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Dräger Infinity Acute Care System M540, Instructions For Use Manual

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Contents

8

Instructions for use – Infinity Acute Care System – Monitoring Applications VG6.n

Configuring the alarm message behavior. . . . . 131
Configuring the arrhythmia alarm setup . . . . . . 134
Alarm setup for ST   . . . . . . . . . . . . . . . . . . . . . 135
Auto setting all alarm limits. . . . . . . . . . . . . . . . 138
Alarm history and stored events. . . . . . . . . . . . 139
Viewing a snapshot of a single event . . . . . . . . 141
Viewing current alarms . . . . . . . . . . . . . . . . . . . 142
Configuring alarm settings temporarily. . . . . . . 142
Configuring the SpO2 alarm priority . . . . . . . . . 143
Remote alarm control . . . . . . . . . . . . . . . . . . . . 144
Infinity MCable – Nurse call . . . . . . . . . . . . . . . 146
External device disconnection alarm . . . . . . . . 147
The Code function  . . . . . . . . . . . . . . . . . . . . . . 147
The Timer function . . . . . . . . . . . . . . . . . . . . . . 148
Alarm ranges and defaults . . . . . . . . . . . . . . . . 149

Trends/data dialogs

 . . . . . . . . . . . . . . . . . . . . 161

Overview  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Trending behavior. . . . . . . . . . . . . . . . . . . . . . . 162
Graphical trends . . . . . . . . . . . . . . . . . . . . . . . . 164
Interacting with the graphical trends pages . . . 166
Analysis tool page  . . . . . . . . . . . . . . . . . . . . . . 169
Interacting with the Analysis tool page . . . . . . . 170
Tabular trend  . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Interacting with the tabular trend  . . . . . . . . . . . 174
Mini-trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Data review pages . . . . . . . . . . . . . . . . . . . . . . 177
Reports tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

Calculations

 . . . . . . . . . . . . . . . . . . . . . . . . . . 181

Overview  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Accessing the calculation functions . . . . . . . . . 183
Viewing the calculation results . . . . . . . . . . . . . 185
Laboratory data  . . . . . . . . . . . . . . . . . . . . . . . . 186
Calculation equations . . . . . . . . . . . . . . . . . . . . 187
Drug calculations . . . . . . . . . . . . . . . . . . . . . . . 191
Accessing the drug calculation functions . . . . . 191
Customized drug list. . . . . . . . . . . . . . . . . . . . . 192
Drug calculator equations. . . . . . . . . . . . . . . . . 194

ECG, arrhythmia, and ST segment

 . . . . . . . . 197

Overview of ECG and heart rate monitoring  . . 199
ECG precautions  . . . . . . . . . . . . . . . . . . . . . . . 200
Connecting the 3-, 5-, 6-wire lead sets for 
ECG monitoring . . . . . . . . . . . . . . . . . . . . . . . . 201
Connecting the lead sets for 12-lead 
monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202

Connecting the lead wires for neonatal 
monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . .  203
Patient preparation for ECG monitoring  . . . . .  204
ECG display  . . . . . . . . . . . . . . . . . . . . . . . . . .  205
ECG colors  . . . . . . . . . . . . . . . . . . . . . . . . . . .  207
Electrode placement . . . . . . . . . . . . . . . . . . . .  208
12-lead monitoring. . . . . . . . . . . . . . . . . . . . . .  211
Accessing the ECG functions . . . . . . . . . . . . .  211
ECG parameter setup functions  . . . . . . . . . . .  212
Monitoring paced patients . . . . . . . . . . . . . . . .  216
Pacemaker precautions. . . . . . . . . . . . . . . . . .  217
Optimizing pacer processing . . . . . . . . . . . . . .  219
Arrhythmia monitoring overview  . . . . . . . . . . .  219
Selecting arrhythmia leads  . . . . . . . . . . . . . . .  220
Arrhythmia processing. . . . . . . . . . . . . . . . . . .  221
Arrhythmia modes . . . . . . . . . . . . . . . . . . . . . .  221
Arrhythmia display. . . . . . . . . . . . . . . . . . . . . .  223
Accessing the arrhythmia functions. . . . . . . . .  225
Arrhythmia parameter setup functions  . . . . . .  225
Monitoring ST overview. . . . . . . . . . . . . . . . . .  226
Standard ST monitoring. . . . . . . . . . . . . . . . . .  226
TruST 12-lead monitoring . . . . . . . . . . . . . . . .  227
12-lead ST monitoring . . . . . . . . . . . . . . . . . . .  227
Connecting lead sets for ST monitoring  . . . . .  227
ST display . . . . . . . . . . . . . . . . . . . . . . . . . . . .  228
Reviewing ST complexes  . . . . . . . . . . . . . . . .  229
ST measuring points . . . . . . . . . . . . . . . . . . . .  231
ST reference . . . . . . . . . . . . . . . . . . . . . . . . . .  232
ST alarm settings  . . . . . . . . . . . . . . . . . . . . . .  233
Accessing the ST settings . . . . . . . . . . . . . . . .  233
ST setup functions. . . . . . . . . . . . . . . . . . . . . .  234
Learning/relearning QRS pattern  . . . . . . . . . .  236

Impedance respiratory rate (RRi)

. . . . . . . . .  239

Overview of respiration monitoring . . . . . . . . .  240
Respiration precautions. . . . . . . . . . . . . . . . . .  240
Connecting the 3-, 5-, 6-wire lead sets for 
respiration monitoring . . . . . . . . . . . . . . . . . . .  241
Connecting the lead sets for 12-lead 
monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . .  242
Connecting the lead wires for neonatal 
monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . .  243
Patient preparation for respiration monitoring .  244
Respiration display  . . . . . . . . . . . . . . . . . . . . .  246
Adjusting the detection threshold and 
activating the breath marker . . . . . . . . . . . . . .  247
Respiration measuring modes. . . . . . . . . . . . .  247
Accessing the respiration settings. . . . . . . . . .  248

Summary of Contents for Infinity Acute Care System M540

Page 1: ...Instructions for use Infinity Acute Care System Monitoring Applications Software VG6 n WARNING To properly use this medical device read and comply with these instructions for use ...

Page 2: ...n with the numbering restarting with 1 for each new sequence of actions Bullet points indicate individual actions or diffe rent options for action Dashes indicate the listing of data options or objects A Letters in parentheses refer to elements in the related figure A Letters in figures denote elements referred to in the text The greater than symbol indicates the navigati on path in a dialog Bold ...

Page 3: ...LNCS TM are trademarks of Masimo Corporation CapnoLine Capnostream FilterLine Microcap MicroPod Microstream Oridion VitalCapTM are trademarks of Oridion Medical 1987 Ltd Edwards Vigilance Vigileo EV1000 are trademarks of Edwards Lifesciences LLC Smart CapnoLineTM Guardian BIS VISTA Medtronic Nellcor OxiMax SatSeconds are trademarks of a Medtronic company Dismozon pur is a trademark of BODE Chemie ...

Page 4: ...rk Office and in other countries All devices referenced in these instructions for use may not be approved for sale in all countries Please check with your local Dräger representative Microstream MicroPod External Capnography Module patents The capnography component of this product is covered by one or more of the following US patents 6 437 316 6 428 483 6 997 880 7 488 229 8 414 488 8 412 655 and ...

Page 5: ...provides important in formation about a potentially hazardous situation which if not avoided could result in death or serious injury CAUTION A CAUTION statement provides important infor mation about a potentially hazardous situation which if not avoided may result in minor or mod erate injury to the user or patient or in damage to the medical device or other property NOTE A NOTE provides additiona...

Page 6: ... be used installed reprocessed maintained or repaired exclusively by defined target groups Users Users are persons who use the product in accordance with its intended use Service personnel Service personnel are persons who are responsible for the maintenance of the product Service personnel must be trained in the maintenance of medical devices and install reprocess and maintain the product Experts...

Page 7: ... 68 Customizing the display 68 Parameter priority 73 Views 74 Profiles status 75 Managing profiles and views 86 Standby mode 87 Privacy mode 88 Screen lock 89 Assembly and preparation 91 Assembly overview 92 Docking undocking the M540 93 Locking unlocking the M540 94 Additional M540 accessories 95 Connecting the system cables 95 Mounting the Infinity MCable Masimo SET Masimo rainbow SET Nellcor Ox...

Page 8: ...the 3 5 6 wire lead sets for ECG monitoring 201 Connecting the lead sets for 12 lead monitoring 202 Connecting the lead wires for neonatal monitoring 203 Patient preparation for ECG monitoring 204 ECG display 205 ECG colors 207 Electrode placement 208 12 lead monitoring 211 Accessing the ECG functions 211 ECG parameter setup functions 212 Monitoring paced patients 216 Pacemaker precautions 217 Opt...

Page 9: ...blood pressure hose and cuff 292 Patient preparation for non invasive blood pressure monitoring 293 Non invasive blood pressure display 294 Non invasive blood pressure measurement modes 296 Venous stasis 299 Accessing the non invasive blood pressure settings 300 Non invasive blood pressure parameter setup functions 300 Invasive blood pressure IBP 301 Overview of invasive blood pressure monitoring ...

Page 10: ...ing the CCO SvO2 settings 399 SvO2 parameter setup functions 399 External devices MEDIBUS X devices 401 External device monitoring 402 Precautions 403 Compatible MEDIBUS X devices 403 Supported MEDIBUS X ventilator and anesthesia data 404 Viewing MEDIBUS X parameter data 411 Parameter fields 411 Viewing loops 412 The Show all pages 413 Accessing parameter setup functions 414 Paw setup functions 41...

Page 11: ... options 503 Overview 504 Configuring IT tabs 504 Accessing an IT tab 505 Supported IT applications 506 Connecting to the network 507 Troubleshooting 509 Overview 510 Device communication messages 510 Messages 513 ECG 517 ST 520 ARR 521 Respiration RRi 523 SpO2 526 Non invasive blood pressure NIBP 534 Temperature 537 Invasive blood pressure IBP 539 Mainstream CO2 543 Microstream CO2 547 Cardiac Ou...

Page 12: ...12 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 13: ...g accessories 15 Sterile accessories 15 Restriction of distribution 15 Restrictions for use 15 Connected devices 15 Safe connection with other electrical equipment 15 Electrical safety 16 Connection to hospital network 16 Patient safety 16 Patient monitoring 17 General safety information 18 Not for use in areas of explosion hazard 19 Information on electromagnetic compatibility 19 Operating locati...

Page 14: ...ing Strictly observe all WARNING and CAUTION statements throughout these instructions for use and all statements on medical device labels Failure to observe these safety information statements constitutes a use of the medical device that is inconsistent with its intended use WARNING Risk of incorrect use Instructions for use must be kept accessible for the user WARNING Risk of medical device failu...

Page 15: ...le use accessories must not be reused reprocessed or resterilized CAUTION Device for use in health care facilities only and exclusively by persons as defined in the target groups see Definition of target groups on page 6 WARNING Risk of electric shock and of device malfunction Any connected devices or device combinations not complying with the requirements mentioned in these instructions for use c...

Page 16: ...g diseases Medical device modification or misuse can be dangerous WARNING The leakage current increases when multiple medical devices are connected to a patient Make sure that the galvanic isolation of each device is suitable for the intended application Connect only equipment that is set up and tested according to IEC standards to the analog and digital signal inputs and outputs Connect only pass...

Page 17: ...ient monitoring system that provides appropriate information on medical device performance and patient condition Patient safety may be achieved by a wide variety of means ranging from electronic surveillance of medical device performance and patient condition to direct observation of clinical signs The responsibility for selecting the best level of patient monitoring lies solely with the user of t...

Page 18: ...evant information If access to the Dräger website is not possible contact the local Dräger organization WARNING Risk of explosion and of chemical burns Improper handling of batteries can result in explosions and chemical burns Do not throw batteries into fire Do not force batteries open WARNING To avoid electric shock inspect all cables before use Never use cables that appear cracked worn or damag...

Page 19: ...lothing and shoes touching a potential equalization pin before and during connection of the pins or using electrically insulating and antistatic gloves All users concerned must be instructed in these ESD protective measures WARNING To avoid interfering with device operation do not operate devices monitor MPod MCable and accessories within equipment that emits microwave or other high frequency emis...

Page 20: ...sistant to defibrillation before defibrillating a patient CAUTION To prevent burns and electric shock due to rerouting of electrical current through electrodes do not position the defibrillator pads near any electrodes or sensors CAUTION Only defibrillate across the chest CAUTION To protect the patient during defibrillation and to ensure accurate ECG information use only ECG electrodes and cables ...

Page 21: ...ications closet is recommended and is the responsibility of the operating organization Dräger recommends that operating organiza tions restrict physical access to unused ether net ports on the IACS Dräger recommends that operating organiza tions restrict physical access to unused USB and serial ports on the IACS Dräger relies on the medical device isolation mechanism of the VLANs and the proper co...

Page 22: ...22 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 23: ...Instructions for use Infinity Acute Care System Monitoring Applications VG6 n 23 Application Application Intended use 24 Indications for use 24 ...

Page 24: ...eart rate Arrhythmia adult and pediatric patients only 12 lead analysis ST segment analysis including TruST adult and pediatric patients only Apnea Impedance respiratory rate RRi Invasive blood pressure IBP Non invasive blood pressure NIBP Temperature Cardiac output only available when the M540 is docked in an IACS configuration adult and pediatric patients only Arterial oxygen saturation SpO2 Pul...

Page 25: ...ew Overview 26 Infinity Medical Cockpit 26 Infinity PS250 power supply unit PS250 27 Infinity P2500 power supply unit P2500 27 Infinity M540 patient monitor M540 28 Infinity M500 docking station M500 28 Front view of the M500 28 Rear view of the M500 29 Additional hardware 29 Device symbols 32 Abbreviations 36 ...

Page 26: ...ides communi cation between the M540 and the Cockpit and charges the battery in the M540 PS250 refers to the Infinity PS250 power sup ply Com Hub power supply unit P2500 refers to the Infinity P2500 Docking the M540 refers to placing the M540 on the M500 Undocking the M540 refers to removing the M540 from the M500 for patient transport The following diagram shows the basic components of the IACS I...

Page 27: ...he device is connected to AC power Battery indicator yellow LED that lights up briefly during startup or fault conditions such as a faulty battery Infinity P2500 power supply unit P2500 The following diagram shows the bottom of the P2500 A Two interchangeable system cable connectors one for the M540 one for the Cockpit B Power cable connection C Infinity network connector D Nurse call connector E ...

Page 28: ...efer to the Instructions for use Infinity Acute Care System Infinity M540 Infinity M500 docking station M500 The M500 is the mechanical device that secures and powers the M540 It also charges the battery and controls the communication between the M540 and the Cockpit through an optical Ethernet link Front view of the M500 A Locking mechanism secures the M540 for more detailed information see Locki...

Page 29: ...n saturated with oxygen SpO2 and reports the perfusion index PI and the pulse rate PLS Connects directly to the SpO2 connector of the M540 see page 256 and page 274 Infinity MCable Masimo SET rainbow Measures the percentage of functional hemoglobin saturated with oxygen SpO2 and reports the perfusion index PI and the pulse rate PLS In addition it measures total arterial hemoglobin SpHb total oxyge...

Page 30: ...ation of CO2 N2O and anesthetic agents Sevoflurane Desflurane Isoflurane Halothane and Enflurane in the breathing gas Connects directly to the CO2 connector of the M540 see the instructions for use Infinity Acute Care System Infinity M540 Scio Four Oxi Measures the concentration of CO2 N2O O2 and anesthetic agents Sevoflurane Desflurane Isoflurane Halothane and Enflurane in the breathing gas Scio ...

Page 31: ...of the M540 see page 283 or to the CO2 connector with a Y cable Secondary video display Extends the viewing capabilities of a Cockpit to an additional video display Secondary displays mirror the content of the Cockpit Connects to a Cockpit using the DVI 1 connector located on the back panel see the instructions for use Infinity Acute Care System Medical Cockpit R50N recorder Produces timed and con...

Page 32: ...Upper alarm limits Caution Observe the accompanying documentation Autoset alarm limits Directive 93 42 EEC concerning Medical Devices Alarm monitoring deactivated temporarily Access to trend pages Alarm monitoring deactivated permanently The button next to this symbol accesses special procedure pages Acoustic alarm signal paused temporarily Access to alarm functions Acoustic alarm signal turned of...

Page 33: ...gured views and layouts Lung symbol that pulsates with each detected breath Access to parameter pages Heart blip that flashes with each detected pulse Adult patient category Pediatric patient category Neonatal patient category Pacer detection is activated the heart symbol flashes with each detected paced pulse Battery status LED Scrolls to additional tabs and pages Battery charging error Power on ...

Page 34: ...d Date of manufacture Trend configuration Complete screen calibration procedure Keyboard access Repeat screen calibration procedure Nurse call Display filter When selected only the connected parameters and associated setup pages are displayed When deselected all parameters and associated setup pages are displayed Manufacturer Zeroing all pressures Parameter is excluded from display Parameter is re...

Page 35: ...ges to a view ESD warning Save as symbol IPXx Degree of protection against solid particle and liquid ingress e g IPX1 IPX4 etc Navigates forward on a web page Refreshes a web screen Displays the main screen Navigates backward on a web page Defibrillation proof Type CF equipment Stops loading the web page Gas in Defibrillation proof Type BF equipment Gas out Caution Federal law restricts this devic...

Page 36: ...atural rubber latex which may cause an allergic reaction Not made with natural rubber latex Abbreviation Description MVspon Spontaneous minute volume fractional leak Relative leakage PACED Percentage of paced beats SC Psupp goal Pressure support goal SmartCare O2 Inspiratory expiratory oxygen concentration difference AAMI Association for the Advancement of Medical Instrumentation AHA American Hear...

Page 37: ...Dynamic host configuration protocol DNS Domain name system DO2 Oxygen delivery DO2I Oxygen delivery index Abbreviation Description dV1 to dV6 Derived chest leads DVI Digital visual interface E Lung elastance ECG Electrocardiogram EDV End diastolic volume EDVI End diastolic volume index EF Ejection fraction EIP End inspiratory pressure Enf Enflurane Enf cons Cumulated enflurane consumption ESV End ...

Page 38: ...ane concentration inEnf Inspiratory enflurane concentration inHal Inspiratory halothane concentration Abbreviation Description inIso Inspiratory isoflurane concentration inxMAC MAC factor inN2O Inspiratory N2O concentration inSev inspiratory sevoflurane concentration Insp term Inspiratory termination criterion based on peak inspiratory flow iO2 Inspired O2 ISO Isoelectric point Iso Isoflurane Iso ...

Page 39: ...el during APRV PI Perfusion index SpO2 PIP Peak inspiratory pressure Pinsp Inspiratory pressure Abbreviation Description Plow Lower pressure level during APRV PLS Pulse rate from SpO2 PLS ART Arterial blood pressure pulse rate Pmax Maximum inspired pressure Pmean Mean airway pressure Pmin Minimum airway pressure Pplat Plateau pressure PTC Post tetanic count PS250 Power supply unit Psupp Pressure a...

Page 40: ... hemoglobin SpMet Methemoglobin saturation SpOC Total oxygen content SpO2 Oxygen saturation measured by pulse oximetry SpO2 CO Ox CO oximetry Abbreviation Description SQI Signal quality index ST x ST deviation of lead x STdV1 STdV3 STdV4 STdV6 ST segment deviations of derived leads SV Stroke volume SVI Stroke volume index SvO2 Venous oxygen saturation SVR Systemic vascular resistance SVRI Systemic...

Page 41: ...VO2 Oxygen consumption VO2 Oxygen consumption VO2I Oxygen consumption index VTACH Ventricular tachycardia VT Tidal volume VTe Tidal volume expired VTemand Mandatory expiratory tidal volume VTespon Spontaneous expired total volume VTespon mean Spontaneous expired mean total volume VThf Tidal volume for HFO VTimand Mandatory inspired tidal volume VTi Tidal volume inspired VTispon Spontaneous inspire...

Page 42: ...42 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 43: ... 63 Supported messages 63 Dialogs and pages 64 Main menu bar and quick access toolbar 65 Main menu bar 65 Quick access toolbar 66 Filtering the parameter content 67 Auto and manual display modes 67 Auto view mode 67 Manual view mode 67 Auto view setup toolbar 68 Customizing the display 68 Screen brightness 68 Touchscreen versus mouse 68 Calibrating the touchscreen 68 Cockpit screen in split screen...

Page 44: ...y after patient transport An M540 on wireless transport transmits the data to the ICS Infinity CentralStation during transport The central component of the IACS is the Cockpit This medical grade workstation provides centralized viewing and control of Infinity monitoring systems and IT applications at the point of care The Cockpit is available in the following sizes Both offer a large viewing angle...

Page 45: ... C700 B DVI cable C Secondary display option D USB cable E Keyboard and mouse option F Device connectivity cable option G M540 patient monitor H M500 docking station I System cables J R50N recorder option Not available in the EU K AC power L Infinity network M Infinity MCable Nurse call option N P2500 PS250 O Hospital network P Ethernet cable 005 A C O N B E F G H I I D K L J M P P ...

Page 46: ...re automatically transferred to the M540 and vice versa Docking the M540 As soon as the user docks the M540 in the M500 the following happens at the Cockpit The message Connecting to M540 appears in the center of the Cockpit screen The Cockpit makes the data of the M540 available to the Infinity network Docking to the same Cockpit If the user undocks an M540 from a Cockpit and later docks the M540...

Page 47: ...s at the ICS that the bed is disconnected When the wireless option for an M540 is activated and configured properly the ICS displays the wireless symbol Data are no longer trended at the Cockpit With each docking or undocking of an M540 there is a short transition period One minute of trend data collected during this transition period may not be displayed at an ICS equipped with software version V...

Page 48: ...tored or the alarm is acknowledged The alarm tone sounds even if alarms are paused or the alarm volume has been deactivated The alarm volume is automatically adjusted to 100 until the network connection is restored Once the Cockpit re establishes communication with the network the previous alarm volume is restored The message Offline appears on cyan background in the network message area of the Co...

Page 49: ...ansfers A Transfer tab B Care area selection arrow C Current patient column D Device name column E Start transfer button To transfer data over the network The IACS network supports the transfer of patient data from a source device such as an Infinity Delta Delta XL Kappa or an IACS Cockpit to another Cockpit 1 Place the source device in standby mode 2 Go to the Cockpit to which you wish to transfe...

Page 50: ...ransfer and return to the Transfer page Transfer to discharge the patient from the Cockpit and initiate the data transfer During the transfer the Cockpit and M540 display the message Transferring data A successful transfer results in the following The Cockpit returns to the main screen The message Transfer Complete appears in the Cockpit header A failed transfer results in the following The Cockpi...

Page 51: ...request timed and continuous recordings of the remote device from the Cockpit To access the remote view 1 Select the Views button on the main menu bar to access the Views dialog 2 Select the Remote view tab This dialog lists all of the beds in the monitoring unit of the Cockpit 3 Select a bed from the list in the Views dialog to access the remote view of an individual patient 4 Select the Connect ...

Page 52: ...ting concept 52 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n A Disconnect button B Audio Pause button C Continuous Recording button D Timed Recording button 007 Views A B C D ...

Page 53: ...Central Station setting is activated see page 475 The message Not Monitored By Central appears on cyan background in the network message area of the Cockpit A single notification alarm of low alarm priority sounds within 25 seconds until communication with the ICS is restored or the alarm is acknowledged The alarm tone sounds even when alarms are paused or the alarm volume has been deactivated The...

Page 54: ...the instructions for use Infinity CentralStation IT applications Several optional IT applications provide remote access to patient data from the Cockpit For example the PatientWatch application accessible with the Infinity Gateway allows viewing of up to four different bedside monitors that are connected to the Infinity network If configured accordingly IT applications are accessible by selecting ...

Page 55: ... with a different alarm pause state than that of the Cockpit Both devices observe the remaining alarm pause interval Connection power problems there is a power supply failure The LEDs on the front indicate that the Cockpit and the M540 are on battery charge The Cockpit sounds an alarm of medium priority and switches to battery charge for up to five minutes before performing a safe shutdown The M54...

Page 56: ...e page 475 none of the above features are supported the Cockpit loses communication with an external device The Cockpit tries to restore the link If the corresponding function is activated an alarm sounds and the message External device disconnected appears on the Cockpit and ICS see External device disconnected alarm control on page 461 Miscellaneous the Cockpit and the M540 are monitoring a pati...

Page 57: ...t preserves the integrity of the patient data and the user settings Locked options The IACS supports several locked options For a list of options refer to the instructions for use Infinity Acute Care System Monitoring Accessories Temporary options Temporary options make it possible for an M540 in an IACS configuration to perform the intended functions together with the Cockpit when the devices do ...

Page 58: ...3 Export protocol This function allows sharing data with other Dräger and third party devices such as clinical information and anesthesia record systems and data loggers The export protocol connector is located on the P2500 PS250 see page 27 Refer to the section Connected devices on page 15 when connecting third party devices Display Resolution C500 2nd generation 1440 x 900 pixels C700 2nd genera...

Page 59: ...f the Cockpit when it is connected to an M540 The screen of a monitoring Cockpit is divided into the following main areas A Header bar B Main menu bar C Auto view toolbar if activated D Monitoring area For a more detailed overview of general user interface components of the IACS refer to the instructions for use Infinity Acute Care System Medical Cockpit 008 A B C D ...

Page 60: ...ield C of the header bar displays the patient name Selecting this field opens the Demographics page see page 101 The content of the patient name field changes when the Code button is selected on the main menu bar to activate a set of user defined emergency monitoring functions In this case the patient data field displays a timer along with a Stop and a Reset button For more information on the Code...

Page 61: ... mode or mini trend display is selected see page 458 When opening a dialog the waveform channels and parameter fields are reduced to fit on the right side of the screen see figure on page 64 This display behavior prevents the vital signs from being obscured while the user is performing setup tasks Selecting the Home button on the main menu bar or pressing the rotary knob closes any open dialogs an...

Page 62: ... other subordinate parameters who are displayed below each other B C The parameter labels D appear above the respective parameter values The following example shows how the same parameter field changes when more parameters occupy the main screen Each parameter field has less space to display its content The primary parameter value A still appears bigger than the subordinate parameters B C which no...

Page 63: ... the message Waveforms stopped appears on each waveform channel After approximately 60 seconds the waveforms start scrolling again To restart the waveforms earlier select the Freeze waveforms button again Freezing waveforms does not affect continuous monitoring of all parameters and does not freeze waveforms on the M540 Supported messages The Cockpit displays numerous messages that indicate a spec...

Page 64: ...arms button opens the Alarms dialog The user can also access parameter specific dialogs and pages directly by selecting the corresponding parameter fields on the main screen For example if the user selects the heart rate HR parameter field the Sensor parameters dialog with the ECG page appears A Dialog title B Horizontal tabs the selected tab appears light blue C Button that closes the dialog D Di...

