Ambulatory Blood Pressure
Monitors
90207/90217
Operations Manual
070-0137-03 Rev. J
more time to care
© 2004 Spacelabs Medical, Inc.
All rights reserved. Contents of this publication may not be reproduced in any form without the written permission of Spacelabs
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• assembly operations, re-adjustments, modifications or repairs are carried out by persons authorized by Spacelabs
Medical, and
• the electrical installation of the relevant room complies with the requirements of the standard in force, and
• the equipment is used in accordance with the operations manual.
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or other information which will assist appropriately qualified technical personnel to repair those parts of the equipment which are
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training, and service for the life of your Spacelabs Medical equipment.
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U.S.A.
Spacelabs Medical, Inc.
5150 220th Ave SE
Issaquah, WA 98029
Telephone: 425-657-7200
Telephone: 800-522-7025
Fax: 425-657-7212
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Rx
Only
of, a physician.
Table of Contents
Contents
Operation
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
ABP Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Replacing the Batteries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Main Battery Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Lithium Battery Replacement (90207 only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Initializing the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Connecting Directly to a Local Report Generator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Connecting Directly to the PC Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Connecting to the Base Station via Modem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Office Check Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Preparing the Patient and Precautions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
Using Cuff Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10
Correlating with Manual Readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Patient Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Data Transfer and Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Cleaning the Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Cleaning the Cuff and Carrying Pouch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-12
Removing/Installing the Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-12
Event Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13
Accuracy
Checking Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Required Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Accuracy Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Troubleshooting
Problem Solving Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Servicing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Symbols
i
Contents
Overview
The Spacelabs Medical Models 90207 and 90217 Ambulatory Blood Pressure (ABP) monitors are
small, lightweight, battery-powered units designed to take blood pressure and heart rate
measurements for 24 or 48 hours, or for longer periods of time.
These measurements are recorded in the monitors and may be transferred to an ABP Analysis
System (FT1000A/FT2000A or equivalent), the PC Interface, the Base Station, or a Report
Generator for data analysis, report printing, and archiving.
Operation
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Preparing the Patient and Precautions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Data Transfer and Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Event Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Each monitor and a base station can operate in a direct connect mode (when both units are in the
same location) or in a remote connection mode (using modems).
ABP Monitor
The monitors have the following features:
• Four-digit LCD display
• Battery powered
• Serial communications port
• Power ON/OFF switch
• Reading START/STOP button
• Blood pressure cuff
The monitors are carried in pouches that are strapped and/or belted to the side of the patient.
Blood pressure and heart rate measurements are taken using a blood pressure cuff attached to
the patient's arm. This information is recorded in the monitors and can be transferred over a
modem link or by direct connection between the monitors and one of the ABP analysis systems.
The monitors can be programmed to either activate or deactivate the following features:
• Display the cuff pressure at each bleed step.
• Display the systole, diastole, and heart rate at the end of each measurement.
• Bleed to 40 mmHg rather than stopping at the diastolic value.
• Beep before and after each reading.
Front Panel
The 90207 and 90217 front panels include the LCD display, cuff hose connector, and a
START/STOP switch.
1-1
Ambulatory Blood Pressure Monitors
Rear Panel
The rear panels of both monitors contain program input and data output communication ports. On
the 90207, the power ON/OFF switch is also located on the rear panel. On the 90217, the ON/OFF
switch is located on the top panel.
Replacing the Batteries
“AA” batteries provide the main power source for the monitors. The 90207 uses four batteries, and
the 90217 uses three. These batteries should be replaced or recharged before the start of each
patient monitoring. Use either alkaline or NiCad batteries.
In the 90207, a lithium battery (P/N 146-0008-xx) is used to back up the monitor memory and
should be replaced periodically. The 90217 backup battery should not require replacement.
Main Battery Replacement
Note:
If the main “AA” batteries must be replaced during patient monitoring, this replacement must
be accomplished within one minute to ensure successful resumption of the test (90207 only).
Caution
1 Power the monitor OFF, and remove the door over the battery compartment.
2 Replace the AA alkaline or NiCad batteries, being careful to observe polarities.
• The monitor will not operate if the alkaline, nickel cadmium, or lithium batteries are
incorrectly installed. If the monitor is going to be stored for an extended period of
time, remove the batteries to prevent the possibility of leakage or discharge.
• Spacelabs Medical is not responsible for product damage incurred as a result of AA
battery leakage. In the event your unit has been damaged by a leaking battery,
contact the battery manufacturer for any recoverable repair or replacement costs.
Spacelabs Medical will assist you in determining those costs.
3 Gently replace the battery cover and secure the latch.
4 Power the monitor ON. Check that the LCD display is ON. If there is no display, power the
monitor OFF and review the problem-solving checklist in
Troubleshooting on page 3-1.
Lithium Battery Replacement (90207 only)
The lithium battery is located in the battery compartment under a pry-off cover to the right of the
AA batteries.
