ePM-Compact Operators Manual PDF

ePM 10/ePM 10A/ePM 10C ePM 12/ePM 12A/ePM 12C ePM 15/ePM 15A/ePM 15C Patient Monitor Operator’s Manual © Copyright 2018-2020 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved. Release time: 2020-07 Revision: 7.0...

ePM 10/ePM 10A/ePM 10C ePM 12/ePM 12A/ePM 12C ePM 15/ePM 15A/ePM 15C Patient Monitor Operator’s Manual © Copyright 2018-2020 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All rights reserved. Release time: 2020-07 Revision: 7.0 I Intellectual Property Statement SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray) owns the intellectual property rights to this Mindray product and this manual. This manual may refer to information protected by copyrights or patents and does not convey any license under the patent rights of Mindray, nor the rights of others. Mindray intends to maintain the contents of this manual as confidential information. Disclosure of the information in this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden. Release, amendment, reproduction, distribution, rental, adaption and translation of this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden. is the registered trademarks or trademarks owned by Mindray in China and other countries. All other trademarks that appear in this manual are used only for editorial purposes without the intention of improperly using them. They are the property of their respective owners. Responsibility on the Manufacturer Party Contents of this manual are subject to changes without prior notice. All information contained in this manual is believed to be correct. Mindray shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing, performance, or use of this manual. Mindray is responsible for the effects on safety, reliability and performance of this product, only if: all installation operations, expansions, changes, modifications and repairs of this product are conducted by Mindray authorized personnel; the electrical installation of the relevant room complies with the applicable national and local requirements; the product is used in accordance with the instructions for use. WARNING This equipment must be operated by skilled/trained clinical professionals. It is important for the hospital or organization that employs this equipment to carry out a reasonable service/maintenance plan. Neglect of this may result in machine breakdown or personal injury. II Warranty THIS WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE. Exemptions Mindray's obligation or liability under this warranty does not include any transportation or other charges or liability for direct, indirect or consequential damages or delay resulting from the improper use or application of the product or the use of parts or accessories not approved by Mindray or repairs by people other than Mindray authorized personnel. This warranty shall not extend to Malfunction or damage caused by improper use or man-made failure. Malfunction or damage caused by unstable or out-of-range power input. Malfunction or damage caused by force majeure such as fire and earthquake. Malfunction or damage caused by improper operation or repair by unqualified or unauthorized service people. Malfunction of the instrument or part whose serial number is not legible enough. Others not caused by instrument or part itself. Company Contact Manufacturer: Shenzhen Mindray Bio-Medical Electronics Co., Ltd. Address Mindray Building, Keji 12th Road South, High-tech Industrial Park, Nanshan, Shenzhen 518057, P.R.China Website www.mindray.com E-mail Address: [email protected] Tel: +86 755 81888998 Fax: +86 755 26582680 EC-Representative: Shanghai International Holding Corp. GmbH (Europe) Address: Eiffestraβe 80, 20537 Hamburg, Germany Tel: 0049-40-2513175 Fax: 0049-40-255726 III Preface Manual Purpose This manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety. This manual is based on the maximum configuration and therefore some contents may not apply to your product. If you have any question, please contact us. This manual is an integral part of the product. It should always be kept close to the equipment so that it can be obtained conveniently when needed. Intended Audience This manual is geared for clinical professionals who are expected to have a working knowledge of medical procedures, practices and terminology as required for monitoring of critically ill patients. Illustrations All illustrations in this manual serve as examples only. They may not necessarily reflect the setup or data displayed on your patient monitor. Conventions Italic text is used in this manual to quote the referenced manuals, chapters, sections and formulas. Bold text is used to indicate the screen texts and names of hard keys. → is used to indicate operational procedures. IV Contents 1 Safety.................................................................................................................................................................................. 1 - 1 1.1 Safety Information..........................................................................................................................................................................................1 - 1 1.1.1 Warnings..............................................................................................................................................................................................1 - 1 1.1.2 Cautions................................................................................................................................................................................................1 - 2 1.1.3 Notes......................................................................................................................................................................................................1 - 2 1.2 Equipment Symbols.......................................................................................................................................................................................1 - 3 2 Equipment Introduction................................................................................................................................................... 2 - 1 2.1 Intended Use.....................................................................................................................................................................................................2 - 1 2.2 Applied Parts.....................................................................................................................................................................................................2 - 1 2.3 System Components......................................................................................................................................................................................2 - 2 2.3.1 Main Unit..............................................................................................................................................................................................2 - 2 2.3.2 Input Devices......................................................................................................................................................................................2 - 5 2.3.3 Printing Devices.................................................................................................................................................................................2 - 5 3 Getting Started.................................................................................................................................................................. 3 - 1 3.1 Equipment Preparation Safety Information..........................................................................................................................................3 - 1 3.2 Monitor Installation........................................................................................................................................................................................3 - 2 3.2.1 Unpacking and Checking...............................................................................................................................................................3 - 2 3.2.2 Environmental Requirements.......................................................................................................................................................3 - 2 3.3 Setting Up the Equipment...........................................................................................................................................................................3 - 2 3.3.1 Connecting the AC Mains...............................................................................................................................................................3 - 2 3.3.2 Connecting with the Docking Station (for ePM 10/ePM 10A/ePM 10C).......................................................................3 - 3 3.3.3 Connecting the Vehicle DC Power Source (for ePM 10/ePM 10A/ePM 10C)...............................................................3 - 3 3.3.4 Connecting the Input Devices......................................................................................................................................................3 - 4 3.4 Turning on the Monitor.................................................................................................................................................................................3 - 4 3.5 Operation and Navigation...........................................................................................................................................................................3 - 4 3.5.1 Using the Touchscreen....................................................................................................................................................................3 - 5 3.5.2 Using the On-Screen Keyboard....................................................................................................................................................3 - 5 3.5.3 Using the Barcode Reader..............................................................................................................................................................3 - 6 3.5.4 Using the Remote Controller........................................................................................................................................................3 - 6 3.6 Screen Display..................................................................................................................................................................................................3 - 6 3.6.1 On-screen Symbols...........................................................................................................................................................................3 - 7 3.6.2 Menus....................................................................................................................................................................................................3 - 8 3.6.3 Quick Keys............................................................................................................................................................................................3 - 8 3.7 Operating Modes.......................................................................................................................................................................................... 