Dräger Infinity Vista Instructions For Use Manual Download Page 236

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C-4

Infinity Vista

VF6

C D

EFAULT

ETTINGS

AND

IOMEDICAL

UPPORT

ST Segment Analysis

ST Measurement
Point

Beat offset
+80ms

n/a

Factory

ST Isoelectric Point

Beat onset
-28ms

n/a

Factory

ST Alarm

Off

n/a

Saved Setup

Alarm Limits
(upper/lower)

+1.0mm/
-1.0mm

n/a

Saved Setup

Alarm Recording

Off

n/a

Saved Setup

*For Adult and Pediatric monitoring only. All values shown apply to both ST<lead1> and
ST<lead2>.

Respiration

Alarm

Off

Saved Setup

Alarm Limits
(upper/lower)

30/5

80/20

Saved Setup

Alarm Recording

Off

Saved Setup

Rsp Mode

Auto

Saved Setup

Rsp Marker

Off

Saved Setup

Apnea Time

Off

15 seconds

Saved Setup

Coincidence Alarm

Off

Saved Setup

SpO

Alarm

Off

Saved Setup

Alarm Limits
(upper/lower)

100/90%

95/85%

Saved Setup

Alarm Recording

Off

Saved Setup

Tone Source

ECG

Previous Patient

Tone Volume

Off

Previous Patient

Bar Graph

Off

Previous Patient

Averaging

Normal

Previous Patient

Adult
Settings

Pediatric
Settings

Neonatal
Settings

After patient discharge,
settings return to...?

Summary of Contents for Infinity Vista

Page 1: ...Instructions for Use Infinity Vista Infinity Patient Monitoring Series ...

Page 2: ......

Page 3: ...Configured Monitoring Series Infinity Vista Instructions for Use WARNING For a full understanding of the performance characteristics of this equipment the user should carefully read this manual before operating ...

Page 4: ...ission of Drägerwerk AG Co KGaA Dräger devices are intended for use by qualified medical personnel only Before using Dräger devices read all the manuals that are provided with each device carefully Patient monitoring equipment however sophisticated should never be used as a substitute for the human care attention and critical judgment that only trained health care professionals can provide This de...

Page 5: ...the Infinity Vista monitor z For network data transfer only After a network transfer of telemetry data to an Infinity Vista monitor ST trend points may appear two minutes apart z NBP parameter values transferred from an Infinity Vista monitor to an Infinity Vista XL Gamma X XL monitor are displayed in the trend graphs rather than in the trend tables of the destination monitor z When power cycling ...

Page 6: ...lt Pediatric and Neonatal populations with the exception of Arrhythmia and ST Segment Analysis which are not intended for the neonatal population Indications for Use These devices are capable of monitoring z Heart Rate z Respiration Rate z Invasive Pressure z Non Invasive Pressure z Arrhythmia z Temperature z Arterial oxygen saturation z Pulse rate z central apnea z ST Segment Analysis This device...

Page 7: ...on which if not avoided could result in death or serious injury CAUTION A CAUTION statement provides important information about a potentially hazardous situation which if not avoided may result in minor or moderate injury to the user or patient or in damage to the equipment or other property NOTE A NOTE provides additional information intended to avoid inconveniences during operation ...

Page 8: ...Messages 5 Trends 6 Recordings 7 ECG and Heart Rate 8 Arrhythmia 9 ST Segment Analysis 10 Respiration 11 Pulse Oximetry 12 Non Invasive Blood Pressure 13 Invasive Blood Pressure 14 Temperature 15 Appendices Options and Accessories A Cleaning Disinfecting Sterilizing B Default Settings and Biomedical Support C Technical Data D Glossary Index ...

Page 9: ...tibility 1 2 Reducing EMI 1 3 Site of Operation 1 3 Electrical Safety 1 4 Connections to Peripheral Devices 1 4 Safety Inspection and Maintenance 1 5 Electrosurgery and Defibrillation Safety 1 6 Pacemaker Safety 1 6 Device Markings 1 7 General Description 1 8 Front Panel 1 9 Back Panel 1 10 Left Side Panel 1 11 Right Side Panel 1 12 Infinity Vista Display 1 13 Alarm Colors 1 13 Parameter Colors 1 ...

Page 10: ...twork Safety Considerations 3 6 Alarm and Status Messages 3 7 CHAPTER 4 Admission Discharge Transfer Overview 4 2 Patient Admission 4 2 Admit Menu 4 3 Patient Category 4 4 Name and ID 4 5 Admit Date 4 6 Patient Discharge 4 7 Data Transfer 4 8 Transfer Across the Network 4 8 Transfer with a Data Memory PC Card 4 10 CHAPTER 5 Alarms and Messages Alarm Grades 5 2 Life Threatening Alarms 5 2 Serious A...

Page 11: ... 7 Recording Formats 7 8 Recording Trends 7 10 Recording Alarms 7 12 Stored Recordings 7 13 Event Recall 7 13 Saving Printing Deleting Stored Recordings 7 15 Recording Status Messages 7 16 CHAPTER 8 ECG and Heart Rate Overview 8 2 Patient Preparation 8 2 Selecting and Preparing the Electrodes 8 2 Preparing the Patient s Skin 8 3 Positioning the Electrodes 8 4 ECG Monitoring Settings 8 7 Cable Type...

Page 12: ...APTER 9 Arrhythmia Overview 9 2 Turning Arrhythmia Monitoring ON 9 4 Arrhythmia Setup 9 5 Rate and Count 9 6 Arrhythmia Alarms 9 6 Arrhythmia Alarm Recordings 9 7 Relearning a Patient s ECG 9 7 CHAPTER 10 ST Segment Analysis Overview 10 2 ST Monitoring Display 10 3 ST Setup 10 4 Isoelectric and ST Measuring Points 10 5 ST Reference Complex 10 6 ST Alarms 10 7 CHAPTER 11 Respiration Monitoring Over...

Page 13: ...12 5 SpO2 Monitoring Display 12 6 SpO2 Display Channel 12 6 SpO2 Display Amplitude 12 7 Cascade Display 12 8 SpO2 Monitoring Settings 12 9 Pulse Tone Source 12 9 Pulse Tone Volume 12 10 Signal Strength Bar Graph 12 11 Averaging Mode 12 11 CHAPTER 13 Non Invasive Blood Pressure Overview 13 2 NBP Safety Considerations 13 3 Cuff Selection and Placement 13 4 NBP Measurements 13 6 Single Measurements 1...

Page 14: ...lood Pressure IBP A 8 Non invasive Blood Pressure NBP A 9 Power Sources A 10 Displays and Display Components A 11 Recorder A 11 Miscellaneous A 12 CHAPTER B Cleaning and Disinfecting Cleaning and Disinfecting B 2 Monitor B 2 Patient Cables B 2 Reusable ECG Electrodes B 3 Reusable SpO2 Sensor B 3 NBP Cuff B 3 Temperature probes and cables B 3 Reusable Pressure Transducers and Cables B 4 Masimo SET ...

Page 15: ...ogs C 13 Changing Units of Measure C 13 Parameter Colors C 14 NBP SpO2 Interlock C 16 ASY VF Alarms C 16 Pacer Mode C 17 CHAPTER D Technical Data Overview D 2 Regulatory Compliance D 2 Basic System Components D 3 Monitoring Specifications D 7 Electromagnetic Compatibility D 15 Glossary Index ...

Page 16: ...xiv Infinity Vista VF6 This page intentionally left blank ...

Page 17: ...tenance 1 5 Electrosurgery and Defibrillation Safety 1 6 Pacemaker Safety 1 6 Device Markings 1 7 General Description 1 8 Front Panel 1 9 Back Panel 1 10 Left Side Panel 1 11 Right Side Panel 1 12 Infinity Vista Display 1 13 Alarm Colors 1 13 Parameter Colors 1 14 Rotary Knob 1 14 Fixed Keys 1 15 Menus 1 16 Power Sources 1 17 MultiMed NeoMed Pod 1 18 Recorder 1 19 Remote Displays 1 19 Complete Men...

Page 18: ...g instructions carefully before using the monitor Specific warnings and cautions are found throughout the User s Manual where they apply WARNING Monitor operation is currently not supported in the following environments magnetic resonance imaging MRI aircraft ambulance home or hyperbaric chamber environments CAUTION Use only batteries that are approved by Dräger contact your local representative T...

Page 19: ... The site of operation for the monitor must meet temperature humidity and air pressure requirements For details see the product description in Appendix D WARNING Do not operate the monitor in presence of flammable anesthetic mixtures with air oxygen or nitrous oxide If the devices are used where flammable anesthetic substances are used the possibility of an explosion cannot be excluded WARNING Do ...