1 Power the monitor OFF, and remove the door over the battery compartment.
2 Remove the pry-off cover, and note the polarity of the battery and socket indicators.
3 Remove the old lithium battery by carefully prying it out (curved forceps are recommended).
4 Install the new lithium battery and replace the pry-off cover. The underside of this cover is
divided into two unequal-sized compartments. Install the cover with the smaller compartment
oriented over the lithium battery.
5 Gently replace the battery compartment cover and secure the latch.
1-2
Ambulatory Blood Pressure Monitors
Note:
Once the lithium battery has been completely discharged, it is considered non-hazardous and
can be safely discarded.
Initializing the Monitor
The ABP monitors must be initialized prior to the start of patient monitoring. Initialization specifies
the monitoring period, patient information, time format, measurement interval, monitor tone
ON/OFF during selected periods, event code display, and whether or not to display pressure
values. To initialize the monitor, connect it to one of the following analysis systems.
Connecting Directly to a Local Report Generator
For a direct connection to the 90207 or 90217 monitor, place the monitor into the chute on the
Report Generator (Model 90239A or equivalent) as displayed below.
LOCAL REPORT CONFIGURATION
Operation
Figure 1-1: Report Generator
Connecting Directly to the PC Interface
For a direct connection to a PC-compatible computer via a Model 90121, 90219-02, or 90219-03:
• Connect the ABP interface cable to the serial port on the 90219 or 90121 system and to the
monitor. Refer to the 90121 ABP Report Management System Operations Manual
(P/N 070-0529-xx) for more information on the report management system.
90219 or 90121 system
cable to serial port
Figure 1-2: PC interface direct connect configuration
ABP
Monitor
1-3
Ambulatory Blood Pressure Monitors
Connecting to the Base Station via Modem
For a modem connection to a remote IBM XT/AT/PS2 (or equivalent) base station, refer to Figure
1-3.
cable to
to
base
station
modem
public
telephone
network
modem
Figure 1-3: Modem connection configuration
Note:
The actual initialization procedure is discussed in the 90219 ABP PC Interface/Base Station
Operations Manual (P/N 070-0238-XX).
serial port
ABP
Monitor
phone
Modem Speed and Compatibility Issues
The 90207 and 90217 units operate Hayes-compatible modems only. You can identify your model
type by plugging the communications cable into your 90207/90217 unit and looking at the numbers
on the display. The acceptable modem types and maximum speeds of 90207/90217 units are
summarized below:
Table 1: 90207/90217 acceptable modem speeds
Model Type Max Speed
older 90207 1200 1200 only 9999
newer 90207 1200 any Hayes 1999/9999
older 90217 up to 9600 up to 9600 2999/9999
newer 90217 9600 any Hayes 0999/9999
Modems
Accepted
Display
1-4
Ambulatory Blood Pressure Monitors
Connection Procedure
1 If you are using an older 90207 with a 1200 modem, set the switches on the modem as follows:
Switch # Setting at monitor site
1 down
2 up
3 down
4 down
5 down
6 up
7 up
8 down
9 up
10 up
2 Connect the serial port cable (P/N 012-0096-00) between the monitor and the modem.
Note:
If call waiting or call forwarding are options on a telephone used to transfer data, ensure that
both are deactivated. Otherwise modem communications may be interrupted. In addition,
telephone systems such as CBX or PBX can cause interference with the modem, or the
modem can cause interference with the switching system.
Operation
To initialize the monitor for remote connection:
1 Contact the base station by telephone (for remote operation only).
2 Ask the base station operator to initialize the monitor. Give the following information to the
operator:
• Patient's name
• Patient ID number
• Whether monitor display is to be active or not
• Time of day (12- or 24-hour format)
• Whether to display measurement (systolic/diastolic and heart rate)
• Multiple or single cycle times. If using a single cycle for the 24-hour monitoring period,
indicate the cycle interval and whether the tone is on or off. For multiple cycle times,
specify each cycle interval and whether the tone is on or off for each cycle.
• Any other information the base station operator may request
3 The base station operator enters the patient information in the computer.
4 Prepare the monitor to receive the patient data from the base station.
• Power ON the modem.
• When instructed by the base station operator, power ON the ABP monitor.
Note:
The modem link must be established within 10 to 20 seconds for the 90207, and within
45
seconds for the 90217. If this does not occur, power the monitor OFF and then ON again to
retry.
1-5
Ambulatory Blood Pressure Monitors
5 When the transfer of information is complete, the ABP monitor will beep. Voice communication
is restored after the monitor beeps.
• Power OFF the monitor and disconnect the monitor from the modem.
• If direct connection between the monitor and the base station is used, power OFF the
monitor and disconnect it from the ABP data interface unit.
To transfer readings from the monitor to the base station:
1 Contact the base station by telephone (for remote operation only).
2 Ask the base station operator to read the monitor. Give the following information to the operator:
• Patient's name
• Patient ID number
• Any other information the base station operator may request
3 The base station operator enters the patient information in the computer. (If the monitor is in a
remote location, the operator turns the base station modem ON.)
