Welch Allyn Propaq CS User manual

Propaq

Vital Signs Monitor

®

CS

Directions for Use

Models 242, 244, 246

Software Version 3.5X

Copyright © 2004 by Welch Allyn. Welch Allyn

are registered trademarks of Welch Allyn. Welch Allyn is protected under various patents and patents pending. Masimo
SET

are registered trademarks and Signal Extraction Technology

®

DURASENSOR
LIFEPAK

®

, C-LOCK

®

6s

are registered trademarks of Medtronic Physio-Control Corporation.

®

and OXISENSOR

®

is a registered trademark of Welch Allyn. Propaq

is a trademark of Masimo Corporation. NELLCOR

®

are registered trademarks of Nellcor Puritan Bennett, Inc. LIFEPAK

™

®

, Propaq

®

CS, and Acuity

and

®

,

®

®

5

and

Copyright Notice: Software in this Product is Copyright© 2004 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 all over the world.
Under such laws, you are licensed to use the copy of the software incorporated with this instrument as intended in the operation
of the product in which it is embedded, but 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 remains with Welch Allyn or its vendors. Welch Allyn will make available specifications necessary for
interoperability of this software on request; however, users should be aware that use of Welch Allyn hardware and software with
devices or software not sold by Welch Allyn or its authorized dealers and affiliates may lead to erroneous results and
consequent danger in patient care, and may also void Welch Allyn's warranty.

This device complies with Part 15 of the FCC rules and the Canadian ICES-003. Operation is subject to the following conditions:
(1) This device may not cause harmful interference, and (2) This device must accept any interference received, including any
interference that may cause undesired operation.

Disclaimers: Welch Allyn cautions the reader of this manual:

• This manual may be wholly or partially subject to change without notice.

• All rights are reserved. No one is permitted to reproduce or duplicate, in any form, the whole or part of this manual without
permission from Welch Allyn.

•Welch Allyn will not be responsible for any injury to the user or other person(s) that may result from accidents during
operation of the Propaq monitor.

•Welch Allyn assumes no responsibility for usage not in accordance with this manual that results in illegal or improper use of
the Propaq monitor.

• No implied license: Possession or purchase of this device 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.

Welch Allyn Technical Support:

USA 1-800-

Latin America ([phone]

European Call Center ([phone]

United Kingdom 0-207-365-6780

535-6663

France ([phone]

Australia ([phone]

Germany ([phone] Singapore ([phone]

Canada 1-800-561-8797

South Africa ([phone]

Japan ([phone]

China ([phone]

For information concerning this document or any Welch Allyn product, contact:

Welch Allyn

Customer Service
8500 SW Creekside Place
Beaverton, Oregon 97008-7107 USA

Within USA, toll free:

Phone: [phone]
Phone Technical Services: (800)

535-6663

WorldWide:

Phone: [phone]
Fax: [phone]
Fax Technical Services: [phone]

Internet: http://www.welchallyn.com
E-mail Technical Services: [e-mail]
E-mail Marketing Dept.: [e-mail]

Welch Allyn European Customer Service

IPA Business Park, Dublin Road
Navan, County Meath, Ireland
Phone: [phone]
Fax: [phone]

Welch Allyn U.K. Ltd.

Cublington Road, Aston Abbotts
Buckinhamshire HP22 4ND, England
Phone: [phone]
Fax: [phone]

Welch Allyn Italia

Via Napo Torriani, 29, 20124 Milan, Italy
Phone: [phone]
Fax: [phone]

Welch Allyn GmbH: Germany

Postfach 31, Zollerstrasse 2-4
72417 Jungingen, Germany
Phone: [phone]
Fax: [phone]

Welch Allyn: France

814 Rue Charles de Gaulle
77100 Mareuil les Meaux, France
Phone: [phone]
Fax: [phone]

Welch Allyn: Pacific

P. O. Box 39-293 Howick, Auckland, New Zealand
Phone: [phone]
Fax: [phone]

Welch Allyn: Asia

Room1002, 10/F Tung Sun Comm. Centre
194-200 Lockhart Road, Wanchai, H.K.
Phone: [phone]
Fax: [phone]

Welch Allyn: Latin America

MD International, 11300 NW 41st Street
Miami, FL 33172 USA
Phone: [phone]
Fax: [phone]

Reorder Kit No: 810-1441-XX

Manual Part No:
810-1097-03
Rev. A 8/04
Printed in USA

®

0123

Contents

1 – General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Intended Use, Symbols, and Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Learn Propaq CS Operation with In-Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2 – Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Prepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Set Patient Alarms and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Change the Current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Change Powerup Patient Mode or Store Customized Settings . . . . . . . . . . . . . . . . . . 21

3

3 – Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Perform ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . . . . . . . . . . 28

Perform Invasive Blood Pressure (IBP) Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Take a Non-Invasive Blood Pressure (NIBP) Reading . . . . . . . . . . . . . . . . . . . . . . . . . 32

Perform Temperature Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Perform SpO
Perform Mainstream CO
Perform Sidestream CO
Set Up the CO

