Welch Allyn Medical Diagnostic Equipment 406, 408 User Manual

Micropaq

Monitor

Directions for use

Model 406 and Model 408 Software version 1.7X

ii Welch Allyn Micropaq Monitor

Welch Allyn assumes no responsibility for injury 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 indications for use published in this manual.

Welch Allyn, Acuity, Micropaq, and FlexNet

Nellcor

is a registered trademark of Nellcor Puritan Bennett.

are registered trademarks of Welch Allyn.

Masimo and SET are registered trademarks of Masimo Corporation.

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 within 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, please call Welch Allyn Technical Support:

USA + 1 315 685 4560

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

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

800 535 6663

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

Australia + 61 2 9638 3000

800 074 793

REF 103512 (CD)

Manual Part Number 80015977 Ver A, 2010-03

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

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

www.welchallyn.com

Contents

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

iii

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

General warnings and cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Introducing the monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Understanding the monitor and the FlexNet Network . . . . . . . . . . . . . . . . . . . . . 8

Monitor features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Operating settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Demonstration mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

2 - Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Connect a new patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Monitor a patient out of range of Acuity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Stop monitoring a patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Reconnect a recently monitored patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Reassign a monitored patient to a new room in the same unit . . . . . . . . . . . . . 32

Transfer a monitored patient to a new room in a different unit. . . . . . . . . . . . . . 33

Reassign the monitor to a new patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

3 - Alarms & alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

About alarms and alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Alarm holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Respond to a patient alarm at monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Customize patient alarm limits at the monitor . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Respond to an equipment alert at the monitor. . . . . . . . . . . . . . . . . . . . . . . . . . 38

Alert messages and display information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

4 - Monitor patient at Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

5 - Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Change the battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Recharge a battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Inspect the monitor, batteries, battery charger, and accessories . . . . . . . . . . . . 45

Clean the monitor, batteries, and battery charger. . . . . . . . . . . . . . . . . . . . . . . . 45

Clean the accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Recycling monitor components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Change the network name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

iv Contents Welch Allyn Micropaq Monitor

6 - Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Operating settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

7 - Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

General information

Intended use

The Micropaq® monitor is intended to be used by clinicians for single or multiparameter vital signs monitoring of ambulatory and nonambulatory pediatric and adult patients in health care facilities. The monitor is able to withstand light rain exposure over short periods of time (uniform distribution of approximately 1 mm of water per minute for 10 minutes or less).

The Micropaq monitor is intended to operate with an Acuity through wireless communication over the Welch Allyn connects multiple devices to the Acuity Central Monitoring System through hardwired Ethernet networks and Wireless Local Area Networks (WLANs). If the Micropaq monitor is moved out of range or loses communication with the FlexNet network, it continues to monitor the patient, display patient data, and generate local patient alarms or alert messages.

• The ECG channel is intended primarily for five-lead ECG monitoring, although

• The Pulse Oximetry channel is intended for continuous noninvasive monitoring of

The most likely locations for patients monitored by this device are step-down units, telemetry departments, general medical/surgical floors, emergency departments, and inhospital transport.

three-lead ECG monitoring is supported.

functional oxygen saturation of arterial hemoglobin (SpO (measured by an SpO

sensor).

Central Monitoring System

FlexNet® network. FlexNet

) and pulse rate

This guide was written for clinicians. Although this guide may describe some monitoring techniques, Welch Allyn expects that the operator is a trained clinician who knows how to take and interpret a patient’s vital signs.

Federal USA law restricts sale of the device identified in this manual to, or on the order of, a licensed medical practitioner.

2 Chapter 1 General information Welch Allyn Micropaq Monitor

IPX1

Li++

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.

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

The following symbols appear on the monitor or accessories.

Symbol Definition Symbol Definition

Direct current Enclosure Protection Drip proof: Classification

IPX1 per EN60529: 1991

Alternating current (battery charger) Fuse

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

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

Signifies the device has met all essential requirements of European Medical Device Directive 93/42/EEC for a Class 1 product (battery charger)

Protective earth ground (battery charger) Separate batteries from other disposables for

recycling

Lithium Ion battery For indoor use only (battery charger)

Caution: Refer to Directions For Use and

Keep away from rain

accompanying documentation

See the accompanying manual Recycle the monitor and battery

separately from other waste. Refer to

www.welchallyn.com/weee for collection

point and additional information.