4 Prepare the monitor to transfer data to the base station.
• Power ON the modem.
• When instructed by the base station operator, power ON the ABP monitor (for remote
operation only).
Note:
The modem link must be established within 10 to 15 seconds for the 90207, and within
45
seconds for the 90217. If this does not occur, power OFF the monitor and return to step 1.
5 When the transfer of information is complete, the ABP monitor will beep. Voice communication
is restored after the monitor beeps.
Power OFF the monitor. Disconnect the monitor from the modem.
Modem Indicator Lights
Modem indicators at the local modem are lit, flashing, or unlit depending on the stage of operation.
When the monitor is turned on, the RD (Receive Data) and SD (Send Data) lights will flash for
several seconds. The OH (On Hook) indicator becomes lit when the monitor starts communicating
with the remote modem. When the modems connect, the CD (Carrier Detect) is lit. The SD and RD
lights flash as data is being transferred.
After the transmission is complete and the monitor is turned off, the HS, TR, and MR indicators will
always remain lit at the local modem.
Setup Test
Note:
Verify that the cable connections are secure.
Power ON the ABP monitor. It will display "9999." While the monitor is being read or initialized, the
digits will change to indicate that communication is taking place between the monitor and the
analysis system. When communication is complete, the digits will no longer change.
1-6
Ambulatory Blood Pressure Monitors
Office Check Mode
The monitor automatically enters an office check mode for the first five measurements immediately
following initialization. This allows you to verify the performance of the monitor on an individual
patient without the need for re-initialization to reset the display features.
While in the office check mode, the monitor operates as follows:
• Displays the cuff pressure on each bleed step
• Displays systole, diastole, and heart rate at the end of the measurement
• Bleeds one step below the diastolic value as determined by the monitor
Terminating Office Check Mode
For the 90207 (versions earlier than 2.14), press the START/STOP key twice to cancel each of the
remaining readings. The office check mode is terminated when the sum of the canceled and
successful measurements equals five.
For the 90217 and 90207 (versions 2.14 and later), press the START/STOP key twice to cancel a
single blood pressure reading. The office check mode is terminated when a blood pressure
reading is canceled.
Any event that prevents a successful blood pressure measurement (other than a manual cancel) is
not counted as one of the five office check mode readings.
Operation
Reinstating Office Check Mode
The office check mode can be reinstated in the 90217 and the 90207 (versions 2.14 and later).
To reinstate the office check mode without initialization of the monitor:
1 Power ON the monitor.
2 When the version displays on the LCD, press and hold the START/STOP key.
3 Release the START/STOP key when EC03 displays on the LCD.
An EC13 will be logged to indicate the time at which the office check mode was reinstated. The
office check mode will be enabled for five additional successful measurements.
1-7
Ambulatory Blood Pressure Monitors
Preparing the Patient and Precautions for Use
• Blood pressure measurements determined with this device are equivalent to those
obtained by a trained observer using the cuff/stethoscope auscultation method, within the
limits prescribed by the American National Standard, Electronic, or automated
sphygmomanometers.
- The fifth Korotkoff sound was used to determine overall efficiency.
• As in manual auscultatory methods, accurate readings might not always be achieved
under some conditions. Patient movement, the position of the cuff relative to the level of
the heart, extreme heart rates and blood pressures, various arrhythmias, and the subject’s
physiological condition and other factors can hinder an accurate reading. Vibration, such
as that in a moving automobile, is an environmental problem that can affect readings.
• When some of the above factors prevent an accurate reading, an event code is provided to
indicate the reason for the missed blood pressure reading. When only a single blood
pressure parameter (systole, diastole, or mean arterial pressure) is obscured and the other
two parameters are measured, the obscured parameter can be replaced with a computed
value.
• If such a value is computed in the 90217, it appears on the report in angle brackets, e.g.,
< value >. On the monitor display, dashes are displayed instead of the estimated value.
The ratio used in the formula is determined by the previous successful measurements of
the pressure, rather than a fixed ratio.
• Consult a physician for interpretation of pressure measurements.
After the monitor has been initialized, prepare the patient for monitoring as follows:
1 Power ON the monitor (wait for the monitor to perform self-tests). When the LCD displays the
current time, the monitor is ready for operation.
2 Strap the monitor to the patient’s hip opposite the side on which the cuff is worn. Secure the
monitor using the patient's own belt or the ABP pouch strapped over the opposite shoulder.
When using the shoulder strap, use the belt supplied with the monitor or the patient’s belt to
provide additional security.
3 Proper cuff selection and application is essential to ensure the accuracy of blood pressure
measurements. To select the proper cuff, first measure the circumference of the limb at the
point where the cuff is to be applied. Match the limb measurement to the range of appropriate
circumferences (in centimeters) specified on each cuff (refer to
Table 2: Cuff sizes, Circumference Ranges and Part Numbers
Description
Pediatric Cuff 12 to 20 cm 015-0118-01Q 015-0118-01
Small Adult Cuff 17 to 26 cm 015-0067-01Q 015-0067-01
Adult Cuff 24 to 32 cm 015-0068-02Q 015-0068-02
Large Adult Cuff 32 to 42 cm 016-0077-01Q 016-0077-01
Limb
Circumference
Part Number
Quick-Disconnect
Table 2).