4 – Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Respond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Customize Alarm Limits Based on Patient’s Current Vital Signs . . . . . . . . . . . . . . . . . 50

Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Connect Nurse Call Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Respond to An Equipment Alert. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Troubleshooting Equipment Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

5 – Printing & Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Print Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Display or Print Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Set Printer Options and Automatic Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

2

Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

2

Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

2

Display and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

2

Propaq CS Directions for Use

4

6 – Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Understanding the Propaq CS, Acuity, and the FlexNet™ Network . . . . . . . . . . . . . . 67

Hardwired (Serial) Connection to Acuity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Wireless Connection to Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

7 – Defibrillator Synchronization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . . . . . . . . . . . . . 79

Synchronous Cardioversion with LIFEPAK 6s Defibrillator . . . . . . . . . . . . . . . . . . . . . 82

8 – Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Connect the AC Power Adapter to Recharge the Battery . . . . . . . . . . . . . . . . . . . . . . 85

Replace Monitor Input Power Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

Inspect and Clean the Monitor and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Service Interval Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Change the Wireless Propaq CS Network Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

9 – Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Set the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

Factory Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

10 – Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Welch Allyn

1 – General Information

Intended Use, Symbols, and Safety Information

Intended Use

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 and ambulance 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.

5

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 (SpO
hemoglobin at a peripheral measurement site.

The Capnography (CO
End-tidal CO

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 prevails.

(ETCO

2

) channel is intended to noninvasively measure oxygen saturation of arteriolar

2

) channel is intended to noninvasively measure the following vital signs or events:

2

), Inspired CO

2

(INCO

2

), Breath Rate, and Apnea.

2

Symbols

Warning

WARNING statements in this manual identify conditions or practices that could result in personal
injury.

Caution

CAUTION statements in this manual identify conditions or practices that could result in damage to
the equipment or other property.

Note

NOTE statements provide additional important information.

Propaq CS Directions for Use

6

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)

Tw o way communication port

On Input port

For continued fire protection, use only the

Output port

specified fuse

Direct current Alternating current

Direct current or alternating current

Separate batteries from other disposables for

1

recycling.

Caution: Refer to Directions For Use and
accompanying documentation

Battery charging when green indicator

IPX1

Enclosure Protection Drip proof:
Classification IPX1 per IEC Publication 529

Temperature sensor input

illuminated

Patient connections are Type CF, isolated for
direct cardiac application, and protected
against defibrillation

Patient connections are Type BF, and

Tr ansformer meets requirements of a
short-circuit-proof safety-isolating power
transformer

1

For indoor use only (on power adapter only)

protected against defibrillation

Protected during defibrillation Stacking limit by number

n

This way up Temperature limits

Fragile

n%

Keep away from rain Altitude limit

Humidity limit

n

Patient connections are Type B Signifies the device has met all essential

requirements of European Medical Device
Directive 93/42/EEC for a Class 1 product

The CE Mark and Notified Body Registration
Number signify the device has met all

0123

essential requirements of European Medical
Device Directive 93/42/EEC

Urgent alarm notification (output to Nurse
Call system)

NRTL/C

Evaluated to CSA 601-1
and UL2601-1

C

The Canadian Standards Association has
evaluated this device according to CSA
601-1 and Underwriters Laboratory Standard
UL 2601-1

1

.

This device has been tested and certified by
the Canadian Standards Association
International to comply with applicable U.S.

US

and Canadian medical safety standards.

Apply the NIBP cuff as shown.

NIBP cuff sizes:
Thigh
Large adult
Adult

Small adult
Child
Infant

1. This symbol is on the Universal Power Adapter.

2

Single-use only (not reusable).

1

Welch Allyn

Chapter 1 – General Information 7

General Warnings and Cautions

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

systems safety standards such as IEC 601-1-1. 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.

manual and all accessory Directions For Use before operating the monitor.

it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.

limits, maximum cuff inflation pressure, and internal algorithm settings.

and humidity ranges.

their shelf or mount. Lift the monitor only by its handle; do not lift it by any attached cables.

not operate the apparatus from ac power with a damaged power adapter cord or plug.

electrode wires must be inspected, properly maintained, and in proper working order to allow the equipment to
function properly and protect patient safety.

entanglement or strangulation.

circuit so that the return paths cannot be made through monitoring electrodes and probes.

conductive parts in contact with the patient. Avoid contact with any accessories connected to the monitor’s left side
panel.

other patient-applied parts should not contact other conductive parts, including earth ground, at any time.

combination with air, oxygen-enriched environments, or nitrous oxide; explosion can result.

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.

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.

Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical

This monitor is to be operated by qualified personnel only. The operator of this monitor should read this entire

Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn

Always check the patient mode when monitoring a new patient. The patient mode determines default alarm

The monitor may not meet its performance specifications if stored or used outside the specified temperature

Place the Propaq monitor and accessories in locations where they cannot harm the patient if they fall from

Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient.