3 - 10 3.7.1 Monitoring Mode........................................................................................................................................................................... 3 - 10 3.7.2 Privacy Mode.................................................................................................................................................................................... 3 - 11 3.7.3 Night Mode....................................................................................................................................................................................... 3 - 11 3.7.4 Standby Mode................................................................................................................................................................................. 3 - 12 3.8 Configuring Your Monitor......................................................................................................................................................................... 3 - 13 3.8.1 Setting the Date and Time.......................................................................................................................................................... 3 - 13 3.8.2 Adjusting the Screen Brightness.............................................................................................................................................. 3 - 13 3.8.3 Adjusting the Volume................................................................................................................................................................... 3 - 13 3.9 Starting Monitoring a Patient.................................................................................................................................................................. 3 - 13 1  3.10 Stopping a Parameter Measurement................................................................................................................................................. 3 - 13 3.11 General Operation..................................................................................................................................................................................... 3 - 14 3.11.1 Switching On or Off a Parameter........................................................................................................................................... 3 - 14 3.11.2 Displaying Parameter Numerics and Waveforms............................................................................................................ 3 - 14 3.11.3 Displaying the Parameter List................................................................................................................................................. 3 - 14 3.11.4 Accessing Parameter Setup Menus...................................................................................................................................... 3 - 14 3.11.5 Changing Measurement Colors............................................................................................................................................. 3 - 15 3.12 Freezing Waveforms................................................................................................................................................................................. 3 - 15 3.12.1 Freezing Waveforms................................................................................................................................................................... 3 - 15 3.12.2 Viewing Frozen Waveforms.................................................................................................................................................... 3 - 15 3.12.3 Unfreezing Waveforms.............................................................................................................................................................. 3 - 15 3.12.4 Printing Frozen Waveforms..................................................................................................................................................... 3 - 15 3.13 Capturing the Screen............................................................................................................................................................................... 3 - 15 3.14 Checking Software Licenses.................................................................................................................................................................. 3 - 16 3.15 Turning Off the Monitor.......................................................................................................................................................................... 3 - 16 4 User Screens.......................................................................................................................................................................4 - 1 4.1 Choosing a Screen..........................................................................................................................................................................................4 - 1 4.2 Normal Screen..................................................................................................................................................................................................4 - 1 4.2.1 Entering the Normal Screen..........................................................................................................................................................4 - 1 4.2.2 Configuring the Normal Screen...................................................................................................................................................4 - 1 4.3 The Big Numerics Screen..............................................................................................................................................................................4 - 2 4.3.1 Entering the Big Numerics Screen..............................................................................................................................................4 - 2 4.3.2 Configuring the Big Numerics Screen.......................................................................................................................................4 - 2 4.4 Minitrends Screen...........................................................................................................................................................................................4 - 2 4.4.1 Entering the Minitrends Screen...................................................................................................................................................4 - 2 4.4.2 The Display of Minitrends Screen...............................................................................................................................................4 - 3 4.4.3 Viewing the Long Trends...............................................................................................................................................................4 - 3 4.4.4 Setting Minitrends Parameters....................................................................................................................................................4 - 3 4.4.5 Setting the Minitrend Length.......................................................................................................................................................4 - 4 4.4.6 Setting the Alarm Statistics Switch.............................................................................................................................................4 - 4 4.4.7 Setting the Alarm Statistics Duration........................................................................................................................................4 - 4 4.4.8 Routine Vital/Baseline.....................................................................................................................................................................4 - 4 4.5 The OxyCRG Screen........................................................................................................................................................................................4 - 4 4.5.1 Entering the OxyCRG Screen........................................................................................................................................................4 - 5 4.5.2 OxyCRG Events...................................................................................................................................................................................4 - 5 4.5.3 The Display of the ABD Event Area.............................................................................................................................................4 - 5 4.5.4 Setting OxyCRG Parameters..........................................................................................................................................................4 - 5 4.5.5 Setting the Threshold of ABD Events.........................................................................................................................................4 - 5 4.5.6 Editing ABD Events...........................................................................................................................................................................4 - 6 4.6 The Targeted Goal Screen............................................................................................................................................................................4 - 6 4.6.1 Entering the Targeted Goal Screen............................................................................................................................................4 - 6 4.6.2 The Display of the Targeted Goal Screen.................................................................................................................................4 - 6 4.6.3 Configuring the Targeted Goal Screen Layout......................................................................................................................4 - 7 4.6.4 Operating the Targeted Goal Screen.........................................................................................................................................4 - 7 5 Managing Patients............................................................................................................................................................5 - 1 5.1 Discharging a Patient....................................................................................................................................................................................5 - 1 2  5.1.1 Manually Discharging a Patient..................................................................................................................................................5 - 1 5.2 Admitting a Patient........................................................................................................................................................................................5 - 1 5.3 Managing Patient Information...................................................................................................................................................................5 - 2 5.3.1 Entering the Patient Management Menu.................................................................................................................................5 - 2 5.3.2 Editing Patient Information...........................................................................................................................................................5 - 2 5.3.3 Loading Patient Information from the CMS............................................................................................................................5 - 2 5.3.4 Loading Patient Information from the ADT Server...............................................................................................................5 - 3 5.4 Exporting Patient Data..................................................................................................................................................................................5 - 3 5.5 Deleting Patient Data.....................................................................................................................................................................................5 - 3 6 Managing Configurations................................................................................................................................................. 