Page 65: ...be moved This key configuration becomes part of a profile For more information see page 452 The following buttons appear on the main menu bar 011 B B B B B B B B A C Alarms Opens the Alarms dialog Mark event Stores an event in the alarm history Code Executes pre configured functions during an emergency Views Opens the Views dialog Print screen 1 Prints the contents of the current screen on a conne...

Page 66: ...lists the quick access symbol and the associated toolbar they open when selected Quick access symbol Associated Toolbar Located next to the Alarms button All alarms off or All alarms paused depending on configuration Auto set all Located next to the Views button Show all ECG Remote view Print screen C700 only Located next to the Trends Data button ECG report Rest ECG report ST report Alarm history...

Page 67: ...layed Auto and manual display modes The user interface has two display modes Auto view and manual view Auto view mode Auto view mode is a plug and play concept where the content of the main screen depends on the connected parameter signals For example as soon as an SpO2 MCable is connected the associated parameters become available for display When the MCable is disconnected the parameters are rem...

Page 68: ...ontrol the brightness of the Cockpit screen by selecting night and day mode see page 445 Night mode reduces the luminance of the screen so it is less disturbing to a patient while providing enough contrast for the clinical staff During night time mode the entire background of the screen appears almost black All buttons turn dark gray Touchscreen versus mouse Use the touchscreen or a mouse to inter...

Page 69: ... side continues to display the real time parameters while the left panel displays either a tabular trend loops ECG show all page ECG ventilation ECG ST or ST parameters see page 446 If the web enabled IT option is also activated this panel also displays IT applications that are accessible using IT tabs see page 72 The following diagram shows how the split screen mode divides up the screen A Header...

Page 70: ...nds feature is activated see page 447 If the split screen mode is not activated the mini trend panel shifts to the left edge of the screen Mini trends are updated continuously NIBP mini trends can either be represented in tabular or graphical format see Trending behavior on page 162 All other parameters appear only as graphical mini trends A Header bar B Main screen menu bar C Auto view setup tool...

Page 71: ...it screen The following diagram shows the Cockpit display when the Multi tab split screen feature is activated by itself see page 447 A Header bar B Main screen menu bar C Monitoring area with real time vital signs D Multi tab split screen three tabs whose content is configurable To configure the Multi tab split screen see page 455 567 A B C D ...

Page 72: ...ked The Mini trends feature is activated see page 447 Once the application is configured and the IT application feature is activated see page 479 the corresponding tab appears to the left of the monitoring area The Patient tab G always appears as the top tab It always returns to the main screen of the Cockpit for viewing the real time parameter display For detailed information on setting up IT tab...

Page 73: ...on on the screen For example the top parameter in the parameter selection window occupies the top spot on the main screen For more information see Configuring parameters for display on page 448 Parameter priority list The priority list appears in the parameter selection window of the Auto view page see page 446 Change the parameter priority by switching the position of the parameters in the Auto v...

Page 74: ...re configured setups This sharing of views eliminates time consuming setup tasks Views can be assigned to each profile see page 488 Selecting a view Reconfigure the screen by selecting a different view To select a view 1 Select the Views button on the main menu bar 2 Select the Views tab if it is not already selected to open a popup with pre configured views 3 Select the desired view from the Cust...

Page 75: ...ded in the five profiles is a Dräger default profile that cannot be changed The Dräger default profile is activated when the Cockpit is booted up for the first time new software is installed or factory defaults are restored The user defined patient default profile is activated whenever a new patient category is selected In addition the patient default profile is activated after patient data are tr...

Page 76: ...onitoring Color Alarm limits Alarm on off setting Alarm archive setting Arrhythmia see page 225 ARR mode Alarm archive setting Alarm priority high medium low or off Arrhythmia alarm settings see page 134 Alarm priority Rate Count ST see page 234 ST monitoring ST lead1 ST lead2 ST lead3 ST Mini Trend TruST 12 lead Event duration s Selected isoelectric point Selected ST measuring point Alarm on off ...

Page 77: ...rm archive setting Non invasive blood pressure see page 300 Interval time min Inflation mode Chime Color Alarm on off setting Alarm limits Alarm archive setting Parameter Included settings Invasive blood pressure Scale Filter Large mean Min scale ICP Color Alarm on off setting Alarm limits Alarm archive setting Respiration see page 240 Resp lead Mode Size Resp marker Resp monitoring Coincidence de...

Page 78: ...ed settings Scio Agent see page 365 Agent selection for variants with manual identification only Agent parameter field configuration Agent xMAC mini trend configuration Alarm status Alarm limits Alarm archive settings Trend scales Trends Graphical trend setup Tabular trend setup Reports Case summary setup External device profile settings External devices CCO SvO2 see page 398 Parameter 1 Parameter...

Page 79: ...aw External devices BIS see page 379 Scale uV BIS secondary parameter External devices NMT see page 385 Display temperature Parameter Included settings Alarm profile settings Alarm system settings see page 458 All alarms paused Show alarm limits Cardiac bypass OR Alarms Alarm bar enabled Alarm validation Pacer detection mode ASY VF alarms NIBP SpO2 interlock Config see page 458 Alarm volume and to...

Page 80: ...ystem settings see page 445 Monitoring sweep speed mm s Respiratory sweep speed mm s Show parameter units General profile settings Anesthesia and BIS graphical trend Configuration order of parameters Open lung tool Procedures profile settings Wedge see page 317 Scale Sweep speed mm s Reference waveform Analysis tool see page 169 Parameter selection Duration Biomed profile settings Bedside setup se...

Page 81: ...e blood pressure see page 295 Venous stasis Continuous mode ST see page 234 ST relearn Arrhythmia see page 225 Relearn Respiration see page 240 Relearn Invasive blood pressure see page 319 Selected labels from M540 etCO2 Infinity MCable Mainstream CO2 see page 345 Atm pressure Alarm history see page 139 Filter settings All Arrhythmia High priority Medium priority Low priority Time Priority Message...

Page 82: ... are install persist settings only which are identified in the following table For details on each setting such as available selections and detailed descriptions of each setting refer to the cross referenced pages Setting Shared and install persist settings Install persist only settings Screen layout settings see page 445 Brightness X Night time X General alarm settings see page 458 External devic...

Page 83: ...HP Universal Print Driver X Paper Size X Biomed patient monitor settings see page 473 Line frequency X French NFC mode X OR Alarms X HLM Bypass sync Biomed country settings see page 471 Language X Time zone X Daylight savings X Biomed unit of measurement settings page see page 472 Pressure X etCO2 X Temperature X ST X SpHb X Agent X Weight X Height X Biomed patient monitor settings page see page 4...

Page 84: ...ay X Primary DNS X Biomed network settings see page 475 Monitoring unit ID X Monitoring unit label X Care unit label X Bed label X Hospital name X Enable Central Station X Enable Remote Control X Enable Remote Silence X Biomed IT tab settings see page 482 identical for the Innovian PatientWatch Symphony Web browser and Application pages IT tabs X Name X URL X Block Popups X Full Trust X Tab visibl...

Page 85: ...n page 184 All hemodynamic parameters X All oxygenation ventilation parameters X Laboratory calculation parameter selections see page 186 PaCO2 X PaO2 X SaO2 X Hgb X Body size calculations selections see page 182 BSA X Wt weight X Ht height X Drug profile settings see page 193 For all 40 pre configured drug profiles the following settings are stored as part of each individual drug profile Name of ...

Page 86: ...functions are available for detailed instructions see Profile setup on page 484 Selecting a profile Saving a profile password protected Transferring a profile password protected Deleting a profile Entering a profile name and description Assigning a profile to a default view default profiles are automatically activated after a restart or a patient discharge Transferring profiles Profiles can be tra...

Page 87: ...canceled The message Standby Touch Screen to resume monitoring is displayed in the center of the screen To place the Cockpit in standby mode 1 Select the symbol next to the Start Standby button on the main menu bar to display the Standby toolbar 2 Select the Standby button on the toolbar or 1 Select the Start Standby button on the main menu bar to display the Standby dialog 2 Select the Start tab ...

Page 88: ...d from the Cockpit and the M540 displays but continue to be displayed at the ICS The alarm bar is deactivated Acoustic alarm signals are only provided at the ICS The message Privacy Touch Screen to resume monitoring is displayed in the center of the screen To place the Cockpit into privacy mode 1 Select the symbol next to the Start Standby button on the main menu bar 2 Select Privacy on the toolba...

Page 89: ...he touchscreen To activate screen lock 1 Select the Start Standby button on the main menu bar to display the Standby dialog 2 Select the Start tab if it is not already selected 3 Select the On button next to the menu selection Screen lock When screen lock is activated the touchscreen does not respond to touch and the rotary knob LED flashes Screen lock automatically deactivates after one minute Ho...

Page 90: ...90 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 91: ... 93 Front view of the M500 M540 docked 93 Side view of the M500 M540 undocked 93 Locking unlocking the M540 94 Additional M540 accessories 95 Connecting the system cables 95 Connecting the system cable to the PS250 P2500 and the Cockpit 95 Connecting the system cable to the PS250 P2500 and the M500 96 Mounting the Infinity MCable Masimo SET Masimo rainbow SET Nellcor OxiMax 97 ...

Page 92: ...unting solutions Various mounting solutions are available It is the responsibility of the hospital to install test and ensure the proper and safe operation of any mounting solution Contact your Dräger representative for specific approved mounting solutions CAUTION Avoid mounting solutions that could impede air flow since the M500 PS250 P2500 require ade quate airflow to dissipate heat In addition ...

Page 93: ...ortion of the M540 with the curved portion of the M500 2 Press the M540 C into the M500 D until it clicks into place 3 Push the locking tab A of the M500 towards the front to the locked position to fasten the M540 into place To lock the M540 into place permanently see Lock ing unlocking the M540 on page 94 To undock the M540 1 Push the locking tab A of the M500 towards the back If the locking tab ...

Page 94: ... tool A into the middle hole B on the locking tab and turn it clockwise to the locked position The locking tab is fixed and you cannot remove the M540 unless you unlock it again using the hex wrench tool A Hex wrench tool 2 mm B Center hole on locking tab for locking unlocking the M540 C Release buttons for undocking the M540 D Locking tab To unlock the M540 1 Insert the 2 mm hex wrench tool A int...

Page 95: ...ons for use Connecting the system cables Connecting the system cables involves 2 main steps Connecting a system cable to the PS250 P2500 and the Cockpit Connecting a system cable to the PS250 P2500 and the M500 Connecting the system cable to the PS250 P2500 and the Cockpit 1 Connect one end of the system cable to the sys tem connector on the back of the Cockpit refer to the instructions for use In...

Page 96: ...pplications VG6 n Connecting the system cable to the PS250 P2500 and the M500 1 Connect one end of the system cable B to the M500 system connector 2 Connect the other end of the system cable to one of the two PS250 P2500 system connec tors see diagram on page 95 306 Side view of the M500 B ...

Page 97: ...MCable can be mounted to the M540 The Nellcor OxiMax MCable can be mounted in the same way A M540 B Tabs of the MCable mount adapter that lock into the side of the M540 C MCable mount D Cable end of the MCable E Blue SpO2 connector F Indentations for locking the MCable mount adapter G Intermediate cable or reusable SpO2 sensor which connects directly to MCable 477 Side view connectors Bottom view ...

Page 98: ...er C points in the same direction as the connector side of the M540 2 Align the tabs on the mount adapter B with the indentations on the M540 and push firmly until the mount adapter clicks in place 3 Connect the MCable D to the blue SpO2 con nector on the M540 To remove the MCable mount adapter 1 Insert a flat head screwdriver or equivalent tool between the indentations for locking the MCable moun...

Page 99: ...ications VG6 n 99 Getting started Getting started Overview 100 Turning the IACS on off 100 Viewing demographic data 101 Admitting a patient 102 Admitting a patient using Get HIS 103 Discharging a patient 103 Patient categories 104 Selecting the patient category 105 ...

Page 100: ...king undocking the M540 on page 93 To turn the Cockpit on Press the on off key B of the Cockpit The LEDs A and the on off key light up green The Cockpit emits a power up tone and per forms a selftest After a brief moment the Dräger startup screen appears before the Cock pit main screen appears To turn the M540 on Press the on off key C of the M540 The M540 emits a high pitched tone followed by two...

Page 101: ... a patient manually see page 102 Admit a patient over the network via the Get HIS function see page 103 Discharge a patient see page 103 Change the patient category see page 105 A Demographics tab B Patient name keyboard symbol C Patient ID keyboard symbol D Physician name keyboard symbol E Get HIS button F Patient category buttons Adult Pediatric Neonate G Birth date fields H Admit date fields I ...

Page 102: ...lected 3 Enter the patient name use the symbol B next to the Patient name field to activate a keyboard for entering the patient name up to 25 alphanumeric characters 4 Enter the patient ID use the symbol C next to the Patient ID field to activate a keyboard for entering the ID number up to 12 alphanumeric characters 5 Enter the name of the physician use the symbol D next to the Physician name fiel...

Page 103: ...tient ID use the symbol C next to the Patient ID field to activate a keyboard for entering the ID number up to 13 alphanumeric characters 4 Select the Get HIS button E in the Demographics page see page 101 The Get HIS button appears grayed out and is not selectable when the HIS is not available or when the Cockpit is not connected to it Discharging a patient You can discharge a patient from the Co...

Page 104: ...t have been pre configured by the factory or the hospital for more information see Patient and default profiles on page 75 The Cockpit supports the following patient categories If an M540 docks with a different patient category from the one selected on the Cockpit the following happens The Cockpit aligns its patient category to the M540 patient category setting During the patient category alignmen...

Page 105: ...ry to adult or pediatric causes the weight to appear blank To change the patient category from the Start page The following steps are only possible when the Patient profile selection function is activated see page 473 Select the left most field on the header bar to access the Demographics page directly or 1 Select Start Standby on the main menu bar 2 Select the Start tab if not already selected 3 ...

Page 106: ...106 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 107: ...vating acoustic alarm signals 117 Pausing alarm monitoring temporarily 117 Activating or deactivating alarm monitoring 118 Configuring the alarm settings for a patient 119 Activating deactivating alarms 119 Setting the upper and lower alarm limits 120 Configuring the alarm setup for an individual pa rameter 121 Configuring the alarm setup for multiple parameters 123 Configuring the alarm message b...

Page 108: ...ages are described in detail in the Troubleshooting chapter starting on page 509 The color of an alarm message corresponds to the priority of the associated alarm condition see Alarm priorities on page 109 The alarm settings for a patient can be set up to generate automatic recordings and or store alarms for later event review in the alarm history A physiological alarm can also activate an externa...

Page 109: ...larm conditions All low priority alarms alert you to technical issues that may compromise the ability of the system to monitor the patient An example of a low priority alarm condition is an artifact on the ECG waveform Alarm processing When you dock an M540 on the M500 see page 93 all optical and acoustic alarm signals are transferred to the Cockpit automatically Acoustic alarm signals only sound ...

Page 110: ...ignals To acknowledge a latched alarm condition Press one of the following two keys The yellow key or on the front of the Cockpit The yellow key on the front of the M540 or Select the All alarms off or All alarms paused button the name and function of the button depends on the Cockpit configuration see page 459 To access the button press the quick access symbol next to the Alarms button on the mai...

Page 111: ...sts which parameters have an alarm validation time Parameters that do not appear in the table have no validation times and acoustic and optical alarm signals are triggered almost immediately Parameter Upper alarm limit Lower alarm limit ECG Heart rate HR 6 s 6 s Pulse rate PLS 6 s 10 s ST segment analysis ST 15 s to 60 s selectable 1 60 s Respiratory rate RRi 14 s 14 s Respiratory rate RRc 8 s 10 ...

Page 112: ...field 1 in header bar Alarm bar if activated see page 460 Alarm message in header bar refer to Messages on page 513 High life threatening for example asys tole ventricular fibrillation Flashing red background Red background Flashing red White alarm message on red background Medium serious for example alarm limit violations Flashing yellow background Yellow background Flashing yellow Black alarm me...

Page 113: ... solid color for any unacknowledged single notification alarm However the alarm bar is inactive when Only low priority alarm conditions exist The alarm bar is deactivated see page 460 Cardiac bypass or Privacy modes are activated see page 119 Alarm monitoring is deactivated see page 125 Header bar The header bar displays the alarm message on the background color corresponding to the alarm priority...

Page 114: ...E Normally acoustic alarm signals only sound at the Cockpit not at the M540 Therefore all acoustic alarm signals are transferred automatically from the M540 to the Cockpit once you dock the M540 However if you want alarms to sound at both devices select the alarm tone at the M540 manually Alarm priority IEC fast IEC slow Infinity High The following acoustic alarm signal is repeated every 4 5 s Thr...

Page 115: ...alarm volume of the Cockpit Minimum alarm volume setting The alarm volume is tied to the setting Minimum alarm volume see page 461 for more information If the minimum alarm volume is set to a higher volume than the selected alarm volume the alarm volume is adjusted to the higher setting If the minimum alarm setting is set to a lower setting than the current alarm volume the alarm volume does not c...

Page 116: ...ly These two distinct tones help the user identify if a speaker is malfunctioning The user should also test the optical alarm signals and acoustic alarm signals by creating an alarm condition for example by lowering the upper alarm limit of the heart rate To end the test restore the alarm limits to the previous setting see Configuring the alarm settings for a patient on page 125 Viewing current al...

Page 117: ...ring the message HR ASY VF off appears SpO2 desaturation alarms The alarm priority is upgraded to high priority if the SpO2 value falls below the Desat alarm limit Deactivating the SpO2 alarm automatically deactivates the desaturation alarm The desaturation alarm can be activated only if SpO2 alarms are activated see page 148 page 263 and page 277 When using the Infinity MCable Nellcor OxiMax this...

Page 118: ...asive blood pressure hardware failures such as a transducer failure Unplugged transducers Disconnected hemodynamic pods A wedge pressure measurement that ends before the 30 second zeroing period ends will activate the alarm limit for the parameter PA M only Privacy mode When privacy mode is activated the following happens at the Cockpit All patient data are removed from the Cockpit and the M540 bu...

Page 119: ...y records either the message Cardiac bypass on or Cardiac bypass off When the Cockpit is in cardiac bypass mode and the M540 is undocked cardiac bypass mode is not supported on the M540 Cardiac bypass is activated on the M540 after it docks to a Cockpit that is in cardiac bypass mode To activate or deactivate this function see page 460 If French NFC mode is activated Cardiac bypass mode is not ava...

Page 120: ...gnal is generated If multiple alarm conditions arise during an active pre silence period the Cockpit triggers a single acoustic alarm signal for the alarm condition corresponding to the highest priority The Cockpit remains silent for any subsequent alarm conditions of equal or lower alarm priority Initiating a pre silence period You can initiate a pre silence in several ways From the Cockpit From ...

Page 121: ...kpit see page 144 Quiet mode This feature gives you the flexibility to decide if you want restricted or full annunciation of future alarm conditions after you have already paused alarms This feature affects the audio pause behavior of the IACS and the ICS To activate or deactivate the quiet mode feature refer to Alarm setup configuring the alarm volume and tones on page 461 Activated quiet mode If...

Page 122: ...it The appearance of the yellow key depends on the Cockpit hardware version see page 26 or Press the F1 keyboard key Pressing the key that initiated the audio pause period again cancels the audio pause state and all alarm events are reported as usual To initiate an audio pause from the M540 Press the yellow key on the M540 in an IACS configuration You can audio pause alarms on the M540 when it is ...

Page 123: ...61 Pausing alarm monitoring temporarily If the password protected alarm pause feature is activated see page 459 you can pause alarm monitoring temporarily The alarm pause duration is adjustable from 1 minute to 5 minutes default is 2 minutes The following happens when you pause alarm monitoring Acoustic and optical alarm signals for new alarm conditions are suppressed for all parameters until alar...

Page 124: ...any active alarm condition stop immediately The alarming parameter field and alarm bar return to the pre alarm state Alarm messages are removed from the alarm message field of the header bar The far right field of the header bar turns yellow and displays the message All alarms off 0 and the following symbol The message All alarms off is recorded in the alarm history see page 140 NOTE If configured...

Page 125: ...ngs of multiple parameters in one page When setting alarm limits make sure that they are appropriate for the patient s condition Activating deactivating alarms Except for the following parameters you can activate or deactivate the alarm function for individual parameters Asystole and ventricular fibrillation for these arrhythmia events you cannot deactivate alarms unless the ASY VF alarms feature ...

Page 126: ...o set the alarm limits of all parameters quickly based on a percentage For more information on the Auto set function see page 139 For information regarding special SpO2 alarm limit behavior refer to the chapters SpO2 and Pulse CO Ox monitoring with Masimo SET MCable on page 260 and SpO2 and pulse rate with Nellcor OxiMax MCable on page 277 Archive function Depending on the active archive setting t...

Page 127: ...justing the alarm settings always appear at the top The alarm setup portion looks different depending on the parameter For example the following diagram shows a setup page for a composite parameter such as non invasive blood pressure There are separate alarm settings for each composite parameter systolic diastolic and mean A Alarm on off buttons for each parameter B Auto set button C Buttons setti...

Page 128: ...he parameter field when alarm monitoring is deactivated 4 Select the setup button C to adjust the upper alarm limits 5 Select the setup button D to adjust the lower alarm limits 6 Select one of the following settings for the Archive buttons E to determine what happens in response to an alarm Off no event is stored and no recording is generated Store stores the event for later review see page 140 R...

Page 129: ...or each parameter Each setup row consists of several fields for configuring the individual alarm settings When you select a field to configure a setting an orange border highlights the selected row A Limits tab B Parameter labels column C Alarm on off column D Lower limits column E Actual parameter values F Upper limits column G Archive column H General ARR and ST tabs I Display filter button J Au...

Page 130: ...ameter field when alarm monitoring is deactivated 6 Select the corresponding button in the Lower column D to adjust the lower alarm limits 7 Select the corresponding button in the Upper column F to adjust the upper alarm limits 8 Use one of the following settings in the Archive column G to determine what happens in response to an alarm Off no event is stored and no recording is generated Store sto...

Page 131: ...n be audio paused but resumes if the condition persists beyond the two minute audio pause time The message appears in the header bar of the Cockpit until the condition disappears or you acknowledge Message Available settings Description SpO2 sensor off 1 SpO2 check sensor 2 Alarm settings High Medium Low default for SpO2 check sensor One shot off default for SpO2 sensor off Assigns an alarm priori...

Page 132: ...The event is treated as a latching alarm Medium The event is treated as a medium priority alarm Low The event is treated as a persistent low priority alarm One shot The event is treated as a single notification alarm of low priority The message ECG leads off appears briefly in the header bar until the user acknowledges the condition or the condition disappears No optical or acoustic alarm signals ...

Page 133: ...be configured for this alarm message The archive setting follows the general archive status for the parameter For details on how to change the archive settings of a parameter refer to page 127 PiCCO ART catheter unplugged Alarm settings Alarm column High default off Assigns an alarm priority to the PiCCO ART catheter unplugged alarm or deactivates it The selected alarm priority affects how the ala...

Page 134: ...e selected row A Limits tab B Arrhythmia category column for identifying the ARR label C Alarm priority column for selecting an alarm pri ority D Rate column for setting the rate E Count column for setting the count F Archive column G ARR tab H Arrhythmia mode buttons I Relearn button Configuring ARR alarm settings In addition to ARR alarm settings the Limits ARR page also allows you to select the...

Page 135: ...6 Select the corresponding setup button in the Count column E to set the count 7 Use one of the following settings in the Archive column F to determine what happens in response to an alarm Off no event is stored and no recording is generated Store stores the event for later review see page 140 Record generates a timed recording Str Rec generates a timed recording and stores the event 8 Select the ...

Page 136: ...plications VG6 n A Limits tab B Parameter label column C Alarm on off column D Lower limits column E Actual parameter values F Upper limits column G Archive column H ST tab I Auto set all button J Event duration s button K ST relearn button 020 Alarms A B C D E F G H I J K ...

Page 137: ...monitoring A crossed out triangle appears in the parameter field when alarm monitoring is deactivated 5 Select the corresponding setup button in the Lower column D to adjust the lower alarm limits 6 Select the corresponding setup button in the Upper column F to adjust the upper alarm limits 7 Use one of the following settings in the Archive column G to determine what happens in response to an alar...

Page 138: ...t affected SpO2 Adult pediatric 100 saturation Neonate 98 saturation Current value value 5 ST Current value 2 0 mm Current value 2 0 mm FiO2 via Scio 100 21 etCO2 via Scio 100 18 inHal etHal inIso etIso inEnf etEnf inSev etSev inDes etDes 5 0 1 above parameter value 5 0 1 below parameter value etCO2 Current value 25 Current value 20 RRc and all others Alarm limit that is closest to but not more th...

Page 139: ... alarm history is an electronic record of alarms and events The alarm history records an entry under the following circumstances An alarm occurs for a parameter whose archive function is set to Store or Str Rec These alarm events are marked with the symbol and can be viewed in greater detail see page 141 Whenever an arrhythmia event occurs even when the alarm function is deactivated Only the archi...

Page 140: ...Select the Alarm history tab A Alarm history tab B Identifies an event C Date of the alarm D Time the alarm was stored E Duration of the alarm F Alarm priority G Alarm message H Print button for printing an alarm history report I Button for filtering the alarm history according to time priority or message J Button for filtering the alarm history according to category To filter the alarm history Th...

Page 141: ...pshot of all connected parameter values and waveforms Of the 20 second event capture 10 seconds were recorded before and 10 seconds were recorded after the event occurred To view a snapshot of a stored event 1 Select Alarms on the main menu bar 2 Select the Alarm history tab 3 Select the row of the event marked with the symbol that you wish to view The following diagram shows the event snapshot sc...

Page 142: ...igure alarm settings temporarily 1 Select Alarms on the main menu bar 2 Select the Settings tab Selection Available settings Description Alarm volume Off 5 10 to 100 in increments of 10 default is 50 NOTE The 5 setting is only available when the Minimum alarm volume setting is set to 5 Determines the volume of the alarm tone You can never turn the alarm volume lower than the selected setting for M...

Page 143: ...ff message The SpO2 sensor off message appears when the MCable detects that the sensor is no longer attached to the patient The alarm priority for this message can be configured separately for each patient category It is available for the following SpO2 cables Masimo rainbow SET MCable Masimo SET MCable For information on how to configure the alarm priority for the setting SpO2 sensor off see page...

Page 144: ...work it communicates with other Infinity monitors including other monitoring Cockpits that support remote viewing functions Furthermore the patient of any monitor that is connected to the network can be admitted at the ICS for central monitoring If you are viewing another monitor in remote view you can audio pause alarms at the remote bed You can also allow remote devices to audio pause alarms at ...

