Propaq® CS
Vital Signs Monitor
Models 242, 244, 246
Software version 3.7X
ii |
Welch Allyn Propaq CS Vital Signs Monitor |
© 2008 Welch Allyn. All rights are reserved. No one is permitted to reproduce or duplicate, in any form, this manual or any part thereof without permission from Welch Allyn.
Welch Allyn assumes no responsibility for any injury to anyone, or for any illegal or improper use of the product, that may result from failure to use this product in accordance with the instructions, cautions, warnings, or statement of intended use published in this manual.
Welch Allyn, Propaq, Acuity, FlexNet, and Smartcuf are registered trademarks of Welch Allyn.
SET and Masimo are registered trademarks of Masimo Corporation. Possession or purchase of a Masimo SpO2-equipped monitor does not convey any express or implied license to use the device with unauthorized sensors or cables which would, alone or in combination with this device, fall within the scope of one or more of the patents relating to this device.
Nellcor and Oximax are registered trademarks of Nellcor Puritan Bennett.
Software in this product is copyright by Welch Allyn or its vendors. All rights are reserved. The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded. The software may not be copied, decompiled, reverse-engineered, disassembled or otherwise reduced to human-perceivable form. This is not a sale of the software or any copy of the software; all right, title and ownership of the software remain with Welch Allyn or its vendors.
For information about any Welch Allyn product, call the nearest Welch Allyn representative:
USA |
+ 1 315 685 4560 |
Australia |
+ 61 2 9638 3000 |
|
800 535 6663 |
|
800 074 793 |
Canada |
800 561 8797 |
China |
+ 86 216 327 9631 |
European Call |
+ 35 3 46 906 7790 |
France |
+ 33 1 60 09 33 66 |
Center |
|
|
|
Germany |
+ 49 7477 92 71 86 |
Japan |
+ 81 3 3219 0071 |
Latin America |
+ 1 305 669 9003 |
Netherlands |
+ 31 15 750 5000 |
Singapore |
+ 65 6419 8100 |
South Africa |
+ 27 11 777 7555 |
United Kingdom |
+ 44 20 7365 6780 |
Sweden |
+ 46 8 58 53 65 51 |
REF 810-2734-XX (CD)
REF 810-2707-XX (Printed, English only)
Manual 810-2689-01 Ver A, 2008-06
|
Welch Allyn Ltd |
Welch Allyn Protocol, Inc. |
Navan Business Park |
8500 SW Creekside Place |
Dublin Road, Navan |
Beaverton, OR 97008-7107 USA |
County Meath, Republic of Ireland |
www.welchallyn.com
iii
Contents
1 - General information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Intended use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 General warnings and cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Controls and connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Learn Propaq CS operation with Inservice Mode . . . . . . . . . . . . . . . . . . . . . . . . 13
2 - Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Prepare the Propaq CS monitor for a new patient . . . . . . . . . . . . . . . . . . . . . . . 15 Set patient alarms and alarm limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Change the current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Change Powerup Patient Mode or store customized settings . . . . . . . . . . . . . . 19
3 - Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Perform ECG/RESP monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Using the Propaq CS monitor with pacemaker patients. . . . . . . . . . . . . . . . . . . 27 Perform Invasive Blood Pressure (IBP) monitoring . . . . . . . . . . . . . . . . . . . . . . . 28 Take a Noninvasive Blood-Pressure (NIBP) reading . . . . . . . . . . . . . . . . . . . . . . 32 Perform temperature monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Perform SpO2 monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Perform Mainstream CO2 monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Perform sidestream CO2 monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Set up the CO2 display and alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
4 - Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Description of alarm and alert tone patterns. . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Silence an active alarm or alert tone for 90 seconds . . . . . . . . . . . . . . . . . . . . . 49 Inhibit alarm and alert tones for four minutes: 4 MIN SUSPND . . . . . . . . . . . . . 51 Inhibit alarm and alert tones indefinitely: ALL ALARMS. . . . . . . . . . . . . . . . . . . 52 Summary of alarm and alert keys and Acuity Central Station messages . . . . . . 53 Customize alarm limits based on patient’s current vital signs . . . . . . . . . . . . . . 54 Alarm holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Connect nurse call option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Troubleshooting equipment alert messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
5 - Printing & trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Print patient data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Display or print trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Set printer options and automatic printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
6 - Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Understanding the Propaq CS, Acuity, and FlexNet network . . . . . . . . . . . . . . . 71 Hardwired (Serial) connection to Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Wireless connection to Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
iv |
Contents |
Welch Allyn Propaq CS Vital Signs Monitor |
7 - Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Avoid electrostatic discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Connect the AC power adapter to recharge the battery . . . . . . . . . . . . . . . . . . . 81 Replace monitor input power fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Install printer paper. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Inspect and clean the monitor and accessories . . . . . . . . . . . . . . . . . . . . . . . . . 86 Service interval recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Recycling monitor components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Extended storage precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Change the Wireless Propaq CS network name . . . . . . . . . . . . . . . . . . . . . . . . 88
8 - Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Set the time and date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Change the date format, ECG filter, and units . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Factory default settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
9 - Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
1
The Propaq CS monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal, pediatric, and adult patients in health care facility bedside applications. It is also intended for intra-facility transport.
•The ECG channel is intended for five-lead or three-lead ECG monitoring.
•The Respiration (RESP) channel is intended to detect the rate or absence of respiratory effort, deriving the signal by measuring the ac impedance between selected terminals of ECG electrodes.
•The Invasive Pressure (IBP) channel is intended for measuring arterial, venous, and intracranial pressures (and umbilical artery and vein pressures for neonates) using invasive transducers.
•The Noninvasive Blood Pressure (NIBP) channel is intended for indirectly measuring arterial pressures using an inflatable cuff. If ECG is also monitored, the Propaq CS Smartcuf™ software algorithm automatically synchronizes the NIBP measurement process to the occurrences of the R-wave, increasing accuracy in cases of extreme artifact and diminished pulses. The operator may disable or enable the Smartcuf algorithm in the NIBP Menu.
•The Temperature (TEMP) channel is intended to measure temperature using an attachable probe.
•The Pulse Oximetry (SpO2) channel is intended to noninvasively measure oxygen saturation of arteriolar hemoglobin at a peripheral measurement site.
