Welch Allyn Medical Diagnostic Equipment 246, 242, 244 User Manual

Propaq® CS Vital Signs Monitor

Directions for Use

Models 242, 244, 246 Software version 3.7X

ii Welch Allyn Propaq CS Vital Signs Monitor

Welch Allyn assumes no responsibility for any injury to anyone, or for any illegal or improper use of the product, that may result from failure to use this product in accordance with the instructions, cautions, warnings, or statement of intended use published in this manual.

Welch Allyn, Propaq, Acuity, FlexNet, and Smartcuf are registered trademarks of Welch Allyn.

SET and Masimo are registered trademarks of Masimo Corporation. Possession or purchase of a Masimo SpO monitor does not convey any express or implied license to use the device with unauthorized sensors or cables which would, alone or in combination with this device, fall within the scope of one or more of the patents relating to this device.

Nellcor and Oximax are registered trademarks of Nellcor Puritan Bennett.

Software in this product is copyright by Welch Allyn or its vendors. All rights are reserved. The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded. The software may not be copied, decompiled, reverse-engineered, disassembled or otherwise reduced to human-perceivable form. This is not a sale of the software or any copy of the software; all right, title and ownership of the software remain with Welch Allyn or its vendors.

For information about any Welch Allyn product, call the nearest Welch Allyn representative:

-equipped

USA + 1 315 685 4560

800 535 6663

Australia + 61 2 9638 3000

800 074 793 Canada 800 561 8797 China + 86 216 327 9631 European Call

+ 35 3 46 906 7790 France + 33 1 60 09 33 66

Center Germany + 49 7477 92 71 86 Japan + 81 3 3219 0071 Latin America + 1 305 669 9003 Netherlands + 31 15 750 5000 Singapore + 65 6419 8100 South Africa + 27 11 777 7555 United Kingdom + 44 20 7365 6780 Sweden + 46 8 58 53 65 51

REF 810-2734-XX (CD) REF 810-2707-XX (Printed, English only)

Manual 810-2689-01 Ver A, 2008-06

Welch Allyn Protocol, Inc. 8500 SW Creekside Place Beaverton, OR 97008-7107 USA

www.welchallyn.com

Welch Allyn Ltd Navan Business Park Dublin Road, Navan County Meath, Republic of Ireland

Contents

1 - General information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 - Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

iii

Intended use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

General warnings and cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Controls and connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Learn Propaq CS operation with Inservice Mode . . . . . . . . . . . . . . . . . . . . . . . . 13

Prepare the Propaq CS monitor for a new patient . . . . . . . . . . . . . . . . . . . . . . . 15

Set patient alarms and alarm limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Change the current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Change Powerup Patient Mode or store customized settings . . . . . . . . . . . . . . 19

3 - Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Perform ECG/RESP monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Using the Propaq CS monitor with pacemaker patients . . . . . . . . . . . . . . . . . . . 27

Perform Invasive Blood Pressure (IBP) monitoring . . . . . . . . . . . . . . . . . . . . . . . 28

Take a Noninvasive Blood-Pressure (NIBP) reading . . . . . . . . . . . . . . . . . . . . . . 32

Perform temperature monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Perform S pO Perform Mainstream CO Perform sidestream CO Set up the CO

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

display and alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

4 - Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Description of alarm and alert tone patterns. . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Silence an active alarm or alert tone for 90 seconds . . . . . . . . . . . . . . . . . . . . . 49

Inhibit alarm and alert tones for four minutes: 4 MIN SUSPND . . . . . . . . . . . . . 51

Inhibit alarm and alert tones indefinitely: ALL ALARMS. . . . . . . . . . . . . . . . . . . 52

Summary of alarm and alert keys and Acuity Central Station messages . . . . . . 53

Customize alarm limits based on patient’s current vital signs . . . . . . . . . . . . . . 54

Alarm holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Connect nurse call option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Troubleshooting equipment alert messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

5 - Printing & trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Print patient data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Display or print trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Set printer options and automatic printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

6 - Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Understanding the Propaq CS, Acuity, and FlexNet network . . . . . . . . . . . . . . . 71

Hardwired (Serial) connection to Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Wireless connection to Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

iv Contents Welch Allyn Propaq CS Vital Signs Monitor

7 - Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Avoid electrostatic discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Connect the AC power adapter to recharge the battery . . . . . . . . . . . . . . . . . . . 81

Replace monitor input power fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Install printer paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Inspect and clean the monitor and accessories . . . . . . . . . . . . . . . . . . . . . . . . . 86

Service interval recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Recycling monitor components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Extended storage precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

Change the Wireless Propaq CS network name . . . . . . . . . . . . . . . . . . . . . . . . 88

8 - Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Set the time and date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Change the date format, ECG filter, and units . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Factory default settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

9 - Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

General 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 transport.

