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Dräger Infinity Delta, Instructions For Use Manual

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Dräger Infinity Delta Instructions For Use Manual Download Page 439

26 Pulse Contour Cardiac Output 

(PiCCO) monitoring

Overview.......................................................................................................................26-2

 Body Surface Area (BSA), Predicted Body Weight (PBW), Predicted Body 

Surface Area (PBSA) .........................................................................................26-5

Precautions ..................................................................................................................26-6
PiCCO Setup including IBP ........................................................................................26-8
Averaging p-CO Measurements ...............................................................................26-12
Display Features ........................................................................................................26-15
PiCCO Parameter Setup............................................................................................26-16

Quick Reference – PiCCO Setup .......................................................................26-18

Optimizing Results for PiCCO Measurements........................................................26-23

Blood temperature baseline...............................................................................26-23
Arterial blood pressure signal ...........................................................................26-23
Central Venous pressure....................................................................................26-24
Amount of Bolus .................................................................................................26-24
Temperature of Injectate ....................................................................................26-24
Injection time .......................................................................................................26-24
Catheter types .....................................................................................................26-25
Thermodilution (TD) Measurements..................................................................26-25
Cables ..................................................................................................................26-25
General measurement problems .......................................................................26-25

Status Messages .......................................................................................................26-26

Summary of Contents for Infinity Delta

Page 1: ...nity Patient Monitoring Series Software VF8 WARNING To properly use this medical device the user must obtain a full understanding of the performance characteristics of this medical device prior to use by carefully reading these Instructions for Use ...

Page 2: ...s of Aspect Medical Systems Inc and are registered in the USA EU and other countries A 2000 and BISx are trademarks of Aspect Medical Systems Inc The Infinity BISx pod bears the CE label in accordance with the provisions of the Directive 93 42 EEC of 14 June 1993 concerning medical devices this label is not applicable for US devices The Infinity BISx pod is manufactured by Covidien 15 Hampshire St...

Page 3: ...arnings Cautions Notes 5 Cross references 5 Quick Reference Tables 5 Footer 5 Applicability 6 Safety Considerations 6 Site of Operation 7 Inspection and Maintenance 8 Defibrillator Precautions 10 Pacemakers 11 Peripheral Devices 11 Electrosurgery 11 Electromagnetic Compatibility 13 Table of Contents 14 ...

Page 4: ... an R50 recorder either directly or via the Infinity Network Indications for Use The Infinity Delta series monitors are capable of monitoring Heart rate Respiration rate Invasive pressure Non invasive pressure Arrhythmia Temperature Cardiac output Arterial oxygen saturation Pulse rate Apnea ST segment analysis 12 lead ST segment analysis tcpO2 tcpCO2 EEG signals FiO2 etCO2 Respiratory mechanics An...

Page 5: ...e used when the patient is not under gas anesthesia Documentation Features Warnings Cautions Notes Cross references Cross references specify chapter and page for example page 16 3 refers to chapter 16 page 3 The chapter number is given when text refers to an entire chapter for example chapter 1 Quick Reference Tables Wherever possible a quick reference table is provided for easy access to informat...

Page 6: ...port proper safe and accurate operation of equipment read all operating instructions carefully before you use the monitor The monitor complies with IEC 60601 1 and applicable collateral and particular standards NOTE Software funtionality is identical between the following products Infinity Delta Siemens SC 7000 Infinity Delta XL Siemens SC 9000XL Infinity Kappa Siemens SC 8000 with the following e...

Page 7: ...tient avoid direct contact between these items external surfaces and the patient Only the items indicated on the list of accessories in the Approved Options and Accessories chapter have been tested and approved to be used with the device Accordingly it is strongly recommended that only these accessories be used in conjunction with the specific device Otherwise the correct functioning of the device...

Page 8: ...pilled on the equipment remove the affected unit from service as soon as possible and contact the technical personnel to verify that patient safety is not compromised CAUTION Before moving the patient disconnect the patient from all sensors that will not be used to avoid patient injury CAUTION Read all cleaning instructions for example originating from the disinfectant manufacturer and the hospita...

Page 9: ...ns WARNING Repair of the device may only be carried out by trained service personnel otherwise the correct functioning of the device may be compromised Regular annual maintenance functional and safety test according to IEC 62353 is recommended in addition to national regulations and laws for example accident prevention regulations Connecting this medical device to other medical devices could resul...

Page 10: ...ent monitor within the same room The installer or service provider should verify that the interconnected system s leakage currents meet the electrical safety requirements mentioned above The installer or service provider should also verify that the electrical safety classification of each device is suitable for the intended application To avoid electric shock inspect all cables before use Never us...

Page 11: ...electrosugery CAUTION Only defibrillate across the chest To avoid potentially re routing electrical current through electrodes thus causing burns and electric shock do not position the defibrillator pads near any electrodes or sensors To protect the monitor from damage during defibrillation for accurate ECG information and to protect against noise and other interference use only ECG electrodes and...

Page 12: ...t flowing through the lead wires For better performance also set the ECG fil ter option to ESU Dräger recommends using the ESU block during electrosurgery If you do not have an ESU block or a MultiMed Plus OR use only Dräger blue ECG lead sets They help protect the patient from burns caused by ESU induced current flowing through the leads While the ESU block or the MultiMed Plus OR cable are in us...

Page 13: ...s B Maximize distance between electro medical devices High power devices relating to electrocautery electrosurgery and radiation X ray as well as electrical stimulators and evoked potential devices may produce interference on the monitor Strictly limit access to portable radio frequency sources e g cellular phones and radio transmitters Portable phones may periodically transmit even when in standb...

Page 14: ...Delta XL 1 13 Power Sources Kappa 1 17 Getting Started 1 19 Menu Access 1 21 Data Archive Applications 1 24 Help Functions 1 27 Monitor Setup Overview 2 2 Configuring the Monitor 2 2 Setups Management 2 9 Specialty Menus 2 12 Software Upgrades 2 24 Network Applications Overview 3 2 Connecting to the Network 3 3 Pick and Go Transport Delta Delta XL only 3 5 Infinity Explorer Support 3 6 Wireless Ne...

Page 15: ...History Table 5 14 OR Alarms 5 15 Trends Overview 6 2 Trend Setup 6 2 Trend Graphs 6 3 Trend Table 6 6 Mini Trends 6 7 Recordings Overview 7 2 Recordings 7 2 Recorder Setup 7 8 Print Screen 7 11 Reports 7 11 Status Messages 7 13 ECG and Heart Rate Overview 8 2 ECG Precautions 8 3 Patient Preparation 8 8 ECG Leads 8 14 ECG Signal Processing and Display 8 15 Alarms and Alarm Conditions 8 16 ECG Setu...

Page 16: ...G Monitoring Overview 11 2 Precautions 11 2 Connecting the EEG Pod 11 3 EEG Setup 11 6 Status Messages 11 9 Respiration Overview 12 2 RESP Precautions 12 3 Patient Preparation 12 4 Display Features 12 5 RESP Setup Menu 12 6 OxyCRG OCRG Monitoring 12 9 Status Messages 12 18 Non Invasive Blood Pressure Overview 13 2 Display Features 13 2 NBP Setup 13 3 Status Messages 13 13 Invasive Blood Pressure O...

Page 17: ...ions Hemo Oxy Vent Calculations 16 3 Hemodynamic Calculations Hemo Calcs 16 10 Drug Calculations 16 12 Pulse Oximetry SpO2 Overview 17 2 Precautions 17 2 Hardware Setup 17 4 Patient Preparation 17 7 Display Features 17 8 SpO2 Setup 17 8 Status Messages 17 10 MicrO2 Standalone Pulse Oximeter 17 19 Transcutaneous Blood Gas Monitoring Overview 18 2 Precautions 18 3 Patient Preparation 18 4 Hardware 1...

Page 18: ... 4 etCO2 Setup 20 6 Calibration 20 7 Status Messages 20 8 Respiratory Mechanics Overview 21 2 Precautions 21 2 Hardware Setup 21 4 Paw and Vent Setup Menus 21 7 Display Features 21 10 Alarms 21 24 Cleaning and Calibration 21 24 Status Messages 21 24 FiO2 Fractional Inspired O2 monitoring Overview 22 2 Precautions 22 2 Display Features 22 3 FiO2 Setup 22 3 Status Messages 22 6 Scio Four Modules Ove...

Page 19: ...e 25 8 Status Messages 25 9 Pulse Contour Cardiac Output PiCCO monitoring Overview 26 2 Precautions 26 6 PiCCO Setup including IBP 26 8 Averaging p CO Measurements 26 12 Display Features 26 15 PiCCO Parameter Setup 26 16 Optimizing Results for PiCCO Measurements 26 23 Status Messages 26 26 Body Temperature Overview 27 2 Temperature Display 27 4 Temperature Setup 27 6 Status Messages 27 6 Periphera...

Page 20: ...g and Disinfecting Overview 29 2 ECG 29 3 NBP 29 4 IBP 29 4 SpO2 29 6 Trident NMT Pod 29 7 etCO2 and Respiratory Mechanics 29 7 FiO2 29 11 Temperature 29 12 Glossary A 1 Technical Data Overview B 3 Overall Regulatory Standard Compliance B 3 Electromagnetic Compatibility EMC B 3 System Components B 8 Displays B 18 Monitoring Accessories B 21 Monitoring Specifications B 33 Approved Options and Acces...

Page 21: ...r Cardiac Output PiCCO C 19 Invasive Blood Pressure IBP C 20 Cardiac Output C 23 Transcutaneous Blood Gas C 24 End Tidal CO2 etCO2 C 24 etCO2 Respiratory Mechanics C 26 FiO2 C 26 MultiGas Monitoring C 27 NMT Monitoring C 28 BISx Monitoring C 29 EEG C 29 Pod Communication C 29 ...

Page 22: ...22 DELTA DELTA XL KAPPA VF8 INFINITY DELTA SERIES USER S GUIDE This page intentionally left blank ...

Page 23: ... Delta Delta XL 1 13 Infinity Docking Station IDS 1 14 Battery Power 1 14 Power Sources Kappa 1 17 Getting Started 1 19 Accessing the Main Screen 1 19 Using the Rotary Knob 1 20 Remote Keypad 1 21 Menu Access 1 21 Fast Access Menu 1 22 Main Menu 1 22 Fixed Keys 1 23 Control Buttons 1 23 Data Archive Applications 1 24 Storing Events 1 25 Event Recall 1 26 Navigating the Event Recall Screen 1 27 Hel...

Page 24: ...m connection is optional Two PodCom connections are standard on the Kappa Delta XL Three PodCom connections are available on Kappa MIB Kappa only Advance Communication Delta Delta XL only MIB II 1 to 4 Option for IDS Wireless Networking OR mode for the IDS and or monitor Overview Delta Delta XL The Pick and Go feature allows you to disconnect the Delta or Delta XL monitor from the network and tran...

Page 25: ...base unit and a display unit These Instructions for Use use the word Kappa monitor to refer to the CPU base unit unless otherwise specified The Kappa is designed to operate with a separate large screen display The monitor displays trended data in graphical and tabular trends Kappa Monitoring System 1 Display unit 2 Kappa base unit ...

Page 26: ... cables Applicable Software Options on a memory option card include Options for Delta only Delta second PodPort option Options for Kappa only Kappa 4 to 5 channel option Kappa advanced communication option II Delta and Kappa only Delta and Kappa 5 to 6 channel option Delta and Delta XL only OR Mode option loaded in the IDS NOTE For a complete list of accessories available with this product see App...

Page 27: ...analysis option Wireless networking option ARIES option Physio calculations option ACE full arrhythmia option ARIES Physio Calcs ACE arrhythmia option package OR mode option loaded in the monitor Base Unit Monitor Front View Delta 1 Fixed keys 2 Main menu fixed key 3 Main screen fixed key 4 Battery charge indicator 5 Power switch 6 Alarm bar not available on SC 7000 ...

Page 28: ...HemoMed connector 2 Rotary knob 7 Connectors for Aux Hemo or PodCom 3 Analog balloon pump sync QRS sync defib connector 8 MultiMed connector 4 NBP hose connector 9 Cable strain relief 5 Auxiliary PodCom connector 1 Fixed keys 2 Main menu fixed key 3 Main screen fixed key 4 Battery charge indicator 5 Power switch ...

Page 29: ...ta XL 1 External lead acid battery compartment 2 Connector for docking station interface plate 3 Connector for AC adaptor 4 Slot for etCO2 module 1 External lead acid battery compartment 2 Connector for docking station interface plate 3 Connector for AC adapter 4 Slot for etCO2 module ...

Page 30: ...r output X13 8 Infinity network connector X14 4 Video out VGA X16 9 Potential equalization 5 RS232 connector Scio module Smart Pod remote keypad Vital Connect Cable VCC Alarm output nurse call 2 X8 10 AC input 1 NOTE Alarm output nurse call requires the alarm output cable with partnumber 5194928 2 NOTE Alarm output nurse call requires the alarm output cable with partnumber 4314626 1 HemoMed connec...

Page 31: ...onitor Left Side Kappa 1 HemoMed connector 2 Connectors for Aux Hemo or PodCom 3 MultiMed connector 4 NBP connector 1 Advanced Communications Options 2 CANBUS connector for old Scio module PN 68 71 255 3 MIB connectors 4 Scio Independent Surgical Display ISD connector ...

Page 32: ... power cords should be run as close together as reasonably possible to reduce loop area The video output connector on the back of the Kappa is not galvanically isolated If you use a video monitor other than one specified by Dräger it must comply with IEC 60601 1 and be suitable for use in the presence of flammable anesthetic mixtures see Safety Considerations on page 6 Based on the intended use of...

Page 33: ...ated If you use a video monitor other than one specified by Dräger it must comply with IEC 60601 1 and be suitable for use in the presence of flammable anesthetic mixtures and or flammable liquids see Safety Considerations on page 6 Based on the intended use of the system the video monitor must also have suitable classifications for water ingress protection as well as radiated and conducted emissi...

Page 34: ...ush battery all the way into compartment Isolated patient connection Type CF Close battery compartment door Complies with the European Medical Device Directive 93 42 EEC This end up Type BF defibrillator protected Artery symbol and arrow should be placed over brachial or femoral artery Gas in Contains no latex material Gas out Manufacturer s lot number Observe WEEE Waste Electrical and Electronic ...

Page 35: ...rom a distance A rotary knob and fixed keys duplicate those of the monitor and pods while a numeric keypad allows you to enter data See page 1 22 for more information Export protocol Allows you to share data with other Dräger and third party devices for example clinical information and anesthesia record systems and data loggers see Dräger publication Infinity RS 232 Export Protocol Reference Bookl...

Page 36: ...you to transfer data upgrade software store setups download setups and store diagnostic logs QRS Sync output Allows you to synchronize defibrillators to the patient s heart beat during cardioversion Balloon pump interface Permits interaction with a balloon pump by providing two analog output signals ECG and ART Power Sources Delta Delta XL The Delta Delta XL monitor can be powered by the Infinity ...

Page 37: ...thium ion battery The external battery which can easily be replaced when depleted can power the monitor for approximately 50 minutes If it runs low or you remove it from a monitor that has been using battery power the monitor automatically switches to an internal battery which can power the monitor for approximately 180 minutes see page B 8 NOTE The SC7000 9000XL monitor s internal lead acid batte...

Page 38: ...CAUTION The battery charger display is only accurate if the batteries are in normal working condition NOTE When AC power is disconnected the battery charge display takes up to 15 seconds to reflect the internal battery s actual capacity and up to 60 seconds to reflect the external battery s actual capacity The battery indicator is not displayed if the monitor is not connected to the Infinity netwo...

Page 39: ...atteries For optimal performance charge and use external batteries at temperatures below 35 C 95 F Follow local regulations for disposal of batteries To prevent fire or explosion never dispose of batteries in fire NOTE To maximize the available charge for transport leave the monitor connected until you are ready to move the patient Reconnect the monitor immediately after transport Dräger recommend...

Page 40: ...tches to battery power to provide continued patient monitoring without any loss of data The base unit continues to operate and alarm on battery power for approximately 20 minutes An internal battery can power the Kappa monitor but not the Kappa video display for up to approximately 20 minutes depending on the monitoring setup It is intended for short term use only for example as a backup during po...

Page 41: ...ry charger display is only accurate if the batteries are in normal working condition NOTE When the monitor is disconnected from AC power the battery charge display takes up to 60 seconds to reflect the battery s actual capacity Battery Charge Display Display Charge Left Action The battery is fully charged Not applicable The battery is half full Connect to power The battery is very low 25 of power ...

Page 42: ... down tone Accessing the Main Screen After you power up the monitor the main screen appears To return to the main screen from a menu or other display Press the Main Screen fixed key located just above the rotary knob on the front panel of the monitor The main screen appears as shown in the following illustration The standard Delta monitor provides five waveforms with adjacent parameter boxes Kappa...

Page 43: ...unction by dialing the rotary knob 2 Press the rotary knob and click to confirm your selection A list of choices appears or the field switches to its alternate value for example ON to OFF You can also use the rotary knob to enter letters or numbers 1 Click on a field for example Physician The monitor displays a data entry screen similar to the following 2 Use the rotary knob to select each charact...

Page 44: ...ay screen To connect the remote keypad to the monitor Delta Delta XL Plug one end of the keypad cable into the keypad and the other into the connector marked RS232 on the right side of the monitor Kappa Plug one end of the keypad cable into the keypad and the other end into the keypad input connector on the monitor s rear panel Menu Access There are two ways of accessing the menus The Fast Access ...

Page 45: ...a submenu Arrow icon for example Review Displays another column No icon for example Standby Executes a function To display the Main menu 1 Press the Menu fixed key The primary list of Main menu options appears 2 Click on a page icon next to a heading to open a main menu submenu or on an arrow icon to display another column of main menu options see page 2 2 for detailed information on configuring t...

Page 46: ...s Opens a table from which you can set upper and lower alarm limits Print Screen Prints the currently displayed screen to a network laser printer All Alarms Off Suspends all alarms for a pre selected time or cancels the suspension NBP Start Stop Starts or stops a non invasive blood pressure NBP measurement Code Activates a set of monitor functions for urgent care Fast Access Displays the Fast Acce...

Page 47: ...Event recall Each database indicates the time of the data capture and parameter values and or waveforms active at the time of capture Trends Calculations and Alarm History are discussed in the following chapters Event Recall and Storage is explained later in this section Trends see chapter 6 Stored events are marked with the time and date of capture as follows Trend table an icon over the time lin...

Page 48: ...fixed key on the front of the monitor allows you to capture an event manually All data displayed on the Main Screen at the time of capture is archived for later identification and comparison The number of events you can store depends on the Max Channels setting on the Main Screen menu see page 2 5 If the Max Channels setting is 8 the monitor stores four sets of waveforms if set to 6 the monitor st...

Page 49: ...you discharge a patient reset the monitor or temporarily lose power To access the Event Recall screen 1 Press the Fast Access fixed key 2 Click on Event Recall to display the Event Recall screen 1 Time of capture 6 View1 2 Parameter values at time of capture 7 Parameter display2 3 Print report 8 Parameter labels 4 Requests recording 9 Waveform delay and speed 5 Saves Deletes events 1 View All disp...

Page 50: ...p Functions You can display a short description of currently highlighted functions at the bottom of all active menus by enabling context sensitive help 1 Press the Menu fixed key to open the Main menu 2 Click on Monitor Setup Another column of options appears 3 Open the Display Options menu by clicking on that heading 4 Select Help Line Display and click to choose ON Additional information about t...

Page 51: ...iew 2 2 Configuring the Monitor 2 2 Main Menu Setup 2 2 Quick Reference Main Menu Setup 2 3 Setups Management 2 9 Specialty Menus 2 12 OR Mode 2 12 Unit Manager 2 14 Biomed 2 20 Parameter Colors 2 22 Software Upgrades 2 24 ...

Page 52: ...llows you to access submenus display screens and execute certain monitor setup functions 1 Press the Menu fixed key to display the Main menu 2 Click on a page icon to open a submenu associated with the Main menu or Click on arrow icon to display another column of submenu options 3 Click on the desired setting to execute functions or access further submenus 4 Click on Exit at the bottom of a submen...

Page 53: ...n display Displays a horizontal cursor User can scroll up and down each waveform NOTES Cursor value is displayed 1 Cursor and value remain displayed until the window closes Buttons remain ghosted until you press the Stop key To exit the cursor tool Press click the rotary knob to exit the cursor control or Press the Main Screen fixed key Not applicable Stop Stops scrolling of all waveforms in the c...

Page 54: ...s Trend Table Event Recall Calc Results OxyCRG neonatal mode only Show All Leads Lab Data and Open Lung Tool Click on Exit to return to the first column of the Main menu The Patient Setup submenu Patient Category Determines the availability of monitoring features such as apnea detection neonates only and ventilation NOTES Clicking on a setting displays a popup message that warns you that things wi...

Page 55: ...iority in the Parameter Priority list If all available channels are filled a higher priority parameter will NOT bump lower priority parameter boxes off the Main Screen when the associated device is connected In order to display the parameter the user must double click on the parameter in the Parameter Priority list In OR Mode if all available channels are filled a higher priority parameter will bu...

Page 56: ...le basic arrhythmia monitoring ST Monitoring Enables and disables ST monitoring for detailed information refer to chapter 10 Select ON to enable ST monitoring Select OFF to disable ST monitoring RESP Monitoring Enables and disables respiration monitoring for detailed information refer to chapter 12 Select ON to enable respiration monitoring Select OFF to disable respiration monitoring Display Mode...

Page 57: ... set the sweep speed for the respiration waveform independently of other parameters Click on 6 25 12 5 25 or 50 mm s Pressure Overlap Displays up to 4 overlapping IBP waveforms in a single oversized channel Overlapped waveforms share a common zero point but each waveform retains the original scale configuration see page 14 14 Select ON to display IBP waveforms in overlapping format Select OFF to c...

Page 58: ...ethod described in steps 3 and 5 Speaker Volumes Allows you to set the volume for alarms pulse tones and attention tones Click on Alarm Volume to set the volume of alarms 10 100 in increments of 10 Click on Pulse Tone Volume to set the volume of the pulse tone OFF 100 in increments of 10 after 5 Click on Attention Tone Volume to set the volume of attention tones OFF 100 in increments of 10 after 5...

Page 59: ...ename the setups you have configured Accessing the Unit Manager Menu Allows you to label name or modify setups on the password protected Unit Manager menu NOTE For information on other Unit Manager functions see page 2 14 To enter the password 1 Press the Menu fixed key to display the Main menu 2 Click on Monitor Setup 3 Click on Unit Manager A data entry box appears 4 Click on each number of the ...

Page 60: ...etup NOTES You can access Restore Setups quickly as follows 1 Press the Menu fixed key 2 Click on Restore Setups 3 Follow Steps 4 6 at right Save Setup and Restore Setup menu selections are also available on the Independent Surgical Display see page 28 20 The configuration of the Independent Surgical Display ISD Save or Restore menu does not affect monitor setups If a monitor is not connected to a...

Page 61: ...ort the patient see page 2 12 1 Open the Unit Manager menu see page 2 9 2 Click on Save Restore 3 Click on Pick And Go 4 Click on one of the following settings to execute the indicated function Automatic When the monitor docks it automatically downloads the default configuration stored in the local Docking Station If this will remove existing parameters from the display a pop up menu asks you to c...

Page 62: ... And Go Delta Delta XL only Follow these procedures to specify if the monitor should download default configurations from the local Docking Station during PICK AND GO operations The new setup pop up menu appears when a new setup will remove a parameter from display or a new setup will cause loss of a locked option or in manual Pick and Go mode see page 2 14 New Setup pop up menu Allows you to rest...

Page 63: ...Attention tone sounds when NBP measurement is complete OFF No tone sounds when NBP measurement is complete Alarm Volume Sets the alarm volume 10 100 in increments of 10 OFF Large IBP Mean Display Determines the relative size of the mean pressure value in invasive pressure parameter boxes ON The mean IBP value is larger than the systolic and diastolic IBP values OFF The systolic diastolic and mean ...

Page 64: ...Description Available Settings The Alarm Control Submenu This menu allows the unit manager to configure alarm annunciation Open the Unit Manager menu click on Alarm Control then follow the procedures outlined in this table to execute the indicated functions All Alarms OFF Key Determines whether clinical personnel can suspend alarms by using the All Alarms Off fixed key on the front of the monitor ...

Page 65: ...c SpO2 6 sec 10 sec1 PLS 6 sec 10 sec1 SpO2 4 sec 4 sec PLS 4 sec immediately All other parametersimmediately 1 See SpO2 Alarm Delay below ON Enables the alarm validation OFF default Disables the alarm validation SpO2 Alarm Delay Validates an SpO2 alarm condition by requiring that the violation persists for 10 seconds lower limit before sounding an alarm NOTE Alarm validation must be turned ON If ...

Page 66: ... not available on a SC 7000 8000 9000XL or Kappa monitor NOTE During multiple alarm conditions the alarm bar flashes only for the alarm condition with the highest priority ON default Alarm bar reacts as follows Flashes red for all high priority alarm conditions Flashes yellow for all medium priority alarm conditions OFF The alarm bar is disabled MIB Alarm Control Allows you to activate deactivate ...

Page 67: ...t and execute functions as described in this table For more information see page 5 6 Continuous Record NOTE If no recorder is available the recording request remains pending for later printing Yes default Provides a continuous recording when you press the Code fixed key No No continuous recording is started when you press the Code fixed key Continuous NBP NOTE You must attach the NBP cuff and disp...

Page 68: ...arm Volume OFF is disabled ghosted If the Code function is disabled by pressing the Code fixed key again the All Alarms OFF feature is deactivated and the All Alarms OFF banner is removed from the display When the Code fixed key is pressed the following happens if the All Alarms OFF setting is set to Disabled The Audio Volume setting is disabled immediately and a speaker icon with a slash mark is ...

Page 69: ...lect and execute functions as described in this table For more about tpO2 CO2 functions see page 18 10 Site Timer Control Restricts or permits access to the site timer see page 18 11 Nurse Clinical personnel can set the site timer in the tpO2 CO2 menu Manager Access to the site timer is restricted by the password protected Unit Manager menu Site Timer Limits the use of the tpO2 CO2 sensor to a spe...

Page 70: ...84 t 37 k where t sensor temperature k metabolic correction factor 4 fixed None No correction factors are applied Extend Site Timer Clears the site timer alarm and extends the site timer by 30 minutes This extension is only allowed once NOTES Selection is ghosted and not selectable until the TP TP site timer alarm sounds Once activated the selection is ghosted again and is not selectable until the...

Page 71: ...nager menu page 2 14 click on Change Password then follow the procedures outlined in this table 1 Scroll through the numbers and click successively on the single digits of the clinical password If you make a mistake click on Backspace and try again 2 Click on Accept to confirm the new password The Pacer Detection Mode submenu This feature allows you to set pacer detection function Open the Unit Ma...

Page 72: ...ow at the bottom of screen to scroll through the display CPS IDS Diag Log Captures data about CPS and IDS performance relating to the monitor s operation Display is read only Click on the down arrow at the bottom of screen to scroll through the display FE Diag Log Captures and displays data about front end performance related to the monitor s operation Display is read only Click on the down arrow ...

Page 73: ...ll time out after approximately 5 minutes It will stay active that long unless the user clicks Accept Parameter Default Color NOTES Any color change set in this menu changes the color of the parameter wherever it is used for example the parameter box waveform trends The parameter list is not limited to only connected parameters Agent parameters HAL ISO ENF SEV DES and O2 N2O cannot change color an...

Page 74: ...E During NBP measurement NBP parameter box becomes white background with black letters numerics regardless of color selected in this menu White RESP Blue O2 N2O White SvO2 parameters White Paw and or Vent parameters Blue BIS NOTE In BIS parameter box SQI remains purple and EMG remains white regardless of color selected in this menu White TP and or TP White FiO2 White EEG1 and or EEG2 and or EEG3 a...

Page 75: ...d on each monitor Masimo Averaging Averaging Time settings see page 17 9 ECG Cable Type setting see page 8 20 After upgrading one monitor save the settings on a memory card and copy the settings to the rest of the installed monitors Dräger recommends that all monitors be upgraded to the same software version in all locations Contact your DrägerService representative to make sure that you are using...