Page 145: ...multaneously each alarm message rotates in the header bar of the Cockpit and in the alarm message field of each monitor The display of remote alarm messages requires configuration see page 145 whereas the color scheme corresponds to the priority of the alarm from the Cockpit For information about alarm priorities see page 109 The remote alarm messages display in the following format bed label alar...

Page 146: ... Selection Available settings Description Alarm group Keypad for configuring an alarm group Allows you to configure several monitors as members of a group All alarms that occur at any of the monitors within the group are broadcast to all other members in the alarm group Remote alarm attention tones On Med and high only Off default Determines whether remote alarms on the network that are configured...

Page 147: ...n is deactivated and the All alarms off message appears in the header bar when you press the Code button see page 465 In addition to activating the pre configured features a timer with a red background appears in the header bar with the following two buttons Stop for stopping the timer The label of the button changes to Start Reset button for resetting the timer to zero The Code button does not fu...

Page 148: ...ar with the following two buttons Stop for stopping the timer The label of the button changes to Start Reset button for resetting the timer to zero To activate the Timer function Press the Timer button on the main menu bar Press the Start button to start the Timer To deactivate the Timer function Press the Timer button on the main menu bar a second time The timer box is removed NOTE Pressing Code ...

Page 149: ...c adult pediatric Off neonate STVM STCVM Increment 0 1 mm or 0 01 mV Upper 0 1 to 45 0 mm 0 01 to 4 50 mV Lower 0 0 to 44 9 mm 0 00 to 4 49 mV 1 0 mm 0 1 mV 0 0 mm 0 mV Off ST Increment 0 1 mm or 0 01 mV Upper 14 9 to 15 0 mm 1 49 to 1 50 mV Lower 15 0 to 14 9 mm 1 50 to 1 49 mV 1 0 mm 0 1 mV 1 0 mm 0 1 mV Off RRi adult Increment 1 Upper 6 to 100 Lower 5 to 99 adult 30 5 Off RRi pediatric neonate ...

Page 150: ...tomatically adjusts to 1 less than the SpO2 low alarm limit The SpO2 desat alarm limit cannot be raised to or above the SpO2 low alarm limit N A 75 Off NOTE Changing this set ting auto matically changes the SpO2 archive setting to the same setting SpHb SpHbv Increment 0 2 g dL 0 1 mmol L Upper 1 2 to 25 0 g dL 0 7 to 15 5 mmol L Lower 1 0 to 24 8 g dL 0 6 to 15 4 mmol L 17 0 g dL 10 6 mmol L 7 0 g...

Page 151: ...6 7 kPa Off NIBP D adult Increment 1 mmHg or 0 1 kPa On Upper 11 to 250 mmHg 1 4 to 33 3 kPa Lower 10 to 249 mmHg 1 3 to 33 2 kPa 110 mmHg 14 7 kPa 50 mmHg 6 7 kPa Off NIBP D pediatric Increment 1 mmHg or 0 1 kPa On Upper 11 to 170 mmHg 1 4 to 22 7 kPa Lower 10 to 169 mmHg 1 3 to 22 6 kPa 80 mmHg 10 7 kPa 35 mmHg 4 7 kPa Off NIBP D neonate Increment 1 mmHg or 0 1 kPa On Upper 11 to 130 mmHg 1 4 to...

Page 152: ...0 2 to 70 2 F Lower 0 0 to 38 9 C 0 0 to 70 0 F 1 0 C 3 6 F 0 0 C 0 0 F Off Txa b Increment 0 1 C or 0 1 F Upper 0 1 to 50 0 C 32 2 to 122 0 F Lower 0 0 to 49 9 C 32 0 to 121 8 F 39 0 C 102 2 F 34 0 C 93 2 F Off IBP S adult Increment 1 mmHg or 0 1 kPa GP1 S to GP4 S LV S RV S On ART S PA S Upper 24 to 300 mmHg 3 2 to 40 0 kPa Lower 25 to 299 mmHg 3 3 to 39 9 kPa 160 mmHg 21 3 kPa for GP1 S to GP4 ...

Page 153: ... D PA D Upper 24 to 300 mmHg 3 2 to 40 0 kPa Lower 25 to 299 mmHg 3 3 to 39 9 kPa 110 mmHg 14 7 kPa for GP1 D to GP4 D ART D 25 mmHg 3 3 kPa for LV D 13 mmHg 1 7 kPa for PA D RV D 50 mmHg 6 7 kPa for GP1 D to GP4 D ART D 2 mmHg 0 3 kPa for PA D LV D RV D Off IBP D pediatric Increment 1 mmHg or 0 1 kPa GP1Dto GP4 D LV D RV D On ART D PA D Upper 24 to 300 mmHg 3 2 to 40 0 kPa Lower 25 to 299 mmHg 3 ...

Page 154: ... D 2 mmHg 0 3 kPa for PA D LV D RV D Off IBP M adult Increment 1 mmHg or 0 1 kPa On Upper 24 to 300 mmHg 3 2 to 40 0 kPa Lower 25 to 299 mmHg 3 3 to 39 9 kPa 125 mmHg 16 7 kPa for GP1 M to GP4 M ART M 80 mmHg 10 7 kPa for LV M 20 mmHg 2 7 kPa for LA ICP CVP 17 mmHg 2 3 kPa for PA M RV M 12 mmHg 1 6 kPa for RA 60 mmHg 8 0 kPa for GP1 M to GP4 M ART M 40 mmHg 5 3 kPa for LV M 7 mmHg 0 9 kPa for PA M...

Page 155: ...V M 7 mmHg 0 9 kPa for PA M RV M 2 mmHg 0 3 kPa for RA ICP 0 mmHg 0 0 kPa for LA CVP Off IBP M neonate Increment 1 mmHg or 0 1 kPa On Upper 24 to 300 mmHg 3 2 to 40 0 kPa Lower 25 to 299 mmHg 3 3 to 39 9 kPa 85 mmHg 11 3 kPa for GP1 M to GP4 M ART M 80 mmHg 10 7 kPa for LV M 20 mmHg 2 7 kPa for LA ICP CVP 17 mmHg 2 3 kPa for PA M RV M 12 mmHg 1 6 kPa for RA 40 mmHg 5 3 kPa for GP1 M to GP4 M ART M...

Page 156: ... 100 Lower 18 to 99 100 20 Store etO2 Increment of 1 Upper 11 to 100 Lower 10 to 99 100 10 Off inN2O On fixed Fixed at 82 82 Not applicable Store fixed RRc Increment of 1 min Adult pediatric On neonate Upper 6 to 150 min when no CO2 device is connected 6 to 100 min when Scio is connected Lower 5 to 149 min when no CO2 device is connected 5 to 99 min when Scio is connected NOTE Scio is not availabl...

Page 157: ...PVC min Increment of 1 On Upper 1 to 50 10 Not applicable Off inHal Increment of 0 1 kPa or 0 1 On Upper 0 1 to 8 5 kPa 0 1 to 8 5 Lower 0 0 to 8 4 kPa 0 0 to 8 4 inHal 1 6 kPa 1 6 adult 1 9 kPa 1 9 pediatric 0 0 kPa 0 0 Store etHal Increment of 0 1 kPa or 0 1 Upper 0 1 to 8 5 kPa 0 1 to 8 5 Lower 0 0 to 8 4 kPa 0 0 to 8 4 8 5 kPa 8 5 0 0 kPa 0 0 Off inIso Increment of 0 1 kPa or 0 1 On Upper 0 1 ...

Page 158: ...iatric 0 0 kPa 0 0 Store etEnf Increment of 0 1 kPa or 0 1 Upper 0 1 to 10 0 kPa 0 1 to 10 0 Lower 0 0 to 9 9 kPa 0 0 to 9 9 10 kPa 10 0 0 kPa 0 0 Off inSev Increment of 0 1 kPa or 0 1 On Upper 0 1 to 10 0 kPa 0 1 to 10 0 Lower 0 0 to 9 9 kPa 0 0 to 9 9 4 4 kPa 4 4 adult 5 1 kPa 5 1 pediatric 0 0 kPa 0 0 Store etSev Increment of 0 1 kPa or 0 1 Upper 0 1 to 10 0 kPa 0 1 to 10 0 Lower 0 0 to 9 9 kPa...

Page 159: ...12 5 kPa 12 5 adult 14 5 kPa 14 5 pediatric 0 0 kPa 0 0 Store etDes Increment of 0 1 kPa or 0 1 Upper 0 1 to 20 0 kPa 0 1 to 20 0 Lower 0 0 to 19 9 kPa 0 0 to 19 9 20 kPa 20 0 0 kPa 0 0 Off xMAC high On The user can not configure the xMAC limits Not applicable Not applicable Store Parameter Alarm default status Alarm limit range Upper limit defaults Lower limit defaults Archive default setting ...

Page 160: ...ec ARTF Off Not adjustable Not adjustable Off RUN Medium not adjustable Rate VTACH 3 to VT count 1 3 to 9 changes based on VTACH Str Rec AIVR Medium Not adjustable VTACH rate 1 119 Not adjustable 3 Off SVT Medium 120 to 200 150 Increments of 10 3 to 10 3 Increments of 1 Str Rec CPT Low Not adjustable Not adjustable Str Rec BGM Low Not adjustable Not adjustable Str Rec TACH Off 100 to 200 130 Incre...

Page 161: ...features 168 Printing a graphical trend report 168 Analysis tool page 169 The layout of the Analysis tool page 169 Interacting with the Analysis tool page 170 Configuring the parameter content 170 Using the cursors 171 Freezing the display 171 Selecting an interval 172 Printing an Analysis tool graphical trend report 172 Tabular trend 172 The layout of the tabular trend 173 Interacting with the ta...

Page 162: ...ected network devices every 60 seconds Trend data can be viewed in graphical or tabular format Additional customization of the trend display includes selecting which parameters are displayed selecting the time period of the trended parameters The Cockpit maintains one trend database per patient If the user docks an M540 that was previously docked on another Cockpit the trend data from the previous...

Page 163: ... 3000 Infinity Perseus A500 Zeus IE Primus family Apollo for a list of trended parameters see page 404 Medibus compatible devices Dräger Evita 2D Dräger Evita 4 Dräger Evita XL for a list of trended parameters see page 434 Maquet SERVO i for a list of trended parameters see page 422 BIS VISTA BIS EMG SQI BSR PWR SEF BCT NMT T NMT Pulse oximetry parameters with Masimo SET SpO2 PLS PI Pulse oximetry...

Page 164: ...a pages you can change the parameter content However the Graph vitals is a pre configured display consisting of the following set of commonly trended parameters which are displayed in four graphical windows To access the graphical trend pages 1 Select the Trends Data button on the main menu bar 2 Select the Trends tab if not already selected 3 Select one of the following graphical trend pages Grap...

Page 165: ...aph tab accesses graphical trends C Table tab accesses the tabular trends D Graph vitals tab accesses the graphical trends of a set of pre configured trend parameters E Ventilation Anesthesia tab accesses the graphical trends of a set of pre configured trend parameters for critical care or anesthesia ventilation F BIS tab accesses the graphical trends for the BIS VISTA device G Trend setup symbol ...

Page 166: ...dibus X devices using the device connectivity option for a list of supported Medibus X devices see page 403 D OK button E Cancel button F Clear all button deselects any buttons that are currently selected G Group of parameter buttons entitled Other for selecting miscellaneous parameters such as SpO2 temperature and so on H Group of parameter buttons entitled CO2 for selecting CO2 related parameter...

Page 167: ... page One way to navigate through the entire trend data is by using the scroll bar It is located at the bottom of the graphical trends pages The scroll bar consists of single and double arrows and a moveable navigation bar The double arrows scroll through larger portions than the single arrows If more trend data are stored than are currently displayed the navigation bar located between the arrows ...

Page 168: ...y features 1 Access the desired graphical trend page see page 164 2 Select the Grids on off button I to display or hide the background grid 3 Select the Graphs button J and use the rotary knob to select how many trend windows are displayed One to four trend windows can be selected 4 Use the View button K to select how much time is displayed on the Graph page The available settings are 1 h 2 h 4 h ...

Page 169: ... three parameters and associated values Use the cursor buttons to reference separate data points on the graphs The corresponding values are displayed next to the graphs The current values for the selected trend parameters are always displayed across the top of the screen To access the Analysis tool page 1 Select the Procedures button from the main menu bar 2 Select the Analysis tool tab The layout...

Page 170: ...ay filter button A to toggle between the filtered or unfiltered display When the button is on a light green background only the buttons of the connected parameters are displayed When the symbol appears on a dark green background the buttons of all parameters whether monitored or not are displayed 5 Select the parameters to display in the selected trend window Up to three parameters can be selected...

Page 171: ...oint The trend parameter fields to the right of the graphical trends show the following information for each parameter corresponding to the cursor positions Δvalue time elapsed between the two cursors Initial value End value In addition to values symbols appear next to the values to indicate how the parameters inside the cursors have trended An equal sign means that the values have remained the sa...

Page 172: ...ns grayed out and cannot be selected To print a recruitment graphical trend report 1 Select the Procedures button from the main menu bar 2 Select the Analysis tool tab 3 Set both cursor buttons see page 171 4 Select the Print button Tabular trend The tabular trend displays trend data in data columns Trend data are updated according to the selected time scale For example if the current time scale i...

Page 173: ...n C Parameter columns D Latest trend data E Graph tab see page 169 F Table tab G Graph vitals tab see page 169 H Anesthesia workstation tab accesses the tabular trends of a set of pre configured trend parameters for critical care or anesthesia ventilation I BIS tab for accessing the tabular BIS trends J Scroll keys and scroll bar K Print button L Setup button for selecting which parameters are dis...

Page 174: ...abular trend panel Navigating through the tabular trend The trend data base for a patient may contain more data than can be displayed on the tabular trend Use the scroll bars to navigate through the entire trend data They are located at the bottom and along the right side of the tabular trend The scroll bars consists of single and double arrows and a movable navigation bar The double arrows scroll...

Page 175: ...mperature and so on L Group of parameter buttons entitled CO2 for selecting for selecting CO2 related parameters M Group of parameter buttons entitled More devices for selecting additional parameters To modify the parameter selection for a tabular trend 1 Access the Trends Table page see page 175 2 Select the trend setup symbol at the bottom of the tabular trend 3 Use the display filter button A t...

Page 176: ...meter appears in the mini trends To configure the mini trend display 1 Select the System setup button on the main menu bar to activate the System setup dialog 2 Select the Auto view tab along the right side of the System setup dialog 3 Select the button next to Mini trends 4 Select one of the following settings Off deactivates the mini trend display 10 min 15 min 20 min 30 min default 45 min 1 h 9...

Page 177: ...nesthesia Ventilation Hemo Labs Reports NOTE The horizontal tab Ventilator changes to Anesthesia Ventilation when a anesthesia machine is connected Data review page Description Available functions Show all page under the ECG tab This page shows the waveforms of all connected leads along with the scale and the waveform label Print button for requesting a Rest ECG report Print button for requesting ...

Page 178: ...modynamic parameters includes parameters available using the device connectivity option Data review page displaying the currently monitored hemodynamic parameter values Hemo Calc Results page Displays calculation results The same page is also available under the Calculations tab see page 185 Setup button for activating a pop up window for selecting which parameters are included or excluded from th...

Page 179: ... summary report see page 502 for details Labs page Laboratory data are sent to the Cockpit over the Infinity network Whenever new laboratory data are available the following happens at the Cockpit An attention tone sounds provided the attention tone feature is activated see page 445 The message New lab data available appears in the header bar The message disappears when the laboratory data is acce...

Page 180: ...180 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 181: ...ulations 183 Viewing the calculation results 185 Viewing and saving calculations 185 Laboratory data 186 Capturing laboratory data 186 Calculation equations 187 Hemodynamic parameters 187 Oxygenation and ventilation parameters 189 Drug calculations 191 Accessing the drug calculation functions 191 Performing drug calculations 192 Customized drug list 192 Customizing the drug list 193 Drug calculato...

Page 182: ...culates oxygenation and ventilation parameters see page 189 in addition to hemodynamic parameters Calculating the body surface area The Ht height and current Wt weight values are used to compute the BSA body surface area in m2 For adult and pediatric patients these values are pulled automatically from the Demographics page which is populated during patient admission see page 102 Because of changin...

Page 183: ...n Ventilation parameters J Hemodynamics parameter values Performing calculations Calculations are based on automatically captured and manually entered values In pediatric and adult mode the current height and weight used to compute the BSA value are taken from the Demographics page the first time you capture any values In neonatal mode you must enter the weight manually The height is taken from th...

Page 184: ...buttons with the current values 4 Select the Capture labs button C The Cockpit populates the available laboratory parameter buttons with current values 5 Edit or add any value by selecting the button next to a parameter label to activate a popup with a keypad The popup displays the valid range of the selected parameter Any modified value is identified by the symbol 6 Select the Enter button on the...

Page 185: ...ults tab G Scroll bar H Save button I Setup button Viewing and saving calculations The Results page allows you to configure the display and save calculations You can save up to 50 calculations before they are overwritten on a first in first out basis The scroll bar G consists of single and double arrow keys and a moveable bar The double arrows scroll through larger portions than the single arrows ...

Page 186: ...se parameters manually 5 Select the OK button in the pop up window to confirm your selection The list of parameters is adjusted accordingly on the Results page To save calculations 1 Select the Procedures button from the main menu bar 2 Select the Calculations tab if not selected 3 Select the Results tab 4 Select the column of calculations you wish to save as reference values An orange frame highl...

Page 187: ...red parameter values for the hemodynamic calculations Label Description Available units ART S Systolic arterial blood pressure mmHg kPa ART M Mean arterial blood pressure mmHg kPa ART D Diastolic arterial blood pressure mmHg kPa C O Cardiac output intermittent L min CCO Cardiac output continuous L min CVP Central venous blood pressure mmHg kPa HR Heart rate bpm PA M Mean pulmonary arterial blood p...

Page 188: ...RT M PWP x SVI g x m m2 PVR Pulmonary vascular re sistance 79 96 x PA M PWP C O dyn x s cm5 PVRI Pulmonary vascular re sistance index 79 96 x PA M PWP CI dyn x s cm5 m2 RPP Rate pressure product ART S x HR mmHg min RVSW Right ventricular stroke work 0 0136 x PA M CVP x SV g x m RVSWI Right ventricular stroke work index 0 0136 x PA M CVP x SVI g x m m2 SV Stroke volume C O x 1000 HR mL SVI Stroke v...

Page 189: ...laboratory values Label Description Available units Hgb Hemoglobin concentration g dL inO2 FiO2 Inspired oxygen PaCO2 Arterial CO2 partial pressure mmHg PaO2 Arterial oxygen partial pressure mmHg Pplat Pplat Pause plateau pressure cmH2 mbar Pb Ambient pressure mmHg kPa PeCO2 Mixed expired CO2 partial pressure mmHg PEEP Positive end expiratory pressure cmH2 mbar PIP Peak inspiratory pressure cmH2 m...

Page 190: ...xygen index 10 x CaO2 x CI DO2 BSA mL min m2 MValv Alveolar minute volume VTe TVd phy x RR mL min MVe Expired minute volume VTe x RR 1000 L min MV C O Ventilation cardiac output ratio MValv C O No units O2ER Oxygen extraction ratio CaO2 CvO2 CaO2 No units P A a O2 Alveolar arterial oxygen difference iO2 x Pb 47 PaCO2 PaO2 iO2 100 x Pb 47 PaCO2 PaO2 mmHg Qs Qt Intrapulmonary right left shunt percen...

Page 191: ...hen a patient is discharged For more information on how to create a customized drug list see page 192 Accessing the drug calculation functions The following diagram shows the Drug calculation page where you perform drug dosage calculations A Drug dosage tab B Select drug list arrow button C Drug calculation tab D Setup button for customizing the drug list see page 192 E Buttons for entering values...

Page 192: ...meters such as Rate by selecting the corresponding button and entering the values on the keypad 5 Select Enter on the keypad to confirm your selection Customized drug list Customizing a drug list requires a clinical password The drug list contains up to 40 drugs with the following pre configured settings the name amount volume dose and unit of measurement Once configured a drug and its settings ar...

Page 193: ...lect an existing drug name for editing or an Untitled entry for adding a new drug name The selected drug is assigned to the Edit drug name field C 6 Select the pencil symbol next to the Edit drug name field C to activate a keyboard 7 Edit or enter a drug name using the keyboard A maximum of 25 alpha numeric characters are available 8 Select the Enter button on the keyboard 9 Select the Amount butt...

Page 194: ... The time over which the infusion is administered User selectable Dose The amount of a drug the physi cian prescribes standardized by weight and time Rate x concentration or Rate x concentration weight Total dose Total dose over duration Dose x duration Total volume Total volume over duration Rate x duration Parameter Range and units Daily weight 0 1 to 350 kg adult pediatric 1 to 10000 g neonate ...

Page 195: ... mol kg min or h 0 01 to 100 000 g kg h k units kg h 0 01 to 100 M units kg h Neonatal 0 01 to 100 000 000 000 µg g h m units g h mEq g h mmol g h 0 01 to 100 000 000 mg g h units g h mol g h 0 01 to 100 000 g g h k units g h 0 01 to 100 M units g h Dose Daily weight per minute Adult and pediatric 0 01 to 1 666 666 666 66 µg kg min mEq kg min m units kg min mmol min Neonatal 0 01 to 1 666 666 666 ...

Page 196: ...196 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 197: ...ation three electrodes IEC AHA 208 Standard configuration five electrodes IEC AHA 208 Pacer configuration five electrodes IEC AHA 209 Standard configuration six electrodes IEC AHA 209 12 lead configuration ten electrodes for 12 lead Rest ECG monitoring AHA 210 12 lead configuration ten electrodes for 12 lead Rest ECG monitoring IEC 210 12 lead monitoring 211 Accessing the ECG functions 211 ECG par...

Page 198: ...26 TruST 12 lead monitoring 227 12 lead ST monitoring 227 Connecting lead sets for ST monitoring 227 ST display 228 Reviewing ST complexes 229 Reviewing all ST complexes 229 Zooming in on an ST complex 230 ST measuring points 231 Adjusting ST measuring points 231 ST reference 232 Saving ST reference points 232 ST alarm settings 233 Accessing the ST settings 233 ST setup functions 234 Learning rele...

Page 199: ...for use for detailed parameter specifications It calculates heart rates within a range of 15 beats to 300 beats per minute using the R R intervals of the last 10 seconds This calculation excludes the two longest and the two shortest R R intervals The M540 averages the remaining intervals and displays the result as the current heart rate in the heart rate parameter field For adult and pediatric pat...

Page 200: ...ers from that of its equivalent conventional lead always refer to the conventional lead WARNING To prevent patient injury always verify the timing of the QRS synchronization pulse before attempting cardioversion using the Infinity MCable Analog Sync WARNING Do not rely solely on the ECG when monitoring seizure prone patients Electrical artifacts of non cardiac origin such as seizure may prevent de...

Page 201: ...tor A Orient the lead set C so the exposed pins face towards you as you push it firmly into the ECG port 2 Insert the port cover D to protect the unused ECG lead pins 3 Connect the lead wires to the patient For information on applying the electrodes to the patient refer to the figures starting on page 208 312 A B D 5 C NOTE An ECG lead set can rest in the ECG connector of the M540 without actually...

Page 202: ... information on applying the electrodes to the patient refer to the figures starting on page 208 311 B C A 5 NOTE An ECG lead set can rest in the ECG port of the M540 without actually being connected Make sure that all ECG lead sets are pushed firmly into the ECG port of the M540 Almost every MonoLead features a number on the lead set indicating how many leads connect When connecting a MonoLead ma...

Page 203: ...n the side of the M540 Orient the neonatal ECG adapter cable B so the exposed pins face towards you as you push them firmly into the ECG port 2 Insert the port cover D to protect the unused ECG lead pins on the M540 3 Connect the individual neonatal ECG lead wire C to the neonatal ECG adapter cable B For information on applying the electrodes to the patient refer to the figures starting on page 20...

Page 204: ...urgery keep electrodes as far from the surgical site as possible while maintaining a clinically useful lead configuration Place the cable and lead wires as far from the ESU as possible and perpendicular to the ESU cables Burn Patients use sterile electrodes Clean the equipment thoroughly and follow hospital infection control procedures Incorrect placement of electrodes affects the signal quality E...

Page 205: ...information regarding the content of parameter fields for each parameter see the chapter Troubleshooting on page 509 The ECG parameter field contains the following elements A Parameter label B Units of measure can be activated deactivated C Upper lower alarm limits or crossed triangle symbol when alarms are deactivated D Heart rate value E Heart symbol that flashes with each detected ECG complex i...

Page 206: ...ntify paced beats Pacer spikes are printed on strip recordings Depending on the selected lead set and the ECG cable type up to 3 ECG waveforms are displayed To select the number of leads and the lead set see page 212 042 C B A Lead set Available ECG leads Three elec trodes I II or III Five electrodes I II III aVR aVL aVF V 1 Six electrodes Standard I II III aVR aVL aVF V V 1 TruST I II III aVR aVL...

Page 207: ... coded according to IEC and AHA IEC AHA US L Yellow LA Black F Green LL Red R Red RA White C C2 White white and yellow V V2 Brown brown and yellow N Black RL Green C C5 Gray and white white and black V V5 Gray and brown brown and orange C6 White and violet V6 Brown and violet C4 White and brown V4 Brown and blue C3 White and green V3 Brown and green C1 White and red V1 Brown and red ...

Page 208: ...T segment 208 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n Electrode placement Standard configuration three electrodes IEC AHA Standard configuration five electrodes IEC AHA 314 315 316 317 ...

Page 209: ...ions for use Infinity Acute Care System Monitoring Applications VG6 n 209 ECG arrhythmia and ST segment Pacer configuration five electrodes IEC AHA Standard configuration six electrodes IEC AHA 318 319 320 321 ...

Page 210: ...0 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n 12 lead configuration ten electrodes for 12 lead Rest ECG monitoring AHA 12 lead configuration ten electrodes for 12 lead Rest ECG monitoring IEC 324 322 ...

Page 211: ...You can view all ECG waveforms including TruST on the Show all page see page 215 For information on how to activate TruST see page 234 Accessing the ECG functions Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page If you cannot see the tab select the following two symbols located in ...

Page 212: ...n Settings 1 page Pulse tone volume Off 5 10 default to 100 in increments of 10 Sets the volume of the pulse tone Tone source ECG default SpO2 Sets the source of the pulse tone HR source ECG default derives the heart rate from the ECG signal ART derives the heart rate from the arterial blood pressure signal The heart rate parameter field label changes to APR and appears in the color of ART SpO2 de...