• The ECG channel is intended for five-lead or three-lead ECG monitoring.

• The Respiration (RESP) channel is intended to detect the rate or absence of respiratory effort, deriving the signal by measuring the ac impedance between selected terminals of ECG electrodes.

• The Invasive Pressure (IBP) channel is intended for measuring arterial, venous, and intracranial pressures (and umbilical artery and vein pressures for neonates) using invasive transducers.

• The Noninvasive Blood Pressure (NIBP) channel is intended for indirectly measuring arterial pressures using an inflatable cuff. If ECG is also monitored, the Propaq CS Smartcuf™ software algorithm automatically synchronizes the NIBP measurement process to the occurrences of the R-wave, increasing accuracy in cases of extreme artifact and diminished pulses. The operator may disable or enable the Smartcuf algorithm in the NIBP Menu.

• The Temperature (TEMP) channel is intended to measure temperature using an attachable probe.

• The Pulse Oximetry (SpO saturation of arteriolar hemoglobin at a peripheral measurement site.

• The Capnography (CO vital signs or events: End-tidal CO Apnea.

• Propaq CS monitors that do not include CO light rain exposure over short periods of time (uniform distribution of approximately 1 mm of water/ minute for 10 minutes or less).

This guide was written for clinicians. Although this guide may describe some monitoring techniques, Welch Allyn and interpret a patient’s vital signs. This monitor has been designed as a quality monitor; however, inherent limitations require that good clinical judgment always prevail.

) channel is intended to noninvasively measure oxygen

) channel is intended to noninvasively measure the following

expects that you are a trained clinician who knows how to take

(ETCO2), Inspired CO2 (INCO2), Breath Rate, and

or printer options are able to withstand

2 General information Welch Allyn Propaq CS Vital Signs Monitor

Symbols

WARNING Indicates conditions that could lead to illness, injury, or death.

Caution In this manual, indicates conditions that could damage equipment or other property.

Caution On the product, means “Consult the accompanying documentation.”

The following symbols may appear on the Propaq CS monitor or accessories. They are defined by the International Electrotechnical Commission, IEC 878 and IEC 417A.

Off (Standby) Two-way communication port

On Input port

For continued fire protection, use only the specified fuse

Direct current Alternating current

Non-ionizing electromagnetic radiation. This device contains an approved RLAN module frequency 2402 to 2480 MHz

Fuse Recycle the monitor and battery separately

Direct current or alternating current Separate batteries from other disposables for

Caution: Refer to Directions For Use and accompanying documentation

See the accompanying manual Urgent alarm notification (output to Nurse

Battery charging when green indicator illuminated

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

Patient connections are Type BF, and protected against defibrillation

IPX1

Output port

Non-ionizing electromagnetic radiation. This device contains an approved RLAN module frequency 5150 to 5825 MHz

from other waste. Refer to

www.welchallyn.com/weee for collection

point and additional information.

recycling.

Enclosure Protection Drip proof: Classification IPX1 per EN 60529

Call system)

Temperature sensor input

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

For indoor use only (on power adapter only)

Protected during defibrillation Stacking limit by number

This way up Temperature limits

Fragile Humidity limit

Keep away from rain Altitude limit

Patient connections are Type B The device has met all essential requirements

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

Directions for Use General information 3

The CE Mark and Notified Body Registration Number signify the device has met all essential requirements of European Medical Device Directive 93/42/EEC

Restrictions for use of wireless device in Europe. European Communities Class 2 radio equipment

FCC ID: PGUWA11A07 IC: 4168a-WA11A07

The Canadian Standards Association has

NRTL/C

Evaluated to CSA 601-1 and UL2601-1

Apply the NIBP cuff as shown.

NIBP cuff sizes: Thigh Large adult Adult Small adult Child Infant

This device complies with FCC and Industry Canada requirements for international radiators (802.11 wireless)

evaluated this device according to CSA 601-1 and Underwriters Laboratory Standard UL 2601-1.

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

Apply the NIBP cuff as shown.

Single-use only (not reusable).

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 Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical systems safety standards such as IEC 60101-1- 1. W it h in ce r t ai n g overnmen t al j u r i sdic t i ons , a l l int e r conn e c ted accessory equipment must be labeled by an approved testing laboratory. After interconnection with accessory equipment, risk (leakage) current and grounding requirements must be maintained.

WARNING This monitor is to be operated by qualified personnel only. The operator of this monitor should read this entire manual and all accessory directions for use before operating the monitor.

WARNING Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.

WARNING Always check the patient mode when monitoring a new patient. The patient mode determines default alarm limits, maximum cuff inflation pressure, and internal algorithm settings.

WARNING The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges.

WARNING Place the Propaq monitor and accessories in locations where they cannot harm the patient if they fall from their shelf or mount. Lift the monitor only by its handle; do not lift it by any attached cables.