Page 20: ...ith local electric codes The universal AC adapter should be connected to a fully tested hospital grade outlet with proper grounding CAUTION In the interest of patient safety and equipment performance Dräger does not authorize the connection of other manufacturers equipment not approved by Dräger It is the user s responsibility to contact Dräger to determine compatibility and warranty status if con...

Page 21: ...at safety and functional checks be performed on the monitor at least once each year The temperature and non invasive blood pressure circuits of the monitor should be calibrated at least every two years These checks should be performed by authorized personnel as described in the appropriate Service manual When main or battery power is not available the monitor stores patient data and settings in an...

Page 22: ...l transducers and intermediate cables off of earth ground and away from the ESU knife and return wires z Use the SpO2 pulse rate instead of the ECG to determine the heart rate z Use rectal temperature probe sheaths to cover any internally placed temperature sensors z Always use the accessories designed for ESU environments z If pacer detection is on the ESU interference may be detected as pacer sp...

Page 23: ...t a Alternating current Danger Risk of explosion if used in presence of flammable anesthetics P0123 This device bears the P label in accordance with the provisions of the Directive 93 42 EEC of 14June 1993 concerning medical devices IPX1 Protected against harmful effects of dripping water NBP Non Invasive Blood Pressure IBP Invasive Blood Pressure Waste Electrical and Electronic Equipment WEEE dis...

Page 24: ...orespirogram neonatal mode only z Non Invasive Blood Pressure Monitoring z Invasive Blood Pressure Monitoring available option z Trend Storage z Event Storage z Recordings z Patient Data Transfer via PC Card or Network z Wireless Network Operation The monitor has an 8 4 color display and a rechargeable battery A universal AC adapter is available for connection to a hospital grade outlet For export...

Page 25: ...FRONT PANEL VF6 Infinity Vista 1 9 Front Panel 1 Fixed Keys 3 Power ON OFF Key 2 Rotary Knob ...

Page 26: ...1 10 Infinity Vista VF6 1 OVERVIEW Back Panel 1 Power Supply Connection 3 X7 Alarm Output R50 Recorder RS232 2 X5 External VGA 4 Battery Compartment Cover ...

Page 27: ...LEFT SIDE PANEL VF6 Infinity Vista 1 11 Left Side Panel 1 NBP Hose Connection 2 MULTIMED NEOMED Connection ...

Page 28: ...1 12 Infinity Vista VF6 1 OVERVIEW Right Side Panel 1 Carrying Handle 3 Memory Card Slot 2 USB Connector 4 QRS Sync Output ...

Page 29: ...w background are used for serious alarms and their messages e g Rsp Too High z Black letters on a white background are used for advisory alarms and their messages e g Rsp Lead Off z Amber letters on a dark gray background are used for network messages see the Network Applications chapter for details z White letters on a blue background are used for messages and information unrelated to the network...

Page 30: ...e rotary knob you can z Select a screen area parameter box or waveform field z Call up a menu and change menu options z Scroll through trend tables and graphs z Scroll through stored events z Switch between trend tables and graphs STEPS Calling up a menu 1 Turn the knob clockwise or counterclockwise to navigate the screen Selected areas appear framed 2 Press click the knob to call up a screen area...

Page 31: ...ed to this monitor the recording is stored as an event and can be viewed printed or deleted at a later date Alarm Limits Press this key to access the alarm limits table NBP Start Stop Press this key to start a manual NBP measurement or to stop one in progress All Alarms Off Press this key to silence all alarms for three minutes Fast Access Press this key to access trend and event data Menu Press t...

Page 32: ...veform area Use the rotary knob or a fixed key to access menus A complete menu tree is shown at the end of this chapter NOTE z Some menu items are only available if the corresponding monitoring function has been enabled selected i e full arrhythmia monitoring invasive blood pressure monitoring z Parameter boxes for invasive blood pressure IBP show the labels ART PA CVP ICP or a generic pressure la...

Page 33: ... Power Sources The monitor can be operated with battery power or connected to line power via an AC adapter See the chapter Monitor Setup for a description of battery operation and the AC adapter Monitor with Battery Monitor with AC Adapter ...

Page 34: ... management ECG cable sets the SpO2 sensor and temperature probes are housed in a MULTIMED or NEOMED pod See the chapter Monitor Setup for information on assembling the patient cables MultiMed 5 Pod and Accessories MultiMed 6 Pod and Accessories NeoMed Pod and Accessories ...

Page 35: ...ccessories appendix Complete Menu Structure see below NOTE If you use a video monitor other than the one approved by Dräger it must comply with IEC 60601 1 Upon installation the installer must ensure that in normal and single fault conditions the entire system meets the requirements of IEC 60601 1 and IEC 60601 1 1 Medical Electrical Systems Standards Refer to the video monitor s operating instruc...

Page 36: ...scharge Patient Admit Patient Category Adult Pediatric Neonate Name dial in ID dial in Admit Date current date Care Unit select Bed Label select Discharge Discharge Patient No Yes Transfer Care Unit select Transfer Bed select Start Transfer Confirm Cancel Copy Data Copy to Card Name ID Start Transfer ...

Page 37: ... Bottom Channel All NBP with Lithium Ion battery Screen Brightness Dim Bright Monitor Options Speaker Volume 10 20 100 OFF Trend Setup Channel 1 select parameter Channel 2 select parameter Channel 3 select parameter Recordings Primary Recorder select Secondary Recorder select Review Event Recall Biomed password Alarm Groups 1 255 Standby ...

Page 38: ...splay Menu Alarm Limits Table Standby Bottom Channel All Waveform Wave NBP NBP Trend Graphs Trend Tables Event Recall Channel 1 2 3 Waveform select param Size param specific Parameter Upper dial in Autoset Lower dial in Alarm ON OFF Record Record Store Str Rec OFF ...

Page 39: ...e ECG SpO2 Tone Volume 10 20 100 OFF Pacer Detect ON OFF if Pacer Mode adv Fusion QRS Mark ON OFF Arrhythmia Setup Rate dial in Count dial in Alarm ON OFF Record Record Store Str Rec OFF ECG Processing ECG1 ECG1 2 ECG Leads 3 5 6 Arrhythmia Basic Full OFF Relearn last relearn ...

Page 40: ... Menu Resp P Box Resp Mode Manual Auto OFF Resp Marker ON OFF Relearn last relearn Apnea Time 10 30 OFF Coincidence ON OFF SpO2 P Box Tone Source ECG SpO2 Tone Volume 10 20 100 OFF Bar Graph ON OFF Averaging Normal Fast Sensor Type informational only ...

Page 41: ... Menu ST P Box ISO place point ST place point Ref ON OFF Save last save NBP P Box Interval Mode 2 240 OFF Calibration Mode ON OFF Inflation Mode Adult 270 Ped 180 Neo 140 Measurement Tone ON OFF IBP P Box Label select pressure Zero Cal Factor 80 120 Mano Cal mmHg 1 300 ...

Page 42: ...ncel Locked Options Enable Option Demo Lock 1 2 3 4 software key Diagnostic Logs Units T C or F Pressures mmHg or kPa ST mm or mV Service password service functions Monitor Setup Alarm Light not implemented Parameter Colors select color NBP SpO2 Interlock ON OFF ASY VF Alarms Always On Follow HR Pacer Mode Basic Advanced ...

Page 43: ...dapter 2 2 Using the Battery 2 3 Assembling MultiMed and NeoMed Pods 2 8 Starting the Monitor 2 9 Main Screen Configuration 2 10 Waveform Selection 2 10 Bottom Channel Display 2 11 Setting the Master Speaker Volume 2 13 Standby 2 14 Saving Setups 2 15 ...

Page 44: ...or switches to battery power without loss of monitoring data or settings CAUTION z Before monitoring your patient the battery that is delivered with a new monitor has to be fully charged see below z Before monitoring your patient be sure you have read the Important General Safety Considerations in the Overview chapter CAUTION Use only the AC adapter approved by Dräger Using a non approved power su...

Page 45: ...he Battery The battery powers the monitor when the monitor is not connected to line power via the AC adapter The battery fits into the battery compartment at the back of the monitor There are two types of batteries lead acid or lithium ion shown below Lead acid batteries provide 75 minutes of continuous monitoring lithium ion batteries provide 210 minutes of continuous monitoring in Bright Screen ...

Page 46: ... you change to battery operation With a lead acid battery the display always dims on battery power With a lithium ion battery you can choose whether or not the displays dims The Brightness setting remains in effect through a power cycle Regardless of the setting lithium ion batteries can power the monitor for at least three hours even if the display remains bright during battery operation STEPS Se...

Page 47: ... be pushed into the clip in the left side of the battery compartment 4 With the battery pushed into the left side of the battery compartment press the right side of the battery into the clip at the right side NOTE Before installing the battery read the cautions and warnings in the Important General Safety Considerations section at the beginning of this manual NOTE A lithium ion battery can replace...