Alarm(s) off Patient connections are Type CF, isolated for

direct cardiac application, and protected against defibrillation

This way up Stacking limit (by number)

Humidity limit Altitude limit

Fragile IATA/ICAO Hazard Class 9 Package

(International Air Transport Association/

International Civil Aviation Organization)

Temperature limits Single use only

Directions for Use Chapter 1 General information 3

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

FCC ID: PGUWA11AO7

IC: 4168a-WA11A07

Symbol Definition Symbol Definition

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

The monitor is connected to Acuity The monitor is not connected to Acuity

(Flashing) The monitor is searching for a connection to Acuity

Not magnetic resonance safe.

Monitor Front Panel Keys

Select Key and Silence Patient Alarm/ Equipment Alert Key- Selects the choice highlighted on the menu. During patient alarms, silences the tone at the monitor and at Acuity (if connected) for 90 seconds. During equipment alerts, silences or acknowledges (dismisses) the alert. Snapshot Key - When connected to Acuity, pressing this key sends Acuity a snapshot print to the Acuity central station printer. A total of 21 seconds of patient numeric and waveform data (14 seconds of history, 7 seconds after the key is pressed) will be sent to the printer. See

”Snapshot key” on page 10 for more

information.

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

Scroll Up Key and Reset Alarm Tone KeyScrolls up menus on the display. During patient alarms, resets the tone at the monitor and at Acuity (if connected).

Scroll Down Key and Main Menu Key- Pressing this key scrolls down menus on the display, or causes the Main Menu to appear if no menu is displayed.

4 Chapter 1 General information Welch Allyn Micropaq Monitor

Battery charger labels and LEDs

Eight-bay battery charger

(008-0651-XX)

Green LED on continuously Battery is fully charged.

Green LED flashing

Green LED flashing very slowly Battery detected and waiting to be charged.

Yellow LED on continuously Something is wrong with the battery or the

General warnings and cautions

Familiarize yourself with all warnings and cautions before using the monitor.

WARNING When considering a treatment protocol that involves wireless communication of patient data, be sure to recognize some limitations inherent in wireless communications. When the monitor is not connected to the network:

• There are no patient alarms or alerts at the Acuity Central Station.

• Acuity does not perform arrhythmia and ST analysis on the patient data

and does not generate related alarms.

• Patient data is not saved.

WARNING Do not try to monitor neonatal patients with the monitor. The

monitor is intended for adult or pediatric patients. It is not intended for use with pediatric patients (or infants) weighing less than 22 lbs (10 kg).

Battery is charging.

charger. (See ”Battery Status and Possible

Response” on page 44.)

WARNING Always check the patient mode at Acuity when monitoring a new patient. The patient mode determines default alarm limits 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 Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient.

WARNING During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient.

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

WARNING Do not use the 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.

Directions for Use Chapter 1 General information 5

WARNING Magnetic Resonance (MR) Safety. This monitor is designated Not MR Safe, as defined in the ACR Guidance for Safe MR Practices, 2007. Do not place this monitor in Zones 3 or 4, in MR environments for which Zones have been established and marked in accordance with the Guidance. In MR environments for which Zones have not been designated, do not place this monitor into a magnetic field with field strength larger than the field strength that your facility permits to exist in areas that are accessible by personnel, patients, and guests without MR safety precautions. Failure to follow these precautions creates a risk that the magnetic field will damage the monitor, causing it to overheat and potentially burn patents and cause a fire. The damage to the monitor caused by exposure to magnetic fields may be immediate or latent. If the damage is latent, it can cause the monitor to overheat at some time subsequent to its exposure to the magnetic field.

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

WARNING Exposure to Radio Frequency (RF) radiation. To comply with Federal Communications Commission (FCC) RF exposure requirements, this device shall be used in accordance with the operating conditions and instructions provided in this manual, including the section ”Install the carrying pouch” on page 28.