4 General information Welch Allyn Propaq CS Vital Signs Monitor

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

WARNING Inspect the power adapter cord periodically for fraying or other damage, and replace the adapter as needed. Do not operate the apparatus from ac power with a damaged power adapter cord or plug.

WARNING Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and electrode wires must be inspected, properly maintained, and in proper working order to allow the equipment to function properly and protect patient safety.

WARNING As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation.

WARNING Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes.

WARNING During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient. Avoid contact with any accessories connected to the monitor’s left side panel.

WARNING To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and other patient-applied parts should not contact other conductive parts, including earth ground, at any time.

WARNING Do not operate this product in the presence of flammable anesthetics or other flammable substance in combination with air, oxygen-enriched environments, or nitrous oxide; explosion can result.

WARNING Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical interference with ECG monitor operation. This interference may distort the displayed or recorded ECG signal, thereby preventing accurate rhythm analysis. Avoid operating this device near equipment of this type.

WARNING When using a power adapter with this monitor, be sure to connect the power adapter to a three-wire, grounded, hospital-grade receptacle. Do not under any circumstances attempt to remove the grounding conductor from the power plug of the power adapter. Do not plug the power adapter into an extension cord. If there is any doubt about the integrity of the protective earth ground of the receptacle for the power adapter, do not plug in the power adapter; operate the monitor only on battery power. Contact your biomedical engineering department for assistance in identifying the proper power receptacle and making appropriate power connections.

WARNING To help protect against electrical shock due to leakage current, use only monitor ac power adapters recommended in Welch Allyn Products and Accessories (810-0409-XX).

WARNING For best product performance and measurement accuracy, use only accessories supplied by Welch Allyn or recommended in Welch Allyn Products and Accessories. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. Use of accessories not recommended by Welch Allyn may result in increased electromagnetic emissions or decreased electromagnetic immunity of the equipment.

Directions for Use General information 5

WARNING If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation and acceptable risk (leakage) current values.

WARNING Some or all NIBP safety functions are disabled in the NIBP TEST screen in the Service Menu. Do not attempt to conduct NIBP TEST when the cuff is attached to a patient.

WARNING Do not use the Propaq CS monitor in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. Such use can cause fire or explosion resulting in patient injury and monitor damage.

WARNING Impedance pneumography and CO

monitoring may not operate

properly when used in conjunction with high-frequency jet ventilation or high-frequency oscillatory ventilation.

WARNING This monitor should only be repaired by qualified service personnel. The operator should not attempt to open the monitor case or perform any maintenance on the monitor except for procedures explicitly described in this manual that can be performed by operators such as inspection and cleaning.

WARNING When taking NIBP measurements, periodically observe the patient’s limb to make sure that the circulation is not impaired for a prolonged period of time. Also make sure the blood pressure cuff is properly placed according to the Propaq CS Directions for Use. Be especially careful when using the short-term automatic mode (TURBOCUF). Prolonged impairment of circulation or improper cuff placement can cause contusions.

WARNING The range of values measured by the monitoring parameters is provided in the Specifications section of the Propaq CS Directions for Use. Operation of the monitor outside the range of specified values is not recommended and may cause inaccurate results.

WARNING Electronic equipment that emits very strong electromagnetic or radio frequency signals can cause electrical interference with monitor operation, including causing the monitor to turn off power. Avoid operating this monitor near such equipment. For guidance about electromagnetic emissions and the recommended separation distance between the monitor and such equipment, refer to the specifications section of this manual.

WARNING Military radars are allocated as primary users in the bandwidths between 5.25 - 5.35 GHz and 5.47 to 5.725 GHz. In the event a radar signature is detected, the Access Point moves to a new channel, which can temporarily interrupt patient monitoring. If the device (wireless) is operated near a military radar, the radar could cause damage to the device.

WARNING This product contains no user-serviceable components. Any unauthorized changes to the product invalidate Welch Allyn’s warranty and also invalidate all applicable regulatory certifications and approvals.

WARNING Do not use the pulse oximeter as a replacement or substitute for ECG-based arrhythmia analysis.

6 General information Welch Allyn Propaq CS Vital Signs Monitor

Caution Changes or modifications not expressly approved by Welch Allyn could void the purchaser’s authority to operate the equipment.

Caution Do not autoclave the Propaq CS monitor. Autoclave accessories only if the manufacturer's instructions clearly approve it. Many accessories can be severely damaged by autoclaving.

Caution Federal USA law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner.

It is possible for the monitor to detect a problem that prevents the monitor from operating properly. If this occurs, the monitor displays an error message and error number. Report such errors to Welch Allyn.