Page 213: ...II aVR aVL aVF V1 to V6 Default for lead 1 II Default for lead 2 V with TruST and a 6 wire lead set plus a 4 wire lead set the default is V2 Default for lead 3 aVF Assigns specific leads for each waveform depending on which lead mode is selected Size mV cm 0 25 0 5 1 default 2 4 8 mV cm Sets the scale of individual ECG waveforms Color Red green default blue yellow light blue purple orange white De...

Page 214: ...g Controls the sensitivity to various artifact sources When the M540 is in OR mode and the filter selection is set to Monitor the hardware low pass ESU filter is activated RRi is unavailable 12 lead ECG monitoring is unavailable None of these filter settings are of diagnostic quality Pacer detection Not available in neonatal mode On default Off the message Pacer off appears in the waveform channel...

Page 215: ...setting arrhythmia processing occurs only on the lead displayed in waveform channel 1 ECG1 2 setting arrhythmia processing occurs on the leads displayed in the waveform channels 1 and 2 Size all ECG mV cm 0 25 0 5 1 default 2 4 8 mV cm Sets the amplitude of all displayed ECG leads QRS threshold Normal default Low WARNING Risk of inaccurate HR value If the QRS setting is set to Low in the pres ence...

Page 216: ...entify pacer spikes When pacer detection is deactivated the message Pacer off appears in the top ECG channel To optimize pacer monitoring follow the guidelines on page 219 To activate deactivate pacer detection Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the Settings ...

Page 217: ...atients with pacemakers Deactivating pacer detection for paced patients may result in pacemaker pulses being counted as regular QRS complexes which could prevent an asystole alarm from being detected Always verify that the pacer detection status is correct for the patient Be aware that setting the ECG filter option to ESU deactivates pacemaker detection automatically WARNING Interference from a mo...

Page 218: ...ce them if necessary Transcutaneous electrical nerve stimulators Signals from transcutaneous electrical nerve stimulators TENS often resemble pacer signals and can be labeled as such The M540 can reject valid QRS complexes which follow misinterpreted TENS signals If TENS signals continue to register as pacer spikes deactivate pacer detection see page 214 WARNING Pay close attention to pacemaker pa...

Page 219: ...hese values to the Cockpit for display Arrhythmia monitoring is not available for neonates To make sure that asystole and ventricular fibrillation alarms are reported even when heart rate alarm monitoring and arrhythmia monitoring is deactivated set the ASY VF alarms selection in the General settings page to Always on see page 458 The selected arrhythmia mode see page 221 controls which arrhythmia...

Page 220: ...he lead in the top channel ECG1 2 dual channel selection determines the heart rate and ARR based on the leads in the two top channels To select arrhythmia leads Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the Settings 2 tab 4 Select the button next to ECG1 or ECG1 2 a...

Page 221: ... selectable interval 12 ARTF artifact background rhythm For a description of the arrhythmias and associated events see Arrhythmia modes An arrhythmia with a high grade alarm configura tion has a higher priority than an arrhythmia with a medium low or disabled alarm grade configuration An arrhythmia with a medium grade alarm configu ration has a higher priority than an arrhythmia with a low or disa...

Page 222: ...he VTACH rate 2 4 PVC Premature Ventricular Contraction PVC alarm limit exceeded The PVC parameter value represents the number of QRS complexes classified as PVCs over a 1 minute interval ARTF Artifact More than 50 of beats in the last minute were classified as questionable Advanced arrhythmia monitoring mode includes Basic mode events plus the following additional events RUN Ventricular RUN Serie...

Page 223: ...ate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the ARR settings tab 4 Select one of the following modes next to ARR mode button located below the arrhythmia alarm setup table Off Basic Advanced only available when the full arrhythmia option is unlocked Arrhythmia display When arrhythmia m...

Page 224: ... field contains the following elements A Heart rate parameter label B Units of measure can be activated deactivated C Arrhythmia label D Area reserved for actual event calls for example Brady or the message LEARN E Upper lower alarm limits or crossed triangle symbol when alarms are deactivated F Number of Premature Ventricular Contractions PVC per minute G PVC min label H Heart rate I Heart symbol...

Page 225: ...ess the ECG page 2 Select the ARR settings tab Arrhythmia parameter setup functions All arrhythmia setup functions take place in the ARR settings page Selection Available settings Description ARR mode Off Basic default Advanced requires the full arrhythmia locked option Selects which events are reported see page 221 for more details Relearn None Establishes a new QRS templates See Configuring the ...

Page 226: ...itoring functions are configurable on parameter specific setup pages see page 234 Before performing any monitoring functions refer to the section For your safety and that of your patients on page 13 Standard ST monitoring The 6 wire lead set monitors eight ECG leads of which two are chest leads V and V 12 lead ST analysis provides the most comprehensive view of a patient s condition However with o...

Page 227: ...de mm or mV between the current ST vector and the ST vector at the time of the last reference STCVM values also show a change in the location of the ST vector over time To activate or deactivate ST monitoring You can activate deactivate ST monitoring at any time as follows Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 S...

Page 228: ...the alarm status of parameters Parameter fields can also report technical conditions such as disconnected sensors and so on For detailed information regarding the content of parameter fields for each parameter see the chapter Troubleshooting on page 509 The ST parameter field contains the following elements A Selected ST lead labels B Upper lower alarm limits or crossed triangle symbol when alarms...

Page 229: ...s The following diagram shows the ST complex page The number of displayed ST complexes depends on the connected lead set A ECG tab B ST complex tab C Save reference button D Print button for generating an ST report E ST button F Reference on off button G ISO button H Relearn button I ST panels for each monitored ST lead including waveform scale ST measuring point isoelectric point and reference po...

Page 230: ...n ST panel on the ST complex page see page 229 A ECG tab B Waveform scale C ST complex tab D Save reference button saves the displayed ST complex as a reference point E Print button for printing an ST report F Reference on off button G ST button H Lead button for selecting the desired lead I ISO button J Show all button accesses the general ST complexes screen K Relearn button see page 236 L ST la...

Page 231: ...er you adjust the isoelectric and ST measuring points the ST deviation is recomputed During this computation the changing ST deviation values appear yellow The values appear green when the computation is completed To change ST measuring points Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access th...

Page 232: ...9 and the single ST complex page see page 229 Saving a reference point in either screen saves all currently displayed ST complexes as reference points To save ST reference points Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the ST complex tab to display the general ST ...

Page 233: ... more detailed information on how to configure these functions see Alarm setup for ST on page 135 To access the ST alarms page Select the heart rate parameter field to select the ECG page directly or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the ST alarms tab to display the ST alarms page Accessing the ST settings Select the heart rate p...

Page 234: ...hether TruST monitoring is available see page 218 ST relearn not available if ECG is not connected in neonatal mode or ST monitoring is disabled None Purges stored average ST complexes blanks displayed average ST complexes and learns the arrhythmia and dominant QRS pattern ST lead1 ST lead2 ST lead3 Three electrodes STI STII STIII Five electrodes STI STII STIII STaVR STaVL STaVF STV Six electrodes...

Page 235: ...end Three electrodes STI STII STIII Five electrodes STI STII STIII STaVR STaVL STaVF STV Six electrodes STI STII STIII STaVR STaVL STaVF STV STV Six electrodes with TruST activated STI STII STIII STaVR STaVL STaVF STdV1 STV2 STdV3 STdV4 STV5 STdV6 Ten electrodes STI STII STIII STaVR STaVL STaVF STV1 STV2 STV3 STV4 STV5 STV6 STCVM and STVM Default STII Selects an ST lead for inclusion in the ST min...

Page 236: ...vail able lead if the ARR processing setting is ECG1 2 A lead off condition of a processed lead is re solved The neutral lead is changed A lead set is physically connected if that lead set provides the neutral or processed lead s The cable type is changed The OR Alarm setting is changed The M540 is docked in an IACS configuration whose profile has a different ECG lead configu ration A standalone M...

Page 237: ...Select the heart rate parameter field to select the ECG page or 1 Select Sensor parameters from the main menu bar 2 Select the ECG tab to access the ECG page 3 Select the ST settings tab 4 Select Relearn NOTE If configured to appear on the main menu bar a Relearn ARR button is accessible on the main menu bar For more information see page 452 NOTE If configured to appear on the main menu bar a Rele...

Page 238: ...238 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 239: ...re lead sets for respiration monitoring 241 Connecting the lead sets for 12 lead monitoring 242 Connecting the lead wires for neonatal monitoring 243 Patient preparation for respiration monitoring 244 Respiration display 246 Ventilation parameter field 246 Breath markers 246 Adjusting the detection threshold and activating the breath marker 247 Respiration measuring modes 247 Accessing the respira...

Page 240: ... apnea monitoring Refer to the Instructions for use Infinity Acute Care System Infinity M540 for a detailed description of the M540 respiration functions The respiration monitoring functions are configurable in the parameter specific setup page see page 248 Before performing any monitoring functions refer to the section For your safety and that of your patients on page 13 Parameter specific error ...

Page 241: ...ient refer to the figures starting on page 208 WARNING The monitor reports an apneic event when no breaths are detected within the established apnea alarm time period Therefore do not rely on RRi monitoring as the sole method for detecting cessation of breathing Dräger recommends the monitoring of additional parameters that indicate the patient s oxygenation status such as etCO2 and SpO2 Heart rat...

Page 242: ... patient For information on applying the electrodes to the patient refer to the figures starting on page 208 311 A B C NOTE An ECG lead set can rest in the ECG port of the M540 without actually being connected Make sure that all ECG lead sets are pushed firmly into the ECG port of the M540 Almost every MonoLead features a number on the lead set indicating how many leads connect When connecting a M...

Page 243: ... ECG connector A on the side of the M540 Orient the neonatal ECG adapter cable B so the exposed pins face towards you as you push them firmly into the ECG channel 2 Insert the port cover C to protect the unused ECG lead pins on the M540 3 Connect the individual neonatal ECG lead wires E to the neonatal ECG adapter cable D For information on applying the electrodes to the patient refer to the figur...

Page 244: ...ollow the same precautions for respiratory monitoring as for ECG monitoring see page 201 and observe the following general recommendations Place the electrodes so they generate the clearest possible signals with minimal artifact Electrodes that adhere tightly and have a large conductive area provide the best results Use a 5 wire lead set to improve the respiration signal where the N electrode for ...

Page 245: ...5 Impedance respiratory rate RRi For neonates place the RA and LA electrodes at the midaxillary line Position the LL electrode below the diaphragm and umbilicus Avoid the liver area and ventricles of the heart to prevent blood flow artifact 495 328 AHA electrode neonates placement ...

Page 246: ...surement RRi B Upper lower alarm limits or crossed triangle symbols when alarms are deactivated C Respiratory rate value D Lung symbol that blinks with each detected breath Breath markers Breath markers indicate the time of breath detection not the beginning or end of respiration If breath markers also appear during artifact set the respiration measuring mode to manual and adjust the breath detect...

Page 247: ... patients with regular breathing patterns It uses the optimal breath detection threshold calculated at the beginning of respiration monitoring Manual appropriate for adult or pediatric patients whose breathing patterns show excessive variation Also appropriate for neonates with irregular breathing rhythms whose respiration signals may otherwise not be reliably evaluated The M540 does not set a bre...

Page 248: ...alarm functions For detailed alarm setup information see Configuring the alarm settings for a patient on page 125 Ventilation parameter setup functions All respiration setup functions take place in the Resp page Selection Available settings Description Settings 1 page Resp lead I II default Selects the lead for respiration monitoring Relearn None Initiates a relearning of the respiration signal Mo...

Page 249: ... blue purple orange white default Determines the color of the waveforms parameter labels and values Settings 2 page Coincidence detect On Off default Determines whether or not you are alerted when the respiratory rate is within 20 of the heart rate which is an indication that the M540 is counting heart beats as respiration RRi apnea time s Off 10 15 default 20 25 30 seconds Determines how long an ...

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Page 251: ... parameters 252 SpO2 and Pulse CO Ox precautions 254 Connecting the Masimo SET MCable 256 Connecting the Masimo rainbow SET MCable 257 Patient preparation 258 Applying the sensor 258 SpO2 and Pulse CO Ox display 259 Reviewing the SpO2 and Pulse CO Ox parameters 262 Accessing the SpO2 settings 263 SpO2 parameter setup functions 264 Masimo rainbow SET Pulse CO Ox parameter setup functions 266 Passwo...

Page 252: ...ral tissue The PI value provides information regarding the perfusion status of the selected application site This provides a means to select the most optimal site The Infinity MCable Masimo rainbow SET measures additional parameters that continuously and non invasively measure blood constituents SpO2 and Pulse CO Ox measurements are for adult pediatric and neonatal patients with the following exce...

Page 253: ...es circulating blood volume and vascular tone The unit of measurement is Carboxyhemoglobin saturation SpCO measures the amount of carbon monoxide that is bound to hemoglobin The unit of measurement is Methemoglobin saturation SpMet measures the methemoglobin concentration in arterial blood The unit of measurement is Various sensors are available for the Masimo rainbow SET MCable The availability o...

Page 254: ...d blood samples should be analyzed by laboratory instruments to completely understand the condition of the patient WARNING The pulsations from an intra aortic balloon support can elevate the pulse rate Verify the pulse rate of the patient against the heart rate WARNING Elevated levels of methemoglobin MetHb may lead to inaccurate SpO2 and SpCO measurements Elevated levels of total bilirubin may le...

Page 255: ... use the device with unauthorized sensors or cables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device NOTE Purchase of this device confers no express or implied license under any Masimo patent to use this instrument with any oximetry sensor that is not manufactured or licensed by Masimo For a list of approved sensors se...

Page 256: ...able A SpO2 port on the M540 B MCable connector C MCable 14 pin connector D or F Intermediate cable connector to MCable E or G Intermediate cable connector to sensor To connect the Masimo SET MCable 1 Attach the MCable connector B to the blue SpO2 port A of the M540 2 Attach the sensor intermediate cable D or F to the connector of the Masimo SET MCable 14 pin connector C 3 Attach the appropriate M...

Page 257: ...Fields that appear empty denote parameters that might be activated later A Masimo MCable can be mounted to the back of an M540 see page 97 To connect the Masimo rainbow SET MCable 1 Attach the MCable connector B to the blue SpO2 port A of the M540 2 Attach the intermediate cable D E to the 20 pin connector of the MCable C 3 Attach the appropriate Masimo sensor to the end of the intermediate cable ...

Page 258: ...arterial catheter or intravascular line The maximum sensitivity mode for Masimo MCable is recommended for patients with low perfusion or when the low perfusion or low signal quality message is displayed on the screen in APOD or normal sensitivity mode This mode is not recommended for care areas where patients are not monitored visually such as general wards It is designed to interpret and display ...

Page 259: ...ts of SpO2 parameter field A user configurable Pulse CO Ox parameter field when a Masimo rainbow SET MCable with additional parameters activated is connected SpO2 pulse plethysmogram waveform The following table lists the maximum times the M540 requires to report the parameter values after connecting the sensor to the MCable 330 NOTE After connecting the sensor if the sensor LED does not light up ...

Page 260: ...le The Pulse CO Ox parameter field appears in addition to the regular SpO2 parameter field when a Masimo rainbow SET MCable is connected that supports parameters in addition to the standard parameter set SpO2 PLS PI The parameter content of the parameter field is configurable see page 266 The display of Pulse CO Ox parameters SpHb SpHbv SpOC SpMet PVI SpCO is affected by the following conditions B...

Page 261: ...ing elements A Parameter 1 Pulse CO Ox label B Parameter 2 Pulse CO Ox label C Upper lower alarm limits or crossed triangle symbols when alarms are deactivated for the parameters SpOC and PVI there are no alarm limits D Parameter 3 Pulse CO Ox label E Parameter 3 Pulse CO Ox value F Parameter 2 Pulse CO Ox value G Alarm off symbol when alarms are deactivated When alarms are activated the alarm lim...

Page 262: ...SET parameter is activated on the Masimo rainbow SET MCable only the parameter label but no trends appear The following diagram is an example of a Show all page A SpO2 tab B Show all sub tab C Duration button to select the trend duration D Display area showing parameter labels values trend scales mini trend and selected intervals To access the SpO2 and Pulse CO Ox Show all screen 1 Select the CO O...

Page 263: ...lect Sensor parameters from the main menu bar 2 Select the horizontal SpO2 Pulse CO Ox tab If you cannot see the tab select the following two symbols located in the upper right corner of the dialog symbol and the display filter button 3 Select the horizontal SpO2 tab to access the SpO2 page or Select the Pulse CO Ox tab to access the Masimo rainbow SET specific setup page or the vertical Setup tab...

Page 264: ... height exceeds the display size of the channel the waveform appears clipped this does not affect the SpO2 signal processing FastSat mode On Off default Allows rapid tracking of arterial oxygen saturation changes When the Averaging time setting is set to 2 to 4s the FastSat mode selection is grayed out Sensitivity mode Normal default standard mode APOD adaptive probe off detection the least sensit...

Page 265: ... s oxygen saturation A longer averaging time provides a more accurate result However in clinical situations where rapid physiological changes have to be monitored use a shorter averaging time Color Red green blue yellow light blue purple orange white default Determines the color of the waveforms and parameter labels and values Selection Available settings Description NOTE The password protected al...

Page 266: ... PVI SpCO SpMet Selects the parameter for the parameter 1 location in the Pulse CO Ox parameter field The associated parameter label and value have the largest font With an Hb sensor the default parameter is SpHb With a CO sensor the default parameter for the parameter 1 location in the parameter field changes automatically to SpCO Changes to the parameter selection are retained if the same sensor...

Page 267: ...nected The parameter selection changes to the default selection if another Masimo rainbow SET sensor type is connected Show parameters right button SpHb 1 SpOC PVI default SpMet Selects the parameter for the parameter 3 location in the Pulse CO Ox parameter field PVI is the default parameter for the parameter 3 location in the parameter field for both CO and Hb sensors Changes to the parameter sel...

Page 268: ...ging time provides a more accurate result However in clinical situations where rapid physiological changes have to be monitored use a shorter averaging time Pulse CO Ox mini trend SpHb 1 default SpCO SpOC SpMet PVI SpCO is the default when a CO sensor is used Selects the parameter to be included in the mini trend display Color Red green blue yellow light blue purple orange white default Determines...

Page 269: ... Selection Available settings Description SpHb Cal Arterial default Venous Selects the blood sampling source which is used to calculate the SpHb value The SpHb value changes to SpHbv when the SpHb Cal setting Venous is selected PVI averaging time Short Long default Determines how responsive the monitor is to rapid physiological changes while tracking pleth variability index A longer averaging time...

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Page 271: ...nd pulse rate with Nellcor OxiMax MCable Overview of SpO2 monitoring 272 Supported parameters 272 SpO2 precautions 273 Connecting the Nellcor OxiMax MCable 274 Patient preparation for SpO2 monitoring 275 Applying the sensor 276 SpO2 display 277 SpO2 parameter field 277 Accessing the SpO2 settings 278 SpO2 parameter setup functions 278 ...

Page 272: ... SpO2 Because light absorption varies with blood volume and blood volume varies with pulse rate the Nellcor OxiMax MCable can also derive a pulse rate PLS SpO2 measurements are for adult pediatric and neonatal patients Refer to the Instructions for use Infinity Acute Care System Infinity M540 for a detailed description of the M540 SpO2 functions The SpO2 monitoring functions are configurable in th...

Page 273: ...d the condition of the patient WARNING The pulsations from an intra aortic balloon support can elevate the pulse rate Verify the pulse rate of the patient against the heart rate WARNING To reduce the hazard of burns during surgery keep the sensor or transducer and their associated cables away from the surgical site the electro surgical unit return electrode and earth ground WARNING Inspect the app...

Page 274: ... of the Nellcor OxiMax MCable C 3 Attach the appropriate sensor cable to the end of the intermediate cable E see page 276 for more information NOTE Do not use a functional tester to assess the accuracy of an SpO2 sensor or an SpO2 sensor monitor Since SpO2 sensor measurements are statistically distributed only about two thirds of those measurements can be expected to fall within A rms of a CO oxim...

Page 275: ... better sensor placement Pulses may be counted erroneously due to the following conditions Placement of a sensor that is too tight Patient experiences hypotension severe vasoconstriction severe anemia or hypothermia Arterial occlusion proximal to the sensor Patient is in cardiac arrest or is in shock Bright light causing erratic measurement or missing values Cover the sensor with opaque material i...

Page 276: ...ctly and attach it to your patient 3 Connect the sensor to the Nellcor OxiMax MCable WARNING Inspect the application site every two to three hours to ensure skin quality and correct opti cal alignment If the skin quality changes move the sensor to another site Change the application site at least every four hours NOTE Read the instructions provided with the sensor for optimal application technique...

Page 277: ... parameter field contains the following elements A SpO2 label B Units of measure can be activated deactivated C PLS pulse label D PLS value E Upper lower alarm limits or crossed triangle symbols when alarms are deactivated F Alarm off symbol when alarms are deactivated When alarms are activated the alarm limits are displayed instead G Message area for SpO2 messages H SpO2 saturation value I SpO2 b...

Page 278: ...tion see Configuring the alarm settings for a patient on page 125 SpO2 parameter setup functions All SpO2 setup functions take place in the SpO2 page Selection Available settings Description Pulse tone volume Off 5 10 default 20 30 40 50 60 70 80 90 100 Sets the volume of the pulse tone Tone source ECG default SpO2 Selects the source of the pulse tone which affects both the ECG and the SpO2 parame...

Page 279: ...nds NOTE When SatSeconds is set to any value other than Off the Desat alarm status is set to Off This selection does the following Analyzes desaturation events by multiplying their duration seconds by the number of percentage points the patient exceeds the alarm limit Eliminates nuisance alarms caused by brief and numerous violations of lower and upper alarm limits Overrides the alarm validation s...

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Page 281: ...ature monitoring 282 Precautions 282 Connecting the temperature sensors 283 Connecting the temperature sensors to the M540 284 Connecting the temperature sensors to the hemodynamic pods 285 Temperature display 286 Temperature parameter field 286 Accessing the temperature settings 287 Temperature parameter setup functions 287 ...

Page 282: ...erature functions Before performing any monitoring functions refer to the section For your safety and that of your patients on page 13 Parameter specific error messages are listed on page 537 Supported parameters Ta T1a direct temperature values Tb T1b direct temperature values T T1 temperature difference values Precautions NOTE The temperature functions and associated probes should be calibrated ...

Page 283: ...cute Care System Monitoring Applications VG6 n 283 Temperature Connecting the temperature sensors You can connect temperature sensors directly to the M540 or to one of the following hemodynamic pods MPod QuadHemo Hemo4 pod Hemo2 pod ...

Page 284: ...sly A M540 temperature port B Dual temperature Y cable C Dual temperature Y cable connectors D Single temperature sensor E Temperature sensor connecting directly to the M540 To connect two temperature sensors 1 Connect the temperature sensors D to the connectors C of the dual temperature Y cable 2 Connect the connector B of the dual temperature Y cable to the M540 temperature port A To connect a s...

Page 285: ...nsor connector A to the MPod QuadHemo Tb port C or Ta port D 2 Connect the connection cable to the monitor connector B of the MPod QuadHemo and to the gray hemo connector on the M540 To connect temperature sensors to the Hemo2 pod and the Hemo4 pod 1 Connect the temperature sensor connectors E to the Ta port H and or the Tb port G of the Hemo4 pod or the Hemo2 pod 2 Connect the connection cable to...

Page 286: ... is displayed The values for the second temperature appear blank Temperature parameter field Parameter fields report parameter values and indicate the alarm status of parameters Parameter fields can also report technical conditions such as disconnected sensors and so on For detailed information regarding the content of parameter fields for each parameter see the chapter Troubleshooting on page 509...

Page 287: ...bol and the display filter button The top portion of the page contains the Auto set and Alarm buttons for configuring the alarm functions For detailed alarm setup information see Configuring the alarm settings for a patient on page 125 Temperature parameter setup functions All temperature setup functions take place in the Temp Temp 1 pages see page 287 Selection Available settings Description Para...

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Page 289: ...se and cuff 292 Patient preparation for non invasive blood pressure monitoring 293 Applying the blood pressure cuff 293 Non invasive blood pressure display 294 Non invasive blood pressure parameter fields 294 Continuous mode 295 Interval mode 295 Non invasive blood pressure measurement modes 296 Single measurement mode 296 Interval mode 296 Venous stasis 299 Activating or deactivating venous stasi...

Page 290: ...ric and neonatal patients To protect the patient from excessive inflation limits the blood pressure cuff automatically deflates when A measurement exceeds 2 minutes in adult and pediatric mode A measurement exceeds 90 seconds in neonatal mode Refer to the instructions for use Infinity Acute Care System Infinity M540 for a detailed description of the M540 non invasive blood pressure functions The n...

Page 291: ...omy WARNING When measuring non invasive blood pressure and another parameter simultaneously on the same limb the measurement of the other parameter can be temporarily interrupted WARNING Accurate non invasive blood pressure measurements depend on the correct size and type of the blood pressure cuff in relation to the patient s arm circumference The wrong sized cuff or cuffs outside the range or si...

Page 292: ... is appropriate for the patient 2 Connect the blood pressure cuff C to the hose B 3 Connect the non invasive blood pressure hose B to the non invasive blood pressure connector A of the M540 NOTE The accuracy of the oscillometric blood pressure signal can decrease up to loss of measurement under the following conditions weak pulses irregular pulses patient movement artifacts tremor artifacts respir...

Page 293: ...apply the cuff on a limb that is already used for other measurements Make sure that other patient connections do not interfere with each other The following diagram depicts a typical Dräger cuff A Index line B Artery marker C Range labels D Size indicator Correct patient positioning For a patient with hypertension who is not in a lying position perform the resting blood pressure measurement as fol...

Page 294: ...nous stasis mode the cuff pressure and the label Venous stasis appears in the non invasive blood pressure parameter field If you cannot apply the cuff at heart level adjust the displayed systolic and diastolic non invasive blood pressure values as follows add 8 mmHg 1 1 kPa for each 10 cm 4 inches above the heart subtract 8 mmHg 1 1 kPa for each 10 cm 4 inches below the heart Non invasive blood pr...

Page 295: ... Inflation pressure value J Label Inflation pressure K Systolic diastolic pressure value Interval mode The following diagram shows a parameter field when the interval mode is selected see page 297 for more information A NIBP parameter label B Unit of measurement can be activated deactivated C Time since last non invasive blood pressure measurement D Last mean pressure value E Alarm limits or cross...

Page 296: ... is displayed in the parameter field until the new measurement is completed New values appear at the end of a measurement A chime sounds at the end of a measurement when the corresponding function is activated see page 300 Single measurement mode Single measurement mode allows you to start measurements when needed You can start and stop a single measurement at the M540 and at the Cockpit To start ...