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.” See ”ECG specifications” on page 53 for disclosure of the pacemaker pulse rejection capability of this instrument.

WARNING This wireless medical device was tested and, when used with a metal-free accessory between the monitor and the patient, complies with FCC RF Exposure (SAR) guidelines. The use of accessories containing metal may not ensure compliance with FCC RF exposure guidelines. Specific Absorption Rate (SAR) is a measurement of radio frequency energy. The FCC permits a maximum SAR value of 1.6 mW/g. The highest SAR value for this patient monitor, when worn by a patient in accordance with the directions for use, is

0.560 mW/g.

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 is operated near a military radar, the radar could cause damage to the device.

WARNING Changes or modifications not expressly approved by Welch Allyn could void the purchaser’s authority to operate the equipment. This product does not contain any user serviceable components. Any unauthorized product changes or modifications will invalidate Welch Allyn’s warranty and all applicable regulatory certifications and approvals.

WARNING Motion artifact can affect the accuracy of patient vital sign measurements. Minimize patient motion whenever possible.

6 Chapter 1 General information Welch Allyn Micropaq Monitor

WARNING For patients with a pacemaker, position the monitor to maintain a minimum 6-inch distance between the monitor and pacemaker. Immediately turn the monitor off and provide appropriate patient care if you have any reason to suspect that the monitor is interfering with the pacemaker. The Health Industry Manufacturers Association recommends this minimum 6-inch distance between a hand-held wireless radio and a pacemaker, which is consistent with the independent research by, and recommendations of, Wireless Technology Research.

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

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 Use of ECG and SpO

cables not specified by Welch Allyn may

negate defibrillator protection and risk patient injury.

WARNING Use of Masimo LNOP

sensors/cables will not provide protection

in accordance with IEC defibrillation standards when used with this device.

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 Use only accessories supplied by Welch Allyn or recommended in the Welch Allyn Products and Accessories booklet (810-0409-XX). The monitor will only meet the listed specifications when using accessories listed by Welch Allyn. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use.

WARNING As with all medical equipment, carefully route the patient cabling to reduce the possibility of patient entanglement or strangulation. Use the supplied garment clips to secure the cable properly.

WARNING When positioning the monitor pouch on the patient, make sure the straps do not entangle the patient’s neck or cause choking. Make sure the straps do not restrict the movement of the patient’s limbs or create a hazard when walking or moving.

WARNING If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation.

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

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

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 monitor should be serviced only by a Welch Allyn service technician while under warranty. Contact Welch Allyn for information about post-warranty period service.

Directions for Use Chapter 1 General information 7

Introducing the monitor

The monitor is a patient-worn vital signs monitor for use by adult or pediatric ambulatory patients.

• One or two ECG channels displayed

• Up to 2 ECG leads displayed at the monitor: I, II, III, V, aV

• Up to 7 ECG leads displayed at Acuity: I, II, III, V, aV

• One ECG lead displayed at the monitor and at Acuity: Fixed lead II with 3-lead cable, or 5-lead cable with only RA, LA and LL electrodes attached.

• Pulse oximetry (SpO 408 only)

• Two-way wireless communication within Welch Allyn’s FlexNet network

• LCD for display of ECG waveforms, SpO and heart rate/pulse rate data, and messages from Acuity

• Standalone operation with patient alarms when out of range of the network

• Patient alarm limits that can be set at the monitor or at Acuity

• Configurable formats for single- or dual-waveform ECG display

• Internal antenna

• Snapshot key

• Lightweight (less than two pounds with battery)

• Rugged and tolerant of brief water exposure

• Rechargeable battery

• Sleep mode to extend battery life

• Your model may be shipped with an attached identification number on the front of the monitor.