Inspect the power adapter cord periodically for fraying or other damage, and replace the adapter as needed. Do

Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and

As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient

Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return

During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other

To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and

Do not operate this product in the presence of flammable anesthetics or other flammable substance in

Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical

When using a power adapter with this monitor, be sure to connect the power adapter to a three-wire, grounded,

Propaq CS Directions for Use

8

Warning

To help protect against electrical shock due to leakage current, use only monitor ac power adapters

recommended in the Welch Allyn Products and Accessories booklet (P/N 810-0409-XX).

For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or
recommended in the Welch Allyn Products and Accessories booklet. Use accessories according to your facility’s
standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use.

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.

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.

When using the motion tolerant pulse oximetry channel, a very sudden and substantial change in pulse rate
can result in erroneous pulse rate readings. Be sure to validate the patient data and patient condition before
intervention or change in patient care.

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.

Impedance pneumography and CO
high-frequency jet ventilation or high-frequency oscillatory ventilation.

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.

monitoring may not operate properly when used in conjunction with

2

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.

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. The Propaq CS Service Manual (P/N 810-1101-XX) is available from Welch Allyn to assist the
biomedical engineer during post-warranty period service.

Welch Allyn

Controls and Connectors

Nurse Call

Option

Chapter 1 – General Information 9

Yellow antenna cap
indicates Wireless
Propaq CS

Alarm Light

Alarm(s) Off Light

Suspend/
Resume
Alarm

Suspends alarm tone
for 90 seconds or
resumes alarm tone
(if active)

SpO

Option

Mainstream
CO2 Option

Printer Option

Sidestream

CO2 Option

2

Starts or stops NIBP
reading

Returns the display to
the Main Menu

Printer Buttons

Start/
Stop
NIBP

Home

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
connected to an Acuity system. These keys allow control of all monitoring and setup functions.

NET OFF

key is displayed in the upper left corner if the monitor is

Note

touch-screen to misinterpret the command and respond to the wrong key.

Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the

Caution

touch-screen. Use your finger to press the touch-screen keys.

Propaq CS Directions for Use

Do not touch the screen with a sharp object such as a pen or pencil. Sharp objects can damage the

10

System Control and Connectors (Right Side Panel)

On/Off Switch

Input Fuse

3A

2AG

Power Input Connector

12-28V, 3A

Patient Connectors (Left Side Panel)

Model 242

ECG
NIBP
Temperature (two channels)*

ECG / EKG RESP

!

NIBP
PSNI

T1

T2

Model 244

ECG
Invasiv Pressure (one channel)
NIBP
Temperature (two channels)*

NIBP
PSNI

DEFIB SYNCHROMONITOR

!

!

Defib Sync Connector

Real-time ECG Output Connector

EKG x 1000

!

!

Speaker

Connector for Acuity or Modem-Propaq

Battery Charging Light

Model 246

ECG
Invasive Pressure (two channels)
NIBP
Temperature (two channels)*

ECG / EKG RESPINV. BP

P1

NIBP

T1

!

T2

PSNI

ECG / EKG RESPINV. BP

P1

T1

!

T2

Propaq CS Model 242

ECG / EKG RESP

P

!

S

COMPATIBLE

N

I

HP

NIBP

HP Model 242*

*The HP (Hewlett-Packard) side panels provide only one temperature connector.

Propaq CS Model 244

INV. BP

COMPATIBLE

ECG / EKG RESP

P1

P

!

S
N

I

HP

HP Model 244*

NIBP

INV. BP

P2

Propaq CS Model 246

INV. BP

COMPATIBLE

HP

INV. BP

ECG / EKG RESP

P1

!

P
S
N

I

P2

HP Model 246*

NIBP

Welch Allyn

Option Connectors

!

CO

Chapter 1 – General Information 11

CO

2

2

!

Mainstream CO2 Connector Sidestream CO2 Connector

Cable: see Welch Allyn

Products and

Accessories Guide

(810-0409-XX)

Masimo SpO2 Connector

(motion tolerant)

Nurse Call Connector

Masimo SpO2 Connector

(motion tolerant)

SpO

2

!

NELLCOR
SENSORS/ CAPTEURS

Cable: see Welch Allyn

Products and

Accessories Guide

(810-0409-XX)

Propaq CS Directions for Use

Nellcor SpO2 Connector

(newer style, motion tolerant)

Nellcor SpO2 Connector

(older style, without motion

tolerance)

12

Display

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

to disconnect

monitor from

Acuity

network.

Patient name

entered at

Acuity Central

Station.

When

selected,

trends are

displayed

here.

STATSCALE

automatically adjusts

all waveform scales for

optimum viewing.

Patient mode Status messages can appear here.Time of day

ADULT

NET
OFF

ON NETWORK

II

mV

1

cm

MON

V

mV

1

cm

MON

130

P

100

1

70

30

P

15

2

0

STATSCALE

ALARMS

17:05:10

ALLEN KIM

PRINT FAULT

ACUITY

TRENDS

HR

BPM

112

1

P

(M)

mmHg

( 96)

P2

(M)

( 15)

mmHg

NIBP

(M)

( 85)

mmHg

TEMP

°F

MCO2

38

mmHg

SpO2

%

MORE

S

121

D

79

S
D

S

122

D

58

100.4

T1

98.6

T2
∆T

BR

Br/m

97

25

9

1.8

12

While changing monitor settings, a status window may appear below the waveform:

Heart Rate Source:
HR indicates ECG;
PR indicates blood
pressure or SpO

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).