Page 297: ... page directly or Select Sensor parameters from the main menu bar 2 Select the NIBP tab to access the NIBP page 3 Select Interval time min and make your selection The available settings are Off default 1 2 2 5 3 5 10 15 20 30 45 60 120 240 min For any interval setting of 5 minutes and up the following time alignment occurs After the first measurement is completed all subsequent measurements align ...

Page 298: ...blood pressure parameter field to select the NIBP page directly or 2 Select Sensor parameters from the main menu bar 3 Select the NIBP tab to access the NIBP page 4 Select On or Off next to Continuous mode To stop continuous measurements Press the NIBP start stop button on the main menu bar or Deactivate Continuous mode in the NIBP page see page 300 WARNING When using continuous mode observe the p...

Page 299: ...300 4 Select On next to Venous stasis During active venous stasis the non invasive blood pressure parameter field reports the remaining time and displays the message Stasis in the parameter field As soon as venous stasis is terminated the parameter field resumes its previous appearance see page 294 Interval measurements are suspended during venous stasis but resume immediately after the cuff defla...

Page 300: ...unctions All non invasive blood pressure setup functions take place in the NIBP page see page 300 Selection Available settings Description Interval time min Cardiac bypass modeautomatically deactivates interval measurements Off default 1 min 2 min 2 5 min 3 min 5 min 10 min 15 min 20 min 25 min 30 min 45 min 60 min 120 min 240 min Defines intervals for non invasive blood pressure measurements Infl...

Page 301: ... invasive blood pressure monitoring 308 Invasive blood pressure display 308 Invasive blood pressure parameter field 308 Large mean value 309 Invasive blood pressure waveforms 309 Labeling invasive blood pressure channels 310 Standard labels 311 Pressure label conflicts 312 Pod and M540 label conflicts 312 Zeroing a pressure transducer 312 Zeroing a specific transducer 312 Zeroing all pressure tran...

Page 302: ...our safety and that of your patients on page 13 Parameter specific error messages are listed on page 539 Supported parameters See page 310 for available invasive blood pressure labels Systolic pressures GP1 S to GP4 S ART S PA S LV S RV S Diastolic pressures GP1 D to GP4 D ART D PA D LV D RV D Mean pressures GP1 M to GP4 M ART M PA M LV M RV M Additional pressures ICP CVP LA RA If both ART and ICP...

Page 303: ...sure label windows E Transducer slots MPod QuadHemo This pod measures up to four pressures cardiac output and temperature F Key for zeroing all pressures simultaneously see page 312 G Key for starting a cardiac output measurement H Key for starting wedge pressure measurements I Intermediate cables for attaching the transducers 339 NOTE The ports for temperature and cardiac output are located on th...

Page 304: ... connector that connects to the M540 B Transducer adapter cables for attaching the transducers Invasive blood pressure precautions There are additional warnings regarding pulmonary wedge pressure on page 315 341 A B WARNING To prevent patient injury never reuse a single use transducer WARNING Do not zero all pressures simultaneously us ing the key if any pressure waveform is flat nearly static ...

Page 305: ...on cable D Transducer cable E Transducer slot F Transducer adapter cable G Invasive blood pressure adapter block To connect the Hemo4 pod and Hemo2 pod 1 Attach the invasive blood pressure adapter G to the bottom of the Hemo4 pod Hemo2 pod 2 Connect one end of the connection cable C to the Hemo4 pod or the Hemo2 pod port B 3 Connect the other end of the connection cable C to the gray hemodynamic p...

Page 306: ...od connection cable F Transducer cable G Transducer adapter cable To connect the MPod QuadHemo 1 Connect one end of connection cable C to the port located along the right side of the MPod QuadHemo B 2 Connect the other end of the connection cable E to the gray hemodynamic port of the M540 A 3 Insert the transducers into the transducer slots D 4 Connect the transducer cables F to the transducer ada...

Page 307: ...ransducer E Transducer cables To connect the Dual Hemo MCable 1 Attach the transducers D to the transducer adapter cables C The transducer adapter cables are permanently fastened to the Dual Hemo MCable 2 Connect the Dual Hemo MCable connector B to the gray hemodynamic port A on the M540 Preventing fluid ingress Refer to the following figure to correctly position the Dual Hemo MCable to prevent fl...

Page 308: ... report parameter values and indicate the alarm status of parameters Parameter fields can also report technical conditions such as disconnected sensors and so on For detailed information regarding the content of parameter fields for each parameter see the chapter Troubleshooting on page 509 The content of the invasive blood pressure parameter fields depends on whether the parameter is pulsatile or...

Page 309: ...rge mean value display Select the invasive blood pressure parameter field to select the IBP page directly or 1 Select Sensor parameters from the main menu bar 2 Select the desired IBP tab for example GP1 along the right side of the IBP page 3 Select On next to Large mean Invasive blood pressure waveforms Invasive blood pressure waveforms are either displayed in separate waveform channels or in ove...

Page 310: ...to GP4 are automatically assigned depending on how many pressures are connected The zero value the date and time associated with the pressure channel remain unchanged even if a new label is assigned To assign a pressure label manually Select the invasive blood pressure parameter field to select the IBP page directly or 1 Select Sensor parameters from the main menu bar 2 Select the IBP tab to acces...

Page 311: ...ood pressure labels IBP Labels Label Pressure type Measured pressures Measurement range ART Arterial blood pressure Systolic diastolic mean 50 to 400 mmHg 6 6 to 53 3 kPa LV Left ventricular blood pressure PA Pulmonary arterial blood pressure RV Right ventricular blood pressure CVP Central venous blood pressure Mean CPP 1 Cerebral perfusion pressure RA Right atrial blood pressure LA Left atrial bl...

Page 312: ...ast once a day Perform additional zeroing under the following circumstances After introducing a catheter into the vascular system of the patient Before each monitoring session Each time you use a new transducer or pressure tubing Whenever you connect the transducer cable to the monitor If the reported pressure values seem incorrect When the message 0 please check zero appears For zeroing to be suc...

Page 313: ... to the patient and open it to air 6 Select the button next to Zero in the IBP page If the zeroing of the transducer is successful the message 0 zero accepted appears If zeroing failed the message 0 did not zero appears In that case repeat steps three to five Zeroing all pressure transducers This procedure zeroes all pressure transducers simultaneously Zeroing all pressures simultaneously from the...

Page 314: ... transducers to the heart level of the patient 2 Close the stopcocks to the patient and open them to air 3 Select the Sensor parameters Zero all buttons on the main menu bar C700 or Select the symbol next to the Sensor parameters button on the main menu bar C500 or Select the IBP parameter field to access the IBP page 4 Select the Zero button 5 Verify that the transducers have been zeroed If zeroi...

Page 315: ...e an accurate PWP value Prolonged inflation of the balloon can result in pulmonary hemorrhage or infarction WARNING The PA catheter may move into the wedge position before the balloon is inflated One sign of this catheter drift is that the PWP waveform becomes wedge shaped Follow your hospital s clinical guidelines to correct the catheter s position WARNING Do not over inflate the balloon because ...

Page 316: ...finish appears 3 Press the Wedge key A again to save the value The following happens on the Wedge page of the Cockpit see page 317 The message IBP appears in the message field A new PWP value calculated during the next 10 seconds appears An attention tone sounds at the end of the calculation when the corresponding feature is activated see page 445 Also the message Deflate bal loon and press Save w...

Page 317: ...ally The wedge pressure value is saved automatically when You close the Wedge page 240 seconds have elapsed after the wedge pressure was started and a valid PWP value exists A Prepare wedge button B Start wedge button C Freeze Adjust button D Save wedge button E Cancel wedge button F Message field G PWP value H PWP results window I Scale button J Sweep speed mm s button K Reference waveform button...

Page 318: ... RRi 8 Select the Start wedge button B The message Wedge in progress appears in the message field F A new PWP value calculated during the next 10 seconds appears An attention tone sounds at the end of the calculation when the feature is activated see page 445 Also the message Deflate balloon and press Save wedge to finish appears in the message field F The PA and reference waveforms are stopped an...

Page 319: ... functions All invasive blood pressure setup functions take place in the IBP page see page 319 Selection Available settings Description Zero None Zeroes only the pressure indicated on the IBP page and displays the time and date of the last zeroing see page 313 Label ART PA CVP LA LV RV RA ICP GP1 to GP4 The defaults are as follows Channel 1 GP1 Channel 2 GP2 Channel 3 GP3 Channel 4 GP4 Allows you ...

Page 320: ...s invasive blood pressure parameters have the following defaults ART GP1 to GP4 red PA yellow CVP blue ICP LA purple RA RV orange LV yellow Determines the color of the waveforms parameter labels and values ICP parameter page only Min scale On Off default Allows you to select the minimum scale When this function is activated the following happens The lower value is set at 25 mmHg 3 kPa The higher v...

Page 321: ...precautions 322 Connecting the cardiac output hardware 323 Patient preparation for cardiac output monitoring 325 Cardiac output display 326 Cardiac output computation constant 327 Cardiac output measuring modes 329 Automatic measurements 329 Manual measurements 331 Saving the cardiac output value 332 Reviewing the cardiac output averages 333 Accessing the cardiac output settings 334 Cardiac output...

Page 322: ... output of the patient The lower the cardiac output value the more the injectate cools the blood When computing cardiac output the M540 takes the following factors into account Injectate volume temperature density and specific heat of the fluid that is being injected Baseline blood temperature density and specific heat of the blood Temperature changes of the blood injectate mixture Area under the ...

Page 323: ...rdiac output intermediate cable F Cardiac output port of the MPod QuadHemo G Thermistor port of the cardiac output intermediate cable H Catheter cable and thermistor cable To connect the cardiac output hardware using the MPod QuadHemo 1 Connect the gray connector of the hemodynamic cable B to the gray hemodynamic port A of the M540 2 Connect the red connector of the hemodynamic cable C to the MPod...

Page 324: ...mediate cable H Thermistor cables To connect the cardiac output hardware using the Hemo4 and the Hemo2 pod 1 Connect the gray connector of the hemodynamic cable B to the gray hemodynamic port A of the M540 2 Connect red connector of the hemodynamic cable C to the Hemo4 Hemo2 pod port D 3 Connect the pod connector of the cardiac output intermediate cable F to the cardiac output port of the Hemo4 He...

Page 325: ...en for catheter type Use an in line injectate system Systems that measure the injectate temperature in the ice bath can introduce errors These errors happen because the injectate temperature changes between its removal from the ice bath and the injection If you fill your syringes manually fill them with the same volume each time The recommended amount is 10 cc for adults and 5 cc for pediatric pat...

Page 326: ...ements A C O label B Time stamp of the last saved cardiac output average this area is blank if no measurements have been taken over the past 24 hours C Blood temperature label D Blood temperature Tblood value acquired from the hemodynamic pod E Upper lower alarm limits or crossed triangle symbol when alarms are deactivated F Injectate temperature label G Injectate temperature value H Previously sa...

Page 327: ...mputation constants and select one that corresponds to the used injectate volume and temperature To enter a computation constant manually Make sure the catheter type Other is selected see page 334 otherwise the button Comp constant is not available on the Procedures C O page 1 Access the C O page see page 334 or Access the Procedures C O page see page 333 2 Select the keypad symbol next to Comp co...

Page 328: ... C 23 to 60 9 F Tinj 16 1 to 25 C 61 0 to 80 F Tinj 20 C 68 F 7F 10 cc 0 561 0 608 0 542 7F 5 cc 0 259 0 301 0 247 7 5F 10 cc 0 574 0 595 0 564 7 5F 5 cc 0 287 0 298 0 257 5F 5 cc 0 285 0 307 0 270 BD Ohmeda computation constants Injectate temperature Tinj sensor connected Catheter size Injectate volume Tinj 5 to 16 0 C 23 to 60 9 F Tinj 16 1 to 25 C 61 0 to 80 F 7 5F 10 cc 0 579 0 628 7 5F 5 cc 0...

Page 329: ...s been computed Automatic measurements In auto mode the message Inject when ready appears in the Procedures C O page of the Cockpit when the baseline blood temperature is stable If the blood temperature becomes unstable the message Inject when ready is replaced by the message Poor baseline To select the automatic cardiac output mode see page 334 Arrow computation constants Catheter size Injectate ...

Page 330: ...stable the measurement is canceled automatically If no temperature drop is detected the waveform stops and the message 0 No Temperature Change appears 4 Repeat step 2 to take additional measurements or to repeat a measurement making sure to wait for the Inject when ready message The Procedures C O page see page 333 stores up to five cardiac output measurements Each value panel is touch sensitive a...

Page 331: ...bar 2 Select the C O tab to access the Procedures C O page 3 Select the Start C O button on the Cockpit Inject the saline solution immediately 4 Repeat steps 1 and 2 for additional measurements The Procedures C O page see page 333 stores up to five cardiac output averages with time stamps Each value panel is touch sensitive and allows you to include or exclude a value from the calculation of the a...

Page 332: ...erage Closing the Procedures C O page without saving the cardiac output value s causes any unsaved values to be lost To save the cardiac output value manually 1 Select Procedures from the main menu bar 2 Select the C O tab to access the Procedures C O page 3 Select the Save C O average button The stored cardiac output value and the time stamp are stored in the trend function and the parameter fiel...

Page 333: ...e button C Most recent cardiac output average D Blood and injectate temperature value field E Waveform field F Up to five cardiac output measurements with time stamps Each value panel is touch sensitive and allows you to include or exclude a value from the calculation of the average Any value that is crossed out is excluded from the average If you touch the panel again the value reappears and will...

Page 334: ...tons for configuring the alarm functions For detailed alarm setup information see Configuring the alarm settings for a patient on page 125 Cardiac output parameter setup functions All cardiac output setup functions take place in the C O page Selection Available settings Description Catheter type BD Ohmeda default Edwards Baxter Arrow Other Displays the currently selected catheter type Catheter siz...

Page 335: ...her was selected see page 334 The computation constant depends on the injectate volume and temperature according to the specific values provided by the catheter C O mode Auto default Manual Determines the cardiac output measurement mode see page 329 Start C O None Starts a cardiac output measurement see page 329 Color White default there is no color selection for cardiac output Determines the colo...

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Page 337: ...ainstream CO2 monitoring 338 Supported parameters 338 CO2 precautions 339 Connecting the CO2 sensor 340 Patient preparation for CO2 monitoring 341 CO2 display 342 CO2 parameter field 342 CO2 waveforms 343 Troubleshooting 343 Using the CO2 dialog 345 CO2 Limits 345 CO2 parameter setup 345 Performing a calibration check 348 Required accessories 348 ...

Page 338: ...uctions for use Infinity Acute Care System Infinity M540 for ordering information of the appropriate size of accessories As respiration gases flow through the airway adapter the sensor analyzes the expired and inspired air of the patient The analysis is accomplished by sending a beam of infrared light through transparent ports in the airway adapter while detecting changes in CO2 absorption levels ...

Page 339: ... was detected Clinical diagno sis of a true apneic event however requires multiple physiological signals WARNING CO2 alarms do not activate until the first breath is detected after turning on the monitor or discharging a patient WARNING The surface temperature of the sensor may rise to 43 C 109 F Prolonged exposure to the patient s skin may result in a burn CAUTION Leaks in the breathing circuit f...

Page 340: ...irway adapter D Y piece E Airway adapter F Endotracheal tube adapter To connect the hardware The IACS is only compatible with the sensors 6871950 revision 5 or higher Previous revisions are not compatible 1 Connect the CO2 sensor cable connector B to the yellow CO2 port A on the M540 2 Select a suitable Mainstream airway adapter C whose windows are clean and dry replace the adapter if necessary 3 ...

Page 341: ...N2O or Heliox select the gas that is being administered in the CO2 setup page Make sure to manually adjust the ambient pressure to the actual measurement value Automatic ambient pressure compensation is not provided Failure to compensate for supplemental gases results in inaccurate measurement values When switching adapter types from reusable to disposable or adult to pediatric or vice versa there...

Page 342: ...ameter field contains the following elements A etCO2 end tidal CO2 label B Unit of measurement can be activated deactivated C inCO2 label inspired CO2 D inCO2 value the level of CO2 in the airway during inspiration taken as the minimum value during the previous measurement interval E Upper lower alarm limits or crossed triangle symbols when alarms are deactivated F RRc respiratory rate parameter l...

Page 343: ...iratory phase D Onset of expiratory phase E Baseline during inspiration Troubleshooting In addition to evaluating the clinical status of a patient CO2 waveforms can help troubleshoot problems with equipment The following table shows how CO2 waveforms can be used to identify common problems 349 A B C D E Description Cause CO2 waveform Alveolar plateau showing a downward slope that merges with a des...

Page 344: ...w CO2 zero drift Insufficient expiratory time Faulty expiratory valve Inadequate inspiratory flow Malfunction of a CO2 absorber system Partial rebreathing circuits Change in slope of ascending limb Possible absence of an alveolar plateau Obstruction caused by one of the following Partial obstruction in expiratory limb of breathing circuit Foreign matter in upper airway Partially kinked or occluded...

Page 345: ...arm limit functions takes place in the Mainstream tab within the CO2 dialog The Mainstream tab displays fields on the upper left side for etCO2 inCO2 and RRc settings etCO2 and RRc allow adjustment of the upper alarm limit use of the Archive feature and use of Auto set For inCO2 only the upper alarm limit and Archive can be used CO2 parameter setup All setup functions for CO2 take place in the CO2...

Page 346: ...e for pressure can cause inaccurate measurements Gas compensation Air default N2O O2 O2 50 HeliOx Compensates for supplemental oxygen or N2O or Heliox Failure to compensate for supplemental oxygen can cause inaccurate measurements RRc apnea time s Off default 10 15 20 25 30 s Specifies the time the M540 waits before reporting a cessation of breathing as an apnea event RRc apnea time s settings app...

Page 347: ...t light blue purple or ange white Determines the color of the waveforms and parameter labels values Color settings apply to both Mainstream and Microstream Change parame ter CO2 default Examples HR SpO2 PLS CO Ox CO2 NIBP RRi T T1 GP1 GP2 GP3 GP4 ST Changes the parameter field to a different pa rameter Selection Available settings Description ...

Page 348: ...ibration check according to the healthcare facility s guidelines While a calibration check is in progress any active alarms continue to display on the Cockpit however CO2 and RRc related alarms are temporarily disabled until a valid breath is detected and the associated value displays in the CO2 parameter field Required accessories Test filter attached to the CO2 sensor and shown in the following ...

Page 349: ...CO2 monitoring Overview of Microstream CO2 monitoring 350 Supported parameters 350 Accessories 350 Using the Microstream MCable 350 CO2 display 351 CO2 parameter field 351 CO2 waveform 351 Troubleshooting 352 Using the CO2 dialog box 353 CO2 limits 353 CO2 parameter setup 354 Calibration Check 355 Required accessories 355 ...

Page 350: ...tes for ambient pressure within the defined operating ranges The Microstream MCable is intended for use with adult pediatric and neonatal patients with the appropriate accessories Before performing any monitoring functions refer to the chapter For your safety and that of your patients on page 13 Supported parameters etCO2 end tidal CO2 concentration inCO2 inspiratory CO2 concentration RRc respirat...

Page 351: ...rement interval F Crossed triangle symbol when inCO2 alarms are turned off G Crossed triangle symbol when RRc alarms are turned off H RRc value respiratory rate derived from the CO2 signal I RRc respiratory rate parameter label J etCO2 value highest level of CO2 in the airway during the expiratory phase within the measurement interval CO2 waveform The M540 also displays an instantaneous CO2 wavefo...

Page 352: ...ial airway that is too small for the patient Elevated waveform baseline with corresponding increase in CO2 level Rebreathing due to one of the following causes Insufficient expiratory time Faulty expiratory valve Inadequate inspiratory flow Malfunction of a CO2 absorber system Partial rebreathing circuits Change in slope of ascending limb Possible absence of an alveolar plateau Obstruction caused ...

Page 353: ...splays on the Cockpit 1 Touch the CO2 parameter field 2 Touch the Microstream tab Or if the CO2 parameter field is not displayed Select Sensor parameters from the main menu bar Microstream tab to access the Microstream page If you cannot see the tab select the following two symbols located in the upper right corner of the dialog symbol and the display filter button CO2 limits Setup functions for C...

Page 354: ...Off Store default Str Rec Determines what happens in response to an apnea event Next service in Informational only settings are not applicable The remaining hours until maintenance is required Averaging Last valid breath Off 10 s 20 s default 30 s Controls the specific time or the interval used to select the maximum measured etCO2 and the minimum measured inCO2 Scale 0 to 40 mmHg default 0 to 60 m...

Page 355: ...ance on page 547 Perform a calibration check according to the healthcare facility s schedule guidelines Required accessories A gas canister with a mix of 5 CO2 21 O2 balanced N2 Sample line Contact the biomed or service personnel for the required accessories if needed To perform a calibration check 1 Select the Calibration check tab 2 Follow the instructions as they display on the Calibration chec...

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Page 357: ...eter setup functions 363 Agent alarm setup 364 Agent parameter setup functions 365 CO2 display 366 CO2 parameter field 366 CO2 O2 parameter field 367 CO2 waveform 367 Troubleshooting 368 O2 display 370 O2 parameter field 370 O2 N2O parameter field 371 Agent display 372 Agent parameter field 372 Agent xMAC parameter field 373 Agent N2O parameter field 374 Manual agent identification 375 Automatic a...

Page 358: ...alues During warm up reported values may not be accurate Wait until the gas analyzer has com pleted initialization and warm up Refer to the Technical Data appendix in the gas analyzer supplement for further information regarding gas analyzer accuracy WARNING Risk due to defective sensors If the gas analyzer is not ready for operation the patient will not be adequately monitored Before using the me...

Page 359: ...a valid breath Mixed Agents 0 out of range high 0 reduced accuracy 0 sensor failure 0 value temporarily unavail Check water trap sample line Gas sensor failure CO2 reduced accuracy CO2 sensor failure Gas sensor reduced accuracy agent val inN2O 82 FiO2 val Inspiratory xMAC high Sample line blocked Scio is not connected Scio unavailable for neonates Scio warming up Accur low Second agent detected Wa...

Page 360: ...y Acute Care System Monitoring Applications VG6 n Supported parameters The following parameters are supported RRc inCO2 etCO2 FiO2 displays as inO2 in parameter fields etO2 inN2O etN2O inSev etSev inDes etDes inIso etIso inHal etHal inEnf etEnf xMAC ...

Page 361: ...he CO2 O2 or Agent parameter field 2 Touch the Scio tab Or if the CO2 O2 or Agent parameter field is not displayed Select Sensor parameters from the main menu bar Scio tab to access the Scio page If you cannot see the tab select the following two symbols located in the upper right corner of the dialog symbol and the display filter button CO2 alarm limits The CO2 tab displays fields on the upper le...

Page 362: ...ttings Description RRc apnea time s Off default 10 15 20 25 30 Specifies the time the M540 waits before reporting a cessation of breathing as an apnea event RRc Apnea archive Off Store default Str Rec Record Determines what happens in response to an apnea Parameter field CO2 default CO2 O2 Configures the CO2 display based on the selected setting Scale mmHg 40 60 80 100 Adjusts the size of the CO2 ...

Page 363: ...r setup functions Setup functions for O2 parameters take place in the O2 tab within the Scio dialog NOTE When a gas analyzer without O2 monitoring is connected the controls for O2 alarms are not available in the Scio setup menu Selection Available settings Description Parameter field O2 O2 N2O Configures the O2 display based on the selected setting Scale 0 100 15 35 20 100 default 25 45 35 55 45 6...

Page 364: ...he parameter field when alarm monitoring is deactivated 2 Touch the corresponding field in the Lower column C Use the rotary knob to set the lower alarm limit and press the rotary knob to confirm the setting 3 Touch the corresponding field in the Upper column E Use the rotary knob to set the upper alarm limit and press the rotary knob to confirm the setting 4 Touch the corresponding field in the A...

Page 365: ...ted the expiratory value of the primary agent is displayed Agent Scio Four Oxi and Scio Four only Desflurane Enflurane Halothane Isoflurane Sevoflurane default Configures the Scio Four or Scio Four Oxi module to measure the concentration levels of a user specified anesthetic agent WARNING Use care when selecting the agent manually Measurements are inaccurate if the wrong agent is selected Scio Fou...

Page 366: ...ay at the end of expiration Respiratory Rate RRc the patient s respiratory rate derived from the etCO2 signal A etCO2 label B etCO2 value highest level of CO2 in the airway during the expiratory phase within the measurement interval C etCO2 alarm limits displays crossed triangle symbol when etCO2 alarms are turned off D inCO2 label E inCO2 value the level of CO2 in the airway during inspiration ta...

Page 367: ...arm is turned off G inO2 FiO2 alarm limits displays crossed triangle symbol when inO2 alarms are turned off H Abbreviation for expiratory I etCO2 value highest level of CO2 in the airway during the expiratory phase within the measurement interval J etO2 value highest level of O2 in the airway during the expiratory phase within the measurement interval K etCO2 alarm limits displays crossed triangle...

Page 368: ...g es with a descending limb Inadequate seal around the endotracheal tube Leaky or deflated endotracheal or tracheostomy cuff Artificial airway that is too small for the patient Elevated waveform base line with corresponding in crease in CO2 level Rebreathing due to one of the fol lowing causes Disposable airway adapter is used although the Cockpit is configured for the reusable adapter type Contam...

Page 369: ...ruction caused by one of the following Partial obstruction in expiratory limb of breathing circuit Foreign body in upper airway Partially kinked or occluded artificial airway Herniated endotracheal or tracheostomy tube cuff Bronchospasm Elevated baseline with pronounced slope on de scending limb Faulty ventilator circuit valve Rebreathing see above Description Cause Capnogram ...

Page 370: ... tidal O2 etO2 the level of O2 in the airway at the end of expiration A O2 label B Abbreviation for inspiratory C inO2 FiO2 value the level of O2 in the airway during inspiration taken as the minimum value within the measurement interval D inO2 FiO2 alarm limits displays crossed triangle symbol when inO2 alarms are turned off E Abbreviation for expiratory F etO2 value the highest level of O2 in th...

Page 371: ... O2 in the airway during inspiration taken as the minimum value within the measurement interval E inN2O value the level of N2O in the airway during inspiration taken as the minimum value within the measurement interval F inO2 FiO2 alarm limits displays crossed triangle symbol when inO2 alarms are turned off G Abbreviation for expiratory H etO2 value the highest level of O2 in the airway during the...

Page 372: ...agent may display Agent during agent identification for gas analyzers with automatic identification B Inspired primary agent value the level of anesthetic agent in the airway during the inspiration phase C Abbreviation for inspiratory D Inspiratory alarm limits for primary agent E Abbreviation for expiratory F Expired primary agent value the level of anesthetic agent in the airway during the expir...