The Propaq CS monitor should be serviced only by a Welch Allyn service technician while under warranty. Propaq CS Service Manual (810-2708-XX) is available from Welch Allyn to assist the biomedical engineer during post-warranty period service.

Directions for Use General information 7

Controls and connectors

Yellow antenna cap indicates Wireless Propaq CS

Nurse Call Option

SpO2 Option

Alarm Light Alarm(s) Off Light

Silence/Reset

Silences alarm tone for 90 seconds or re-enables alarm tone (if active)

Start/Stop NIBP

Starts or stops NIBP reading

Mainstream CO

Option

Printer Option

Sidestream CO

Option

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 left corner if the monitor is connected to an Acuity system. These keys allow control of all monitoring and setup functions.

Note

Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the touch-screen to misinterpret the command and respond to the wrong key.

Caution Do not touch the screen with a sharp object such as a pen or pencil. Sharp objects can damage the touch-screen. Use your finger to press the touch-screen keys.

Home

Returns the display to the Main Menu

Printer Buttons

NET OFF key is displayed in the upper

System control and connectors (right side panel)

On/Off Switch

Input Fuse

Power Input Connector

2AG

12-28V, 3A

DEFIB SYNCHROMONITOR

EKG x 1000

Defib Sync Connector Contact Welch Allyn technical support for information (for specifications, see page 97)

Real-time ECG Output Connector

Speaker

Connector for Acuity or Modem-Propaq Battery Charging Light

8 General information Welch Allyn Propaq CS Vital Signs Monitor

Patient connectors (left side panel)

Model 242

ECG NIBP Temperature (two channels)*

ECG / EKG RESP

NIBP PSNI

Propaq CS Model 242

ECG / EKG RESP

COMPATIBLE

NIBP

HP Model 242*

Model 244

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

ECG / EKG RESPINV. BP

NIBP

PSNI

Propaq CS Model 244

INV. BP

COMPATIBLE

ECG / EKG RESP

S N

NIBP

HP Model 244*

Model 246

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

ECG / EKG RESPINV. BP

NIBP

NIBP PSNI

PSNI

INV. BP

Propaq CS Model 246

INV. BP

COMPATIBLE

INV. BP

ECG / EKG RESP

P S N

NIBP

HP Model 246*

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

Directions for Use General information 9

Option connectors

Mainstream CO2 Connector Sidestream CO2 Connector

Cable: see Welch Allyn

Products and

Accessories

(810-0409-XX)

Masimo SpO2 Connector

(motion-tolerant)

Nurse Call Connector

Cable: see Welch Allyn

Products and Accessories

(810-0409-XX)

Masimo SpO2 Connector

(motion-tolerant)

Nellcor SpO2 Connector

10 General information Welch Allyn Propaq CS Vital Signs Monitor

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 mode Status messages can appear here.Time of day

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

98.6

1.8

vital sign outside the measurable range, it

displays

- - - (below the range) or + + + (above the range).

Patient name

entered at Acuity

Central Station.

When selected,

trends are

displayed here.

STATSCALE

automatically

adjusts all

waveform scales

for optimum

viewing.

ADULT

NET OFF

ON NETWORK

MON

130

100

STATSCALE

17:05:10

ALLEN KIM

ALARMS

PRINT FAULT

ACUITY

TRENDS

BPM

112

(M)

mmHg

( 96)

(M)

( 15)

mmHg

NIBP

(M)

( 85)

mmHg

TEMP

MCO

mmHg

SpO

121

S D

122

100.4

T1 T2 ΔT

Br/m

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

ECG1

waveform is

always

displayed if

active.

Status

window

ADULT

NET OFF

ON NETWORK

MON

ECG/RESP

HR/PR TONE

PACER DISPLAY

ECG BANDWIDTH

RESP LEAD

RESP MONITORING : ON

17:05:10

ALLEN KIM

: OFF

: ON

: MONITOR (0.5-40Hz)

: Ld2 (RA-LL)

CHANGE

PRINT FAULT

BPM

112

(M)

mmHg

( 96)

(M)

( 15)

mmHg

NIBP

(M)

( 85)

mmHg

TEMP

MCO

mmHg

SpO

121

S D

122

100.4

T1 T2 ΔT

Br/m

98.6

1.8

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

ETCO2 concentration

Breath Rate from CO

Oxygen saturation is a percentage value.