Page 48: ...th a new monitor needs to be fully charged before monitoring When connected to line power via the AC Adapter the monitor automatically charges the battery and the green Battery Charger LED lights up the monitor can be turned on or off To charge the battery 1 Connect the monitor to line power and let the lead acid battery charge for 5 hours the lithium ion battery for 8 hours The Battery Charging m...

Page 49: ...the monitor 4 Lift the battery from under the locking tab and pull the battery out CAUTION Use the battery charger to charge lead acid batteries only Lithium ion batteries are not compatible with the Dräger lead acid battery charger NOTE If the monitor is connected to AC power monitoring can continue while you replace the battery If the monitor is not connected to AC power turn the monitor off bef...

Page 50: ... as illustrated prior to connecting them to the monitor Parameter specific patient preparation is described in the individual parameter chapters 1 SpO2 sensor 2 ECG lead sets 3 Temperature sensor NOTE The FiO2 and TEMP B connectors of the NEOMED pod are not supported with the Infinity Vista monitor WARNING Do not use the NEOMED Pod during electrosurgery Use during cautery may result in burns to th...

Page 51: ...s NOTE z If an internal failure or error should occur the monitor s screen turns blank If this should happen turn the monitor off then on again In case of persistent failure remove the monitor from service and call your Biomed technician z Do not use the monitor if you do not have an AC Adapter or a fully charged battery Call your Biomed if you are not familiar with the use of the battery or the p...

Page 52: ...waveform channel with the rotary knob and click the knob 2 In the Channel Setup menu click on Waveform and select the desired parameter or ECG lead for display For more information including the ECG cascaded display see the chapter ECG and Heart Rate NOTE Settings for screen brightness are explained under Using the Battery above NOTE If you change the monitor s parameter display and the central st...

Page 53: ...he Bottom Channel Display 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Main Screen 4 Click on Bottom Channel 5 Click on All or NBP to select one of the following bottom channel displays NOTE You can also call up the Bottom Channel menu by pressing the Fast Access fixed key ...

Page 54: ...2 12 Infinity Vista VF6 2 MONITOR SETUP Bottom Channel showing all parameter boxes Bottom Channel showing NBP values ...

Page 55: ...s you cannot turn the speaker volume off when the monitor operates as a stand alone device or if the French NFC mode has been selected a Service setting z If your monitor is operating in the Infinity network and you turn the speaker volume off a crossed speaker symbol appears above the first waveform channel NOTE The setting for the master speaker volume defines the maximum volume for all tones in...

Page 56: ...y 2 Click on Standby STEPS Exiting Standby 1 To resume monitoring press the Main Screen fixed key The New Patient prompt appears 2 Select New Patient No if you want to resume monitoring the same patient Select New Patient Yes if you want to start monitoring a new patient If admitting a new patient the monitor erases all previously stored patient data see the chapter Admission Transfer Discharge NO...

Page 57: ...incidence alarm pacemaker setting and detection bottom channel display selection recording selections on off store and trend setup STEPS Saving a Setup password required 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Biomed 4 Dial in the Biomed password and click the knob 5 Click on Save Setups 6 Click on Save Setup select Confirm or Cancel and click the knob The monitor saves the ...

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Page 59: ...read the Network Safety Considerations at the end of this chapter NOTE z The current software operates on the Dräger Infinity network but does not support the Dräger Sirenet network z To assure optimal network performance of your monitoring system make sure all network components operate at the appropriate software level as disclosed in the Dräger compatibility chart For more information contact y...

Page 60: ...ges at the local bedside monitor from other devices within the network z Print recordings on network recorders and laser printers z Transfer patients between monitors in the network z View patient data of up to 16 patients at a dedicated central station z Admit patients at a central station z Control alarms from a central station z Initiate a Relearn of a patient s ECG and respiration pattern from...

Page 61: ... icon NOTE z Patient name and ID continuously identify the patient on central displays recordings and data bases z If a wireless monitor is transmitting data to a central station but has not been assigned a viewport at that station the message Not monitored by central appears in the monitor s message area z When the battery charge of an undocked wireless Infinity monitor becomes low the central st...

Page 62: ...d upon power up the monitor displays the message Network Error z If a wireless monitor loses contact with all access points and wireless transmission is interrupted i e you remove the wireless card or the monitor is out of range the network generates an offline message and the monitor operates as a standalone device z If the bedside monitor s speaker volume had been set to OFF during network opera...

Page 63: ...re Unit is a group of bedside monitors with the same hospital assigned identification i e CCU ICU The name of a Care Unit must be unique within the Infinity network configuration z Always select the care unit before selecting the bed label because the Bed Label menu only lists bedside monitors located in the selected care unit z After turning the monitor on it receives a list of available care uni...

Page 64: ...e aware that certain structural limitations within the hospital building may interfere with signal transmission other devices emitting radio frequencies such as microwave ovens or warmers may interfere with signal transmission the frequencies emitted by the device may interfere with the operation of other wireless operated medical equipment z The installation of wireless equipment must be performe...

Page 65: ...n The bedside monitor is treated as being offline Network Alarm Error An interruption in the network communication has been detected while an alarm is active the speaker volume at the bedside monitor has been increased to its maximum level Not Monitored by Central A wireless monitor is transmitting to a central station but is not assigned a viewport on the central station s cluster screen Offline ...

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Page 67: ...Transfer Overview 4 2 Patient Admission 4 2 Admit Menu 4 3 Patient Category 4 4 Name and ID 4 5 Admit Date 4 6 Patient Discharge 4 7 Data Transfer 4 8 Transfer Across the Network 4 8 Transfer with a Data Memory PC Card 4 10 ...

Page 68: ... station You can transfer patient data between monitors over the Infinity network or with the help of a data card If you discharge a patient the monitor deletes the patient s monitoring data Patient Admission When you turn on the monitor or exit the standby mode the monitor displays a New Patient prompt to assure that previously stored patient data is deleted before you monitor a new patient To st...

Page 69: ...nu 1 Press the Menu fixed key 2 Click on Admit Discharge 3 Click on Patient Admit NOTE You cannot enter selections for Care Unit and Bed Label when the monitor is operating as a stand alone device For information on selecting the care unit and bed label see the chapter Network Applications ...

Page 70: ...essages z Stops any NBP measurement in progress z Deletes stored trend data events and recordings z Returns alarm limits to their category specific default settings see appendix Default Settings and Biomedical Support z Returns waveform display scales sizes to their category specific default settings see appendix Default Settings and Biomedical Support z Sets the display range for trend values acc...

Page 71: ...the second character and click If you need to separate words i e first name from last name click on a blank space 5 Enter the remaining characters accordingly The Admit Menu can display up to 9 characters at a time but you can enter additional characters up to 25 for the name and up to 12 for the ID by scrolling past the up arrow n at the end of the line thereby shifting the entry to the left Once...

Page 72: ...tient Admit menu Menu Admit Discharge Patient Admit see above 2 Click on Admit Date The monitor automatically enters the current date 3 If necessary edit the date by clicking on the day month or year entry fields and dialing in the desired date 4 To exit the date entry line simply scroll off to the left or right ...

Page 73: ... Default Settings and Biomedical Support STEPS Discharging a Patient 1 Press the Menu fixed key 2 Click on Admit Discharge 3 Click on Discharge 4 Click on Discharge Patient YES When you discharge a patient at the bedside monitor the central station deletes the bedside s data from the bed view and displays a Discharge banner for this bedside monitor NOTE You can also discharge a patient from the Ne...

Page 74: ... Press the Menu fixed key 2 Click on Admit Discharge 3 Click on Transfer The Transfer menu opens NOTE z When a data transfer takes place between two monitors whose selected units of measure do not match i e C F mmHg kPa mm mV the destination monitor adopts the units of measure that were selected at the source monitor z When a data transfer takes place between two monitors with different enabled so...

Page 75: ...d from the source monitor and admitted to the destination monitor If the transfer is interrupted or unsuccessful the destination monitor displays a transfer error message In this case the source monitor retains its data and you can attempt the transfer again NOTE The menu shows only those care units which have at least one bedside monitor in Standby mode NOTE z The Transfer Bed menu displays all n...

Page 76: ...he data transfer see the section Name and ID above When copying data to a memory card the source monitor erases all information previously stored on the card Similarly copying data from a card to a monitor overwrites not appends all data currently stored in the destination monitor At the end of a successful data transfer from the card the destination monitor erases all contents from the card CAUTI...

Page 77: ...ce monitor 2 Press the Menu fixed key 3 Click on Admit Discharge 4 Click on Copy Data 5 Click on Copy to Card The monitor displays the Copy to Card menu 6 When the message Ready appears in the Status field click on Start Transfer Confirm or Cancel to cancel the transfer CAUTION Before a copy the monitor erases all contents of the card ...

