7 Hardkeys (Silence, Alarms Off, Main Screen)

8 Navigation knob

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1 Introduction

MX800:

1 Color coded alarm lamps

2 Alarms Off lamp

3 Power on/Standby switch with integrated LED: Green - On/ Standby, Red - Error

4 AC power LED

5 Mounting quick-release lever (when this is pressed the monitor is not fixed on the mounting)

6 Part number and serial number

Devices for Acquiring Measurements

The patient monitor acquires patient measurements using the devices described in this section. You can also extend the measurement capabilities of your monitor with such devices. Of these measurement devices, only the X2 has its own power on/standby switch, and can be powered from an external power supply or a rechargeable battery when not directly connected to the monitor (refer to the IntelliVue X2 Instructions for Use for details). All the rest take their power exclusively from the monitor, and switch on automatically when you turn on the monitor. A green power-on LED indicates when they are drawing power from the monitor. A permanently illuminated, or flashing, red LED indicates a problem with the unit that requires the attention of qualified service personnel.

All symbols used on the front panels are explained in “Symbols” on page 389.

WARNING

When connecting devices for acquiring measurements, always position cables and tubing carefully to avoid entanglement or potential strangulation.

Flexible Module Rack (M8048A)

The 8-slot flexible module rack (FMS-8) lets you use up to eight plug-in physiological measurement modules. For the MX800, you can connect two FMSs to use up to 10 measurement modules.

The maximum number of specific module types that can be used simultaneously in an FMS-8 is: five pressure modules, four temperature modules, four VueLink or IntelliBridge modules (any combination).

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1 Introduction

Connect the FMS to the monitor via the measurement link cable (MSL). Use the MSL connector on the left-hand side to connect an additional MMS. Use the connector on the right to connect to the monitor.

1 X1 Multi-Measurement Module

2 Multi-Measurement Module mount

3 Flexible Module Rack FMS-8

4 Power on LED

5 Interruption indicator

4-Slot Flexible Module Rack (FMS-4)

The 4-Slot flexible module rack (FMS-4) lets you use up to four plug-in physiological measurement modules.

The maximum number of specific module types that can be used simultaneously in an FMS-4 is: four pressure modules, four temperature modules, four VueLink or IntelliBridge modules (any combination).

Connect the FMS to the monitor via the measurement link cable (MSL). Use the MSL connector on the left-hand side (if you have the appropriate option) to connect an additional MMS. Use the connector on the back to connect to the monitor.

Measurement Modules

You can use up to eight measurement modules with the Flexible Module Rack (M8048A). Available modules are:

•Invasive blood pressure (M1006B)

•Temperature (M1029A)

•Oxygen saturation of arterial blood (SpO2) (M1020B)

•Cardiac output (M1012A), and Continuous cardiac output with M1012A Option #C10

•Transcutaneous gas (M1018A)

•Mixed venous oxygen saturation - SvO2 (M1021A)

•Intravascular Oxygen Saturation - ScvO2 or SvO2 (M1011A)

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1 Introduction

•Recorder (M1116B)

•VueLink device interface (M1032A)

•IntelliBridge EC10

•EEG (M1027A)

•Bispectral Index - BIS (M1034A)

•Spirometry (M1014A)

You can plug in and unplug modules during monitoring. Insert the module until the lever on the module clicks into place. Remove a module by pressing the lever upwards and pulling the module out. A measurement automatically switches on when you plug the module in, and switches off when you unplug it. Reconnecting a module to the same monitor restores its label and measurement settings, such as alarms limits. If you connect it to a different monitor, the module remembers only its label.

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

Press the Setup key on the module's front to display the measurement's setup menu on the monitor screen. When the setup menu is open, a light appears above the key. Some modules have a second key. On the pressure module, for example, it initiates a zeroing procedure.

Example Module (SpO2)

1Module name

2Setup key LED

3Setup key to enter setup menu of measurement modules or external device data window. Some modules have a second module-specific key next to this one, for example Zero.

4Connector socket for patient cable/transducer

X1 Multi-Measurement Module (M3001A)

The X1 Multi-Measurement Module (MMS) can simultaneously monitor 3-, 5-, 6- or 10-lead ECG (including arrhythmia and ST monitoring), respiration, SpO2, NBP and either invasive pressure or

temperature.

You can connect it to the monitor via a cable or mount it on the left side of the FMS.

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1 Introduction

X1 Connectors and Symbols

1 White ECG/Resp connector

2 Blue SpO2 connector

3 Red NBP connector

4 Combined pressure (red) and temperature (brown) connector - connect either invasive pressure transducer or temperature probe. You might have a version of the MMS that does not have this connector.

5 NBP STAT key - starts NBP STAT series of measurements

OR

Zero key - initiates a zero procedure for the connected pressure transducer when pressed and held for a second

6 NBP Start/Stop key - starts or stops NBP measurements

7 Silence: acknowledges all active alarms by switching off audible alarm indicators and lamps

X2 Multi-Measurement Module (M3002A)

The X2 Multi-Measurement Module (MMS) can simultaneously monitor 3-, 5-, 6- or 10-lead ECG (including arrhythmia and ST monitoring), respiration, SpO2, NBP and either invasive pressure and

temperature, or CO2. It has a color touchscreen display.