6 - 1 6.1 Configuration Introduction.........................................................................................................................................................................6 - 1 6.2 Setting Default Patient Category...............................................................................................................................................................6 - 1 6.3 Setting Default Configuration....................................................................................................................................................................6 - 1 6.4 Saving Current Settings................................................................................................................................................................................6 - 1 6.5 Deleting a Configuration..............................................................................................................................................................................6 - 2 6.6 Transferring a Configuration.......................................................................................................................................................................6 - 2 6.6.1 Exporting a Configuration..............................................................................................................................................................6 - 2 6.6.2 Importing a Configuration.............................................................................................................................................................6 - 2 6.7 Printing Configurations.................................................................................................................................................................................6 - 2 6.8 Loading a Configuration...............................................................................................................................................................................6 - 3 6.9 Modifying Configuration Password..........................................................................................................................................................6 - 3 7 Networked Monitoring..................................................................................................................................................... 7 - 1 7.1 Network Introduction....................................................................................................................................................................................7 - 1 7.2 Network Safety Information........................................................................................................................................................................7 - 1 7.3 Connecting the Monitor to the CMS........................................................................................................................................................7 - 1 7.4 Connecting the eGateway...........................................................................................................................................................................7 - 2 7.5 Viewing Other Patients..................................................................................................................................................................................7 - 2 7.5.1 Remote View.......................................................................................................................................................................................7 - 2 7.5.2 Alarm Watch........................................................................................................................................................................................7 - 4 7.5.3 Auto Displaying the New Alarm Bed..........................................................................................................................................7 - 5 7.6 MLDAP.................................................................................................................................................................................................................7 - 6 7.7 Connecting the Wireless Network.............................................................................................................................................................7 - 6 7.8 Disconnecting the Wireless Network.......................................................................................................................................................7 - 6 8 Interfacing with External Devices.................................................................................................................................... 8 - 1 8.1 Introduction to Interfacing with External Devices..............................................................................................................................8 - 1 8.2 Interfacing Safety Information....................................................................................................................................................................8 - 1 8.3 Differences in Displayed Values.................................................................................................................................................................8 - 1 8.4 Connecting an External Device..................................................................................................................................................................8 - 2 8.5 Accessing the Integrated Devices Screen..............................................................................................................................................8 - 2 8.6 Displaying Parameters from External Devices.....................................................................................................................................8 - 3 8.6.1 Setting Waveform Properties for Parameters from External Devices............................................................................8 - 3 8.6.2 Setting Alarms from External Devices.......................................................................................................................................8 - 3 8.6.3 Setting Parameters from External Devices for Display........................................................................................................8 - 3 3  8.6.4 Setting Units for Parameters from External Devices............................................................................................................8 - 4 8.6.5 Accessing the Loops Screen..........................................................................................................................................................8 - 4 8.7 Viewing Alarms from External Devices...................................................................................................................................................8 - 4 8.8 Viewing Parameter Trends from External Devices..............................................................................................................................8 - 4 8.9 Recording and Printing Parameter Trends from External Devices................................................................................................8 - 4 9 Alarms.................................................................................................................................................................................9 - 1 9.1 Alarm Introduction.........................................................................................................................................................................................9 - 1 9.2 Alarm Safety Information.............................................................................................................................................................................9 - 1 9.3 Understanding the Alarms..........................................................................................................................................................................9 - 1 9.3.1 Alarm Categories...............................................................................................................................................................................9 - 1 9.3.2 Alarm Priorities..................................................................................................................................................................................9 - 2 9.3.3 Alarm Indicators................................................................................................................................................................................9 - 2 9.3.4 Alarm Status Symbols......................................................................................................................................................................9 - 3 9.4 Accessing On-screen Help for Technical Alarms (AlarmSight).......................................................................................................9 - 3 9.5 Checking Physiological Alarm List............................................................................................................................................................9 - 3 9.6 Changing Alarm Settings.............................................................................................................................................................................9 - 3 9.6.1 Setting Parameter Alarm Properties..........................................................................................................................................9 - 3 9.6.2 Setting Alarm Tone Properties.....................................................................................................................................................9 - 4 9.6.3 Setting the Auto Limits for New Patient Switch....................................................................................................................9 - 4 9.6.4 Initiating Auto Alarm Limits..........................................................................................................................................................9 - 5 9.6.5 Setting the Alarm Delay