2

.

ECG1

waveform

is always

displayed

if active.

Status

window

ADULT

NET
OFF

ON NETWORK

17:05:10

ALLEN KIM

II

mV

1

cm

MON

ECG/RESP

HR/PR TONE

PACER DISPLAY

ECG BANDWIDTH

RESP LEAD

: OFF

: ON

: MONITOR (0.5-40Hz)

: Ld2 (RA-LL)

RESP MONITORING : ON

NEXT

CHANGE

PRINT FAULT

HR

BPM

112

1

P

( 96)

P2

( 15)

NIBP

( 85)

TEMP 100.4

°F

MCO2

mmHg

(M)

(M)

(M)

38

mmHg

mmHg

mmHg

S

121

D

79

S
D

S

122

D

58

T1
T2
∆T

BR

Br/m

25

9

98.6

1.8

12

SpO2

%

97

PREVIOUS

MENU

Systolic, diastolic,
and mean pressures
are uniquely labeled
and displayed.

ETCO2
concentration

Breath Rate
from CO

2

Oxygen saturation is
a percentage value.

Welch Allyn

Chapter 1 – General Information 13

Menus

Menus for some patient vital signs are displayed only if the option is included in your Propaq CS
monitor.

Main Menu

MAIN MENU

NIBP

ECG/

RESP

INVASIVE

PRESSURE

SpO2/

CO2

SETUP

SpO2 CO2

CO2 MENU 1

RANGE

mm/s MORE

CO2 MENU 2A (NO CO2 SENSORS)

GAS

COMP

RESPONSE

CO2 MENU 2B (MAINSTREAM CO2 ACTIVE)

GAS

COMP

RESPONSE SOURCE

CO2 MENU 2C (SIDESTREAM CO2 ACTIVE)

GAS

COMP

RESPONSE SOURCE

SpO2 MENU 1

SIZE MORE

SpO2 MENU 2

RESPONSE C-LOCK PREVIOUS

INVASIVE PRESSURE MENU 1

RANGE RESCALE ZERO P1 MORE

ZERO P2

PREVIOUS

MENU

FLOW

RATE

PREVIOUS

MENU

MENU

PREVIOUS

MENU

PREVIOUS

MENU

PREVIOUS

MENU

PREVIOUS

MENU

ECG/RESP MENU 1

ECG1

SIZE

ECG/RESP MENU 2

NEXT PREVIOUS

NIBP MENU

START AU TO/

STOP

MANUAL

Propaq CS Directions for Use

CANCEL

INVASIVE PRESSURE MENU 2

LABELP1FORMAT

ECG1
LEAD

CHANGE

INTERVAL

P1

ECG2

SIZE

TURBOCUF

LABEL

P2

RESP

SIZE

SMARTCUF

CANCEL

FORMAT

P2

MORE

MENU

PREVIOUS

MENU

14

Setup Menus

NIBP ECG/

RESP

SETUP MENU 1

STATSCALE

TREND MENU

PRINT NEXT

ACUITY MENU (HARDWIRED CONNECTION)

ALARMS MENU

STAT SET SUSPEND ALL

RESUME

INVASIVE

PRESSURE

WAVE

WAVE SEL

SELECT

ACUITY

NET
OFF

ALARMS

SpO2/

CO2

TREND

SNAPSHOT PREVIOUS

LIMITS PREVIOUS

SETUP

MOREALARMS TRENDS

PRINT

OXYCRG

1

MENU

MENU

SETUP MENU 2

NEXT CHANGE WAVE

SELECT

PRINTER

MORE

ALARM LIMITS MENU

NEXT

PARAMETER

1

Acuity Menu is
displayed if the monitor
is connected to Acuity.
See page 67 for details
about Acuity hardwired
and wireless
communication
options.

2

ON/OFF key is not
displayed for HR/PR
alarm limits if the
HR/PR ALARM
LIMITS setting is set
to CANNOT TURN
OFF.

3

Service 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.

4

Patient Mode menu
is accessed when
CHANGE is pressed
for PATIENT MODE.

5

Radio menu is
displayed for
Wireless Propaq CS.