, aVL, or aVF with 5-lead cable

) monitoring (Model

Model 406

Model 408

ECG monitoring

ECG monitoring and either one of two pulse oximetry (SpO2) monitoring options:

•SpO

with Masimo® SET® technology, indicated by:

with NELLCOR® OxiMax® technology, indicated by:

8 Chapter 1 General information Welch Allyn Micropaq Monitor

SpO2

FlexNet Network

Micropaq monitors

Access Points

To Other Access Points

To Other Acuity

Central Stations

Acuity Central Station

SpO2

Understanding the monitor and the FlexNet Network

The monitor is intended to operate with an Acuity® Central Station as part of Welch Allyn’s FlexNet network. FlexNet allows multiple devices to communicate through hardwired Ethernet networks and Wireless Local Area Networks (WLANs). The Acuity Central Station provides the primary display and entry of patient data for a patient connected to the monitor.

SpO2

Each patient-worn monitor supports two-way communication with an Acuity Central Station through an access point in the FlexNet network. The access point is a digital radio transceiver that connects to the FlexNet network. During monitoring, the monitor sends the patient data to Acuity. Acuity and the monitor continuously analyze the data. Acuity provides appropriate alarm or alert messages at the Central Station and other network devices such as a hallway message panel and the monitor itself. Acuity also stores the patient data for viewing or report printing.

If the monitor is moved out of range or loses communication with the FlexNet network and Acuity, it continues to monitor the patient and display patient data. While not communicating with Acuity, the monitor continues to generate local patient alarms or alert messages. Patient data is not stored and Acuity does not perform waveform analysis or generate arrhythmia messages while the monitor is not communicating with Acuity.

When the monitor is returned to within range of the FlexNet network, it automatically reconnects to Acuity.

Directions for Use Chapter 1 General information 9

SpO2 Connector ECG Connector

Visual Alarm Indicator

Liquid Crystal Display

Snapshot key

Scroll Up Key and Reset Patient Alarm Tone Key

Scroll Down Key and Main Menu Key

Select Key and Silence Patient Alarm/ Equipment Alert Key

Back

Battery pack latch

Battery

SpO

connector clip

(model 408) or

cover (model

406)

Monitor features

Controls and connectors

10 Chapter 1 General information Welch Allyn Micropaq Monitor

Note

Visual alarm indicator

Green Flashes slowly during normal operation.

Red Flashes during patient alarm, remains on continuously when alarms are

silenced or suspended.

Yellow Flashes during an equipment alert or while not connected to the network.

Remains on continuously if the operator suspends an alert at Acuity for 90 seconds or acknowledges (dismisses) a low battery alert from the monitor or Acuity.

The flashing green LED indicates that the monitor is connected to the network but not necessarily connected to a patient. If the monitor is actively monitoring a patient, the green LED indicates no alarms or alerts are detected.

Audible alarm indicator

Beeps to indicate a patient alarm, and beeps faster for life-threatening arrhythmia alarms (see ”Patient alarm and equipment alert specifications” on page 58).

Snapshot key

Beeps to indicate when the equipment needs attention. This beep tone is slower than patient alarm tones (see ”Patient alarm and equipment alert specifications” on page 58).

Volume can be configured as high, low, or off (configured at Acuity).

Volume can be configured differently for network connection or stand-alone operation (configured at Acuity).

When connected to Acuity, pressing this key sends a snapshot of the patient’s numeric and waveform data to the Acuity Central Monitoring System. Depending on how Acuity is configured, this will cause Acuity to print a 21-second snapshot (14 seconds of history, 7 seconds of data after the button is pressed) to the Acuity central station printer.

Snapshot is the default selection of the monitor. However, the connected monitor will inherit the configuration previously defined by Acuity. For example, if Acuity has defined the Snapshot key to respond with a Nurse Call function and a new monitor is introduced to the system, the Snapshot key definition will remain as Nurse Call.

For more information about using the Acuity Central Monitoring System, refer to

Acuity Directions For Use.

Scroll Up key and Reset Patient Alarm Tone key

Scrolls up menus on the display.

Resets a silenced patient alarm tone.

Directions for Use Chapter 1 General information 11

Note

Scroll Down key and Main Menu key

Scrolls down menus on the display.

Displays the Main Menu.

Select key and Silence Patient Alarm/Equipment Alert key

Selects the choice highlighted on the menu.

