Welch Allyn 52000 User manual

Vital Signs Monitor Operator’s Manual
CAUTION: United States Federal Law restricts this device to sale by or on the order of a licensed health care practitioner.
Table of Contents
About the Operator’s Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Product Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Indications/Contraindications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Special Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Blood Pressure Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Temperature Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
SpO2 Operating Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Pulse Rate Feature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Unpacking Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Controls, Indicators and Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Front Panel Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Side & Rear Panel Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Set-Up Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
AC Power Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Charging the Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Power On/Off and System Check Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Setting the Date and Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Choosing Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Blood Pressure Hose & Cuff Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Temperature Probe Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
SpO2 Sensor Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Setting up the Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Setting the Programmable Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Blood Pressure - High Systolic Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Blood Pressure - Low Systolic Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Blood Pressure - High Diastolic Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Blood Pressure - Low Diastolic Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Pulse Rate - High Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Pulse Rate - Low Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
SpO2 - Low Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Temperature Measurement Range Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Alarm Indications and Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Measuring Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Setting the DEFAULT Inflation Pressure Preset Level . . . . . . . . . . . . . . . . . . . . . . . . .26
Blood Pressure Cuff Selection Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Positioning the Blood Pressure Cuff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Manual Mode Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Automatic Mode Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Reviewing Information From Prior Cycles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
“Erase data” function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Measuring Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Selecting the Temperature Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Selecting Temperature Operation Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Taking An Oral Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Taking an Axillary Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Taking a Rectal Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Measuring SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
SpO2 Operation Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Taking an SpO2 Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Using the SpO2 Pulse Tone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Printer Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Printing Options: batch print or streaming print mode . . . . . . . . . . . . . . . . . . . . . . . . . 39
Using the RS232 Computer Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Mean Arterial Pressure (MAP)/Data Send Mode/Data Stream Mode . . . . . . . . . . . . . . . . 41
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Error Indications and Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
General Guide to Problems and Corrective Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Quick Guide to Taking a Manual (Auscultatory) Blood Pressure . . . . . . . . . . . . . . . . . . 47
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Battery Removal & Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Blood Pressure Calibration Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Temperature Calibration Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
SpO2 Calibration Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Warranty Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Service Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Service Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Technical Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Service Manual/Spare Parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Service Loaners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
APPENDIX A: Mounting Accessories & Assembly Instructions . . . . . . . . . . . . . . . . . . . . 57
APPENDIX B: Nurse Call Interface Wiring Diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
APPENDIX C: Supplies and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
APPENDIX D: Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Welch Allyn and Welch Allyn Vital Signs Monitor are registered trademarks of Welch Allyn, Inc.
Nellcor Puritan Bennett™ is a registered trademark of Nellcor Puritan Bennett, Inc.

About the Operator’s Manual

The operator manual is designed to help you understand the capabilities and operation of your Welch Allyn Vital Signs Monitor.
The information included in this manual is inclusive of all options available with the Welch Allyn Vital Signs Monitor (ie. SpO2, Temperature and Printer). The applicability of some sections of this
operator manual will depend on the configuration of your particular unit.
This information is intended as a comprehensive guide to the operation of the Welch Allyn Vital Signs Monitor. To achieve satisfactory results, the operator should read this manual thoroughly before attempting to use the monitor. A quick reference operator's guide is provided on the side of the monitor as a convenient reference for experienced operators.

Product Overview

The Welch Allyn Vital Signs Monitor is designed to non-invasively and automatically measure sys­tolic and diastolic blood pressure, pulse rate, temperature and oxygen saturation (SpO2) for adult and pediatric patients. The Welch Allyn Vital Signs Monitor is not intended to be used on Neonatal patients. All blood pressure, pulse, temperature and SpO2 values are displayed on large, easy-to­read displays, and may be printed via an integrated thermal printer, as desired.
The rechargeable battery and wide variety of mounting accessories make the Welch Allyn Vital Signs Monitor convenient for many locations. The operator may choose any combination of simul­taneous measurement modalities. This flexibility, combined with features such as programmable alarms and automatic blood pressure cycles, makes the Welch Allyn Vital Signs Monitor ideal for a wide variety of patient monitoring needs.
The Welch Allyn Vital Signs Monitor is intended for use in a wide variety of health care settings. This includes hospital departments, as well as patient transport within the hospital environment. The Welch Allyn Vital Signs Monitor is also intended for use in alternate care settings, such as physician offices, freestanding ambulatory care and surgery centers, health clinics and nursing homes. The Welch Allyn Vital Signs Monitor may also be used during patient transport within any of these alter­nate care environments.
The Welch Allyn Vital Signs Monitor is not intended for the monitoring of patients during transport external to the health care environment (eg. ambulance, helicopter transport). The Welch Allyn Vital Signs Monitor is not intended for use in environments which are not supervised by a health care practitioner.