SETTING

2

UP DOWNNEXT

ON/

OFF

TIME/DAY MENU

NEXT UP DOWN ENTER

SERVICE MENU 1

TEST

SERVICE MENU 2

TEMP
TEST

SERVICE MENU 3

3

IBP

TEST

3

PIXEL

TEST

3

CAL

SpO2
TEST

NET

TEST

SYSTEM RADIO

CO2

TEST

PCMCIA

TEST

SERVICE

MORENIBP

MORE

MORESETTINGS SCREEN

SETTINGS MENU

NEXT CHANGE

PREVIOUS

MENU

PRINTER SETUP MENU

NEXT

CHANGE

CHANGE

PRINT

TREND

PREVIOUS

MENU

WAVE SELECT MENU

NEXT INSERVICE PREVIOUS

PATIENT MODE MENU

NEONATAL PEDIATRIC SETUP

ON/

OFF

4

ADULT

NO

INSERVICE

PREVIOUS

MENU

MENU

MODE SETUP MENU

NEXT POWERUP* USE

NOW

SAVE

PREVIOUS

MENU

RADIO MENU5

NETWORK

STATUS

NETWORK
MONITOR

CHANGE

NET NAME

PREVIOUS

MENU

Welch Allyn

Chapter 1 – General Information 15

Learn Propaq CS Operation with In-Service Mode

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. During 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. If you have been monitoring a patient, turn off the monitor and turn it back on.

If your monitor is programmed so that the NIBP Automatic Mode is selected at powerup,
select one of the Factory Patient Modes as the powerup patient mode (see page 21). Then turn
the monitor off and turn it back on. (The in-service mode is not available if the NIBP
Automatic Mode has been selected.)

3. From the Main Menu, press SETUP, WAVE SELECT, INSERVICE.

The Propaq CS monitor has two sets of simulated patient information. To change between the
sets, from the Main Menu press SETUP, WAVE SELECT, and INSERVICE again.

While in the in-service 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.

4. To exit the in-service mode, turn off the monitor.

If you changed the powerup patient mode in step 2, be sure to restore the appropriate
powerup patient mode according to your local protocol.

Note

or the NIBP Automatic Mode has been selected. If the monitor is in in-service 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 in-service mode, and then turn on in
the normal operating mode.

The in-service mode is not available if the monitor detects that a sensor has been connected (except for an NIBP cuff)

The pacemaker signal indicators are not displayed in the in-service mode.

Propaq CS Directions for Use

16

Welch Allyn

2 – Setup

Prepare the Propaq CS Monitor for a New Patient

Warning

17

again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.

Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on

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

SETUP, MORE, MORE). If the battery voltage is 7.4V or less or a low battery message is displayed, connect the

monitor to an ac power adapter to recharge the battery (see page 22). Connecting the adapter does not interrupt
patient monitoring.

Check the battery voltage level on the powerup screen (or check it on the Time/Day window: Home,

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

SELECT PATIENT MODE BASED ON AGE:

NEO : < 44 WEEKS GEST. AGE

PED : > 44 WEEKS GEST. AGE,

< 9 YEARS

ADULT:

> 9 YEARS

BATTERY: 8.2 VOLTS

Home

NEONATAL

PEDIATRIC

ADULT

SETUP

PREVIOUS

MENU

4. 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 21 for information about preset Factory patient modes or programmable Custom patient
modes.

Note

originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.

Propaq CS Directions for Use

If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the

18

5. To select which vital sign waveforms will display, from the Main Menu press

WAVE SELECT.

Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select

SETUP, MORE,

window..

SETUP

ECG

1 : ON

ECG

2 : ON

PA

: ON

: ON

2

P

NEXT

ON/
OFF

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.

WAVE SELECT

2 : ON

CO

RESP : ON

2 : ON

SpO

NIBP : ON

INSERVICE

PREVIOUS

MENU

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

HR/PR RR/BR

CURRENT SOURCE : ???
SELECTED SOURCE : ECG
SWEEP (mm/s)

ALARM TONE
HR/PR TONE

PATIENT MODE

BRIGHTNESS

:

:
:

:

:

25.0

LOW

OFF

ADULT

NORMAL

???

---

6.25

The ? ? ? is
displayed until
a source is
active.

NEXT

CURRENT SOURCE When the selected HR/PR source is no longer available, the current

CHANGE

WAVE

SELECT

PRINTER

MORE

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.

SWEEP (mm/s) Selectable sweep speeds for HR/PR: 12.5, 25, 50 mm/sec.

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.

Welch Allyn

Chapter 2 – Setup 19

P2

25

25

S

Set Patient Alarms and Alarm Limits

1. From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu:

S

(M)

ALARM STATUS

APNEA :

HR/PR :

P1 :

P2 :

2 :

CO

STAT SET

SUSPEND

RR/BR :

SpO

2 :

NIBP :

TEMP :

ALL

ALARMS

( 15)

NIBP

( 85)

TEMP

°F

MCO2

mmHg

SpO2

%

LIMITS

All alarm limits are on.

At least one alarm limit is off.

mmHg

(M)

mmHg

T1
T2
∆T

38

PREVIOUS

MENU

D

S

122

D

58

100.4

98.6

1.8

BR

12

Br/m

97

9

Bells also
appear in
numerics
windows.

(No bell) All alarm limits are off or the vital

sign is not being monitored.

2. Press LIMITS to display the Alarms Limits window:

(M)

(M)

38

mmHg

mmHg

T1
T2
∆T

ON/
OFF

D

S

122

D

58

99.8

98.6

1.2

BR

12

Br/m

97

9

Arrow indicates

there are more

parameters that

are not displayed.