Directions for Use General information 11

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/

SETUP

SpO

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

FLOW

RATE

ECG/RESP MENU 1

ECG1 SIZE

ECG/RESP MENU 2

NEXT PREVIOUS

NIBP MENU

START AUTO/

STOP

INVASIVE PRESSURE MENU 2

LABEL

MANUAL

ECG1 LEAD

CHANGE

FORMAT

INTERVAL

ECG2

SIZE

CANCEL

LABEL

TURBOCUF

RESP

SIZE

CANCEL

FORMAT

SMARTCUF

12 General information Welch Allyn Propaq CS Vital Signs Monitor

a w

Setup Menus

NIBP ECG/

RESP

INVASIVE

PRESSURE

SpO

SETUP

SETUP MENU 1

SCALE

WAVE

SELECT

ACUITY

MOREALARMS TRENDSSTAT

SETUP MENU 2

SELECT

PRINTER

MORENEXT CHANGE WAVE

TREND MENU

PRINT NEXT

NET

OFF

ACUITY MENU (HARDWIRED CONNECTION)

TREND

SNAPSHOT PREVIOUS

OXYCRG

ALARMS MENU

STAT SET 4 MIN

ALARM LIMITS MENU

PARAMETER

SUSPND RESUME

SETTING

UP DOWNNEXT

LIMITS PREVIOUS

ON/ OFF

Acuity Menu is displayed if the monitor is connected to Acuity. See “Understanding the Propaq

CS, Acuity, and FlexNet network” on page 71 for details

bout Acuity hardwired and

ireless communication

options.

ON/OFF key is not displayed for HR/PR alarm limits if the HR/PR

LARM LIMITS setting is set to

CANNOT TURN OFF.

Service menu tests are only

or use by authorized service personnel and are only available in the Adult patient mode. RADIO key is only displayed

or Wireless Propaq CS.

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

Radio menu is displayed for Wireless Propaq CS.

2.4 GHz radio card models

only.

TIME/DAY MENU

NEXT UP DOWN ENTER

SERVICE MENU 1

TEST

SERVICE MENU 2

TEMP

TEST

SERVICE MENU 3

IBP

TEST

PIXEL

TEST

CAL

SpO TEST

NET

TEST

SYSTEM RADIO

SETTINGS MENU

NEXT CHANGE ALL

PRINTER SETUP MENU

CHANGE

TREND

WAVE SELECT MENU

NEXT INSERVICE PREVIOUS

PATIENT MODE MENU

NEONATAL PEDIATRIC SETUP

ON/ OFF

INSERVICE

ADULT

MODE SETUP MENU

NEXT POWERUP* USE

NETWORK

STATUS

NETWORK

MONITOR

CHANGE

NET NAME

RADIO MENU

NOW

SERVICE

MORENIBP

MORESETTINGS SCREEN

SAVE

CO2

TEST

PCMCIA

TEST

ALARMS

Directions for Use General information 13

Learn Propaq CS operation with Inservice 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. In in-service mode, the monitor display and all printouts include the message SIMULATING or SIMULATED DATA.

To practice with your Propaq CS monitor:

1. Disconnect all patient cables connected to the monitor. You can leave the NIBP cuff

connected to the monitor so you can take NIBP measurements.

2. To temporarily remove customized alarm settings, press Home, SETUP, MORE,

CHANGE, SETUP, USE NOW, YES.

3. To put the Propaq monitor in (non-alarming) Inservice Mode 1, press Home, SETUP,

WAVE SELECT, INSERVICE.

4. To set the Propaq monitor in (alarming) Inservice Mode 2, press Home, SETUP,

WAVE SELECT, INSERVICE.

Within 5 seconds, the monitor alarms because the “patient’s” vital signs fall outside the alarm limit ranges.

5. Confirm the following:

The monitor is sounding an alarm A vital sign numeric is flashing The small red light in the top right corner of the monitor is flashing The SILENCE and LIMITS keys are showing on the screen

6. To silence the alarm tone for 90 seconds, press Silence/Reset or SILENCE.

Visual alarm indications remain, and the alarm tone resets after the 90-second silence period.

7. To bring the Propaq monitor back into the (non-alarming) Inservice Mode 1, press

INSERVICE.

The “patient’s” vital sign readings will return to acceptable levels within the alarm limit range.

8. While in the inservice mode, you can press any monitor keys (except the

AUTO

/MANUAL key in the NIBP Menu) to change a function setting. For example,

you can change ECG and RESP waveform sizes, set alarm limits, or set custom settings.

You can also apply the NIBP cuff to yourself and take NIBP measurements.

9. Turn off the Propaq monitor.

Any previously set custom patient mode settings are restored when you turn it on again.

Under these conditions, if the monitor fails to generate visual or auditory alarm indications, carefully repeat the above steps. If the monitor is still unresponsive, remove it from circulation and take it to your facility’s biomedical service department for evaluation.

14 General information Welch Allyn Propaq CS Vital Signs Monitor

Note

The inservice mode is not available if the monitor detects that a sensor has been connected (except for an NIBP cuff) or the NIBP Automatic Mode has been selected. If the monitor is in inservice mode and you connect a sensor (except for an NIBP cuff) or press the NIBP AUTO/MANUAL key, the monitor will turn off power to exit the inservice mode, and then turn on in the normal operating mode.