Indications/Contraindications for Use

The Welch Allyn Vital Signs Monitor is intended for monitoring of blood pressure, pulse rate, tem­perature and oxygen saturation (SpO2) of adult and pediatric patients. The device is not designed,
sold or intended for use except as indicated.
Vital Signs Monitor 1
The Welch Allyn Vital Signs Monitor is not intended to be used on Neonatal patients.* To
ensure pediatric blood pressure accuracy and safety, note that the Welch Allyn Small Child cuffs are the SMALLEST CUFFS approved for use with young children and infants. The circumference of the child’s arm must fit within the range markings on the cuff.
* Welch Allyn defines neonates as children 28 days or less of age if born at term (37 weeks gesta­tion or more); otherwise, up to 44 gestational weeks. This definition comes from the AAMI SP10 1992 standard.
The monitor should not be used on patients who are linked to heart/lung machines.

Safety Warnings & Cautions

All operating personnel should be familiarized with the general safety information in this summary. Specific warnings and cautions will also be found throughout the operator's manual. Such specific warnings and cautions may not appear here in this summary.
Conforms to
IEC60601-1 UL2601-1 CAN/CSA C22.2 No 601-1
Attention, Consult Accompanying Docu­ment
Approved to Australia AS 3200.1, Appendix Z
Class II Equipment
Defibrillator-proof,
Type BF Applied Part
Transport Temperature
Handle with Care
IPXØ
+
Not protected against the ingress of water
Battery Operated Device
See “Battery Compartment” on page 16 for Location See “Charging the Battery” on page 17 See “Battery Removal & Replacement” on page 48
Storage Humidity
2 Vital Signs Monitor

General Warnings

THE WELCH ALLYN VITAL SIGNS MONITOR IS NOT INTENDED TO BE USED ON NEONATAL PATIENTS. Welch Allyn defines neonates as children 28 days or less of age if born
at term (37 weeks gestation or more); otherwise, up to 44 gestational weeks. This definition comes from the AAMI SP10 1992 standard.
To ensure pediatric blood pressure accuracy and safety, note that the Welch Allyn Small Child cuffs are the SMALLEST CUFFS approved for use with young children and infants. The circumference of the child’s arm must fit within the range markings on the cuff.
The Welch Allyn Vital Signs Monitor is designed for use by medical clinicians. Although this manual may illustrate medical monitoring techniques, this system should only be used by a trained clinician who knows how to take and interpret a patient's vital signs.
The information in this operator's manual is a comprehensive guide to the operation of the Welch Allyn Vital Signs Monitor. To achieve satisfactory results the operator should read the manual thoroughly before attempting to use the Monitor.
To ensure patient safety, use only accessories and supplies (i.e. cuffs, hoses, temperature probes, SpO2 sensors etc.) recommended or supplied by Welch Allyn for the Welch Allyn Vital
Signs Monitor.
Do not operate the Welch Allyn Vital Signs Monitor in the presence of flammable anesthetics or other explosive atmosphere. An explosion may result.
It is the operator’s responsibility to set alarm limits as appropriate for each individual patient.
Avoid compression of the pneumatic tubing of the Welch Allyn Vital Signs Monitor. Compression of the tubing may cause system errors to occur in the Monitor.
The Welch Allyn Vital Signs Monitor is safe to use in the presence of high frequency surgical equipment
Care should be taken to prevent water or other fluid from entering any connectors on the Monitor. Should this occur, the connectors should be dried with warm air. All monitoring functions should then be checked for proper operation.
Any Monitor which has been dropped or damaged should be checked by qualified service personnel to ensure proper operation prior to use.
Cords should periodically be checked for fraying or other damage, and replaced as necessary.
There are no user serviceable parts inside the Monitor other than paper replacement and battery replacement.
This Monitor should not be used on patients who are linked to heart/lung machines.
This Monitor will not operate effectively on patients who are experiencing convulsions or tremors.
This device complies with current required standards for electromagnetic interference and should not present problems to other equipment or be affected by other devices. As a precaution, avoid using this device in close proximity to other equipment.
Do not autoclave.

Blood Pressure Warnings

To ensure pediatric blood pressure accuracy and safety, note that the Welch Allyn Small Child cuffs are the SMALLEST CUFFS approved for use with young children and infants. The circumference of the child’s arm must fit within the range markings on the cuff.
Vital Signs Monitor 3
Blood pressure measurements may be inaccurate if cuffs and/or hoses are used other than those provided for the Welch Allyn Vital Signs Monitor by Welch Allyn.
Blood pressure measurements may not be accurate for patients experiencing moderate to severe arrhythmias.
When monitoring over an extended period of time, or at frequent intervals, it is recommended to check the cuff site and cuffed extremity regularly for possible ischemia, purpura and/or neuropathy.
Do not fit the Blood Pressure system with Luer Lock adapters. There is a risk of user misconnection with an IV line introducing air bubbles into a patient’s blood.