Press NEXT

PARAMETER to

scroll down. After

the selection

reaches the last

parameter, it

returns to the top

(HR/PR).

ALARM LIMITS

UPPER LOWER

HR/PR BPM 120 50

*

30
20
100
OFF
OFF
220
110
120

100.0

100.0

5.0

UP

RR/BR
APNEA DELAY
SpO

2

ETCO2
INCO2
NIBP S
NIBP D
NIBP (M)
T1

T2
∆T

NEXT

PARAMETER

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.

Br/M

mmHg
mmHg
mmHg
mmHg
mmHg

NEXT

SETTING

sec
%

°F
°F
°F

5

90

OFF

75
35
50

95.0

95.0

0.0

DOWN

( 15)

NIBP

( 85)

TEMP

°F

MCO2

mmHg

SpO2

%

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.

Propaq CS Directions for Use

Home

20

Change the Current Patient Mode

1. To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to
access the Patient Mode window:

PATIENT MODE

SELECT PATIENT MODE BASED ON AGE:

NEO : < 44 WEEKS GEST. AGE

PED : > 44 WEEKS GEST. AGE,

< 9 YEARS

ADULT:

NEONATAL

> 9 YEARS

PEDIATRIC

BATTERY: 8.2 VOLTS

ADULT

SETUP

PREVIOUS

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 21 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.

Welch Allyn

Chapter 2 – Setup 21

P2

25

Change Powerup Patient Mode or Store Customized Settings

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
page 95).

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.

S

(M)

mmHg

(M)

mmHg

T1
T2
∆T

38

PREVIOUS

MENU

D

S

122

D

58

100.4

98.6

1.8

BR

12

Br/m

97

9

Asterisk
indicates which
patient mode is

currently

selected for

powerup.

MODE SETUP

FACTORY:

CUSTOM

* = PATIENT MODE ON POWERUP

NEXT

*ADULT PED

:

ADULT PED

POWERUP* USE

BATTERY: 9.2 VOLTS

NOW

NEO

NEO

( 15)

NIBP

( 85)

TEMP

°F

MCO2

mmHg

SpO2

%

SAVE

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.

Propaq CS Directions for Use

22

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 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).

Home

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.

Welch Allyn

3 – Monitoring

Perform ECG/RESP Monitoring

Warning

23

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.

ECG R-wave detection. Therefore, always select the ECG lead with the most prominent QRS complex when monitoring
respiration via impedance pneumography.

RESP measurement frequencies may interfere with one another.

is not recommended for use on paced patients.

possible.

failure to detect apnea, or a failure to display a Lead Fail message.

may cause the monitor to display inaccurate heart rates.

per minute, it may display incorrectly low heart rates, due to intermittent picking of R-waves.

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.

settings.

SpO

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.

again. This clears the prior patient’s trend values and alarm limit settings.

Impedance pneumography detects respiratory effort via changes in chest volume; therefore, impedance

The Propaq CS monitor automatically rejects cardiovascular artifact. This function is dependent upon accurate

Don’t place the Propaq CS monitor with RESP in close proximity to another respiration monitor because the

Because pacemaker pulses in some instances may be falsely counted as breaths, impedance pneumography

Motion artifact can cause incorrect breath rate or heart rate readings. Minimize patient motion whenever

If a disconnected lead is in too close proximity to other electrical devices, it may cause false heart rate, a

The Propaq CS monitor does not provide arrhythmia analysis. Therefore, arrhythmias are not analyzed and

The Propaq CS monitor will show + + + for HR numerics between 301-350 beats per minute. Above 350 beats

High-intensity radio frequency (RF) energy from external sources, such as an improperly connected

Verify patient mode. Incorrect patient mode may result in inaccurate heart rates and inappropriate alarm

To help prevent injury, use the provided garment clips to route the ECG cables away from the patient’s head.

Use of ECG cables with loose or faulty detachable lead wires may cause erratic behavior of the ECG waveform,

(C-LOCK), and NIBP (Smartcuf) due to intermittent ECG lead wire connections.

2

Use only ECG safety cables that are designed so that they cannot accidently be plugged into an ac mains

Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on

Propaq CS Directions for Use

24

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.

• 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.

• 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.

Welch Allyn

Chapter 3 – Monitoring 25

6. Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes
to the patient as shown.

RA

LA

G

+

If using MCL1,

Standard 3-lead
Configuration

RA

V1

5-lead Configuration

RL

LL

LA

LL

select LEAD II
on the monitor,
and use all three
electrodes.

V6

One of six V lead
electrode placement
sites for the C lead.

7. Plug the ECG cable into the ECG connector on the monitor's left side panel.

Marriott
Configuration
MCL 1

RA

Neonate 3-lead Configuration

(G)=LA (-)=RA (+)=LL

LA

LL

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.