Part Number
Luer-Lock
Extra-large Adult Cuff 38 to 50 cm 016-0109-01Q 016-0109-01
1-8
Ambulatory Blood Pressure Monitors
Table 3: Optional Accessories
Accessories Part Number
Cuff Support Harness 015-0070-xx
Service Manual 070-0502-xx
Quick Disconnect Coupling 712-0794-00
Male Quick Disconnect to Luer Adapter 712-0773-00
4 Position the cuff so that the center of the inflatable bladder is directly over the brachial artery.
The center of the bladder location is marked on the outside of the cuff. Once the proper position
is determined, the cuff must be tightened to ensure that it is equally snug at the top and bottom
edges and that it is not kinked. This is especially important on larger arms. Insert a finger
between the cuff and the limb to ensure it is not too tight. It may be necessary to wrap the cuff
with its tail at an angle to achieve uniform tightness. If the cuff is not equally snug at the top and
bottom edges, the number of readings available will be limited and the monitor may indicate
that the cuff is improperly applied.
Operation
Caution
• Avoid compression or restriction of pressure in the NIBP patient connector tubes.
Check that operation of the equipment does not result in prolonged impairment of
circulation.
• Do not apply cuff to areas of breached or injured skin.
• This product contains natural latex rubber components to which some people may
be allergic. These components include the bladder and the first four inches of tubing
extending from the cuff.
Note:
• Use only Spacelabs Medical cuffs with this monitor. Using other manufacturer’s cuffs may
result in inaccurate readings, even if the manufacturer’s recommended size is observed.
• If the cuff is too small, pressure readings may be falsely high; a cuff that is too large
produces a falsely low reading. The bladder can be positioned in the cuff for either the left
or right arm.
5 Once the cuff is applied, the arm should be relaxed at the patient's side. To avoid reading errors
due to hydrostatic pressure differences, the level of the cuff on the arm should be near the level
of the heart.
6 Lead the hose up the arm with the cuff and place it across the back of the patient. Drape the
hose so it does not cause the patient discomfort and is not pinched shut by too tight a radius.
The following figure shows the most common positions for the cuff hose.
1-9
Ambulatory Blood Pressure Monitors
ALTERNATIVE #1
ALTERNATIVE #2
7 Connect the hose to the monitor.
8 To verify proper monitor operation, take one or more blood pressure readings. Push the
START/STOP key to begin a measurement. Spacelabs Medical recommends taking three
readings in the office so that the patient becomes comfortable with operation of the monitor and
the measurement process.
9 Show the patient how to enter information in the patient diary. Make sure the patient knows
what to do if the cuff becomes very uncomfortable during a measurement, if it slips out of place,
or if event codes are displayed on the monitor screen (refer to
11). In addition, ensure the patient knows how to care for the monitor.
10 When you are satisfied that the monitor is operating properly, the remaining measurements in
the check mode can be canceled. Refer to
Office Check Mode on page 1-7.
Patient Instructions on page 1-
Using Cuff Support
Note:
Keeping the blood pressure cuff in place is very important both for patient comfort and for
accuracy of the readings. This becomes particularly challenging when the arm has
considerable taper, as is often the case with obese patients.
1 Once the cuff is successfully applied to the patient, put the large loop of the support around the
opposite arm. Adjust the length so that the junction of the straps fits well back on the shoulder
towards the neck.
2 Fasten the rear short strap to the rear of the armpit. Be careful to clip to the material only and
not to the bladder.
3 Fasten the front strap to the top layer of the cuff material at the location where the hose exits
the cuff. Adjust the length of these straps to apply a minor amount of tension to hold the cuff in
position.
1-10
Ambulatory Blood Pressure Monitors
Correlating with Manual Readings
The monitor bleeds pressure in discrete steps (not continuously), using the oscillometric method of
blood pressure determination. If manual pressure readings are taken simultaneously with the
monitor readings, interpolation is required to accurately correlate monitor systolic and diastolic
pressure values with the manual auscultatory pressures.
• For systole, record the first pressure at which a Korotkoff sound is heard. Actual systolic
pressure is somewhere between the pressure when the sound is heard and the previous
(higher) pressure where no sound was heard. The interval of uncertainty can be reduced by
half by adding one half of the bleed step size (4 mmHg) to the manual systolic pressure.
• For diastole, record the cuff pressure at which the last Korotkoff sound was heard. Actual
diastolic pressure is somewhere between that pressure and the next lower pressure. Thus,
you must subtract one half of the bleed step size (4 mmHg) from the manual diastolic
pressure.