•The Capnography (CO2) channel is intended to noninvasively measure the following vital signs or events: End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea.
•Propaq CS monitors that do not include CO2 or printer options are able to withstand light rain exposure over short periods of time (uniform distribution of approximately 1 mm of water/ minute for 10 minutes or less).
This guide was written for clinicians. Although this guide may describe some monitoring techniques, Welch Allyn® expects that you are a trained clinician who knows how to take and interpret a patient’s vital signs. This monitor has been designed as a quality monitor; however, inherent limitations require that good clinical judgment always prevail.
2 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
WARNING Indicates conditions that could lead to illness, injury, or death.
Caution In this manual, indicates conditions that could damage equipment or other property.
Caution On the product, means “Consult the accompanying documentation.”
The following symbols may appear on the Propaq CS monitor or accessories. They are defined by the International Electrotechnical Commission, IEC 878 and IEC 417A.
Off (Standby)
On
For continued fire protection, use only the specified fuse
Direct current
Non-ionizing electromagnetic radiation. This device contains an approved RLAN module frequency 2402 to 2480 MHz
Fuse
Direct current or alternating current |
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Caution: Refer to Directions For Use and |
IPX1 |
accompanying documentation |
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See the accompanying manual |
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Battery charging when green indicator illuminated
Patient connections are Type CF, isolated for direct cardiac application, and protected against defibrillation
Patient connections are Type BF, and protected against defibrillation
Protected during defibrillation
n
This way up
Fragile |
n% |
Keep away from rain
n
Two-way communication port
Input port
Output port
Alternating current
Non-ionizing electromagnetic radiation. This device contains an approved RLAN module frequency 5150 to 5825 MHz
Recycle the monitor and battery separately from other waste. Refer to www.welchallyn.com/weee for collection point and additional information.
Separate batteries from other disposables for recycling.
Enclosure Protection Drip proof: Classification IPX1 per EN 60529
Urgent alarm notification (output to Nurse Call system)
Temperature sensor input
Transformer meets requirements of a short-circuit-proof safety-isolating power transformer
For indoor use only (on power adapter only)
Stacking limit by number
Temperature limits
Humidity limit
Altitude limit
Patient connections are Type B |
The device has met all essential requirements |
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of European Medical Device Directive |
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93/42/EEC for a Class 1 product |
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Directions for Use |
General information |
3 |
The CE Mark and Notified Body Registration Number signify the device has met all essential requirements of European Medical Device Directive 93/42/EEC
Restrictions for use of wireless device in Europe. European Communities Class 2 radio equipment
FCC ID: PGUWA11A07 IC: 4168a-WA11A07
NIBP cuff sizes:
Thigh
Large adult
Adult
Small adult
Child
Infant
This device complies with FCC and Industry Canada requirements for international radiators (802.11 wireless)
NRTL/C
Evaluated to CSA 601-1 and UL2601-1
The Canadian Standards Association has evaluated this device according to CSA 601-1 and Underwriters Laboratory Standard UL 2601-1.
This device has been tested and certified by the Canadian Standards Association International to comply with applicable U.S. and Canadian medical safety standards.
Apply the NIBP cuff as shown.
Apply the NIBP cuff as shown.
Single-use only (not reusable).
Familiarize yourself with all warnings and cautions before using the Propaq CS monitor. In addition to the following, other warnings and cautions appear throughout this manual.
WARNING Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical systems safety standards such as IEC 60101-1-1. Within certain governmental jurisdictions, all interconnected accessory equipment must be labeled by an approved testing laboratory. After interconnection with accessory equipment, risk (leakage) current and grounding requirements must be maintained.
WARNING This monitor is to be operated by qualified personnel only. The operator of this monitor should read this entire manual and all accessory directions for use before operating the monitor.
WARNING Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.
WARNING Always check the patient mode when monitoring a new patient. The patient mode determines default alarm limits, maximum cuff inflation pressure, and internal algorithm settings.
WARNING The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges.
WARNING Place the Propaq monitor and accessories in locations where they cannot harm the patient if they fall from their shelf or mount. Lift the monitor only by its handle; do not lift it by any attached cables.
4 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
WARNING Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient.
WARNING Inspect the power adapter cord periodically for fraying or other damage, and replace the adapter as needed. Do not operate the apparatus from ac power with a damaged power adapter cord or plug.
WARNING Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and electrode wires must be inspected, properly maintained, and in proper working order to allow the equipment to function properly and protect patient safety.
WARNING As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation.
WARNING Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes.
WARNING During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient. Avoid contact with any accessories connected to the monitor’s left side panel.
WARNING To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and other patient-applied parts should not contact other conductive parts, including earth ground, at any time.
WARNING Do not operate this product in the presence of flammable anesthetics or other flammable substance in combination with air, oxygen-enriched environments, or nitrous oxide; explosion can result.
WARNING Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical interference with ECG monitor operation. This interference may distort the displayed or recorded ECG signal, thereby preventing accurate rhythm analysis. Avoid operating this device near equipment of this type.
WARNING When using a power adapter with this monitor, be sure to connect the power adapter to a three-wire, grounded, hospital-grade receptacle. Do not under any circumstances attempt to remove the grounding conductor from the power plug of the power adapter. Do not plug the power adapter into an extension cord. If there is any doubt about the integrity of the protective earth ground of the receptacle for the power adapter, do not plug in the power adapter; operate the monitor only on battery power. Contact your biomedical engineering department for assistance in identifying the proper power receptacle and making appropriate power connections.
WARNING To help protect against electrical shock due to leakage current, use only monitor ac power adapters recommended in Welch Allyn Products and Accessories (810-0409-XX).
WARNING For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or recommended in Welch Allyn Products and Accessories. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. Use of accessories not recommended by Welch Allyn may result in increased electromagnetic emissions or decreased electromagnetic immunity of the equipment.
Directions for Use |
General information |
5 |
WARNING If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation and acceptable risk (leakage) current values.
WARNING Some or all NIBP safety functions are disabled in the NIBP TEST screen in the Service Menu. Do not attempt to conduct NIBP TEST when the cuff is attached to a patient.
WARNING Do not use the Propaq CS monitor in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. Such use can cause fire or explosion resulting in patient injury and monitor damage.
WARNING Impedance pneumography and CO2 monitoring may not operate properly when used in conjunction with high-frequency jet ventilation or high-frequency oscillatory ventilation.