Propaq CS Directions for Use

26

P1

121

S

mV

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
OFF

II

MON

V

MON

2

Ld

RESP

mV

1

cm

mV

1

cm

ECG1

SIZE

ADULT
ON NETWORK

2X

17:05:10

ALLEN KIM

ECG

1

LEAD

PRINT FAULT

ECG2
SIZE

RESP
SIZE

HR

BPM

112

1

P

(M)

( 96)

P2

(M)

( 15)

NIBP

(M)

( 85)

TEMP

°F

MCO2

38

mmHg

SpO2

%

12. Press buttons as desired to adjust the display:

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.

mmHg

mmHg

mmHg

T1
T2
∆T

MORE

S

121

D

79

S

25

D

S

122

D

58

100.4

98.6

1.8

BR

12

Br/m

97

9

BR indicates
respiration rate is
derived from
active CO2

channel.
RR indicates CO

is not monitored
and respiration
rate is derived
from ECG/RESP.

2

Selections aVR, aVL, aVF, and V are only available with a 5-lead ECG cable.

The ECG2 lead is always V, except when the ECG1 lead is V (in that 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.

The QRS detector sensitivity threshold is not affected by changing the ECG
display size. Likewise, the RESP breath detector threshold is not affected by
changing the RESP display size.

13. Press MORE to display the second ECG/RESP menu and status window:

ECG bandwidth selected:

MON = Monitor

EXT = Extended

1

cm

MON

ECG/RESP

HR/PR TONE

PACER DISPLAY

ECG BANDWIDTH

RESP LEAD

: OFF

: ON

: MONITOR (0.5-40Hz)

: Ld2 (RA-LL)

RESP MONITORING : ON

NEXT

CHANGE

(M)

mmHg

( 96)

P2

(M)

( 15)

mmHg

NIBP

(M)

( 85)

mmHg

TEMP 100.4

°F

MCO2

38

mmHg

SpO2

%

PREVIOUS

D

79

S
D

S

122

D

58

T1
T2
∆T

BR

Br/m

97

MENU

25

9

98.6

1.8

12

Welch Allyn

Chapter 3 – Monitoring 27

14. Press NEXT and CHANGE as desired to adjust the display.

HR/PR TONE Sets heart tone loudness to LOW, MEDIUM, HIGH, or OFF.

If SpO2 is monitored, tone pitch varies with the SpO2 value.

PA CER DISPLAY Turns on and off the pacer indicator in the ECG waveform.

If the patient has a pacemaker, you may want to turn on the pacer indicator
(see page 28).

ECG BANDWIDTH Selects the bandwidth for displayed and printed data.

MONITOR is 0.5-40 Hz (Adult mode) or 0.5-120 Hz (Pediatric and

Neonatal mode).

Monitor Mode filters out extraneous noise and artifact to provide a more
stable display.

EXTENDED is 0.05-40 Hz (Adult mode) or 0.05-120 Hz (Pediatric and

Neonatal mode).

Extended Mode is a higher-resolution setting that allow more detailed
analysis.

Always use Extended Mode when observing ST segment morphology on
the display or printer. Although Monitor Mode is useful to minimize
baseline wander due to artifact, ST segments can be distorted in Monitor
Mode. This can potentially cause underestimation of ST elevation and
overestimation of ST depression. Although the monitor does not have
automated ST segment monitoring, ST segments may be accurately
displayed and printed in Extended Mode.

RESP LEAD Selects the RESP lead: Ld1 (RA-LA) or Ld2 (RA-LL). RESP lead

selection is independent of ECG lead selection.

Choose the RESP lead that gives you the best signal. If neither signal is
adequate, experiment with nonstandard electrode placement such as
placing the RA and LA electrodes on the respective mid-axillary lines just
above 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.

Propaq CS Directions for Use

28

Use the Propaq CS Monitor With Pacemaker Patients

Warning

Pacemaker signals can differ from one pacemaker to the next. The Association for Advancement of Medical
Instrumentation (AAMI) cautions that “in some devices, rate meters may continue to count the pacemaker rate during
occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate meter alarms. All pacemaker patients
should be kept under close or constant observation.”

The presence of much pacer-like noise can cause the displayed heart rate to be erratic even though the ECG
trace may look undistorted with the pacer indicator off. To help avoid this noise problem, use fresh ECG electrodes
and make sure the ECG cable lead wires make good connections.

If the patient being monitored has a pacemaker, the Propaq CS monitor detects and can indicate the
occurrence of pacemaker signals.

1. To access the monitor pacer indicator, from the Main Menu press ECG/RESP, MORE, and then

NEXT to select the PACER DISPLAY.

2. Press CHANGE to set the PACER DISPLAY either ON or OFF.

When ON, the monitor displays (and prints on printouts) vertical dashed lines to indicate
each time a pacemaker signal is detected. (If the pacemaker signal is strong enough, the
monitor also displays it as a waveform “spike.”)