Patient Instructions
If the cuff becomes uncomfortable during a reading, make certain the patient knows how to
terminate the readings by pressing the STOP key on the front of the monitor.
If the cuff slips out of place, make certain the patient understands correct repositioning of the cuff
for successful readings. If the cuff is not properly positioned, event codes may appear on the
monitor.
Operation
Note:
The patient should make every effort to keep the monitor dry. However, there is no hazard if
the monitor does get wet. If this occurs, turn the monitor off and return it to Spacelabs Medical
for service.
Data Transfer and Reports
After monitoring is complete, connect the monitor to either a PC Direct or Base Station interface to
transmit patient data and generate blood pressure reports. Refer to 90121 ABP Report
Management, 90219-02/03 ABP PC Interface/Base Station (P/N 070-0238-xx), or 90239 ABP
Report Generator (P/N 070-0399-xx) Operations Manuals for more details.
Note:
Any pulse rate obtained from the ABP cuff should be used only as a guideline for the heart
rate.
Cleaning
Visually inspect the monitor, air hose, and pressure cuff for dirt, debris, frayed or worn areas, etc.,
prior to patient use.
Cleaning the Monitor
Use a soft, damp cloth and mild detergent mixed with water to wipe the exterior of the monitor.
Clean the air hose with isopropyl alcohol.
1-11
Ambulatory Blood Pressure Monitors
Cleaning the Cuff and Carrying Pouch
Small soiled or stained areas may be cleaned by gentle scrubbing with a sponge or cloth soaked in
a mild soap and water solution.
The cuff wrap (with the air bladder removed) and the pouch are machine washable on “delicate”
cycle only. Do not wash in large commercial-type washers or with bed linens or gowns.
Ensure that the carrying pouch is dry before re-use.
Removing/Installing the Bladder
To remove the bladder, follow the steps listed below.
1 Using fingers only, fold or roll up the bladder inside the cuff. Do not use pencils, pens, or other
hard objects, because these may damage the bladder.
2 Remove the bladder through the hose exit opening.
Once the bladder is removed, mate together the hook-and-loop surfaces of the velcro attachment
before washing.
Re-install the bladder into the cuff wrap in reverse order. Make certain that all folds in the bladder
are removed and that the long end of the bladder fits into the long end of the cuff (refer to Figure 1-
4).
OPENING FOR
RIGHT ARM
BLADDER
(shown inserted into cuff wrap
for left arm application)
Note:
The cuff hose can exit from either opening in the cuff, depending on whether you plan a right
arm or left arm application.
OPENING FOR
LEFT ARM
ARTERY
Figure 1-4: Bladder configuration
1-12
Ambulatory Blood Pressure Monitors
Event Codes
The monitor displays an event code whenever an event prevents the unit from successfully
completing a blood pressure measurement. The two numerical digits of the event code indicate
the reason the measurement was aborted. The table below lists event codes that are displayed on
the monitor, as well as event codes that appear on the Event Code Report.
Monitor Report Condition
EC00
EC10 Excess movement artifact. Frequent EC10 messages may indicate an air leak.
Operation
EC01
EC20
EC30
EC40
EC50
EC60
EC70
EC80
EC90
EC11 Did not pump above the mean arterial level.
A) A very large number of movement artifacts
B) Heart rate arrhythmia
A) Movement artifact at mean arterial pressure
B) Heart rate arrhythmia
A) Movement artifact at asystole
B) Heart rate arrhythmia
A) Movement artifact at diastole
B) Heart rate arrhythmia
A) Movement artifact
B) Heart rate arrhythmia
Systole was found to be above the highest cuff pressure. However, this result
appears to be an error caused by motion artifact. Therefore, the cuff will not be
inflated to a higher pressure on the next measurement attempt.
A) Movement artifact
B) Heart rate arrhythmia
A) Movement artifact
B) Heart rate arrhythmia
EC02
EC21 Did not pump above systolic pressure.
EC91 Systole appears higher than the selected maximum cuff pressure limit.
EC12
EC22 Overpressure.
EC32 Overpressure.
EC42 No cuff attached.
Did not reach initial cuff pressure. The cuff may have been improperly applied or
there may be an air leak.
1-13
Ambulatory Blood Pressure Monitors
Monitor Report Condition
EC52 Kinked hose.
EC62 Cuff applied too loosely.
EC82 Kinked hose.
EC03
EC03
EC13
EC04
EC04
ECn4
EC05
EC15 Equipment malfunction. Return to Spacelabs Medical for service.
EC25 Unit failed to initialize. Please initialize.
EC35
Patient canceled reading by pressing STOP key. No retry attempt is made
following an EC03 code.
The Office Check Mode has been reinstated. No retry attempt is made following
an EC13 code.
Blood pressure measurement not completed in the maximum time allowed.
Occasional EC04 messages may result from excessive patient movement.
Frequent EC04 messages would indicate an improperly applied cuff or a
monitor malfunction which requires service.