SpO2 Warnings

The operation of the SpO2 sensor in MRI environments is specifically not recommended.
If pulse oximetry measurements are suspect, verify the reading using another clinically accepted measurement method.
Prolonged use or the patient’s condition may require changing the SpO2 sensor site periodically.
Change the sensor site and check skin integrity, circulatory status, and correct alignment at least every 4 hours.
When using the motion tolerant pulse oximetry channel, a very sudden and substantial change in pulse rate can result in erroneous pulse rate radings. Be sure to validate the patient data and patient condition before intervention or change in patient care.
Use only SpO2 sensors and accessories which are compatible with the SpO2 configuration purchased. Welch Allyn Vital Signs Monitor with the Nellcor Puritan Bennett pulse oximetry
option may only be used with Nellcor brand sensors and accessories.
Do not use a damaged sensor or pulse oximetry cable. Do not use a sensor with exposed optical components.
Tissue damage is caused by incorrect application or duration of use of an SpO2 sensor. Inspect the sensor site periodically as directed in the sensors direction for use.
Pulse oximetry readings and pulse signal is affected by certain ambient environmental conditions, sensor application errors, and certain patient conditions.
Do not immerse or wet the sensor.

Temperature Warnings

Single-use, disposable probe covers, available from Welch Allyn will limit patient cross­contamination. The use of any other probe cover or the failure to use a probe cover may produce temperature errors and is specifically not indicated.
Oral probes (blue) are to be used for taking oral and axillary temperatures only. Rectal probes (red) are to be used for taking rectal temperatures only. The use of the wrong probe may produce temperature errors.
Do not allow the tip of the temperature probe to come into contact with any heat source (e.g., hands or fingers) prior to taking a temperature measurement. If this occurs, discard the probe cover and start the temperature determination again.
4 Vital Signs Monitor

General Cautions

If the accuracy of any measurement is in question, check the patient's vital sign(s) by an alternate method and then check the Monitor for proper functioning.
Ensure the Monitor is placed on a secure surface or use one of the optional mounting accessories.
Do not place fluids on the Monitor.

Blood Pressure Cautions

Extremity and cuff motion should be minimized during blood pressure determinations.
If the blood pressure cuff is not at heart level, the difference in reading due to the hydrostatic effect should be noted. The value of 1.80 mmHg must be added to the displayed reading for every inch (2.5cm) above heart level. The value of 1.80 mmHg must be subtracted from the displayed reading for every inch (2.5cm) below heart level.
Proper blood pressure cuff size and placement is essential to the accuracy of the BP determination. See “Chart for Determining Cuff Size” on page 27.
When measuring blood pressure on children younger than age 3 it is recommended that the Pressure Preset (initial inflation pressure) be set at 160 mmHg or lower.

SpO2 Cautions

The pulse oximeter is calibrated to determine the percentage of arterial oxygen saturation of functional hemoglobin. Significant levels of dysfunctional hemoglobins such as carboxyhemoglobin or methemoglobin may affect the accuracy of the measurement.
Some intravascular dyes, depending on the concentration, may affect the accuracy of the SpO2 measurement.
Some sensors may not be appropriate for a particular patient. If at least 10 seconds of perfusion pulses cannot be observed for a given sensor, change sensor location or sensor type until this condition is achieved.

Temperature Cautions

Do not allow the tip of the temperature probe to come into contact with a heat source (i.e. hands or fingers) prior to taking a temperature measurement. If this occurs discard the probe cover and start the temperature determination process again.
Normal mode (10 second) axillary temperatures are accurate only for children under the age of four. Normal mode axillary temperatures will not be accurate on older children or adults. The Welch Allyn Vital Signs Monitor is not intended to be used on Neonatal patients.
When taking rectal temperatures, extreme caution should be used to avoid risk of bowel perforation in children.
Vital Signs Monitor 5

Special Features

The following special features enhance the use of the Welch Allyn Vital Signs Monitor:
Choice of Measurement Modalities
Non-invasive blood pressure, temperature, and SpO2 measurements may be made independently or simultaneously.
Operator Selectable BP Measurement Intervals
Automatically takes BP measurements at intervals from 1 to 90 minutes. Special "STAT" mode allows continuous blood pressure measurements for up to 15 minutes.
Programmable Alarms
Both visual and audible alarms indicate readings outside of operator programmable high/low limits, and also indicate system hardware/software problems.
Non-Invasive, Oscillometric BP
Eliminates the risks associated with invasive monitoring, with no need for microphones or external transducers.
Prior Data Recall
Measurement data from up to 99 previous determinations is available at the touch of a button.
Operator-Friendly Results
Large, easy-to-read LED displays are complemented by an integrated thermal printer.
AC or Self-Contained Battery Power
The Welch Allyn Vital Signs Monitor is conveniently available in many locations, for a variety of monitoring needs, including interdepartmental transport within the facility.