Page 373: ...t in the airway during the inspiration phase E Inspiratory alarm limits for primary agent F Abbreviation for expiratory G Expired primary agent value the level of anesthetic agent in the airway during the expiration phase H Expiratory alarm limits for primary agent I Expiratory alarm limits for secondary agent J Expired secondary agent value the level of anesthetic agent in the airway during the e...

Page 374: ...sthetic agent in the airway during the inspiration phase E Inspiratory alarm limits for primary agent F Abbreviation for expiratory G Expired primary agent value the level of anesthetic agent in the airway during the inspiration phase H Expiratory alarm limits for primary agent I Expiratory alarm limits for secondary agent J Expired secondary agent value the level of anesthetic agent in the airway...

Page 375: ...field is blank and the Agent label displays Agent Mixed Agent When the gas analyzer detects a mixture of two anesthetic agents the displayed real time waveform is the primary agent concentration The color of the waveform and the first agent label in the Agent parameter field represents the agent with the highest expiratory xMAC value primary agent The following label indicates the SEV agent with t...

Page 376: ... only When only a Scio module is connected this section is blank PIP Pplat Pmean PEEP R Cdyn E Tcase VT auto MVmand MVspon MV auto RRmand RRspon RR auto Current measurements gases These values can come from either a Scio module or a MEDIBUS X device However when a Scio module is connected these values always come from the Scio module FiO2 inCO2 inN2O inHal inEnf inIso inDes inSev etO2 etCO2 etN2O ...

Page 377: ... guiding values only The binding values are specified on the package information leaflet of the anesthetic agent The MAC values are dependent upon the age of the patient The values specified in the table according to ISO 80601 2 55 apply to a patient age of 40 years IACS provides age corrected xMAC if the user has entered a birth date for the patient If no birth date is entered IACS uses 40 years ...

Page 378: ...hours the gas analyzer is available without zeroing for at least the first 90 minutes of monitoring However if the IACS and or gas analyzer has been powered down or has been in Standby or Discharge for more than two hours a warm up procedure occurs when the IACS begins monitoring The warm up procedure includes zeroing and can take up to 7 5 minutes During this time accuracy is reduced During zeroi...

Page 379: ...tral index BIS External Device Bispectral index BIS Overview of BIS monitoring 380 Supported parameters and settings 380 BIS precautions 381 Device compatibility 381 BIS display 381 BIS parameter field 381 Waveforms 383 Accessing the BIS settings 384 BIS parameter setup functions 384 BIS Show all page 384 ...

Page 380: ... and that of your patients on page 13 For detailed information and technical specifications regarding BIS monitoring with the BIS VISTA devices refer to the documentation provided by the manufacturer Supported parameters and settings BIS Bispectral index EMG Electromyograph indicator SQI Signal quality index BSR Suppression ratio PWR Total signal power SEF Spectral edge frequency BCT Burst count S...

Page 381: ...is supported via the device connectivity option Only connect peripheral medical devices to a patient monitor if those devices comply with the electrical safety requirements found in IEC 60601 1 Refer to Safe connection with other electrical equipment on page 13 of these instructions for use for information on how to connect devices safely WARNING The following section lists all of the external dev...

Page 382: ...l SQI H BIS value EMG bar graph The EMG bar graph consists of 5 tic marks As the amplitude increases more tic marks are filled in white A First section is filled in 30 to 38 dB B Second section is filled in 39 to 47 dB C Third section is filled in 48 to 55 dB D All sections filled in 55 dB 559 NOTE If the SQI value is less than 15 the parameter values for BIS BSR BCT SEF and PWR will be replaced b...

Page 383: ...raph consists of 5 bars The more bars are filled in green the better the quality of the signal A SQI value between 0 and 20 B SQI value between 21 and 40 C SQI value between 41 and 60 D SQI value between 61 and 80 E SQI value between 81 and 100 Waveforms One EEG waveform labelled as EEG T is displayed next to the BIS parameter field 560 B C D A E ...

Page 384: ...all tab BIS parameter setup functions All BIS setup functions take place in the BIS page Selection Available settings Description Settings page Scale uV 5 10 25 50 100 default 250 µV Selects the scale of the EEG T waveform Smoothing rate s Informational data only Not applicable BIS secondary parameter BSR BCT default SEF PWR Selects a secondary parameter and assigns it to the BIS parameter field s...

Page 385: ...of NMT monitoring 386 Supported parameters 386 Supported modes 386 Supported settings 386 NMT precautions 387 Device compatibility 387 NMT display 387 NMT parameter field single measurement mode 388 NMT parameter field PTC mode 388 NMT parameter field TOF TOFS mode 389 Printing NMT information 390 Accessing the NMT settings 390 The NMT page 391 NMT parameter functions and settings 392 ...

Page 386: ... trended and available on the Infinity network and export protocol All trended NMT parameters are available for network transfer For more information see page 163 Supported modes The following modes from the NMT device are supported Single mode measures the muscle twitch in response to a single stimulation pulse 1 Hz and 0 1 Hz stimulation is supported TOF Train of Four A sequence of four stimulat...

Page 387: ...aking diagnostic or therapeutic decisions Connecting peripheral devices is supported via the device connectivity option Only connect peripheral medical devices to a patient monitor if those devices comply with the electrical safety requirements found in IEC 60601 1 Refer to Safe connection with other electrical equipment on page 13 of these instructions for use for information on how to connect de...

Page 388: ...splay depends on menu setting see page 391 E Time stamp of the current value the time stamp identifies the time the Cockpit received the value from the connected device F No cal message to indicate that the NMT device was not calibrated G Single twitch value NMT parameter field PTC mode The NMT parameter field in PTC mode contains the following elements A Neuromuscular transmission label NMT B NMT...

Page 389: ... when the TOF count is than three twitches or there are four twitches and the magnitude of the first twitch is 20 C Time stamp of the current value the time stamp identifies the time the Cockpit received the value from the connected device D Count down time bar and value indicating the remaining time in the interval before the start of the next set of measurements displayed only in TOFs mode The l...

Page 390: ...he Print button in the lower left corner of the NMT page or 1 Select Sensor parameters from the main menu bar 2 Select the NMT tab to access the NMT page 3 Select the Print button in the lower left corner of the NMT page Accessing the NMT settings Select the NMT parameter field to select the NMT page directly or 1 Select Sensor parameters from the main menu bar 2 Select the NMT tab to access the N...

Page 391: ...he scroll bar Once the data base reaches 500 measurements the oldest measurement is replaced by the most recent one Unlike trends the measurements on the NMT page cannot be transferred The following diagram depicts the NMT page A Display temperature button for activating or deactivating the temperature display in the NMT parameter field B Settings field displays the settings of the connected third...

Page 392: ...f the NMT device Stim current mode Auto The NMT device establishes a supramaximal current during the first measurement and uses it for subsequent measurements Manual The stimulation current was selected manually Sensitivity 1 512 Between 1 and 512 no default Displays the sensitivity of the NMT device Pulse width 200 or 300 µs Determines the width of the pulse Print Prints the current NMT settings ...

Page 393: ... External device continuous cardiac output CCO Overview of CCO monitoring 394 External device alarms 394 Reference handbook 394 Supported parameters 395 CCO precautions 397 CCO SvO2 display 398 CCO SvO2 parameter field 398 Viewing the CCO SvO2 parameters 398 Accessing the CCO SvO2 settings 399 SvO2 parameter setup functions 399 ...

Page 394: ...CCO monitoring functions are configurable in the parameter specific setup page see page 399 Before performing any monitoring functions refer to the section For your safety and that of your patients on page 13 External device alarms If the external device alarm feature is activated at the Cockpit see page 461 and an external device is disconnected from the Cockpit the following happens at the Cockp...

Page 395: ...vice SvO2 Venous oxygen saturation Not applicable Continuous trend Vigilance II Vigileo EV1000 CCO Continuous cardiac output L min Not applicable Continuous trend CCI Continuous cardiac output index L min m2 Calculated value on Cockpit requires height and weight values from the Cockpit Continuous trend SVR Systemic vascular resistance dyn x s cm5 Calculated value at the Cockpit requires the values...

Page 396: ...End diastolic volume mL Not applicable Not trended EDVI End diastolic volume index mL m2 Calculated value on Cockpit requires height and weight values from the Cockpit Not trended ESV End systolic volume mL Not applicable Not trended ESVI End systolic volume index mL m2 Calculated value on Cockpit requires height and weight values from the Cockpit Not trended EF Ejection fraction Not applicable No...

Page 397: ...itor and any peripheral devices but the cable s enclosure is not electrically isolated from the peripheral device itself WARNING The Cockpit does not annunciate alarms for external device parameters WARNING Always refer to the primary data source before making diagnostic or therapeutic decisions Connecting peripheral devices is supported via the device connectivity option Only connect peripheral m...

Page 398: ...ndary parameter label C Secondary parameter value D Third parameter label E Third parameter value F Primary parameter value Viewing the CCO SvO2 parameters The Show all page displays the values of the currently monitored CCO SvO2 parameters To access the CCO SvO2 parameters 1 Select the Sensor parameters button from the main menu bar 2 Select the CCO tab If you cannot see the tab select the follow...

Page 399: ...ctions Selection Available settings Description Parameter 1 SvO2 default Tblood CCO CCI VO2 DO2 SaO2 SVR SVRI EDV EDVI ESV ESVI EF SV SVI SVV Selects the primary parameter in the CCO parameter field Parameter 2 SvO2 Tblood CCO default CCI VO2 DO2 SaO2 SVR SVRI EDV EDVI ESV ESVI EF SV SVI SVV Selects the secondary parameter in the CCO parameter field Parameter 3 SvO2 Tblood CCO CCI VO2 DO2 SaO2 SVR...

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Page 401: ...3 Compatible MEDIBUS X devices 403 Supported MEDIBUS X ventilator and anesthesia data 404 Supported parameters on the Cockpit 404 Supported waveforms 410 Viewing MEDIBUS X parameter data 411 Parameter fields 411 Viewing loops 412 The Show all pages 413 Configuring the ventilator Show all page 413 Accessing parameter setup functions 414 Paw setup functions 415 Ventilator parameter setup functions 4...

Page 402: ...fety and that of your patients on page 13 For device specific error messages refer to the instructions for use of the connected ventilator External device alarms Alarms from the ventilator are transmitted to the Infinity network and made available for alarm annunciation at the ICS For more information refer to the Instructions for use Infinity CentralStation If the external device alarm feature is...

Page 403: ...n with other electrical equipment on page 13 of these instructions for use for information on how to connect devices safely WARNING The following table lists all of the external devices and related software versions that Dräger has validated Dräger cannot make any claim for the reliability of the data for subsequent or previous software versions or for any devices that have not been validated In t...

Page 404: ...BUS X ventilator and anesthesia parameters are displayed and trended on the Cockpit Refer to page 403 for a list of supported ventilators and anesthesia machines and the compatible software versions Parameter label Description Unit of mea sure ment Displayed in Ventila tion or Anesthesia Show all page see page 413 Cockpit Trends page Available for display in parame ter field Yes No Air cons Accumu...

Page 405: ...Pa etIso End tidal isoflurane concentration Anesthesia Continuous trend Yes kPa etN2O End tidal nitrous oxide concentration Anesthesia Continuous trend Yes etO2 End tidal oxygen concentration Anesthesia and Ventilation Continuous trend Yes etSev Endtidal sevoflurane concentration Anesthesia Continuous trend Yes kPa FiO2 Inspiratory oxygen fraction Anesthesia and Ventilation Continuous trend Yes ap...

Page 406: ...ation Anesthesia Continuous trend Yes kPa inSev Inspiratory sevoflurane concentration Anesthesia Continuous trend Yes kPa Iso cons Isoflurane consumption mL Anesthesia Continuous trend No leak Leakage minute volume in of inspiratory minute volume Ventilation Continuous trend No MV Minute volume L min Ventilation and Anesthesia Continuous trend Yes MVe Minute volume expired L min Ventilation Contin...

Page 407: ...sthesia Not trended No P0 1 Occlusion pressure mbar Ventilation Continuous trend No Phf Pressure amplitude during HFO mbar Ventilation Continuous trend No Phigh Upper pressure level during APRV mbar Ventilation Continuous trend No PIP Peak inspiratory pressure mbar Ventilation and Anesthesia Continuous trend Yes Plow Lower pressure level during APRV mbar Ventilation Continuous trend No Pmin Minimu...

Page 408: ...ntinuous trend No RRp Respiratory rate based on pressure min Ventilation Continuous trend Yes RRspon Spontaneous respiratory rate min Ventilation Continuous trend No RSB Rapid shallow breathing index 1 min L Note adult and pediatric patients only Ventilation Continuous trend No Sev cons Sevoflurane consumption mL Anesthesia Continuous trend No Tispon Spontaneous inspiratory time s Ventilation Cont...

Page 409: ... VTCO2 CO2 production volume per breath mL Ventilation Continuous trend No VTe Expiratory tidal volume mL Ventilation Continuous trend Yes VTemand Mandatory expiratory tidal volume mL Ventilation Continuous trend No VTespon Spontaneous expiratory tidal volume mL Ventilation Continuous trend No VTespon mean Expiratory spontaneous mean tidal volume mL Ventilation Continuous trend No VThf Tidal volum...

Page 410: ...tinuous trend No VTspon Spontaneous tidal volume mL Note Only mL is supported L is supported on source device Ventilation Continuous trend No VT Wt Tidal volume per kg body weight mL kg Ventilation Continuous trend No xMAC xMAC mean alveolar concentration derived from expiratory concentration no units Anesthesia Continuous trend Yes Parameter label Description Unit of mea sure ment Displayed in Ve...

Page 411: ...ume pressure volume Parameter fields Parameter fields report parameter values and indicate the alarm status of parameters Parameter fields can also report technical conditions such as disconnected sensors and so on The content of a parameter field can be configured For more information see page 414 The following diagram shows a typical parameter field for a MEDIBUS X parameter A Primary parameter ...

Page 412: ...d progresses counterclockwise to the original starting point To view loops You can view loops from the Ventilator or the Anesthesia workstation tabs Which tab is displayed depends on whether a ventilator or an anesthesia workstation is connected 1 Select the Sensor parameters button on the main menu bar 2 Select the Ventilator tab or the Anesthesia workstation tab 3 Select the PV Loop tab to view ...

Page 413: ... ventilator Show all page You can configure the parameter display of the ventilator Show all page and adapt it to the parameter set of the connected device To configure the ventilator Show all page 1 Select the Sensor parameters button on the main menu bar Select Ventilator Configure show all A page with twenty six buttons appears NOTE Depending on which devices are connected to the Cockpit two Ve...

Page 414: ...ou can configure the display of ventilation and anesthesia parameters in the following tabs located under the Ventilator or the Anesthesia workstation tabs Paw Vent CO2 when a ventilator is connected or CO2 O2 Agent when anesthesia workstation is connected 1 Select Sensor parameters from the main menu bar 2 Select the Ventilator or the Anesthesia workstation tab If you cannot see the tab select th...

Page 415: ...Paw parameter field Parameter 2 PEEP PIP Pmean default Pplat Selects the second parameter in the Paw parameter field Parameter 3 PEEP default PIP Pmean Pplat Selects the third parameter in the Paw parameter field Color Red green blue yellow light blue default purple orange white Determines the color of all MEDIBUS X parameter fields waveforms and loops Selection Available settings Description Flow...

Page 416: ... RRf RRp VT auto available parameters depends on source device VTe VTACH VTi Selects the primary parameter in the ventilation parameter field automatically when the Vent parameter display setting is set to Auto The specific parameter supported by the source device is assigned automatically according to the priority list Parameter 2 MVe MVi VTe VTACH VTi RR default RRf RRp Selects the second parame...

Page 417: ... available parameter depends on source device RR RRf RRp VT auto default available parameters depends on source device VTe VTACH VTi Selects the primary parameter in the ventilation parameter field automatically when the Vent parameter display setting is set to Auto The specific parameter supported by the source device is assigned automatically according to the priority list Color Red green blue y...

Page 418: ...ight blue purple orange white Determines the color of the CO2 parameter field and waveform Menu selections when Anesthesia workstation tab is selected etCO2 parameter field etCO2 default etCO2 O2 Determines the appearance of the etCO2 parameter field CO2 Scale 0 to 40 default 0 to 60 0 to 80 0 to 100 mmHg 0 0 to 5 0 default 0 0 to 8 0 0 0 to 12 0 0 0 to 16 0 kPa 0 to 5 default 0 to 8 0 to 12 0 to ...

Page 419: ...alStation Vent Central option 420 External device alarms 420 Precautions 421 Device compatibility 421 Supported Servo i parameters 422 Supported Servo i waveforms 423 Viewing parameter data 423 Parameter fields 424 Viewing loops 425 The Show all page 426 Accessing the parameter setup functions 426 Ventilator Paw setup functions 427 Ventilator parameter setup functions 428 CO2 parameter setup funct...

Page 420: ...a the Cockpit If the patient is admitted at an ICS Infinity CentralStation with software version VF8 and the Vent Central option is activated you can review the above mentioned data at the ICS For more detailed information refer to the VF8 instructions for use entitled Infinity CentralStation External device alarms Alarms from the ventilator are transmitted to the Infinity network and made availab...

Page 421: ... those devices comply with the electrical safety requirements found in IEC 60601 1 Refer to Safe connection with other electrical equipment on page 13 of these instructions for use for information on how to connect devices safely WARNING The following section lists all of the external devices and related software versions that Dräger has validated Dräger cannot make any claim for the reliability o...

Page 422: ... display in parame ter field Yes No Cdyn Dynamic compliance L bar Yes Continuous No etCO2 End tidal CO2 concentration mmHg Not supported for display Continuous and mini trend Yes kPa FiO2 Inspired O2 Yes Continuous No MVe Minute volume expired L min Yes Continuous and mini trend Yes MVespon Spontaneous expiratory minute volume L min Yes Continuous No PEEP Peak end expiratory airway pressure cmH2O ...

Page 423: ...cations Parameter fields Loops pages see page 425 Trends pages see page 163 Show all pages see 426 The Cockpit displays the following waveforms loops and parameters Airway pressure waveform Paw and associated parameter field Expiratory flow waveform and associated flow volume vent parameter field CO2 waveforms and associated parameter field Loops flow volume pressure volume Waveform label Descript...

Page 424: ...information regarding the content of parameter fields for each parameter see the chapter Troubleshooting on page 509 The following diagram shows a ventilator parameter field A Primary parameter label B Second parameter label C Second parameter value D Third parameter label E Third parameter value F Primary parameter value NOTE The following diagram shows a typical parameter field layout This layou...

Page 425: ... point To view loops 1 Select the Sensor parameters button on the main menu bar 2 Select the Ventilator tab If you cannot see the tab select the following two symbols located in the upper right corner of the dialog symbol display filter button 3 Select the PV Loop tab to view pressure volume loops or select the FV Loop tab to view flow volume loops 4 Select the Loops tab to view all loops in one d...

Page 426: ...you cannot see the tab se lect the following two symbols located in the up per right corner of the dialog symbol and the display filter button 2 Select either the Paw or the Vent tabs to access the respective pages NOTE The settings TVi I I E and E I E also appear in the Show all page in addition to the parameters NOTE Depending on which devices are connected to the Cockpit two Ventilator tabs may...

Page 427: ... 70 80 100 120 mbar Determines the scale of the displayed Paw waveform Parameter 1 Pmean PEEP PIP default Selects the primary parame ter in the Paw parameter field Parameter 2 Pmean default PEEP PIP Selects the second parame ter in the Paw parameter field Parameter 3 Pmean PEEP default PIP Selects the third parameter in the Paw parameter field Color Red green blue yellow light blue default purple ...

Page 428: ...played Flow waveform Vol scale 5 10 25 50 default in neonatal mode 75 100 250 500 1000 default in pediatric and adult mode 1500 mL Determines the scale of the displayed Volume waveform Parameter 1 MVe default RR VTe Selects the primary parameter in the Vent parameter field Parameter 2 MVe RR default VTe Selects the second parameter in the Vent parameter field Parameter 3 MVe RR VTe default Selects...

Page 429: ...e settings Description CO2 Scale 0 to 40 default 0 to 60 0 to 80 0 to 100 mmHg 0 0 to 5 0 default 0 0 to 8 0 0 0 to 12 0 0 0 to 16 0 kPa 0 to 5 default 0 to 8 0 to 12 0 to 16 Determines the scale of the dis played CO2 waveform Atm pressure 570 to 800 mmHg Determines the ambient pres sure setting Color Red green blue yellow default light blue purple orange white Determines the color of the CO2 para...

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Page 431: ...Central option 432 External device alarms 432 Precautions 433 Device compatibility 433 Supported Medibus ventilator data 434 Supported Medibus parameters on the Cockpit 434 Supported Medibus waveforms 436 Viewing Medibus parameter data 436 Parameter fields 437 Viewing loops 437 The Show all page 438 Accessing the parameter setup functions 439 Ventilator Paw setup functions 439 Ventilator parameter...

Page 432: ...re broadcast to the network via the Cockpit If the patient is admitted at an ICS Infinity CentralStation with software version VF8 and the Vent Central option is activated the above mentioned data is displayed at the ICS For more detailed information refer to the VF8 instructions for use entitled Infinity CentralStation External device alarms Alarms from the ventilator are transmitted to the Infin...

Page 433: ...d in IEC 60601 1 Refer to Safe connection with other electrical equipment on page 13 of these instructions for use for information on how to connect devices safely WARNING The following section lists all of the external devices and related software versions that Dräger has validated Dräger cannot make any claim for the reliability of the data for subsequent or previous software versions or for any...

Page 434: ... table lists which parameters are displayed and trended on the Cockpit Refer to page 433 for a list of supported ventilators and the compatible software versions Parameter label Description Unit of measure ment Displayed in Ventilation Show all page see page 438 Yes No Cockpit Trends page Available for display in parameter field Yes No Cdyn Dynamic compliance L bar Yes Continuous No etCO2 End tida...

Page 435: ...unit Yes Not trended No E I E Expiratory component No unit Yes Not trended No I E Ratio inspiratory to expiratory component No unit Yes Note This parameter is calculated and is not broadcast to the network Not trended No V CO2 Carbon dioxide production mL min Yes Continuous No Vds Serial dead space volume mL Yes Continuous No Vds VTe Ratio of serial dead space volume to expiratory tidal volume Yes...

Page 436: ...ors in the following locations Parameter fields Loops pages see page 437 Trends pages see page 163 Show all pages see 438 The Cockpit displays the following waveforms loops and parameters Airway pressure waveform Paw and associated parameter field Expiratory flow waveform and associated flow volume vent parameter field CO2 waveforms and associated parameter field Loops flow volume pressure volume ...

Page 437: ... the response of the patient to mechanical ventilation You can review loops on two pages Pressure volume and Flow volume Pressure volume loops illustrate changes in compliance resistance and work of breathing A mandatory breath plots counterclockwise while a spontaneous breath plots clockwise Inspiration starts at a point defined by baseline pressure and the volume level at the beginning of inspir...

Page 438: ...e a loop for future analysis and comparison The Show all page The Show all page displays the values of the currently monitored ventilator parameters and units of measure in one screen To access the ventilation show all page 1 Select the Trends Data button on the main menu bar 2 Select Trends Ventilator Show all or 1 Select the Sensor parameters button on the main menu bar 2 Select the Ventilator t...

Page 439: ...s are connected to the Cockpit two Ventilator tabs may be displayed If you select the Ventilator tab and the selected page has the message Medibus X ventilator devices displayed as a header you have selected the wrong Ventilator tab Selection Available settings Description Paw scale 10 15 20 25 default 30 40 50 60 70 80 100 120 mbar Determines the scale of the displayed Paw waveform Parameter 1 Pm...

Page 440: ...the displayed Flow waveform Vol scale 5 10 25 50 default in neonatal mode 75 100 250 500 1000 default in pediatric and adult mode 1500 mL Determines the scale of the displayed Volume waveform Parameter 1 MVe default RR VTe Selects the primary parameter in the Vent parameter field Parameter 2 MVe RR default VTe Selects the second parameter in the Vent parameter field Parameter 3 MVe RR VTe default ...

Page 441: ...vailable settings Description CO2 Scale 0 to 40 default 0 to 60 0 to 80 0 to 100 mmHg 0 0 to 5 0 default 0 0 to 8 0 0 0 to 12 0 0 0 to 16 0 kPa 0 to 5 default 0 to 8 0 to 12 0 to 16 Determines the scale of the dis played CO2 waveform Atm pressure 570 to 800 mmHg Determines the ambient pres sure setting Color Red green blue yellow default light blue purple orange white Determines the color of the C...

Page 442: ...442 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 443: ...uring the recording and report settings 467 Reports setup Reports page 467 Recorder setup 468 Rest ECG setup 469 Reports setup Reports setup page 470 Biomed setup 470 Biomed setup country specific settings 471 Biomed setup units of measure 472 Biomed setup patient monitor setup 473 Biomed setup name service settings 475 Biomed setup network setup 476 Biomed setup printer setup 477 Biomed setup rec...

Page 444: ...h list each menu selection the available settings and a description Some setup pages are more complex and are therefore described in more detail Where necessary diagrams clarify additional setup procedures Screen setup Several Screen setup pages are available for configuring the layout and the content of the screen To access the screen setup functions 1 Select the System setup button on the main m...

Page 445: ...peed mm s 0 62 6 25 default 12 5 25 50 0 62 mm s is not supported on the network and is transmitted as 6 25 mm s on the network Sets the sweep speed of the anesthesia waveform Show parameter units On Off default Activates deactivates the display of units of measurement in the parameter fields Attention tone volume Off 5 10 to 100 in increments of 10 default 40 Determines the volume of the attentio...

Page 446: ...age 449 To access this page see page 444 A Auto display mode selection button B Manual display mode selection button C Show All D Auto view tab E Waveforms button F Layout button for waveforms G Pressure overlap on and off buttons H Parameter boxes button I Layout button for parameter fields J Split screen button K Mini trends selection button L NIBP trend button M Toolbar button N Parameter selec...

Page 447: ... are displayed in adjacent channels 5 Select the Parameter boxes button H and use the rotary knob to select the desired number of parameter fields for display The available selections are Off 1 2 3 default 4 5 6 6 Select the Layout button I Then select the Top or Bottom default button to determine if the parameter fields appear along the bottom or the top of the screen Select the Split screen butt...

Page 448: ...ameter selection window functions dynamically with the auto view setup toolbar see page 449 You can also determine the content of the parameter list by using the display filter button When it appears on a dark green background all parameters are displayed in the parameter selection window even if they are not connected Parameters that are not connected appear gray However as soon as you connect a ...