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1 Introduction

The X2 has the added capability to operate as a stand-alone monitor, and can be powered by a rechargeable battery. This makes it particularly suited to transport situations. When the X2 is disconnected from the original host monitor, it continues to monitor the patient as a stand-alone monitor running on battery power, eliminating the need for a separate transport monitor. When the X2 is connected to a new host monitor, it resumes its role as MMS, ensuring fully continuous monitoring. For details of using the X2 as a stand-alone monitor, refer to the IntelliVue X2 Instructions for Use.

When connected to a host monitor (Companion Mode is indicated), the X2 takes power from the host, including that required for battery charging. The X2 can also be powered by AC mains when not connected to a host monitor using the optionally available external power supply (M8023A). See the

IntelliVue X2 Instructions for Use for details.

X2 Overview

1 On/Standby switch

2 Power and battery indicators (see “X2 Controls and Indicators” on page 20)

3 3.5-inch TFT LCD touchscreen QVGA display

4 Alarm lamps (see “X2 Controls and Indicators” on page 20)

5 Battery eject button

6 Hard keys (see “X2 Controls and Indicators” on page 20)

7 Measurement connectors (see “X2 Patient Connectors, Right Side” on page 21)

8 Battery compartment

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1 Introduction

X2 Controls and Indicators

1External power LED. Green when monitor is powered from an external power source.

2Battery status LED. Yellow when charging. Flashing red when battery is empty.

3On/Standby LED. Green when monitor is on. Red indicates an error.

4On/Standby switch. Disabled when X2 is connected to a host monitor

5Main Screen key: closes all open menus/windows and returns to the main screen.

6SmartKeys key: brings up SmartKeys on the screen.

7Alarms key: turns alarms On/Off, or pauses them.

8Silence key

9Active alarm lamp. Red or yellow, depending on alarm level. Blinks until active alarm is acknowledged.

10Active INOP alarm lamp in light blue. Blinks until active INOP is acknowledged.

11Alarms off indicator. When alarms are suspended, the lamp is red, and the alarms off symbol is shown.

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1 Introduction

X2 Patient Connectors, Right Side

Showing symbols version (international) - English version has text labels

1	Pressure (option)
2	Temperature (option)
3	Noninvasive blood pressure
4	SpO2
5	ECG sync pulse output
6	ECG/Respiration
7	CO2 (option in place of Pressure and Temperature)

X2 Left Side

1	Loudspeaker
2	MSL Connector. Connects to the external power
	supply or a host monitor via the MSL cable for AC
	mains operation, battery charging, and
	communication with a network.

MMS Extensions

The MMS extensions connect to the X1 and X2 MMS and use the MMS settings and power. Trend data and measurement settings from the measurements in the extensions are stored in the MMS.

WARNING

•The MMS extensions can only function when they are connected to an MMS. If the MMS is removed during monitoring, the measurements from both the MMS and the extension are lost.

•Measurements from an MMS extension connected to an X2 are not available when the X2 is running on its own battery power. They are only available when the X2 is powered from AC mains, when connected to a host monitor or the external power supply (M8023A), or from the Battery Extension.

To separate an extension from the MMS, press the release lever down, and push the MMS forward.

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1 Introduction

M3014A, M3015A, M3015B and M3016A Capnography MMS Extensions

The optional M3014A Capnography extension adds mainstream capnography or sidestream capnography, and optionally one pressure plus either a pressure or a temperature, Cardiac Output and Continuous Cardiac Output to the MMS.

M3014A

1 Pressure connectors (red)

2 Temperature connector (brown)

3 Mainstream/sidestream connector CO2

4 Cardiac Output connector

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1 Introduction

The optional M3015A Microstream CO2 extension adds microstream capnography and optionally either pressure or temperature to the MMS. The optional M3015B Microstream CO2 extension adds microstream capnography, two pressures and a temperature to the MMS.

M3015A

M3015B

1Pressure connectors (red) - M3015A optional

2Temperature connector (brown) - M3015A optional

3Inlet

4Microstream connector CO2

5Gas sample outlet

The optional M3016A Mainstream CO2 extension adds mainstream capnography and optionally either pressure or temperature to the MMS.

M3016A

1 Pressure connectors (red)

2 Temperature connector (brown)

3 Mainstream/sidestream connector CO2 (optional)

When a capnography extension is connected to an X2 MMS with CO2, the CO2 from the extension will be automatically deactivated in favor of the one in the X2. If you prefer to use the CO2

measurement on the extension, you can activate it via the measurement selection key (see “Resolving Label Conflicts” on page 40).

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1 Introduction

The cardiac output measurement in the M3014A is deactivated when the extension is used with an X2 MMS, even if the X2 is connected to an external power supply. The cardiac output measurement is only available when the X2 is connected to a host monitor.

M3012A Hemodynamic MMS Extension

1 Cardiac Output (orange; optional)

2 Connection to MMS

3 Pressure connectors (red)

4 Temperature connectors (brown)

The M3012A Hemodynamic extension can be connected to the M3001A Multi-Measurement Module to provide the following additional measurements: Temperature, Pressure, an additional Pressure or Temperature, and C.O. and CCO measurements.