The pacemaker signal indicators are not displayed in the inservice mode.

Setup

Prepare the Propaq CS monitor for a new patient

WARNING Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds and then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.

1. Press the gray recessed MONITOR button on the right side of the monitor to turn the

monitor off (if it is on). Press it again to turn the monitor on. The monitor displays the powerup screen for about 10 seconds, then displays the Main Menu. The monitor is in the powerup patient mode with the associated settings.

2. Confirm that the monitor emits a tone. If the monitor has SpO

and confirm both speakers are working.

Note

Check the battery voltage level on the powerup screen (or check it on the Time/Day window: Home, SETUP, MORE, MORE). If the battery voltage is 7.4V or less or a low battery message is displayed, connect the monitor to an ac power adapter to recharge the battery (page 20). Connecting the adapter does not interrupt patient monitoring.

, listen for two tones

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:

NEONATAL

4. Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the

confirmation window appears, press YES to confirm your selection.

> 9 YEARS

PEDIATRIC

BATTERY: 8.2 VOLTS

ADULT

SETUP

16 Setup Welch Allyn Propaq CS Vital Signs Monitor

Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 19 for information about preset Factory patient modes or programmable Custom patient modes.

Note

If you change the patient mode, the CO slightly from the originally-programmed CO Check the CO

alarm limits.

alarm limits in the new mode might vary

alarm limits for the new mode.

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

MORE, WAVE SELECT. Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select window.

SETUP

ECG

: ON

ON/ OFF

WAVE SELECT

2 :

RESP : ON

SpO

: ON

NIBP : ON

INSERVICE

You can turn on all waveforms, but only the first four waveforms selected as ON in the Wave Select window are displayed. You cannot turn off the ECG1 waveform.

6. To set the HR/PR source, display sweep speed, tone volumes, and display brightness,

from the Main Menu press SETUP, MORE to access Setup Menu 2. Use NEXT and CHANGE to select settings.

SETUP

HR/PR RR/BR

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

ALARM TONE HR/PR TONE

PATIENT MODE

BRIGHTNESS

CHANGE

: :

25.0

LOW OFF

ADULT

NORMAL

SELECT

WAVE

???

---

6.25

PRINTER

? ? ? is displayed until a source is active.

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

source is the active source with highest priority. The RR/BR source cannot be manually selected. It is always CO

if CO2 is active.

Otherwise, it is ECG/RESP.

SELECTED SOURCE The user-selected HR/PR source is displayed along with the HR/PR

source currently used by the monitor.

Directions for Use Setup 17

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

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.

Set patient alarms and alarm limits

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

(M)

ALARM STATUS

APNEA :

HR/PR :

P1 :

P2 :

STAT SET

4 MIN

SUSPND

RR/BR :

SpO

NIBP :

TEMP :

All alarm limits are on. At least one alarm limit is off.

( 15)

NIBP

( 85)

TEMP

MCO

mmHg

SpO

LIMITS

mmHg

(M)

mmHg

T1 T2 ΔT

122

100.4

98.6

1.8

Br/m

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:

ALARM LIMITS

HR/PR BPM 120 50

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).

RR/BR APNEA DELAY

SpO ETCO2 INCO2 NIBP S NIBP D NIBP (M) T1

T2 ΔT

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

SETTING

sec %

F F F

UPPER LOWER

30 20 100 OFF OFF 220 110 120

100.0

5.0

OFF

75 35 50

95.0

0.0

DOWN

(M)

mmHg

122

T1 T2 ΔT

Br/m

ON/ OFF

99.8

98.6

1.2

( 15)

NIBP

( 85)

TEMP

MCO

mmHg

SpO

18 Setup Welch Allyn Propaq CS Vital Signs Monitor

3. Press NEXT PARAMETER to highlight the parameter you want to change, then press NEXT SETTING to highlight the limit you want to change.

4. Press UP, DOWN, or ON/OFF to change the limits.

The apnea alarm cannot be turned off at any time.

5. After setting the desired limits, press Home to return to the Main Menu.

Home

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

2. Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.

Note

If you change the patient mode, the CO slightly from the originally-programmed CO Check the CO

alarm limits.

alarm limits in the new mode might vary

alarm limits for the new mode.

Directions for Use Setup 19

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 “Factory default settings” on page 93).

You can also choose to customize and store programmable powerup settings and alarm limits for each patient mode. These are “Custom Patient Mode” settings.

The instructions below describe how to change the powerup patient mode and how to select and store new Custom Patient Mode settings.

Note

When you change patient modes, you also change the alarm limits associated with the new patient mode.

Change the Powerup Patient Mode

1. From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.

MODE SETUP

FACTORY:

Asterisk indicates which patient

mode is currently selected for

powerup.

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.