Page 78: ... software card produces the message Card Contents Invalid together with an error tone and copy to card is not possible STEPS Copy to Monitor 1 Insert the memory card into the memory card slot on the right side of the destination monitor 2 Press the Menu fixed key 3 Click on Admit Discharge 4 Click on Copy Data 5 Click on Copy to Monitor The Copy to Monitor menu appears with the patient Name ID and...

Page 79: ...essage Card data copy unsuccessful If the data on the card is older than 24 hours the error message No data to copy for last 24 hours alerts the user of the invalid procedure NOTE The Offset minutes field shows how many minutes have passed since the patient data was written on the card The field shows a negative value if the card was written earlier than the current time on the destination monitor...

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Page 81: ... Advisory Alarms 5 3 Alarm Settings 5 4 Setting Alarm Limits 5 5 Turning Parameter Alarms On Off 5 6 Turning Alarm Recordings On Off 5 7 Alarm Validation 5 8 Silencing Alarms 5 9 Alarm Silence Key 5 9 All Alarms OFF Key 5 10 Assigning Alarm Groups 5 11 Central Alarms 5 12 Messages 5 13 ...

Page 82: ... highest priority The monitor triggers life threatening alarms for asystole ventricular fibrillation ventricular tachycardia and bradycardia bradycardia in neonatal mode only A life threatening alarm has the following characteristics z The HR parameter box blinks and appears red z The monitor emits a continuous warble tone z The monitor displays the alarm cause in both the parameter box and the me...

Page 83: ...m automatically when the condition ceases to exist z The monitor stops the alarm when a new alarm of equal or higher grade is triggered Advisory Alarms An advisory alarms has the lowest priority It can result from one of three conditions z When the monitor cannot produce a parameter value due to a technical problem e g a lead off condition z A patient cable or accessory failure e g a blocked line ...

Page 84: ...s fixed key The Alarm Limits table has several pages with additional parameters To call up additional pages and parameters z Press the Alarm Limits fixed key again or z Click on the up or down arrow in the upper left hand corner of the table NOTE z Set the alarm volume 10 to 100 in the Monitor Setup menu see the chapter Monitor Setup z Set arrhythmia alarms and alarm recordings on the Arrhythmia S...

Page 85: ...ts that are automatically calculated for each parameter based on current parameter values 3 To accept these limits for all parameters click on AutoSet The automatically calculated limits are written into the Upper and Lower columns NOTE z The AutoSet function sets alarm limits for all parameters at once even for those not displayed on the current page of the Alarm Limits table Exception There is n...

Page 86: ...ssed bell icon in the corresponding parameter box STEPS Turning Parameter Alarms On or Off 1 Press the Alarm Limits fixed key 2 Scroll to the Alarm column of the desired parameter and click the knob 3 Dial in the desired setting and click the knob Parameter Upper Limit Lower Limit SpO2 fixed at 100 5 HR PLS Rsp NBP GP1 GP2 20 15 Temperature 7 7 ST 2 0 2 0 For neonatal monitoring mode the Upper Lim...

Page 87: ...storage setting and click the knob See the Recordings chapter for a description of alarm recordings stored recordings and the Event Recall screen NOTE z In French NFC mode a Service setting either the HR or the SpO2 alarm must be on If you turn one of these alarms off the monitor automatically turns the other alarm on z If the monitor is networked to a central station and the patient has been admi...

Page 88: ...s not trigger the alarm The alarm validation period is part of the software see table below and cannot be modified The monitor triggers the alarm at the end of the validation period Parameters have the following alarm validation periods Parameter Specific Alarm Validation Periods Parameter Upper Limit in seconds Lower Limit in seconds ECG Heart rate HR 2 0 Pulse rate PLS 4 10 ST Segment Analysis 6...

Page 89: ...additional minute If the monitor detects a new alarm condition during the silence period z The monitor annunciates the new alarm immediately delivering both audible and visual alarm indicators z The new parameter box blinks while the parameter box of the previously silenced alarm remains highlighted The new message appears at the bottom of the screen and then alternates with the message for the pr...

Page 90: ... boxes return to normal colors z All alarm messages are removed from the message area z All new alarms are blocked z Currently activated alarms including latched alarms are acknowledged z When on the network the message banner All Alarms OFF appears in the bedside monitor s remote display on the central station and in the ClusterView NOTE When starting the monitor coming out of Standby or answerin...

Page 91: ...rs into separate alarm groups so that only messages from monitors within the same alarm group are shared If you do not want to display any remote alarm message at a particular bedside monitor place that monitor in its own alarm group STEPS Assigning Alarm Groups 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Alarm Groups 4 Click the knob dial in the number of the desired alarm grou...

Page 92: ...n you can remotely z Set alarm limits z Turn parameter alarms On or Off z Silence active alarms z Turn alarm recordings On or Off Changes made to the alarm limits at the central station take effect immediately at the bedside monitor For more information see the Instructions for Use of the central station NOTE z When the monitor is connected to the Infinity network you can turn the master speaker v...

Page 93: ...ackground in the message area e g Asystole and in the parameter box e g ASY The monitor displays status and network messages in the message area at the bottom of the screen Diagnostic messages appear during the self test routines that occur immediately after you turn the monitor on Alarm and most status and network messages appear alternately until the condition has been resolved Diagnostic messag...

Page 94: ... Message LA Lead Off Message ECG Leads Off HR parameter value ST lead1 ST lead2 parameter value blank The monitor has detected a lead off condition for the currently processed lead The cause could be one of the following Unplugged cable Broken cable Loose lead wire Faulty lead wire Dried out gel on the electrode Wrong cable type selection The MULTIMED NEOMED pod may be defective Check the patient ...

Page 95: ...urrent upper or lower alarm limits The current alarm limits are inappropriate for this patient Observe the patient carefully Apply treatment if clinically indicated Change the alarm limits as described in the HR Alarms section Message MultiMed Disconnected PVC parameter value blank HR parameter value ST lead1 ST lead2 parameter value blank The MULTIMED NEOMED pod is disconnected from the monitor V...

Page 96: ...eat if clinically indicated Message BGM Parameter value BGM A sequence of beats with the pattern normal PVC normal PVC normal Observe the patient and treat if clinically indicated Message TACH Parameter value TACH N or more consecutive normal beats with a beat to beat rate the TACH rate Observe the patient and treat if clinically indicated Message PAUS Parameter value PAUS A sequence of two normal...

Page 97: ...r value value Message ST LL ST lead1 and ST lead2 parameter value value The ST rate falls outside the current upper or lower alarm limits The current alarm limits are inappropriate for this patient Observe the patient carefully Apply treatment if clinically indicated Change the alarm limits as described in the Cardiac Monitoring chapter Message ST Lead 1 and or ST Lead 2 Invalid ST lead1 and or ST...

Page 98: ... placement Message Rsp Fault Parameter value Technical problem Turn the monitor off then on If the problem persists take the unit out of operation and call DrägerService Message Rsp High Impedance Parameter value Impedance out of range Broken cables Dried out gel on the electrodes Poor skin preparation Check the cables for damage Check the electrodes Move the electrodes if necessary Message Rsp Te...

Page 99: ...facts Interference due to auxiliary equipment Check the patient and apply treatment if necessary Check the electrode placement and change their position if necessary Move the electrodes away from the source of interference Message Use ECG II for Rsp Parameter value An ECG lead other than lead II is displayed while 3 ECG lead cable is selected Select Lead II to ensure accurate respiration monitorin...

Page 100: ...PLS Motion Parameter value The monitor has detected motion artifacts in the signal The cause can be one of the following The patient is moving The patient is coughing Hemodynamic interference Hypothermia Vascular compromises to the extremity Move sensor to another location Observe the resulting waveform on the screen Message SpO2 No measurement Message PLS No measurement Parameter value The monito...

Page 101: ...alue Parameter value value Message PLS LL value Message PLS UL value Parameter value value The patient s oximetry level or pulse rate falls outside the current alarm limits or the alarm limits are inappropriate for this patient The SpO2 level has changed since you last selected the alarm limits Elevated carboxyhemoglobin or methemoglobin levels Significant levels of intravascular dyes Placement of...

Page 102: ...take the unit out of operation and call your Biomed Message T Unplugged Parameter value The temperature probe is disconnected from the MULTIMED NEOMED pod The MULTIMED NEOMED cable is defective The probe is defective The probe is not recommended for use with your monitor Verify the probe connection to the pod Verify the probe If defective change the probe Message T Test Fail The monitor has detect...

Page 103: ...flushing and repositioning the catheter Message IBP Static Parameter value value This message appears when the invasive pressure alarms are on while zeroing No pulse Turn combined systolic and diastolic alarm off Check the patient Repeat zeroing Message IBP Sys LL value Message IBP Sys UL value Message IBP Mean LL value Message IBP Mean UL value Message IBP Dia LL value Message IBP Dia UL value Pa...