Time.......................................................................................................................................................9 - 7 9.6.6 Restoring the Default Alarm Settings........................................................................................................................................9 - 7 9.6.7 Setting the Length of Printed Waveforms...............................................................................................................................9 - 7 9.6.8 Setting the Switch of the SpO2 Desat Alarm Off....................................................................................................................9 - 7 9.6.9 Setting the Switch of the Apnea Alarm Off............................................................................................................................9 - 8 9.7 Pausing Alarms/Pausing Alarm Tones.....................................................................................................................................................9 - 8 9.7.1 Defining the Pause Function........................................................................................................................................................9 - 8 9.7.2 Pausing Alarms..................................................................................................................................................................................9 - 8 9.7.3 Pausing Alarm Sound......................................................................................................................................................................9 - 9 9.8 Resetting Alarms.............................................................................................................................................................................................9 - 9 9.8.1 Resetting Physiological Alarms....................................................................................................................................................9 - 9 9.8.2 Resetting Technical Alarms........................................................................................................................................................ 9 - 10 9.9 Latching Alarms............................................................................................................................................................................................ 9 - 10 9.10 Nurse Call...................................................................................................................................................................................................... 9 - 10 9.11 Calling for Help........................................................................................................................................................................................... 9 - 10 9.12 Intubation Mode........................................................................................................................................................................................ 9 - 11 9.12.1 Entering the Intubation Mode................................................................................................................................................ 9 - 11 9.12.2 Exiting the Intubation Mode................................................................................................................................................... 9 - 11 9.13 Testing Alarms............................................................................................................................................................................................ 9 - 11 9.14 Actions When an Alarm Occurs............................................................................................................................................................ 9 - 11 10 Monitoring ECG, Arrhythmia, ST and QT.....................................................................................................................10 - 1 10.1 ECG Introduction....................................................................................................................................................................................... 10 - 1 10.2 ECG Safety Information........................................................................................................................................................................... 10 - 1 10.3 ECG Display.................................................................................................................................................................................................. 10 - 1 10.4 Preparing for ECG Monitoring.............................................................................................................................................................. 10 - 3 4  10.4.1 Preparing the Patient Skin........................................................................................................................................................ 10 - 3 10.4.2 Applying Electrodes.................................................................................................................................................................... 10 - 3 10.4.3 Lead Wire Color Code................................................................................................................................................................. 10 - 3 10.4.4 ECG Electrode Placements....................................................................................................................................................... 10 - 4 10.4.5 Choosing the ECG Lead Type.................................................................................................................................................. 10 - 6 10.4.6 Checking Paced Status............................................................................................................................................................... 10 - 6 10.4.7 Enabling Pacer Rejection.......................................................................................................................................................... 10 - 7 10.5 Using 6-lead Placement to Derive 12-lead ECG (D12L) (for ePM 12/ePM 12A/ePM 12C/ePM 15/ePM 15A/ePM 15C)... 10 - 7 10.6 Changing ECG Settings............................................................................................................................................................................ 10 - 8 10.6.1 Choosing an ECG Screen........................................................................................................................................................... 10 - 8 10.6.2 Setting ECG Alarm Properties.................................................................................................................................................. 10 - 8 10.6.3 Setting the Analysis Mode........................................................................................................................................................ 10 - 8 10.6.4 Changing ECG Wave Settings................................................................................................................................................. 10 - 8 10.6.5 Disabling the Smart Lead Off Function..............................................................................................................................10 - 10 10.6.6 Disabling the CrozFusionTM Function................................................................................................................................10 - 10 10.6.7 Adjusting the QRS Volume.....................................................................................................................................................10 - 11 10.6.8 Adjusting the Minimum QRS Detection Threshold.......................................................................................................10 - 11 10.7 Monitoring Arrhythmia..........................................................................................................................................................................10 - 11 10.7.1 Arrhythmia Safety Information.............................................................................................................................................10 - 11 10.7.2 Arrhythmia Events.....................................................................................................................................................................10 - 12 10.7.3 Displaying Arrhythmia Information....................................................................................................................................10 - 13 10.7.4 Changing Arrhythmia Settings.............................................................................................................................................10 - 13 10.7.5 Arrhythmia Alarms....................................................................................................................................................................10 - 15 10.8 ST Segment Monitoring.........................................................................................................................................................................10 - 17 10.8.1 ST Safety Information...............................................................................................................................................................10 - 17 10.8.2 Enabling ST Monitoring...........................................................................................................................................................10 - 17 10.8.3 Displaying ST Numerics...........................................................................................................................................................10 - 18 10.8.4 Displaying ST Segments in the Waveform Area.............................................................................................................10 - 18 10.8.5 Entering the ST View.................................................................................................................................................................10 - 19 10.8.6 Saving the Current ST as Baseline........................................................................................................................................10 - 19 10.8.7 Entering the ST Graphic Window.........................................................................................................................................10 - 20 10.8.8 Changing ST Settings...............................................................................................................................................................10 - 20 10.8.9 Adjusting ST Measurement Points......................................................................................................................................10 - 21 10.9 QT/QTc Interval Monitoring.................................................................................................................................................................10 - 22 10.9.1 QT/QTc Monitoring Limitations............................................................................................................................................10 - 22 10.9.2 Enabling QT/QTc Monitoring................................................................................................................................................10 - 23 10.9.3 Displaying QT/QTc Numerics and Segments...................................................................................................................10 - 23 10.9.4 Entering the QT View................................................................................................................................................................10 - 23 10.9.5 Saving the Current QTc as Baseline.....................................................................................................................................10 - 24 10.9.6 Changing QT Settings..............................................................................................................................................................10 - 24 10.10 ECG Relearning.......................................................................................................................................................................................10 - 25 10.10.1 Auto ECG Relearning..............................................................................................................................................................10 - 25 10.10.2 Initiating an ECG Relearning Manually............................................................................................................................10 - 25 10.11 Calibrating ECG......................................................................................................................................................................................10 - 25 10.12 Defibrillation Synchronization Pulse Output..............................................................................................................................10 - 25 10.13 ECG Troubleshooting...........................................................................................................................................................................10 - 26 11 Resting 12-Lead ECG Analysis (for ePM 12/ePM 12A/ePM 12C/ePM 15/ePM 15A/ePM 15C)..................................11 - 1 5  11.1 Resting 12-Lead ECG Analysis Introduction..................................................................................................................................... 11 - 1 11.2 Entering the 12-Lead Screen................................................................................................................................................................. 11 - 1 11.3 Initiating Resting 12-Lead ECG Analysis............................................................................................................................................ 11 - 1 11.4 Changing 12-Lead ECG Analysis Settings......................................................................................................................................... 11 - 1 11.4.1 Setting the High Frequency Filter......................................................................................................................................... 11 - 1 11.4.2 Setting the Baseline Drift Removal....................................................................................................................................... 11 - 2 11.5 Glasgow Resting 12-lead ECG Analysis Algorithm Settings....................................................................................................... 11 - 2 11.5.1 Editing Patient Information (for Glasgow Algorithms).................................................................................................. 11 - 2 11.5.2 Setting Tachycardia and Bradycardia Thresholds (for Glasgow Algorithms)........................................................ 11 - 2 11.5.3 Setting the 12-Lead Interpretation Report (for Glasgow Algorithms).................................................................... 11 - 3 11.6 Saving the 12-Lead Interpretation Report........................................................................................................................................ 11 - 3 11.7 Printing the 12-Lead Interpretation Report..................................................................................................................................... 11 - 3 11.8 Exiting the ECG 12-Lead Screen........................................................................................................................................................... 11 - 3 12 Monitoring Respiration (Resp).....................................................................................................................................12 - 1 12.1 Resp Introduction...................................................................................................................................................................................... 12 - 1 12.2 Resp Safety Information.......................................................................................................................................................................... 12 - 1 12.3 Resp Display................................................................................................................................................................................................ 12 - 1 12.4 Preparing for Resp Monitoring............................................................................................................................................................. 12 - 2 12.4.1 Preparing the Patient................................................................................................................................................................. 12 - 2 12.4.2 Placing the Electrodes............................................................................................................................................................... 12 - 2 12.5 Changing Resp Settings.......................................................................................................................................................................... 12 - 3 12.5.1 Setting the Resp Alarm Properties........................................................................................................................................ 12 - 3 12.5.2 Setting the RR Source................................................................................................................................................................ 12 - 3 12.5.3 Choosing the Respiration Lead.............................................................................................................................................. 12 - 3 12.5.4 Setting the Resp Waveform Size............................................................................................................................................ 12 - 4 12.5.5 Setting the Resp Waveform Speed....................................................................................................................................... 12 - 4 12.5.6 Setting the Auto Detection Switch....................................................................................................................................... 12 - 4 12.5.7 Adjusting the Resp Waveform Detection Threshold...................................................................................................... 12 - 4 12.6 Resp Troubleshooting.............................................................................................................................................................................. 12 - 4 13 Monitoring Pulse Oxygen Saturation (SpO2)..............................................................................................................13 - 1 13.1 SpO2 Introduction..................................................................................................................................................................................... 13 - 1 13.2 SpO2 Safety Information......................................................................................................................................................................... 13 - 1 13.3 SpO2 Measurement Limitations........................................................................................................................................................... 13 - 2 13.4 SpO2 Display................................................................................................................................................................................................ 13 - 3 13.5 Preparing for SpO2 Monitoring............................................................................................................................................................ 13 - 4 13.6 Changing the SpO2 Settings.................................................................................................................................................................. 13 - 4 13.6.1 Changing the SpO2 Alarm Settings...................................................................................................................................... 13 - 4 13.6.2 Nellcor Sat-Seconds Alarm Management........................................................................................................................... 13 - 4 13.6.3 Setting the Nellcor SpO2 Sat-Seconds................................................................................................................................. 13 - 5 13.6.4 Setting SpO2 Sensitivity (for Masimo SpO2)...................................................................................................................... 13 - 5 13.6.5 Enabling FastSAT (for Masimo SpO2)................................................................................................................................... 13 - 6 13.6.6 Displaying SIQ (for Masimo SpO2)......................................................................................................................................... 13 - 6 13.6.7 Changing Averaging Time (for Masimo SpO2)................................................................................................................. 13 - 6 13.6.8 Changing Sensitivity (for Mindray SpO2)............................................................................................................................ 13 - 7 13.6.9 Showing/Hiding PI...................................................................................................................................................................... 13 - 7 6  13.6.10 Monitoring SpO2 and NIBP Simultaneously.................................................................................................................... 13 - 7 13.6.11 Changing the Sweep Speed of the Pleth Wave.............................................................................................................. 13 - 7 13.7 Changing the PR Settings....................................................................................................................................................................... 13 - 7 13.7.1 Changing the PR Alarm Settings............................................................................................................................................ 13 - 7 13.7.2 Changing the QRS Volume....................................................................................................................................................... 