(where n = 1 to 9) Indicates that one or more of the blood pressure results have
been corrupted and subsequently recovered. Frequent occurrence of this
message would indicate a malfunction that requires service.
The individual blood pressure result has been corrupted and cannot be
recovered.
90207
At least one of the blood pressures or time readings obtained before the event
code is erroneous. Interpret all readings with caution.
90217
The monitor needs to be reinitialized.
EC05
EC05 &
EC45
EC05 &
EC55
EC05 &
EC65
EC05 &
EC75
EC45
EC55
EC65
EC75 Equipment malfunction. Return to Spacelabs Medical for service.
Invalid bleed size. The monitor has automatically changed the bleed size to
8 mmHg.
An unexpected loss of power possibly caused by: a) removal of the batteries
during a blood pressure measurement, b) hardware overpressure, or c) a
hardware time-out. Frequent EC55 messages would indicate a malfunction
which requires service.
90207
Equipment malfunction. Return to Spacelabs Medical for service.
90217
Extremely large artifact.
1-14
Ambulatory Blood Pressure Monitors
Monitor Report Condition
Operation
EC05 &
EC85
EC05 &
EC95
EC07
EC08
EC85 Equipment malfunction. Return to Spacelabs Medical for service.
Cuff pressure baseline out of bounds. The monitor should correct the baseline
EC95
EC78 Clogged connector filter.
EC18
EC28 Diastole above 200 mmHg.
EC38 Pulse pressure less than 16 mmHg.
EC48
EC58
automatically within 10 minutes, or it can be set by initialization of the monitor. If
initialization does not correct the condition, the monitor must be returned to
Spacelabs Medical for calibration.
Too few data entries to accurately determine blood pressure. The message may
indicate that the cuff is not being worn by the patient (taken off but left
connected to the monitor). The message may also indicate that motion artifacts
cause the majority of the incomplete data.
A) Movement artifact at mean arterial pressure
B) Heart rate arrhythmia
A) Movement artifact at diastole
B) Heart rate arrhythmia
EC09
EC68 Division by zero.
EC19 Contradictory instructions sent to hardware (e.g., “pump on and valve open”).
EC29 Diastolic pressure value cannot be obtained from the data available.
90207
Systolic pressure cannot be obtained from the data available.
EC39
EC49
EC59 Heart rate value cannot be obtained from the data available.
EC69 Heart rate value cannot be obtained from the data available.
EC79
90217
Algorithm could not process input data quickly enough, resulting in an input
queue overflow.
90207
Mean arterial pressure cannot be obtained from the data available.
90217
This monitor must be initialized.
Bleed steps were too small. This may be caused by a partially obstructed air
hose. All blood pressure attempts following this message are inhibited. Attempts
can be enabled by turning the power switch OFF then ON.
1-15
Ambulatory Blood Pressure Monitors
Monitor Report Condition
EC99 Unexpected or contradictory data (such as a negative cuff pressure).
LLL
EC16 Low battery detected prior to start of measurement.
Lbb
EC26
Low battery detected after measurement started. Usually caused by the pump
drawing enough current to lower the battery voltage.
The report does not print an event code for this condition, which is a low backup
battery. Contact Spacelabs Medical for replacement of the battery.
1-16
Contents
Checking Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Checking Accuracy
Accuracy of the monitor pressure readings should be checked annually. Recalibration is
necessary only if the unit is not within the accuracy limits.
Required Equipment
• A full-size mercury sphygmomanometer or aneroid gauge.
Note:
Ensure the mercury sphygmomanometer or aneroid gauge is calibrated and indicates “0” with
no pressure.
• T-tube (P/N 016-0040-00).
• A pressure cuff and a rigid cylinder sized to fit the pressure cuff.
Accuracy
2-1
Ambulatory Blood Pressure Monitors
Accuracy Procedure
To check the accuracy of the monitor:
1 Disconnect the cuff hose from the monitor. Connect the T-tube splitter to the monitor pneumatic
connector and the sphygmomanometer.
2 Wrap the pressure cuff around the rigid cylinder, and then fasten the cuff. Connect the cuff hose
to the remaining connection on the T-tube splitter. The test setup should appear as shown
below.
712-0039-01 CALIBRATION KIT
TO SPHYGMOMONOMETER
TO CUFF/CYLINDER
)RUXVHZLWK40RQLWRU4XLFN'LVFRQQHFW&XII&DQ
&RQQHFW
WR
6SK\JPRPRQRPHWHU
&RQQHFW
WR
4XLFN'LVFRQQHFW
)LWWLQJ&XII
)RUXVHZLWK0RQLWRU/XHU)LWWLQJ&XII&DQ
&RQQHFW
WR
6SK\JPRPRQRPHWHU
5HPRYH/XHU%DUE7XELQJ
5HPRYH4XLFN
'LVFRQQHFW)LWWLQJ
&RQQHFW
WR
4
$%30RQLWRU
TO MONITOR
2-2
Ambulatory Blood Pressure Monitors
3 Press START/STOP on the monitor; the monitor should read approximately 165. Compare the
readings on the monitor and the manometer as the pressure bleeds down. The monitor reading
should be within three millimeters or 2%of the manometer reading, whichever is greater
(± the accuracy of the manometer).