Blood Pressure Operating Modes

When a blood pressure measurement cycle is initiated, the cuff will automatically inflate to the default pressure level.
The cuff will immediately begin to deflate in a stepped fashion and will determine systolic pressure and diastolic pressure from the pulses sensed by the cuff at various pressure levels. This is the oscillometric method of non-invasive blood pressure monitoring.
Blood pressure measurements may be initiated manually, or automatically at time intervals deter­mined by the user.
At the completion of a measurement cycle the systolic and diastolic pressures are displayed. If the Monitor is in Automatic Mode, the measured values are kept on display until the next BP measure­ment is initiated. When not in Automatic Mode, the measured values are displayed for two min­utes, after which time the display screen is blanked. The most recent BP measurement may be recalled by pressing the REVIEW button.
When in Automatic Mode, if the unit is unable to determine the systolic or diastolic value, the mea­surement will be automatically repeated once.

Blood Pressure Manual Mode

In the Manual Mode, a single blood pressure determination is made only when the START button is pushed. The manual mode is the default mode of operation for blood pressure determinations.
6 Vital Signs Monitor
A measurement cycle may be cancelled at any time by pressing the CANCEL button. This action immediately initiates a rapid cuff deflation.
The blood pressure measurement data will appear on the display immediately following the mea­surement. The display will blank after two minutes. If the display is blanked, pressing the REVIEW button on the front panel will recall the measurement. Up to 99 prior measurements are available for review or printing.
In Blood Pressure Manual Mode, the following alarm limits may be activated; SYSTOLIC HIGH LIMIT, SYSTOLIC LOW LIMIT, DIASTOLIC HIGH LIMIT, DIASTOLIC LOW LIMIT, PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT. Blood pressure determinations which activate alarms are indicated by flashing displays and a repetitive audible tone. If an alarm limit is violated, subse­quent blood presssure determinations may be made only after the alarm condition is reset by press­ing any button on the Monitor's display.

Blood Pressure Automatic Mode

The Automatic Blood Pressure Mode is entered by pressing the AUTO button. Pressing the AUTO button displays a choice of 11 cycle interval times as follows: "St" (STAT mode), 1 minute, 3 min­utes, 4 minutes, 5 minutes, 10 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes and 90 minutes. These choices represent the time interval from the beginning of one cycle to the begin­ning of the next automatic cycle. STAT mode allows the monitor to take continuous blood pressure measurements for 15 minutes. In addition, the operator may choose to disable the Auto Mode by choosing "--" (two dashes).
NOTE: In the STAT and 1-minute automatic cycle mode, the Welch Allyn Vital Signs Monitor
will automatically take blood pressure measurements in 1-minute intervals for up to 15 minutes.
A measurement cycle may be cancelled at any time by pressing the CANCEL button. This action immediately initiates a rapid cuff deflation.
The blood pressure measurement data will appear on the display immediately following the mea­surement and will remain displayed until the next measurement cycle is initiated.
In Blood Pressure Auto Mode, the following alarm limits may be activated; SYSTOLIC HIGH LIMIT, SYSTOLIC LOW LIMIT, DIASTOLIC HIGH LIMIT, DIASTOLIC LOW LIMIT, PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT. Blood pressure determinations which activate alarms are indi­cated by flashing displays and a repetitive audible tone. Any alarm limit violation must be reset to continue automatically timed blood pressure determinations. The alarm may be reset by pressing any button on the Monitor's display.

Temperature Operating Modes

Thermometry measurements are made with the integrated Welch Allyn SureTemp® thermometer. Oral and rectal probes utilize single-use disposable probe covers which limit cross-contamination. Oral, axillary or rectal temperatures are taken using 'Normal' or 'Monitor' operating modes. Axillary temperatures are taken using the oral probe.
In Normal mode the thermometer's microprocessor "predicts" body temperature in about 4 seconds for oral temperatures, about 10 seconds for axillary temperatures and in about 15 seconds for rectal
Vital Signs Monitor 7
temperatures. The Monitor mode displays the patient's actual temperature after 3 minutes for oral/ rectal mode and 5 minutes for axillary mode, and will continue to display an updated temperature as long as the probe remains in place.
NOTE: Normal mode axillary temperatures (10 seconds) are accurate only for children under
the age of four.
NOTE: The Welch Allyn Vital Signs Monitor is not intended to be used on Neonatal patients.
Temperature readings may be displayed in Fahrenheit or Celsius scales.