13 - 8 13.7.3 Setting the PR Source................................................................................................................................................................. 13 - 8 13.7.4 Showing/Hiding PR..................................................................................................................................................................... 13 - 8 13.8 Displaying SpO2 Statistics...................................................................................................................................................................... 13 - 8 13.8.1 Selecting the Range of each SpO2 Section and the Target Section.......................................................................... 13 - 9 13.8.2 Selecting the SpO2 Statistics Length.................................................................................................................................... 13 - 9 13.9 SpO2 Troubleshooting............................................................................................................................................................................. 13 - 9 13.10 Nellcor Information...............................................................................................................................................................................13 - 10 13.11 Masimo Information.............................................................................................................................................................................13 - 10 13.12 Masimo End-User License Agreement...........................................................................................................................................13 - 10 14 Monitoring Temperature (Temp)..................................................................................................................................14 - 1 14.1 Temperature Introduction...................................................................................................................................................................... 14 - 1 14.2 Displaying the Temp Numerics Area.................................................................................................................................................. 14 - 1 14.3 Temperature Display................................................................................................................................................................................ 14 - 1 14.4 Preparing for Temperature Monitoring............................................................................................................................................. 14 - 1 14.5 Changing Temperature Settings.......................................................................................................................................................... 14 - 2 14.5.1 Setting the Temperature Alarm Properties........................................................................................................................ 14 - 2 14.5.2 Selecting the Temperature Label........................................................................................................................................... 14 - 2 14.5.3 Displaying the Temperature Difference.............................................................................................................................. 14 - 2 14.6 Temperature Troubleshooting............................................................................................................................................................. 14 - 2 15 Monitoring Noninvasive Blood Pressure (NIBP).........................................................................................................15 - 1 15.1 NIBP Introduction...................................................................................................................................................................................... 15 - 1 15.2 NIBP Safety Information.......................................................................................................................................................................... 15 - 1 15.3 NIBP Measurement Limitations............................................................................................................................................................ 15 - 2 15.4 Measurement Modes................................................................................................................................................................................ 15 - 2 15.5 NIBP Display................................................................................................................................................................................................. 15 - 2 15.6 Preparing for NIBP Measurements...................................................................................................................................................... 15 - 3 15.6.1 Preparing the Patient for NIBP Measurements................................................................................................................. 15 - 3 15.6.2 Placing the NIBP Cuff.................................................................................................................................................................. 15 - 3 15.7 Starting and Stopping NIBP Measurements.................................................................................................................................... 15 - 4 15.8 Viewing NIBP Analysis.............................................................................................................................................................................. 15 - 4 15.9 Changing NIBP Settings........................................................................................................................................................................... 15 - 5 15.9.1 Setting the NIBP Alarm Properties......................................................................................................................................... 15 - 5 15.9.2 Setting the Initial Cuff Inflation Pressure............................................................................................................................ 15 - 5 15.9.3 Setting the NIBP Interval........................................................................................................................................................... 15 - 5 15.9.4 Selecting NIBP Start Mode........................................................................................................................................................ 15 - 5 15.9.5 Enabling the NIBP End Tone.................................................................................................................................................... 15 - 5 15.9.6 Setting NIBP Sequence.............................................................................................................................................................. 15 - 6 15.9.7 Setting the NIBP Display Format............................................................................................................................................ 15 - 6 15.9.8 Setting the NIBP Alarm Limits Display Switch................................................................................................................... 15 - 6 15.9.9 Showing/Hiding PR..................................................................................................................................................................... 15 - 6 7  15.9.10 Correcting the NIBP Measurements................................................................................................................................... 15 - 6 15.10 Assisting Venous Puncture.................................................................................................................................................................. 15 - 6 15.11 NIBP Maintenance................................................................................................................................................................................... 15 - 7 15.11.1 NIBP Leakage Test..................................................................................................................................................................... 15 - 7 15.11.2 NIBP Accuracy Test................................................................................................................................................................... 15 - 7 15.12 NIBP Troubleshooting........................................................................................................................................................................... 15 - 7 16 Monitoring Invasive Blood Pressure (IBP)...................................................................................................................16 - 1 16.1 IBP Introduction......................................................................................................................................................................................... 16 - 1 16.2 IBP Safety Information............................................................................................................................................................................. 16 - 1 16.3 Preparing for IBP Monitoring................................................................................................................................................................ 16 - 2 16.3.1 IBP Equipment to Patient Connection................................................................................................................................. 16 - 2 16.3.2 Measuring an Invasive Blood Pressure................................................................................................................................ 16 - 2 16.3.3 Zeroing the IBP transducer...................................................................................................................................................... 16 - 3 16.4 Measuring ICP Using the Codman ICP Transducer....................................................................................................................... 16 - 3 16.4.1 Zeroing the Codman ICP transducer.................................................................................................................................... 16 - 3 16.4.2 Measuring ICP............................................................................................................................................................................... 16 - 3 16.5 IBP Display.................................................................................................................................................................................................... 16 - 4 16.6 Changing IBP Settings............................................................................................................................................................................. 16 - 4 16.6.1 Changing the IBP Alarm Settings.......................................................................................................................................... 16 - 4 16.6.2 Changing the Pressure Label.................................................................................................................................................. 