WARNING This monitor should only be repaired by qualified service personnel. The operator should not attempt to open the monitor case or perform any maintenance on the monitor except for procedures explicitly described in this manual that can be performed by operators such as inspection and cleaning.
WARNING When taking NIBP measurements, periodically observe the patient’s limb to make sure that the circulation is not impaired for a prolonged period of time. Also make sure the blood pressure cuff is properly placed according to the Propaq CS Directions for Use. Be especially careful when using the short-term automatic mode (TURBOCUF). Prolonged impairment of circulation or improper cuff placement can cause contusions.
WARNING The range of values measured by the monitoring parameters is provided in the Specifications section of the Propaq CS Directions for Use. Operation of the monitor outside the range of specified values is not recommended and may cause inaccurate results.
WARNING Electronic equipment that emits very strong electromagnetic or radio frequency signals can cause electrical interference with monitor operation, including causing the monitor to turn off power. Avoid operating this monitor near such equipment. For guidance about electromagnetic emissions and the recommended separation distance between the monitor and such equipment, refer to the specifications section of this manual.
WARNING Military radars are allocated as primary users in the bandwidths between 5.25 - 5.35 GHz and 5.47 to 5.725 GHz. In the event a radar signature is detected, the Access Point moves to a new channel, which can temporarily interrupt patient monitoring. If the device (wireless) is operated near a military radar, the radar could cause damage to the device.
WARNING This product contains no user-serviceable components. Any unauthorized changes to the product invalidate Welch Allyn’s warranty and also invalidate all applicable regulatory certifications and approvals.
WARNING Do not use the pulse oximeter as a replacement or substitute for ECG-based arrhythmia analysis.
6 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
Caution Changes or modifications not expressly approved by Welch Allyn could void the purchaser’s authority to operate the equipment.
Caution Do not autoclave the Propaq CS monitor. Autoclave accessories only if the manufacturer's instructions clearly approve it. Many accessories can be severely damaged by autoclaving.
Caution Federal USA law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner.
It is possible for the monitor to detect a problem that prevents the monitor from operating properly. If this occurs, the monitor displays an error message and error number. Report such errors to Welch Allyn.
The Propaq CS monitor should be serviced only by a Welch Allyn service technician while under warranty. Propaq CS Service Manual (810-2708-XX) is available from Welch Allyn to assist the biomedical engineer during post-warranty period service.
Directions for Use
Nurse Call Option
SpO2 Option
Mainstream CO2
Option
Printer Option
Sidestream CO2
Option
General information |
7 |
Yellow antenna cap indicates
Wireless Propaq CS
Alarm Light
Alarm(s) Off Light
Silence/Reset
Silences alarm tone for 90 seconds or re-enables alarm tone (if active)
Start/Stop NIBP
Starts or stops NIBP reading
Home
Returns the display to the
Main Menu
Printer Buttons
Touch-screen controls
The front panel touch-screen provides five softkeys along the bottom and three icon-labeled keys along the right side. An Acuity® NET OFF key is displayed in the upper left corner if the monitor is connected to an Acuity system. These keys allow control of all monitoring and setup functions.
Note Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the touch-screen to misinterpret the command and respond to the wrong key.
Caution Do not touch the screen with a sharp object such as a pen or pencil. Sharp objects can damage the touch-screen. Use your finger to press the touch-screen keys.
System control and connectors (right side panel)
On/Off Switch |
MONITOR |
DEFIB SYNCHRO |
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! |
Input Fuse |
3A |
EKG x 1000 |
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2AG |
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! |
!
Power Input Connector
12-28V, 3A
Defib Sync Connector
Contact Welch Allyn technical support for information (for specifications, see
page 97)
Real-time ECG Output Connector
Speaker
Connector for Acuity or Modem-Propaq
Battery Charging Light
8 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
Patient connectors (left side panel)
Model 242 |
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Model 244 |
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ECG |
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ECG |
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NIBP |
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Invasiv Pressure (one channel) |
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Temperature (two channels)* |
NIBP |
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Temperature (two channels)* |
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ECG /EKG RESP |
INV. BP |
P1 ECG /EKG RESP |
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! |
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NIBP |
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NIBP |
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PSNI |
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T1 |
PSNI |
T1 |
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! |
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T2 |
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T2 |
Propaq CS Model 242 |
Propaq CS Model 244 |
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ECG /EKG |
RESP |
INV. BP |
P1 ECG /EKG RESP |
! |
P |
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! |
P |
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S |
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S |
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COMPATIBLE |
N |
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COMPATIBLE |
N |
HP |
I |
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HP |
I |
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NIBP |
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NIBP |
HP Model 242* |
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HP Model 244* |
Model 246
ECG
Invasive Pressure (two channels) NIBP
Temperature (two channels)*
INV. BP |
P1 |
ECG /EKG |
RESP |
NIBP |
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PSNI |
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T1 |
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! |
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T2 |
INV. BP |
P2 |
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Propaq CS Model 246 |
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INV. BP |
P1 |
ECG /EKG |
RESP |
!
COMPATIBLE
HP
P
S
N
I
INV. BP |
P2 |
NIBP |
HP Model 246*
*The HP (Hewlett-Packard) side panels provide only one temperature connector.
Directions for Use |
General information |
9 |
Option connectors
CO2
CO2
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! |
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! |
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Mainstream CO2 Connector |
Sidestream CO2 Connector |
Nurse Call Connector |
Cable: see Welch Allyn |
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Products and |
Cable: see Welch Allyn |
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Accessories |
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Products and Accessories |
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(810-0409-XX) |
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(810-0409-XX) |
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Masimo SpO2 Connector |
Masimo SpO2 Connector |
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(motion-tolerant) |
(motion-tolerant) |
Nellcor SpO2 Connector
10 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
You can select up to four waveforms to be shown on the Propaq CS monitor. When only one waveform is selected, a trend window automatically appears beneath the waveform.