Temperature Normal Mode

In Normal mode, the device will measure temperature at discrete intervals and then calculate the rate of change according to a proven algorithm. This allows the thermometer to predict the end point that the thermistor would reach if it were left in the mouth until it reached mouth temperature. This predictive feature allows the thermometer to arrive at an accurate oral temperature reading in approximately 4 seconds.
Normal mode is the default operating mode for temperature determinations.
Operator selectable patient alarm limits are not available in temperature Normal mode. However, temperatures which are outside of the operating range of the device will be noted on the tempera­ture display.

Temperature Monitor Mode

Continuous Monitor mode operation is normally used for longer term monitoring and when difficult situations prevent accurate temperatures from being taken in the Normal mode. The probe must be in contact with tissue for at least three (3) minutes for accurate oral/rectal temperature measure­ment and five (5) minutes for accurate axillary temperature measurement. Monitor mode tempera­tures may not be identical to predicted 'Normal' temperatures because of ambient temperature influence and other factors. The trend in temperature is the important standard to be observed when in the Monitor mode.
Operator selectable patient alarm limits are not available in temperature Monitor mode. However, temperatures which are outside of the normal operating range of the device will be noted on the temperature display.

SpO2 Operating Mode

The Welch Allyn Vital Signs Monitor incorporates the Nellcor Puritan Bennett™ pulse oximetry mod­ule which determines arterial oxyhemoglobin saturation (SpO2%) by measuring the absorption of
red and infrared light passed through the tissues. Changes in absorption caused by pulsation of blood in the vascular bed are used to determine arterial saturation and pulse rate.
Oxygen saturation percent is calculated with each pulse detected, and thus the monitor display is continually updated. The pulse signal bar graph is an indicator of the strength and quality of the detected pulses.
8 Vital Signs Monitor
When SpO2 is measured, the patient's pulse rate is also measured and displayed. A pulse rate measurement from the SpO2 determination overrides a pulse rate measurement derived from a
blood pressure measurement.
When measuring SpO2 the user may enable the SpO2 Pulse Tone feature. A short audible tone is emitted with every patient heartbeat. The frequency of the tone is based on the patient’s SpO2 level. The lower the frequency of the tone, the lower the patients SpO2 level.
In SpO2 monitoring mode, operator selectable alarm limits for low SpO2 % may be activated. A condition which violates the SpO2 low limit alarm is indicated by a flashing display and repetitive audible tone. Should a patient alarm condition for SpO2 or pulse rate occur, the Monitor will indicate an alarm condition (flashing & beeping) while continuing to monitor and display the patient's current
SpO2%. The alarm will automatically reset when the patient's condition returns to within the preset alarm parameters.
Should a patient alarm condition for SpO2 or pulse rate occur, the operator may invoke "Silence Mode" by pressing the SILENCE button. This will silence the audible tone (display will continue to
flash), while the practitioner attends to the patient and the monitor. Silence mode resets automati­cally after 30 seconds, or when the patient's condition returns to within the preset alarm parame­ters.
Removal of the SpO2 sensor from the patient will initiate an alarm, unless the SpO2 and pulse rate alarms are turned off. To reset the sensor alarm, press any button on the Monitor's display.
SpO2 is generally measured via pulses detected using a finger sensor. However, for certain situa­tions SpO2 may be measured at alternate sites including the earlobe, forehead and toes. Special sensors must be employed in these situations.

SpO2 Monitor Mode

The SpO2 monitor performs most accurately with the fingerclip sensor, which may be used on all fingers except the thumb. The finger clip sensor is recommended for spot checks or short term
continuous monitoring.
The device determines arterial oxyhemoglobin saturation (SpO2 %) by measuring the absorption of red and infrared light passed through the tissue. Oxygen saturation and pulse rate are displayed on
the LED digital display. On each detected pulse, the pulse signal bar graph flashes. The intensity of this signal is a simple visual indicator of waveform signal strength, and can identify situations where the pulsatile nature of the tissue may not be adequate for an accurate SpO2 reading. The update
interval of the bar graph should correspond to the patient's pulse rate. This is an indication of the quality of the SpO2 signal.
All Welch Allyn Vital Signs Monitors with pulse oximetry capability are equipped with a pulse tone. This audible tone beeps in synchronization with each beat of the patient’s heart. In addition, the fre­quency of the tone will vary based on the patient’s oxygen saturation value. The higher the tone’s frequency, the higher the patient’s oxygen saturation value. The user may change the pulse tone volume, or turn this feature off as necessary.
Vital Signs Monitor 9