Page 104: ...ant drop in the cuff pressure during inflation Check for leaks in the cuff or hose Change the cuff and hose if necessary Message NBP Fault Power Cycle Monitor Parameter value Faulty equipment Improper cuff placement Transducer needs calibration NBP hardware needs repair or calibration Hardware safety timer has expired Check the hose and cuff Check proper placement of cuff Turn the monitor off then...

Page 105: ...ge the current alarm limits for this patient Message NBP Out of Range Parameter value NBP values are above below the NBP measuring range Check patient and treat if necessary Verify that the inflation mode is appropriate for the patient Change if necessary Message NBP Low Inflation Limit Parameter value The patient s systolic pressure is above the current inflation limit Change to a higher inflatio...

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Page 107: ...6 Trends Overview 6 2 Trend Setup 6 2 Trend Graphs 6 3 Trend Table 6 5 Special Conditions and Codes 6 6 ...

Page 108: ...rend screens However you can select any three parameters for the top positions on these screens see below The order of these parameters is saved as part of the setup when you save the current monitoring configuration see the chapter Monitor Setup For non invasive blood pressure the monitor stores a trend value at the end of a successful measurement or an error code at the end of an unsuccessful me...

Page 109: ...ight of the graph in white or in the color of the alarm grade if the parameter was in alarm during the one minute trend sampling interval Each trended parameter has a scaled vertical axis to the left of the trend display channel Values that fall outside the trend scale are plotted at the maximum or minimum of that scale To see these values move the cursor to the plotted line and read the values on...

Page 110: ...rend window of 1 2 4 8 or 12 hours A smaller time scale i e 1 hour displays more detail than a larger time scale i e 12 hours The time stamps on the horizontal time axis reflect the scale selected z Cursor display or hide a vertical cursor Turn the rotary knob to move the cursor to a specific location time on the trend graphs screen The stored trend values corresponding to that location appear to ...

Page 111: ...n for the parameters being monitored The monitor identifies parameter labels by their color Trend values appear in white or in the color of the alarm grade if the parameter was in alarm during the one minute trend sampling interval STEPS Calling up the Trend Table 1 Press the Menu fixed key 2 Click on Review 3 Click on Trend Tables NOTE You can also call up the Trend Table by pressing the Fast Acc...

Page 112: ...ence of the alarm with the highest priority detected during the one minute trend sampling interval Trend storage and display priorities are as follows 1 Power up testing and standby 2 Life threatening alarms i e ASY VT VF 3 Out of range conditions or 4 Serious alarms Alarm limit violations and apnea 5 Advisory alarms Artifact and lead off conditions For conditions that fall under the same priority...

Page 113: ...Overpressure NBP F Fault SpO2 PLS NBP L Lead Off ECG Rsp ST M Failure to measure NBP ISO and ST measuring points changed O No pulsations NBP U Unplugged cable loss of communication X Measurement time out NBP LRN Learning Rsp ARR ON Power up patient admit exit from Standby STB Standby TST System test blank No value Respiration monitoring off NBP between measurements ST monitoring off T over or unde...

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Page 115: ...Recorders 7 5 Recording Waveforms 7 6 Timed Recordings 7 6 Continuous Recordings 7 7 Recording Formats 7 8 Recording Trends 7 10 Recording Alarms 7 12 Stored Recordings 7 13 Event Recall 7 13 Saving Printing Deleting Stored Recordings 7 15 Recording Status Messages 7 16 ...

Page 116: ...y the patient s name ID and bed label as well as the date and time of the recording request If no recorder is available the monitor automatically stores up to 10 recordings which you can later view print save or delete via the Event Recall screen see the section on Event Recall You can request a recording manually by pressing the Record fixed key or the monitor can trigger alarm recordings automat...

Page 117: ...of the monitor CAUTION Always place recorders and laser printers on a flat and stable surface to prevent them from falling NOTE z The configuration installation of a network laser printer is a Service function z Use of the R50 recorder keys Alternate Speed and mm s is not supported by the Vista monitor R50 Recorder Connection ...

Page 118: ...d side should be facing up 4 Align the paper roll with the paper guides If not aligned the paper could jam 5 Close the paper door 6 To verify proper connection and paper loading generate a timed recording CAUTION z Use only the recording paper specified by Dräger Use of other paper could result in unclear printing and damage to the printing head z Store all paper in an environment that meets the r...

Page 119: ... available the monitor stores the recording see the section Stored Recordings in this chapter STEPS Assigning Network Recording Devices 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Recordings 4 Click on Primary Recorder select the desired recorder printer and click the knob again 5 Click on Secondary Recorder select a secondary recorder printer if available and click the knob aga...

Page 120: ...ed prior to the recording request Delay and about 10 seconds after the recording request If no recorder printer is available the monitor stores the recording see Stored Recordings below You can cancel the storage within 5 seconds of the initial recording request The monitor cancels a timed recording if you modify the display size or scale of a waveform while the recording is ongoing STEPS Starting...

Page 121: ...timed recording with 20 seconds of patient data NOTE z You can request a continuous recording during an alarm timed trend and diagnostic log recording To do so first stop the recording in progress with the Record fixed key on the monitor then press and hold the same key to start the continuous recording z Continuous OCRG recordings are not supported NOTE z If the user requests a continuous recordi...

Page 122: ...Vista VF6 7 RECORDINGS Recording Formats A timed or continuous recording consists of a header and two waveforms with proper scales units of measure and parameter labels R50 Recording Strip Printout of Laser Printer ...

Page 123: ...s disabled z Recording mode timed or continuous z or blanks if numeric values and waveforms are unavailable The printout shows the top two waveforms that were displayed on the monitor s screen at the time of the print request A small black marker along the bottom of the printout indicates the time of the print request NOTE z If the second waveform channel is set to Cascade only the waveform in the...

Page 124: ...is available for that parameter in the tabular trend columns or in the graphical trend window You must view the graphical and tabular trends in order to record them An alarm recording request preempts a trend recording In monitors that display Neonatal OCRG the recorder prints 144 seconds of patient OCRG data that occurred prior to pressing the Record fixed key The illustration below shows an OCRG...

Page 125: ...cording Trend Graphs 1 Display the Trend Graph 2 Press the Record fixed key on the monitor The illustration below shows a typical trend graph recording strip NOTE Because of the larger paper size laser printers are best suited to print out trend data ...

Page 126: ...eform during recording You can also cancel an alarm recording by pressing the monitor s Record fixed key or the Stop key on the recorder The monitor alerts you to a cancelled recording request by briefly displaying the message Recording Cancelled If a cascaded waveform is displayed the recording prints out only the top waveform If a new alarm occurs while an earlier alarm is ready to print or the ...

Page 127: ... storage in progress press the Record fixed key on the monitor within 5 seconds of the start of the recording storage Event Recall You can view 4 seconds of waveform data for each stored recording on the Event Recall screen 4 seconds of pre event request data The screen also shows the parameter values at the time of the recording storage To call up the Event Recall screen 1 Press the Menu fixed ke...

Page 128: ...e recording and the type of the recording bedside timed or the parameter in alarm STEPS Navigating the Event Recall Screen 1 Click on Prev to call up older stored recordings 2 Click on Next to call up more recently stored recordings 3 Click on More next to the list of parameters to view additional parameters and their values at the time of the recording storage ...

Page 129: ...d it is marked by a padlock icon STEPS Saving a Stored Recording 1 Call up the Event Recall screen 2 Click on Prev or Next to select a stored recording 3 Click on Save click on Save again to unlock the saved recording STEPS Printing or Deleting a Stored Recording 1 Call up the Event Recall screen 2 Click on Prev or Next to select a stored recording 3 Click on Print or Delete NOTE You can only dele...

Page 130: ...to print the recording Check Printer Printer error Laser printer connection lost printer out of paper or tray open Recorder Out of Paper Load paper to obtain recordings Recording Cancelled The recording has been cancelled following a user s request Wait for the message to clear to request another recording Recording Finished The recording is printed Another recording can be initiated Recording Sta...

Page 131: ...11 Pulse Tone Volume 8 12 Pacer Detection 8 13 Displaying Sync Marks 8 14 ECG and HR Safety Considerations 8 15 HR Alarm Settings 8 15 Neonatal ECG Monitoring 8 15 ECG 50 60 Hz Notch Filter Setting 8 15 Muscle Stimulators 8 15 Electrosurgery ESU 8 16 Infusion pumps 8 17 Defibrillators and Cardioversion 8 17 High P Waves and T Waves 8 18 Pacemakers 8 18 AV Sequential or DDD Pacemakers 8 19 Pacemake...