Note:
If the monitor pressure values fall outside the allowed tolerance, call your local Customer
Service Representative or Spacelabs Medical for servicing.
4 At the end of the procedure, the monitor displays an event code indicating that no dynamic
blood pressure measurements were obtained.
5 Disconnect the T-tube splitter from the monitor. Disconnect the air hose and
sphygmomanometer.
Accuracy
2-3
Contents
Problem Solving Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Servicing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Problem Solving Checklist
Problem Possible Cause Solution
Data not retained. Replace backup battery.
Low or no power.
Monitor display is
incorrect
May be one of the following:
time-out, no reading due to air
leak in the system, improper cuff
size, cuff not properly attached to
the monitor.
Troubleshooting
Check the batteries for a full
charge; if needed, replace or
recharge the batteries.
Isolate cause and correct.
Monitor displays “LLL”
and alarm sounds
Monitor displays event
code Lbb during
self-testing (90207
only)
Cuff too tight
Cuff too loose
Incorrect time
displayed
Low main battery condition.
Low backup battery condition.
Cuff placed on the patient too
tightly.
Air pump staying on too long.
Cuff placed on the patient too
loosely.
Air pump not staying on long
enough.
Batteries removed for more than
one minute (90207 only).
Power OFF the monitor
immediately. Replace batteries
within 60 seconds after removal
to continue monitoring.
Replace backup battery before
continuing.
Reposition the cuff.
Return unit to Spacelabs Medical
for service.
Reposition the cuff.
Return unit to Spacelabs Medical
for service.
Re-initialize monitor.
3-1
Servicing
There is a 12-month warranty on this product.
Field service of the ABP monitor is limited to replacing batteries and accessories. If other repair is
required, return the monitor to Spacelabs Medical. Contact your Spacelabs Medical Customer
Service Representative for shipping details.
Caution
Ambulatory Blood Pressure Monitors
Any attempt to perform service or repair to the monitor will result in cancellation of the
warranty.
3-2
Symbols
The following list of international and safety symbols describes all symbols used on Spacelabs Medical
products. No one product contains every symbol.
Symbol Description Symbol Description
HELP Key Keyboard Connection
SPECIAL FUNCTIONS Key Mouse connection
RECORD Key START/STOP Key
NORMAL SCREEN Key START/STOP
MONITOR SETUP Key STOP or CANCEL Key
ALARMS Key CONTINUE Key
PREVIOUS MENU Key ENTER Key
ON — Power Connection to Mains
ON Position for Push Button Power
Switch
On Direction ON/OFF
Television; Video Display Video Output
OFF — Power Disconnection from
Mains
OFF Position for Push Button Power
Switch
ON — Part of the Instrument Only OFF — Part of the Instrument Only
4-1
Ambulatory Blood Pressure Monitors
Symbol Description Symbol Description
Stand-by STAND-BY Key
PAUSE or INTERRUPT Slow Run
Reset Power Indicator LED
?
Alarm
Temporary Shut Off of Alarm Tone
or Screen Indicators
Indicator — Remote Control Indicator — Local Control
PRINT REPORT Key Indicator — Out of Paper
Partial ON/OFF Recorder Paper
1
2
1
3
Normal Screen Return to Prior Menu
2
3
Clock/Time Setting Key TREND/TIMER Key
HELP (Explain Prior Screen) Key Keypad
Activate Recorder for Graphics Indoor Use Only
START (NIBP) Key Auto Mode (NIBP)
Output No Output (Terminated)
4-2
Ambulatory Blood Pressure Monitors
Symbol Description Symbol Description
Data Input/Output Input/Output
Input Reset
Menu Keys Waveform/Parameter Keys
Symbols
1
2
3
1
2
3
Monitor Setup
Select Program Options
B
Access Special Function Menu Return Unit to Monitor Mode
1
Serial Port 1 Serial Port 2
External marker push button
connection
Arterial Pulse
1
2
3
1
2
3
A
Set Initial Conditions Menu
2
SDLC
SDLC Port
Electrocardiograph or
Defibrillator Synchronization
Gas Exhaust Foot Switch
Enlarge, Zoom Delete
x
12,200 m
PCMCIA Card Event
Keep Dry Fragile; handle with care
Environmental Shipping/Storage
Altitude Limitations
Environmental Shipping/Storage
Temperature Limitations
This Way Up
Environmental Shipping/Storage
Humidity Limitations
4-3
Ambulatory Blood Pressure Monitors
Symbol Description Symbol Description
Open Padlock Closed Padlock
Down Arrow Up Arrow
Hard Drive Power Indicator LED
Antenna Mermaid Connector
Microphone Omnidirectional Microphone
Audio Output, Speaker Activate Telemetry Recorder
Network Connection Universal Serial Bus
Gas Sampling Port Gas Return Port
Remote Alarm; Nurse Alert Nurse Call
Battery Status Low Battery
Battery
Replace only with the appropriate
battery.