16 - 5 16.6.3 Setting the Pressure Type for Display.................................................................................................................................. 16 - 5 16.6.4 Changing the Sensitivity........................................................................................................................................................... 16 - 5 16.6.5 Setting the IBP Waveform........................................................................................................................................................ 16 - 6 16.6.6 Setting the Display Format of Artery Pressure.................................................................................................................. 16 - 6 16.6.7 Showing/Hiding the Alarm Limits of Artery Pressure.................................................................................................... 16 - 6 16.6.8 Setting the Use PA-D as PAWP Switch................................................................................................................................. 16 - 6 16.6.9 Enabling PPV Measurement.................................................................................................................................................... 16 - 6 16.6.10 Overlapping IBP Waveforms................................................................................................................................................. 16 - 7 16.7 Measuring PAWP....................................................................................................................................................................................... 16 - 7 16.7.1 PAWP Equipment to Patient Connection........................................................................................................................... 16 - 8 16.7.2 Preparing to Measure PAWP................................................................................................................................................... 16 - 8 16.7.3 Measuring PAWP......................................................................................................................................................................... 16 - 8 16.7.4 Setting the Waveforms of the PAWP Screen..................................................................................................................... 16 - 9 16.7.5 Performing Hemodynamic Calculation.............................................................................................................................16 - 10 16.8 IBP Troubleshooting...............................................................................................................................................................................16 - 10 17 Monitoring Cardiac Output (C.O.)................................................................................................................................17 - 1 17.1 C.O. Introduction....................................................................................................................................................................................... 17 - 1 17.2 C.O. Safety Information........................................................................................................................................................................... 17 - 1 17.3 C.O. Measurement Limitations............................................................................................................................................................. 17 - 1 17.4 C.O. Display.................................................................................................................................................................................................. 17 - 2 17.5 C.O. Equipment to Patient Connection............................................................................................................................................. 17 - 2 17.6 Performing C.O. Measurement............................................................................................................................................................. 17 - 3 17.6.1 Preparing for C.O. Measurement........................................................................................................................................... 17 - 3 17.6.2 Setting C.O. Measurement....................................................................................................................................................... 17 - 3 17.6.3 Performing C.O. Measurement............................................................................................................................................... 17 - 4 8  17.7 Changing C.O. Settings............................................................................................................................................................................ 17 - 5 17.7.1 Setting C.O. Alarm Properties.................................................................................................................................................. 17 - 5 17.7.2 Selecting the Primary C.O. Parameter.................................................................................................................................. 17 - 5 17.8 C.O. Troubleshooting............................................................................................................................................................................... 17 - 5 18 Monitoring Carbon Dioxide (CO2)................................................................................................................................18 - 1 18.1 CO2 Introduction........................................................................................................................................................................................ 18 - 1 18.2 CO2 Safety Information............................................................................................................................................................................ 18 - 1 18.3 CO2 Measurement Limitations.............................................................................................................................................................. 18 - 1 18.4 CO2 Display.................................................................................................................................................................................................. 18 - 2 18.5 Measuring CO2 Using Sidestream/Microstream CO2 Module................................................................................................... 18 - 2 18.5.1 Preparing to Measure CO2 Using Sidestream CO2 Module.......................................................................................... 18 - 2 18.5.2 Preparing to Measure CO2 Using Microstream CO2 Module....................................................................................... 18 - 4 18.5.3 Zeroing the Sidestream/Microstream CO2 Module........................................................................................................ 18 - 5 18.6 Measuring CO2 Using Mainstream CO2 Module............................................................................................................................. 18 - 5 18.6.1 Preparing to Measure CO2 Using Mainstream CO2 Module......................................................................................... 18 - 5 18.6.2 Zeroing the Mainstream CO2 Sensor.................................................................................................................................... 18 - 6 18.7 Changing Settings for All CO2 Modules............................................................................................................................................. 18 - 6 18.7.1 Changing CO2 Alarm Settings................................................................................................................................................. 18 - 6 18.7.2 Setting the CO2 Waveform....................................................................................................................................................... 18 - 6 18.7.3 Setting the RR Source................................................................................................................................................................. 18 - 7 18.7.4 Entering the Standby Mode..................................................................................................................................................... 18 - 7 18.7.5 Entering the Intubation Mode................................................................................................................................................ 18 - 7 18.8 Changing Settings for Sidestream and Microstream CO2 Module.......................................................................................... 18 - 7 18.8.1 Setting the Auto Standby......................................................................................................................................................... 18 - 7 18.8.2 Setting Humidity Compensation........................................................................................................................................... 18 - 7 18.9 Setting the Gas Compensation............................................................................................................................................................. 18 - 8 18.10 Choosing a Time Interval for Peak-Picking..................................................................................................................................... 18 - 8 18.11 Changing Barometric Pressure........................................................................................................................................................... 18 - 9 18.12 Performing the Leakage Test.............................................................................................................................................................. 18 - 9 18.13 CO2 Calibration......................................................................................................................................................................................... 18 - 9 18.14 CO2 Troubleshooting............................................................................................................................................................................. 18 - 9 18.14.1 Troubleshooting the Sidestream/Microstream CO2 Module.................................................................................... 18 - 9 18.14.2 Troubleshooting the Mainstream CO2 Module............................................................................................................18 - 10 18.15 Oridion Information..............................................................................................................................................................................18 - 10 19 Review............................................................................................................................................................................19 - 1 19.1 Review Overview........................................................................................................................................................................................ 