During patient alarms, silences the tone at the monitor and Acuity (if connected) for 90 seconds. During equipment alerts, silences or acknowledges (dismisses) the alert at the monitor and Acuity.

Battery

Insert the battery to turn on power. Remove the battery to turn off power. (While the battery is removed, the monitor does not perform patient monitoring.)

If you do not use END TELE to disconnect from the network as described above, the Acuity Central Station generates a DROPOUT equipment alert at Acuity.

If you want to monitor this same patient at a later time, you will need to reselect the patient name from the monitor or confirm the patient ID at Acuity.

Recharge the battery while it is removed from the monitor. (See ”Recharge a battery” on page 43.)

To order a new battery, see ”Battery Status and Possible Response” on page 44.

12 Chapter 1 General information Welch Allyn Micropaq Monitor

Patient name as entered at Acuity. If the patient name has not been entered, the monitor displays the last four digits of the monitor serial number, such as:

ID:6472

SpO2 numeric data is a percentage value.

HR indicates the heart

rate is from ECG.

PR (pulse rate) is

displayed if SpO

is active

and ECG is not (pulse rate

is derived from SpO2).

If the monitor detects

a vital sign outside

the measurable range,

it displays:

- - - (below the range)

+ + + (above the range).

ECG lead is selectable

Low battery icon flashes to indicate monitor will shut off in 30 minutes or less.

Indicates the monitor

is connected to

Acuity.

Waveform scale is

selectable

Indicates one or more patient alarms are disabled (off).

ECG waveform is displayed when active.

Dashed lines indicate the monitor detects a pacemaker signal (display of pacer detection can be enabled or disabled at Acuity)

This symbol indicates the monitor is not communicating with Acuity: Flashing indicates the monitor is associated with an access point, but not communicating with Acuity. Continuous on indicates the monitor is not communicating with an access point or Acuity.

Symbol is displayed at the monitor whenever the Snapshot key is pressed.

SpO2 pulse amplitude indicator (not proportional to pulse volume)

Display

Although the Acuity Central Station is the primary location for viewing patient data, the monitor provides information to support patient care.

Display sleep mode

In order to extend battery life, the display becomes blank after two minutes if no keys are pressed. The display becomes active again if an alarm or alert occurs, a key is pressed, the initial Acuity connection occurs, a cable is inserted, or an electrode is attached.

The display will not become blank if a patient alarm is occurring, an Acuity message is displayed, or the monitor is in Demo mode or Service mode.

Directions for Use Chapter 1 General information 13

Press to select or change the highlighted choice.

Press to move through the menu.

Main Menu

When you first press , the Main Menu appears:

EXIT Exit the Main Menu (the menu disappears).

ACUITY... Access the Acuity Menu with network options. The Acuity Menu

is only accessible while connected to Acuity.

EXIT Exit all menus and return to the monitoring

screen.

END TELE Discontinue monitoring a patient.

NEW ROOM Reassign a patient to a new room in the same

unit.

TRANSFER Transfer a patient to a new room in a new unit.

NEW PATIENT Assign the monitor to a new patient.

PATIENT INFO Display patient information such as ID, name,

unit and room.

Whenever the monitor is connected to Acuity and you select ACUITY... from the Main Menu, the monitor displays the message ACUITY CONTACTED to confirm that Acuity has been contacted. The monitor continues to display this message until Acuity responds, or you press to acknowledge the message and clear the screen. If the monitor detects an alarm or alert, it clears the screen to display the appropriate alarm or alert message. The length of time required for Acuity to respond to your selection at the monitor can vary widely depending on the amount of network traffic and other conditions.

ECG LEAD... Access a menu to change the ECG 1 or ECG 2 lead selection (I, II,

III, aV

, aVL, aVF, or V). Available vectors depend on the connected

electrodes.

14 Chapter 1 General information Welch Allyn Micropaq Monitor

Note

ECG SCALE... Change the scale of the ECG waveform. If two waveforms are

displayed, both have the same scale.

