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Operation

 Operator’s Manual Addendum

 ADD-13

1.4

Operation

When used with a respiratory sensor, the Respiration Rate parameter provides 
a continuous, non-invasive measurement of respiration rate, in breaths per 
minute, for adults in hospitals or hospital-type facilities. Respiration rate is 
derived by analysis of changes in the photoplethysmogram (PPG) signal that 
occur during the respiratory cycle. Extremes of respiration rate and/or signifi-
cant changes in respiration rate over time may indicate that patient status is 
deteriorating and additional assessment is warranted. 

Reference 

Theory of 

Operations

, p. ADD-25

,

for the theory behind how the Respiration Rate param-

eter works. Reference 

Monitoring System Constraints

, p. ADD-22, for informa-

tion on related alarm limits.

Note:

Respiration rate values are updated every five seconds. Users should be aware that the 
reported respiration rate represents an average over a period of time and does not 
necessarily represent the instantaneous respiration rate. Low and high respiration rate 
alarms are triggered immediately when the reported rate falls outside the alarm limits 
and no further alarm delay is applied.

1.4.1

Prerequisites

Before starting a monitoring session, confirm the following:

The monitoring system is powered on, has successfully completed its power-on 
self-test, and has the Respiration Rate parameter enabled. Contact a qualified 
service technician to have the monitoring system upgraded if the Respiration Rate 
parameter does not appear on the screen.

Note:

 If the Respiration Rate parameter is enabled and a parameter module that 

does not support Respiration Rate is subsequently installed in the monitoring 
system, the following error is displayed at power-up:

“Parameter module does not support RR. Replace with compatible parameter 
module or deactivate RR in Service Mode.”

The monitoring system is connected to power or the battery is fully charged.

An interface cable is connected to the monitoring system sensor port as described 
in the 

Operator’s Manual

.

A respiratory sensor is connected to the interface cable and correctly applied to 
the patient as described in the 

Instructions for Use

. Reference 

Required Pulse 

Oximetry Sensor Usage

, p. ADD-14 for additional information.

Summary of Contents for Nellcor GR101704-RR

Page 1: ...Operator s Manual Addendum Nellcor Bedside Respiratory Patient Monitoring System Respiration Rate Version 2 0...

Page 2: ...chnical Services While the information set forth herein is believed to be accurate it is not a substitute for the exercise of professional judgment The equipment and software should only be operated a...

Page 3: ...equired Pulse Oximetry Sensor Usage ADD 14 1 4 3 Respiration Rate Safety Information ADD 15 1 4 4 Menu Options ADD 15 1 4 5 Additional Alarm Messages ADD 19 1 5 Data Output ADD 19 1 6 Performance Cons...

Page 4: ...ii Operator s Manual Addendum...

Page 5: ...and pulse rate data but augments it To obtain respiration rate data caregivers must use a Nellcor Adult Respira tory Sensor The parameter provides alarms for high and low respiration rate Settings fo...

Page 6: ...peration Additional sensor usage information safety messages menu options and alarm information 5 Product Data Output Additional data fields in data output 6 Performance Considerations Additional moni...

Page 7: ...ING External factors including certain ambient conditions sensor application errors and certain patient conditions may compromise the accuracy of the displayed respiration rate value Always consider c...

Page 8: ...e monitoring system Reliance on respiration rate information alone is not recommended Health care personnel should always consider clinical signs and symptoms when assessing the patient and before int...

Page 9: ...n Safety and effectiveness of Respiration Rate in patients on mechanical ventilation have not been established Caution An SpO2 alarm may be the first indication of hypoventilation Caution A low SpO2 a...

Page 10: ...Covidien approved Nell cor sensors to the monitoring system refer to their Instructions for Use Nellcor Oxygen Saturation Accuracy Specification Grid Provides sensor specific guidance related to desir...

Page 11: ...tion use only as a continuous non invasive monitor of arterial oxygen saturation SpO2 and pulse rate of adult pediatric and neonatal patients during both motion and no motion conditions and for patien...

Page 12: ...Respiration Rate RR Fields Note The monitoring system displays respiration rate levels from 4 to 40 breaths min Detected breaths min above 40 appear as 40 Detected breaths min below 4 appear as 4 1 R...

Page 13: ...Product Overview Operator s Manual Addendum ADD 9 Pleth View Figure 1 2 Pleth View with Respiration Rate Trend View Figure 1 3 Trend View with Respiration Rate...

Page 14: ...ellcor Respiration Rate ADD 10 Operator s Manual Addendum Combined Pleth and Trend View Figure 1 4 Combined View with Respiration Rate Numbers Only Blip View Figure 1 5 Blip View with Respiration Rate...