Page 132: ...ou first turn on the monitor it calculates heart rate within 15 seconds or 3 beats whichever is longer and displays the value in the HR parameter box Thereafter the heart rate is updated after every detected beat The heart symbol j pulsates with every detected QRS complex When the HR alarm is turned off a crossed bell appears beside the HR value When monitoring a paced patient the letter P is adde...

Page 133: ...electrode contact site with ultrafine sandpaper 220 400 grit Apply the electrodes one at a time and make sure the electrode gel is in contact with the abraded skin area 4 For severely diaphoretic patients use a benzoin prep for tighter adherence of the electrodes 5 Inspect the electrode gel to make sure it is moist Apply the pad with a circular motion on the adhesive area first then press gently o...

Page 134: ...d wire and its associated color for the IEC 2 AHA US and IEC 1 color schemes The following pictures show possible configurations of 3 5 and 6 lead electrode sets Note that these configurations are examples only final configuration must be determined by a trained clinical personnel 3 Lead Standard Configuration Lead Wires IEC 2 AHA US IEC 1 LA Black Yellow LL Red Green RA White Red V Brown White RL...

Page 135: ...PATIENT PREPARATION VF6 Infinity Vista 8 5 3 Lead MCL1 Configuration 5 Lead Standard Configuration NOTE Select ECG I in the waveform channel for monitoring the MCL1 configuration ...

Page 136: ...nfiguration 3 Lead Configuration for Neonates When monitoring neonates the use of a 3 lead configuration is recommended Dräger also recommends use of the NEOMED Pod for neonates Position the right arm RA left arm LA and left leg LL electrodes as illustrated below ...

Page 137: ... set to ensure the proper detection and display of augmented leads STEPS Selecting the Cable Type 1 Click on the HR parameter box 2 Click on More 3 Click on ECG Leads 4 Dial in the desired cable type and click the knob NOTE If an augmented lead was displayed when switching from a 5 lead or 6 lead cable to a 3 lead cable set the monitor defaults to the display of lead II This ensures the display of...

Page 138: ...he waveform channel where the ECG waveform is currently displayed 2 Click on Waveform 3 Select the desired ECG lead and click the knob 4 Click on Size 5 Select the desired display amplitude and click the knob NOTE z The lead assigned to the first waveform channel cannot be assigned to the second waveform channel except in Cascade mode z If you change the monitor s leads and the central station is ...

Page 139: ...channel into the second channel STEPS Selecting the Cascade Display 1 Click on the second waveform channel 2 Click on Waveform 3 Select Cascade and click the knob NOTE z The Cascade is only available in the second waveform channel z The second channel of a cascaded waveform cannot be printed on recordings NOTE You cannot adjust the display amplitude Size for the second waveform channel when Cascad...

Page 140: ...ssive artifact The monitor processes the two leads displayed in the top two waveform channels If no lead or only one lead is currently displayed in these channels the monitor uses the last leads previously displayed there STEPS Selecting One or Two Channel Signal Processing 1 Click on the HR parameter box 2 Click on More 3 Click on ECG Processing 4 Select the desired setting ECG1 or ECG1 2 and cli...

Page 141: ...With ECG as the pulse tone source the tone s pitch is constant rather than modulated see the chapter Pulse Oximetry and a pulsating j symbol appears in the HR parameter box with each detected heart beat STEPS Selecting the Pulse Tone Source 1 Click on the HR parameter box 2 Click on Tone Source 3 Select ECG and click the knob ...

Page 142: ...lume 3 Select the desired setting and click the knob NOTE z Tone volume settings are common to both ECG and SpO2 source signals Whatever setting you select for ECG is valid for SpO2 and vice versa z The monitor s Master Speaker Volume see the chapter Monitor Setup determines the volume of all tones If you select a pulse tone volume higher than that of the speaker volume the pulse tone volume sound...

Page 143: ...ivity to fused paced beats To select the Pacer Fusion mode in the HR menu advanced pacer functions have to be enabled in the Biomed menu When monitoring paced patients Dräger suggests the following z Use the electrode positions that are best suited for paced patients see the electrode placement section z Select the lead with the highest R wave z Follow the pacemaker precautions given at the end of...

Page 144: ...during synchronization For heart rates between 30 and 250 beats per minute with QRS amplitudes greater than or equal to 0 5 mV the sync pulse occurs within 35 ms of the R wave peak See the section ECG and HR Safety Considerations for details STEPS Displaying QRS Sync Marks 1 Click on the HR parameter box 2 Click on QRS Marks 3 Dial in the desired setting ON OFF and click the knob NOTE If SpO2 is d...

Page 145: ...long with masking QRS complexes As a result detection of the QRS complexes becomes unreliable When these cannot be sensed reliably incorrect HR calculations may result leading to both false positive and false negative HR alarms Muscle Stimulators NOTE z If arrhythmia detection is on alarms for asystole ASY and ventricular fibrillation VF are automatically on and cannot be turned off z By default a...

Page 146: ...ing a MULTIMED 6 pod ignore the extra V lead connection 3 Plug a standard white ECG lead set into the ESU block as shown Do not use shielded blue lead wires with the ESU block 4 Remove the ESU block to continuously monitor the patient WARNING z Dräger recommends using the ESU block during electrosurgery If you do not have an ESU block use only Dräger blue ECG lead wires They help protect the patie...

Page 147: ...pacer spikes that display on the ECG The ECG waveform s and the HR value may be affected during electrosurgery However after discontinuing the use of electrosurgery equipment the waveform s and value are displayed as normal Infusion pumps Use of an infusion pump may cause artifact in ECG signals To determine if the pump is the source of electrical interference in the signal turn it off if possible...

Page 148: ...o anticipate every waveform characteristic WARNING The monitor may count high amplitude P or T waves 0 2 mV of long duration as QRS complexes This can result in missed low rate alarms If the displayed heart rate HR is higher than that indicated by the waveform the monitor may be counting unusually high T waves or P waves as QRS complexes WARNING In case of uncertainty regarding the interpretation ...

Page 149: ... Fusion Mode be certain that the patient has a biphasic pacemaker external or implanted and that it is accurately programmed as appropriate for that patient z Do not select Fusion Mode if you are uncertain what type of pacemaker is in use or how it is programmed z Select Fusion Mode only to suppress repeated false asystole and or false low heart rate alarms z Selecting Pacer Fusion Mode may increa...

Page 150: ...ar Large Amplitude Pacer Pulses Transcutaneous Electrical Nerve Stimulators TENS TENS signals are similar to pacemaker spike signals and may be accidentally labeled as such by the monitor WARNING Some pacemakers especially external pacemakers emit pulses with amplitudes far exceeding those shown in the pacer pulse rejection table The monitor may misinterpret such pulses as valid QRS complexes and ...

Page 151: ...rhythmia Classification Expert ACE The Infinity Vista monitor uses Dräger s ACE TM Arrhythmia Classification Expert technology to screen out misleading or erroneous arrhythmia information ACE is not rule based it uses trained logic to draw informed conclusions about the patient This provides more accurate detection of legitimate cardiac events while reducing the likelihood of false alarms ...

Page 152: ...to the stored reference and classified as either normal or irregular arrhythmia During the learning phase LRN appears in the HR parameter box and the message Arrhythmia Relearning in the message area at the bottom of the screen You can also initiate a learning phase manually at any time see the section Relearning a Patient s ECG below Date and time of the last learning phase are indicated in the H...

Page 153: ... VT rate AIVR Accelerated Idioventricular Rhythm 3 or more PVCs with a rate the VT rate SVT Supraventricular Tachycardia N or more consecutive normal beats with a beat to beat rate the SVT rate CPT Ventricular Couplet A sequence of beats with the pattern normal PVC PVC normal BGM Ventricular Bigeminy A sequence of beats with the pattern normal PVC normal PVC normal TACH Sinus Tachycardia N or more...

Page 154: ...detects an arrhythmia event it displays the label of the event and an alarm message in the message area at the bottom of the screen NOTE z If arrhythmia detection is on alarms for asystole ASY and ventricular fibrillation VF are automatically on and cannot be turned off z If a continuous recording is in progress when you turn arrhythmia monitoring on printing stops and the recording is canceled z ...

Page 155: ...a Setup table spans 2 pages Click on one of the arrow keys in the upper left hand corner to view additional parameters NOTE z Alarm settings for PVC can be selected in the Alarm Limits table see the chapter Alarms and Messages z By default alarms for asystole and ventricular fibrillation are always on however these alarms can be disabled in the password protected Biomed menu see the appendix Defau...

Page 156: ...nd click the knob NOTE You can change limits only for VT BRDY rate only SVT TACH and PAUS rate only The displayed limits for RUN and AIVR are informational NOTE You cannot turn the alarms for asystole ASY and ventricular fibrillation VF off in the Arrhythmia Setup table Disabling alarms for these life threatening events is a password protected function see Default Settings and Biomedical Support W...