Pulse Rate Feature

The Welch Allyn Vital Signs Monitor is capable of determining pulse rate as an adjunct to the blood pressure measurement and the SpO2 measurement.
The pulse rate, in beats per minute, will be determined primarily from the SpO2 measurement methodology. In the case where SpO2 is not available, or is disabled, the pulse rate display will be driven by data from the blood pressure measurement method.
There are two operator selectable alarm limits for the pulse rate. They are PULSE RATE HIGH LIMIT and PULSE RATE LOW LIMIT. Pulse rates which activate alarm limits are indicated by a flashing display and a repetitive audible tone.
Should a pulse rate alarm occur when the pulse rate measurement is derived from the blood pres­sure measurement, no subsequent blood pressure or pulse rate measurements may be made until the alarm is reset. The alarm may be reset by pressing any button on the Monitor's display.
Should a pulse rate alarm occur when the pulse rate measurement is derived from the SpO2 mea­surement, the monitor will indicate an alarm condition (flashing & beeping) while continuing to mon-
itor and display the patient's current SpO2% and pulse rate. The alarm will automatically reset when the patient's condition returns to within the preset alarm parameters.
Should a patient alarm condition for pulse rate occur during SpO2 monitoring, the operator may invoke "Silence Mode" by pressing the SILENCE button. This will silence the audible tone (display
will continue to flash), while the practitioner attends to the patient and Monitor. Silence mode resets automatically after 30 seconds, or when the patient's condition returns to within the preset alarm parameters. If an alarm limit is violated, subsequent determinations of any type may only be made after the alarm condition is reset.
10 Vital Signs Monitor

Unpacking Checklist

After you have unpacked the Welch Allyn Vital Signs Monitor and the components, identify each item with the checklist that follows and inspect for missing items. Retain the shipping materials in the event of shipping damage or for return, if necessary, to Welch Allyn/Tycos for repair or warranty service.
All Welch Allyn Vital Signs Monitors include the following components (A-G):
A. Welch Allyn Vital Signs Monitor
This device is a portable, light weight device designed to automatically measure and display blood pressure and pulse rate. Options available include pulse oximetry, temperature and inte­grated printer.
B. Operator Manual (This manual)
To achieve satisfactory results, the operator should read this manual thoroughly before attempt­ing to use the monitor. Save this manual for helpful product reference.
C. Instrument Warranty Card
Fill this out today and return to Welch Allyn. This card validates your warranty.
D. Blood Pressure Cuffs
Includes one (1) Adult and one (1) Large Adult blood pressure cuff.
NOTE: A full range of cuff sizes are available (as accessory items) however, the Large Adult
cuff will fit the majority of adults and give the most accurate blood pressure measurement.
E. Blood Pressure Hose
With connector, connects a variety of blood pressure cuffs to the monitor.
F. AC Power Transformer and Line Cord
Operates the monitor and charges the internal battery.
G. Cuff Clip
Attaches to the rear of the monitor to hold the blood pressure cuff. Not used if mobile stand, pole mount or wall mount accessories are purchased. Certain Welch Allyn Vital Signs Monitors will include the following items, based on the options purchased:

Printer Option

H. Box of Printer Paper
Six (6) rolls of thermal printer paper. One additional roll will be pre-loaded into the printer.

Pulse Oximetry (SpO2) Option

I. Finger Clip SpO2 Sensor and Cord
Other sensors are available separately.
Vital Signs Monitor 11

Temperature Option

J. Oral Temperature Probe
The blue oral probe is used for both oral and axillary temperature determinations. A red rectal probe is available separately.
K. Temperature Probe Covers
One box of 25 single use, disposable probe covers for both oral and rectal temperature determi­nations.
NOTE: Report any signs of shipping damage to the carrier. If an item is missing or damaged,
contact the Welch Allyn Service Center near you.

Controls, Indicators and Connections

NOTE: In this section, all drawing and text are representative of the Welch Allyn Vital Signs
Monitor with all available options (i.e. Blood Pressure plus Pulse Oximetry (SpO Temperature and Printer). Your Monitor may not include all functions, depending on
the options purchased.
M
N
P
R
I
S
),
2
Pulse
Volume
Tone
K
Charging
Low Battery
Select Alarm
J
G
H
L
O
Q
Power Start Cancel
Review Auto
Silence
T
A
BCDEF