Page 449: ...orms for display with the Waveforms button E 3 Select the number of parameter fields for display with the Parameter boxes button H 4 Select the parameter and use the rotary knob to move it up or down the parameter selection window N to the desired position As you move the parameter up or down the list the display symbol next to the parameter can change For example a parameter that previously appea...

Page 450: ...al parameters are relegated to the not displayed status You can either display or hide the auto view setup toolbar see page 447 You can also change the display status of a parameter display mode by switching its position on the auto view setup toolbar To change the display status of a parameter 1 Select the field on the auto view setup toolbar of the parameter whose display mode you wish to change...

Page 451: ...o a custom view 1 Select the System setup button on the main menu bar 2 Select the Screen setup tab if not already selected 3 Select the Views tab A password popup appears 4 Select the view whose name is followed with an asterisk and appears in italic font for example Basic OR This display convention identifies a view that has been modified and whose changes have not yet been saved 5 Select the Sa...

Page 452: ... appear on the quick access toolbar instead The depicted menu bar is an exact replica of the actual menu bar As you make changes to the menu bar on the Config buttons page the actual menu bar on the main screen changes accordingly A Alarms button B Mark event button C Code button D Views button E Print screen button F Freeze waveforms button G Trends Data button H Procedures button I Sensor parame...

Page 453: ...t the Cockpit for two minutes Auto set all Adjusts the alarm limits of all parameters automatically Code Executes pre configured functions during an emergency Night time Controls the brightness of the Cockpit screen Default view Resets the Cockpit to the factory default view Discharge Discharges a patient from the Cockpit Freeze waveforms Stops the waveform from scrolling for approximately 60 seco...

Page 454: ...ttons button Remote view Provides access to patient data from other Infinity monitors within the same monitoring unit Rest ECG report Prints a diagnostic report generated from a 12 lead ECG Show all ECG Displays all ECG waveforms Standby Places the Cockpit in standby mode Start C O Starts a cardiac output measurement Start wedge Starts a pulmonary wedge measurement Split screen Turns the split scr...

Page 455: ...Split screen button is assigned to the menu bar See To configure the function keys on page 453 To configure the split screen 1 Select the System setup button on the main menu bar 2 Select the Screen setup tab if not already selected 3 Select the Multi tab split screen tab 4 Select the Tab 1 Tab 2 or Tab 3 to select the desired content from the following list of available choices Anesthesia show al...

Page 456: ...button G Save View symbol To access the view editor 1 Select the System setup button on the main menu bar 2 Select the Screen setup tab View editor tab C 3 Enter the password and select the Enter button View editor functions In the following procedures the letters in parentheses correspond to the View editor diagram The View editor allows you to perform the following functions Modify existing view...

Page 457: ...CG lead for display 7 Repeat steps 4 and 5 for all panels in the selected layout template 8 Select the symbol G next to Save View field see diagram on page 456 to save the changes under the existing name or Select the symbol next to the View field A to access a keyboard for renaming the current view To assign a view to profiles You can assign a view to a profile after you modify a view or at any t...

Page 458: ...m settings To access the alarms pages 1 Select System setup on the main menu bar A password popup appears 2 Select the Alarms tab 3 Enter the password and select the Enter button 4 Select one of the following tabs to access the respective setup page General settings Volume Tone Code M540 settings Alarms setup general settings The following table lists the available settings of the General settings...

Page 459: ...h a timer and the following symbol No timeout The button on the alarm toolbar changes to All alarms off This button is accessible by selecting the symbol on the quick access toolbar see page 74 When the All alarms off button is selected the following happens All alarm functions are suppressed until you select the button again which activates the alarm function The message All alarms off appears in...

Page 460: ...ted when OR alarms is activated see page 119 Cardiac bypass On Off default Activates deactivates cardiac bypass mode Alarm functions are affected when cardiac bypass mode is activated see page 119 This mode is not available when the French NFC mode is enabled see page 473 NIBP SpO2 interlock On Off default On the SpO2 alarm function is deactivated during non invasive blood pressure and Pulse CO Ox...

Page 461: ...are turned off Selection Available settings Description Minimum alarm volume 5 10 to 100 in increments of 10 50 default Off Determines which alarm volume settings are available under the Alarm volume button This setting does not affect the volume of the attention or the pulse tone Alarm volume Off 5 10 to 100 in increments of 10 default is 50 Determines the volume of the alarm tone You can never t...

Page 462: ...xists This alarm tone is suppressed if you initiate an audio pause When the Cockpit is in OR mode the volume of the alarm tone corresponds to the Alarm volume setting of 10 When OR mode is not activated the volume equals to 50 This feature is not supported on remote devices On a truncated acoustic alarm signal sounds every 30 seconds for an alarm condition of medium or high priority Low priority a...

Page 463: ...larms off and the symbol The alarm message field appears solid until the 30 second pass Then the tone sounds again and the message and the symbol flash again On remote devices the message does not flash but appears on solid red background with the identical message and symbol When cardiac bypass mode is activated this feature is not available Any changes to this setting on the Cockpit are adopted ...

Page 464: ...larm priority will not be reported with an alarm tone Off Any new alarm condition regardless of its alarm priority overrides an already active audio pause state at the Cockpit and at the ICS if the patient is admitted there All optical and acoustic alarm signals are reported fully for any new alarm condition For detailed information how quiet mode affects the audio pause behavior see page 121 Sele...

Page 465: ... select the Code button All audible and optical alarm signals are deactivated at the Cockpit and at the ICS The message area flashes red with the message All alarms off The symbol appears in the header bar The All alarms paused setting is set to No timeout if the selection All alarms off reminder is set to On an alarm tone sounds every 30 seconds to indicate that the alarms were disabled Selecting...

Page 466: ... to match the M540 when it is undocked The Transport alarm volume setting is tied to the minimum alarm volume setting see page 461 If the minimum alarm volume is set to a higher volume than the selected Transport alarm volume setting the Transport alarm volume setting is adjusted to the higher setting If the minimum alarm setting is set to a lower setting than the current Transport alarm volume se...

Page 467: ...following tabs to access the respective setup page Recorder setup Rest ECG report Reports setup Reports setup Reports page The following table lists the available settings of the Reports page Selection Available settings Description ECG ST ECG report Rest ECG report ST report Prints the selected report See Available reports on page 498 for detailed descriptions of each report Alarms Alarm history ...

Page 468: ...ion Auto default Manual Auto the top two displayed waveforms are automatically selected for recordings If no waveforms are displayed no recording is generated Manual the two selected waveforms under Waveform 1 and Waveform 2 are printed Waveform 1 Selected parameter under Waveform Selection setting factory default is ECG Lead II Assigns the selected waveform to the top channel on R50N recordings p...

Page 469: ...lt and pediatric patients NOTE If the ECG Filter is set to ESU Rest ECG report cannot be generated Selection Available settings Description Gender Unknown default Male Female The selected information is included in the report Race Unknown default Caucasian Asian African Other Medication 1 No meds Unknown default list of medications Medication 2 Condition 1 Pick list with several choices for indica...

Page 470: ...IT setup select the desired tab such as Web browser Innovian and so on NOTE Reports printed on a laser printer use the settings in the Reports setup page not the settings de fined in the trend setup pages Selection Available settings Description Waveform delay s 6 10 default 15 s Determines the amount of delay pre event data included in a timed strip report Delay data refers to data that originate...

Page 471: ...wegian Norway Bokmal Portuguese Brazil Swedish Sweden Dutch Nether lands Japanese Japan Russian Russia Turkish Turkey Polish Poland Greek Greece Hungarian Hungary Chinese Simpli fied PRC Czech Czech Re public Dutch Belgium French Belgium Selects the language of the Cockpit screen text You must select the language of the M540 independently Time zone User selectable list of time zones Allows you to ...

Page 472: ...tient discharge Selection Available settings Description Pressure mmHg default kPa Assigns the selected unit of measurement to the parameter Whenever you change a unit of measurement the Cockpit discharges the patient CO2 mmHg default kPa Assigns the selected unit of measurement to the parameter Whenever you change a unit of measurement the Cockpit discharges the patient Applies to Mainstream and ...

Page 473: ...Off default When this feature is activated HR alarms cannot be deactivated and the all alarm pause period cannot exceed 3 minutes Simulation basic On Off default Activates or deactivates basic simulation mode This feature is used when the M540 is connected When activated the Cockpit uses the simulator mode from the M540 and adds additional device connectivity parameters External display Analog Dig...

Page 474: ...he A500 is in cardiac bypass mode Cardiac bypass is automatically disabled when the A500 is no longer in cardiac bypass mode Manual when an anesthesia machine is connected and the OR Alarms setting is activated at the Cockpit the Cardiac bypass feature must be activated manually see page 460 Restore factory settings None Restores all patient and monitoring settings to the factory defaults Do not r...

Page 475: ...d IACS is used for the Name service setting If the Name service setting and any bed labels match the IACS bed label does not appear on the ICS Care unit label Bed label Hospital name Enable Central Station On default Off If this feature is activated and an ICS is connected to the network the message Not Monitored By Central appears in the Cockpit header bar if the Cockpit is not assigned to an ICS...

Page 476: ... settings for IP address Subnet mask Gateway and Primary DNS are pulled automatically from the server IP address User selectable Allows you to select an IP address manually the DHCP setting has to be set to Disabled Subnet mask User selectable Allows you to set up a subnet mask the DHCP setting has to be set to Disabled Gateway User selectable Allows you to set up a gateway the DHCP setting has to...

Page 477: ...nter IP address User selectable Allows you to configure the IP address for printing reports on a network printer HP Universal Print Driver Informational only Displays the version of the print driver Paper Size Letter Legal A4 Allows you to select the printer paper Print test page Select the Print screen button to verify that the printer is working properly Selection Available settings Description ...

Page 478: ...he connected USB flash drive D Select this button to export the current profiles to the connected USB flash drive E Select this button to import the profiles from the connected USB flash drive F Select this button to export the shared system profile G Select this button to import the shared system profile H Window displaying status messages relating to the function that is being executed I Service...

Page 479: ... tab feature is activated Regardless of how many IT tabs are configured the top tab is always labeled Patient and provides access to the Cockpit main screen To activate or deactivate IT tab feature 1 Access the IT setup page see page 470 2 Select the IT tabs button 3 Select the On or Off button next to the IT tabs selection Configuring IT tabs browser setup You can set up a browser as an IT tab th...

Page 480: ... refer to the diagram of the Web browser page To add a browser page 1 Access the Web browser page see page 470 2 Select the Add button K The label Undefined appears in the pick list J as a place holder 3 Select the following buttons to configure the corresponding settings Select the symbol next to the Name menu selection D to activate an keyboard for changing the label Undefined to an actual name ...

Page 481: ... the pick list 3 Select the Delete button L Configuring Citrix applications The following diagram shows the Application page for configuring Citrix applications Citrix allows you to access remote applications without running the actual application on the Cockpit A Application tab B IT tabs C Name symbol and field D Name column E Value column F List of Citrix client object properties G Auto logoff ...

Page 482: ...Citrix environment The Name column D defines the property being used and the Value column E defines the value needed Refer to the Citrix ICA Client Object documentation for more information Configuring IT tabs The following diagram shows an example of an IT page When the appropriate IT application option is unlocked IT tabs appear with the corresponding label of a pre configured URL address provid...

Page 483: ... to the URL menu selection D to activate a keyboard for entering the URL Select the Full Trust on or off button E to select the security setting for this website Select the Block Popups on or off button F to allow or prevent popups from appearing on this website 4 Select the Tab visible on or off button G to display or hide the tab Once an IT application is correctly set up the website is accessib...

Page 484: ...u can select a profile with pre configured patient and device settings A Profiles tab B Select profile tab C Adult selection button D Pediatric selection button E Neonate selection button F Profile arrow button G Description window of selected profile To select a profile 1 Select the System setup button on the main menu bar 2 Select the Profiles tab A Select profile tab B 3 Select the desired pati...

Page 485: ...tored The adult profiles pediatric profiles neonate profiles pages have identical setup functions The only exception is their content which is patient category specific This is important when you are resetting all profiles to Dräger profiles Only the profiles within the currently selected patient category are affected To save changes to an existing profile In the following steps the letters in par...

Page 486: ... it to an existing view using the Save Profile pop up window A Profile name field and setup button B Description field and setup button C Default view field and selection button D Save Profile button To save a new profile 1 Repeat steps 1 to 6 for saving changes to an existing profile see page 485 2 Select the Save profile as button H in the Save Profile page see diagram on page 485 The Save Profi...

Page 487: ...iatric and neonate A Adult tab B Pediatric tab C Neonate tab D Views tab E Set as Default button F Delete Profile button G Profile name field and setup button H Description field and setup button I Views button J Default view field and selection arrow K Pick list of available profiles To access the patient specific Profiles pages 1 Select the System setup button from the main menu bar 2 Select the...

Page 488: ...fault profile for the selected patient category After each patient discharge or a restart of the Cockpit the default profile is automatically loaded when that patient category is selected Select the Delete Profile button F to delete the selected profile Use the button next to the Profile name field G of the profile page to name the profile The name appears in the Select profile page see page 484 U...

Page 489: ...possible among Cockpits within in the same monitoring unit The following diagram shows the Profile transfer page which consists of a list of connected devices within the monitoring unit A Profiles tab B Device name column C Status column D Profile transfer tab E Start transfer button F Clear selection button G Select all button NOTE Use a FAT32 flash drive for importing or exporting profiles USB f...

Page 490: ...mporting shared system profiles from a Cockpit that has options unlocked such as physiological calculations that are locked on the destination Cockpit the shared system profiles are imported However the settings relating to the locked feature will not become active until the option is unlocked on the destination Cockpit Unlike transferring profiles over the network using a USB flash drive has the ...

Page 491: ...hared system profiles from a USB flash drive 1 Insert the USB device in the USB port of the Cockpit where you wish to transfer the profiles to 2 Select the System setup button from the main menu bar 3 Select the Biomed tab 4 Enter the Biomed password 5 Select the Service tab 6 Select the Import shared system profile button to import all shared system profiles from the USB device to the Cockpit A c...

Page 492: ...492 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 493: ...Overview 494 R50N recorder 494 Replacing the recorder paper 494 Timed recordings 495 Remote Recordings 495 Automatic alarm recordings 496 Continuous recordings 497 Causes for automatic cancellation of recordings 497 Requesting recordings 497 Available reports 498 Printing reports 498 Configuring a case summary report 502 ...

Page 494: ... are printed on an R50N recorder which is connected to the network or to the PS250 P2500 using a cross over cable The R50N is a two channel strip recorder A Stop key stops a recording in progress B mm s key does not function Replacing the recorder paper To replace the paper 1 Open the paper door and remove the empty paper roll and any paper remaining in the printing mechanism 2 Place a new paper r...

Page 495: ...contains delay data that originated before the recording was initiated and real time data that was acquired after the recording started The ratio of delay and real time data are configurable see page 467 Strip recordings also include pacer spikes if present The header of a timed recording contains the following information Parameter values at the time the recording starts printing Patient name and...

Page 496: ...ld of the parameter whose alarm function you wish to activate or deactivate to access that parameter page directly or Select Sensor parameters from the main menu bar select the desired parameter tab to access the page 2 Select the button next to the Archive setting and select either Store Str Rec Record to generate a recording or Off to deactivate the feature To assign an alarm priority to arrhyth...

Page 497: ...ircumstances If the Cockpit loses its connection to the network The recordings resume when the network connection is restored If you place the Cockpit into standby mode If you discharge a patient Requesting recordings The following table lists where you can request manual timed and continuous recordings Type of report Description How to request the recording Timed recording A strip recording of a ...

Page 498: ...ing information Date Page number Report title Printing reports The following table outlines the types of reports that are available Most reports can be requested from several places on the Cockpit Type of report Description How to request the report Print screen Prints the current display Whenever you request a print screen it is printed on the connected laser printer C700 Select the Print screen ...

Page 499: ...ed appropriately for the patient see page 469 Timed waveformreport Prints strip reports of all currently displayed waveforms the waveform duration and delay time settings are configurable see page 470 Select the symbol next to the Trends Data button on the main menu bar Timed wvf report Select the Trends Data button on the main menu bar Trends Reports General reports Timed wvf report Continuous wa...

Page 500: ...he selected Table interval min setting see page 470 Select the symbol next to the Trends Data button on the main menu bar Trend table report Select the Trends Data button on the main menu bar Trends Table Print Select the Trends Data button on the main menu bar Trends Reports General reports Trend table report Graph vitals report Prints the contents of the Graph vitals page Select the Trends Data ...

Page 501: ...nfigured in the Reports page of the Trends Data dialog see page 179 Select the symbol next to the Trends Data button on the main menu bar Case summary report Select the Trends Data button on the main menu bar Trends Reports General reports Print case summary Select the Trends Data button on the main menu bar Trends Reports General reports OR report Print case summary OR report Prints a brief summa...

Page 502: ... a case summary report ECG report Anesthesia trend report OR report To setup a case summary report 1 Select the Trends Data button on the main menu bar 2 Select the Reports tab if not already selected 3 Select the Setup tab to display the setup page to be included in the case summary report 4 Select one or more of the following reports the buttons of the selected reports appear dark green ECG repo...

Page 503: ...ications VG6 n 503 IT applications options IT applications options Overview 504 Configuring IT tabs 504 Web browser 504 Accessing an IT tab 505 Supported IT applications 506 Connecting to the network 507 EC 60601 1 2005 and 60601 1 2012 clause 14 13 compliance 507 ...

Page 504: ...as the blocking of popups and so on For detailed information see Biomed IT setup on page 479 If the Cockpit loses communication with an application a message appears on the corresponding IT application page The Cockpit tries to restore the communication with the IT application as quickly as possible Web browser In addition to IT applications you can also setup a browser with pre configured website...

Page 505: ...played the Cockpit header bar is always visible to report the patient s monitoring data status The top IT tab is the Patient tab that returns you to the main screen displaying the patient s vital signs A Patient tab always returns you to the main screen with the patient s vital signs B Navigate backward and forward C Stops loading the web page D Refreshes the screen E Displays the main screen F Ad...

Page 506: ... Whenever you access the Innovian tab the local patient is displayed or the admit screen is presented if the local patient has not yet been admitted to Innovian Solution Suite application For more information refer to the instructions for use Innovian Solution Suite Infinity Symphony Suite VF7 An application that provides retrospective analysis of patient data stored on the ICS The tab can be conf...

Page 507: ...ess must be entered EC 60601 1 2005 and 60601 1 2012 clause 14 13 compliance Subsequent changes to the IT network can include among other things IT network configuration changes Adding or removing additional devices to from the IT network Upgrading and or updating network equipment connected to the IT network Hospital personnel for example biomedical or network engineers should read the accompanyi...

Page 508: ...oducts paging interfaces and connections to 3rd party medical devices IEEE 1073 conformant interfaces Medical Information Bus for connections to 3rd party medical devices IEEE 1073 3 2 or 1073 3 1 and 1073 4 1 Serial data connections conforming to USB 2 0 for human interface devices mouse keyboards mass storage devices such as flash disks CD drives etc Security for Dräger wireless products is impl...

Page 509: ...messages 510 Messages 513 ECG 517 ST 520 ARR 521 Respiration RRi 523 SpO2 526 Non invasive blood pressure NIBP 534 Temperature 537 Invasive blood pressure IBP 539 Mainstream CO2 543 Microstream CO2 547 Calibration and maintenance 547 CO2 monitoring 548 Sample line 550 Cardiac Output C O 551 Recording status messages 554 Scio 556 Status Messages 566 ...

Page 510: ... order These tables identify possible alarm causes and provides corrective action The various causes and remedies should be worked through in the order listed until the problem has been resolved Device communication messages Warning Message of high priority Caution Message of medium priority Advisory Message of low priority Priority Message Cause Remedy None Check IP address Duplicate PDS or Multi...

Page 511: ...ssigned to a central station A wireless M540 is out of range of the access point Admit the patient at the central station Return the M540 inside the range of the wireless access point Check network connectivity Offline The Cockpit is disconnected from the Infinity network Check the network connectivity please plug in power supply Loss of AC power forces the Cockpit to run on battery charge power f...

Page 512: ...elearn The indicated function was initiated from the central station Informational message no action required None Remote Limit Change The indicated function was initiated from the central station Informational message no action required None Silenced at Remote Remote alarm silence initiated from the central station or another Cockpit Informational message no action required Priority Message Cause...

Page 513: ...ode is changed to Basic or Advanced Audio paused with timer The yellow Audio paused 2 min key next to the rotary knob was pressed Press the key again to remove the message Audio off This message appears in the alarm message field when the Audio off feature is set to On Activate the Audio off setting to remove the message All alarms off bypass This message appears in the alarm message field when yo...

Page 514: ...n the filter setting is set to Off see page 214 Activate the function to remove the message HR alarms off This message appears in the alarm message field under the following circumstances When the alarm limits for heart rate are deactivated and the ASY VF alarms function is set to Always on see page 460 When the alarm limits for heart rate are deactivated the basic arrhythmia function is activated...

Page 515: ...emove the message None Pacer off Pacer fusion These messages appear above the ECG waveform when the corresponding function is activated or deactivated see page 214 Deactivate the function to remove the message None Privacy Touch Screen to resume monitoring This message appears in the center of the Cockpit screen when privacy mode has been activated see page 88 All patient data are removed from the...

Page 516: ...Care System Monitoring Applications VG6 n None Waveforms stopped This message appears above all waveforms when you press the Freeze waveforms button on the main menu bar see page 88 Select the button again to remove the message Priority Message Cause Remedy ...

Page 517: ...ent and treat if necessary Change the alarm limits 0 out of range high 1 The parameter value is replaced by The parameter value is above the measurement range of the monitor 0 artifact 1 2 The parameter value is replaced by Patient movement shivering tremors Bad electrode contact Excessive signal noise interference from auxiliary equipment Check the electrodes and reapply if necessary Make sure th...

Page 518: ...eplace new disposable electrodes Select another ECG lead for processing If monitoring augmentedleads verify that the number of selected leads in the ECG setup page is correct Check cable s and connection s Replace cable s if necessary None None None None None None LA lead off LL lead off RA lead off RL lead off V lead off V1 lead off V2 lead off V3 lead off V4 lead off V5 lead off V6 lead off V le...

Page 519: ...entral station is not possible Check that the patient is admitted at the central station Check that the central station has the Rest ECG option activated None ECG report complete Parameter value The Rest ECG report has been printed Informational message no action required None 0 comm failure 1 Parameter value The external device is not available Check the configuration at the central station None ...

Page 520: ...y Make sure the patient s skin is properly prepared Isolate the patient from auxiliary equipment if possible Inspect and replace faulty cable s and wire s Reapply gel on reusable electrodes and reapply them or replace new disposable electrodes Reapply the electrode s Make sure the patient s skin is properly prepared If a lead or electrode cannot be replaced select another ST lead for processing ST...

Page 521: ... the patient and treat if necessary Check the placement of electrodes and change their position if necessary 0 out of range high 1 The parameter value is replaced by The parameter value is above the measurement range of the monitor Check the patient and treat if necessary Check the placement of electrodes and change their position if necessary 0 Unplugged 1 The parameter value is replaced by ECG l...

Page 522: ...ppears blank After 100 beats the M540 cannot determine the dominant normal complex on any lead selected for QRS processing Check the electrode preparation Reapply electrodes if necessary None 0 relearning 1 LEARN The M540 is learning the patient s QRS complex to establish a reference template Informational message no action required In the parameter field the value is replaced by an ARR abbreviati...

Page 523: ...er than 150 breaths per minute The M540 may be counting artifacts as valid breaths The M540 may be counting interfer ence caused by faulty equipment Check the pa tient and treat if necessary Check the placement of electrodes Move the elec trodes away from the source of interference 0 apnea 1 APNEA Neonatal apnea condition was detected Check the patient and treat if necessary Check the placement of...

Page 524: ...nd treat if necessary Check and change the electrode placement if you receive a coincidence message until you obtain a clear respira tion signal Change the de tection thresh old in manual mode or initiate a relearning in auto mode RRi relearning LEARN Relearn is in progress Informational mes sage no action required 1 0 is a placeholder for the parameter label RRi Priority Message Parameter field P...

Page 525: ...e replaced se lect another lead for processing in the RRi setup page 0 artifact 1 2 The parameter value is replaced by Persistent artifact was detected RRi high impedance The parameter value is replaced by A high respiration impedance was detected 0 lead unavailable 1 The parameter value is replaced by Faulty or disconnected electrodes 1 0 is a placeholder for the parameter label RRi 2 After disch...

Page 526: ...detected but have not yet been computed Wait until message disappears None Masimo rainbow SET only Low 0 SIQ 1 Associated parameter values are still displayed Poor signal quality Measurement reading is obscured Check the patient and treat if necessary Make sure the SpO2 sensor is attached properly to the patient Check all cable connections None Low SpO2 SIQ Low SpO2 SIQ Parameter values are still ...

Page 527: ...alarm limit Parameter value The parameter value is above the upper alarm limits Check the patient and treat if necessary Change the alarm limits Any SpO2 MCable SpO2 alarm limit PLS alarm limit Masimo rainbow SET only SpHb alarm limit SpHbv alarm limit PVI alarm limit SpOC alarm limit SpMet alarm limit Parameter value The parameter value is above below the set upper lower alarm limits The priority...

Page 528: ...ace cable Parameter values for SpO2 PLS PI SpHb SpHbv SpOC SpCO SpMet and PVI are replaced by NOTE SpHb SpOC SpCO SpMet and PVI are supported by Masimo SET only Cable expired Replace the cable Any Masimo MCable SpO2 cable expires soon Cable expires soon Cable near expiration Replace the cable Priority Message Parameter field Problem Solution ...

Page 529: ...he SpO2 sensor is disconnected Make sure the SpO2 sensor is attached properly to the patient Check all cable connections None Masimo rainbow SET only 0 sensor calibrating 1 Sensor calibrating Parameter values are replaced by The sensor is being checked for functional integrity Wait until message disappears This message appears right before the message SpO2 searching None Any SpO2 MCable SpO2 desat...

Page 530: ...placed by Interference such as artifact or too much ambient light was detected Make sure the sensor is properly attached Make sure that no nail polish or some other substance is blocking the light Change the sensor location 1 0 is a placeholder for the parameter label SpO2 2 After discharging a patient or starting the device the alarm becomes active only after a numeric value has been received for...

Page 531: ...rameter values for SpO2 PLS PI and PVI Parameter values for SpHb SpHbv SpOC SpMet SpCO are replaced by The device cannot calibrate the Masimo rainbow SET parameters and is attempting to display the standard Masimo parameters Remove and reapply the sensor If the problem persists contact Dräger authorized service personnel Any Masimo MCable SpO2 replace cable next pt Replace cable next pt Parameter ...