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Page 77: ...onnecting the Kappa to from the Network 3 4 Network Message Delta Delta XL Kappa 3 4 Pick and Go Transport Delta Delta XL only 3 5 Infinity Explorer Support 3 6 Wireless Network 3 6 Wireless Network Safety Considerations 3 7 Wireless Network Setup 3 7 Wireless Mode 3 10 Wireless Messages 3 12 Network Transfer 3 12 Patient Data 3 12 Software Licenses 3 13 Remote View 3 13 Privacy 3 16 ...

Page 78: ...display information from up to 16 networked monitors simultaneously For more information on the central station see the Infinity CentralStation Instructions for Use Your monitor s RemoteView function allows you to display other networked monitor screens print remote recordings and silence remote alarms see page 3 13 Via the Remote Control function on the Infinity CentralStation you can perform the...

Page 79: ...port the MultiGas module or MIB protocol Connecting the Delta Delta XL to the Network For the Delta Delta XL you can also use a Docking Station to access the network refer to the Infinity Docking Station and Docking Station Power Supply Hardware Installation Instructions Connecting the monitor to the network 1 Place the monitor on the IDS or Docking Station using both hands one holding the handle ...

Page 80: ... hands to tilt the monitor forward and lift it off the IDS or Docking Station Connecting disconnecting the Kappa to from the Network Plug the network cable into the Infinity network connector X14 on the rear panel of the monitor see page 1 3 Unplug the network cable to disconnect the Kappa monitor from the network Network Message Delta Delta XL Kappa Once the monitor is connected to the network th...

Page 81: ...he patient the monitor continues to use the setups configured at the ICU bedside 3 Dock the monitor in the OR the monitor uploads the OR default monitor settings 4 Undock the monitor in the OR the monitor retains the OR and patient setups 5 Return transport the monitor continues to monitor the patient using the OR monitoring configuration 6 Redock the monitor at the ICU bedside the monitor uploads...

Page 82: ...on the monitor The wireless card communicates with access points which are strategically placed within a monitoring unit in order to cover the desired transmission area A wireless network offers the following Seamless patient transport A wireless monitor continues to communicate with the Infinity network during Pick and Go transport situations and its data remains on the central display after leav...

Page 83: ...ransmitting and receiving components of the network When using the wireless network be aware that certain structural limitations within the hospital building may interfere with signal transmission other devices emitting radio frequencies such as leaky microwave ovens or warmers may interfere with signal transmission the frequencies emitted by the device may interfere with the operation of other me...

Page 84: ...rägerService representative 2 Facing the monitor turn the card so that the flat side back label faces you 3 Press the card firmly into the memory card slot until the slot s release button protrudes Delta Delta XL Memory Card Slot NOTE The wireless card and adapter are slotted and can only be inserted in one orientation Do not force the card into the adapter there are pins in the adapter that can b...

Page 85: ... the monitor turn the card so that the flat side back label faces down 4 Press the card firmly into the Memory Card slot until the slot s release button protrudes 5 Turn the monitor back on Kappa Memory Card Slot Wireless Card Removal Press the release button and remove card from slot NOTE The wireless card and adapter are slotted and can only be inserted in one orientation Do not force the card i...

Page 86: ...icon to reflect signal strength The icon and the date time icon alternate with other secondary messages in the network messaging area There are five different signal strength icons In wireless mode the monitor uploads setups from the docking station and communicates with all supported devices connected to the IDS NOTE Wireless networking is a locked option Contact your hospital s technical personn...

Page 87: ... and Go A monitor in IDS mode will automatically switch to wireless mode when it is undocked from the Docking Station if a wireless card is inserted see page 3 8 and all wireless settings are correct contact your hospital s technical personnel When the monitor is re docked to the Docking Station it will automatically return to IDS mode CAUTION When the monitor is in wireless mode patient data is n...

Page 88: ...tion over the network you can use menu options See page 4 3 for more information Message Condition Display Area Offline The monitor travels out of range of AP or The wireless card is removed Network Invalid memory card The wireless card is defective Local Wireless option not enabled The wireless card was inserted without the wireless option enabled NOTE To clear the message either install the wire...

Page 89: ...ocking Station is being used temporarily loans its licenses to the monitor The following guidelines apply to the transfer of locked options involving Pick and Go When the IDS of the care unit transfers its setups to a monitor it temporarily adds its licenses as well These loaned licenses temporarily unlock options on the monitor Temporary licenses remain valid on the monitor even after it undocks ...

Page 90: ... Main Screen fixed key to return to Main Screen or click on Select Remote Bed to return to the Remote View menu NOTE To access Remote View functions see the section Remote View Screen on page 3 15 Alarm Group Assigns the monitor an alarm group number 0 255 allowing you to restrict the number of messages received over the network from the central station or other bedsides 1 Press the Fast Access fi...

Page 91: ...e Bed to display the Remote View screen John Doe 1 Accesses the Remote View menu 8 Screen label display only 2 Local bed display 9 Local bed message 3 Remote View menu bar 10 Remote bed label 4 Remote bed display Remote View 11 Exit arrow restores local bed display 5 Remote bed alarm message area 12 Local bed label 6 Silences remote bed alarm for 60 seconds 13 Initiate Remote bed recording see the...

Page 92: ...us recordings see Chapter 7 Recordings You cannot select waveforms for remote recordings Waveforms are printed according to the remote bed s recording setup If the remote bed is configured for manual waveform selection see page 7 9 the recording s waveforms may differ from those displayed on the Remote View menu If the local bed alarms while Remote View is displayed the monitor behavior depends up...

Page 93: ...cy 3 Press the Main Screen fixed key to return to the main screen WARNING When a bedside monitor is in privacy mode audible alarms only sound at the Infinity CentralStation the bedside monitor does not provide audible alarms or activate its alarm bar NOTE Alarm bar not applicable to SC 7000 8000 9000XL or Kappa ...

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Page 95: ...4 Admission Transfer and Discharge Overview 4 2 Admitting a Patient 4 2 Transferring Patient Data 4 3 Data Transfer Using the Memory Card 4 4 Network Data Transfer 4 6 Discharging a Patient 4 7 ...

Page 96: ...e and destination monitors are connected to the Infinity network Discharging a patient deletes all related data both on the monitor and at the central station Monitor and patient settings return to their local default settings and all recordings are cancelled Admitting a Patient Admitting a patient at the bedside monitor 1 Press the Menu fixed key 2 Click on Admit Discharge 3 Click on Admit to dis...

Page 97: ...al you must access the Patient Setup menu see page 2 1 If you change a patient s category the weight selection is cleared and must be entered again In neonatal mode additional settings gestational age and birth weight are available Day of Life and corrected GA values also appear in a read only field Entries and changes regarding a patient s height and weight affect all other monitor menus and disp...

Page 98: ... Make sure you copy information to the destination monitor before you perform significant monitoring functions Memory Card Transfer WARNING Use electrostatic discharge ESD prevention practices when inserting the PCMCIA card into the monitor In some environmental conditions insertion of the memory card could cause the monitor to reset as the result of an ESD event The patient s stored event and tre...

Page 99: ...r Copying patient data from the card to the destination monitor 1 Insert the memory card in the destination monitor 2 Press the Menu fixed key on the destination monitor 3 Click on Admit Discharge 4 Click on Copy Patient Data The large arrow now indicates that the direction of the data flow is from monitor to card 5 Click on Move To Monitor If the date and time are correct on both monitors the fol...

Page 100: ...he fixed key Menu The main menu appears 2 Scroll to Standby and click The screen goes blank except for the following message Standby Press Main Screen to resume monitoring 3 Press the Menu fixed key at the destination monitor 4 Click on Admit Discharge 5 Click on Transfer to display the Transfer Patient Data menu If you are transferring data from outside the destination care unit proceed with step...

Page 101: ...displays the message Discharge In Progress When the patient has been successfully discharged the following discharge banner appears Press main screen to resume monitoring Discharging a patient from the Main menu 1 Press the Menu fixed key 2 Click on Admit Discharge 3 Click on Discharge The monitor displays the following message Discharge will delete patient data 4 Click on Discharge again The moni...

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Page 103: ... Latching 5 5 Alarm Management 5 5 Suspending Alarms 5 5 Alarm Control 5 6 Alarm Setup Alarm Limits Table 5 6 Upper and Lower Alarm Limits 5 8 Modifying Alarm Functions 5 12 Quick Reference Alarm Limits Table Setup 5 13 Alarm Limits Shortcut 5 14 ST and Arrhythmia Alarms 5 14 Alarm History Table 5 14 OR Alarms 5 15 ...

Page 104: ...larm devices such as a nurse call system Activation of an alarm recording The monitor issues alarms for parameters who are set to ON in the Alarm Limits table see page 5 6 It is not a prerequisite for the parameter to be on display or connected for a parameter to alarm The monitor does not alarm for the following parameters Cardiac Output C O Pulmonary Wedge Pressure PWP Injectate Temperature IT P...

Page 105: ...ns set at 100 until you change it on the Alarm Limits menu see page 5 6 Alarm Priorities The monitor has three alarm priorities high medium and low Previously Dräger has referred to these as life threatening L T serious SER and advisory ADV alarm conditions You can define alarm priorities for arrhythmia and ST parameters only using the arrhythmia setup table see page 9 6 or the ST alarms table see...

Page 106: ...hed beep long pause If more than one alarm occurs simultaneously the monitor sounds only the highest priority auditory alarm tone and flashes the alarm bar in that alarm s color The monitor also flashes several parameter boxes and displays the associated alarm messages in sequence All alarm priorities initiate an alarm recording if the recording function is enabled The alarm limits table controls ...

Page 107: ... for 60 seconds Visual alarm indications remain on the screen The alarm tone resumes if a new alarm occurs during an alarm silence period or if a high or medium priority alarm condition persists past the one minute silence period NOTE High priority and medium priority alarms do not latch in OR mode see page 2 12 for more information Alarm Latching Behavior High priority alarms are latched visual a...

Page 108: ...e configured only on the Alarm Control menu which in turn is accessible only via the password protected Unit Manager menu For a description of available functions on the Alarm Control menu see page 2 13 Alarm Setup Alarm Limits Table The alarm limits table allows you to modify the alarm limits of multiple parameters in a single location The Alarm Limits table displays values only if the associated...

Page 109: ...5 7 1 Set alarm limits 7 On line help message 2 Store and or record alarms 8 Click on arrows to scroll up or down 3 Storage recording options 9 List of parameters 4 Access Arrhythmia setup 10 Auto set 5 Access ST alarm limits 11 Enable alarms 6 Alarm volume ...

Page 110: ...mHg 14 7 kPa S Pediatric Low 50 mmHg 6 7 kPa High 120 mmHg 16 0 kPa M Pediatric Low 50 mmHg 6 7 kPa High 80 mmHg 10 7 kPa D Pediatric Low 30 mmHg 4 0 kPa High 80 mmHg 10 7 kPa S Neonatal Low 50 mmHg 6 7 kPa High 120 mmHg 16 0 kPa M Neonatal Low 40 mmHg 5 3 kPa High 85 mmHg 11 3 kPa D Neonatal Low 35 mmHg 4 7 kPa High 80 mmHg 10 7 kPa BIS From BISx pod only You cannot control alarms from Aspect A20...

Page 111: ...g 16 7 kPa D Adult Pediatric Low 50 mmHg 6 7 kPa High 110 mmHg 14 7 kPa S Neonatal Low 50 mmHg 6 7 kPa High 120 mmHg 16 0 kPa M Neonatal Low 40 mmHg 5 3 kPa High 85 mmHg 11 3 kPa D Neonatal Low 35 mmHg 4 7 kPa High 80 mmHg 10 7 kPa HR 20 to 300 beats per minute On Adult Low 45 bpm High 120 bpm Pediatric Low 50 bpm High 150 bpm Neonatal Low 80 bpm High 170 bpm iCO2 iCO2 2 to 10 mmHg 0 3 to 1 3 kPa ...

Page 112: ...mHg 16 7 kPa D Adult Low 50 mmHg 6 7 kPa High 110 mmHg 14 7 kPa S Pediatric Low 50 mmHg 6 7 kPa High 120 mmHg 16 0 kPa M Pediatric Low 40 mmHg 5 3 kPa High 85 mmHg 11 3 kPa D Pediatric Low 35 mmHg 4 7 kPa High 80 mmHg 10 7 kPa S Neonatal Low 50 mmHg 6 7 kPa High 80 mmHg 10 7 kPa M Neonatal Low 40 mmHg 5 3 kPa High 70 mmHg 9 3 kPa D Neonatal Low 25 mmHg 3 3 kPa High 60 mmHg 8 0 kPa PA S M D 5 to 30...

Page 113: ...gh 80 bpm RRc 5 to 145 breaths per minute Adult Off Ped Neo On Adult Low 5 bpm High 30 bpm Pediatric Neonatal Low 20 bpm High 60 bpm RRc 5 to 90 breaths per minute Off Low 5 bpm High 30 bpm RV S M D 5 to 300 mmHg 0 7 to 40 0 kPa Off S Low 10 mmHg 1 3 kPa High 35 mmHg 4 7 kPa M Low 7 mmHg 0 9 kPa High 17 mmHg 2 3 kPa D Low 2 mmHg 0 3 kPa High 13 mmHg 1 7 kPa SpO2 SpO22 20 to 100 NOTE High and low S...

Page 114: ...0o F Off Low 34 0 o C 93 2 o F High 39 0 o C 102 2 o F ΔT ΔT2 ΔT3 32 0 to 35 0 oC 25 6 to 95 0oF Off Low 0 0 oC 32 0 oF High 2 0 oC 35 6 oF tpCO2 pCO22 10 to 150 mmHg 1 3 to 20 0 kPa On Low 4 0 mmHg 0 5 kPa High 6 7 mmHg 0 9 kPa tpO2 tpO2 10 to 300 mmHg 1 3 to 40 0 kPa On Low 6 7 mmHg 0 9 kPa High 10 7 mmHg 1 4 kPa PCCO 0 50 to 25 00 L min Off Low 5 50 L min High 9 50 L min PCCI 0 75 to 15 00 L mi...

Page 115: ...tion for the selected parameter ON Alarm off icon Upper Determines current upper alarm limit Settings are parameter specific Current Read only cannot be modified Not applicable Lower Determines current lower alarm limit Settings are parameter specific Parameters Upper Limit Lower Limit Ta T1a b T2a b T3a b 107 of current value 93 of current value ΔT1 ΔT2 ΔT3 PVC min iCO2 iCO2 No change No change S...

Page 116: ...ient Events are deleted when the patient is discharged Data is stored in the monitor and remains with the patient during Pick and Go transports Data also survives power shutdowns The Alarm History table records all high priority and medium priority alarms every activation and deactivation of cardiac bypass mode every change of patient category and records whenever you perform an All Alarms Off or ...

Page 117: ...d measurement Low One shot ECG Leads Invalid QRS processing leads invalid for 10 seconds Faulty electrode contact or lead set Unplugged lead set Wrong Cable Type selected on ECG Lead Setup menu see page 8 18 Low One shot Apnea Breath has not been detected for Apnea Time AT seconds No alarm Single attention tone Breath has not been detected for AT x 2 seconds No alarm Single attention tone Breath h...

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Page 119: ...6 Trends Overview 6 2 Trend Setup 6 2 Display Mode 6 3 Channel Assignment 6 3 Trend Graphs 6 3 Trend Table 6 6 Mini Trends 6 7 ...

Page 120: ...nually and automatically stored events are identified on an event summary bar at the top of the trend display as outlined below Trend Table An icon over time line marks manually stored events only alarms and arrhythmia calls are not marked see illustration on page 6 6 Trend Graphs A small yellow vertical line marks manually and automatically stored events see illustration on page 6 4 For informati...

Page 121: ...y channels To display parameter trends 1 Access the Trend Setup menu see page 6 2 2 Select Display Mode and select Manual mode 3 Scroll to the channel you want to format and click on it A list of available parameters appears 4 Click on the parameter whose trended values you wish to view in trend graphs Trend Graphs Trend graphs display stored trend data in the form of individual graphs for each pa...

Page 122: ...tiple value parameter display set of variable values for example ART plotted as a multi layered band below here top layer systolic pressure bottom layer diastolic pressure blank layer in the middle mean pressure 7 Trend scales 2 Activate cancel cursor 8 Selected scrolling intervals 3 Print a report 9 Scroll trends 4 Request a trend recording 10 Vertical marker showing time of alarm arrhythmia or m...

Page 123: ...of arrows below the trend graphs or click on the horizontal bar at the bottom of the screen and dial to the desired time Click on Hours dial to the desired trend duration 1 2 4 8 12 or 24 hr and click again to confirm your choice This function also affects scrolling intervals when you use the horizontal bar or arrows as described above Click on Cursor to display a vertical white line a correspondi...

Page 124: ... the last acquired during that interval with the rightmost column reserved for most recent data To view the Trend Table 1 Click on the Fast Access fixed key on the front of the monitor 2 Click on Trend Table NOTE The time stamp indicates the end of the interval If the Interval setting is 15 minutes then the time stamp 11 15 marks a column of data trended between 11 00 00 and 11 14 59 1 Request tre...

Page 125: ...continuing to monitor main screen waveforms and parameter boxes Mini trend graphs follow the color coding and display order of the parameters they represent and are updated with new trend data every 60 seconds To display Mini Trends 1 Press the Fast Access fixed key 2 Click on Split Screen 3 Click on 10 Min Trends 60 Min Trends Ventilation or Off 4 Press the main screen fixed key to exit the menu ...

Page 126: ...6 8 DELTA DELTA XL KAPPA VF8 6 TRENDS NOTE You can only select one parameter for the mini trend display from a parameter box that contains multiple parameters Mini trend display Main Screen ...

Page 127: ...nuous Recordings 7 7 Events and Trends 7 7 Pending Recordings 7 7 Recorder Setup 7 8 Quick Reference R50 Series Setup Menu 7 8 Primary and Secondary Recorders 7 9 Replacing Recorder Paper 7 10 Print Screen 7 11 Reports 7 11 Quick Reference Reports Setup 7 12 Status Messages 7 13 ...

Page 128: ...orms Alarm recordings may be automatically triggered depending on how they are configured or on the associated condition see chapter 5 Alarms for more information All recordings are identified by the patient name and ID the bed number and the date and time of the recording Recordings Layout Recordings contain one two or three waveforms on 50 mm strips To print a waveform you must first display it ...

Page 129: ...stic Code The following table explains the characters which make up the diagnostic code in the header of a strip recording The first column shows each character s position in the string left to right NOTE Values and alarm off indicators active at the time of the recording request are printed after the recording header for each parameter if appropriate 1 Patient name ID and bed label 4 Origin and t...

Page 130: ...ed for VF and Pacer Pulse Detection X 1 2 3 S T U V a b c d e f g h i A B C D E F G H I j k l m n o p q r J K L M N O P Q R None I II III aVR aVL aVF V V V1 V2 V3 V4 V5 V6 V7 V8 V9 dV1 dV2 dV3 dV4 dV5 dV6 dV7 dV8 dV9 V1R V2R V3R V4R V5R V6R V7R V8R V9R dV1R dV2R dV3R dV4R dV5R dV6R dV7R dV8R dV9R ...

Page 131: ... ECG1 ECG2 lead valid to process 7 VT Count 5 F Value VT Count where A F corresponds to 10 15 8 VT Rate 0 A Value VT Rate 100 10 where A corresponds to 10 9 SVT Count 3 A Value SVT Count where A corresponds to 10 10 SVT Rate 0 A Value SVT Rate 100 10 where A corresponds to 10 11 TACH Count 5 F Value TACH Count where A F corresponds to 10 15 12 TACH Rate 0 A Value TACH Rate 100 10 where A correspon...

Page 132: ...a Setup menu see chapter 5 Alarms To request a timed recording Press the Record fixed key on the front of the monitor To cancel a timed recording Press the Record fixed key again or the recorder s Stop fixed key 17 RESP Size 1 K Value RESP Size 5 where A K corresponds to 10 20 18 19 minutes since breath detector initialization 00 99 Number of minutes that have elapsed since the breath detector was...

Page 133: ... Event Recall 3 Click on Record at the bottom of the displayed screen Pending Recordings Recorders connected to the monitor may be temporarily unavailable to print for example during a paper change If another recorder is available the recording is rerouted to that recorder and printed there in its entirety If no recorder is available the data becomes a pending recording and is printed as soon as a...

Page 134: ...up menu you can customize a variety of recorder functions To access the R50 series Setup menu 1 Press the Menu fixed key to display the Main menu 2 Click on Monitor Setup 3 Click on Recordings 4 Click on R50 Setup to display the Setup menu Quick Reference R50 Series Setup Menu The functions listed on the R50 Setup menu are described below NOTE The mm s or Alternate Speed key only functions while a...

Page 135: ...matically selected for recordings Manual The waveforms that you have selected are printed see Waveform 1 and Waveform 2 settings Waveform 1 Assigns the top waveform for R50 recordings provided Waveform Selection is set to Manual ECG1 ECG2 RESP ART PA RV LV RA LA CVP ICP ICP2 ICP3 ICP4 GP1 GP2 SpO2 etCO2 etCO2 O2 Agent Paw Flow Vol EEG1 EEG2 EEG3 EEG4 BIS Waveform 2 Assigns the waveform for channel...

Page 136: ...hen the recorder is about to run out of paper a red line appears on the recording strip Replace the paper as soon as possible to provide continued operation To replace the recorder paper 1 Open the paper door 2 Pull out the paper roll from the spool holder 3 Remove any paper remaining in the printing mechanism 4 Place the new paper roll into the spool holder Unroll a few inches of paper from the b...

Page 137: ...etwork you can generate reports on a laser printer In addition to trends ECG and standard waveforms you can also print reports of events and conditions stored in the Event Recall database For more information see page 1 27 To open the Reports setup menu 1 Press the Fast Access fixed key to display the Fast Access menu 2 Click on Reports to display the Reports menu Available functions on the Report...

Page 138: ...est report Click on the printer icon again to stop printing the report Waveform Delay Determines the amount of pre event data included in the timed recording 6 10 15 s Waveform Duration Determines the length of timed report 10 20 s Trend Graph Prints a graphical trend report See chapter 6 Trends for more information Click on printer icon to request report Trend Table Prints tabular trend report Se...

Page 139: ...is appropriately assigned Inspect the cable replace it if necessary Primary Secondary Recorder not assigned You have not specified a recorder Specify a recorder from the R50 Assign menu Primary Secondary Recorder door open The paper door is open Close the door to the recorder paper compartment Timed recording started The recorder is currently printing Let the recorder finish printing Recording not...

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Page 141: ... Nerve Stimulators 8 8 Patient Preparation 8 8 Three Five Six and TruST Twelve Lead Configurations 8 9 TruST Twelve Lead Configuration 8 10 Twelve Lead Configurations Standard and Frank 8 11 ECG Leads 8 14 Regular ECG Leads 8 14 TruST 12 Lead 8 14 ECG Signal Processing and Display 8 15 Alarms and Alarm Conditions 8 16 ECG Setup Menu 8 17 Quick Reference Table ECG Setup 8 17 Status Messages 8 23 ...

Page 142: ...p to two temperature probes A connector for an FiO2 sensor is available only on the NeoMed cable The MultiMed cable also has connectors for an SpO2 sensor and up to two temperature probes The NeoMed pod has all these connectors plus a connector for an FiO2 sensor The SpO2 port is not enabled if you have a Masimo SET or Nellcor OxiMax logo on the front of your monitor Before you begin ECG and heart...

Page 143: ... every clinically possible waveform characteristic Consequently for some paced patients the monitor may not count heart rates accurately and may misinterpret rate dependent arrhythmias WARNING Use ECG strip recordings for documentation only they are not of diagnostic quality Use a resting 12 lead ECG for diagnostic purposes instead Diagnostic interpretation of a 12 lead ECG should only be performe...

Page 144: ...ar exceeding the 700mV maximum amplitude specified for the monitor The monitor may incorrectly detect these large pacemaker pulses as valid QRS complexes and may fail to detect cardiac arrest Interference from a monitor may cause some rate adaptive implantable pacemakers to pace at unnecessarily high rates Be extra vigilant with patients when using these types of pacemakers Make sure pacer detecti...

Page 145: ...Using a five lead or six lead cable set to maximize your range of signal choices you can further optimize ECG signal acquisition and processing for paced patients as follows 1 Activate pacer detection as described above 2 Select the lead with the least interference and highest R wave for display in channel ECG1 3 Scroll again to Filter on the ECG menu 4 Toggle between Monitor and OFF until you det...

Page 146: ...mproved reliability The ESU filter helps to protect the patient from burns caused by ESU induced currents flowing through unprotected leads See chapter 29 for information on cleaning the device NOTE Place the electrodes as far from the surgical incision as possible while maintaining a clinically useful configuration Place the cable and lead wires as far from the ESU as possible and perpendicular t...

Page 147: ...ible If the artifact disappears the pump is the probable cause To reduce such artifact choose the lead with the best signal for monitoring or replace the electrodes Rerouting invasive pressure tubing away from the infusion pump tubing may also improve the signals Line Isolation Devices To reduce the effect of line isolation devices which may cause temporary disturbances transients in the ECG signa...

Page 148: ...nder the following conditions ECG signal degradation Excessive patient perspiration Patient skin irritation A wide selection of reusable and disposable electrodes is available Select the best electrode for the monitoring situation Dräger recommends Ag AgCl disposable electrodes If you are using pre gelled electrodes verify that there is enough gel in the electrode gel filled area Never use disposa...

Page 149: ...w typical ECG lead configurations and color codes designated by the IEC and the AHA US Five Lead Standard Three Lead Standard Infinity TruST Five Lead Paced Patients V1 V2 V3 V4 V5 V6 Chest Lead Standard Six Lead Standard NOTE For Infinity TruST 12 lead monitoring the recommended lead placements for V and V are V2 and V5 chest lead ...

Page 150: ...his type of lead derivation has a high degree of correlation with measured leads but should not be used for diagnostic 12 lead ECG analysis TRUST electrodes are placed in the six lead standard configuration As with the six lead pod waveforms from eight leads can be viewed on the Delta monitor but TRUST also processes and displays four additional lead waveforms These TruST leads are viewable in the...

Page 151: ... parameter box 2 Click on ECG Options 3 Scroll to TruST 12 Lead and select ON Twelve Lead Configurations Standard and Frank You can select electrode configuration according to Standard or Frank Lead format Twelve lead monitoring is available only if you are using the MultiMed 12 lead pod To select 12 lead configuration 1 Click on the HR parameter box 2 Click on Lead Setup 3 Scroll to 12 Lead Posit...

Page 152: ... as shown in the following illustrations 2 Select Standard on the ECG menu as described on page 8 Electrode placement may differ slightly depending on whether you are monitoring ECG or ST as shown in the following illustrations The signal morphology for ST Monitoring and Rest ECG configurations may also differ Twelve Lead Standard Format Rest ECG ST Analysis ...

Page 153: ...ding for standard 12 lead monitoring ECG Lead AHA US IEC LA Black Yellow LL Red Green RA White Red RL Green Black V1 Brown and red White and red V2 Brown and yellow White and yellow V3 Brown and green White and green V4 Brown and blue White and brown V5 Brown and orange White and black V6 Brown and violet White and violet ...

Page 154: ...d Frank on page 8 11 The displayed limb leads are true limb leads The chest leads remain derived Frank leads are converted to standard 12 lead format If a Frank electrode falls off the monitor displays a Lead Off message and the corresponding Frank electrode label Devices connected to the monitor via the network central station printers CRS work with data in the 12 lead format The CRS can display ...

Page 155: ...II aVR aVL aVF V1 V6 2 1 ECG3 is available only when HR ARR and ST parameter boxes are on the main screen 2 V and V are chest leads aVR aVL and aVF are augmented leads ECG Pod Cable Set Channels Leads Available MultiMed 6 6 lead ECG1 3 I II III aVR aVL aVF V 1 V 1 V2 2 V52 ECG2 3 I II III aVR aVL aVF V 1 V 1 V2 2 V5 2 ECG3 I II III aVR aVL aVF V 1 V 1 dV1 2 V2 2 dV3 2 dV4 2 V5 2 dV6 2 NOTE TruST l...