Front Panel Functions

A. POWER Button & Indicator Light
This on/off button controls the power to the Monitor. The indicator light will glow when the unit is on. Battery power will be used unless the Monitor is powered through the AC power trans­former.
B. START Button
Pressing this button initiates an on-demand blood pressure cycle.
12 Vital Signs Monitor
C. CANCEL Button
If a blood pressure cycle is in progress, pressing this button aborts the cycle and immediately releases the cuff pressure. In "STAT" automatic blood pressure mode, pressing the cancel button aborts the cycle in process, and cancels the "STAT" mode as well.
When pressed for 3 seconds, the cancel button erases all stored data in the Welch Allyn Vital Signs Monitor.
D. REVIEW Button
Pressing this button will display the most current set of stored data including BP & pulse rate and/or SpO2 and/or temperature. Subsequent presses will display the next most recent data
sets.
E. AUTO Button & Indicator
Pressing this button allows the operator to scroll through the automatic blood pressure interval options. Time intervals are displayed in minutes on the CYCLE display (see below). Choosing any time interval except "--" will cause the Auto indicator light to glow, and blood pressure deter­minations to be made according to the displayed time interval.
F. SILENCE Button & Indicator
During SpO2 monitoring, should an SpO2 or Pulse Rate alarm condition occur, pressing the Silence button invokes 'Silence Mode'. This will silence the audible tone (display will continue to
flash), while the practitioner attends to the patient and Monitor. Silence mode resets automati­cally after 30 seconds, or when the patient's condition returns to within the preset alarm param­eters. In Silence Mode, the silence indicator light will glow.
G. SELECT ALARM Button
Pressing this button allows the operator to select a specific parameter for which an alarm thresh­old will be set. The HIGH ("HI") or LOW ("LO") indicator will show in the CYCLE display, and the current value will appear in the respective display.
H. SET Buttons (Arrow Up or Arrow Down)
These buttons increment or decrement the currently displayed alarm threshold.
The SET-Arrow Up button has additional functionality. See“Using the RS232 Computer Inter­face” on page 40
I. PULSE TONE Indicator
This indicator will be lit when the pulse tone function is enabled.
J. PULSE TONE Button
Pressing this button allows the operator to control the volume of the SpO2 pulse tone.
K. SYSTOLIC Display
This red LED display shows the systolic blood pressure.
Additionally, this display can show systolic alarm limits (see above).
Vital Signs Monitor 13
L. DIASTOLIC Display
This red LED display shows the diastolic blood pressure
Additionally, this display can show diastolic alarm limits (see above).
M. SpO2 Display
This red LED display shows the percent saturation of arterial hemoglobin (SpO2%).
Additionally, this display can show SpO2 low saturation alarm limits (see above).
N. PULSE SIGNAL BAR GRAPH
This bar graph gives a visual indication of the strength and quality of the pulses detected by the SpO2 sensor. Additionally, this bar graph can indicate the volume level of the SpO2 pulse tone.
(see above).
O. PULSE Display
This yellow LED display shows the pulse rate.
Additionally, this display can show pulse rate alarm limits (see above).
P. TEMPERATURE Display and Indicator
The red LED display shows the temperature in degrees Fahrenheit or Celsius. The temperature scale (°F or °C) will be shown by a green indicator. Also, temperature monitor mode is indicated by a green indicator.
Q. CYCLE Display
This red LED display shows the time (in minutes) between automatically initiated blood pressure measurements, or "St" for STAT mode (continuous blood pressure measurements for up to 15 minutes).
Additionally, this display identifies the high and low alarm limits for the various parameters, dur­ing alarm select mode, and the cycle number during review mode.
R. CHARGING Indicator
This flashing yellow indicator will signify that the internal battery is being charged when the Monitor is powered through the AC power transformer. When the Monitor is fully charged, the flashing will be replaced with a solid yellow indicator light.
S. LOW BATTERY Indicator
This yellow indicator light will remain on continuously as a visual indicator when the battery charge is weak. The indicator will flash as a visual indicator that the battery charge is critically low.
T. MEMORY Indicator
This green indicator will flash when the unit has reached its maximum capacity of 99 data sets in storage. Also, it will remain on continuously when the operator is reviewing stored data sets.
14 Vital Signs Monitor

Side & Rear Panel Connections

H
A
B
D
E
I
G
F
J
K
C
A. SpO2 Sensor Connection
Nine pin connector for the SpO2 sensor.
B. Temperature Probe Connector
Connector for either oral/axillary (blue) or rectal (red) probe.
C. Temperature Probe Holder
Active temperature probe is inserted here when not in use. Removing and replacing the probe turns the temperature on and off, respectively.
D. RS232 Data Interface Connector
Port for the connection of a cable to an external computer, network, or nurse call system.
E. Transformer Power Connector
AC power transformer connector.
F. Pressure Hose Connector
Connector for blood pressure hose.
G. Printer
Compartment and paper feed area for integrated thermal printer.
H. Print Button
Pressing this button initiates a print operation.
Vital Signs Monitor 15
I. Printer Feed Button
Pressing this button advances the paper in the printer.
J. Mounting Keyholes
Mounting accessories are attached via these keyholes.
K. Battery Compartment
Contains the internal battery. Removal of 4 screws allows changing battery without affecting other internal parts.