Page 157: ...trodes z You observe clinically questionable arrhythmia calls z There have been significant changes in the patient s ECG z The message ARR Relearn appears in the message area The monitor automatically relearns in the following cases z When you turn arrhythmia monitoring on or change between basic and full arrhythmia monitoring z When you change the displayed ECG leads while arrhythmia monitoring i...

Page 158: ...HR parameter box 3 Click on More 4 Click on Relearn During the learning phase LRN appears in the HR parameter box and the message Arrhythmia Relearning in the message area at the bottom of the screen Once learning is complete date and time of the learning phase are displayed in the HR Setup menu next to the Relearn selection NOTE You cannot initiate a relearning if arrhythmia monitoring is turned ...

Page 159: ...10 ST Segment Analysis Overview 10 2 ST Monitoring Display 10 3 ST Setup 10 4 Isoelectric and ST Measuring Points 10 5 ST Reference Complex 10 6 ST Alarms 10 7 ...

Page 160: ...n this pattern serves as a baseline for determining subsequent normal beats The monitor stores an average ST complex that is derived from those beats classified as normal In order to obtain an ST segment deviation value the monitor then compares the isoelectric and the ST segment level of the average complex The ST segment deviation represents the difference in voltage between the isoelectric and ...

Page 161: ...hannels display ECG leads the ST parameter box appears next to the second waveform channel If only the first waveform channel displays an ECG lead the ST parameter box appears at the bottom of the screen If ST1 or ST2 alarm limits are disabled a crossed bell appears next to the corresponding ST value When ST alarms are on and an ST value goes above or below the user defined limits the ST parameter...

Page 162: ...asurement points in relation to the beginning and end of the QRS complex respectively When you click on ISO or ST the location of the isoelectric and measuring points is indicated by vertical lines on the ST1 and ST2 waveforms Numerical values at the bottom and on the right side of the waveforms further define the location of these two points in milliseconds or millimeters millivolts z Ref erence ...

Page 163: ...tric point is 28 milliseconds before the start of the QRS complex as measured along the horizontal time axis The default position for the ST measurement point is 80 milliseconds after the end of the QRS complex The starting and ending points for the QRS complex are determined by the QRS detection algorithm In practice however the determination of the isoelectric and ST measurement points must be m...

Page 164: ... ST segment waveform to highlight changes in the ST segment since the last save Upon saving the reference complex is time stamped and available for display STEPS Displaying the ST Reference Complex 1 Click on the ST parameter box 2 Click on Ref to turn the display of the reference complex ON or OFF STEPS Saving the ST Reference Complex 1 Click on the ST parameter box 2 Click on Save Date and time ...

Page 165: ...it and 1 0 mm or 0 10 mV for the lower limit However adjustments to the upper and lower alarm limit settings must be made based on careful clinical evaluation You can set the upper and lower limits within the following range z 15 0 mm to 15 0 mm in 0 1 mm increments 1 5 mV to 1 5 mV in 0 01 mV increments when using millivolts NOTE Always check the upper and lower ST alarm limits before starting ST...

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Page 167: ...itoring 11 3 Rsp Safety Considerations 11 4 Respiration Monitoring Display 11 5 Rsp Display Channel 11 5 Resp Display Amplitude 11 6 Respiration Monitoring Settings 11 7 Rsp Mode 11 7 Resp Markers 11 8 Apnea Time 11 9 Coincidence Alarm 11 10 Relearning a Patient s Respiration Pattern 11 11 OxyCRG Monitoring Neonatal Option 11 12 Displaying OCRG Waveforms 11 12 OCRG Recordings 11 14 ...

Page 168: ...ection sensitivity is based on the waveform amplitude you select see the section Respiration Monitoring Display below The monitor is designed to z Display the respiration waveform continuously z Calculate the average respiration rate per minute z Detect apnea in adult pediatric and neonatal patients Patient Preparation Selecting and Preparing the Electrodes Proper selection and preparation of the ...

Page 169: ...ustrated below The monitor uses the right arm RA electrode and the left leg LL electrode as the path for the high frequency signal For deep abdominal breathers you may want to move the right arm RA electrode in order to span the maximum expansion and contraction of the lungs NOTE If you are using this electrode placement for monitoring respiration lead I and II are compromised for monitoring ECG ...

Page 170: ...d be observed closely and heart rate alarms should be enabled and set appropriately The use of additional methods for respiratory monitoring such as SpO2 are recommended whenever possible z Large amplitude pacer spikes 100 mV or greater may interfere with the monitor s ability to monitor respiration z Impedance respiration monitoring and pacemaker spike detection are inoperative when using either ...

Page 171: ...x valid breaths Rsp Display Channel Display the Rsp Waveform in one of the bottom display channels as follows STEPS Selecting the Rsp Display Channel 1 Click on the desired waveform channel 2 Click on Waveform 3 Select Rsp and click the knob NOTE z When using a 3 Lead ECG cable you must display ECG lead II If Lead I or III is displayed instead the monitor does not calculate a respiration rate and ...

Page 172: ...s are z 10 to 100 in increments of 10 default 50 STEPS Selecting the Rsp Display Amplitude 1 Click on the Rsp waveform channel 2 Click on Size 3 Select the desired display amplitude and click the knob WARNING In Manual Mode if you set the size of the respiration waveform too low shallow breaths may not be counted If set too high cardiac artifact might be counted as breaths Therefore always turn re...

Page 173: ...he respiration signal adjusting it over several minutes It also adjusts the sensitivity for large baseline drifts and lead off conditions In Manual mode you adjust the sensitivity by increasing or decreasing the waveform display amplitude see the section Selecting the Rsp Display Amplitude STEPS Selecting the Respiration Mode 1 Click on the Rsp parameter box 2 Click on Resp Mode 3 Select the desir...

Page 174: ...eath detection occurs on a clipped portion of the waveform as when the waveform exceeds the waveform channel s selected size respiration is still detected and marked In manual mode always use the displayed markers to set the waveform size at a point where shallow breaths are counted and cardiac artifacts rejected STEPS Displaying Resp Markers 1 Click on the Rsp parameter box 2 Click on Rsp Marker ...

Page 175: ... after the selected apnea time has elapsed the monitor triggers a serious alarm STEPS Selecting the Apnea Time 1 Click on the Rsp parameter box 2 Click on Apnea Time 3 Select the desired setting and click the knob NOTE z Regardless of the apnea time setting the monitor continues to alarm for respiration rate artifact and lead off conditions if the respiration alarm is On z The detection of central...

Page 176: ... message Coincidence if the coincidence alarm is turned on If the coincidence alarm is off the monitor does not alarm but still displays the message This alarm grade is serious for neonatal monitoring and advisory for adult and pediatric monitoring Check and change the electrode placement if you receive a coincidence message until you obtain a clear respiration signal STEPS Turning the Coincidence...

Page 177: ...l you must initiate the learning of the respiration pattern manually Whenever you change or reposition electrodes or if you notice significant changes in the patient s breathing pattern repeat the learning process STEPS Relearning a Patient s Respiration Pattern 1 Click on the Rsp parameter box 2 Click on Relearn During the learning phase the monitor displays the message Rsp Relearning at the bott...

Page 178: ...ing requires that sensors and electrodes for SpO2 HR and respiration are attached to the patient Displaying OCRG Waveforms The OxyCRG waveforms are displayed in the second and third waveform channels The second waveform channel shows the beat to beat Heart Rate bbHR trend and the SpO2 trend waveforms The bbHR trend has a range of 65 to 290 The SpO2 trend has a range from 70 to 100 The third wavefo...

Page 179: ...OXYCRG MONITORING NEONATAL OPTION VF6 Infinity Vista 11 13 STEPS Adjusting the OCRG Waveform Size 1 Click on the third waveform channel 2 Click on Size 3 Select the desired size and click the knob ...

Page 180: ...rm channels not the first channel An apnea event triggers an OCRG alarm recording which includes 108 seconds of pre apnea OCRG data and 36 seconds of post apnea OCRG data If no recorder is available the monitor stores the OCRG apnea alarm recording see the chapter Recordings for a description of stored recordings NOTE OCRG recordings cannot be printed on a laser printer This page intentionally lef...

Page 181: ...lication 12 4 SpO2 Safety Considerations 12 5 SpO2 Monitoring Display 12 6 SpO2 Display Channel 12 6 SpO2 Display Amplitude 12 7 Cascade Display 12 8 SpO2 Monitoring Settings 12 9 Pulse Tone Source 12 9 Pulse Tone Volume 12 10 Signal Strength Bar Graph 12 11 Averaging Mode 12 11 ...

Page 182: ...rmine the functional oxygen saturation of the patient s arterial blood SpO2 and an accompanying pulse rate A sensor is attached to the patient usually the finger and measures the absorption of light by the oxyhemoglobin The light sent through the tissue is transformed into a signal that is processed by the monitor The monitor is designed to z Display the oximetry waveform z Calculate the SpO2 puls...