Pacemaker signal indicators

NET
OFF

II

MON

mV

1

cm

ADULT
ON NETWORK

17:05:10

ALLEN KIM

PRINT FAULT

HR

BPM

80

1

P

(M)

mmHg

( 96)

P2

S

121

D

79

S

25

When OFF, the vertical lines are not displayed (or printed), but the pacemaker signal
waveform spike is still displayed if strong enough.

Note

Pacemaker pulses are not counted as heartbeats as defined by the Pacer Pulse Rejection specifications (see
page 98).

Noise on the ECG signal may be detected as pacer signals, causing the pacer indicator to appear on the display. If you
don't need to indicate pacemaker signals, turn off the pacemaker indicator for a better ECG waveform display.

Welch Allyn

Chapter 3 – Monitoring 29

II

BPM

112

Perform Invasive Blood Pressure (IBP) Monitoring

Warning

connected to its cable shield. Using a conductive transducer case with such a shield connection risks high-frequency
burns at the ECG electrodes if the transducer case becomes earth grounded.

functions, partial disconnection will not be detected, nor will the use of some incompatible transducers. The user must
exercise reasonable measures to ensure that approved transducers are used and that pressure transducers are
connected properly.

again. This clears the prior patient’s trend values and alarm limit settings.

recommended in the Welch Allyn Products and Accessories booklet. Use accessories according to your facility’s
standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. Do not
use light-sensitive disposable transducers.

If electrocautery is used, always avoid using any transducer with a conductive (metal) case that is electrically

Although complete disconnections of invasive pressure transducers will be detected by the normal alarm

Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on

For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or

1. Inspect the transducer cable and transducer dome for wear, breakage, or fraying. Replace any
worn or broken accessory.

2. Set up the transducer according to your hospital's procedures. Always refer to the transducer
manufacturer’s Directions for Use. If the transducer is a disposable unit with separate cable,
connect the transducer to the transducer cable.

3. Plug the transducer (or transducer cable) into an invasive pressure connector on the monitor
left side panel.

MON

MON

P

1

mV

1

cm

V

mV

1

cm

RANGE

RESCALE

ZERO P1

ZERO P

P

1

NIBP

( 85)

TEMP

°F

MCO2

mmHg

SpO2

%

2

ZEROED

(M)

38

NOT

mmHg

T1
T2
∆T

MORE

S

122

D

58

100.4

98.6

1.8

BR

12

Br/m

97

The message
NOT ZEROED
immediately
appears in the IBP
numerics window
for the invasive
pressure channel
being used.

4. To zero the transducer, open the transducer's stopcock to atmospheric air. Wait a few seconds
for the transducer to settle.

Before zeroing, make sure the transducer cable is properly connected to the monitor and the
transducer is open to atmospheric air and positioned at the same level as the patient’s heart. The
monitor will not zero the transducer if the pressure waveform is pulsatile, there is too much signal
noise, or the transducer’s offset is too great.

Propaq CS Directions for Use

30

25

S

5. If the ZERO menu is not displayed, from the Main Menu press

P1

(or ZERO P2). The word ZEROING appears in the numerics window during zeroing.

INVASIVE PRESSURE, then ZERO

If you want to cancel the zeroing process, press CANCEL.

6. Wait for a brief tone to sound and the word ZEROED to appear in the blood pressure
numerics window.

7. Close the transducer's stopcock. The monitor displays the pressure scale and numerics.

8. If the transducer will not zero, the monitor displays the words ZERO REJECTED in the

numerics window. Press CANCEL and try zeroing again beginning at step 4. The monitor does
not display numerics or scales until an acceptable zero reference is established.

You can rezero an IBP transducer at any time after you again open the transducer stopcock to
atmospheric air. If the transducer has already produced pressure readings, rezeroing provides a new
zero reference for the monitor.

If the zero value is not accepted, the monitor continues to use the previous zero reference and
displays numerics and waveforms based on that value.

If the transducer still does not zero, try another transducer or another cable.

Warning

If you press ZERO after an invasive pressure channel has been successfully zeroed and the channel is
currently monitoring a pressure waveform, the message ZERO REJECTED will display in the IBP numerics window. This
message continues to display in place of the valid invasive pressure numerics until you press Home, INVASIVE
PRESSURE, and then CANCEL in the IBP menu. If an IBP alarm occurs while ZERO REJECTED is displayed in place of
IBP numerics, the IBP numerics will not flash to indicate invasive pressure is in alarm.

9. To set up the IBP display, from the Main Menu press INVASIVE PRESSSURE to display the first
IBP menu:

(M)

D

mmHg

S

(M)

D

mmHg

T1
T2
∆T

38

MORE

PREVIOUS

MENU

122
58

100.4

98.6

1.8

BR

12

Br/m

97

9

First IBP
menu

Second IBP
menu

IBP labels are

user-selectable.

V

MON

P

1

P

2

mV

1

cm

130

100

70

30

15

0

RANGE

LABEL

P

( 15)

NIBP

( 85)

TEMP

°F

MCO2

mmHg

SpO2

%

RESCALE

1

FORMAT

P

1

ZERO P1

LABEL

P

2

ZERO P2

FORMAT

2

P

Welch Allyn