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*

1Table 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

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

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

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

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

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

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

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

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

1Introduction

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.

1Introduction

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

MX800:

1 Introduction

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).

1Introduction

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.

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.

1 X1 Multi-Measurement Module 2 Multi-Measurement Module

mount

3 Flexible Module Rack FMS-8 4 Power on LED 5 Interruption indicator

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 (SpO

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

• Transcutaneous gas (M1018A)

• Mixed venous oxygen saturation - SvO

• Intravascular Oxygen Saturation - ScvO

) (M1020B)

(M1021A)

or SvO2 (M1011A)

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)

1 Module name

2 Setup key LED

3 Setup 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.

4 Connector 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, SpO

temperature.

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

, NBP and either invasive pressure or

1Introduction

X1 Connectors and Symbols

1 White ECG/Resp connector

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, SpO

temperature, or CO

. It has a color touchscreen display.

2 Blue SpO

3 Red NBP connector

4 Combined pressure (red) and temperature

connector

(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

, NBP and either invasive pressure and

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.

X2 Overview

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.

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

1Introduction

X2 Controls and Indicators

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

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

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

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

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

6 SmartKeys key: brings up SmartKeys on the screen.

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

8 Silence key

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

acknowledged.

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

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

shown.

X2 Patient Connectors, Right Side

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

1 Introduction

1 Pressure (option)

2 Temperature (option)

3 Noninvasive blood pressure

X2 Left Side

4 SpO

5 ECG sync pulse output

6 ECG/Respiration

7 CO

1 Loudspeaker

2 MSL Connector. Connects to the external power

(option in place of Pressure and Temperature)

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.

1Introduction

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 CO

4 Cardiac Output connector

1 Introduction

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

extension adds

microstream capnography, two pressures and a temperature to the MMS.

M3015A M3015B

1 Pressure connectors (red) - M3015A optional

2 Temperature connector (brown) - M3015A optional

3 Inlet

4 Microstream connector CO

5 Gas sample outlet

The optional M3016A Mainstream CO

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 CO

(optional)

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

, the CO2 from the extension

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

1Introduction

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

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.

1 Cardiac Output (orange; optional)

2 Connection to MMS

3 Pressure connectors (red)

4 Temperature connectors (brown)

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.

1 Introduction

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.

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 HR numeric to call up the menu.

Setup ECG menu. Select the ECG wave segment to call up the ECG Lead

Patient Demographics window, or select the

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.

1Introduction

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,

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

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

3 Take 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 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.

Alarms Off.

SmartKeys

1 Introduction

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 previous Screen

freeze waves quick admit a patient

set alarm limits enter patient identification menu to

change alarm volume end case to discharge a patient

change QRS volume view information for patients in

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

change Screen, or revert to default screen

admit/discharge/transfer

other beds

change screen brightness (not for independent displays)

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 zero invasive pressure transducer

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

1Introduction

start a delayed recording access pop-up recording keys

access Vital Signs recording function access Select Waves recording

function

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 analyzer - exit standby mode suppress zero for all gas

measurements

unpair equipment and continue central monitoring with the monitor

unpair equipment and continue central monitoring with the telemetry device

access the spirometry data window access ST Map application

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

access remote applications (if Application Server is connected)

access EEG CSA access the EEG montage

display external device information access timers

access ProtocolWatch set standard or EASI lead placement

switch CO

pump off new lead setup

enter data manually start/stop car seat assessment record

open the

Histogram window open Unit Conversion window

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

1 Introduction

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.

1Introduction

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 single characters, or use the 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.

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

Clr key to delete entire entries. Select Enter to confirm what you have

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