Page 156: ...e level of artifact on an analyzed channel determines the weight that channel receives a cleaner channel receives a greater weight When the noise in one channel exceeds a certain level the channel is excluded from the composite signal and the monitor effectively shifts to single channel processing If both channels show excessive noise the message ECG Artifact appears until at least one channel is ...

Page 157: ...rly detect low heart rate conditions in such cases place the lead with the highest R wave relative to the T and or P wave in channel ECG1 If the monitor continues to misinterpret P or T waves reposition the electrodes or use a pulse oximeter to monitor the patient s pulse rate Disconnected Electrodes If more than one electrode is disconnected messages are cycled When any lead is reconnected all le...

Page 158: ...al condition Scroll to the appropriate note and click again Notes are displayed on the screen and can printed on reports Press the Main Screen fixed key to return to the main screen The Size ECG Submenu This submenu allows you to configure the following functions Size ALL ECG Changes display amplitude of ECG waveforms NOTES The monitor s normal QRS detection threshold is approximately 0 35 mV depe...

Page 159: ...G channels Cascade cascades ECG1 data into the second channel Channel 1 Channel 2 Channel 3 Selects leads for continuous display in ECG channel s on the main screen Channel 1 Channel 2 Channel 3 scroll through the list of available leads and click to select for display NOTE The Cable Type setting determines the list of available leads for selection 12 Lead Position Configures monitor for Standard ...

Page 160: ...rdless of which ECG cable is connected For example if you connect a MultiMed 6 MultiMed Plus or MultiMed Plus OR with a 6 lead wire set but the Cable Type is set to 5 the monitor will only process and display 7 leads The V lead will not be displayed trended or broadcast to the network in this case However the V lead will still be displayed in the Show All screen To display all 8 leads you must set...

Page 161: ...OFF default to disable pacemaker detection Select Fusion to enable pacer detection but minimize pacer tail rejection to reduce missed detection of pseudo fused paced beats which results in false asystole alarms QRS Sync Marker The vertical white line that is displayed on each detected QRS complex indicates when it is safe to perform synchronized cardioversion NOTE Sync output pulses can trigger th...

Page 162: ...ion Ischemia Hypertension Congenital HD Valvular HD Pericarditis Respiratory Disease Endocrine Disease Pacemaker Pulm Embolism Post Op Changes Cardiomyopathy Other NOTE Available when Aries option is installed None Chest Pain Chest Pain Increase Chest Pain Gone Chest Pain Decrease Routine ECG Treatment Change Start Thrombolytics Post Thrombolytics ECG Post Intervention Post PTCA Post CABG Position...

Page 163: ...or cannot detect a signal it defaults to ECG for the heart rate Click on SpO2 to derive heart rate from pulse oximetry signal HR parameter box label changes to PLS and displays values in white The pulse visual blip and audio tone show no change indicating SpO2 saturation values Click on AUTO to derive heart rate from ECG signal or other available signals If an ECG signal is unavailable the monitor...

Page 164: ...lect Relearn to initiate a relearning process see chapter 9 Arrhythmia Monitoring for more information about relearning a reference template Message Definition and or Possible Cause Suggested Action HR HR The patient s heart rate is outside the current alarm limits Check the patient and treat if necessary Change the alarm limits HR Out of Range High The patient s heart rate is outside the upper me...

Page 165: ...enu see page 8 20 Inspect and replace defective cables and wires Reapply gel on disposable electrode s If a lead or electrode cannot be replaced select another ECG lead for processing Verify that the number of leads selected in the ECG Lead Setup menu matches the applied lead set see page 8 20 ECG Report Server Busy Try Later The Infinity CentralStation is currently processing a report Wait a few ...

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Page 167: ...w 9 2 About the Arrhythmia Template 9 3 Beat and Rhythm Classification 9 3 Automatic Learning and Relearning 9 4 Arrhythmia Setup 9 5 Modes Full Basic OFF 9 5 Channel Lead Selection 9 6 Arrhythmia Setup Table 9 6 Status Messages 9 9 ...

Page 168: ...the signal The monitor considers all beats questionable if a baseline shift exceeds specified limits The monitor uses the results of QRS processing for arrhythmia analysis During multiple lead arrhythmia processing each lead s QRS complexes are measured and compared against its learned dominant normal beat The monitor classifies beats based on information acquired from all available leads WARNING ...

Page 169: ...refers to the analysis of individual beats If a new beat s features do not match those of the reference template the new beat is classified as abnormal paced or questionable The monitor uses all detected beats to calculate the heart rate eliminating questionable beats from arrhythmia classifications Rhythm event classification refers to the analysis of sequences of beats The monitor compares the s...

Page 170: ... to beat rate TACH rate setting 2 3 BRDY Sinus bradycardia 8 or more consecutive normal beats with an average rate sinus bradycardia rate setting 2 NOTES When in neonatal mode bradycardia is a low heart rate alarm Brady Alarm neonate only which is a high alarm can be configured independently of the low HR alarm which is a medium alarm PAUS Pause Sequence of two beats classified as normal or PVC wi...

Page 171: ...Monitoring 3 Scroll through the available settings Basic Full or OFF and click to verify your selection ARR Mode Available Display Parameters Parameter box OFF ASY asystole VF ventricular fibrillation ARTF artifact Basic ARR label to register arrhythmia occurrence ASY asystole VF ventricular fibrillation ARTF artifact VT ventricular tachycardia Full All arrhythmia events See page 9 3 for a complet...

Page 172: ...QRS ARR Select 3 Select ECG1 or ECG1 2 and click Arrhythmia Setup Table When the monitor is operating in Full arrhythmia mode the ARR setup table allows you to configure arrhythmia monitoring according to your patient s needs The monitor can detect all events listed in the first column of the table Using the remaining columns you can modify the attributes of each event Fields that are not applicab...

Page 173: ...larm is highlighted when you first click on a parameter 4 Click to access settings of the selected arrhythmia function 5 Dial through settings and click to confirm your selection 6 Repeat steps 2 5 to configure additional arrhythmia functions or parameters 1 Sets the rate and count 2 Stores or records events alarms 3 Arrhythmia mode settings 4 Selects the arrhythmia mode 5 Accesses a second page 6...

Page 174: ...fied High Medium Low off Rate Together with the count the rate determines the point at which an event call is triggered NOTES You cannot modify the rate for the following parameters ASY VF CPT BGM or ARTF RUN and AIVR cannot be modified because their settings derive from VT They are included to quantify their derivation based on current VT values VT 100 to 200 increments of 10 RUN Same as VT Rate ...

Page 175: ...per alarm limit Check the patient Cannot Learn Lead X At the end of the Learning phase the dominant normal complex could not be determined for Lead X one of the two leads selected for QRS processing Arrhythmia analysis proceeds using the other lead as a source Lead X is ignored until a Relearn is initiated Check the leads Choose another lead for QRS processing Relearning Monitor is learning a norm...

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Page 177: ...ST Monitoring Overview 10 2 MultiMed Pods for ST Analysis 10 3 ST Display 10 4 ST Analysis Setup 10 4 Quick Reference ST Analysis Menu 10 5 Measuring Points 10 6 ST Alarms Table 10 10 Status Messages 10 11 ...

Page 178: ... wave at a default position of 80 ms after the QRS offset The following figure illustrates a typical QRS complex The ST analysis feature examines QRS complexes classified as normal beats from up to twelve selected ECG leads The monitor learns each ST lead combining the measurements and features of normal beats into a composite or average QRS complex It derives the ST segment deviation from this av...

Page 179: ...t and pediatric patients enhances the accuracy of ST parameters During 12 lead ST monitoring the monitor trends all twelve ST leads plus ST Vector Magnitude STVM and ST Change in Vector Magnitude STCVM STVM is the magnitude mm or mV of the ST vector the ECG vector at the ST measurement point A combination of the ST deviation values from all twelve leads it measures the ST level throughout the hear...

Page 180: ...me format as strip recordings where 1 millimeter mm on the grid corresponds to 0 1 millivolt mV ST Analysis Setup The ST analysis menu allows you to execute most of the functions involved in analyzing the ST segment To open the ST Analysis menu Click on the ST parameter box if displayed or 1 Press the Menu fixed key on the front of the monitor 2 Click on Patient Setup 3 Click on Parameters A list ...

Page 181: ... displayed on the Measuring Points screen Learns the patient s arrhythmia and dominant QRS rhythm Identifies the new dominant QRS complex NOTES New complexes are displayed on the Measuring Point screen see page 10 6 Relearn is also accessible from the ECG and ARR setup menus All Relearn operations are stored in the trends database Markers on the trend displays indicate when a Relearn operation occ...

Page 182: ...ble via the ST Analysis menu page 10 4 you can change the isoelectric and ST measuring points to achieve an accurate ST deviation measurement Measuring Points Displays the average S T complex for each monitored ST lead as well as TruST leads NOTE See page 10 6 for more information ISO changes the point that defines position of the isoelectric point ST changes the point that defines position of the...

Page 183: ... over current S T complexes Color code Reference magenta current green 4 Generates ST report with ARIES software only 5 ST measuring point current value 6 Recalculates the QRS complex 7 Isoelectric measuring point with current value Measuring Points Screen 12 Lead Create reference template Dial to the desired ST lead and click Measuring Points Screen 3 Lead Large Format Zoom Screen ...

Page 184: ...rkers indicate changes in the placement of measuring points as well as Relearn operations The labels CHG Change and LRN Relearn appear in time stamped columns in the Trend Table and in the ST Trend Graphs Also in the Trend Graphs a solid white vertical line in the ST trend graphs marks the time of a measuring point change while a dotted vertical line marks the time a Relearn operation was initiate...

Page 185: ... to white For each average S T complex displayed the value in millimeters for ST deviation changes to reflect the new ISO measurement point 1 Click on ST to highlight the position of the current ST measuring point in milliseconds The vertical ST reference line changes to yellow 2 Use the rotary knob to move the ST vertical line along the horizontal axis As you move the line the ST value also in ye...

Page 186: ...r modifying alarm limits on page 5 6 4 Use the control keys at the top of the parameter list Auto Set and bottom of the screen Event Duration Relearn to perform other ST alarm functions Menu Item Description Settings Auto Set Changes the upper and lower limits mm or mV for all active ST leads NOTE The main Alarm Limits menu s Auto Set feature also uses this calculation to adjust alarm limits of ac...

Page 187: ...ectrode contact or faulty lead wire Inspect and replace defective cables and wires Reapply gel on reusable electrode s Reapply electrodes Make sure the patient s skin is properly prepped If a lead or electrode cannot be replaced select another ST lead for processing Cannot Derive STVM Cannot Derive STCVM At least one of the 12 leads is disconnected or STVM was invalid at the time the reference val...

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Page 189: ...11 EEG Monitoring Overview 11 2 Precautions 11 2 Connecting the EEG Pod 11 3 EEG Setup 11 6 Quick Reference EEG Setup 11 7 Status Messages 11 9 ...

Page 190: ...rode is at the Fp site and the negative electrode is at the Cz site Precautions The following precautions apply to EEG monitoring during electrosurgery Place EEG electrodes above the mastoid bone Do not perform electrosurgery above the mastoid bone NOTE EEG pod H W Failure message appears if the EEG pod software and the monitor software are not compatible The EEG pod is intended for use with surfa...

Page 191: ... monitor using the Hemo Aux or Aux connector For a complete list of Dräger EEG accessories available with this product see page C 20 1 Lead diagram 6 Channel 1 2 Electrode connections 7 Neutral 3 Channel 4 8 Trig area reserved for future use not yet functional 4 Channel 3 9 Cable to monitor 5 Channel 2 ...

Page 192: ...gative connection and so forth The displayed measurement for channel one is the differential between the 1 and the 1 electrode Referential mode uses one electrode for each channel and all four channels share the reference R electrode For example channel one has a positive connection channel two has a positive connection and both share the same reference connection Use the referential block which f...

Page 193: ...electrodes a positive and a negative In referential mode all channels use the same reference electrode and only use one numbered electrode positive 1 Channel 2 electrode 1 Channel 2 electrode 2 Neutral electrode 2 Neutral electrode 3 Channel 2 electrode 3 Reference electrode 4 Channel 1 electrode 4 Channel 1 electrode 5 Channel 1 electrode REFERENTIAL MODE DIFERENTIAL MODE ...

Page 194: ... associated EEG menu appears You can display up to four EEG channels at the same time All four EEG menus show the same settings for the various channels EEG1 EEG2 EEG3 EEG4 The monitor displays each EEG waveform next to its respective parameter box see page 2 5 for information about displaying parameter boxes A typically configured EEG parameter box is shown below 1 Lead label 2 Parameters with cu...

Page 195: ... Right Back Specific site labels Fp Fp1 Fp2 Fz F3 F4 F7 F8 Cz C3 C4 T7 T8 Pz P3 P4 P7 P8 O O1 O2 NOTE Refer to the diagram on top of the EEG pod for site locations Size Determines the amplitude of each EEG waveform 5 10 25 50 100 250 or 500 µV Size ALL Determines the amplitude of all EEG waveforms simultaneously 5 10 25 50 100 250 or 500 µV EEG Channels Allows you to display up to 4 channels for E...

Page 196: ... EEG channels display the same parameters The figure below shows the median and spectral edge frequencies as well as the distribution of the Delta Theta Alpha and Beta frequency bands as shown in the Power Spectra screen Med Median Frequency at median point where 50 of the energy lies above and below SEF Spectral Edge Frequency Frequency below which user defined percentage of the power lies If SEF...

Page 197: ...noise artifact On Default Off 1 Caution Only qualified personnel should access Filter functions 2 Selection is grayed out if EEG pod is software version VE0 Message Possible Cause Suggested Action EEG Check Electrodes An EEG channel has degraded suggesting poor electrode contact Replace the electrodes EEG Pod Initializing The EEG pod is warming up Wait until the pod has warmed up before attempting...

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Page 199: ...iration Setup 12 6 OxyCRG OCRG Monitoring 12 9 Scale 12 10 Cursor 12 10 Review Summary Screen Overview 12 11 Accessing Review Summary Screen 12 11 Quick Reference Table OCRG Review Summary 12 14 OCRG Setup Menu 12 15 Quick Reference Table OCRG Setup 12 15 Second and Third Channel Label 12 16 Time Base 12 16 Recordings 12 17 Status Messages 12 18 ...

Page 200: ...ation waveform and rate from these impedance changes The monitor can use ECG leads I or II for breath detection regardless of the lead selected for QRS processing The measurement range for impedance respiration monitoring is 0 to 155 breaths per minute The range for alarm settings is 5 to 150 breaths per minute In neonatal and pediatric mode the monitor can detect central apnea Using the appropria...

Page 201: ...eported within the established apnea time period Therefore do not rely on impedance respiration 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 rate limit alarms should also be enabled and set appropriately While the ESU block or the MultiMed Plus...

Page 202: ...best results Use a 5 lead cable set with RL as a neutral electrode to improve the RESP signal You may want to position the electrodes to span the maximum expansion and contraction of the lungs especially in the case of deep abdominal breathers For neonates place the RA and LA electrodes at nipple level midaxillary line Position the LL electrode below the diaphragm and umbilicus Avoid the liver are...

Page 203: ...hing with or without a ventilator as shown below In the RESP parameter box a lung symbol blinks whenever a breath is detected The display of respiration alarms alarm limits and parameter values follows the standard display of other parameters Respiration Waveforms Patient breathing independently Patient breathing with ventilator assistance inspiration expiration expiration inspiration 1 Alarm limi...

Page 204: ...piration waveform size is set too low shallow breaths may not be counted If it is set too high cardiac artifact will be counted as breaths Therefore always use the respiration marker to verify breath detection at the desired amplitude Auto Optimal breath detection threshold calculated at the beginning of RESP monitoring Intended for patients with regular breathing patterns Manual The monitor does ...

Page 205: ...sk an apnea condition NOTE Enable respiration alarms before setting Coincidence Detect to ON ON The RESP Coincidence message appears whenever respiration heart rate coincidence is detected default for Neonatal patient monitoring OFF the monitor does not detect respiration heart rate coincidence default for adult and pediatric patient monitoring RESP Monitoring Enables and disables respiration moni...

Page 206: ...o NOTE Initiate a relearn if electrodes have been repositioned and or if your patient s breathing pattern changes Not applicable NOTE The selection Relearn is ghosted in manual mode RESP Alarm Displays respiration alarms on the Alarm Limits table see page 5 6 Not applicable The Respiration Setup Menu Menu Item Description Settings ...

Page 207: ...O2 pods are connected each displays a parameter box on the main screen The labels of the second pod are marked by an asterisk hence the parameter label tpO2 For screen display the tpO2 CO2 parameter label is sometimes shortened to tpO2 11 23 26 1 Activate cursor 8 Respiration etCO2 label Apnea label appears when an apnea event occurs and is displayed 2 Cursor time 9 Respiration etCO2 waveform 3 Ex...

Page 208: ... vertical bar appears on the trend area of the screen and cursor time is displayed in the upper right corner The numbers on the left side of the screen no longer represent scale values but rather parameter values at the time marked by the cursor The monitor continues to display current real time values on the right of the screen When you move the cursor to the right or the left with the rotary kno...

Page 209: ...a event data if available Event data associated with the trigger event appears in the other two rows BRDY SpO2 or Apnea color coded as follows Bradycardia green SpO2 white Apnea blue Accessing Review Summary Screen To access the OCRG review screen Enter the alarm history table and click on quick access key OxyCRG Review or Click on the Summary button on the OCRG screen NOTE The OCRG Review Summary...

Page 210: ...r is highlighted 2 Click once 3 Turn the rotary knob to update the time bar This blanks the data until the end of the next step 4 Once the time bar shows the time frame desired click the rotary knob again and the data refreshes Time interval setting To change the time interval scale on the time bar use the Hours button on the OCRG Review Summary screen Time intervals of 1 2 4 default 6 12 or 24 ho...

Page 211: ...d the cursor time appear on the screen 3 Turn the rotary knob to move the cursor along the data graphed 4 Move the cursor until it overlaps a trigger event BRDY and SpO2 high low data if available is displayed The apnea time if available appears 1 Number of apnea events for data on display 7 Apnea time 2 Cursor date time 8 Cursor button 3 BRDY high low values 9 Associated data green 4 Trigger even...

Page 212: ...applicable Right Paging button Double Arrows Scrolls right through the data without blanking the data Not applicable Horizontal Scroll Bar Turning the rotary knob moves a horizontal frame within the scroll window This updates the Time bar blanking data Pressing the rotary knob after the time bar update restores review screen data Not applicable Hours Changes time interval for data on OCRG Summary ...

Page 213: ...nce Table OCRG Setup NOTE The OCRG setup menu does not time out It remains displayed until the user removes it The OCRG Setup Menu Menu Item Description Settings Parameter 2 Displays a list of label choices for updating the second channel of the OCRG menu SpO2 tpO2 tpO2 Parameter 3 Displays a list of label choices for updating the third channel of the OCRG menu RESP etCO2 Time Displays Time Base c...

Page 214: ...O2 Time Base You can select either a three minute or a six minute OCRG time base The default time base is three minutes To change the OCRG time base to six minutes 1 Click the Setup button on the OCRG screen 2 Click Time Base 3 Click on 6 min 4 Enter clinical password NOTE The clinical password menu does not time out It remains displayed until you click on Accept After the clinical password is ent...

Page 215: ...the oxycardiorespirogram is displayed If no recorder is connected the monitor stores OxyCRG alarm recordings for later printing For more information about manual and alarm recordings see chapter 7 Recordings The following illustration shows a typical OCRG recording 1 Respiration waveform 2 Oxygenation data SpO2 or tpO2 tpO2 3 bbHR data ...

Page 216: ...the patient and treat if necessary Check the placement of electrodes Change their position if necessary Carry out a RESP relearn Reset breath detection sensitivity to manual mode RESP Coincidence The patient s heart rate and respiration rate fall within 20 of each other Observe the patient and treat if necessary Check and change the electrode placement if you receive a coincidence message until yo...

Page 217: ...re that is suspect Reapply gel or change the electrode Check the MULTIMED pod and replace it if necessary RESP Relearning The user has turned on respiration monitoring or has clicked on Relearn None required RESP Artifact Persistent artifact Check the patient cable and lead wires carefully Check the electrode placement Change their position if necessary RESP H W Failure Not applicable Call your ho...

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Page 219: ...ure Overview 13 2 Display Features 13 2 NBP Setup 13 3 Safety Considerations 13 3 Cuff Selection and Placement 13 3 Setup Menu and Quick Reference Table 13 8 Taking NBP Measurements 13 9 Venous Stasis 13 12 Status Messages 13 13 ...

Page 220: ...s The monitor can initiate blood pressure measurements singly at set intervals or continuously over a 5 minute period The monitor can be configured to sound an attention tone whenever an NBP measurement is completed see page 2 9 for information Display Features The monitor displays non invasive blood pressure in the form of numerical values and trends There is no NBP waveform For information on tr...

Page 221: ...ect cuff size for your patient Measure the circumference of your patient s limb and use the markings on the cuff to select the correct cuff size WARNING Obstructions may cause the cuff to inflate and deflate improperly and result in inaccurate readings Check the hose and cuff for damage and dirt Do not allow the hose and cuff to come in contact with fluids and make sure that they are not compresse...

Page 222: ...g air into the patient s blood vessels never connect pneumatic connectors to an intravascular system Before monitoring neonates and infants Select the correct cuff size and hose Select the neonatal or pediatric patient category if not already selected This protects neonates infants and pedi atric patients from high cuff pressures used for adults NOTE The accuracy of the oscillometric blood pressur...

Page 223: ...of the back of the thigh The cuff label this side to patient must be placed against the skin 3 Place the marker over the artery pointing to hand or foot Once the cuff is applied the cuff label index line must fall within the area marked as range 4 Wrap the deflated cuff snugly around the limb without impeding blood flow 5 Caution the patient not to talk or move upon inflation of the cuff NOTE Plac...

Page 224: ...art level If the cuff is not placed at heart level adjust the displayed systolic and diastolic readings 8mmHg for each 10cm above the heart and 8mmHg for each 10cm below the heart In selecting a monitoring site make sure patient connections do not interfere with each other Dräger recommends that you do not put an NBP cuff on a limb that is already used for other measurements 1 Cuff size indicators...

Page 225: ...e Cuff 1 Grasp the hose at the cuff connection and insert it into the mating hose connector until it clicks into place 2 To remove the cuff retract the metal collar on the NBP adapter hose NOTE There are separate hoses for pediatric adult and neonatal patient categories Select the appropriate hose based on intended monitoring application NBP hose connector Kappa Delta Delta XL NBP hose connector ...

Page 226: ...for series of single NBP measurements OFF 1 2 2 5 3 5 10 15 20 25 30 45 60 120 240 min Venous Stasis Stops blood flow to lower part of cuffed limb for a fixed time OFF ON Continuous Mode Initiates successive NBP measurements for 5 minutes OFF ON Inflation Limit Sets threshold for maximum cuff inflation initial inflation will be less Neonatal patient category 140 mmHg Pediatric patient category Ped...

Page 227: ...gures NBP calibration CAUTION Only qualified DrägerService personnel should access this function If you leave NBP Cal Mode ON accidentally NBP will default to an NBP inactive state To restore NBP to normal operating mode power cycle the monitor OFF ON NBP Alarms Accesses NBP alarms and associated variables on Alarm Limits table Not applicable NBP Chime Produces a tone when NBP measurement is compl...

Page 228: ...w interval time resets the timer After the first measurement the NBP parameter box displays results A countdown bar indicates the amount of time left before the next measurement You can take additional single or continuous measurements without affecting the interval cycle The minimum interval is 30 seconds between the end of one measurement and the start of another to allow for reperfusion of the ...

Page 229: ... to achieve reperfusion of the limb The entire continuous measurement cycle is aborted if there is an NBP alarm To stop a continuous measurement in progress click again on Continuous Mode in the NBP menu or press the NBP Start Stop fixed key The entire measurement cycle is canceled WARNING Rapid prolonged cycling of non invasive pressure measurements have on occasion been associated with petechia ...

Page 230: ...ng a constant pressure in the cuff the monitor stops the flow of blood to the lower extremity of the cuffed limb long enough to cannulate the patient The cuff in venous stasis mode will occlude the limb for about as long as an NBP measurement approximately two minutes for adult and approximately one minute for neonatal patients To begin cuff inflation click on Venous Stasis Click again to terminat...

Page 231: ...ation limit setting NBP Check Cuff Size The patient s pulsations are too small to determine blood pressure Check the cuff size Move the cuff to another limb NBP Venous stasis started Venous stasis mode is enabled No action is required NBP Venous stasis ending There are 10 seconds remaining in venous stasis mode No action is required NBP Venous stasis ended Venous stasis mode is disabled or complet...

Page 232: ...s movement Restart measurement If the message persists contact the hospital s technical personnel or DrägerService NBP Blocked Line The inflation rate is too high during the inflation cycle or the time to dump the 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 and...

Page 233: ...he patient and treat if necessary Check the cuff for obstructions Retry the measurement NBP Retrying The monitor failed to detect sufficient pulsations aborted the measurement then started a new one No action is required NBP Overpressure Circuit Failure The cuff overpressure circuit has failed Contact the hospital s technical personnel or Dräger DrägerService NBP Meas Circuit Failure Software or h...

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Page 235: ...p 14 3 Tubing 14 3 Transducers 14 3 Hemodynamic Pods 14 6 IBP Y Cables 14 10 Display Features 14 11 IBP Setup 14 13 Quick Reference IBP Setup 14 13 Labeling Pressure Channels 14 14 Pressure Label Conflicts 14 17 Pulmonary Wedge Pressure Display 14 18 Status Messages 14 20 ...

Page 236: ...s follows IBP Labels Label Pressure Type Measured Pressures Measurement Range ART Arterial Systolic diastolic mean 50 to 400 mmHg NOTE see status messages page 14 20 LV Left Ventricular Systolic diastolic mean PA Pulmonary Arterial Systolic diastolic mean RV Right Ventricular Systolic diastolic mean CVP Central Venous Mean RA Right Atrial Mean LA Left Atrial Mean ICP Intercranial Mean ICP2 Intercr...

Page 237: ...connection to the patient Shorter tubing reduces signal attenuation and the effects of motion artifacts High pressure tubing limits signal dampening Follow your hospital s clinical procedures in assembling the tubing system Be sure to remove all bubbles from the system as they dampen the signal and could lead to incorrect systolic pressure measurements Transducers Transducers are available in a va...

Page 238: ...t 2 Close the transducer stopcock to the patient and open it to air 3 a Click on the parameter box associated with the transducer you want to zero The parameter setup menu appears NOTE You can also access the parameter menu as follows 1 Press the Menu fixed key to display the main menu 2 Click on Patient Setup 3 Click on Parameters 4 Scroll to the desired parameter and click WARNING Do not use the...

Page 239: ...meter or Simulator To recalculate the calibration factor using a manometer or a pressure simulator 1 Open the setup menu of the IBP parameter you wish to monitor see page 14 13 2 Connect manometer or pressure simulator to the transducer 3 Close transducer to the patient and open it to the manometer 4 Use the manometer or simulator to create a pressure on the transducer within the associated pressu...

Page 240: ... bubbles 3 Align the level of the tubing tip and the transducer membrane 4 Open the transducer to the tubing 5 Tape the tubing tip to an IV pole at a level 136 cm above the transducer dome 6 Follow the procedure outlined above for the manometer using 100 mmHg as the manometer value 7 Remove excess calibration tubing before reconnecting the lines to the patient Hemodynamic Pods The following hemody...

Page 241: ... execute the following functions Smart Zero zeroes all transducers connected to pod and open to air Wedge Starts a pulmonary wedge pressure measurement not available on the PiCCO pod C O Start Starts a cardiac output measurement NOTE The monitor automatically assigns P1a d P2a d and P3a d as temporary pressure labels when pressure transducers are initially connected These temporary pressure labels...

Page 242: ...e attached to a separate transducer plate which are available from the applicable manufacturer purchase them local ly or contact your Dräger representative for information 4 Transducer 5 Temperature connectors Mpod Quad Hemo only 6 Transducer plate MPod Quad Hemo only 7 Connector reserved for future use not functional Hemo4 Pod Hemo2 Pod HemoMed Pod PiCCO Pod MPod Quad Hemo ...