CUSTOM

BATTERY: 9.2 VOLTS

*ADULT PED

ADULT PED

* = PATIENT MODE ON POWERUP

POWERUP* USE

NEO

NOW

SAVE

(M)

( 15)

NIBP

(M)

( 85)

TEMP

MCO

mmHg

SpO

S D

mmHg

122

mmHg

T1 T2 ΔT

Br/m

100.4

98.6

1.8

20 Setup Welch Allyn Propaq CS Vital Signs Monitor

Customize Patient Mode settings

1. From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.

2. The patient mode you want to reprogram (ADULT, PED, or NEO) must be currently selected. To make sure it is currently selected, press NEXT as needed to highlight the desired mode, then press USE NOW and YES.

3. Press Home to exit the Mode Setup window, then use other menus and keys to set the monitor settings and alarm limits as desired.

A convenient way to access settings and alarm limits for all functions without connecting cables is to select the in-service mode (disconnect all patient cables, turn the monitor power off and then on, then press SETUP, WAVE SELECT, INSERVICE from the Main Menu).

WARNING If any alarms are set to OFF and you select SAVE to store settings for a Custom patient mode, those alarms will be OFF when the monitor powers up in that Custom patient mode or that Custom patient mode is selected. Consider carefully before setting Custom patient mode powerup alarms to OFF.

Home

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.

Monitoring

Perform ECG/RESP monitoring

WARNING Impedance pneumography detects respiratory effort via changes in chest volume; therefore, impedance pneumography can be used to detect central apnea. However, apnea episodes with continued respiratory effort, such as obstructive apnea and mixed apnea, may go undetected. Also, artifact due to patient motion, apnea mattress shaking, or electrocautery use may cause apnea episodes to go undetected. Always monitor and set alarms for SpO impedance pneumography to monitor respiratory function.

WARNING The Propaq CS monitor automatically rejects cardiovascular artifact. This function is dependent upon accurate ECG R-wave detection. Therefore, always select the ECG lead with the most prominent QRS complex when monitoring respiration via impedance pneumography.

WARNING Don’t place the Propaq CS monitor with RESP in close proximity to another respiration monitor because the RESP measurement frequencies may interfere with one another.

WARNING Because pacemaker pulses in some instances may be falsely counted as breaths, impedance pneumography is not recommended for use on paced patients.

when using

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

WARNING If a disconnected lead is in too close proximity to other electrical devices, it may cause false heart rate, a failure to detect apnea, or a failure to display a Lead Fail message.

WARNING The Propaq CS monitor does not provide arrhythmia analysis. Therefore, arrhythmias are not analyzed and may cause the monitor to display inaccurate heart rates.

WARNING The Propaq CS monitor shows + + + for HR numerics between 301 and 350 beats per minute. Above 350 beats per minute, it may display incorrectly low heart rates, due to intermittent picking of R-waves.

22 Monitoring Welch Allyn Propaq CS Vital Signs Monitor

WARNING High-intensity radio frequency (RF) energy from external sources, such as an improperly connected electrosurgical unit, can induce heat into electrodes and cables which can cause burns on the patient. Reading errors and damage to equipment may also result. This hazard can be reduced by (1) avoiding the use of small ECG electrodes, (2) selecting ECG electrode attachment points remote from the surgical site and from the electrosurgical return electrode, (3) using electrosurgical return electrodes with the largest practical contact area, and (4) assuring proper application of the electrosurgical return electrode to the patient.

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

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

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

(C-LOCK), and NIBP

(Smartcuf) due to intermittent ECG lead wire connections.

WARNING Use only ECG safety cables that are designed so that they cannot accidently be plugged into an ac mains outlet or make contact with other hazardous electrical potentials including earth ground. To prevent damage during defibrillation, don’t use ECG cables without 1 k

Ω series resistors.

WARNING Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values and alarm limit settings.

Caution To protect the Propaq CS monitor from damage during defibrillation, for accurate ECG information, and for protection against noise and other interference, use only ECG electrodes and cables specified or supplied by Welch Allyn (these cables have the required current-limiting resistors). Follow recommended application procedures.

• Impedance pneumography (RESP) is not recommended for use with high frequency ventilation.

• Since RESP is derived from the same leads as the ECG channel, the Propaq CS monitor determines which signals are cardiovascular artifact and which signals are a result of respiratory effort. If the breath rate is within five percent of the heart rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths and trigger an apnea alarm.

• When monitoring RESP it is highly recommended that you use SpO

monitoring as a

backup monitoring method.

• It is recommended that Propaq CS monitor respiratory measurements not be made in close proximity to electrically radiated equipment. When the Propaq CS monitor is operated per EN 60601-1-1 (radiated RF immunity 3 V/m), field strengths above 2 V/m may cause erroneous measurements at various frequencies.