1 WAVEFORM There are four possible ECG waveform display selections:

1 WAVEFORM the default selection

2 WAVEFORMS

5 SECONDS

FULL SCREEN

Pressing changes to the next selection. This change does not take effect until after you exit the Main Menu. See ”Display” on page 12 for descriptions.

LIMITS... Enter the Alarm Limits Menu (”Customize patient alarm limits at

the monitor” on page 37) and change alarm limits.

SYSTEM INFORMATION

Display information about the network connection and SpO module.

SERVICE MENU Enter Service Mode for a demonstration mode (Demo, see

”Demonstration mode” on page 17) or service functions for

technicians. Service Mode is not available if any cables are plugged in.

To restrict access to the Main Menu, a Menu Lock option can be configured for the monitor at the Acuity Central Station. When the Menu Lock is enabled, the operator must press and hold down and for two seconds to gain access to the Main Menu. The Menu Lock is disabled if the monitor loses communication with Acuity.

Directions for Use Chapter 1 General information 15

1 Waveform

The single ECG 1 (lead II)

waveform is displayed.

Full Screen

The single ECG 1 (lead II) waveform is allowed to occupy most of the screen.

2 Waveforms

ECG 1 (lead II) and ECG 2

(lead V) are both displayed.

5 Seconds

ECG 1 (lead II) cascades from

one line to the other.

Waveform options

There are four ECG waveform options as shown:

To change the waveform selection during operation:

1. Press to display the Main Menu.

2. Press as needed to highlight the current waveform selection. Then press as needed to select the desired display.

16 Chapter 1 General information Welch Allyn Micropaq Monitor

Messages from Acuity

The monitor displays messages sent from Acuity as needed, including patient alarms and equipment alerts. When Acuity messages are displayed, they temporarily override information displayed on the lower half of the monitor screen.

Accessories

Battery charger (8-battery) Micropaq Directions For Use

Battery ECG electrodes

3-lead ECG cable (optional) 5-lead ECG cable

ECG extension cable (optional) Carrying pouch

sensors (Masimo or Nellcor) SpO2 cable (Masimo or Nellcor)

SpO

Operating settings

The following monitor operating settings can be set at the monitor or at the Acuity Central Station:

• Patient alarm limit settings (ECG and SpO

• ECG lead and scale selection

• ECG display format

Many other monitor operating settings (such as patient mode and alarms volume) can only be set at the Acuity Central Station. See ”Operating settings” on page 51 for a list of all settings and where they are set.

Default settings

When the monitor connects to Acuity for a new patient, the Acuity Central Station downloads the appropriate default settings stored at Acuity. While the monitor is connected to Acuity, settings can be changed either at the monitor or at the Acuity Central Station.

If the monitor is temporarily disconnected from Acuity and the operator changes settings at the monitor, those settings are transmitted to and stored at Acuity when the monitor reconnects.

Directions for Use Chapter 1 General information 17

Power-Up Screen

Main Menu

Demonstration mode

You can practice using the monitor with the Demo mode of operation, including connection to Acuity.

The Demo mode cannot be activated while you are monitoring a patient or if any cables have been plugged into the monitor. During the Demo mode, the monitor and Acuity display the message SIMULATION.

To practice with the monitor in Demo mode:

1. Disconnect all patient cables connected to the monitor.

2. Remove the battery (if installed).

3. Insert the battery and watch for the Power-Up screen.

4. After the Power-Up screen disappears, press to display the Main Menu.

18 Chapter 1 General information Welch Allyn Micropaq Monitor

Service Menu

A simulated waveform and numerics are displayed.

Demonstration Mode

SIMULATION indicates the Demo mode is active.

5. Press to highlight SERVICE MENU, then press to display the Service Menu.

6. Press to highlight DEMO MENU, then press to display the Demo Menu.

7. Press to highlight DEMO 1 or DEMO 2, then press to start.

Demo Mode Display Values and Alarm Limits

Display Demo 1 Demo 2

ECG Waveform Normal sinus rhythm,

normal ST

ECG Heart Rate SpO2 Pulse Rate

Saturation% 97 88 Lower 90

SpO

a. Demo 2 will cause patient alarms.