Page 243: ...rmediate cables which are permanently fastened to the back of the MPod To connect the hemodynamic pod to the monitor 1 Plug one end of the cable into the appropriate monitor connector 2 Connect the other end of the cable into the hemodynamic pod connection port Hemo4 Pod 1 Transducer 2 Transducer cable 3 Adapter blocks Rear View Side View 1 Hemo2 Hemo4 or MPod Quad Hemo connector second connector ...

Page 244: ...essure transducers are initially connected These temporary pressure labels must be relabeled with an appropriate permanent label corresponding to the pressure site being monitored To connect the IBP Y cable to the monitor 1 Plug a transducer into the intermediate cable as shown 2 Plug the other end of the intermediate cable into the Y cable 7 or 10 pin 3 Repeat steps 1 and 2 for a second transduce...

Page 245: ...ameter box is shown below NOTE The monitor automatically assigns P1a d P2a d and P3a d as temporary pressure labels when pressure transducers are initially connected These temporary pressure labels must be relabeled with an appropriate permanent label corresponding to the pressure site being monitored NOTE These temporary pressures are not included in graphical and tabular trends on the monitor un...

Page 246: ...played in the bottom of the ICP ICP2 ICP3 ICP4 parameter box IBP waveforms can be displayed in standard or overlapping format When IBP waveforms are overlapped you can show scale values for the overlapped parameters side by side the order of the display corresponding to the priority of the parameter boxes by setting the Common Scale setting to OFF on the IBP setup menu see page 14 14 The following...

Page 247: ... of the parameter you have selected displayed at the top of the menu Quick Reference IBP Setup Available functions present on all IBP setup menus are described in the following table IBP Setup Menus Menu Item Description Available Settings Zero Zeroes the transducer and displays time and date of last zeroing operation see page 14 3 Not applicable read only Scale Sets the upper values of the IBP wa...

Page 248: ...and Rows 2 and 3 representing data from the Hemo2 Hemo4 MPod Quad Hemo or PiCCO pod either of which may be Manometer Cal Allows you to enter the manometer or simulator reading and start calibration see page 14 5 10 300 Pressure Overlap Allows you to view up to four IBP parameters on a single baseline ON OFF Common Scale Sets the waveforms to one scale OFF 5 10 15 20 25 30 35 40 50 75 100 125 150 1...

Page 249: ...P setup menu see page 14 13 2 Scroll to Pressure Labels and click 3 Scroll to the channel you wish to label and click The first label in the column on the right side of the menu is highlighted 4 Scroll to the desired label and click 5 Repeat steps 3 and 4 to assign other pressure labels 1 Transducer location letter 2 HemoMed or Y cable connector 3 Hemo2 Hemo4 MPod Quad Hemo or PiCCO Kappa Delta De...

Page 250: ...BLOOD PRESSURE 1 Signal source 1 HemoMed or Y cable 2 3 Hemo2 Hemo4 Infinity MPod Quad Hemo or PiCCO 2 Select labels 3 Transducer location 4 Hemo4 pod example only showing Aux Hemo3 monitor connection and parameter labels on Kappa Delta Delta XL ...

Page 251: ...th previously stored labels is connected to a monitor the pod and the monitor may be storing different pressure labels for the same channel causing a conflict The label stored in a pod prevails if a transducer is connected to the pod The pod keeps the label and the monitor assigns that parameter label to the Pressure Labels screen If a transducer is not connected to the pod the label stored in the...

Page 252: ...for 10 seconds and calculates a wedge pressure value PWP During the measurement the PA parameter box shows no systolic or diastolic values and PA alarms are disabled NOTE PWP is not available with the PiCCO pod WARNING During wedge pressure measurements Alarm monitoring for invasive pressures if enabled is temporarily disabled to prevent nuisance alarms The parameter box does not display a crossed...

Page 253: ...croll to the desired sweep speed 6 25 12 5 25 or 50 mm s and click 7 Inflate the balloon and click on Wedge to start the measurement The message Wedge in Progress appears When the calculation is complete the PA and RESP waveforms stop a horizontal cursor line through the PA waveform indicates the new PWP value and the monitor instructs you to deflate the balloon Control keys at the bottom of the s...

Page 254: ...ll A clot on the catheter tip Check the patient and treat if necessary Open the system to the patient by turning the stopcock Follow hospital procedures for dislodging catheters Follow hospital procedures for clotted catheters xx Unplugged The pressure transducer for the specified parameter is either unplugged or defective Active pressure reconnect or replace the cable Inactive pressure turn off a...

Page 255: ...ducer xx Cal Failed Out of Range The mercury calibration failed because the measured value was too high or too low Make sure the transducer is zeroed then retry If the retry fails replace the transducer If calibration requires a factor outside this range replace the transducer xx Zero before Cal During calibration more than 5 minutes have elapsed since the last successful zeroing of the transducer...

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Page 257: ...w 15 2 Accuracy 15 3 Main Screen Display 15 4 C O Setup Hardware 15 5 C O Setup Menu 15 6 Quick Reference C O Setup 15 6 Measurement Mode 15 7 C O Measurement Procedures 15 10 Averaging C O Measurements 15 12 Status Messages 15 14 ...

Page 258: ...es the temperature of the blood as it leaves the heart The monitor restores C O settings to their default values when you discharge a patient or select New Patient after turning on the monitor If you subsequently press the C O Start fixed key or if you press C O Start after a catheter is disconnected the monitor displays the C O setup menu sounds a tone and requests that you confirm the current se...

Page 259: ...and injection Use an in line temperature sensor to eliminate this source of error If you hand fill your syringes fill them with the same volume each time The recommended amount is 10cc for adults and 5cc for pediatric patients Avoid touching the body of the syringe The warmth of your hand will warm the injectate very quickly Inject the entire volume in one swift continuous motion Perform the injec...

Page 260: ...od temperature acquired from the Hemo2 or Hemo4 pod currently used to measure C O Time of the C O Average Time the currently displayed C O average was taken Injectate temperature IT Temperature of the injectate solution acquired from the hemodynamic pod being used for C O measurements The following diagram shows a typical C O parameter box NOTE If no new measurements have been taken for 24 hours t...

Page 261: ...up using the HemoMed pod NOTE Hemo2 and Hemo4 pods have an additional and clearly marked connector for body temperature monitoring only For more information on hemodynamic pods see page 14 6 HemoMed setup for Cardiac Output 1 Injectate solution 7 C O catheter cable 2 Injectate temperature probe 8 Thermistor port 3 Thermistor T piece 9 Distal lumen 4 Proximal lumen 10 Balloon lumen 5 Stopcock 11 Th...

Page 262: ...ust be obtained from the same pod Menu Item Description Available Settings C O Start Starts a C O measurement see page 15 10 Not applicable Catheter Type Displays the currently selected catheter type NOTE Due to corporate mergers Baxter cardiac output catheters and accessories may be labelled as being from Edwards Ohmeda cardiac output catheters and accessories may be labelled as being from Becton...

Page 263: ...omatic modes the monitor sounds an attention tone when the C O value has been computed On the C O Averaging screen the value is displayed in the next available box and the Save AVG field is updated The value in the main screen parameter box does not change until you save the C O average To change the measurement mode open the C O setup menu as described on page 15 6 and select the desired mode Pro...

Page 264: ...xter BD Ohmeda and Arrow catheters WARNING An incorrect computation constant may yield incorrect C O measurements and put the patient at risk Confirm that the manually entered computation constant is correct for the catheter you are using Edwards Baxter Injectate Temperature IT Sensor connected IT Sensor disconnected Catheter Size Injectate Volume IT 5 to 16 IT 16 to 27 C IT 0 C 7F 10 cc 0 561 0 6...

Page 265: ...the injectate volume and temperature being used 5F 5 cc 0 291 0 316 0 279 5F 3 cc 0 170 0 188 0 160 Arrow Injectate Temperature IT Sensor connected Catheter Size Injectate Volume IT 1 C 1 C IT 24 C 1 C 7 5F 10 cc 0 532 0 586 7 5F 5 cc 0 249 0 265 7 5F 3 cc 0 131 0 155 7F 10 cc 0 541 0 601 7F 5 cc 0 250 0 273 7F 3 cc 0 134 0 156 5F 5 cc 0 267 0 303 5F 3 cc 0 157 0 192 BD Ohmeda Injectate Temperatur...

Page 266: ...after you see the READY message A thermodilution curve appears displaying the change in blood temperature 3 Repeat step 2 to take an additional measurement making sure you wait for the READY message If a temperature drop is not is detected within four minutes the Averaging screen closes and you must repeat steps 1 and 2 for additional C O measurements NOTE If the monitor detects that a new Edwards...

Page 267: ...tor begins to calculate a C O value as soon as it detects a blood temperature drop If the monitor fails to detect the temperature drop caused by the injectate the waveform disappears after 30 seconds An attention tone sounds an error message appears in the local message area and three asterisks appear in the Save AVG field Repeat steps 1 and 2 for additional measurements NOTE C O Start is only ava...

Page 268: ...ates the five values displayed on the C O Averaging screen with their corresponding thermodilution curves C O Averaging 1 Stable blood temperature detected see page 15 8 5 Current injectate temperature 2 Current average of C O values Click to save displays if values are out of range 6 Current blood temperature 3 Exit C O Averaging screen C O value not stored 7 C O measurement values Newest value a...

Page 269: ...he Main Screen parameter box to the time of the latest measurement included in the average You also save the calculated average any time you quit the C O Averaging screen by accessing another menu or the Main Screen or whenever four minutes to pass without a C O measurement Review Curves 1 Current average of C O values click to save average appear if the values are out of range 2 Button for return...

Page 270: ...nnect them Discard the unused intermediate cable C O Out of Range High C O Out of Range Low The cardiac output value is greater than 20 liters min or less than 0 5 liter min because of the following conditions A physiological condition Unstable baseline Incorrect injectate volume catheter size or Comp Constant Defective catheter cable or cartridge Check the patient and treat if necessary Use coole...

Page 271: ...r transducer has become disconnected Reconnect the cable or transducer If message persists replace defective part C O Poor Baseline The temperature curve did not return to baseline within 30 seconds of pressing C O START because of the following conditions Unstable patient temperature Defective catheter cable or cartridge Follow hospital procedures Repeat the measurement If message persists replac...

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Page 273: ...alculations 16 3 Hemodynamic Parameters 16 5 Oxygenation and Ventilation Parameters 16 7 Lab Data 16 8 Hemodynamic Calculations Hemo Calcs 16 10 Hemo Calcs 16 10 Drug Calculations 16 12 Titration Tables 16 12 Drug Calculator Setup 16 13 Default Drug Setup Unit Manager 16 16 ...

Page 274: ...ion The monitor can also be configured to calculate drug related parameters including concentration rate total dose and total volume In addition to these standard calculation features two additional features are available with the PhysioCalcs software option Hemodynamics The monitor calculates hemodynamic parameters based on cardiac output invasive blood pressure and patient data for example heigh...

Page 275: ...ck on Hemo or Hemo Oxy Vent to display the associated calculations menu 4 Click on Capture Values to save the date and time of the capture and display the current values of input parameters You can use captured values immediately or hold them for later calculations 5 Click on Results The Calculations screen appears see the following page NOTE Before initiating a physiological calculation you must ...

Page 276: ...scroll to determine type of data displayed in View column Reference values stored via Save Reference key Normal Range standard ranges for parameter values Units units of measure for parameter values 2 View column 6 Save latest set of calculated data for display in View column 3 View category 7 Send report request to laser printer at central station 4 Display labels definitions and ranges 8 Click a...

Page 277: ...amic values using these parameters Label Parameter Value Description Derivation Units ART S Systolic Arterial Pressure Monitored input mmHg kPa ART M Mean Arterial Pressure Monitored input mmHg kPa ART D Diastolic Arterial Pressure Monitored input mmHg kPa CO CCO ICO Cardiac Output continuous intermittent Monitored input L min p CO Thermodilution Cardiac Output via the PiCCO pod Monitored input L ...

Page 278: ...r Cardiac Index via the PiCCO pod PCCO BSA L min m2 LHCP P Left Heart Coronary Perfusion Pressure ART D PWP mmHg LVSW Left Ventricular Stroke Work 0 0136 x ART M PWP x SV g x m beat LVSWI Left Ventricular Stroke Work Index 0 0136 x ART M PWP x SVI g x m m2 beat PVR Pulmonary Vascular Resistance 80 x P AM PWP CO dynes x sec x cm 5 PVRI Pulmonary Vascular Resistance Index 80 x P AM PWP CI dynes x se...

Page 279: ...ssure Monitored input mmHg PeCO2 Mixed Expired CO2 Pressure Monitored input mmHg PEEP Peak End Expiratory Pressure Monitored input cmH2O PIP Peak inspiratory Pressure Monitored input cmH2O RRc RRc RRv Respiratory Rate Monitored input L m SaO2 SaO2 Arterial Oxygen Saturation Input data SvO2 Venous Oxygen saturation Monitored input TVe Expired Tidal Volume Monitored input ml breath Label Parameter D...

Page 280: ...MV CO Ventilation Cardiac Output ratio MV alv CO None O2ER Oxygen Extraction Ratio CaO2 CvO2 CaO2 None P A a DO2 Alveolar arterial Oxygen Difference iO2 x PB 47 PaCO2 PaO2 mmHg Qs Qt Intrapulmonary Right left Shunt Percentage shunt 1 1 C a v O2 P A a O2 x 003 TVd phys Tidal Volume deadspace physiological TVe x 1 PeCO2 PaCO2 ml TVd TV phys Ratio of Tidal Volume deadspace to Tidal Volume deadspace p...

Page 281: ... lab data is available 5 Click on Capture Labs to capture blood gas values 6 Click on Calculate or Results The Calculations screen appears with updated derived parameters 1 Time date stamp indicating the time the monitor receives data Labeled according to the following criteria test time the time and date are generated by blood analysis device and sent with the lab results Arrival time the time an...

Page 282: ...ht data result in incorrect or blank output values For a complete set of calculations perform both a pulmonary wedge PWP measurement and a C O measurement Blank values on the Calculations Results screen result from failure to perform both measurements Hemo Calcs To access Hemo Calc results without locked options 1 Click on the Menu fixed key 2 Click on Review 3 Click on Calc Results to display the...

Page 283: ... WT Patient s weight as entered p CO Thermodilution Cardiac Output via the PiCCO pod PCCO Pulse Contour Cardiac Output via the PiCCO pod The monitor automatically calculates the following hemodynamic parameters Each parameter s unit of measure is indicated in parentheses SV Stroke Volume ml SVR Systemic Vascular Resistance dynes x sec x cm 5 ICI CI Intermittent Cardiac Index liters min m2 SVI Stro...

Page 284: ... is not deleted when a patient is discharged from the monitor Titration Tables After you have entered the appropriate information the monitor displays a titration table showing the units of measure you have specified on the Drug Calculator or Drug List Setup menu Rates are displayed in green in the right column Whenever you change an entry on the Drug Calculator menu the monitor automatically upda...

Page 285: ...ew a titration table using the Drug Calculator menu When you assign a drug to the Drug Dosage menu its name automatically appears on the Drug Calculator menu where you can quickly calculate a new infusion rate see page 16 14 Drug Calculator Setup The following table summarizes tasks you can perform using the Drug Calculations function Drug Calculation Task Menu Initial Step Patient specific drugs ...

Page 286: ...the name of the drug you wish to assign by clicking on the letters under the text entry window Edit your entry using the control buttons at the bottom of the screen 8 Click on Accept to confirm Calculating a Drug Use the following procedures to enter information on the Drug Calculator menu 1 Press the Fast Access fixed key The Fast Access menu appears 2 Click on Drug Dosage 3 Click on New Drug see...

Page 287: ...ver you modify the adult or pediatric daily weight entry You must enter a daily weight whenever you calculate a drug for a neonate Drug Calculator Menu Menu Item Range and Units Drug name Not applicable Weight of patient 0 255 0 kg adult pediatric 0 30 000 g neonate Amount of drug 0 100 000 000 000 micrograms mcg m units mEg mmol 0 100 000 000 milligrams mg units mol 0 100 000 grams g k units Volu...

Page 288: ...ck on Untitled or on the name of a drug you wish to change The Drug List Setup menu appears figure at right 8 Click on Name Drug to display a text entry box 9 Enter the name of the drug you wish to assign by clicking on the letters under the text entry window Edit your entry using the control buttons at the bottom of the screen 10 Click on Accept when you are done Dose weight per minute 0 1 666 66...

Page 289: ... data category A text entry box appears 3 Click successively on single digits to enter the desired value 4 Click on Change Units to modify units of measure 5 Scroll through available units of measure and click to select 6 Click on Dose Units 7 Scroll through available dose units and click to confirm 8 Click on Accept to confirm your choices ...

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Page 291: ...ient Preparation 17 7 Display Features 17 8 SpO2 Setup 17 8 Quick Reference Table SpO2 Setup 17 9 Status Messages 17 10 Monitor with Masimo Logo Status Messages 17 10 Monitor with Nellcor Logo Status Messages 17 12 Monitor Without Masimo or Nellcor Logo Status Messages 17 14 MicrO2 Standalone Pulse Oximeter 17 20 Overview 17 20 Parameters 17 21 SpO2 MicrO2 Setup 17 21 SpO2 MicrO2 Trends 17 22 Micr...

Page 292: ...cause light absorption varies with blood volume and blood volume varies with pulse rate the monitor can also derive a pulse rate PLS The SpO2 sensor available for adult pediatric and neonatal patients is connected to the monitor via the various MultiMed and NeoMed cables or the Infinity Masimo SET SpO2 SmartPod or the Infinity Nellcor Oximax SpO2 SmartPod pod Precautions Refer to the Safety Consid...

Page 293: ... premature infants receiving supplemental oxygen Inspect the application site every two to three hours to check the skin quality and correct optical alignment If the skin quality changes move the sensor to another site Change the application site at least every four hours Use only Dräger specified sensors Other sensors may not provide adequate protection against defibrillation and may put the pati...

Page 294: ... or implied license to use the device with unauthorized sensors or cables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device 1 Masimo SET logo means Masimo SET compatibility is enabled 2 X8 connector 3 Infinity Kappa 4 Masimo SET pod with X8 connection cable to monitor 5 Masimo LNOP intermediate cable 6 Masimo LNOP SpO2 ...

Page 295: ...chase of this instrument confers no express or implied license under any Nellcor patent to use this instrument with any oximetry sensor that is not manufactured or licensed by Nellcor WARNING Only use Nellcor intermediate cables and sensors recommended by Dräger 1 Nellcor Oximax logo means Nellcor Oximax compatibility is enabled 2 X8 connector 3 Infinity Kappa 4 Nellcor Oximax pod with X8 connecti...

Page 296: ...sor 8 Dräger Nellcor Intermediate cable 9 SpO2 connector on MultiMed Plus cable 10 Infinity Delta Delta XL WARNING Only use Dräger SpO2 intermediate cables and SpO2 sensors Do not use other manufacturer s cables or sensors NOTE A monitor that does not have a Masimo SET or Nellcor Oximax logo in the area near the rotary knob is compatible with OxiSure via SpO2 connector on various MultiMed cables s...

Page 297: ...s Observe proper sensor placement and cover the sensor with opaque material if interference due to ambient light is suspected 1 Select the sensor type and size best suited for your patient 2 If the sensor is reusable clean it before and after each patient use 3 Position the sensor correctly and attach it to your patient 4 Connect the sensor to the patient cable For the appropriate patient cable fo...

Page 298: ...enu fixed key 2 Click on Patient Setup 3 Click on Parameters to display a list of available parameters 4 Click on SpO2 NOTE The SpO2 pulse plethysmogram waveform is not normalized and is NOT directly proportional to the pulse amplitude The monitor automatically tries to maximize the size of this waveform so the size only decreases when the signal quality is marginal 1 SpO2 value 2 Alarm limits cro...

Page 299: ...E If the waveform height exceeds the display channel s size the waveform is clipped SpO2 signal processing is not affected 10 100 increments of 10 Averaging MultiMed cable and Nellcor Oximax pod only Determines the averaging of SpO2 values NOTE The setting Normal is less sensitive to artifact but slower to trigger an alarm The setting Fast is quicker to alarm but more sensitive to artifact NOTE Th...

Page 300: ...Not applicable Message Possible Cause Suggested Action SpO2 SpO2 The patient s SpO2 falls outside the current upper or lower alarm limits Observe the patient and treat if necessary PLS PLS The patient s pulse rate falls outside the current upper or lower alarm limits SpO2 Low limit value 20 The patient s SpO2 falls below the current lower alarm limit by 20 or more PLS Out of Range Low High The pul...

Page 301: ...ted Relocate the sensor to another extremity Contact DrägerService SpO2 No Measurement The monitor has not been able to compute a valid measurement within the last 30 seconds because of unstable measurement conditions Make sure the SpO2 sensor is properly attached to the patient at a site free of patient motion and all cables are properly connected Contact DrägerService SpO2 Regulation Error Incon...

Page 302: ...spital s technical personnel or DrägerService SpO2 Artifact Sensor Site A persistent artifact Wrong sensor and or site used High pulse amplitude Sensor not properly placed Electrical optical interference Light is blocked Make sure the SpO2 sensor is the correct type and is properly attached to the patient Make sure the patient is not moving and all cables are properly connected Make sure no electr...

Page 303: ...the cables are securely connected Check for a defective sensor SpO2 Pod Failure Pod hardware or software failure Disconnect reconnect the pod if the problem persists Disconnect reconnect the pod and or replace it with a good sensor Contact the hospital s technical personnel SpO2 compatibility is a locked option SpO2 Check replace Sensor Defective faulty sensor Replace with a Nellcor compatible sen...

Page 304: ...ected Make sure the sensor is properly attached to the patient s finger Remove the light source Cover the sensor with opaque material Make sure no ambient light can reach the detector Contact DrägerService SpO2 Unrecognized Sensor The monitor does not recognize the sensor connected as valid Check for a defective or an unapproved sensor Replace the sensor Contact the hospital s technical personnel ...

Page 305: ...nplugged The sensor cable is not connected to the MultiMed pod Make sure the cables are securely connected Check for a defective sensor SpO2 non Masimo compatible sensor A non Masimo compatible sensor or SpO2 pod is connected to a monitor that is configured for Masimo Replace with a Masimo compatible sensor Contact the hospital s technical personnel SpO2 compatibility is a locked option SpO2 non N...

Page 306: ...can reach the detector Contact DrägerService SpO2 Unrecognized Sensor The monitor does not recognize the sensor connected as valid Check for a defective or unapproved sensor Replace the sensor Contact the hospital s technical personnel or DrägerService SpO2 Artifact A persistent artifact is detected Make sure the SpO2 sensor is properly attached to the patient patient is not moving and all cables ...

Page 307: ... MultiMed pod Make sure the cables are securely connected Check for a defective sensor SpO2 non Masimo compatible sensor A non Masimo compatible sensor or SpO2 pod is connected to a monitor that is configured for Masimo Replace with a Masimo compatible sensor Contact the biomedical personnel SpO2 compatibility is a locked option Duplicate Device Connected A MultiMed pod with SpO2 sensor and an Inf...

Page 308: ...tal s technical personnel or DrägerService SpO2 Artifact Sensor Site Persistent artifact Wrong sensor and or site was used High pulse amplitude detected Sensor improperly placed Electrical optical interference Light is blocked Make sure the SpO2 sensor is of a correct type and is properly attached to the patient and that the patient is not moving and all cables are properly connected Make sure no ...

Page 309: ...roblem persists Disconnect reconnect the pod and or replace with a good sensor Contact the hospital s technical personnel SpO2 compatibility is a locked option SpO2 Check replace Sensor Defective faulty sensor Replace with a Nellcor compatible sensor Contact the hospital s technical personnel SpO2 compatibility is a locked option SPO2 non Nellcor compatible sensor A non Nellcor compatible sensor o...

Page 310: ... X8 connector via an RS232 cable When monitoring SpO2 via the MicrO2 the parameter box is labeled SpO2 SpO2 alarms are set from the Alarm Limits menu see chapter 5 SpO2 does not display a waveform and is not supported for OCRG NOTE You cannot use the remote keypad and or the Masimo SET or Nellcor Oximax pods with the MicrO2 simultaneously MicrO2 pulse oximeter is not supported on monitors with Mas...

Page 311: ... on SpO2 Label to set the label in the parameter box Choices are None Pre ductal and Post ductal If you choose None the SpO2 parameter box will have no label Click on SpO2 Alarm to go to the SpO2 entry in the Alarm Limits menu Parameter Label Units Range SpO2 SpO2 1 to 100 PLS PLS b min 30 to 250 Delta SpO2 SpO2 0 to 99 NOTE SpO2 is the absolute value of SpO2 SpO2 Both SpO2 and SpO2 must be connec...

Page 312: ...th parameter labels The PLS trend is white and PLS trend is blue 3 Click on the Cursor to see the SpO2 SpO2 and SpO2 values 4 The Trend Setup menu has combined selections for the channel in Manual Display mode for SpO2 SpO2 and also for PLS PLS If only SpO2 or SpO2 Not both are connected 1 SpO2 and SpO2 are displayed on their own trend graphs 2 PLS and PLS are displayed on their own trend graphs 3...

Page 313: ...or An invalid value was detected for the sensor calibration resistor Check for a defective or unapproved sensor Replace the sensor Contact the hospital s technical personnel or DrägerService SpO2 Light Blocked Insufficient light is reaching the sensor s light detector NOTE With detached or partially detached disposable sensors the light emitters and detectors may have become misaligned Make sure t...

Page 314: ...Error Inconsistent light level Excess ambient light Make sure the SpO2 sensor is properly attached to the patient Remove or shade any external sources of light entering the sensor Contact DrägerService SpO2 Unplugged The sensor or sensor cable is not connected to the MultiMed pod Make sure that the cables and the sensor are securely connected Check for defective sensor SpO2 Incompatible The MicrO2...

Page 315: ...t Preparation 18 4 Applying the Sensor 18 4 Hardware 18 5 Sensor Warm Up 18 5 Replacing Sensor Membranes 18 6 Calibration Unit 18 7 Calibrating the tpO2 CO2 Sensor 18 8 Display Features 18 10 tpO2 CO2 Setup 18 10 Quick Reference Table tpO2 CO2 Setup 18 11 Status Messages 18 14 ...

Page 316: ...ing the patient s oxygenation status and can reduce the number of blood gas samples needed However it is not intended to replace invasive blood gas monitoring via a blood gas device Blood gas values do not match transcutaneous gas readings NOTE Transcutaneous blood gas measurements are contraindicated for an infant patient under gas anesthesia Anesthetic agents such as halothane can cause incorrec...

Page 317: ...down as soon as the tpO2 CO2 site timer expires If the Auto Heater Shutdown function has been disabled the heater does not shut down and could burn the patient s skin Clean tpO2 CO2 sensors with the pad included in the membrane kit Do not clean the sensor surface with alcohols After applying hand lotion dry your hands thoroughly before handling the sensor and cable because lotions containing isopr...

Page 318: ...le monitoring sites Doing so will help you avoid burning or irritating the patient s sign If the skin becomes irritated simply move the sensor to a different fixation ring and allow the hyperaemia red spot to fade before reusing the earlier monitoring site If you intend to reuse a monitoring site remove excess fluid from the fixation ring after you remove the sensor 3 Degrease the patient s skin a...

Page 319: ...eriod varies it generally takes 10 to 15 minutes Values displayed in the tpO22 CO2 parameter box during calibration and the initial warm up phase are not clinically useful because the reading is only stable after the measurement site is warm and local hyperemization is complete tpO2 CO2 alarms are disabled during warm up The start and end of the warm up period are marked on the trend display with ...

Page 320: ... rings 2 Peel off the two membranes 3 Absorb the old electrolyte solution with the cleaning paper Rub the tip of the sensor two or three times to remove the thin layer of silver that may be on the tpO2 part of the sensor 4 Place two drops of electrolyte solution on the sensor surface below left Check that the solution covers the entire surface and there are no bubbles 5 Turn the sensor over as sho...