Set-Up Procedure

AC Power Connection

The Welch Allyn Vital Signs Monitor may be powered by either AC power or battery power after the battery has been charged.
To install the AC power transformer, insert the round transformer connector into the power port on the side of the Monitor as shown. Insert the connector into the port until it is fully seated. Insert the line cord into the line connector on the transformer.
To power the Welch Allyn Vital Signs Monitor, plug the line cord into the AC mains power source.
Inserting the AC power transformer connector into the Monitor port.
16 Vital Signs Monitor

Charging the Battery

The Welch Allyn Vital Signs Monitor may be powered by either AC power or battery power after the battery has been charged.
UPON INITIALLY RECEIVING THE MONITOR, CHARGE THE BATTERY FOR SIXTEEN (16) HOURS OR UNTIL THE CHARGING INDICATOR LIGHT NO LONGER FLASHES. The battery is charged by attaching the AC power transformer to the Monitor, and plugging the AC power transformer into the AC mains power source.
While charging, the charging indicator will flash a yellow light. When the Monitor is fully charged the flashing light will be replaced with a solid yellow indicator light.

Power On/Off and System Check Procedure

Each time the Welch Allyn Vital Signs Monitor is turned on, the unit performs an internal self-diag­nostic check.

To turn the unit on, press the POWER button.

Upon power up, note that all of the LED segments in each display turn on briefly. An audible tone should also sound. If the internal self-check is successful, the displays will assume their normal functions and the monitor is ready for operation. If the self-check fails, an error code will be shown in the displays.

To turn the unit off, press POWER button.

Note that turning the unit off will erase all stored blood pressure, temperature, SpO2 and pulse rate data.

Setting the Date and Time

1. Initiate the Monitor's internal configuration settings menu by powering up the unit while the START button is depressed. Hold the START button down until all the LED display segments go off. The first message displayed is the revision level of the internal software. This will be displayed in the systolic and diastolic displays.
2. Press the review button four (4) times to advance to the Date Set Screen. The year, month and day will appear in the systolic, diastolic and heart rate displays respectively.
3. Use the SELECT ALARM button to select the date item to be changed. When selected, the date item will flash.

4. Use the SET buttons (arrow up or arrow down) to change the selected date item.

5. After making all the desired date changes, press the REVIEW button to save the changes and advance to the Time Set Screen.
6. When in the Time Set Screen the hour (in 24 hour format) and minutes will appear in the systolic and diastolic displays respectively. Use the SELECT ALARM and SET buttons to set the time (in the same manner as described above).
7. When the time is set as desired, press the REVIEW button to save the time and advance to the next screen.

8. Press the POWER button to turn the Monitor off.

Vital Signs Monitor 17

Choosing Operating Modes

For all Welch Allyn Vital Signs Monitors which are configured with blood pressure and pulse oxime­try capability, the operator may choose to make either parameter non-functional. Having both blood pressure and pulse oximetry operational is the default operating mode. To make either mode non­functional, the user must enter the Monitor’s configuration mode. This may be accomplished by fol­lowing these instructions:
Turn the Monitor off.
Press both the POWER button and the START button simultaneously. The Monitor will enter it’s internal configuration mode.
Press the REVIEW button 9 times. “ON” will appear in both the Systolic and SpO2 displays.
Press the SET (arrow up and arrow down) buttons to cycle through the three options available:
Systolic Display SpO2 Display Monitor Functionality
On On Both blood pressure and pulse oximetry
modes are operational. This is the factory­default mode.
OFF On Blood pressure mode is disabled. Pulse
oximetry mode is operational.
On OFF Blood pressure mode is operational.
Pulse oximetry mode is disabled.
When the desired functionality is displayed, press the REVIEW button once to save this selection.
Turn the Monitor off.
When the Monitor is turned on, the new functionality setting will be established as the default level. The Monitor will always revert to this setting on power up.

Blood Pressure Hose & Cuff Connections

Identify and have available each of the following items:
The Welch Allyn Vital Signs Monitor
Blood pressure cuff
Blood pressure hose
Using the illustrations below for reference, perform the following set-up procedures:
1. Inspect the blood pressure hose and note that one end has a connector fitting and the other end does not. Attach the end without the connector to the pressure hose connector on the monitor
18 Vital Signs Monitor
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