80 125 Lower 50

Normal sinus rhythm, normal ST

Alarm Limits (On)

(not applicable)

Upper 120

Upper 100

8. While in Demo mode you can practice changing settings such as ECG lead selection and alarm limit adjustment. (These changes only affect the Demo mode and are erased when you exit the Demo mode.)

9. To change to the other Demo selection, press to display the menu, then scroll down to highlight TOGGLE DEMO MODE and press .

10. To exit the Demo mode, either insert a patient cable or remove and insert the battery. The monitor restarts and enters the normal monitoring mode.

If any patient cables are connected, there will be some patient data displayed. The format depends on the monitor default settings.

Example of Initial Monitor Screen

The monitor is

searching for a

network

connection.

Possible Acuity Unit

selections.

Press to view more.

Example of Acuity Unit Selection

Monitoring

Connect a new patient

Connect to the network

1. Insert a battery into the monitor to turn it on. After a few seconds the monitor PowerUp Screen is replaced by an initial monitoring screen.

2. After the network connection is established, the monitor may prompt you to select an Acuity Unit (if your facility has more than one Acuity unit):

20 Chapter 2 Monitoring Welch Allyn Micropaq Monitor

Note

Network Connection

Symbol

Possible

patients to

select.

Example of Patient List

SELECT

PATIENT

428-02-2392, Hopkins, Bill J 520-29-0319, Phillips, Mary L 532-94-8372, Smith, Frank R

▼

Select Patient at Central

3. Press or to highlight the desired Acuity unit, then press .

When you press or to highlight the desired Acuity unit and then press , your selection will begin to flash between normal and reverse video to confirm that the monitor is communicating your selection to Acuity. You cannot scroll to another selection during this time. The selection continues to flash until Acuity responds back to the monitor. Then the monitor displays the next appropriate screen (such as a list of possible patients). The length of time required for Acuity to respond to your selection at the monitor can vary widely depending on the amount of network traffic and other conditions.

Be sure to select an Acuity unit. Even though the monitor is connected to the network (as indicated by the green LED and network connection symbol), the Acuity Central Station may not display any indication of this monitor until after you have selected an Acuity unit.

4. The monitor displays a list of possible patients.

If your patient has been pre-admitted to the selected Acuity unit, they will be included in the list.

5. Scroll through the patient list to look for your patient’s name.

• If your patient is not in the list, highlight Select Patient at Central and press .

The patient name will need to be entered later at the Acuity Central Station.

WARNING If you do not select the patient name at the monitor at this time, do not adjust any alarm limits until after the patient name and ID are confirmed at Acuity. When the patient name and ID are confirmed at Acuity, Acuity downloads the default settings and patient alarm limits for that Acuity unit to the monitor, thereby overriding any previous settings and alarm limits.

At power-up, the monitor retains the most recent patient mode. The patient mode can only be changed at Acuity. If the patient is being monitored when the patient mode is changed, there is a brief interruption in the display and recording of ECG and SpO

patient data.

Directions for Use Chapter 2 Monitoring 21

Possible

rooms to

select.

Example of Room List

SELECT

ROOM

1104A 1104B 1105A

Select Room at Central

▼

• If your patient is in the list, highlight the name and press . Within a few

seconds the monitor displays a list of unassigned rooms.

• If you want to assign the patient to a room, highlight the room and press .

• If you do not want to assign a room at this time, highlight Select Room at

Central and press . The patient room will need to be entered later at the monitor (see “Reassign a monitored patient to a new room in the same unit” on page 32) or at Acuity (see “Monitor patient at Acuity” on page 41).

6. If you need to customize alarm limits for your patient, see “Customize patient alarm

limits at the monitor” on page 37.

Perform ECG monitoring

WARNING Motion artifact can cause incorrect 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 readings.

WARNING The monitor does not provide internal arrhythmia analysis. Therefore, arrhythmias may cause the monitor to display inaccurate heart rates.

WARNING The monitor will show + + + 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.

WARNING Do not use the 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 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.” See “ECG specifications” on page 53 for disclosure of the pacemaker pulse rejection capability of this instrument.

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