Page 321: ...LOW WARNING Gas cylinder contents are under pressure Do not puncture Do not store or use near heat or an open flame Never discard the container into fire or an incinerator Exposure to temperatures above 54 C 154 F may cause the contents to vent or the container to burst Remove the safety valve before discarding an empty gas cylinder CALIBRATION UNIT REAR VIEW FRONT VIEW 1 Reference gas cylinder 5 ...

Page 322: ... the tpO2 CO2 sensing elements can vary Calibrate with a known reference gas before each monitoring session and every few hours when in use recommendation is within two hours To calibrate the sensor 1 Attach the reference gas cylinder to the calibration unit 2 Connect one end of the nylon hose to the pipe stub on the calibration unit and the other end to the pipe stub on the pod s calibration cham...

Page 323: ... are displayed on the tpO2 CO2 menu and the site timer once it is enabled starts counting down the timed monitoring session Calibration typically takes 3 to 5 minutes The monitor performs the following functional checks Temperature Test Turns on the sensor heater and verifies the sensor heats to the set temperature 0 05 C within 3 minutes Range Test Verifies the sensor produces voltages within acc...

Page 324: ...n However the heat from the sensor may cause severe burns especially in neonates On the tpO2 CO2setup menu you can restrict the application time of the sensor and establish a temperature set point the target temperature for heating the sensor during calibration The tpO2 CO2 pod s settings for altitude and barometric pressure influence the measurement The tpO2 CO2 pod contains an internal pressure ...

Page 325: ...ttings Procedures Site Timer Limits tpO2 CO2sensor use to a specified period of time When time has expired an alarm sounds until the heater is shut down or until you place the sensor in the calibration chamber and a message is displayed on all network devices The timer starts to count down the monitoring session after sensor calibration A bar graph in the tpO2 CO2 parameter box indicates time rema...

Page 326: ...target temperature to heat the sensor during calibration NOTE The ideal sensor temperature for tpO2 CO2 monitoring on neonates is 43 C or above 99 113 F 37 45 C Current Sensor Temp Displays current temperature of sensor Display only visible only during calibration Last New Membrane Sets the date and time of installation of a new membrane Format of date and time is 10 10 Dec 14 Correction Factors S...

Page 327: ...r the barometric pressure manually and have the pressure sensor calibrated by a qualified DrägerService technician 1 Select Atm Pressure Mode on tpO2 CO2 setup menu 2 Click on Manual 3 Select the desired setting tpO2 Alarm Accesses tpO2 CO2 values in the Alarm Limits table see page 5 6 Not applicable NOTE Some tpO2 CO2 setup functions are also available on the Unit Manager menu where the unit mana...

Page 328: ... up phase has ended before relying on the displayed tpO2 CO2 values for clinical evaluation TP Sensor Unplugged The tpO2 CO2 sensor is unplugged Check all connections Replace the sensor and recalibrate if necessary TP Pod Unplugged The tpO2 CO2 pod is not connected to the monitor Check all connections Replace the pod or connecting cable if necessary Check TP Sensor Site The site timer will expire ...

Page 329: ...the cable and connections If necessary replace the cable or pod TP Drift The actual sensor temperature differs from the target temperature setting by 0 3 C Make sure the sensor is securely placed in the fixation ring and ring is properly attached to the patient Replace the sensor if necessary TP Cartridge pod Incompatible The tpO2 CO2 pod is incompatible with the monitor Replace the pod Contact Dr...

Page 330: ...18 16 DELTA DELTA XL KAPPA VF8 18 TRANSCUTANEOUS BLOOD GAS MONITORING This page intentionally left blank ...

Page 331: ...ream 19 6 Sidestream Adult and Pediatric Patients Only 19 7 Display Features 19 9 Parameters 19 9 Capnograms 19 10 etCO2 Setup 19 11 Quick Reference Table etCO2 Setup 19 12 Cleaning Calibration and Verification 19 14 Cleaning 19 14 Adapter Calibration 19 14 Sensor Calibration and Verification 19 15 Status Messages 19 16 ...

Page 332: ...For mainstream monitoring the sensor fits over a specially designed adapter in the intubated patient s airway or breathing circuit For sidestream detection a sampling pump delivers signals from the adapter to the module or pod NOTE To monitor etCO2 and other airway gases via the MultiGas module see chapter 23 Scio Four Modules To monitor airway pressure flow volume and other respiratory mechanics ...

Page 333: ...the monitor and peripherals Plug one end of connector cable into PodCom connector on left side of monitor Plug the other end into the pod 1 Sidestream input port 2 Sidestream output port 3 Capnostat sensor cable 4 PodComm connection to monitor Slide into slot on rear of monitor until the module rests securely 1 Sidestream output port 2 Sidestream input port 3 Capnostat sensor cable ...

Page 334: ...cording device While these products provide an apnea alarm that alarm condition is initiated based on the elapsed time since the last breath was detected Clinical diagnosis of a true apneic event however requires multiple physiological signals CO2 alarms do not activate until the first breath is detected after turning on the monitor or discharging a patient The accuracy of CO2 and respiration rate...

Page 335: ...es not interfere with the functioning of the suction catheter CAUTION Leaks in the breathing circuit for example an uncuffed endotracheal tube or a damaged airway adapter may significantly affect CO2 and respiratory mechanics measurement values for example airway pressure flow dead space and CO2 production Calibrate the sensor when you switch sensor types for example from adult to neonatal To prev...

Page 336: ...re clean and dry Clean or replace the adapter if necessary 5 Align the marks on bottom of the adapter with the sensor 6 Snap firmly into place 7 Insert the adapter in a vertical position between the elbow and ventilator circuit Y 8 Position sensor cable away from patient 9 Confirm proper connection on the etCO2 setup menu NOTE During nebulization or suction for intubated patients remove the sampli...

Page 337: ...e via sidestream monitoring Sidestream Monitoring Setup 1 Click on the etCO2 parameter box to access the setup menu 2 Click on Measurement Mode 3 Click on Side 4 Make sure the sidestream pump in the etCO2 device turns on and that you feel suction at the input port 5 Select a sidestream airway adapter Make sure the windows are clean and dry Clean or replace the adapter if necessary 6 Use the sidest...

Page 338: ...you used in step and click to confirm your choice 13 Insert the cannula tips into the patient s nostrils pass the cannula tubing behind the ears and slide the retaining sleeve up so that the tubing is snug under the chin 14 Secure the CAPNOSTAT sensor to the bedding or to the patient s bedclothing 15 Make sure the sensor cabling and nasal cannula tubing are secured and out of the patient s way NOT...

Page 339: ...d etCO2 values see chapter 6 Trends Parameters The etCO2 parameter box displays the following parameters and their current values 1 End tidal CO2 value highest average CO2 in the airway during expiratory period 5 Inspired CO2 value minimum average value of CO2 in the airway over the inspiratory period 2 Upper alarm limit 6 Respiration rate 3 Lower alarm limit 7 Respiration icon blinks with each br...

Page 340: ...es Alveolar plateau shows downward slope that merges with descending limb Inadequate Seal Around Endotracheal Tube Leaky or deflated endotracheal or tracheostomy cuff Artificial airway that is too small for the patient Elevated waveform baseline with corresponding increase in etCO2 level Rebreathing Insufficient expiratory time Faulty expiratory valve Inadequate inspiratory flow Malfunction of a C...

Page 341: ... appears 2 Click on Patient Setup A list of available patient setup functions appears 3 Click on Parameters in the second column A list of available parameters appears 4 Click on etCO2 The etCO2 setup menu appears Change in slope of ascending limb Possible absence of an alveolar plateau Obstruction in Apparatus Partial obstruction in expiratory limb of breathing circuit Foreign body in upper airwa...

Page 342: ...r module Agent Compensation pod only Sets value of primary expired anesthetic agent 1 20 Gas Compensation pod only Determines gas percentages for inspiratory and expiratory breathing The table below lists settings on the Gas Compensation menu in the first column and lists automatically calculated percentages in the right five columns Air N2O O2 60 O2 Heliox N2O Compensation module only Compensates...

Page 343: ...ing to Manual Auto Manual Atm Pressure This is the current atmospheric pressure This function is ghosted if you have selected Auto under Atm Pressure Mode 540 to 800 mmHg in increments of 5 Measurement Mode Configures the monitor for mainstream or sidestream monitoring Main Side Respiration Filter module only Filters signal artifact caused by cardiogenic oscillations or Baines rebreathing bumps wh...

Page 344: ...up menu 2 Click on Adapter Cal A popup message etCO2 Place Adapter in Room Air appears Connect the CO2 sensor onto the airway adapter and hold them away from any source of CO2 including the patient s mouth and your own 3 Click on Continue The calibration takes approximately 15 seconds during which the message etCO2 Calibrating Adapter appears 4 When calibration is successful the monitor displays t...

Page 345: ...ays a message informing you that the sensor is warming up 2 minutes at room temperature 3 When the sensor reaches a stable temperature the monitor instructs you to place the sensor on the zero cell 4 Locate the zero and reference cells on the sensor cable 5 Place the sensor on the zero cell The calibration process begins automatically and takes about 20 seconds 6 When calibration is complete the m...

Page 346: ...essure If automatic pressure required contact the hospital s technical personnel etCO2 Sensor Unplugged The etCO2 sensor has been disconnected Disconnect then reconnect the etCO2 sensor If the message persists try another sensor etCO2 Sensor Warming Up The CAPNOSTAT has not yet reached a stable temperature Wait for the sensor to warm up up to three minutes at room temperature If the message fails ...

Page 347: ...on on the zero cell failed Recalibrate If the message persists try a new sensor etCO2 Verifying Sensor Cal Calibrating on reference cell in progress Informational message no action required etCO2 Sensor Cal Verified Verification completed successfully Informational message no action required etCO2 Calibrating Adapter The airway adapter calibration zeroing in room air is in progress Informational m...

Page 348: ...alibrate pump Calibrate the new adapter etCO2 Tubing Blocked Sidestream tubing obstructed or the filter is clogged Clear blockage in the tubing Replace the module pod etCO2 Tubing Leak The sidestream tubing has a leak Change the tubing etCO2 module Disconnected The etCO2 module is not connected to the monitor Check cable and connection Replace cable if necessary etCO2 module Incompatible Corrupt E...

Page 349: ...0 2 Precautions 20 2 Connection 20 3 Monitor Pod Connection 20 3 Accessory connection 20 3 etCO2 Display Features 20 4 Parameters 20 4 Capnograms 20 5 etCO2 Setup 20 6 Quick Reference Table etCO2 Setup 20 7 Calibration 20 7 Status Messages 20 8 ...

Page 350: ...ple flow rate of 50 mL min and requires a proprietary sample line accessory and connects to the monitor via PodCom Precautions Refer to the general precautions section for etCO2 on page 19 2 CAUTION To avoid blocking the sampling tube do not attempt to sterilize the Microstream pod by immersing it in liquids Do not obstruct the exhaust port on the Microstream pod because it prevents air flow NOTE ...

Page 351: ... PodCom connectors on the monitor the second PodCom connector is optional on the Delta 2 Plug the other end of the cable into the Microstream pod Accessory connection Select the appropriate sample line according to your monitoring needs NOTE For a complete list of Microstream accessories provided by Dräger for this product see page C 24 1 Accessory connection 2 Exhaust port 3 PodCom connection to ...

Page 352: ...ting a sampling line to the monitor move the cover of the CO2 port to the side insert the sampling line connector into the CO2 port then turn the connector clockwise to secure it in place This ensures that gas does not leak from the connection point and helps to ensure that measurement accuracy is not compromised 1 End tidal CO2 value highest CO2 in the airway during expiratory period 5 Inspired C...

Page 353: ...eolar plateau shows downward slope that merges with descending limb Inadequate seal around endotracheal tube Leaky or deflated endotracheal or tracheostomy cuff Artificial airway that is too small for the patient Elevated waveform baseline with corresponding increase in etCO2 level Rebreathing Insufficient expiratory time Faulty expiratory valve Inadequate inspiratory flow Malfunction of a CO2 abs...

Page 354: ...lick on Parameters in the second column A list of available parameters appears 4 Click on etCO2 The etCO2 setup menu appears Change in slope of ascending limb Possible absence of an alveolar plateau Obstruction in apparatus Partial obstruction in expiratory limb of breathing circuit Foreign body in upper airway Partially kinked or occluded artificial airway Herniated endotracheal tracheostomy tube...

Page 355: ...l s technical personnel for further information Function Description Settings Scale Determines size of currently displayed waveform 40 mmHg 60 mmHg 80 mmHg 100 mmHg Respiratory Sweep Speed Sets waveform sweep speed on screen display 6 25 mm s 12 5 mm s 25 mm s 50 mm s Averaging Sets interval for CO2 measurements NOTE The monitor reports the maximum value of etCO2 during the specified sampling inte...

Page 356: ...ethe tubing etCO2 Tubing Blocked The FilterLine is obstructed Disconnect and reconnect the FilterLine Disconnect and replace with new FilterLine etCO2 Zeroing Autozero in progress Informational message no action required etCO2 Zero Failed Autozero unsuccessful Retry to autozero Return the pod to the hospital s technical personnel etCO2 Zero Accepted Autozero completed successfully Informational me...

Page 357: ... EEPROM The wrong software or hardware version Try a new pod Consult the hospital s technical personnel Disconnect Duplicate etCO2 pods Multiple pods are connected Disconnect unwanted duplicate pod Service etCO2 pod Pod must be serviced if pump hrs 20 000 hrs Contact DrägerService or replace pod CO2 H W Problem Microstream pod hardware malfunction Disconnect the Microstream pod then reconnect it I...

Page 358: ...20 10 DELTA DELTA XL KAPPA VF8 20 MICROSTREAM ETCO2 MONITORING This page left blank intentionally ...

Page 359: ...ge Sensor Function 21 7 Paw and Vent Setup Menus 21 7 Quick Reference Table Paw and Vent Setup 21 8 Display Features 21 10 Display Parameters Main Screen 21 11 Additional Display Parameters 21 12 Key Concepts of Respiratory Mechanics 21 18 Waveforms 21 20 Loops 21 20 Alarms 21 24 Cleaning and Calibration 21 24 Status Messages 21 24 ...

Page 360: ...se the pod obtains readings for the following End tidal CO2 etCO2 Respiratory mechanics Both etCO2 and respiratory mechanics Precautions Refer to the general precautions section for etCO2 see page 19 3 NOTE This chapter deals exclusively with respiratory mechanics monitoring For information about monitoring etCO2 see chapter 19 You cannot conduct sidestream measurements of etCO2 using the etCO2 Re...

Page 361: ...y mechanics parameters may result Fluid that accumulates in the etCO2 Flow and Flow airway adapter sensors or sensor tubing may cause the reported tidal and minute volumes to be higher than set volumes If reported values are significantly different than expected manually purge the sensor tubing If purging does not clear the fluid replace the airway adapter sensor To avoid accidental disconnections...

Page 362: ... a sign of inaccuracy in either device as the actual quantities being measured at the endotracheal tube and the ventilator may indeed differ Discrepancies can be attributed to a number of factors including compliancy of the tubing airway resistance and heat and humidity of patient expiration Because some ventilators try to compensate for the difference readings may be nearly identical Measurements...

Page 363: ...ensor 2 Plug the sensor tubing into the etCO2 Respiratory Mechanics pod 3 Connect the flow sensor to the breathing circuit as shown in the following illustration A message at the top left of the screen confirms the size of the sensor and its correct connection Sensor Type ETT Size Tidal Volume Patient Age Flow Neonatal 4 mm 1 100 ml Not specified Flow Adult Pediatric 4 mm 200 3000 ml Not specified...

Page 364: ...Flow sensor 4 Connect the etCO2 Flow sensor to the patient breathing apparatus as shown in etCO2 Flow Breathing Circuit Setup on page 21 6 A message at the top of the screen confirms the sensor size and its proper connection 5 Follow procedures for etCO2 mainstream setup page 19 6 ADULT PEDIATRIC PEDIATRIC or NEONATAL Combined etCO2 Flow Sensors To pod To pod To ventilator To ventilator To patient...

Page 365: ... and Flow Volume Vent setup menus you can configure the monitor to display respiratory mechanics parameters To access respiratory mechanics parameters setup menus Click on the parameter box labeled Paw on the main screen to open the Airway Pressure setup menu or Vent to open the Flow Volume setup menu Each of these setup menus has a second page that is displayed by clicking on the more arrow at th...

Page 366: ...shold Sets the pressure level used to distinguish spontaneous breathing from mechanical breathing 0 50 cmH2O NOTE The Mech Spon threshold item may require adjustment based on the patient s PIP value for pressure support ventilator modes If adjustment is not made all breaths will be considered mechanical The appropriate level for the threshold depends on the ventilator Gas Compensation Informs the ...

Page 367: ...ow parameters are frozen during purging Waveforms are not drawn MVe Alarm Opens the Alarm Limits table beginning at MVe setting Not applicable Gas Compensation Informs the monitor of ventilation gas in current use See page 19 12 for more information on gas compensation Air N2O O2 60 Heliox NOTE N2O O2 is available in OR mode only Agent Concentration available in OR mode only Informs the monitor of...

Page 368: ...e number and screen position of the parameter boxes depends on your configuration of the Main Screen menu See page 2 5 for instructions on configuring the main screen Split Screen Configures the main screen to display ventilator or trend data and standard waveforms and parameters OFF 60 Min Trends 10 Min Trends Ventilation Function Description Settings VENT Setup Menu 1 Flow volume Vent waveform a...

Page 369: ...er boxes To select the parameters you wish to display in the main screen parameter box open the appropriate setup menu as follows Click on the parameter box labeled Paw airway pressure or Vent Flow Volume or 1 Press the Menu fixed key on the front of the monitor 2 Click on Patient Setup 3 Click on Parameters A list of available parameters appears 4 Click on Paw or Vent To set up respiratory mechan...

Page 370: ... varies according to the View control key setting and the sensor you use Paw Parameter Box Airway Pressure Parameters Vent Parameter Box Airway Flow and Volume Parameters PIP Peak Inspiratory Pressure PIF Peak Inspiratory Flow PEEP Positive End Expiratory Pressure PEF Peak Expiratory Flow MAP Mean Airway Pressure TVi Inspired Tidal Volume Pause Pause Pressure TVe Expired Tidal Volume MVe Expired M...

Page 371: ... the available settings Intermittent Vent Controlled Vent Assisted Vent and click to select a ventilation mode Screen Configurations Neonatal The following illustrations show the Respiratory Mechanics screen variously configured according to flow sensor type neonatal pediatric or adult and View setting intermittent controlled or assisted For parameter definitions units of measure and derivations s...

Page 372: ...21 14 DELTA DELTA XL KAPPA VF8 21 RESPIRATORY MECHANICS T NEONATAL FLOW SENSOR ...

Page 373: ...DISPLAY FEATURES VF8 DELTA DELTA XL KAPPA 21 15 Screen Configurations Adult and Pediatric ADULT and PEDIATRIC FLOW SENSOR ...

Page 374: ...ater than TVe Label Description Derivation Units C20 Cdyn C20 Cdyn Ratio mechanical Ratio of the compliance of the last 20 of inspiration over dynamic lung compliance available only when neonatal sensor is used Cdyn Lung Compliance Dynamic mechanical Ratio of change in volume over change in pressure during inspiration mL cmH2O I E Ratio of Inspiratory to Expiratory Time Ratio of inspiratory time t...

Page 375: ...sec TV lk ET tube leakage mechanical Difference between expired and inspired tidal volume expressed as a percent in mechanical breaths 100 x TVi m TV e m TV i TValv Alveolar Tidal Volume Average volume calculated from difference of expired volume and airway deadspace TVe TVd aw mL TVCO2 CO2 Tidal Volume Volume of CO2 expired per breath calculated from concentration of expired CO2 less concentratio...

Page 376: ...ey Concepts of Respiratory Mechanics Flow waveform showing breath Intervals Inspiration and Expiration Flow waveform showing peak inspiratory flow PIF peak expiratory flow PEF inspiratory volume Vi and expiratory volume Ve Expiration Inspiration PIF Vi PEF Ve ...

Page 377: ...SPLAY FEATURES VF8 DELTA DELTA XL KAPPA 21 19 Pressure waveform showing peak inspiratory pressure PIP pause pressure PAUSE mean airway pressure MAP and peak end expiratory pressure PEEP Dynamic Compliance ...

Page 378: ...r Use the Menu fixed key see page 21 11 to get to the Paw or Vent setup menu 2 Click on Paw Scale on Paw menu or Flow Scale Vol Scale on Vent menu Available settings vary according to the type of waveform you wish to configure See page 21 8 for more information about these settings 3 Scroll to the desired size and click to confirm your choice Loops Loops are graphical representations of waveform d...

Page 379: ...me loops report mechanical and spontaneous breaths the same way Inspiration begins at the origin and moves upward and left to right clockwise Expiration plots below the horizontal axis and progresses right to left in a return to the origin The Flow Volume loop display shows the corresponding PEF value see illustration on page 21 16 Displaying Loops 1 Open the Paw or Vent setup menu see page 21 11 ...

Page 380: ...d click on the More arrow to get to the second page 3 Click on Loop Draw 4 Select 1 or 4 to set the number of display loops or Use the Loop Draw control key at the bottom of the loop display Displaying Loops on page 21 21 to set the number of loops 1 Pressure Volume waveform 2 Display or hide grid 3 Pressure scale 4 Set number of loops displayed 5 Clear reference loop from screen 6 Save last compl...

Page 381: ...lick on Ventilation 5 Press the main screen fixed key and the small loop display appears in the upper left corner To learn more about Paw or Vent menu selections see the Quick Reference Table Paw and Vent Setup on page 21 8 Alarms The following alarms annunciate if they are enabled when the etCO2 Respiratory Mechanics pod detects a violation of alarm limits PIP high priority alarm user sets upper ...

Page 382: ... measurements Check the patient and the airway circuit Flow Adult Pediatric Sensor Pediatric Sensor Neonatal Sensor Indicated Flow or CO2 Flow sensor connected Verify that the flow or the etCO2 flow sensor type matches the patient category Flow Invalid Sensor An unknown sensor is connected Replace the sensor Flow Purge in Progress Purging flow sensors and tubing None Flow Unable to Zero Purge Sens...

Page 383: ...od etCO2 module and or etCO2 respiratory mechanics pod are connected at the same time Disconnect the redundant source of etCO2 NOTE Messages are valid only when an etCO2 Respiratory Mechanics pod is connected with the exception of Flow Sensor Disconnected Message Condition Suggested action ...

Page 384: ...21 26 DELTA DELTA XL KAPPA VF8 21 RESPIRATORY MECHANICS This page intentionally left blank ...

Page 385: ...22 FiO2 Fractional Inspired O2 monitoring Overview 22 2 Precautions 22 2 Display Features 22 3 FiO2 Setup 22 3 Menu Access 22 4 Calibration 22 4 Status Messages 22 6 ...

Page 386: ...ent of oxygen being monitored stays the same Changes in humidity change the percentage of oxygen in the air but not the partial pressure As a result the reading does not change and may not accurately reflect the concentration of oxygen For example if 100 oxygen is displayed as saturated with 100 humidity the actual concentration of oxygen is 97 The FiO2 sensor which has a minimal response to gases...

Page 387: ... Neonatal 2 Plug an FiO2 sensor cable into the FiO2 connector on the NeoMed pod 3 Plug the NeoMed pod into the MultiMed connector on the monitor 4 Attach a sensor into the FiO2 sensor cable Push the sensor firmly into cable receptacle until you hear it click 5 Place the sensor in the incubator or under the oxygen hood 1 FiO2 value and label 2 Alarm limits crossed bell icon if alarm is disabled 3 A...

Page 388: ...ted There are two types of calibration 1 point calibration measures the oxygen in room air typically 21 and calibrates the monitor to that measurement A 2 point calibration uses two measurements room air and 100 oxygen to calibrate the monitor A 2 point calibration provides more accurate FiO2 monitoring because the monitor is calibrated to two different measurements 1 point calibration should be p...

Page 389: ...bration Cal Gas A 2 point calibration of the system to 100 dry oxygen and room air 21 oxygen should be performed every week 1 Make sure the monitor is turned on that the NeoMed pod is properly connected and set up for FiO2 monitoring 2 Set up the sensor for O2 calibration following your hospital s guidelines 3 Open the FiO2 menu see page 22 4 4 Click on 2 Point Cal 5 Supply 100 O2 when instructed ...

Page 390: ...in Progress The monitor is performing a 21 1 point calibration Wait FiO2 100 Cal in Progress The monitor is performing a 100 2 point calibration Wait FiO2 Cal Required The sensor needs to be calibrated Perform a calibration FiO2 Cal Paused The monitor is waiting for the sensor to be exposed to room air during 2 point calibration Remove the sensor from the T piece and expose it to room air FiO2 H W...

Page 391: ...23 10 Warm Up 23 11 Calibration 23 12 Scio Setup 23 12 etCO2 Monitoring 23 12 O2 N2O Monitoring Scio Four Oxi plus and Scio Four Oxi only 23 15 N2O Monitoring Scio Four plus and Scio Four only 23 17 Agent Monitoring 23 18 Combined Display O2 Agent N2O Scio Four Oxi plus only 23 22 Dual Agent Display Scio Four Oxi plus Scio Four plus only 23 24 Maintenance and Repair 23 24 Changing the Sampling Tub...

Page 392: ...s can interface with specific third party devices via an MIB protocol converter A Scio module is a free standing unit that samples breathing gases from adult and pediatric patients in non partial and total rebreathing systems NOTE The Dräger MultiGas and MultiGas modules are not supported by the Infinity Delta Series VF6 software and higher NOTE The Scio module comes in four different models with ...

Page 393: ... mixture You must manually select the primary anesthetic agent see page 23 21 The Scio Four Oxi communicates real time and derived gas information to the host system The monitor saves values derived by the modules in its trend storage The Scio Four Oxi module calculates both inspiratory and expiratory O2 values iO2 and etO2 Scio Four plus The Scio Four plus continuously measures the content of CO2...

Page 394: ...t amounts of light A paramagnetic cell is used for the measurement of O2 This cell uses a physical reaction that is proportional to the O2 concentration Mechanical shocks during measurement or the presence of other paramagnetic agents can distort the measurement of oxygen concentration Due to the response time of the sensors and the gas sample flow rate the stated accuracy of O2 CO2 N2O and anesth...

Page 395: ...uit with fresh gas at regular intervals The presence of aerosols in the breathing circuit should be avoided displayed agent concentration may be affected and or watertrap membrane may be affected Always use Dräger specified Scio polypropylene sampling tubing Never use standard pressure sensor tubing PVC because it absorbs anesthetic agents which are released later degassing resulting in erroneous ...

Page 396: ...roximately once every two hours The typical purging zeroing cycle lasts no longer than 25 seconds Waveforms flatline and parameter box values blank from the screen during this cycle The message Multigas Zero in Progress appears in the message box An extended zeroing cycle may be performed after the unit is initially powered up NOTE In case of a power outage the Scio module shuts off and when power...

Page 397: ...l 3 Fan exhaust screen 11 Software version label 4 X2 connector 12 RS232C connector X2 9 pin 5 Safety label Attention Consult the accompanying document 13 Medibus connector 6 Exhaust port 14 Hardware version label 7 Safety label Gas out 15 Model name example only 8 External power supply connector Scio Module 6871255 Back Panel Scio Module 6871450 Back Panel ...

Page 398: ...ilation holes on the underside are not obstructed Place the module at least 25 cm 10 inches from any possible source of ignition such as sparking Place the module close enough to the patient so that the sampling tubing can reach the airway T connector and the exhaust tubing the hospital s exhaust gas scavenging system without stretching Installing the Water Trap Install the water trap into its rec...

Page 399: ...r 1 To the IDS Kappa via a Scio connecting cable PN 7876878 or 7876886 in the X3 Scio ISD connector 2 To the IDS Kappa via a Scio connecting cable PN 78 76 878 or 7876886 with a Scio Y cable MS13749 in the X3 Scio ISD connector 3 To the Delta Delta XL Kappa monitor directly via the Scio Direct Connect cable PN 6871581 in the X8 connector Kappa Left View 1 Scio connector cable connector X3 2 Scio I...

Page 400: ...t clicks into place For other breathing systems Use the sample gas return kit with an integrated bacterial filter and connect it to the breathing system used adjacent to the expired gas valve so that the returned sample gas is routed through the CO2 absorber NOTE Do not use the module without a water trap NOTE If possible use sample gas recirculation for the following reasons To prevent increased ...