Page 532: ...e SpO2 sensor expires soon Sensor expires soon Parameter values SpO2 sensor near expiration Adhesive sensor near expiration Replace the sensor Any SpO2 MCable 0 sensor failure 1 Sensor failure Parameter values are replaced by Hardware failure Faulty SpO2 sensor Make sure the SpO2 sensor is properly attached to the patient and all cables are properly connected Replace the sensor Contact Dräger auth...

Page 533: ...mes active only after a numeric value has been received for that parameter 3 In the parameter field the parameter value is replaced by Any Masimo MCable SpO2 unrecognized cable 3 Unrecognized cable Parameter values are replaced by An incompatible cable is connected Connect the right type of ca ble Contact DrägerSer vice Any SpO2 MCable SpO2 unrecognized sensor Unrecognized sensor Parameter values ...

Page 534: ...t circuit failure NIBP zero out of range or faulty transducer Check all hardware contact DrägerService 1 0 is a placeholder for the parameter label NIBP 0 low inflation limit 1 The message Last measurement failed is followed by the message Low inflation limit Parameter values are replaced by The pressure of the patient is greater than the maximum allowed cuff inflation pressure Select the next hig...

Page 535: ...surement failed is followed by the message Blocked line Parameter values are replaced by The inflation rate is too high during the inflation cycle or the time to evacuate residual cuff pressure at the end of the deflation cycle is too short Select a different cuff Check the hose and cuff for damage Restart the measurement If the message does not clear DrägerService 1 0 is a placeholder for the par...

Page 536: ...ck the cuff for obstructions Repeat the measurement 1 0 is a placeholder for the parameter label NIBP 0 open line 1 The message Last measurement failed is followed by the message Open line Parameter values are replaced by There was no significant increase in cuff pressure during the inflation cycle Make sure that the hose and cuff are properly connected to the monitor None Venous stasis started Pa...

Page 537: ...its 0 out of range high 1 The parameter value is replaced by The parameter value is above below the measurement range of the monitor Check the patient and treat if necessary Check the equipment and replace if necessary 0 out of range low 1 The parameter value is replaced by Cannot derive 0 2 The parameter value is replaced by The cable is either faulty or unplugged Check the equipment and replace ...

Page 538: ...toring Applications VG6 n 1 0 is a placeholder for the parameter label T for Temp 2 After discharging a patient or starting the device the alarm becomes active only after a numeric value has been received for that parameter Priority Message Parameter field Problem Solution ...

Page 539: ...imit Parameter value The parameter value is above below the upper lower alarm limits Check the patient and treat if necessary Change the alarm limits CPP alarm limit CPP alarm limit Parameter value The parameter value is above below the upper lower alarm limits Check the patient and treat if necessary Change the alarm limits 0 out of range low 1 Theparametervalue is replaced by The parameter falls...

Page 540: ...tatic waveform Keep all tubing motionless then rezero Change the transducer Check stopcock then rezero 0 static pressure 1 Parameter value Static pressure detected on a pulsatile signal due to a physiological condition such as an asystole a transducer thatis closed to the patient a catheter tip that is lodged against a vessel wall a clot on the catheter tip Check the patient and treat if necessary...

Page 541: ...ro offset error 1 Parameter value Transducer zeroing failed because static pressure was too high or too low Keep all tubing motionless Replace the transducer Check the stopcock and zero again None Inflate balloon Press Wedge to Start This message appears in the Wedge dialog only Parameter value Action required to start wedge measurement Press Start wedge button to begin wedge measurement None Wedg...

Page 542: ...balloonand press Save wedge to finish This message appears in the Wedge dialog only Parameter value Action required to complete wedge measurement Press Save wedge button to finish wedge measurement 1 0 is a placeholder for the respective IBP label including CPP Priority Message Parameter field Problem Solution ...

Page 543: ...instream sensor calibration procedure was unsuccessful Try again or contact DrägerService None CO2 calibration in progress The mainstream sensor calibration procedure is in progress Informational message no action required None CO2 calibration successful The mainstream sensor calibration procedure was successful Informational message no action required 0 check airway adapter 1 The mainstream senso...

Page 544: ...ue might not be accurate Check the patient and ventilation CO2 out of range high 1 The parameter signal is outside the measuring range of the monitor Check the patient and treat if necessary Check the equipment and replace if necessary None CO2 please zero Instructional message for the mainstream sensor only Zero the mainstream sensor 0 sensor too warm 1 The CO2 mainstream sensor is too warm due t...

Page 545: ...it is possible to zero the sensor after the message has been displayed for at least 10 minutes None 0 zeroing failed Zeroing of the sensor has failed or the sensor is faulty Try to zero the sensor again making sure not to breathe on the sensor If zeroing fails again replace the sensor and contact DrägerService None 0 zeroing in progress The CO2 zeroing is in progress Informational message no actio...

Page 546: ...inity Acute Care System Monitoring Applications VG6 n 0 apnea Apnea was detected Check the patient and treat if necessary Check the placement of the sensor 1 In the parameter field the parameter value is replaced by Priority Message Cause Remedy ...

Page 547: ...he Microstream MCable calibration procedure is in progress Informational message no action required None CO2 calibration required The Microstream MCable calibration procedure is due Contact DrägerService None CO2 MCable Maintenance is due Maintenance for Microstream MCable is due Contact DrägerService None 0 zeroing failed Resetting the Microstream MCable to zero has failed the standard three atte...

Page 548: ... Check the equipment and replace if necessary CO2 sensor unplugged 1 The Microstream MCable is disconnected Check the CO2 connections CO2 MCable unplugged The Microstream MCable is disconnected from the monitor Reconnect the Microstream MCable to the monitor CO2 MCable failure The Microstream MCable hardware has failed due to one of the following issues a corrupt EPROM erasable programmable read o...

Page 549: ...n 15 minutes In this case it is possible to zero the sensor after the message has been displayed for at least 10 minutes None 0 zeroing in progress The Microstream MCable is being reset to zero Informational message no action required etCO2 alarm limit etCO2 alarm limit except inCO2 The parameter value is above below the set upper lower alarm limits Check the patient and treat if necessary Change ...

Page 550: ...ple line blockage occurred and the Microstream MCable is attempting to clear the sample line Informational message no action required Sample line blocked The sample line is blocked during the purging process Replace the sample line Sample line disconnected The sample line is disconnected from the Microstream MCable Securely connect the sample line to the Microstream MCable ...

Page 551: ...utside the measurement range because of a faulty sensor Check equipment and replace if necessary C O Catheter Fault Bad Ref 2 Parameter value The C O blood thermistor calibration resistor does not meet the specified tolerance Check the catheter and replace if necessary Contact DrägerService C O Pod Fault Bad Ref 2 Parameter value The C O reference values do not meet the specified tolerances Remove...

Page 552: ...rsists replace faulty components None 0 Check Injectate Probe Parameter value The thermistor is not connected or became disconnected during a measurement Connect the probe and repeat the measurement None 0 duplicate device connected 1 Parameter value Multiple C O sources are connected This includes CCO devices connected via the device connectivity option Disconnect duplicate C O sources None 0 Inj...

Page 553: ...Repeat the measurement If problem persists replace the catheter Use a cooler injectate None 0 Poor Baseline 1 Parameter value Poor blood temperature baseline during C O measurement Follow hospital procedures Repeat the measurement Replace the faulty components if the message persists None 0 Use Cooler Injectate 1 Parameter value The difference between the temperature of the blood and the injectate...

Page 554: ...iority Message Parameter field Problem Solution Priority Message Problem Solution None Primary Recorder Not Connected or Secondary Recorder Not Connected A recording was requested but no recorder is available Try again then contact DrägerService None Primary Recorder Out of Paper or Secondary Recorder Out of Paper A recording was requested but the recorder is out of paper Replace the recorder pape...

Page 555: ...med Recording Request Accepted or Continuous Recording Request Accepted The recorder is not available and the requested recording is queued or stored for later printing None None Timed Recording Finished or Timed Recording Canceled The requested recording is printed None The requested recording was manually canceled None Continuous Recording Canceled None Recording Not Accepted The assigned record...

Page 556: ...g Check sample line and water trap for damage or blockage and resolve these as needed Observe the prescribed exchange intervals NOTE The 0 symbol indicates CO2 N2O O2 xMAC and any agents that may appear in the alarm message Alarm Priority Alarm Cause Remedy Medium 0 out of range high Agent concentration has exceeded the Scio upper limit of the measurement range Check vaporizer fresh gas settings a...

Page 557: ...known accuracy or automatic identification is taking more time than usual possibly due to Zeroing failure Polluted ambient air during zeroing Electromagnetic distur bances Overheating Ensure clean ambi ent air Remove radiating de vices e g tele phone Check ambient tem perature Check water trap and sample line Change the water trap or sample line if necessary Power cycle Scio Change vaporizer setti...

Page 558: ... system Call DrägerService Medium 0 out of range high CO2 concentration has exceeded the Scio upper limit of the measurement range Check vaporizer fresh gas settings and ventila tion Low etAgent Note This alarm only occurs for the primary agent Expiratory anesthetic gas concentration has fallen below the lower alarm limit for more than 15 seconds Soda lime is dried out Check vaporizer and fresh ga...

Page 559: ...d fresh gas settings High FiO2 Inspiratory O2 concentration has fallen below the lower alarm limit for At least 15 seconds with respiratory phases At least 30 seconds without respiratory phases Check O2 concentration and fresh gas settings Check breathing system for large leaks Check O2 supply Medium FiO2 Inspiratory O2 concentration has exceeded the upper alarm limit for more than 15 seconds Chec...

Page 560: ...oncentration has fallen below the lower alarm limit for more than 15 seconds Soda lime is dried out Check vaporizer and fresh gas settings Check breathing system for large leaks Exchange soda lime Medium inAgent NOTE This alarm occurs only for the primary agent Inspiratory anesthetic gas concentration has exceeded the upper alarm limit At least 15 seconds with respiratory phases At least 30 second...

Page 561: ...s Medium Inspiratory xMAC high The inspiratory anesthetic gas concentration has exceeded 3 xMAC for more than 3 minutes Check vaporizer and fresh gas settings High Inspiratory xMAC high The inspiratory anesthetic gas concentration has exceeded 5 xMAC or while the patient is breath ing The inspiratory anesthetic gas concentration has exceeded 3 xMAC for more than 30 seconds The expiratory anestheti...

Page 562: ...le has failed due to Sample line occlusion Electrical disturbance Internal failure Check sample line Remove radiating devices e g telephone Use alternative N2O measurement system Call DrägerService Low 0 value temporarily unavail N2O parameter has unknown accuracy possibly due to Zeroing failure Polluted ambient air during zeroing Electromagnetic distur bances Overheating Ensure clean ambi ent air...

Page 563: ...Accuracy of the O2 sensor cannot be guaranteed Ensure clean ambi ent air Check water trap and sample line Change the water trap or sample line if necessary Wait for automatic ze roing Power cycle the gas analyzer Call DrägerService Medium 0 sensor failure The O2 sensor in the patient gas measurement module has failed due to Sample line occlusion Electrical disturbance Internal failure Use alternat...

Page 564: ...he gas analyzer Change vaporizer settings Call DrägerService Medium RRc Respiratory rate has exceed ed the limit Check ventilation Medium RRc Respiratory rate is below the limit Check ventilation Medium RRc apnea No breathing or ventilation Start manual ventila tion Check ventilation set tings Check spontaneous breathing ability of the patient Sample line is not connected Connect sample line to br...

Page 565: ... second anesthetic agent has been detected NOTE This alarm could be an expected clinical behavior if the clinician regularly uses two agents as part of the process Wait for the transition phase to end after changing anesthetic agents Flush the system if necessary Check fresh gas settings Medium Third agent detected NOTE This alarm occurs only on gas analyzers with automatic identification A mixtur...

Page 566: ...that the expiratory xMAC is out of range high when Primary agent secondary agent and or N2O are out of range high Expiratory xMAC exceeds 10 Check vaporizer fresh gas settings and ventilation Alarm Priority Alarm Cause Remedy Message Condition Suggested action Scio zeroing is in progress Zeroing cycle in progress Wait for the zeroing cycle to complete ...

Page 567: ...intenance concepts 569 Inspection 569 Visual inspection 569 Inspection safety checks 570 Scope of inspection safety checks for the Cockpit C500 C700 570 Scope of inspection safety checks for the PS250 P2500 570 Scope of inspection safety checks for the M540 571 Metrological checks 571 Preventive maintenance 572 Maintenance Restart 573 ...

Page 568: ... device must be inspected and serviced at regular intervals A record must be kept on this preventive maintenance We recommend obtain ing a service contract with DrägerService through your vendor For repairs we recommend that you contact DrägerService CAUTION When servicing devices from Dräger always use spare parts that are qualified to Dräger standards Dräger cannot warrant or endorse the safe pe...

Page 569: ...ll system cables power plugs and discontinue use if there are any signs of damage 5 Inspect all patient cables leads and strain reliefs for general condition Make sure the connectors are properly engaged at each end Concept Definition Maintenance All measures inspection preventive maintenance repair intended to maintain and restore the functional integrity of a medical device Inspection Measures i...

Page 570: ...lectrical safety requirements according to IEC62353 6 Verify that the optical and acoustic alarm signals function properly Scope of inspection safety checks for the PS250 P2500 The safety checks are no substitute for preventive measures including preventive replacement of wearing parts as identified by the manufacturer 1 Check accompanying documents Instructions for use are available 2 Perform a f...

Page 571: ...lified DrägerService personnel 5 Check the following safety features The power LED and the battery indicator LED function properly The C500 C700 are powered correctly Check the functional integrity of the Infinity MCable Nurse call Functional integrity of the button located on the front of the device Functional integrity of the non invasive blood pressure overpressure sensor including the valves a...

Page 572: ... of the M540 If the non invasive blood pressure air inlet filter seems dirty or damaged replace it before the recommended two years The air inlet filter should be replaced if the M540 was exposed to liquid See Exchanging the ambient air filter in the Technical documentation which is available from DrägerService Every two years Replace Expert Internal M540 battery For devices that have high transpo...

Page 573: ...is required for scheduled maintenance 30 seconds Select Restart Restarts IACS immediately Records Restart is required message to alarm history Select Cancel Delays the next restart message until a semi critical or critical threshold is reached No action taken during message duration Restarts IACS Records Restart is required message to alarm history Semi critical Discharge or Standby Restart is req...

Page 574: ...the time remaining until restart A medium priority alarm is activated 2 minutes Select Restart Restarts IACS immediately Records Restart is required message to alarm history No action taken during message duration Restarts IACS Records Restart is required alarm event to alarm history Restart Threshold Mode s of operation Message content Message duration Options Result s ...

Page 575: ... on reprocessing 577 Safety information 577 Information on disinfectants 577 Disinfectants 578 Classifications for reprocessing 579 Classification of medical devices 579 Classification of device specific components 579 Reprocessing list 580 Reprocessing procedures 581 Validated reprocessing procedures 581 Disinfection with cleaning 581 ...

Page 576: ...ARNING Do not immerse or rinse the device and its peripherals If you spill liquid on the device including the battery or accessories or accidentally immerse it in liquid disconnect the device from the power source and allow it to dry completely for at least 24 to 48 hours Contact Dräger authorized service personnel regarding the continued safety of the device and its peripherals before placing it ...

Page 577: ...there is an increased risk of infection and the products may no longer function correctly Observe the infection prevention and reprocessing regulations of the healthcare facility Observe national hygiene and reprocessing regulations Use validated procedures for reprocessing Reprocess reusable products after every use Observe the manufacturer s instructions for cleaning agents disinfectants and rep...

Page 578: ...rial compatibility The manufacturers of the surface disinfectants have verified at least the following spectra of activity Bactericidal Yeasticidal Virucidal or virucidal against enveloped viruses Observe the specifications from the disinfectant manufacturers Class of active disinfectant ingredient Surface disinfectant Manufacturer Chlorine releasing agents Actichlor plus Ecolab Klorsept 17 Medent...

Page 579: ...erve the instructions for use for the compo nents The following classification is a recommendation from Dräger Non critical PS250 P2500 Semi critical A None Semi critical B None Critical None Classification Explanation Non critical Components that come only into contact with skin that is intact Semi critical A B Components that carry breathing gas or come into contact with mucous membranes or path...

Page 580: ...g Applications VG6 n Reprocessing list Components Disinfection with cleaning Manual cleaning followed by disinfection by immersion Machine cleaning with thermal disinfection Steam sterilization Special reprocessing measures PS250 Yes N A N A N A N A P2500 Yes N A N A N A N A ...

Page 581: ...After the product has been exposed to the disinfectant for the specified contact time remove residual disinfectant 4 Wipe with a cloth dampened with water preferably drinking water quality Allow the product to dry 5 Check the product for visible soiling Repeat steps one through four if necessary 6 Check the product for visible damage and replace if necessary Procedure Agent Manufacturer Concentrat...

Page 582: ...582 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 583: ...subject to EU Directive 2002 96 EC WEEE In order to comply with its registration according to this directive this device may not be disposed of at municipal collection points for waste electrical and electronic equipment Dräger has authorized a company to collect and dispose of this device To initiate collection or for further information contact the local Dräger organization ...

Page 584: ...584 Instructions for use Infinity Acute Care System Monitoring Applications VG6 n This page has been left blank intentionally ...

Page 585: ...plications VG6 n 585 Technical data Technical data Overview 586 Device combinations 586 Infinity PS250 power supply 587 Infinity P2500 589 Infinity MCable Nurse call 591 Infinity R50N 592 Sound pressure 593 Secondary display 593 Electromagnetic compatibility 593 ...

Page 586: ...by Dräger the safety and the functional integrity of the individual devices can be compromised The operating organization must ensure that the device combination complies with the applicable editions of the relevant standards for medical devices Device combinations approved by Dräger meet the requirements of the following standards IEC 60601 1 3rd edition general requirements for safety device com...

Page 587: ...s AC power RS232 Alarm output System cable Infinity network Ethernet Potential equalization connector Environmental specifications Humidity non condensing Operating 20 to 95 Storage Transport 20 to 95 Temperature Operating 0 to 40 C 32 to 104 F Storage 20 to 60 C 4 to 140 F The PS250 has an operating temperature range of 0 to 40 C 32 to 104 F When the battery is being charged at ambient temperatur...

Page 588: ... Electrical specifications Electrical protection Class 1 Input voltage 100 to 240 V AC 50 60 Hz Input current 3 0 to 1 3 A Mode of operation Continuous Batteries Dräger NiMH battery pack Operating time approximately 5 min Recharging time 8 hours DC output 24 V nominal SELV according to IEC 60601 1 ...

Page 589: ...ating 0 C to 40 C 0 F to 104 F Storage 20 C to 60 C 4 F to 140 F Ambient pressure Operating 647 hPa to 1060 hPa Storage 500 hPa to 1060 hPa Protection against ingress of water IPX1 according to IEC 60529 protected against harmful effects of dripping water when mounted vertically with the connectors facing down Electrical specifications Input voltage 100 to 240 V AC 50 to 60 Hz Input current 4 A Mo...

Page 590: ...ature issue The Cockpit LEDs on the front light up for a few seconds when the Infinity P2500 is connected to AC mains after it has been disconnected for an interval to indicate that the LED is working properly Automatic shutdown Overload limit the device shuts down Power overload exceed 285 W at system connector Current overload exceed 14 A short circuit protected Output voltage exceed 32V Tempera...

Page 591: ...de of operation Continuous Power requirements Input voltage 24 V DC maximum Input current 1 A DC maximum Switching capacity 15 W maximum Protection against electric shock Three contacts from the open cable have a galvanic isolation of 1 5 k V AC Environmental requirements Operation Temperature 5 to 55 C 41 to 131 F Relative humidity 5 to 95 non condensing Ambient pressure 375 to 825 mmHg 50 to 110...

Page 592: ... Power requirements Input voltage 100 to 240 V AC 50 60 Hz 1 A Risk management Protection class Class 1 Protection against liquid ingress IPX0 according to IEC 60529 Mode of operation Continuous Environmental requirements Operation Temperature 15 to 40 C 59 to 104 F Relative humidity 10 to 95 non condensing Ambient pressure 550 to 775 mmHg 73 to 103 kPa Storage Temperature range 20 to 40 C 4 to 10...

Page 593: ...ble to other medical electrical equipment and older equipment may be particularly susceptible to interference Sound pressure levels for IEC alarm tones Measurements per ISO 3744 5 to 100 volume setting Device Low priority Medium priority High priority C500 1st generation 50 dB A to 68 dB A 53 dB A to 69 dB A 55 dB A to 71 dB A C700 1st generation 53 dB A to 70 dB A 54 dB A to 71 dB A 55 dB A to 73...

Page 594: ...nce CAUTION The equipment should not be used adjacent to or stacked with other equipment if adjacent or stacked use is inevitable the equipment should be observed to verify normal operation in the configuration in which it will be used NOTE The equipment is intended for use in the electromagnetic environments specified below The user of this equipment should assure that is used in such an environm...

Page 595: ...the relative humidity should be at least 30 Electrical fast transients bursts IEC 61000 4 4 PS250 P2500 lines 2 kV Longer input output lines 1 kV 2 kV 1 kV Mains power quality should be of a typical commercial or hospital environment Surges on AC mains lines IEC 61000 4 5 Common mode 2 kV Differential mode 1 kV 2 kV 1 kV Mains power quality should be a typical commercial or hospital environment Po...

Page 596: ...0 5 periods 30 25 periods 95 5 seconds Mains power should be a typical commercial or hospital environment If user requires continued operation during power mains interruptions ensure batteries are installed and charged Ensure battery life exceeds longest anticipated power supply failures or provide additional uninterruptible power supply Electromagnetic immunity Immunity against IEC 60601 1 2 test...

Page 597: ...transmitter as below Recommended separation distance where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may oc...

Page 598: ... equipment b Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m Recommended separation distances Recommended separation distances between portable and mobile RF telecommunication devices and the Cockpit max PEIRP W 150 kHz to 800 MHz Distance 1 m 800 MHz to 2 5 GHz Distance 1 m Comments if applicable 0 001 0 04 0 07 0 003 0 06 0 12 0 010 0 12 0 23 0 040 0 21 0 4 F...

Page 599: ...Instructions for use Infinity Acute Care System Monitoring Applications VG6 n 599 This page has been left blank intentionally ...

Page 600: ...shutdown 140 viewing 140 Alarm light see alarm bar Alarm limits Auto set all 139 display on off 143 461 for individual parameters 139 Alarm messages Mainstream CO2 543 Microstream CO2 547 Alarm messages configuring 131 Alarm messages viewing current message 116 Alarm monitoring multiple parameters on off 130 single alarm on off 128 ST on off 137 turning alarm monitoring on off 125 Alarm priorities...

Page 601: ...on 325 precautions 322 saving average 332 starting a measurement 331 starting measurement 335 Calculations body surface area 182 drug calculations 191 hemodynamic calculations 187 lab data 186 oxygenation ventilation calculations 189 saving calculations 186 viewing stored calculations 186 192 Calibrating the touch screen 68 Calibration check Microstream accessories 355 to perform 348 Cardiac bypas...

Page 602: ...0 432 DHCP on off 477 Discharging a patient 103 disinfectants information 577 Display ARR 223 CCO 398 CO2 342 ECG 205 IBP 308 NIBP 294 RESP 246 381 387 SpO2 Masimo SET 259 SpO2 Nellcor OxiMax 277 ST 228 Temperature 286 Ventilator 411 423 424 436 Display filter 67 Display mode selecting auto or manual mode 448 Display status parameters 451 Display customizing 68 DNS configuring 477 Docking station ...

Page 603: ...ring 476 I IBP 301 color selecting 320 filter selection 320 labeling pressure channels 310 large mean value display 309 messages 539 precautions 304 pressure label conflicts 312 standard labels 311 wedge pressure 315 zeroing a specific sensor 313 zeroing all sensors 313 Impedance derived pacemakers 218 Importing profiles 491 Infinity Medical Cockpit 26 Infinity network loss of connection 49 Infini...

Page 604: ...use with patient types 350 Mini trends description 176 display mode 70 on off 448 setting up screen area 176 Minimum alarm volume 82 mixed agent Scio 375 Monitoring sweep speed selecting 446 Monitoring unit assigning 476 assigning label 476 Multiple alarm conditions 110 N Naming a profile 489 Nellcor Oximax MCable connecting 274 Neonatal ECG monitoring connections 203 Neonatal patient category def...

Page 605: ...474 Patient safety 16 17 PatientWatch description 506 Pausing alarm monitoring 123 Pausing alarm tones 121 Paw scale adjusting 415 427 Pediatric patient category definition 104 selecting 104 Persistent alarms 108 Pre configured code settings 147 Pre silencing alarms 120 Precautions C O 322 CCO 397 CO2 339 ECG 200 IBP 304 Respiration 240 381 387 SpO2 273 Pressure channels labelling 310 Pressure lab...

Page 606: ... central station ICS 53 recordings 495 Remote notification of alarms 146 Remote view functions 53 Removing the M540 93 Repairs 14 Report Alarm history report requesting 500 Calculations report requesting 501 Case summary report requesting 501 Continuous waveform report requesting 499 ECG report requesting 498 Graph vitals report requesting 500 Graphical Trend report requesting 500 OR report reques...

Page 607: ...ion mode on off 474 Single measurement mode 296 Single parameter alarms on off 128 Six lead ST monitoring 226 Sound pressure technical specifications 593 Special alarm conditions 117 SpHb 268 Split screen mode 69 tabular trends 176 SpO2 40 alarm delay on off 461 averaging time selecting 265 268 color 265 268 desaturation alarms 117 FastSat mode 264 measurement method 252 272 messages 526 patient p...

Page 608: ... 176 trend graphs 164 Troubleshooting 510 TruST 40 12 lead on off 234 Turning on the Cockpit 100 Turning on the M540 100 Twelve lead ST monitoring 226 Types of reports 498 U Undocking the M540 48 93 V Validating alarm conditions 111 Venous stasis on off 300 Vent Central option 420 432 Ventilator display 411 423 424 436 monitoring principles 420 432 Ventilator loops 412 425 437 Ventilator setup col...

Page 609: ...Instructions for use Infinity Acute Care System Monitoring Applications VG6 n 609 This page has been left blank intentionally ...

Page 610: ...hout customer requests Directive 93 42 EEC concerning Medical Devices Manufacturer Draeger Medical Systems Inc 3135 Quarry Road Telford PA 18969 1042 U S A 215 721 5400 800 4DRAGER 800 437 2437 FAX 215 723 5935 http www draeger com In Europe Middle East Africa Latin America Asia Pacific distributed by Drägerwerk AG Co KGaA Moislinger Allee 53 55 D 23542 Lübeck Germany 49 451 8 82 0 FAX 49 451 8 82...

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