NET OFF |
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Heart Rate Source: HR |
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indicates ECG; |
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to disconnect |
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PR indicates blood |
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monitor from |
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pressure or SpO2. |
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Acuity network. |
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Time of day |
Status messages can appear here. |
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Patient mode |
Patient name |
NET ADULT |
17:05:10 |
PRINT FAULT |
HR |
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OFF ON NETWORK ALLEN KIM |
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BPM112 |
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entered at Acuity |
II |
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mV |
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P1 |
S |
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Central Station. |
1cm |
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(M) |
121 |
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D |
79 |
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MON |
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( 96) mmHg |
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When selected, |
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P2 |
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displayed here. |
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(M) |
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TEMP |
T1 |
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P 100 |
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T2 |
98.6 |
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T |
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STATSCALE |
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MCO2 |
BR |
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automatically |
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adjusts all |
P 15 |
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SpO2 |
97 |
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STATSCALE |
ALARMS |
ACUITY |
TRENDS |
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viewing. |
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Heart Rate in beats per minute.
Bells indicate alarm limit status
All numeric values are continuously displayed and updated.
If the monitor detects a vital sign outside the measurable range, it displays
- - - (below the range) or
+ + + (above the range).
While changing monitor settings, a status window may appear below the waveform:
ECG1 |
NET |
ADULT |
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17:05:10 |
PRINT FAULT |
HR |
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waveform is |
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ON NETWORK ALLEN KIM |
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P1 |
121 |
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Systolic, diastolic, |
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active. |
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( 96) mmHg |
79 |
and mean |
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MON |
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ECG/RESP |
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(M) |
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Status |
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D |
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uniquely labeled |
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window |
HR/PR TONE |
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: OFF |
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NIBP |
S |
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and displayed. |
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(M) |
122 |
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D |
58 |
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PACER DISPLAY |
: ON |
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( 85) mmHg |
ETCO2 |
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TEMP |
T1 |
100.4 |
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ECG BANDWIDTH |
: MONITOR (0.5-40Hz) |
F |
T2 |
98.6 |
concentration |
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T |
1.8 |
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RESP LEAD |
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MCO2 |
BR |
Breath Rate from |
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RESP MONITORING : ON |
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38 |
12 |
CO |
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Br/m |
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SpO2 |
97 |
Oxygen saturation |
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is a percentage |
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NEXT |
CHANGE |
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PREVIOUS |
value. |
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MENU |
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Directions for Use |
General information |
11 |
Menus for some patient vital signs are displayed only if the option is included in your Propaq CS monitor.
Main Menu
MAIN MENU |
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NIBP |
ECG/ |
INVASIVE |
SpO2/ |
SETUP |
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RESP |
PRESSURE |
CO2 |
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SpO2 |
CO2 |
PREVIOUS |
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MENU |
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CO2 MENU 1 |
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RANGE |
mm/s |
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MORE |
PREVIOUS |
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MENU |
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CO2 MENU 2A (NO CO2 SENSORS) |
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GAS |
RESPONSE |
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PREVIOUS |
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COMP |
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MENU |
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CO2 MENU 2B (MAINSTREAM CO2 ACTIVE) |
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GAS |
RESPONSE |
SOURCE |
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PREVIOUS |
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COMP |
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MENU |
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CO2 MENU 2C (SIDESTREAM CO2 ACTIVE) |
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GAS |
RESPONSE |
SOURCE |
FLOW |
PREVIOUS |
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COMP |
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RATE |
MENU |
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SpO2 MENU 1 |
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SIZE |
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MORE |
PREVIOUS |
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MENU |
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SpO2 MENU 2 |
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RESPONSE |
C-LOCK |
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PREVIOUS |
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MENU |
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INVASIVE PRESSURE MENU 1 |
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RANGE |
RESCALE |
ZERO P1 |
ZERO P2 |
MORE |
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CANCEL |
CANCEL |
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INVASIVE PRESSURE MENU 2 |
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LABEL |
FORMAT |
LABEL |
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FORMAT |
PREVIOUS |
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P1 |
P1 |
P2 |
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P2 |
MENU |
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ECG/RESP MENU 1 |
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ECG1 |
ECG1 |
ECG2 |
RESP |
MORE |
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SIZE |
LEAD |
SIZE |
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SIZE |
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ECG/RESP MENU 2 |
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NEXT |
CHANGE |
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PREVIOUS |
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MENU |
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NIBP MENU |
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START |
AUTO/ |
INTERVAL |
TURBOCUF |
SMARTCUF |
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MANUAL |
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STOP |
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12 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
Setup Menus
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NIBP |
ECG/ |
INVASIVE |
SpO2/ |
SETUP |
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RESP |
PRESSURE |
CO2 |
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SETUP MENU 1
STAT |
ALARMS |
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WAVE |
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TRENDS |
MORE |
SCALE |
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SELECT |
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ACUITY |
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SETUP MENU 2 |
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NEXT |
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CHANGE |
WAVE |
PRINTER |
MORE |
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SELECT |
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TREND MENU |
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NEXT |
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TREND |
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OXYCRG |
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ACUITY MENU (HARDWIRED CONNECTION)1 |
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NET |
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SNAPSHOT |
PREVIOUS |
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OFF |
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MENU |
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ALARMS MENU |
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STAT SET |
4 MIN |
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LIMITS |
PREVIOUS |
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SUSPND |
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MENU |
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RESUME |
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ALARM LIMITS MENU2
NEXT |
NEXT |
UP |
DOWN |
ON/ |
PARAMETER |
SETTING |
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OFF |
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1Acuity Menu is displayed if the monitor is connected to Acuity. See “Understanding the Propaq CS, Acuity, and FlexNet network” on page 71 for details about Acuity hardwired and wireless communication options.
2ON/OFF key is not displayed for HR/PR alarm limits if the HR/PR ALARM LIMITS setting is set to CANNOT TURN OFF.
3Service menu tests are only for use by authorized service personnel and are only available in the Adult patient mode.
RADIO key is only displayed for Wireless Propaq CS.
4Patient Mode menu is accessed when CHANGE is pressed for PATIENT MODE.
5Radio menu is displayed for Wireless Propaq CS.
6 2.4 GHz radio card models only.
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TIME/DAY MENU |
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NEXT |
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UP |
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SERVICE |
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SERVICE MENU 13 |
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NIBP |
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IBP |
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SpO2 |
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CO2 |
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MORE |
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TEST |
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TEST |
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TEST |
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SERVICE MENU 23 |
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TEMP |
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PCMCIA |
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TEST |
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TEST6 |
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SERVICE MENU 33 |
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SETTINGS |
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PRINTER SETUP MENU |
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RADIO MENU5 |
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CHANGE |
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PREVIOUS |
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STATUS6 |
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NET NAME |
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Directions for Use |
General information |
13 |
You can practice using the Propaq CS monitor with the in-service mode of operation.