Page 401: ...ect the power supply cord to a hospital outlet Warm Up Upon start up the Scio module passes through an initialization and warm up period During this time the etCO2 in some models O2 and or agent parameter boxes display a question mark NOTE The exhaust port is a hose barb type connector CAUTION During warm up reported values might not be accurate To achieve full accuracy a typical warm up period of...

Page 402: ...ox displays the following current values Inspired CO2 iCO2 The level of CO2 in the airway during the inspi ration phase End tidal CO2 etCO2 The level of CO2 in the airway at the end of expiration Respiration Rate RRc The patient s respiration rate derived from the etCO2 signal by calculating an average rate over the two most recent breaths NOTE Some Scio parameter labels are marked by an asterisk ...

Page 403: ...waveform scale 40 60 80 mmHg Respiratory Sweep Speed Sets waveform sweep speed on screen display 6 25 12 5 25 50 mm s Agent Display Displays a separate agent parameter box Ghosted if the monitor is displaying combined MultiGas parameter box see page 23 22 ON OFF Pressure Comp Sets the compensation for ambient atmospheric pressure Auto 760 mmHg RRc Apnea Time Sets the time that the monitor waits be...

Page 404: ...calibrated against room air Parameter values disappear during zeroing One minute before automatic zeroing the monitor sounds an attention tone and displays the message Auto zero in 1 minute Not applicable etCO2 Alarms Accesses etCO2 alarms in Alarm Limits table see chapter 5 WARNING etCO2 alarms do not activate until the first breath is detected after turning on the monitor or discharging a patien...

Page 405: ...her or not the N2O display is turned on in the O2 menu Typical O2 N2O parameter box displays are shown below To access the O2 N2O setup menu Click on the O2 N2O parameter box or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameters to display a list of available parameters 4 Click on O2 Parameter Box Description Scio module N2O display turned off This module calculates both iO2...

Page 406: ...is displaying a combined MultiGas parameter box see page 23 22 N2O alarms are not supported so N2O alarm limits do not appear in the parameter box ON OFF MultiGas Zero Manually zeroes the Scio module NOTE During zeroing the monitor temporarily blanks Scio parameter values Not applicable Auto Zero Delay Delays automatic zeroing for 5 minutes for uninterrupted monitoring see page 23 13 for informati...

Page 407: ...lay a list of available parameters 4 Click on N2O Quick Reference Table N2O Setup Click on the following items to execute N2O setup functions Parameter Box Description NOTE The parameter box does not show N2O alarm limits because N2O does not alarm N2O Setup Menu Menu Item Description Settings MultiGas Parameter Enables combined MultiGas parameter box display see page 23 22 ON OFF MultiGas Zero Ma...

Page 408: ... is a change of the anesthetic agent during monitoring the parameter box displays the label MIXED and replaces the concentration values with asterisks The mixed label for example HAL HAL indicates the agent that has the highest level of concentration This label will switch to that of the second administered agent when its concentration exceeds that of the first agent NOTE If the monitor displays a...

Page 409: ...ry agent concentrations The table below shows typical agent parameter box displays when using standard MAC values NOTE When connected via a Scio connecting cable PN 7876878 or 7876886 to the X3 or Scio ISD connector the setting chosen in the MAC Calc menu determines whether standard or age based MAC values are used Consult the drug package insert regarding MAC and age for inhaled agents Agent Conc...

Page 410: ...d as a basis for all MAC calculations related to the age of the patient The table below shows typical agent parameter box displays when using age based MAC values CAUTION Age based MAC values only apply if the patient s age is 1 year An age based MAC of 1 year is used if the patient s age is 1 year If the patient age is not entered the default age based MAC of 40 years is used Agent Concentrations...

Page 411: ...age 23 22 ON OFF Agent ID Scio Four Oxi and Scio Four only Configures the Scio Four Oxi or Scio Four module to measure the concentration levels of a user specified anesthetic agent WARNING Use care when setting the agent ID manually Measurements will be inaccurate if the wrong agent ID is selected Scio Four Oxi Scio Four cannot recognize anesthetic gas mixtures Measurements will be inaccurate if a...

Page 412: ... access the combined O2 Agent N2O setup menu 1 Check that MultiGas Parameter selection is set to ON 2 Return to the main screen 3 Click on the O2 Agent N2O combined parameter box Parameter Box Description The Scio module has identified an agent and displays concentration levels for O2 isoflurane and N2O NOTE The combined MultiGas parameter box takes the place of the O2 parameter box on the main sc...

Page 413: ...e 23 21 ON OFF NOTE During the combined display the N2O and agent displays are automatically turned on and their selections are ghosted on the combined menu You can only access these selections and turn the displays off once you have turned off the combined MultiGas parameter display Agent Scale Sets the agent waveform scale 1 20 in increments of 1 MultiGas Zero Manually zeroes the Scio module NOT...

Page 414: ...est the ground resistance chassis and patient leakage currents as well as all alarm functions Make sure that all safety labels are legible Maintain a record of these safety inspections Changing the Sampling Tubing and T Connector The sampling tubing and T connector that connect the Scio module to the patient s airway are not reusable They must be replaced under the following conditions A new patie...

Page 415: ...contents into syringe 5 Remove the syringe and discard it 6 Reseat water trap by pressing it against the Scio A click will indicate that it is seated properly 7 Reconnect the sampling tubing before monitoring a new patient exchange the tubing and T connector see page 23 24 To Replace the Water Trap 1 Disconnect the sampling tubing 2 Remove the trap from its connector by holding it firmly on the ri...

Page 416: ...any accumulation of dust at the fan port 4 Insert a new filter Status Messages Message Condition Suggested Action i parameter et parameter The inspired or expired concentrations of the parameter fall outside the current upper or lower alarm limits for that parameter Check the patient and treat if necessary Adjust the alarm limits for that parameter i parameter out of range high i parameter out of ...

Page 417: ...ful Informational message no action is required MultiGas Zero Failed Zero performed using the wrong gas Occlusion or leak present HW problem Verify that anesthetic gases have not contaminated the surrounding atmosphere Check for leaks and occlusions Call the manufacturer Check Watertrap Sample Line The water trap is full or the sample line is blocked Replace the sample line Empty or the replace wa...

Page 418: ...cted Check the connection and reconnect if necessary Call the manufacturer MultiGas H W failure Loss of communication or hardware problem Check the connections Unplug and re plug the Scio module Power cycle the monitor or undock and redock the monitor Call the manufacturer Message Condition Suggested Action ...

Page 419: ...2 Precautions 24 3 Connections 24 4 Monitoring Modes 24 5 Single Twitch Mode 24 5 Train of Four TOF 24 5 Post Tetanic Count PTC 24 6 Taking NMT Measurements 24 6 Clear NMT References 24 7 Quick Reference Table NMT Monitoring Settings 24 8 Status Messages 24 9 ...

Page 420: ...bers in the nerve Once the supramaximal current has been established the pod performs a reference measurement consisting of four pulses to establish a reference muscle response level reference twitch in the unrelaxed patient In subsequent measurements the pod can compare the relaxed patient s muscle responses to this reference twitch NMT values are displayed in the NMT parameter box and saved as t...

Page 421: ... site and damage to the NMT pod Use peripheral nerve stimulator electrodes with circular conductive areas between 1 cm 39 in and 1 5 cm 59 in in diameter Apply these electrodes according to the Instructions for Use Pay special attention to current densities 2 mA r m s cm2 Stimulation voltage should not exceed the maximum specified by the electrode manufacturer To avoid serious injury to the patien...

Page 422: ...o the Trident pod NMT connector 1 NMT intermediate cable 2 Red positive electrode grabber 3 Black negative electrode grabber 4 NMT hand adapter 5 PodCom cable NOTE Check that the thumb can move unconstrained before applying NMT sensor An EEG or BisX pod can connect to the monitor directly or via the NMT pod s EEG connector See chapter 11 for details about EEG monitoring and chapter 25 for details ...

Page 423: ...eference twitch it uses an internal reference value for single mode measurements Train of Four TOF In this mode default the pod sends a sequence of four stimulation pulses 0 5 seconds apart and measures the magnitude of the resulting muscle twitch after each individual pulse The pod then calculates a TOF response value TOF ratio from 4 to 100 using the ratio between the fourth twitch and the first...

Page 424: ...ockade Measurement intervals are not available in the PTC mode If you want to return to automatic measurement cycles after a PTC measurement select the single or TOF monitoring mode and restart measurements Taking NMT Measurements To access the NMT Setup menu 1 Click on the NMT parameter box on the Main Screen if displayed or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameter...

Page 425: ...ed supramaximal current and reference twitch click on Clear NMT References After you clear NMT references new references are automatically recalculated at the next measurement NOTE To stop stimulation in an emergency disconnect the PodCom cable from the monitor NOTE If the pod cannot establish reference values or if you wish to start over clear the stored references and repeat the startup procedur...

Page 426: ...Allows you to select duration for stimulation pulse 100 µs 200 µs default 300 µs Stim Current Mode Allows you to select stimulation current mode In auto mode the pod establishes a supramaximal current during the first measurement and uses it for subsequent measurements In manual mode the user selects a stimulation current Auto default Manual Stim Current Allows you to select stimulation current re...

Page 427: ...f Record Store Str Rec Message Possible Cause Suggested Action NMT Initializing The pod is performing power up self tests Supramaximal current and reference twitch detected The pod is recalibrating due to a rapid change in twitch amplitude Wait until the self tests are completed Wait until the references are established Wait or cancel reapply and retry NMT Using internal reference Reference twitch...

Page 428: ...high low Check the patient and treat if necessary Check the sensor and replace if necessary NMT TOF Cnt UL TOF Cnt LL The number of twitches fall outside the set alarm limits Check the patient and treat if necessary Change the alarm limits as appropriate NMT Single Out of Range High The single mode parameter value is outside the measuring range high Check the patient and treat if necessary NMT Pod...

Page 429: ...x monitoring Overview 25 2 Precautions 25 2 Patient Preparation 25 3 Display Features 25 3 Connecting the BISx Pod 25 4 BIS Setup 25 5 Quick Reference Table BIS Setup menu 25 6 Checking the Impedance 25 8 Status Messages 25 9 ...

Page 430: ...istration may be associated with the reduction of the incidence of awareness with recall during general anesthesia and sedation Precautions Refer to the Safety Considerations section starting on page 6 at the beginning of these Instructions for Use for general precautions regarding safe device operation CAUTION Use clinical judgment in conjunction with other clinical vital signs to interpret BIS v...

Page 431: ...sor package instructions for patient skin preparation and correct placement Display Features BIS parameters are displayed in the BIS parameter box An associated EEG waveform can also be displayed In the BIS parameter box the display of BIS alarms alarm limits and parameter values follows the standard display of other parameters 1 BIS label 2 BIS value and alarm limits 3 SQI value 4 EMG value 0 to ...

Page 432: ...he sensor cable Attach the BISx pod to an IV pole bed rail or clip it to a bedsheet NOTE An automatic sensor impedance check is initiated each time a BIS sensor is connected to the sensor cable All signal status messages and alarms are suppressed for 60 seconds after a sensor impedance check has ended This allows time for signal quality to recover 1 Sensor cable 2 BISx pod 3 BIS sensor 4 PodCom co...

Page 433: ...BIS setup menu Click on the BIS parameter box if displayed or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameters 4 Click on BIS NOTE Before starting BIS monitoring check that the sensor is connected properly and has passed the impedance check ...

Page 434: ...f the Parameter box above EMG EMG Electromyograph Indicator Range 0 100 dB The power in decibels in the frequency range 70 110Hz is labeled EMG This frequency range contains power from muscle activity as well as power from other high frequency artifacts It is displayed as a simple bar graph located at the bottom of the parameter box below SQI BSR Suppression ratio range 0 100 A calculated paramete...

Page 435: ...of the sensor for more information see page 25 8 Not applicable BISsmoothing rate Selects the smoothing rate at which BIS value is averaged 15 sec default More responsive to state changes for example induction or awakening 30 sec A smoother trend lower variability and less sensitive to artifact Filter Allows you to set filters to ON or OFF NOTE The BISx pod uses filters to screen out undesirable i...

Page 436: ...ck on the BIS parameter box if displayed or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameters 4 Click on BIS 5 Click on Check impedance The BIS impedance menu depicted below classifies the status of each electrode Pass Indicates that the impedance check has passed based on the combined electrode impedance values You can exit the impedance menu and resume normal monitoring F...

Page 437: ...lace the sensor if necessary and perform a manual impedance check Replace the sensor cable BIS UL BIS LL The BIS parameter value is above higher below lower alarm limit Check the patient and treat if necessary Change the alarm limits as appropriate BIS EMG Out of Range High The EMG parameter value is out of range high Check the sensor Isolate the patient from auxiliary equipment if necessary Isola...

Page 438: ... if necessary BIS Pod Failure BISx pod self test failed BISx pod hardware failure BISx pod software failure Defective sensor Check the BISx pod connection Replace the sensor then disconnect and reconnect the pod to continue monitoring Call your hospital s technical personnel or DrägerService Duplicate devices connected Multiple BISx pods or MIB BIS is connected Disconnect the unwanted duplicate po...

Page 439: ...isplay Features 26 15 PiCCO Parameter Setup 26 16 Quick Reference PiCCO Setup 26 18 Optimizing Results for PiCCO Measurements 26 23 Blood temperature baseline 26 23 Arterial blood pressure signal 26 23 Central Venous pressure 26 24 Amount of Bolus 26 24 Temperature of Injectate 26 24 Injection time 26 24 Catheter types 26 25 Thermodilution TD Measurements 26 25 Cables 26 25 General measurement pro...

Page 440: ...es a calibration factor cal determined by the thermodilution cardiac output measurement and the heart rate as well as the integrated values for the area under the systolic part of the pressure curve the aortic compliance and the shape of the pressure curve represented by change of pressure over change of time 0 25 to 25 L min Not applicable PCCI Continuous Cardiac Index Pulse Contour Cardiac Outpu...

Page 441: ... highest and lowest stroke volume divided by a calculated mean stroke volume over the last 30 seconds 0 to 50 10 PPV Pulse Pressure Variation The arterial pulse pressure PP is defined as the difference between the systolic and diastolic pressure PP APsys APdia Pulse pressure is directly proportional to stroke volume such that the pulse pressure variation PPV closely reflects the SVV PPV is present...

Page 442: ...to 800 ml m2 EVLW Extravascular Lung Water correlates to extravascular thermal volume in the lungs and is determined by the mean transit time method 10 to 5000 ml Not applicable EVLWI Extravascular Lung Water Index Extravascular Lung Water normalized to body weight EVLWI EVLW PBW Predicted Body Weight 0 to 50 ml kg 3 0 to 7 0 ml kg GEF Global Ejection Fraction equal to 4 times the stroke volume di...

Page 443: ...m2 PBW Predicted Body Weight kg calculated according to height sex and patient category PBSA Predicted Body Surface Area m2 calculated with the PBW instead of actual body weight Calculation Category Sex PBW kg 50 0 91 height cm 152 4 Adult habitus 1 Male PBW kg 45 5 0 91 height cm 152 4 Female PBW kg 39 0 89 height cm 152 4 Pediatric 152 4 cm habitus 1 Male PBW kg 42 2 0 89 height cm 152 4 Female ...

Page 444: ...lling arterial catheter is contraindicated Do not place the catheter tip in the aorta or within the heart intracardicac blood pressure measurements are not allowed Patients on intra aortic balloon counter pulsation IABP cannot be monitored with pulse contour analysis however the intermittent PiCCO thermodilution will give valid results Always perform a discharge before monitoring a new patient to ...

Page 445: ... incorrectly placed catheters defective connections or sensors and by electromagnetic interference for example electric blankets electric coagulation The displayed GEDV value may be erroneously high in patients with an aortic aneurysm if thermodilution measurements are made via the femoral artery Aortic aneurysms may cause the displayed blood volume GEDV ITBV derived by thermodilution measurements...

Page 446: ...arameter selections vary depending on whether you are dealing with discrete transpulmonary thermodilution parameters or pulse contour parameters See tables below To set up the PiCCO pod and hardware 1 Insert a central venous catheter CVC into the patient 2 Prepare a pressure monitoring kit for arterial pressure monitoring Fill the transducer kit carefully using the flush clip Air bubbles in the pr...

Page 447: ...n of the thermodilution catheter 1 1 CVP catheter1 6 CO port 2 Injectate temperature sensor housing1 7 Pulsion blood pressure transducer1 3 p CO thermistor cable 8 Delta Delta XL or Kappa PodCom connection Delta XL shown 4 p CO intermediate cable 9 10 pin cable to transducer 5 PiCCO pod 10 Pulsion arterial thermodilution catheters1 1 Catheters and blood pressure transducers required for use with t...

Page 448: ...o a slot on the front of the PiCCO pod Make sure the slot s pressure label is ART 10 Slide the Central Venous Pressure transducer into another slot Make sure this slot pressure label is CVP 11 Connect the PiCCO catheter with the blood pressure transducer 12 Use the 10 pin cable to connect the blood pressure transducer to the Delta Delta XL Kappa 13 If you have not already done so enter the patient...

Page 449: ... hemodynamic pod MPod to zero all pressures whose transducers are open to air WARNING Do not use the Smart Zero function if any pressure waveform is flat nearly static Only use the Smart Zero function when all the stopcocks are opened to air NOTE If you use this step 3 b and are unable to zero a particular IBP with the key use the associated parameter box as described in 3 a This method can be mor...

Page 450: ... begin a p CO measurement The Review Curves screen duplicates the five values displayed on the p CO Averaging screen with their corresponding thermodilution curves NOTE If the READY message fails to appear or appears only intermittently the blood temperature may be unstable Check that all connections are correct and that the blood temperature is stable and valid and repeat step 15 see page 26 23 f...

Page 451: ...s is not possible after a p CO Averaging calculation is completed p CO Averaging 1 Current blood temperature 5 Accesses Review Curves screen see below 2 Current injectate temperature 6 T Temp difference The difference between the lowest blood temperature and the baseline blood temperature for each thermodilution measurement 3 Exit p CO Averaging screen 7 p CO measurement values newest value is loc...

Page 452: ...ndicating the last average saved is displayed in the parameter box NOTE It takes a few seconds for the PiCCO algorithm to compute certain p CO values The Save Average button is ghosted until all the values are computed A new p CO measurement cannot be started during this time When all the values are available the Save Average button is unghosted An attention tone sounds to indicate that an average...

Page 453: ...VI EVLW EVLWI PVPI with a time stamp associated with the Thermodilution measurement taken A typical Transpulmonary Thermodilution parameter box is shown in the following graphic NOTE If ART pressure transducer ART catheter and injectate temperature cable are disconnected for 30 minutes or if the PiCCO pod is disconnected from the monitor the PiCCO calibration data will be lost If no new measuremen...

Page 454: ...CO parameter box on the main screen or 1 Press the Menu fixed key to display the Main menu 2 Click on Patient Setup 3 Click on Parameters 4 Click on PiCCO PC 5 Click on Parameter 1 6 Scroll to the PiCCO pulse contour parameter you want to assign as Parameter 1 PCCO PCCI p SV p SVI SVV p SVR p SVRI PPV or dPmax PCCO PCCI p SV p SVI SVV p SVR p SVRI or PPV and click 7 Repeat the previous two steps f...

Page 455: ...xed key to display the Main menu 2 Click on Patient Setup 3 Click on Parameters 4 Click on PiCCO TD 5 Click on Parameter 1 6 Scroll to the PiCCO transpulmonary thermodilution parameter you want to assign as Parameter 1 p CO p CI GEDV GEDVI EVLW EVLWI GEF PVPI CFI ITBV or ITBVI p CO p CI GEDV GEDVI EVLW EVLWI CFI ITBV or ITBVI and click 7 Repeat the previous two steps for Parameter 2 and Parameter ...

Page 456: ...nates which parameter will be trended for Mini Trend PCCI default PCCO p SV p SVI p SVR p SVRI SVV Catheter type Read only field Displays the catheter type in use NOTE Other is displayed if the catheter that is connected requires manual entry of an ACC value Selecting Other displays a key pad for manual entry PV2013L07 PV2014L08 PV2014L16 PV2014L22 PV2015L20 PV2014L50 Other Catheter Position Selec...

Page 457: ...s of 1 mmHg Manual CVP Log CVP value is logged in with a time stamp Not applicable NOTE A total of 20 entries per patient can be stored in the log p CO Start Activates the p CO Averaging screen and starts a p CO measurement NOTES After each thermodilution measurement completes click on p CO Start in the Averaging screen to perform another measurement the monitor does not automatically start a new ...

Page 458: ...in the parameter box even if alarming parameter is not selected to be displayed in the parameter box Not applicable NOTE The user can perform a TD measurement even if ART pressure is not monitored Thermodilution Setup Menu Menu Item Description Available Settings Show All Parameters Displays all the PiCCO continuous and discrete parameters in a separate window Not applicable Parameters Setup Allow...

Page 459: ...is selected CAUTION Confirm that the selected catheter position is accurate before starting a measurement Changing the catheter position after starting a measurement has no effect on the current measurements To correct the catheter position discharge and readmit the patient Art Catheter Const ACC Field ghosted when catheters with automatic ACC detection are connected This field will be unghosted a...

Page 460: ... monitor does not automatically start a new measurement A p CO measurement can be started using the CO Start key on the PiCCO pod the keypad s C O key does not work If p BT or p IT values are invalid or out of range the p CO Start button is ghosted and the Averaging screen cannot be accessed During this time the C O Start fixed key on the PiCCO pod is also inactive Not applicable p BT value p IT v...

Page 461: ...efore the TD measurement and pressure changing mattresses Arterial blood pressure signal A good arterial blood pressure signal is mandatory not under or over dampened Before TD measurements check arterial signal and if necessary flush pressure line to optimize pressure signal values If there is an unstable or static ART pressure signal the p CO curve or value may not be generated because the calib...

Page 462: ... it hard to calculate a good CO measurement In case there is no pulmonary edema room temperature injectate can be used Usually warmer temperature injectate could be used if EVLWI 10 If individual measurements are not in good agreement and the TD peak is low 0 15 C 59 F it is good to use iced injectate or at least injectate coming out of the refrigerator Injectate temperature generally must not be ...

Page 463: ...reen will disappear Check that p IT and p BT are in range in order to restart the measurement p BT range 3 to 31 C 27 to 88 F p IT range 25 to 43 C 77 to 109 F Cables Use of good cables is very important Always inspect the cables before use Check for bent or damaged cable pins before use Make sure the cable connections are free from moisture or other saline deposits Moisture could cause the interm...

Page 464: ...rterial catheter is correctly positioned Check all connections from the catheter to the PiCCO pod PiCCO Blood Temp Sensor Failure Sensor accessory malfunction ART blood temp sensor failure malfunction Check the connections Check the expiration date of catheter Disconnect and examine the catheter or cable Replace the catheter if necessary Check the patient P CO p BT Out of Range The blood temperatu...

Page 465: ...were performed then the ART pressure transducer was connected Check the transducer and connections Reconnect and recalibrate if necessary with a valid ART pressure Replace the transducer if necessary ART CVP Transducer disconnected The ART CVP pressure transducer has been disconnected Check if necessary transducer and connections Reconnect if necessary and rezero Replace the transducer if necessar...

Page 466: ...sion pumps warming blankets etc Wait for READY message to display then repeat the measurement If message persists replace the defective components PCCO UL LL The PCCO is value above upper below lower limit Check the patient and treat if necessary Change the alarm limits as appropriate Check the connections PCCO Out of Range High Low The PCCO parameter value is out of range high low Check the patie...

Page 467: ...rom patient Check sensor check pod and pod connections Replace sensor or pod if necessary Plug and unplug the pod Call your hospital s technical personnel or DrägerService PiCCO Pod Disconnected The PiCCO pod is disconnected Check the cable and connection and replace if necessary Message Possible Cause Suggested Action ...

Page 468: ...26 30 DELTA DELTA XL KAPPA VF8 26 PULSE CONTOUR CARDIAC OUTPUT PICCO MONITORING This page intentionally left blank ...

Page 469: ...27 Body Temperature Overview 27 2 Temperature Display 27 4 Temperature Setup 27 6 Status Messages 27 6 ...

Page 470: ...diac output data see page 15 4 for more information The NeoMed Hemo2 Hemo4 pods and the MPod Quad Hemo are each equipped with two temperature probe connectors The MultiMed pod has one temperature probe connector however a Y cable allows it to also monitor two temperature signals To measure body or blood temperature connect the monitor to the appropriate device as shown below NOTE The temperature f...

Page 471: ...ge 15 4 to monitor blood temperature with one of the hemodynamic pods Use the MultiMed or NeoMed to measure body temperature HemoMed Pod Hemo2 Pod Hemo4 Pod 1 To monitor 2 Temp B 3 Temp A 4 C O Temp B 5 C O MultiMed 5 6 Pod NeoMed Pod Temperature probe s MPod Quad Hemo ...

Page 472: ... MultiMed with Y cable NeoMed Hemo2 Hemo4 pod or the MPod Quad Hemo When acquired via the MultiMed or NeoMed pod temperature signals are displayed as Ta value or Tb value If you are using a MultiMed without a Y cable only Ta displays a value When monitoring temperature using the Hemo2 Hemo4 pod or the MPod Quad Hemo temperature values are further identified according to where they are connected to...

Page 473: ...ure values for example T2a and T2b or one temperature value with a delta temperature value for example T2a and ΔT2 The second value in either case appears in the bottom of the temperature parameter box NOTE The second PodCom connector is optional on the Delta and standard on the Delta XL Delta Delta XL Kappa 1 T2 a or b 2 T3 a or b 3 T a or b w Y cable 4 T a or b 5 Ta or T a or b w Y cable Delta t...

Page 474: ...or the difference between the first probe s reading and the second DT the delta value TEMP alarms Accesses temperature alarm settings on the Alarm Limits table see page 5 6 Status Messages Message Possible Cause Suggested Action The temperature exceeds the upper or lower alarm limits Check the patient and treat if necessary Check equipment and replace if necessary Out of Range High Out of Range Lo...

Page 475: ... Apollo and Zeus Parameters 28 15 SvO2 CCO Monitors 28 17 Radiometer MicroGas 7650 Monitor 28 19 Aspect A 2000 BIS Monitor 28 19 Independent Surgical Display ISD 28 20 MIB Status Messages 28 23 Dräger Infant Incubator C2000 C2000e 28 24 C2000 C2000e Status Messages 28 27 Dräger Infant Incubator Caleo 28 27 Caleo Status Messages 28 30 Dräger Babytherm Infant Warmer 28 30 Babytherm Status Messages 2...

Page 476: ...tocol significantly expand the monitor s capabilities The MIB protocol requires the monitor to be connected to an Infinity Docking Station IDS since MIB functions are not available when the monitor is in DirectNet mode Parameter values acquired from peripheral devices are trended in graphical and tabular format When you modify the parameter display a message identifies the trend data that will be ...

Page 477: ...es 3 00 4 00 Dräger Julian Dräger Cicero B C EM Dräger Julian Primus anesthesia device Dräger Zeus Tested to published protocol Medibus for Zeus 3 n 4 n Dräger Zeus Infinity Empowered NOTE With IDS version 5 1 no MIB converter is required Tested to published protocol Medibus for Zeus Infinity Empowered 1 n Dräger Fabius CE Tested to published protocol Medibus anesthesia devices 4 00 Dräger Fabius ...

Page 478: ...us Cardiac Output SVO2 4 00 Abbott Q2 Continuous Cardiac Output SVO2 4 32 Abbott Oxy 3 SvO2 CCO monitor 104 Edwards Baxter Vigilance Edwards Baxter Vigilance II SvO2 CCO monitor 4 42 5 02 Radiometer MicroGas 7650 Monitor NOTE Works only with MIB II hardware 10 02 VIA V ABG 1 blood gas monitor 1 18JT OSI OpticalCAM blood gas monitor OSI 01838 Rev C AVL OPTI2 blood gas monitor AOPX1 50ds Viasys BEAR...

Page 479: ...ntended as a basis for diagnostic or therapeutic decisions Always refer to the primary data source for these decisions Connecting peripheral devices is supported via the device connection option s RS232 connection 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 the Electrical Safety section f...