All batteries should be disposed of
properly to protect the environment.
Lithium batteries should be fully
discharged before disposal.
Batteries such as lead-acid (Pb) and
nickel-cadmium (Ni-Cd) must be
recycled. Please follow your internal
procedures and or local (provincial)
laws regarding disposal or recycling.
Replace only with the appropriate
battery.
(+ / - signs may be reversed)
Caution - hazardous voltages. To
reduce risk of electric shock, do not
remove the cover or back. Refer
servicing to a qualified service
personnel (U.S.A.).
DANGER - High Voltage
(International)
4-4
Ambulatory Blood Pressure Monitors
Symbol Description Symbol Description
Protective Earth Ground Functional Earth Ground
Replace Fuse Only as Marked Fuse
Symbols
Power supply jack polarity.
(+ / - signs may be reversed)
Alternating Current Direct Current
Both Direct and Alternating Current AC/DC Input
AHz
VW
Amperes Hertz
Volts Watts
IEC 601-1 Type B equipment. The
unit displaying this symbol contains
an adequate degree of protection
against electric shock.
IEC 601-1 Type BF equipment
which is defibrillator-proof. The unit
displaying this symbol contains an
F-type isolated (floating) patientapplied part which contains an
adequate degree of protection
against electric shock, and is
defibrillator-proof.
Equipotentiality Terminal
Class II Equipment
IEC 601-1 Type BF equipment. The
unit displaying this symbol contains
an F-type isolated (floating) patientapplied part providing an adequate
degree of protection against electric
shock.
IEC 601-1 Type CF equipment. The
unit displaying this symbol contains
an F-type isolated (floating) patientapplied part providing a high degree
of protection against electric shock,
and is defibrillator-proof.
Loop Filter Adult NIBP
IEC 601-1 Type CF equipment. The
unit displaying this symbol contains
an F-type isolated (floating) patientapplied part providing a high degree
of protection against electric shock.
4-5
Ambulatory Blood Pressure Monitors
S
Symbol Description Symbol Description
Note Note
WARNING
ETL Laboratory Approved
®
Canadian Standards Association
Approved
U
Risk of Explosion if Used in the
Presence of Flammable Anesthetics
!
!
Warning About Potential Danger to
Human Beings
Noninvasive Blood Pressure (NIBP),
Neonate
Fetal Monitor Connection
RS232 (Digital)
Happy Face Sad Face
CAUTION
Operates on Non-Harmonized
Radio Frequencies in Europe
Attention - Consult Operations or
Service Manual for Description
Caution About Potential Danger to a
Device
Fetal Monitor Connection (Analog)
Physiological Monitor Connection
RS232 (Digital)
Magnifying Glass Compression
File Cabinet List of Rooms
Arrows Printer
Recycle Service Message
Radio transmitting device; elevated
levels of non-ionizing radiation
4-6
Ambulatory Blood Pressure Monitors
Abbreviations used as symbols are shown below.
Symbol Description Symbol Description
1 - 32
ANT 1
ANT 2
CH
ch
C.O.
CO
co
ECG
ecg
EMG
emg
Access Codes
1 Through 32
Diversity Antenna System 1
Diversity Antenna System 2
AIR Air
Arr1
ArrNet2
EEG, EMG, or ECG Channel
EEG Channels - CH1, CH2, CH3, CH4
cmH
EMG Channel - CH5
Cardiac Output
Electrocardiogram
DIA
dia
EEG
eeg
Electromyogram ESIS
Arrhythmia Net 1
Arrhythmia Net 2
O Centimeters of Water
2
Diastolic
Electroencephalogram
Electrosurgical Interference
Suppression
Symbols
EXT External FECG Fetal Electrocardiogram
FHR1
FHR2
HLO
hlo
NIBP
nibp
Fetal Heart Rate, Channel 1
Fetal Heart Rate, Channel 2
GND
gnd
Patient Isolated Ground
High-Level Output Multiview Multi-Lead Electrocardiogram
Noninvasive Blood Pressure N
O Nitrous Oxide
2
PRESS
O
2
Oxygen
press
Pressure
PRS
RESP
resp
SPO2
SpO2
SpO
SaO
2
2
Respiration SDLC Synchronous Data Link Control
Arterial Oxygen Saturation
as Measured by Pulse Oximetry
SVO2
SvO2
Sv
O
Mixed Venous Oxygen Saturation
2
4-7
Ambulatory Blood Pressure Monitors
Symbol Description Symbol Description
SYS
sys
TEMP
temp
VAC Vacuum Connection
Systolic
Temperature UA Uterine Activity or Umbilical Artery
T1
T2
T3
T4
Temperature 1
Temperature 2
Temperature 3
Temperature 4
4-8
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