The cardiac output measurement is deactivated when the extension is used with an X2 MMS unless the X2 is connected to a host monitor.

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.

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1 Introduction

Monitor information line		Other screen elements
1	network connection indicator	10	alarm status area - shows active alarm messages
	(documented in Information
	Center Instructions for Use)
2	bed label	11	status line - shows information messages and prompting you for action
3	patient identification	12	close all open menus and windows and return to main screen
4	patient category	13	enter Main Setup menu
5	paced status	14	scroll right to display more SmartKeys
6	date and time	15	SmartKeys - these change according to your monitor's configuration
7	access the Profiles menu	16	scroll left to display more SmartKeys
8	current screen name/enter	17	Pause Alarms - pauses alarm indicators. Pause duration depends on monitor
	Change Screen menu		configuration. If pause duration is infinite, this key is labeled Alarms Off. Select again
			to immediately re-enable alarm indicators.
9	adjust alarm volume/level	18	Silence - acknowledges all active alarms by switching off audible alarm indicators and
	indicator		lamps permanently or temporarily, if alarm reminder (ReAlarm) is configured on.

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, remote control or a pointing device such as a mouse.

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1 Introduction

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.

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.

Moving Windows

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

1Select the title of the window and keep your finger on the title, or the mouse button pressed.

2Move your finger on the Touchscreen, or move the mouse, to move the window.

3Take your finger off the screen, or release the mouse button, to place the window in the final position.

The new position is only active until the window or menu is closed. Not all locations on the screen can be a target position, a window cannot overlap the monitor info line, the alarms and INOPs or the status line.

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 Alarms Off. Select again to immediately re-enable alarm indicators.

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

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

Main Setup - enter main setup menu.

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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. If you have an integrated PC (iPC) you may also see Smartkeys generated by applications on the iPC.

enter profile menu, or revert to default profile

show BIS Sensor

freeze waves

set alarm limits

change alarm volume

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)

change amplitude (size) of ECG wave

-start/stop manual NBP measurement

-start auto series

-stop current automatic measurement within series

start NBP measurement and measurement series

start veni puncture (inflate cuff to subdiastolic pressure)

access patient reports

change Screen, or revert to default screen

previous Screen

quick admit a patient

enter patient identification menu to admit/discharge/transfer

end case to discharge a patient

view information for patients in other beds

change screen brightness (not for independent displays)

re-learn arrhythmia

enter cardiac output procedure

start NBP STAT measurement

stop automatic or STAT NBP measurement and measurement series

stop current NBP measurement

set the NBP repeat time

zero invasive pressure transducer

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1 Introduction

start a delayed recording

access Vital Signs recording function

set wide automatic alarm limits

access wedge procedure window

review vital signs trend

access event surveillance

access the calculator

gas analyzer - exit standby mode

unpair equipment and continue central monitoring with the monitor

access the spirometry data window

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

access EEG CSA

display external device information

access ProtocolWatch

switch CO2 pump off

enter data manually

open the Histogram window

access pop-up recording keys

access Select Waves recording function

set narrow automatic alarm limits

access the Loops window

review graph trend

access calculations

access the Drug Calculator

suppress zero for all gas measurements

unpair equipment and continue central monitoring with the telemetry device

access ST Map application

access remote applications (if Application Server is connected)

access the EEG montage

access timers

set standard or EASI lead placement

new lead setup

start/stop car seat assessment record

open Unit Conversion window

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1 Introduction

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 Remote Control

The remote control provides you with direct access to five hard keys, a navigation knob and a numeric keypad:

Hardkeys

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	SmartKeys - display a block of SmartKeys specially configured for remote tasks (see below)
5	Back - go back one step to the previous menu.

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Keypad

6 Type numeric data on the keypad and press the Enter key to enter the data on the monitor.

Navigation knob

7 Rotate the knob to highlight screen elements, then press to select the highlighted element.

The remote control can be used with a USB cable connection to the monitor or without a cable using short range radio. When used without a cable, the remote control must be assigned to the monitor. The assignment is made in Configuration or Service mode.

CAUTION

When using a remote control without a cable, it is important that the user knows which remote control is assigned to which monitor. Use the tethering cable delivered with the remote control to attach it to a bed rail or IV pole, or label the remote control with the bed or monitor ID.

Using the SmartKeys Key

The SmartKeys hard key on the remote control displays a block of SmartKeys on the monitor screen.

Nine SmartKeys appear in a 3 by 3 matrix which corresponds to the layout of the numeric pad on the remote control.

Pressing the 1 key on the remote control selects the top left SmartKey, pressing the 8 key selects the

bottom center SmartKey. The . and the key can be used to select the arrow keys to page up and down in the available SmartKeys.

The SmartKeys which appear can be configured so that you have the functions available which you most often need when using the remote control. If no list of SmartKeys has been configured, the standard SmartKeys will be displayed and you can page through to the key you want.

Using the On-Screen Keyboard

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

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

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