Page 480: ...waveform next to the Flow Volume Vent parameter box Loops Pressure Volume loops and Flow Volume loops offer valuable information about the patient s response to mechanical ventilation The monitor automatically erases older loops and replaces them with newer ones The most recent loop is the brightest You can save and display a Reference Loop which serves as a useful point of analysis and comparison...

Page 481: ... You can view smaller loops on the main screen while continuing to display waveforms and parameter boxes 1 Open the Paw Vent setup menu as described above 2 Click on Split Screen 3 Click on Ventilation The small loop display appears in the upper left corner of the screen NOTE For more information on loop display and analysis see chapter 21 1 Display or hide grid 4 Save last completed loop with tim...

Page 482: ...el Bedside and Infinity network units of measure Where displayed Peak Airway Pressure PIP cmH2O Show All Parameters screen Paw Flow and Volume parameter box Vent view Infinity CentralStation Mean Airway Pressure MAP cmH2O Positive End Expiratory Pressure PEEP cmH2O Minute Volume Expired MVe L min Show All Parameters screen Vent Flow and Volume parameter box Vent view Infinity CentralStation Respir...

Page 483: ...Volume parameter box Vent view Infinity CentralStation Mean Airway Pressure Pmean MAP mbar cmH2O Positive End Expiratory Air way Pressure PEEP PEEP mbar cmH2O Minute Volume MV MVe L min L min Show All Parameters screen Vent Flow and Volume parameter box Vent view Infinity CentralStation Breathing Fre quency RRTo tal RR RRv 1 min br m Tidal volume VT TVe mL mL Plateau Airway Pressure Pplat Pause mb...

Page 484: ... Cdyn Cdyn mL mbar mL cmH2O Resistance R Raw mbar L s cmH2O L s 1 The expiratory inspiratory component are displayed in the Show all Parameters screen Menu Item Description Available Settings Show All Parameters Lists all ventilator parameters and current values read only list displays values for PIP MAP PEEP TVe MVe RRv Pause I E InspT iO2 TVi MVi Not applicable Open Lung Tool Accesses Open Lung ...

Page 485: ...5 10 25 50 75 100 250 500 750 1000 or 1500 ml Split Screen Configures main screen to display ventilator or trend data OFF 60 Min Trends 10 Min Trends Ventilation Vent Mini Trend Determines parameter displayed when Split Screen is set to 10 Min or 60 Min Trends NOTE For a list of parameters displayed via the etCO2 Respiratory Mechanics pod see page 21 16 RRv MVe MVi PIP TVe TVi Loop Draw Sets numbe...

Page 486: ...on the front of the monitor 2 Highlight Open Lung Tool and click Display channel Parameter Definition Color Trend Graph 1 PIP or Pause Peak Inspiratory Pressure or Pause Pressure Blue PEEP Positive End Expiratory Pressure White Trend Graph 2 TVi Inspired Tidal Volume Blue TVe Expired Tidal Volume White Trend Graph 3 Cdyn Dynamic Compliance ventilators Primus and Apollo anesthesia machines White NO...

Page 487: ...l presents data that comes from a Dräger Evita 2D 4 XL Savina or Siemens SV300 300A ventilator and Primus or Apollo anesthesia machines 1 Cursor 5 Click and scroll to highlight trend values of individual breaths 2 Open Calculations 6 Adjust scale 3 Display PV Loop 7 Cursor time values 4 Enlarge and diminish OLT ...

Page 488: ...ons for anesthetic gases Parameter values acquired from the anesthesia machine are trended in graphical and tabular form The anesthesia machine provides the range and resolution for all parameters Parameter settings alarms and error messages are not displayed on the monitor they are displayed on the network device such as an Infinity CentralStation Innovian Gateway Symphony instead See the Instruc...

Page 489: ...ox Vent view Infinity CentralStation Mean Airway Pressure MAP mbar MAP cmH2O Peak End Expi ratory Airway Pressure PEEP mbar PEEP cmH2O Respiratory Minute Volume MV L MVe L min Show All Parameters screen Vent Flow and Volume parameter box Vent view Infinity CentralStation Respiratory Rate Freq 1 min RRv br m Expired Tidal Volume VTEXP mL TVe mL Pause Pressure PLAT mbar Pause cmH2O Show All Paramete...

Page 490: ...p Enf i ENF Expired Enflu rane exp Enf et ENF Inspired Desflu rane insp Des i DES Expired Desflu rane exp Des et DES Inspired Sevof lurane insp Sev i SEV Expired Sevoflu rane exp Sev et SEV Inspired Isoflu rane insp Iso i ISO Expired Isoflu rane exp Iso et ISO Note The source for the etCO2 parameter is the Scio module see chapter 23 for details Parameter Anesthe sia device label Anesthesia device ...

Page 491: ...perature C Q2 Vigilance and Vigilance II CCO Continuous Cardiac Output L min Q2 Vigilance and Vigilance II CCI CCO Index L min m2 Vigilance and Vigilance II ICO ntermittent Cardiac Output L min Q2 Vigilance and Vigilance II ICI ICO Index L min m2 Vigilance and Vigilance II SaO2 Arterial Oxygen Saturation Vigilance and Vigilance II SvO2 Venous Oxygen Saturation Q2 Vigilance and Vigilance II SVR Sys...

Page 492: ...Click on MIB SvO2 Quick Reference Table SVO2 CCO Setup To access or execute SVO2 CCO functions listed below select a menu item scroll to the appropriate setting and click Menu Item Description Available Settings Edwards Baxter Available Settings Abbott Show All Parameters Displays a read only list of continuously updated parameter values BT CCO DO2 ICO SaO2 SvO2 SVR CCI VO2 ICI SVRI SV SVI EDV EDV...

Page 493: ...ox the setup menu displays with the text No user selections MIB tpO2 and tpCO2 trends appear in the trend graph table similar to the tpO2 and tpCO2 pod parameters see page 6 3 Aspect A 2000 BIS Monitor The Bispectral Index BIS is a continuously processed EEG parameter that measures the state of the brain during the administration of anesthetics and sedatives The Aspect Medical BIS monitor A 2000 i...

Page 494: ...s the Menu fixed key on the front of the bedside monitor 2 Click on Surgical Display The configuration of ISD menus does not affect other monitor functions displays menus or setups SEF Spectral Edge Frequency Hz Power Total Signal Power dB NOTES SEF and Power are available for viewing only on the Show All Parameters display EEG parameters do not alarm NOTE The ISD only displays those parameters wh...

Page 495: ...selection Display Mode Determines whether the ISD Main Screen displays unconnected as well as connected parameters Click on Manual to display the parameters in the order you have determined regardless of whether or not they are connected Click on Auto to display only connected parameters which appear in the order selected on the Surgical Display s parameter priority table Click on Monitor to displ...

Page 496: ...splay High Medium Low Sweep Speed Determines waveform sweep speed Slow Normal Fast Parameter Display Moves parameter boxes to right or left of the waveform display RIGHT LEFT The Elapsed Time Key Elapsed Time Displays or removes up to two timers in bottom left corner of ISD screen NOTE Click on timer to reset after displayed Click on one of the following settings Begin Timer A Begin Timer B Remove...

Page 497: ...patient and treat if necessary MIB Disconnected The connection between the external device and the monitor has been interrupted after already having been connected Check the cable and reconnect it if necessary Duplicate Device Connected The monitor can accommodate only one MIB connection Make sure that only one MIB device is connected to the monitor Note The variable stands for the parameter displ...

Page 498: ...device is connected However the user can select Incub1 or Incub2 separately from the parameter pick list depending on the number of parameter boxes selected in the menu selection To access the Infant Incubator C2000 C2000e Setup menu Click on the Incub1 Incub2 parameter box main screen or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameters 4 Click on Incub1 Incub2 NOTE The C2...

Page 499: ...en the number of Parameter Boxes is set to 1 When set to 2 the parameter box must be selected from the pick list to be displayed in the appropriate channel Parameter 1 Selects up to 3 parameters for display in Incubator parameter box T1skin default T2skin Tair O2 R H Wt None Parameter 2 T1skin T2skin Tair O2 R H default Wt None Parameter 3 T1skin T2skin Tair default O2 R H Wt None Incubator Mini T...

Page 500: ...o 1 Parameter 1 Selects up to 3 parameters for display in Incubator parameter box T1skin T2skin default Tair O2 R H Wt None Parameter 2 T1skin T2skin Tair O2 default R H Wt None Parameter 3 T1skin T2skin Tair O2 R H Wt default None Incubator Mini Trend Allows you to select parameters for display in mini trends See page 6 7 for more information on mini trend display NOTE Both Incub1 Incub2 can disp...

Page 501: ... Device Connected Multiple devices are connected Make sure only one incubator is connected to the monitor Tair Out of Range The Tair value is out of range Check the patient and treat if necessary Check the connections Unplug and reconnect the incubator Power cycle the monitor or undock and redock the monitor Call the manufacturer T1skin Out of Range The T1skin value is out of range T2skin Out of R...

Page 502: ...er Boxes 1 default 2 NOTE Incub2 Parameter box is not displayed on screen or in parameter priority list when the number of Parameter Boxes is set to 1 When set to 2 the parameter box must be selected from the pick list to be displayed in the appropriate channel Parameter 1 Selects up to 3 parameters for display in Incubator parameter box T1skin default T2skin Tair O2 R H Wt None Parameter 2 T1skin...

Page 503: ...meter 1 Selects up to 3 parameters for display in Incubator parameter box T1skin T2skin default Tair O2 R H Wt None Parameter 2 T1skin T2skin Tair O2 default R H Wt None Parameter 3 T1skin T2skin Tair O2 R H Wt default None Incubator Mini Trend Allows you to select parameters for display in mini trends See page 6 7 for more information on mini trend display NOTE Both Incub1 Incub2 can display a mi...

Page 504: ... selection Message Condition Suggested Action Duplicate Device Connected Multiple devices are connected Make sure only one incubator is connected to the monitor Tair Out of Range The Tair value is out of range high or low Check the patient and treat if necessary Check the connections Unplug and reconnect the incubator Power cycle the monitor or undock and redock the monitor Call the manufacturer T...

Page 505: ... Parameter Boxes 1 default 2 NOTE Warmer2 Parameter box is not displayed when the number of Parameter Boxes is set to 1 When set to 2 the parameter box must be selected from the pick list to be displayed in the appropriate channel Parameter 1 Selects up to 3 parameters for display in warmer parameter box T1skin default T2skin Tmatt HtrPwr None Parameter 2 T1skin T2skin default Tmatt HtrPwr None Pa...

Page 506: ...skin Tmatt HtrPwr None default Warmer Mini Trend Allows you to select parameters for display in mini trends See page 6 7 for more information on mini trend display T1skin T2skin Tmatt HtrPwr default Message Condition Suggested Action Duplicate Device Connected Multiple devices are connected Make sure only one incubator is connected to the monitor T1skin Out of Range The T1skin value is out of rang...

Page 507: ...parameter box appears by default when the device is connected To access the Cerebral Oximetry Setup menu Click on the rSO2 parameter box main screen or 1 Press the Menu fixed key 2 Click on Patient Setup 3 Click on Parameters 4 Click on rSO2 NOTE The Somanetics INVOS Cerebral Somatic Oximeter 5100C is available in adult and pediatric patient categories only Label Parameters Units LrSO2 Regional Ox...

Page 508: ...pplicable Parameter 1 Selects up to 2 parameters for display in rSO2 parameter box LrSO2 RrSO2 default S1rSO2 S2rSO2 Parameter 2 LrSO2 default RrSO2 S1rSO2 S2rSO2 rSO2 Mini Trend Allows you to select parameters for display in mini trends See page 6 7 for more information on mini trend display LrSO2 RrSO2 default S1rSO2 S2rSO2 Message Condition Suggested Action Duplicate Device Connected Multiple d...

Page 509: ...er Plate 29 4 PiCCO Pod 29 5 MPod Quad Hemo 29 5 SpO2 29 6 Reusable SpO2 Sensor 29 6 Infinity Masimo SET SpO2 Pod 29 6 Infinity Nellcor Oximax SpO2 Pod 29 7 Trident NMT Pod 29 7 etCO2 and Respiratory Mechanics 29 7 etCO2 and etCO2 Respiratory Mechanics Pod 29 7 Capnostat Sensor 29 7 Flow Sensor 29 7 Sidestream Sampling Pump etCO2 only 29 8 Infinity etCO2 Microstream SmartPod 29 11 FiO2 29 11 Tempe...

Page 510: ... for example the MultiMed pod MultiGas module battery charger Please read the following instructions carefully before you clean the base unit or peripheral devices Special instructions for cleaning particular devices and accessories are provided in the following pages Do not spray cleaning agents on the monitor or peripherals Wipe them with a cloth moistened with a soap solution Disinfect the surf...

Page 511: ... the ESU block Clean it with a cloth moistened with soap solution Read the operating instructions accompanying the ESU for additional information CAUTION Do not immerse or rinse the monitor and its peripherals If you accidentally spill liquid on a device disconnect the unit from the power source Contact your technical personnel regarding the continued safety of the unit before placing it back in o...

Page 512: ... to water steam hot air sterilization ether chloroform or similar chemicals Always protect the connector from moisture Consult the documentation supplied with your transducer for specific cleaning and sterilizing instructions Hemodynamic Pod Transducer Plate Remove the transducer mounting plate from the front of the hemodynamic pod Wash the plate with hot soapy water CAUTION The NBP cuff can be im...

Page 513: ...effect at the time of testing on the materials utilized in the MPod Quad Hemo include Isopropyl alcohol 40 Compliance this cleaning agent may discolor soft plastic material Sporox II Dismozon pur CAUTION Do not use organic solvents Do not sterilize by steam heat radiation or ETO Do not use sharp objects Make sure that NO liquid enters the pod CAUTION Do not autoclave the MPod Quad Hemo CAUTION If ...

Page 514: ...able SpO2 sensors by wiping them with a gauze pad moistened with a soap solution To disinfect sensors wipe using a cloth moistened with a 70 alcohol solution Dry thoroughly with a lint free cloth before applying to patient Reusable SpO2 Sensor Refer to the cleaning instructions and recommendations provided with the sensor Infinity Masimo SET SpO2 Pod 1 To clean the Masimo SET SpO2 pod disconnect i...

Page 515: ...piratory Mechanics Pod Follow the general instructions on page 29 2 to clean the etCO2 and etCO2 Respiratory Mechanics pods Capnostat Sensor Clean sensor surfaces including the sensor windows with a damp cloth Never immerse the sensor or attempt to sterilize it Dry with a lint free cloth Making sure the sensor windows are clean and dry before you use them Flow Sensor Flow sensors are for single us...

Page 516: ...m hypochlorite bleach The following items are required for cleaning the etCO2 module or pod A 60 cc catheter tip syringe A 2 foot section of 1 8 or 3 16 inch tubing to drain off fluid after it passes through the etCO2 pump A receptacle to receive the fluid after it drains CAUTION To reduce the risk of infection remember that airway and flow sensors are for single patient use only and cannot be ste...

Page 517: ...cted to the exhaust port Repeat two more times for a total of 180cc of fluid 7 Remove the syringe Leave remaining fluid in the pumping system for 30 minutes This disinfects the system 8 After 30 minutes fill the syringe with distilled water and flush through the system Repeat two more times 9 Empty the syringe and use it to push several volumes of air slowly through the system This clears most of ...

Page 518: ...and the drain tubing still connected let the pump run for several minutes to remove any water still trapped in the system 3 Block the sidestream input port with your finger for several seconds and then unblock it Repeat at least ten times 4 Move your finger to the sidestream output port and block the port with your finger for several seconds and then unblock it Repeat at least ten times 5 Remove t...

Page 519: ...ensor using a cloth moistened with ethanol WARNING Do not autoclave or sterilize this device CAUTION Do not spray or pour any liquid directly on the pod accessories or consumables Do not use caustic or abrasive cleaners or harsh solvents including petroleum based or acetone solutions to clean the device Microstream etCO2 consumables are designed for single patient use and are not to be reprocessed...

Page 520: ...in a 3 hydrogen peroxide or 70 alcohol solution CAUTION Do not use phenol disinfectants because vinyl absorbs them Do not use strong aromatic chlorinated ketone ether or ester solvents Do not immerse the cables for any prolonged period in alcohol mild organic solvents or highly alkaline solutions ...

Page 521: ...t and measure five agents Halothane Isoflurane Enflurane Sevoflurane and Desflurane ART Arterial pressure ARTF Artifact ASY Asystole aVF ECG Left leg augmented lead aVL ECG Left arm augmented lead aVR ECG Right arm augmented lead Battery backed memory The circuits inside the monitor that retain information after turning off the monitor Patient settings for example are saved in battery backed memor...

Page 522: ...ical Unit etCO2 End Tidal CO2 Exit arrow A left pointing arrow found at the top left of each menu and at the end of certain menu lists Click on the arrow to return to the previous menu External battery An optional battery capable of powering the monitor for up to 50 minutes See SLA FiO2 Fractional inspired oxygen Fixed keys Function buttons located on the front of the monitor Fixed keys are also f...

Page 523: ...nternal battery is lead acid which powers the monitor for up to 75 minutes Isoelectric line In electrocardiology a reference line representing the resting state of the heart Isoflurane An anesthetic agent IT Injectate Temperature LA ECG Left Arm LA IBP Left Atrial pressure LCD Liquid Crystal Display LL Left Leg Local message area Along the top left of the main screen displays error and status mess...

Page 524: ...espirogram PA Pulmonary Arterial pressure Parameter A monitored physiological function eg heart rate blood temperature PAUS Pause PeCO2 Mixed Expired CO2 PEEP Positive end expiratory pressure PEF Peak Expiratory Flow Pick and Go Pick and Go allows continuous monitoring for a patient moving from one care unit to another while leaving each unit s setups intact PIF Peak Inspiratory Flow PIP Peak Insp...

Page 525: ...easured by pulse oximetry ST deviation The displacement of the ST segment of the ECG waveform over the isoelectric line STCVM ST Change in Vector Magnitude STVM ST Vector Magnitude Strip chart The paper copy of patient data printed out from a recorder SV Stroke Volume SVI Stroke Volume Index SVR Systemic Vascular Resistance SVRI Systemic Vascular Resistance Index SYNC or Sync Synchronization T1a T...

Page 526: ...A 6 DELTA DELTA XL KAPPA VF8 A GLOSSARY This page intentionally left blank ...

Page 527: ...ttery B 14 Battery Charger B 15 R50 N Infinity Recorder B 16 Medical Information Bus MIB II Duo Protocol Converter 72 56 949 B 17 MIB II Protocol Converter 72 56 931 B 17 Displays B 18 Display Unit Kappa only B 18 Surgical Display Controller B 19 Monitoring Accessories B 21 etCO2 Module B 21 etCO2 Pod B 22 etCO2 Respiratory Mechanics Pod B 23 etCO2 Microstream Pod B 24 Hemodynamic Pods B 25 Infini...

Page 528: ...ive Blood Pressure Via Infinity PiCCO Pod B 39 Cardiac Output B 41 Pulse Oximetry OxiSure SpO2 via MultiMed B 41 Pulse Oximetry Masimo SET SpO2 via Pod B 43 Pulse Oximetry Nellcor Oximax SpO2 via Pod B 44 tpO2 CO2 B 45 End Tidal CO2 etCO2 via etCO2 module or pod B 46 End Tidal CO2 etCO2 via Infinity etCO2 Microstream pod B 48 etCO2 Respiratory Mechanics B 50 FiO2 B 53 MultiGas Via Scio Module B 54...

Page 529: ...magnetic compatibility standard for medical electrical equipment IEC 60601 1 2 2001 A1 2004 published by the International Electrotechnical Commission and available from a variety of sources While primarily aimed at device manufacturers this contains a large amount of information that may be useful to interested users of medical equipment The information contained in this section such as separatio...

Page 530: ...onitor s wireless communication For details on wireless deployment contact your Dräger representative Low amplitude signals such as EEG and ECG are particularly susceptible to interference from electromagnetic energy While the equipment meets the testing described below it is not a guarantee of perfect operation the quieter the electrical environment the better In general increasing the distance b...

Page 531: ...uality should be that of a typical commercial or hospital environment Power frequency magnetic field 50 60 Hz IEC 61000 4 8 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment Voltage dips and short interruptions on AC mains input lines IEC 61000 4 11 Dip 95 0 5 periods Dip 60 5 periods Dip 30 25 perio...

Page 532: ... for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the equipment is used exceeds the applicable RF compl...

Page 533: ...2 2 3 10 3 8 3 8 7 3 100 12 12 23 NOTE For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer At 80 MHz and 800 MHz the separation distance f...

Page 534: ...10 Printed circuit boards Board Glass epoxy Fr4 Solder Lead tin Copper etch Lithium battery Heatsink assemblies Cast magnesium alloy Internal battery Lithium Ion NBP assembly Silicon tubing steel copper wire Electrical Specifications Input voltage 11 to 15 V DC Power consumption 70 Watts fully loaded Protection class Internally powered per IEC 60601 1 and for use with specified Class 1 power suppl...

Page 535: ...0 and no continuous tone being generated Advanced Communication Options are not supported during battery operation Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 40 C 4 to 104 F Relative humidity Operating 20 to 90 non condensing Storage 1 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to 795 mmHg 50 to 106...

Page 536: ...ilm Transistor Liquid Crystal TFT LCD Display Active Matrix Size Delta 264 mm 10 4 in diagonal Delta XL 310 mm 12 2 in diagonal Viewing area Delta 211 x 158 mm 8 3 x 6 2 in Delta XL 246 x 184 5 mm 9 7 x 7 3 in Resolution Delta 640 x 480 pixels Delta XL 800 x 600 pixels Color capability 512 Sweep speed 6 25 12 5 25 and 50 mm s 10 Trend storage Data storage 24 hours of trended parameter information ...

Page 537: ...25 ºC Patient leakage current 10 μA Mode of operation Continuous with external power supply for a limited time with battery backup NOTES Battery life varies with parameter configuration The battery life specified above is under the following load conditions MultiMed with SpO2 sensor 2 temperature probes HemoMed pod with 4 IBP transducers and a catheter NBP taking measurements every 15 minutes LCD ...

Page 538: ... rear panel sync connector Amplitude 12 V 5 nominal analog sync connectors Source impedance 5100 Ω Rise time 7 µs Fall time 1 µs Output low no QRS 0 8 V 30 mA sink current Pacemaker pulses Not included User Interface Controls Fixed keys and rotary knob Alarms 3 levels High Medium Low Screen Resolution 800 x 600 Sweep speed 6 25 12 5 25 and 50 mm s 10 accuracy only guaranteed for a 15 display Trend...

Page 539: ...d for use with specified Class 1 power supplies Chassis leakage current 100 μA Mode of operation Continuous Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 50 C 4 to 122 F Relative humidity Operating 20 to 90 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to 795 mmHg 50 to 106 kPa P...

Page 540: ...ing Station bedside monitor Auxiliary Docking Station R50 Recorder Size H x W x D 75 x 197 x 131 mm 3 0 x 7 8 x 5 1 in Physical Attributes Size H x W x D 62 x 182 x 24 mm 2 4 x 7 2 x 0 9 in Weight 635g 1 4 lb Electrical Specifications Battery life 50 minutes Charging time 3 5 hours at 25 C Battery type Lead acid NOTES Battery life varies with parameter configuration The battery life specified abov...

Page 541: ...ency 50 60 Hz nominal Power consumption 2 A 100 V AC 1A 240V AC max fully loaded Protection class Class 1 per IEC 60601 1 Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 40 to 85 C 6 to 185 F Relative humidity Operating 20 to 90 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to 795 mmHg 5...

Page 542: ... Hz Power consumption 1 0 A max Protection class Class 1 Chassis leakage current 300 μA 120 VAC 500 μA 220 VAC Mode of operation Continuous Protection against water ingress Ordinary IPX0 per IEC 60529 Fuses Replace as marked F2A 250V NOTE There are no other user replaceable parts for this device Environmental Requirements Temperature range Operating 15 to 40 C 55 to 104 F Storage 20 to 40 C 4 to 1...

Page 543: ...tions Power source DC powered directly from Dräger IDS Power consumption 4 Watts Isolation Not Isolated Mode of operation Continuous Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 50 C 4 to 122 F Relative humidity Operating 20 to 90 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to...

Page 544: ...90 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to 795 mmHg 50 to 106 kPa VGA Display Output resolution High resolution mode 1024 x 768 Medium resolution mode 800 x 600 Low resolution mode 640 x 480 Horizontal frequency High resolution mode 35 5 kHz Medium resolution mode 37 9 kHz Low resolution mode 31 5 kHz Vertical frequ...

Page 545: ...h medium and low resolution VGA Display Output resolution High resolution mode 1024 x 768 Medium resolution mode 800 x 600 Low resolution mode 640 x 480 Horizontal frequency High resolution mode 35 5 kHz Medium resolution mode 37 9 kHz Low resolution mode 31 5 kHz Vertical frequency High resolution mode 87 Hz interlaced Medium resolution mode 60 Hz non interlaced Low resolution mode 60 Hz non inte...

Page 546: ...tion 12 bits 2 5 mV LSB Sampling range 250 s sec Output range 5 V to 5 V Noise 5 mVpp at 01 to 1 kHz Output impedance 100 Ohms 5 Frequency range DC to 60 Hz 3Db Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 50 C 4 to 122 F Humidity Operating 20 to 90 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 525 to 795 mmHg 70 to 106...

Page 547: ...5 cc Neonatal airway adapter dead space 0 5 cc Moisture resistance Airway adapter can be immersed in water without damage NOTE CapnostatTM III sensor size and weight exclude cable Electrical Specifications Power source Powered directly from monitor Protection against electric shock Type CF Mode of operation Continuous Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F St...

Page 548: ...Electrical Specifications Power source Powered directly from monitor Protection against electric shock Type CF Mode of operation Continuous Defibrillation protection Defibrillation proof applied part per IEC 60601 1 Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 50 C 4 to 122 F Relative humidity Operating 20 to 90 non condensing Storage 10 to 95 with pa...

Page 549: ... against electric shock Type CF Mode of operation Continuous Defibrillation protection Defibrillation proof applied part per IEC 60601 1 Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 50 C 4 to 122 F Relative humidity Operating 20 to 90 non condensing Storage 10 to 95 with packaging Atm pressure Operating 525 to 795 mmHg 70 to 106 kPa Storage 375 to 795...

Page 550: ...against electric shock Type BF Mode of operation Continuous Defibrillation protection Defibrillation Proof Applied Part per IEC 60601 1 Environmental requirements Temperature range Operating 0 to 50 C 32 to 122 F Storage 20 to 70 C 4 to 158 F Relative humidity Operating 10 to 95 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 430 to 795 mmHg 57 to 106 kPa Storage 430 ...

Page 551: ... Hemo4 and HemoMed 140 x 205 x 60 mm 5 5 x 8 1 x 2 3 in MPod QuadHemo 205 x 110 x 80 mm 8 1 x 4 3 x 3 2 in Weight Hemo2 and HemoMed 0 7 kg 1 6 lb Hemo4 0 9 kg 1 9 lb MPod Quad Hemo 0 48 kg 1 1 lb NOTE Hemo2 weight includes one transducer adapter block Hemo4 weight includes two transducer adapter blocks Both weights exclude mounting clamp For the MPod Quad Hemo the weight includes four transducer c...

Page 552: ...od to monitor Degree of protection against ingress of water IPX0 per IEC 60529 Physical Attributes Size H x W x D 140 x 205 x 60 mm 5 5 x 8 1 x 2 3 in Weight 0 9 kg 1 9 lb Note Weight includes two transducer adapter blocks and exclude mounting clamp Electrical Specifications Power source Powered directly from the monitor Protection against electric shock Type CF Mode of operation Continuous Defibr...

Page 553: ...operation Continuous Power from specified power supply Sound pressure level 45 dB A Air ingression leakage 45 ml during zeroing 10 mL min leakage Sample flow rate 150 20 mL min or 200 20 mL min if so specified on back panel Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 70 C 4 to 158 F Relative humidity Operating 5 to 90 Storage 5 to 95 Atmospheric pres...