The in-service mode cannot be activated while you are monitoring a patient. In in-service mode, the monitor display and all printouts include the message SIMULATING or SIMULATED DATA.
To practice with your Propaq CS monitor:
1.Disconnect all patient cables connected to the monitor. You can leave the NIBP cuff connected to the monitor so you can take NIBP measurements.
2.To temporarily remove customized alarm settings, press Home, SETUP, MORE,
CHANGE, SETUP, USE NOW, YES.
3.To put the Propaq monitor in (non-alarming) Inservice Mode 1, press Home, SETUP,
WAVE SELECT, INSERVICE.
4.To set the Propaq monitor in (alarming) Inservice Mode 2, press Home, SETUP,
WAVE SELECT, INSERVICE.
Within 5 seconds, the monitor alarms because the “patient’s” vital signs fall outside the alarm limit ranges.
5.Confirm the following:
The monitor is sounding an alarm A vital sign numeric is flashing
The small red light in the top right corner of the monitor is flashing The SILENCE and LIMITS keys are showing on the screen
6.To silence the alarm tone for 90 seconds, press Silence/Reset or SILENCE.
Visual alarm indications remain, and the alarm tone resets after the 90-second silence period.
7.To bring the Propaq monitor back into the (non-alarming) Inservice Mode 1, press
INSERVICE.
The “patient’s” vital sign readings will return to acceptable levels within the alarm limit range.
8.While in the inservice mode, you can press any monitor keys (except the AUTO/MANUAL key in the NIBP Menu) to change a function setting. For example, you can change ECG and RESP waveform sizes, set alarm limits, or set custom settings.
You can also apply the NIBP cuff to yourself and take NIBP measurements.
9.Turn off the Propaq monitor.
Any previously set custom patient mode settings are restored when you turn it on again.
Under these conditions, if the monitor fails to generate visual or auditory alarm indications, carefully repeat the above steps. If the monitor is still unresponsive, remove it from circulation and take it to your facility’s biomedical service department for evaluation.
14 |
General information |
Welch Allyn Propaq CS Vital Signs Monitor |
Note The inservice mode is not available if the monitor detects that a sensor has been connected (except for an NIBP cuff) or the NIBP Automatic Mode has been selected. If the monitor is in inservice mode and you connect a sensor (except for an NIBP cuff) or press the NIBP AUTO/MANUAL key, the monitor will turn off power to exit the inservice mode, and then turn on in the normal operating mode.
The pacemaker signal indicators are not displayed in the inservice mode.
15
2 Setup
WARNING Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds and then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.
1.Press the gray recessed MONITOR button on the right side of the monitor to turn the monitor off (if it is on). Press it again to turn the monitor on. The monitor displays the powerup screen for about 10 seconds, then displays the Main Menu. The monitor is in the powerup patient mode with the associated settings.
2.Confirm that the monitor emits a tone. If the monitor has SpO2, listen for two tones and confirm both speakers are working.
Note Check the battery voltage level on the powerup screen (or check it on the Time/Day window: Home, SETUP, MORE, MORE). If the battery
voltage is 7.4V or less or a low battery message is displayed, connect
Home
the monitor to an ac power adapter to recharge the battery (page 20). Connecting the adapter does not interrupt patient monitoring.
3.Confirm the monitor is in the correct patient mode according to the patient’s age. If the patient mode is not correct, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window:
PATIENT MODE |
BATTERY: 8.2 VOLTS |
SELECT PATIENT MODE BASED ON AGE:
NEO : < 44 WEEKS GEST. AGE
PED : > 44 WEEKS GEST. AGE, < 9 YEARS
ADULT: > 9 YEARS |
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NEONATAL PEDIATRIC |
ADULT |
SETUP |
PREVIOUS |
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MENU |
4.Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.
16 |
Setup |
Welch Allyn Propaq CS Vital Signs Monitor |
Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 19 for information about preset Factory patient modes or programmable Custom patient modes.
Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.
5.To select which vital sign waveforms will display, from the Main Menu press SETUP, MORE, WAVE SELECT. Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select window.
SETUP |
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WAVE SELECT |
ECG1 |
: ON |
CO2 : ON |
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ECG2 |
: |
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RESP : ON |
ON |
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PA |
: ON |
SpO2 : ON |
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P2 |
: ON |
NIBP : ON |
NEXT |
ON/ |
INSERVICE |
PREVIOUS |
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OFF |
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MENU |
You can turn on all waveforms, but only the first four waveforms selected as ON in the Wave Select window are displayed. You cannot turn off the ECG1 waveform.
6.To set the HR/PR source, display sweep speed, tone volumes, and display brightness, from the Main Menu press SETUP, MORE to access Setup Menu 2. Use NEXT and CHANGE to select settings.
SETUP |
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HR/PR |
RR/BR |
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CURRENT SOURCE |
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??? |
??? |
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SELECTED SOURCE : |
ECG |
--- |
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SWEEP (mm/s) |
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25.0 |
6.25 |
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ALARM TONE |
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LOW |
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? ? ? is displayed |
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HR/PR TONE |
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OFF |
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PATIENT MODE |
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ADULT |
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until a source is |
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active. |
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BRIGHTNESS |
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NORMAL |
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NEXT |
CHANGE |
WAVE |
PRINTER |
MORE |
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SELECT |
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CURRENT SOURCE When the selected HR/PR source is no longer available, the current source is the active source with highest priority. The RR/BR source cannot be manually selected. It is always CO2 if CO2 is active.
Otherwise, it is ECG/RESP.
SELECTED SOURCE The user-selected HR/PR source is displayed along with the HR/PR source currently used by the monitor.
Directions for Use |
Setup |
17 |
SWEEP (mm/s) |
Selectable sweep speeds for HR/PR: 12.5, 25, 50 mm/sec. |
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Selectable sweep speeds for RR/BR: 3.13, 6.25, 12.5 mm/sec. |
ALARM TONE |
Sets the Alarm Tone volume to HIGH, MEDIUM, or LOW. |
HR/PR TONE |
Sets the Heart Tone volume to HIGH, MEDIUM, LOW, or OFF. |
BRIGHTNESS |
Sets the display brightness to NORMAL or LOW. |
WARNING At the highest volume alarm level, the sound pressure level does not exceed safe limits (OSHA HSM 73-1101, 1972). However, additional precautions may be required in patients under treatment with ototoxic medications.