• The Propaq CS monitor counts as “breaths” respiratory efforts that are larger than two times background cardiovascular artifact.

• Even though the Propaq CS monitor contains fully isolated patient-connected circuitry, it has not been specially designed for direct application on a patient’s heart.

• Use only with accessories provided or recommended in the Welch Allyn Products and Accessories booklet.

Directions for Use Monitoring 23

• Severe artifact and interference (such as defibrillation interference) can cause the waveform to move off the display for a few seconds before it is restored.

Prepare for ECG/RESP monitoring

1. Inspect the ECG cable and replace it if it shows signs of wear, breakage, or fraying.

2. Select the appropriate patient mode. To change patient modes, from the Main Menu press SETUP, MORE, CHANGE, then the desired patient mode (NEONATAL, PEDIATRIC, or ADULT) and then YES.

3. Select electrode sites on the patient.

Choose flat areas; avoid fatty areas and major muscles.

4. Shave or clip hair from electrode sites, thoroughly clean skin, and lightly rub dry.

You may use soap and water, isopropyl alcohol or special skin preparation pads. To avoid allergic reactions to electrodes, refer to the electrode manufacturer’s directions.

5. If you are using pre-gelled electrodes, make sure the electrode date is not expired and the gel is intact and not dried out. For best results, use only silver/silver chloride electrode.

If you are using non-gelled electrodes, apply a 1/4- to 1/2-inch mound of gel over the electrode contact area.

For best product performance and measurement accuracy, do not use stainless steel needle electrodes, squeeze bulb electrodes, or electrodes with dissimilar metals. Do not use electrodes from more than one manufacturer on the same patient.

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

Standard 3-lead

Configuration

If using MCL1, select LEAD II on the monitor, and use all three electrodes.

Marriott

Configuration

MCL 1

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

24 Monitoring Welch Allyn Propaq CS Vital Signs Monitor

One of six V lead electrode placement

sites for the C lead.

5-lead Configuration

Neonate 3-lead Configuration

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

8. Support the ECG cable so it does not stress the electrode wires, ECG cable connectors, or electrodes.

9. If an electrosurgical unit will be used, place the ECG cable and electrode wires as far as possible from the surgical site and from the electrosurgical return electrode and its cables. This minimizes interference.

Although the ECG channel contains electrosurgical interference suppression (ESIS) circuitry, noise artifact may be displayed on the ECG trace while an electrosurgical device is in use. Choose electrode placement to minimize interference.

10. Look for an ECG waveform and heart rate on the monitor. Depending on how your monitor is programmed, a beep tone may occur with each detected QRS.

If there is no waveform, check the electrodes, wires, cable, and the monitor for a possible misconnection or lead fault.

11. To set up the ECG/RESP display, from the Main Menu press ECG/RESP to display the first ECG/RESP menu:

ECG1 lead selected

ECG1 size selected

ECG2 lead

The ECG2 lead is always V, except when

the ECG1 lead is V (in that case the

ECG2 lead is II).

RESP waveform is displayed (with RESP

option)

RESP lead selected

RESP size selected

BR indicates respiration rate is derived from active CO2 channel. RR indicates CO

ADULT

NET OFF

ON NETWORK

MON

RESP

ECG

SIZE

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

17:05:10

ALLEN KIM

ECG

LEAD

PRINT FAULT

ECG

SIZE

RESP SIZE

BPM

112

(M)

mmHg

( 96)

(M)

( 15)

mmHg

NIBP

(M)

( 85)

mmHg

TEMP

MCO

mmHg

SpO

121

S D

122

100.4

T1 T2 ΔT

Br/m

98.6

1.8

12. Press buttons as desired to adjust the display:

Directions for Use Monitoring 25

121

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.

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

MON

ECG/RESP

HR/PR TONE

PACER DISPLAY

ECG BANDWIDTH

RESP LEAD

RESP MONITORING : ON

: OFF

: ON

: MONITOR (0.5-40Hz)

: Ld2 (RA-LL)

CHANGE

(M)

( 96)

(M)

( 15)

NIBP

(M)

( 85)

TEMP

MCO

mmHg

SpO

mmHg

S D

mmHg

122

mmHg

T1 T2 ΔT

Br/m

100.4

98.6

1.8

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 SpO

is monitored, tone pitch varies with the SpO2

value.

PACER 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 27).

ECG BANDWIDTH Selects the bandwidth for displayed and printed data.

MONITOR is 0.5 Hz to 40 Hz (Adult mode) or 0.5 Hz to 120 Hz (Pediatric and Neonatal mode).

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

EXTENDED is 0.05 Hz to 40 Hz (Adult mode) or 0.05 Hz to 120 Hz (Pediatric and Neonatal mode).

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

26 Monitoring Welch Allyn Propaq CS Vital Signs Monitor

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. P r e s s 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.

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