19 - 1 19.2 Review Page................................................................................................................................................................................................. 19 - 1 19.2.1 Accessing the Review Page...................................................................................................................................................... 19 - 1 19.2.2 Example Review Page................................................................................................................................................................ 19 - 1 19.2.3 Symbols on Review Pages........................................................................................................................................................ 19 - 2 19.2.4 Common Operations.................................................................................................................................................................. 19 - 2 19.2.5 Tabular Trends Review Page.................................................................................................................................................... 19 - 3 19.2.6 Graphics Trends Review Page................................................................................................................................................. 19 - 4 19.2.7 Events Review Page.................................................................................................................................................................... 19 - 5 19.2.8 Full Disclosure Review Page.................................................................................................................................................... 19 - 6 9  19.2.9 OxyCRG Review Page................................................................................................................................................................. 19 - 7 19.2.10 12-Lead ECG Review Page (for ePM 12/ePM 12A/ePM 12C/ePM 15/ePM 15A/ePM 15C).............................. 19 - 8 19.2.11 ST Review Page.......................................................................................................................................................................... 19 - 9 19.3 Reviewing Discharged Patients..........................................................................................................................................................19 - 10 19.3.1 Checking the Data of a Discharged Patient.....................................................................................................................19 - 10 19.3.2 Checking the Information of a Discharged Patient.......................................................................................................19 - 10 20 Clinical Assistive Applications (CAA)...........................................................................................................................20 - 1 20.1 Early Warning Score (EWS)..................................................................................................................................................................... 20 - 1 20.1.1 Displaying the EWS Numerics Area...................................................................................................................................... 20 - 2 20.1.2 Accessing the EWS Screen....................................................................................................................................................... 20 - 2 20.1.3 Performing EWS Scoring........................................................................................................................................................... 20 - 3 20.1.4 EWS Alarm...................................................................................................................................................................................... 20 - 4 20.1.5 Changing EWS Settings............................................................................................................................................................. 20 - 5 20.1.6 Viewing Historical Scores......................................................................................................................................................... 20 - 5 20.1.7 Viewing Parameter Trends....................................................................................................................................................... 20 - 6 20.2 Glasgow Coma Scale (GCS).................................................................................................................................................................... 20 - 6 20.2.1 Displaying the GCS Parameter Area..................................................................................................................................... 20 - 6 20.2.2 Accessing the GCS Menu.......................................................................................................................................................... 20 - 7 20.2.3 Performing GCS Scoring........................................................................................................................................................... 20 - 7 20.2.4 Setting GCS Scoring Interval................................................................................................................................................... 20 - 7 20.2.5 Reviewing GCS Trend Data...................................................................................................................................................... 20 - 8 20.3 ECG 24h Summary..................................................................................................................................................................................... 20 - 8 20.3.1 Viewing the ECG 24h Summary............................................................................................................................................. 20 - 8 20.3.2 Selecting Typical ECG Strips.................................................................................................................................................... 20 - 8 20.3.3 Reviewing ECG Summary......................................................................................................................................................... 20 - 8 21 Calculation.....................................................................................................................................................................21 - 1 21.1 Calculation Overview............................................................................................................................................................................... 21 - 1 21.2 Calculation Safety Information............................................................................................................................................................. 21 - 1 21.3 Drug Calculations...................................................................................................................................................................................... 21 - 1 21.3.1 Performing Drug Calculations................................................................................................................................................ 21 - 1 21.3.2 Checking the Titration Table................................................................................................................................................... 21 - 2 21.3.3 Drug Calculation Formula........................................................................................................................................................ 21 - 2 21.3.4 Titration Table Calculation Formula..................................................................................................................................... 21 - 2 21.4 Hemodynamic Calculations................................................................................................................................................................... 21 - 3 21.4.1 Performing Hemodynamic Calculations............................................................................................................................. 21 - 3 21.4.2 Input Parameters for Hemodynamic Calculations.......................................................................................................... 21 - 3 21.4.3 Calculated Parameters and Formulas for Hemodynamic Calculations................................................................... 21 - 3 21.5 Oxygenation Calculations...................................................................................................................................................................... 21 - 4 21.5.1 Performing Oxygenation Calculations................................................................................................................................ 21 - 4 21.5.2 Input Parameters for Oxygenation Calculations.............................................................................................................. 21 - 5 21.5.3 Calculated Parameters and Formulas for Oxygenation Calculations....................................................................... 21 - 5 21.6 Ventilation Calculations.......................................................................................................................................................................... 21 - 6 21.6.1 Performing Ventilation Calculations.................................................................................................................................... 21 - 6 21.6.2 Input Parameters for Ventilation Calculations.................................................................................................................. 21 - 6 21.6.3 Calculated Parameters and Formulas for Ventilation Calculations........................................................................... 21 - 6 21.7 Renal Calculations..................................................................................................................................................................................... 21 - 7 10  21.7.1 Performing Renal Calculations................................................................................................................................................ 21 - 7 21.7.2 Calculated Parameters and Formulas for Renal Calculations...................................................................................... 21 - 7 21.7.3 Calculated Parameters and Formulas for Renal Calculations...................................................................................... 21 - 8 22 Recording.......................................................................................................................................................................22 - 1 22.1 Recorder........................................................................................................................................................................................................ 22 - 1 22.2 Starting Recordings................................................................................................................................................................................... 22 - 1 22.2.1 Manually Starting Recordings...............................................................................................................................................