1.From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu:
ALARM STATUS |
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(M) |
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25 |
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9 |
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NIBP |
122 |
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APNEA : |
RR/BR : |
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58 |
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HR/PR : |
SpO2 |
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( 85) mmHg |
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TEMP |
T1 |
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P1 |
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NIBP |
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T2 |
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P2 |
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TEMP |
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MCO2 |
BR |
Bells also appear in |
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12 |
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CO2 |
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Br/m |
numerics windows. |
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SpO2 |
97 |
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STAT SET |
4 MIN |
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LIMITS |
PREVIOUS |
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SUSPND |
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MENU |
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All alarm limits are on.
At least one alarm limit is off.
(No bell) |
All alarm limits are off or the vital sign |
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is not being monitored. |
2. Press LIMITS to display the Alarms Limits window:
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ALARM LIMITS |
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UPPER |
LOWER |
(M) |
S |
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D |
9 |
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( 15) mmHg |
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HR/PR |
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BPM |
120 |
50 |
NIBP |
122 |
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RR/BR |
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Br/M |
30 |
5 |
(M) |
S |
58 |
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D |
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APNEA DELAY |
sec |
20 |
90 |
( 85) mmHg |
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SpO2 |
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% |
100 |
TEMP |
T1 |
99.8 |
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ETCO2 |
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mmHg |
OFF |
OFF |
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T2 |
98.6 |
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INCO2 |
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mmHg |
OFF |
75 |
F |
T |
1.2 |
Arrow indicates there are more |
NIBP S |
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220 |
MCO2 |
BR |
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NIBP D |
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110 |
35 |
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parameters that are not displayed. |
NIBP (M) |
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120 |
50 |
38 |
12 |
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T1 |
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F |
* 100.0 |
95.0 |
mmHg |
Br/m |
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Press NEXT PARAMETER to scroll |
T2 |
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F |
100.0 |
95.0 |
SpO2 |
97 |
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down. After the selection reaches |
T |
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F |
5.0 |
0.0 |
% |
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the last parameter, it returns to |
NEXT |
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NEXT |
UP |
DOWN |
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ON/ |
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the top (HR/PR). |
PARAMETER |
SETTING |
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OFF |
An asterisk indicates this alarm limit was violated during monitoring. Red asterisk = alarm is occurring now.
Yellow asterisk = alarm has occurred since the last time this window was entered.
The asterisk is removed when you exit this menu. The asterisk reappears if the limit is violated again.
18 |
Setup |
Welch Allyn Propaq CS Vital Signs Monitor |
3.Press NEXT PARAMETER to highlight the parameter you want to change, then press NEXT SETTING to highlight the limit you want to change.
4.Press UP, DOWN, or ON/OFF to change the limits. The apnea alarm cannot be turned off at any time.
5.After setting the desired limits, press Home to return to the Main Menu.
Home
1.To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window:
PATIENT MODE |
BATTERY: 8.2 VOLTS |
SELECT PATIENT MODE BASED ON AGE:
NEO : < 44 WEEKS GEST. AGE
PED : > 44 WEEKS GEST. AGE, < 9 YEARS
ADULT: > 9 YEARS |
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NEONATAL PEDIATRIC |
ADULT |
SETUP |
PREVIOUS |
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MENU |
2.Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.
Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 19 for information about preset Factory patient modes or programmable Custom patient modes.
Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.
Directions for Use |
Setup |
19 |
The Propaq CS monitor has standard, preset, default powerup settings and alarm limits for each patient mode: Adult, Pediatric, and Neonatal. These are “Factory Patient Mode” settings (listed on “Factory default settings” on page 93).
You can also choose to customize and store programmable powerup settings and alarm limits for each patient mode. These are “Custom Patient Mode” settings.
The instructions below describe how to change the powerup patient mode and how to select and store new Custom Patient Mode settings.
Note When you change patient modes, you also change the alarm limits associated with the new patient mode.
Change the Powerup Patient Mode
1.From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.
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MODE SETUP |
BATTERY: 9.2 VOLTS |
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S |
25 |
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9 |
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(M) |
D |
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FACTORY: |
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*ADULT |
PED |
NEO |
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NIBP |
122 |
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(M) |
S |
58 |
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D |
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Asterisk indicates which patient |
CUSTOM : |
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ADULT |
PED |
NEO |
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( 85) mmHg |
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TEMP |
T1 |
100.4 |
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mode is currently selected for |
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T2 |
98.6 |
powerup. |
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F |
T |
1.8 |
* = PATIENT MODE ON POWERUP |
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MCO2 |
BR |
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38 |
12 |
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mmHg |
Br/m |
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SpO2 |
97 |
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% |
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NEXT |
POWERUP* |
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USE |
SAVE |
PREVIOUS |
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NOW |
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MENU |
2.Press NEXT to highlight the desired Factory or Custom powerup mode, then press POWERUP* and YES. The new powerup selection is marked by the asterisk.
Changing the powerup mode does not affect the patient mode currently used.
20 |
Setup |
Welch Allyn Propaq CS Vital Signs Monitor |
Customize Patient Mode settings
1.From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.
2.The patient mode you want to reprogram (ADULT, PED, or NEO) must be currently selected. To make sure it is currently selected, press NEXT as needed to highlight the desired mode, then press USE NOW and YES.
3. Press Home to exit the Mode Setup window, then use other menus and keys to set the monitor settings and alarm limits as desired.
A convenient way to access settings and alarm limits for all functions without Home connecting cables is to select the in-service mode (disconnect all patient cables, turn the monitor power off and then on, then press SETUP, WAVE SELECT, INSERVICE from the Main Menu).
WARNING If any alarms are set to OFF and you select SAVE to store settings for a Custom patient mode, those alarms will be OFF when the monitor powers up in that Custom patient mode or that Custom patient mode is selected. Consider carefully before setting Custom patient mode powerup alarms to OFF.
4.Re-enter the Mode Setup window, press NEXT as needed to highlight the desired Custom mode, then press SAVE and YES.
If the in-service mode is used, turn off the monitor to exit the in-service mode.