Page 15: ...tion rate field at the lower right and respiration rate trend data in white below the SpO2 and pulse rate data Respiration data is also docu mented in the clinical log and histogram view Monitoring Hi...

Page 16: ...llcor Respiration Rate ADD 12 Operator s Manual Addendum Monitoring History Clinical Log Figure 1 7 MONITORING HISTORY Clinical Log Monitoring History Histograms Figure 1 8 MONITORING HISTORY Histogra...

Page 17: ...iration rate alarms are triggered immediately when the reported rate falls outside the alarm limits and no further alarm delay is applied 1 4 1 Prerequisites Before starting a monitoring session confi...

Page 18: ...tem continues to post both SpO2 and pulse rate data with the user message NO RR SENSOR CONNECTED and dashes in the RR field Figure 1 10 RR field with No RR Sensor Message If caregivers use a respirato...

Page 19: ...ions specific to Respiration Rate are described below ALARM LIMITS Menu Respiration Rate Alarm Limits The ALARM LIMITS menu includes an option for setting upper and lower res piration rate alarm limit...

Page 20: ...ry Limit changes remain in effect as long as the monitoring system retains power but return to the factory or institutional default settings at power off To temporarily change respiration rate alarm l...

Page 21: ...ator s Manual Addendum ADD 17 Figure 1 13 Adjusting Respiration Rate Alarm Limits 5 Press SAVE CHANGES 6 Press EXIT 7 Confirm that the new limits appear in the respiration rate limit area on the moni...

Page 22: ...G SETTINGS Menu Real Time Respiration Rate Data For monitoring views that include real time trend data the SELECT TRENDS menu includes options to display SpO2 pulse rate respiration rate or any com bi...

Page 23: ...ondition Several new alarms and message accompany the Respiration Rate parameter Reference Troubleshooting p ADD 23 for descriptions and recommended res olutions 1 5 Data Output Respiration rate data...

Page 24: ...Addendum Figure 1 16 Historical Trend Data Export with Respiration Rate Values 1 Time stamp 5 Alarm type 2 High and low readings 6 Pulsatile strength minimum maximum 3 Upper and lower limits 7 Sample...

Page 25: ...limit for respiration rate as configured by the user RR UL Upper alarm limit for respiration rate as configured by the user Alarms Encoded number indicating which alarms were active during the 1 sec...

Page 26: ...for use are not applicable to Nellcor Respiration Rate 1 6 2 Nellcor Sensor Performance Considerations All sensor performance considerations described in the Operator s Manual apply to use of the Nel...

Page 27: ...escription Low Respiration Rate Alarm The patient s respiration rate is below the low alarm limit Resolution Assess patient condition in conjunction with SpO2 and pulse rate readings from the monitori...

Page 28: ...on rate is 0 5 of pulse rate Resolution Assess patient condition in conjunction with SpO2 and pulse rate readings from the monitoring system to determine appropri ate intervention Use an alternate mea...

Page 29: ...signal is used to measure arterial oxygen saturation SpO2 A typical pleth pattern includes a regular cardiac pulse waveform on top of a large con stant baseline component or DC component See Figure 1...

Page 30: ...eases during expiration RSA results in pulse frequency variations Reference Figure 1 17 d Figure 1 17 Variations of the pleth due to respiration The Respiration Rate parameter utilizes these subtle pl...

Page 31: ...imeter equipment measurements are statistically distributed about two thirds of the measurements can be expected to fall in this accuracy ARMS range refer to the Sensor Accuracy Grid for more details...

Page 32: ...hy vol unteers and 75 hospitalized patients Subjects were studied for approximately 30 minutes during which data from capnography and the Nellcor pulse oxim eter were collected Respiration rate was de...

Page 33: ...observations between Respiration Rate Version 2 0 and the capnography based reference method Figure 1 18 p ADD 30 presents a modified Bland Altman plot of these paired observations to provide another...

Page 34: ...e The limits of agreement were derived from data in each respiration rate sub range and are provided in Table 1 10 1 Difference Clinician Overscored Respiration Rate Nellcor Respiration Rate BrPM 3 Up...

Page 35: ...d hospitalized patients Respiration Rate Version 2 0 provided respiration rate with an accuracy of 1 breath per minute when compared to respiration rate derived from a capnography based reference Hosp...

Page 36: ...Page Left Intentionally Blank ADD 32 Operator s Manual Addendum Nellcor Respiration Rate...

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Page 38: ...art No 10104355 Rev L 2015 06 2013 Covidien Covidien Ireland Limited IDA Business and Technology Park Tullamore Covidien llc 1 800 255 6774 T www covidien com 15 Hampshire Street Mansfield MA 02048 US...

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