Page 554: ...graphs and Evoked Response Equipment Defibrillator proof No Environmental Requirements Temperature range Operating 10 to 40 C 50 to 104 F Storage 20 to 40 C 4 to 104 F Relative humidity Operating 20 to 90 non condensing Storage 20 to 90 with packaging Atmospheric pressure Operating 525 to 795 1 mmHg 70 to 106 kPa Storage 375 to 795 1 mmHg 50 to 106 kPa Physical Attributes Size H x W x T 114 3 x 95...

Page 555: ...ction to monitor 3m PodCom interface cable Connection to patient input for each channel and universal neutral Referential mode block provides input for each channel and neutral Power source Powered directly from the monitor Protection against electric shock Type BF Mode of operation Continuous Standards IEC 60601 1 IEC 60601 2 26 Defibrillator proof No Environmental Requirements Temperature range ...

Page 556: ...orage 20 to 50 C 4 to 122 F Relative humidity Operating 20 to 95 non condensing Storage 10 to 95 with packaging Atmospheric pressure Operating 550 to 775 mmHg 73 to 103 kPa Storage 375 to 795 mmHg 50 to 106 kPa Physical Attributes Size H x D 40 x 30 mm 1 59 x 1 2 in Weight 35 g 1 2 oz Connections NeoMed Pod interface cable Mounting 16 mm thread x 1 mm pitch Sensor type Galvanic fuel cell partial p...

Page 557: ...sors Power source Powered directly from monitor Mode of operation Continuous Degree of protection against electric shock Type CF Protection against ingress of water IPX1 per IEC 60529 Environmental Requirements Temperature range Operating 5 to 45 C 41to 113 F Storage 20 to 60 C 4 to 140 F Relative humidity Operating 10 to 95 non condensing Storage 10 to 95 with packaging Atmospheric pressure Opera...

Page 558: ...ors Power source Powered directly from monitor Mode of operation Continuous Degree of protection against electric shock Type CF Protection against ingress of water IPX1 per IEC 60529 Environmental Requirements Temperature range Operating 0 to 45 C 32 to 113 F Storage 40 to 70 C 40 to 158 F Relative humidity Operating 10 to 95 non condensing Storage 10 to 95 with packaging Atmospheric pressure Oper...

Page 559: ...y with 6 lead set Measurement range 15 to 300 1 b min Accuracy 2 bpm or 1 whichever is greater Display update period 2 s QRS detection Amplitude 0 5 to 5 0 mV Duration 70 to 120 ms adult and pediatric 40 to 120 ms neonatal Frequency ranges filter Monitor 0 5 to 40 Hz filter ESU 0 5 to 16 Hz filter OFF 0 05 to 40 Hz NOTE Printed ST and Rest ECG reports conform to EC 11 diagnostic bandwidth requirem...

Page 560: ... bility Exceeds minimum 1 2 mV T Wave amplitude required by ANSI AAMI EC 13 Sect 3 1 2 1 c and IEC 60601 2 27 Sect 6 8 2 bb 2 Heart rate averaging method Heart Rate is normally based on the average R R interval calculated over the last 10 seconds however it updates more quickly to reflect changes to the patient s underlying rate Response time of heart rate meter to change in heart rate HR change f...

Page 561: ...80 msec ST complex Length 892 msec 225 samples Frequency response 0 05 to 40 Hz Update interval 15 seconds 1 normal beat required Trend intervals 1 2 4 8 12 24 hours Trend resolution One data point every 30 seconds ST level alarm adjustment range 1 to 15 mm ST event alarm duration OFF 15 30 45 60 seconds Alarm priority Medium Alarm auto set Current value 2 mm Parameter display Median frequency Spe...

Page 562: ...ck Fp Fp1 Fp2 Fz F3 F4 F7 F8 Cz C3 C4 T7 T8 Pz P3 P4 P7 P8 O O1 O2 Trending 24 hours Each EEG channel for the following parameters Median frequency spectral edge frequency total Power beta alpha theta and delta powers BSR Recordings R50 recorder Analog EEG waveforms Laser printer Analog EEG waveforms Power spectrum Sensing leads I or II user selectable Measurement method Impedance pneumography Det...

Page 563: ...0 mmHg Neonatal 140 110 mmHg 10 mmHg Inflation pressure after a valid measurement 10 mmHg Adult 270 Previous NBPSYS 25 mmHg Pediatric 180 Previous NBPSYS 25 mmHg Neonatal 140 Previous NBPSYS 30 mmHg Inflation pressure after an alarm Adult 270 160 mmHg 10 mmHg Pediatric 180 120 mmHg 10 mmHg Neonatal 140 110 mmHg 10 mmHg Maximum inflation pressure Adult 270 265 mmHg 5 mmHg Pediatric 180 180 mmHg 10 ...

Page 564: ...ution 1 mmHg Measurement range 50 to 400 mmHg Frequency ranges DC to 8 Hz DC to 16 Hz and DC to 32 Hz user selectable Accuracy 1 mmHg or 3 exclusive of transducer whichever is greater Zero balance range 200 mmHg Transducer specifications Dräger provided transducers with a resistance of 200 to 3000 Ω and an equivalent pressure sensitivity of 5μV V mmHg 10 Degree of protection against electric shock...

Page 565: ...ution GEDVI Transpulmonary Thermodilution EVLW Transpulmonary Thermodilution EVLWI Transpulmonary Thermodilution PVPI Transpulmonary Thermodilution Display resolution PCCI 0 01 L min m2 PCCO 0 01 L min p SVI 1 ml m2 SVV 1 p SVR 10 dyn sec cm 5 p SVRI 10 dyn sec cm 5 m2 dPmax 1 mmHg s GEF 1 p CO 0 01 L min GEDV 1 ml GEDVI 1 ml m2 EVLW 1 ml EVLWI 1 ml kg PVPI 0 1 p BT 0 1 ºC 1 ºF Measurement range P...

Page 566: ...p SVR Not applicable p SVRI Not applicable dPmax Not applicable GEF Not applicable p CO Coefficient of variation 1 GEDV Coefficient of variation 2 GEDVI Not applicable EVLW Not applicable EVLWI Not applicable PVPI Not applicable Zero balance range 200mmHg Degree of protection against electric shock Type CF Defibrillation protection Per IEC 601 2 34 ...

Page 567: ...2 pulse rate Measurement method Transmission spectrophotometry Measurement range SpO2 1 to 100 Pulse rate 30 to 250 1 bpm Resolution SpO2 1 Pulse rate 1 b min Calibration range 70 to 100 Display range 0 to 100 Display update period 2 seconds Maximum hold from previous update 30 seconds in the event of artifact or other error Measurement accuracy adult mode 1 2 3 5 Saturation SpO2 0 to 69 not speci...

Page 568: ...nt for the theoretical effect on oximeter measurements of fetal hemoglobin in neonatal blood 5 The pulse rate accuracy has been validated on healthy adult volunteers during induced hypoxia studies in the range of 70 100 SpO2 against a laboratory co oximeter and ECG monitor This variation equals 1 Arms of the pulse rate value measured by the ECG monitor Interfering Substances Carboxyhemoglobin may ...

Page 569: ...nst a laboratory co oximeter and ECG monitor This variation equals 1 Arms of the value measured by a co oximeter 3 The Masimo SET pod with LNOP Adt sensors has been validated for motion accuracy in human blood studies on healthy adult volunteers in induced hypoxia studies while performing rubbing and tapping motions at 2 to 4 Hz at an amplitude of 1 to 2 cm and a non repetitive motion between 1 to...

Page 570: ...ows Nellcor OxiMAX MAX A OxiMAX MAX AL OxiMAX MAX P OxiMAX MAX N OxiMAX MAX I OxiMAX MAX FAST SC A 2 Nellcor OxiCliq A OxiCliq P OxiCliq N OxiCliq I 2 5 Nellcor D YS DS 100A OXI A N OXI P I 3 Nellcor D YS with D YSE Ear Clip D YS with D YSPD Spot Clip 3 5 80 to 100 sensor specific as follows Nellcor MAX R 3 5 Pulse Rate 3 25 250 bpm 3 beats min or 3 whichever is greater NOTES 1 Since pulse oximete...

Page 571: ... hypoxia studies in the range of 70 100 SpO2 against a laboratory co oximeter and ECG monitor This variation equals 1 Arms of the value measured by a co oximeter 3 The pulse rate accuracy has been validated on healthy adult volunteers during induced hypoxia studies in the range of 70 100 SpO2 against a laboratory co oximeter and ECG monitor This variation equals 1 Arms of the pulse rate value meas...

Page 572: ...al Mainstream only Warm up 5 min at 25 C Measurement range 0 to 99 mmHg CO2 partial pressure Accuracy 0 to 40 mmHg 2 mmHg 41 to 70 mmHg 5 of reading 71 to 99 mmHg 8 of reading Stable over 24 hours over full range of readings at atmospheric pressure Drift of measurement accuracy 1 6 mmHg over 8 hours Quantitative effects of humidity and condensate on accuracy Full accuracy specifications are mainta...

Page 573: ...wing table The additional worst case error when compensation is correctly selected for barometric pressure O2 and N2O for the actual fractional gas constituents that are present is 0 to 40 mmHg 2 mmHg additional error 41 to 70 mmHg 3 additional error 71 to 99 mmHg 5 additional error Additional notes regarding cross sensitivity compensation errors Xenon and Helium Constantly bias etCO2 values 38 mm...

Page 574: ...ity levels Adverse effects on performance of cyclical pressures up to 10 kPa 100 cmH2O No effect on accuracy Effect of barometric pressure on accuracy No effect on accuracy Sampling flow rate 50 15 mL min or 7 5 mL min Gas leakage Not applicable Alarm limit resolution etCO2 iCO2 0 1 mmHg 0 01 kPa RRc 1 breath min RRc range pod 0 150 breaths min RRc accuracy 0 to 70 bpm 1 bpm 71 to 120 bpm 2 bpm 12...

Page 575: ...gas levels listed in the following table Quantitative Effects Measured At Gas or Vapor Gas Level Gas levels in volume fraction Nitrous oxide 80 Halothane 6 5 Enflurane 6 5 Isoflurane 6 5 Sevoflurane 9 Xenon 80 Helium 80 Metered dose inhaler propellants Not specified for use Desflurane 24 Ethanol 0 1 Isopropanol 0 1 Acetone 0 1 Methane 1 0 ...

Page 576: ...Adult PIF PEF TVi TVe RRv MVe TV lk 0 to 180 L min 0 to 180 L min 0 100 to 3000 mL 0 100 to 3000 mL 0 to 150 1 min 0 to 60 L min 0 to 100 Measurement range Pediatric PIF PEF TVi TVe RRv MVe TV lk 0 to 120 L min 0 to 120 L min 0 10 to 3000 mL 0 10 to 3000 mL 0 to 150 1 min 0 to 60 L min 0 to 100 Measurement range Neonatal PIF PEF TVi TVe RRv MVe TV lk 0 to 28 L min etCO2 flow 0 to 40 flow only PIF ...

Page 577: ...lv m TValv MValv s MValv m MValv PeCO2 TVd aw TVd TVaw 0 to 400 mL 0 to 120 mL 0 100 to 3000 mL 0 to 60 L min 0 to 50 mmHg 0 to 500 mL 0 to 0 75 Measurement range Pediatric VCO2 TVCO2 TValv s TValv m TValv MValv s MValv m MValv PeCO2 TVd aw TVd TVaw 0 to 400 mL 0 to 120 mL 0 10 to 400 mL 0 to 30 L min 0 to 50 mmHg 0 to 500 mL 0 to 0 75 Measurement range Neonatal VCO2 TVCO2 TValv s TValv m TValv MV...

Page 578: ...or adult pediatric 120 cmH2O Greater of 2 or 0 5 cmH2O CO2 Flow neonatal pediatric or adult pediatric 120 cmH2O Greater of 2 or 0 5 cmH2O Note Static testing with standard known pressure condition CO2 Performance Adapter sensor type size CO2 Range CO2 Accuracy Flow all sizes 0 to 40 2 mmHg 41 to 70 5 of reading 71 to 99 8 of reading CO2 Flow all sizes 0 to 40 2 mmHg 41 to 70 5 of reading 71 to 99 ...

Page 579: ...compensation errors Xenon and Helium Constantly bias etCO2 values 38 mmHg by up to 5 mmHg Desflurane At concentrations 5 constantly biases etCO2 values 38 mmHg by up to 4tommHg Quantitative Effects Measured At Gas or Vapor Gas Level Gas levels in volume fraction Nitrous oxide 60 Halothane 4 Enflurane 5 Isoflurane 5 Sevoflurane 5 Xenon 80 Helium 50 Metered dose inhaler propellants Not specified for...

Page 580: ...shold is max 0 3 Vol The agent identification threshold of a second agent is 0 4 Vol or if Desflurane is the primary agent one tenth 10 of the Desflurane concentration Display values Agents CO2 O2 Inspired and expired concentrations plus trend and waveform N2O Inspired and expired concentrations Measurement methods CO2 Agents N20 Infrared O2 Paramagnetic sensor Display range CO2 0 to 10 resolution...

Page 581: ... Measurement Range 0 to 90 rpm Resolution 1 rpm Accuracy 0 to 60 rpm 1 rpm 60 rpm not specified 1Due to the response time of the sensors and the gas sample flow rate the stated accuracy of O2 CO2 N2O and anesthetic agents is limited by respiratory rate and inspiratory to expiratory I E ratio The effect of respiratory rate and I E ratio settings on accuracy were determined in a simulated breathing ...

Page 582: ... NMT Temp 20 to 40 C Single 0 to 200 of reference twitch TOF Ratio 4 to 150 TOF Count 0 to 4 number of twitches if TOF Ratio 4 or number of twitches 4 PTC 0 to 20 number of twitches Measurement interval None 1s 10s 20s default 1min 5min 15min 30min Accuracy NMT Temp 1 C Single 10 TOF Ratio 10 Display resolution NMT Temp 1 C Single TOF Ratio 1 TOF Count PTC 1 Trend scale range NMT Temp 20 to 40 C i...

Page 583: ... 40 to 100 dB frequency range 0 5 30 Hz Display Resolution 1 dB Spectral edge frequency Parameter Label SEF Measurement Range 0 5 to 30 Hz Display Resolution 0 1 Hz Burst Count Parameter Label BCT Measurement Range 0 to 30 Display Resolution 1 Parameter display Absolute temperature delta temperature with hemodynamic pods Measurement range Absolute 5 to 50 C 23 to 122 F Delta 0 to 55 C 32 to 131 F ...

Page 584: ...B 58 DELTA DELTA XL KAPPA VF8 B TECHNICAL DATA This page intentionally left blank ...

Page 585: ...Oximetry SpO2 C 14 Temperature C 17 Non Invasive Blood Pressure NBP C 18 Pulse Contour Cardiac Output PiCCO C 19 Invasive Blood Pressure IBP C 20 Cardiac Output C 23 Transcutaneous Blood Gas C 24 End Tidal CO2 etCO2 C 24 etCO2 Respiratory Mechanics C 26 FiO2 C 26 MultiGas Monitoring C 27 NMT Monitoring C 28 BISx Monitoring C 29 EEG C 29 Pod Communication C 29 ...

Page 586: ... accessories Power cord Cont Europe CEE 7 2 5 m 4321712 Power cord North America 5 15R 2 25 m 4321720 Power cord Australia and New Zealand AS 3112 3 m 1851705 Power cord Great Britain BS 1363 3 m 1851713 Power cord Switzerland SEV 1011 2 25 m 4321613 Power cord China AS 3112 3 m 1859714 Power cord Denmark 3 m 1868950 Power cord Brazil 3 m 1875523 Power adapter IDS power supply Including 2 5 m conn...

Page 587: ...cking Station IDS integrated MIB 7489375 Infinity Docking Station basic Provides mechanical mounting for Delta or Delta XL devices Can be used with Docking Station Bed Mount 5188813 during patient transport 4715319 Option MIB II 4 channel for IDS Supports connection of up to 4 MIB devices 7261246 WLAN client adapter 802 11 b g Consists of a wireless card MS24694 and adapter MS24595 MS25009 ...

Page 588: ... vertical track of IDS wall mount 4720111 4720061 Rail mount for IDS power supply Plate for mounting IDS power supply on horizontal rails 4720095 Wall bracket for IDS Wall mountable bracket for holding IDS 4720129 Rolling stand bracket for IDS Bracket to mount IDS power supply on pole of a rolling stand 4720103 Mount adapter monitor R50 recorder Bracket to mount an R50 recorder next to bedside mon...

Page 589: ...system 5 m cable with one end unterminated 4314626 Y cable recorder and alarm output For simultaneous recorder and alarm output connection from an interface plate 4313578 Y cable IDS to remote keypad 5596288 Transmitter analog ECG cable Connects transmitter to MultiMed cable to display lead II For use with Infinity Telemetry or TruST Telemetry transmit ter 4316621 Vital connection cable Connects I...

Page 590: ...late 4726399 Patch cable 20 m Shielded cable to connect the IDS or a monitor to a net work wallplate comes with extra connector for field termi nation 4725557 R50 recorder includes paper 5952630 R50 N recorder includes paper and a mounting plate 5740068 Recording paper 10 rolls 4711201 R50 recorder cables IDS interface plate 1 5 m Cable to connect an R50 Recorder to the IDS requires interface plat...

Page 591: ... to corporate mergers Ohmeda accessories may be labelled as being from Becton Dickinson BD Contact BD if there is any doubt as to the identity of the accessories 5944082 MIB cable Puritan Bennett 840 ventilator 7493336 MIB cable Puritan Bennett 7200 5198937 MIB cable Siemens Servoi 5954537 MIB cable Siemens Servo Ventilator 300 300A 5198911 MIB cable Siemens Servo Ventilator 900 5198945 MIB cable ...

Page 592: ...0 Adapter cable 25 m Cable to connect the ISD to a IDS 5194910 Remote display cable 25 m 5191213 5 to 6 channel option Expands display to six channels 5597914 6 to 8 channel option Expands display to eight channels 5597922 4 to 5 channel option for Kappa monitor Not required when ordering the 5 to 6 channel option 5597211 ACE full arrhythmia option Adds calls for run bigeminy couplet PVC and accel...

Page 593: ...6 lead single pin lead sets 1 temperature probe 2 probes with Y cable 1 SpO2 extension cable 1 Integrated ESU filter MS20094 MultiMed 5 pod 2 5m accommodates ECG 3 and 5 lead patient cables 1 temperature probe 2 probes with Y adapter 1 SpO2 extension cable 1 3368391 MultiMed 5 pod 1 5m accommodates ECG 3 and 5 lead patient cables 1 temperature probe 2 probes with Y adapter 1 SpO2 extension cable 1...

Page 594: ...486140 ECG electrodes disp 50 pieces Adult pregelled not for ambulatory use 4527750 Adapter pin neonatal ECG electrodes 10 pieces For connection of neonatal electrodes to the MULTIMED pod and ECG intermediate cables 5194779 Neonatal ECG electrodes disposable 300 pieces 100 pack ages of 3 electrodes 5195024 1 The SpO2 port on the MultiMed cable is not active for monitors with the Masimo SET or Nell...

Page 595: ... 1 m MS16158 ECG 6 lead grabber set IEC1 MS16157 ECG 3 lead grabber set IEC2 AHA US 1 m MS16231 ECG 5 lead grabber set IEC2 AHA US 1 m MS16546 ECG 6 lead grabber set IEC2 1 m MS16547 ECG 6 lead grabber set IEC2 AHA US 1 m MS16547 ECG 3 lead grabber set IEC2 MS16231 ECG 5 lead grabber set IEC2 MS16546 ECG 6 lead grabber set IEC2 MS16547 ECG 3 lead grabber set IEC1 1 m 5956433 ECG 3 lead grabber set...

Page 596: ...S16492 ECG MonoLead 3 IEC1 Euro 1 m MS14555 ECG MonoLead 5 IEC1 Euro 1 m MS14559 ECG MonoLead 6 IEC1 Euro 1 m MS14683 ECG MonoLead 3 IEC2 AHA US 1 m MS14556 ECG MonoLead 5 IEC2 AHA US 1 m MS14560 ECG MonoLead 6 IEC2 AHA US 1 m MS14682 Extension cable 2 m MS16256 ECG MonoLead 3 IEC2 MS14556 ECG MonoLead 5 IEC2 MS14560 ECG MonoLead 6 IEC2 MS14682 Adapter MonoLead 3 5 to MultiMed 5 pod Required to co...

Page 597: ...lection for choosing the SpO2 technology type is password protected Contact your hospital s technical personnel for more information Reusable Dräger reusable SpO2 sensor adult finger Adult sensor for finger application patient weight 40 kg 88 lb NOTE Not for use with MicrO2 Masimo SET or Nellcor OxiMax pods MS13235 Reusable MASIMO LNOP DCI adult finger Adult sensor for finger application Patient w...

Page 598: ...496966 Reusable MASIMO LNCS DCI adult finger Adult sensor for finger application Patient weight 30 kg 66 lb MP00796 MASIMO LNCS DCIP pediatric finger Pediatric adult sensor for finger application Patient weight 10 50 kg 22 110 lb MP00795 NOTE Additional sensors available from Masimo Corpo ration Adhesive Single Patient Use MASIMO LNCS adult finger 20 pieces Patient weight 30 kg 66 lb MP00790 MASIM...

Page 599: ...nects Masimo SET SpO2 pod to Masimo LNOP sensor MS17041 Extension Cable 3 m Connects Masimo SET SpO2 pod to Masimo LNCS sensor MS17522 SpO2 Nellcor extension cable 1 m For use with MultiMed 3 5 6 12 and NeoMed only 3368433 SpO2 Nellcor extension cable 2 m For use with MultiMed 3 5 6 12 and NeoMed only 3375834 SpO2 Masimo ProCal cable 2 m For use with MultiMed 3 5 6 12 and NeoMed only 7492601 SpO2 ...

Page 600: ...154 For use in electrosurgery esophageal and rectal applications Temperature probe adult 1 5 m for MultiMed 4329889 Temperature probe adult 3 m for MultiMed 5204644 Temperature probe pediatric 1 5 m for MultiMed 4329848 Temperature probe pediatric 3 m for MultiMed 5204651 Temp protective covers 10 pieces WARNING Covers contain latex Do not use with skin probes 7014616 Temperature probe adult 3 m 5...

Page 601: ...3 0 m MP00992 Temperature probe pediatric 1 6 m MP00993 Temperature probe pediatric 3 0 m MP00994 Temperature probe adult 1 6 m MP00995 Temperature probe adult 3 0 m MP00996 Temperature probe pediatric 1 6 m MP00997 Temperature probe pediatric 3 0 m MP00998 Reusable Infant cuff 8 13 cm XXS arm circumference MP00911 Child cuff 12 19 cm XS arm circumference MP00912 Small adult cuff 17 25 cm S arm ci...

Page 602: ...x free 10 pieces 2870215 Neonatal cuff 5 8 3 15 0 cm arm circumference Latex free 10 pieces 2870173 NBP connection hose adult 3 7 m 12 1 ft MP00953 NBP connection hose neonatal 2 4 m 28 70 298 PiCCO Pod Kit Includes 1 PiCCO pod 1 Hemo pod adapter 10 pin 1 adapter block to connect PULSION dispos able pressure transducers to the hemo pod adapter 1 PULSION pressure transducer to PiCCO pod interface c...

Page 603: ...Connects the PiCCO PV4046 injectate sensor housing to the CO intermediate cable MS16919 PiCCO pod CO catheter cable Connects the PiCCO arterial thermodilution catheter to the CO intermediate cable MS16918 PiCCO pod CO intermediate cable 1 5 m Connects the PiCCO CO catheter cable and CO ther mistor cable to PiCCO pod MS16916 NOTE All disposables are delivered by PULSION directly Hemo2 pod 4319435 H...

Page 604: ...emo2 or Hemo4 HemoMed pods One for each Hemo2 and two for each Hemo4 HemoMed pod 5196998 Hemo pod adapter Edwards Baxter Adapter block to connect Edwards Baxter pressure trans ducers to the Hemo2 or Hemo4 HemoMed pods One for each Hemo2 and two for each Hemo4 HemoMed pod 5196980 NOTE Due to corporate mergers Baxter accessories may be labelled as being from Edwards Contact Edwards if there is any d...

Page 605: ... Medex SensoNor Hemo2 pod transducer plate for Medex SensoNor transducers 4721614 IBP4 transducer plate Medex SensoNor Hemo4 HemoMed pod transducer plate for Medex SensoNor transducers 4721416 Hemo transducer plate Abbott Braun Hemo2 Hemo4 HemoMed pod transducer plate for Abbott Braun transducers 5192112 Hemo transducer plate Abbott Transpac IV Hemo2 Hemo4 HemoMed pod transducer plate for Abbott M...

Page 606: ...injectate sensor for measure ment of injectate temperatures For use with cable 8420077 5741975 C O thermistor cable Edwards Baxter 8539983 NOTES Due to corporate mergers Baxter cardiac output catheters and accessories may be labelled as being from Edwards Ohmeda output catheters and accessories may be labelled as being from Becton Dickinson BD Contact Edwards and or BD if there is any doubt as to ...

Page 607: ...ytic solution 12 tpO2 and tpCO2 membrane kits O ring remover and cleaning paper MP00715 CAL 1 calibration gas 12 gas cylinders each containing dry gas with 5 CO2 and 20 9 O2 concentrations MP00717 Electrode holder kit MP00718 Calibration unit MP00722 etCO2 module 4319310 etCO2 pod 5740738 etCO2 Microstream pod 7870947 etCO2 CAPNOSTAT TM III sensor Reusable etCO2 sensor with 2 4 m cable Suitable fo...

Page 608: ...et infant neonatal 25 pieces 7869550 For use with non intubated patients Nasal mouth sampling cannula pediatric 25 pieces 7869501 Nasal mouth sampling cannula O2 pediatric 25 pieces 7869584 Nasal sampling cannula adult 25 pieces 7869477 Nasal sampling cannula pediatric 25 pieces 7869469 Nasal sampling cannula high humidity adult 25 pieces 7869592 Nasal sampling cannula high humidity pediatric 25 p...

Page 609: ...O2 Flow Pediatric 5957142 Respiratory mechanics adapter disposable 10 pieces flow neonatal 5957100 Respiratory mechanics adapter disposable 10 pieces CO2 flow adult pediatric 5957126 Respiratory mechanics adapter disposable 10 pieces CO2 flow neonatal 5957118 Respiratory mechanics adapter disposable 10 pieces flow adult pediatric 5957134 FiO2 sensor cable 5597898 FiO2 sensor cell with O ring 90049...

Page 610: ...luids For use with sampling line 8290286 MS13826 External airway filter 10 pieces 0 8 m airway filter 1276695 Sample gas return kit M32692 Water trap set of 12 6870567 Sample line set of 10 8290286 Scio connecting cable X3 0 3 m Cable to connect Scio Module to IDS X3 connector or to MS13504 Scio connecting cable X3 1 5 m Cable to connect Scio module to IDS X3 connector or to MS13865 SCIO direct co...

Page 611: ... connects to Trident pod 7872174 NMT accessory cable clip MS15087 NMT thumb adapter 50 pieces Houses accelerometer when the hand adapter is not being used MS15084 NMT hand adapter Houses accelerometer and temperature sensor con nects to NMT accessory cable MS15086 Accelerometer Measures thumb acceleration during NMT measure ments MS15085 Temperature sensor thermistor Measures skin temperature duri...

Page 612: ...ble lead wires 0 6m and sample electrodes 5736744 EEG reusable lead wires 0 6 m set of 9 5947804 EEG Zip prep electrodes 75 pieces MP00004 EEG referential lead block converter 5954859 Pod Comm cable 3 m Cable used to connect Hemo2 Hemo4 MPod Quad Hemo MultiMed12 EEG NMT and etCO2 pods to Delta Delta XL Kappa 3368425 Pod Comm cable 5 m Cable used to connect Hemo2 Hemo4 MPod Quad Hemo MultiMed12 EEG...

Page 613: ...POD COMMUNICATION VF8 DELTA DELTA XL KAPPA C 29 ...

Page 614: ...out customer request 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 Dräger Medical GmbH Moislinger Allee 53 55 D 23542 Lübeck Germany 49 451 8 82 0 FAX 49 451 8 82 20 ...

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