21
WARNING Impedance pneumography detects respiratory effort via changes in chest volume; therefore, impedance pneumography can be used to detect central apnea. However, apnea episodes with continued respiratory effort, such as obstructive apnea and mixed apnea, may go undetected. Also, artifact due to patient motion, apnea mattress shaking, or electrocautery use may cause apnea episodes to go undetected. Always monitor and set alarms for SpO2 when using impedance pneumography to monitor respiratory function.
WARNING The Propaq CS monitor automatically rejects cardiovascular artifact. This function is dependent upon accurate ECG R-wave detection. Therefore, always select the ECG lead with the most prominent QRS complex when monitoring respiration via impedance pneumography.
WARNING Don’t place the Propaq CS monitor with RESP in close proximity to another respiration monitor because the RESP measurement frequencies may interfere with one another.
WARNING Because pacemaker pulses in some instances may be falsely counted as breaths, impedance pneumography is not recommended for use on paced patients.
WARNING Motion artifact can cause incorrect breath rate or heart rate readings. Minimize patient motion whenever possible.
WARNING If a disconnected lead is in too close proximity to other electrical devices, it may cause false heart rate, a failure to detect apnea, or a failure to display a Lead Fail message.
WARNING The Propaq CS monitor does not provide arrhythmia analysis. Therefore, arrhythmias are not analyzed and may cause the monitor to display inaccurate heart rates.
WARNING The Propaq CS monitor shows + + + for HR numerics between 301 and 350 beats per minute. Above 350 beats per minute, it may display incorrectly low heart rates, due to intermittent picking of R-waves.
22 |
Monitoring |
Welch Allyn Propaq CS Vital Signs Monitor |
WARNING High-intensity radio frequency (RF) energy from external sources, such as an improperly connected electrosurgical unit, can induce heat into electrodes and cables which can cause burns on the patient. Reading errors and damage to equipment may also result. This hazard can be reduced by (1) avoiding the use of small ECG electrodes, (2) selecting ECG electrode attachment points remote from the surgical site and from the electrosurgical return electrode, (3) using electrosurgical return electrodes with the largest practical contact area, and
(4) assuring proper application of the electrosurgical return electrode to the patient.
WARNING Verify patient mode. Incorrect patient mode may result in inaccurate heart rates and inappropriate alarm settings.
WARNING To help prevent injury, use the provided garment clips to route the ECG cables away from the patient’s head.
WARNING Use of ECG cables with loose or faulty detachable lead wires may cause erratic behavior of the ECG waveform, SpO2 (C-LOCK), and NIBP (Smartcuf) due to intermittent ECG lead wire connections.
WARNING Use only ECG safety cables that are designed so that they cannot accidently be plugged into an ac mains outlet or make contact with other hazardous electrical potentials including earth ground. To prevent damage during defibrillation, don’t use ECG cables without 1 kΩ series resistors.
WARNING Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values and alarm limit settings.
Caution To protect the Propaq CS monitor from damage during defibrillation, for accurate ECG information, and for protection against noise and other interference, use only ECG electrodes and cables specified or supplied by Welch Allyn (these cables have the required current-limiting resistors). Follow recommended application procedures.
•Impedance pneumography (RESP) is not recommended for use with high frequency ventilation.
•Since RESP is derived from the same leads as the ECG channel, the Propaq CS monitor determines which signals are cardiovascular artifact and which signals are a result of respiratory effort. If the breath rate is within five percent of the heart rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths and trigger an apnea alarm.
•When monitoring RESP it is highly recommended that you use SpO2 monitoring as a backup monitoring method.
•It is recommended that Propaq CS monitor respiratory measurements not be made in close proximity to electrically radiated equipment. When the Propaq CS monitor is operated per EN 60601-1-1 (radiated RF immunity 3 V/m), field strengths above 2 V/m may cause erroneous measurements at various frequencies.
•The Propaq CS monitor counts as “breaths” respiratory efforts that are larger than two times background cardiovascular artifact.
•Even though the Propaq CS monitor contains fully isolated patient-connected circuitry, it has not been specially designed for direct application on a patient’s heart.
•Use only with accessories provided or recommended in the Welch Allyn Products and Accessories booklet.
Directions for Use |
Monitoring |
23 |
•Severe artifact and interference (such as defibrillation interference) can cause the waveform to move off the display for a few seconds before it is restored.
Prepare for ECG/RESP monitoring
1.Inspect the ECG cable and replace it if it shows signs of wear, breakage, or fraying.
2.Select the appropriate patient mode. To change patient modes, from the Main Menu press SETUP, MORE, CHANGE, then the desired patient mode (NEONATAL,
PEDIATRIC, or ADULT) and then YES.
3.Select electrode sites on the patient.
Choose flat areas; avoid fatty areas and major muscles.
4.Shave or clip hair from electrode sites, thoroughly clean skin, and lightly rub dry.
You may use soap and water, isopropyl alcohol or special skin preparation pads. To avoid allergic reactions to electrodes, refer to the electrode manufacturer’s directions.
5.If you are using pre-gelled electrodes, make sure the electrode date is not expired and the gel is intact and not dried out. For best results, use only silver/silver chloride electrode.
If you are using non-gelled electrodes, apply a 1/4- to 1/2-inch mound of gel over the electrode contact area.
For best product performance and measurement accuracy, do not use stainless steel needle electrodes, squeeze bulb electrodes, or electrodes with dissimilar metals. Do not use electrodes from more than one manufacturer on the same patient.
6.Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes to the patient as shown.
RA |
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LA |
G |
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If using MCL1, |
+ |
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select LEAD II on |
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the monitor, and |
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Standard 3-lead |
LL |
use all three |
Marriott |
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electrodes. |
Configuration |
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Configuration |
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MCL 1 |
(G)=LA (-)=RA (+)=LL |
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24 |
Monitoring |
Welch Allyn Propaq CS Vital Signs Monitor |
RA |
LA |
V1
RL LL
5-lead Configuration
V6
One of six V lead electrode placement sites for the C lead.
RA LA
LL
Neonate 3-lead Configuration
7.Plug the ECG cable into the ECG connector on the monitor's left side panel.
8.Support the ECG cable so it does not stress the electrode wires, ECG cable connectors, or electrodes.
9.If an electrosurgical unit will be used, place the ECG cable and electrode wires as far as possible from the surgical site and from the electrosurgical return electrode and its cables. This minimizes interference.
Although the ECG channel contains electrosurgical interference suppression (ESIS) circuitry, noise artifact may be displayed on the ECG trace while an electrosurgical device is in use. Choose electrode placement to minimize interference.
10.Look for an ECG waveform and heart rate on the monitor. Depending on how your monitor is programmed, a beep tone may occur with each detected QRS.
If there is no waveform, check the electrodes, wires, cable, and the monitor for a possible misconnection or lead fault.
11.To set up the ECG/RESP display, from the Main Menu press ECG/RESP to display the first ECG/RESP menu:
ECG1 lead selected
ECG1 size selected
ECG2 lead
The ECG2 lead is always V, except when the ECG1 lead is V (in that case the ECG2 lead is II).
RESP waveform is displayed (with RESP option)
RESP lead selected
RESP size selected
NET ADULT |
17:05:10 |
PRINT FAULT |
HR |
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OFF ON NETWORK ALLEN KIM |
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BPM112 |
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II |
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mV |
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P1 |
S |
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1cm |
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(M) |
121 |
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D |
79 |
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MON |
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( 96) mmHg |
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P2 |
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25 |
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V |
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S |
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(M) |
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D |
9 |
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mV |
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( 15) mmHg |
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1cm |
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NIBP |
S |
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MON |
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(M) |
122 |
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D |
58 |
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Ld2 |
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( 85) mmHg |
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TEMP |
T1 |
100.4 |
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2X |
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T2 |
98.6 |
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F |
T |
1.8 |
RESP |
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MCO2 |
BR |
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38 |
12 |
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mmHg |
Br/m |
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SpO2 |
97 |
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ECG1 |
ECG1 |
ECG2 |
RESP |
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MORE |
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SIZE |
LEAD |
SIZE |
SIZE |
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BR indicates respiration rate is derived from active CO2 channel.
RRindicates CO2 is not monitored and respiration rate is derived from ECG/RESP.
12.Press buttons as desired to adjust the display:
Directions for Use |
Monitoring |
25 |
ECG1 SIZE |
Selects the ECG1 waveform size: 4, 2, 1, 0.5, or 0.2 mV/cm. |
ECG1 LEAD |
Selects the ECG1 lead: I, II, III, aVR, aVL, aVF, or V. |
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Selections aVR, aVL, aVF, and V are only available with a 5-lead ECG |
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cable. |
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The ECG2 lead is always V, except when the ECG1 lead is V (in that |
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case the ECG2 lead is II). |
ECG2 SIZE |
Selects the ECG2 waveform size: 4, 2, 1, 0.5, or 0.2 mV/cm. |
RESP SIZE |
Selects the RESP waveform size: 1x, 2x, 4x, 8x, or 16x. |
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The QRS detector sensitivity threshold is not affected by changing the |
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ECG display size. Likewise, the RESP breath detector threshold is not |
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affected by changing the RESP display size. |
13. Press MORE to display the second ECG/RESP menu and status window:
0
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1 |
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(M) |
D |
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ECG bandwidth selected: |
cm |
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79 |
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MON |
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( 96) mmHg |
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P2 |
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S |
25 |
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MON = Monitor |
ECG/RESP |
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(M) |
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D |
9 |
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EXT = Extended |
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( 15) mmHg |
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NIBP |
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122 |
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HR/PR TONE |
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OFF |
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(M) |
S |
58 |
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D |
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PACER DISPLAY |
: ON |
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( 85) mmHg |
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TEMP |
T1 |
100.4 |
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ECG BANDWIDTH |
: MONITOR (0.5-40Hz) |
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T2 |
98.6 |
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F |
T |
1.8 |
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RESP LEAD |
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: Ld2 (RA-LL) |
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MCO2 |
BR |
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RESP MONITORING : ON |
38 |
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12 |
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Br/m |
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SpO2 |
97 |
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% |
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NEXT |
CHANGE |
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PREVIOUS |
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MENU |
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14. Press NEXT and CHANGE as desired to adjust the display.
HR/PR TONE |
Sets heart tone loudness to LOW, MEDIUM, HIGH, or OFF. |
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If SpO2 is monitored, tone pitch varies with the SpO2 |
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value. |
PACER DISPLAY |
Turns on and off the pacer indicator in the ECG waveform. |
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If the patient has a pacemaker, you may want to turn on |
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the pacer indicator (see page 27). |
ECG BANDWIDTH |
Selects the bandwidth for displayed and printed data. |
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MONITOR is 0.5 Hz to 40 Hz (Adult mode) or 0.5 Hz to 120 Hz |
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(Pediatric and Neonatal mode). |
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Monitor Mode filters out extraneous noise and artifact |
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to provide a more stable display. |
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EXTENDED is 0.05 Hz to 40 Hz (Adult mode) or 0.05 Hz to 120 |
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Hz (Pediatric and Neonatal mode). |
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Extended Mode is a higher-resolution setting that allow |
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more detailed analysis. |
26 |
Monitoring |
Welch Allyn Propaq CS Vital Signs Monitor |
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Always use Extended Mode when observing ST |
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segment morphology on the display or printer. Although |
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Monitor Mode is useful to minimize baseline wander |
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due to artifact, ST segments can be distorted in Monitor |
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Mode. This can potentially cause underestimation of ST |
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elevation and overestimation of ST depression. Although |
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the monitor does not have automated ST segment |
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monitoring, ST segments may be accurately displayed |
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and printed in Extended Mode. |
RESP LEAD |
Selects the RESP lead: Ld1 (RA-LA) or Ld2 (RA-LL). RESP lead |
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selection is independent of ECG lead selection. |
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Choose the RESP lead that gives you the best signal. If |
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neither signal is adequate, experiment with nonstandard |
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electrode placement such as placing the RA and LA |
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electrodes on the respective mid-axillary lines just above |
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the level of the nipples. |
RESP MONITORING |
Turns RESP on or off. |
15. Set alarms according to your facility’s standards.
Use the ECG filter to display a better waveform
If the ECG waveform appears unclear or distorted, make sure the monitor ECG filter is properly set to reduce interference from your facility’s ac power frequency. To check the filter:
1.Press SETUP, MORE, MORE, SERVICE, YES to access the Service Menu.
2.Press MORE, MORE, SETTINGS to display the Settings Menu.
3.If the FILTER setting does not match your ac power frequency (60 or 50 Hz), press NEXT to highlight FILTER, then press CHANGE to change settings.
Contact a qualified service person if you have questions.