Page 183: ...If you connect an SpO2 pod while a MultiMed NeoMed pod with SpO2 sensor is connected to the monitor the monitor displays an error message z The SpO2 pod interface is a locked option and must be enabled in the password protected Biomed menu z Compatibility for the Masimo SET SpO2 pod is a locked option and must be enabled in the password protected Biomed menu z The USB connector must be configured ...

Page 184: ...the sensor type contact your Biomed department STEPS Applying the Sensor 1 Select a sensor that is best suited for your patient 2 Clean reusable sensors before and after each use 3 Position the sensor correctly and attach it to your patient see sensor manufacturer s recommendations 4 Connect the sensor to the intermediate cable and the intermediate cable to the MULTIMED NEOMED pod 5 Inspect the se...

Page 185: ...ed patients or the presence of substances containing dyes can result in inaccurate pulse oximetry readings z If the monitor detects an SpO2 and or PLS Weak Signal condition during an NBP measurement the audible and visual alarms for the Weak Signal condition are suppressed However the monitor announces all other SpO2 PLS conditions as they occur z A pulse oximeter should not be used as an apnea mo...

Page 186: ... pulse oximetry value appears in the SpO2 parameter box When the SpO2 and PLS alarms are turned off a crossed bell appears next to the parameter values SpO2 Display Channel When monitoring with a 5 or 6 lead ECG cable you can display the SpO2 waveform in any waveform channel If monitoring with a 3 lead ECG cable you cannot display the SpO2 waveform in the top channel STEPS Selecting the SpO2 Displ...

Page 187: ...ts you modify the amplitude of the displayed SpO2 waveform for optimum viewing The available sizes are z 10 to 100 in increments of 10 default 50 STEPS Selecting the SpO2 Display Amplitude 1 Click on the SpO2 waveform channel 2 Click on Size 3 Dial in the desired setting and click the knob ...

Page 188: ...nd waveform channel and click the knob 3 Click on Waveform 4 Select Cascade and click the knob NOTE z The second channel of a cascaded pulse waveform cannot be printed on recordings z The Cascade display is only available in the second waveform channel NOTE The cascade SpO2 waveform disappears from the screen whenever you choose to display the electrocardiogram again in the first channel If you th...

Page 189: ...vels A tone occurs with each pulse detected via the SpO2 signal You can add a bar graph to the SpO2 parameter box to show signal strength see later in this chapter Select SpO2 as the pulse tone source when pulse oximetry is the primary vital sign to monitor or preferred over ECG e g with paced patients or in the presence of HR artifacts STEPS Selecting the Pulse Tone Source 1 Click on the SpO2 par...

Page 190: ... tone source but is not currently being measured no pulse tones are heard You can adjust the pulse tone volume between 10 and 100 or turn the pulse tone off STEPS Selecting the Pulse Tone Volume 1 Click on the SpO2 parameter box 2 Click on Tone Volume 3 Select the desired setting and click the knob NOTE If you select a Tone Volume higher than the speaker volume of the monitor the Tone Volume is th...

Page 191: ...he arterial blood and the derived pulse rate based on the averaging mode you select in the SpO2 menu The two modes are Normal and Fast z The Normal averaging mode updates the SpO2 value and the derived pulse rate in 30 seconds or less 8 seconds or less with the Masimo SET pod z The Fast averaging mode updates the SpO2 value and the derived pulse rate in 12 seconds or less 2 to 4 seconds with the M...

Page 192: ...12 12 Infinity Vista VF6 12 PULSE OXIMETRY STEPS Selecting the Averaging Mode 1 Click on the SpO2 parameter box 2 Click on Averaging 3 Select the desired setting Normal or Fast and click the knob ...

Page 193: ...lood Pressure Overview 13 2 NBP Safety Considerations 13 3 Cuff Selection and Placement 13 4 NBP Measurements 13 6 Single Measurements 13 6 Interval Mode 13 6 Inflation Mode 13 8 Measurement Tone 13 10 NPB Alarms 13 11 ...

Page 194: ...on Main Screen Configuration in the Monitor Setup chapter At the end of each NBP measurement the NBP cuff deflates to a pressure of 10 mmHg or less adult and pediatric modes or to a pressure of 5 mmHg neonatal mode A time stamp in the NBP parameter box indicates the time of the last NBP measurement WARNING Before non invasive blood pressure monitoring please read the safety information in the sect...

Page 195: ...not be accurate with convulsive patients or patients with tremors CAUTION Do not allow the hose or cuff to get in contact with fluids Check the hose and cuff frequently for signs of damage and debris An obstruction in the hose may cause the cuff to inflate and deflate improperly and may result in inaccurate readings NOTE To obtain accurate blood pressure readings keep the limb and cuff motionless ...

Page 196: ...ns and Accessories STEPS Applying the NBP Cuff 1 Ask the patient to sit or lie down The limb should be relaxed extended and placed on a smooth surface for support 2 Place the cuff at 2 to 5 cm above the elbow crease or in the middle of the back of the thigh The cuff label this side to patient must be placed against the skin 3 Place the Artery Ø marker over the artery pointing to hand or foot Once ...

Page 197: ... cuff bladder on the artery so that the hose is to the left or to the right of the artery Connect the NBP cuff and hose to the monitor s hose connector on the left side of the device 1 Cuff Size Indicators 4 Range Labels 2 Artery Label 5 Label This side to patient 3 Index Line NBP Connector ...

Page 198: ... time stamp indicating the time of the measurement appears in the NBP parameter box To cancel an NBP measurement in progress press NBP Start Stop again Interval Mode The interval mode lets you program the monitor to initiate NBP measurements automatically at specific intervals The following time intervals are available z 2 2 5 3 4 5 6 7 8 9 10 11 12 13 14 15 30 45 60 120 180 240 minutes or OFF def...

Page 199: ...to turn the Interval Mode on the interval time is the one that was previously selected z If the Interval Mode is active before you power cycle the monitor the Interval Mode setting is retained through a power cycle If the Interval Mode is turned off before you power cycle the monitor you have to reselect an interval time in the NBP menu before interval measurements can be started with the NBP Star...

Page 200: ...pts to take NBP measurements single or at intervals generate an error tone For more information see the chapter Alarms and Messages Inflation Mode You must select the appropriate inflation limits for your patient The following table shows the monitor s inflation values for each inflation mode Inflation Mode Initial Inflation mmHg Inflation After a Valid Measurement mmHg Maximum Inflation mmHg Mini...

Page 201: ...elect the desired inflation mode and click the knob WARNING If the neonatal inflation mode is selected a blood pressure higher than the inflation range may activate the NBP Cannot Measure NBP No Pulsation or NBP Mean Only alarms If this happens manually check the patient s pressure and if appropriate switch to a pediatric inflation mode ...

Page 202: ...ated by an end of measurement tone 2 beeps The loudness of the tone depends on the setting for the monitor s speaker volume If the volume is turned off the tone does not sound STEPS Turning the Measurement Tone ON OFF 1 Click on the NBP parameter box 2 Click on Measurement Tone 3 Select ON or OFF and click the knob ...

Page 203: ...ements improper placement of the cuff and overpressure conditions You can set the systolic mean and diastolic alarm limits within the following range z 10 to 250 mmHg in increments of 1 mmHg NOTE When an NBP alarm occurs the monitor alerts you once and when the alarm is acknowledged by pressing the Alarm Silence or the All Alarms Off key does not alert you again of the same alarm even though displ...

Page 204: ...13 12 Infinity Vista VF6 13 NON INVASIVE BLOOD PRESSURE This page intentionally left blank ...

Page 205: ...ve Pressure Labels 14 3 IBP Display 14 3 Display Channel and Waveform Amplitude 14 4 Selecting and Preparing the Transducer 14 5 Zeroing and Calibration Check 14 6 Zero and Calibration Check Troubleshooting 14 7 Calibrating Reusable Transducers 14 8 ...

Page 206: ... Limits table see the chapter Alarms and Messages If you are monitoring two invasive pressure parameters each has its own alarm settings For invasive pressure parameters that generate only a mean pressure value you cannot set systolic or diastolic alarm limits NOTE Invasive Blood Pressure Monitoring is a locked option for the Infinity Vista monitor ART Arterial Pressure PA Pulmonary Arterial Press...

Page 207: ... pressure in millimeters of mercury mmHg or kilo pascals kPa and can display up to two pressure waveforms in the lower display channels The pressure parameter boxes show the following information z Parameter label e g ART z Systolic pressure value e g 125 z Diastolic pressure value e g 85 z Mean pressure value e g 102 z A crossed bell if invasive pressure alarms are turned off If the second invasi...

Page 208: ...b 4 Click on Size 5 Select the desired display amplitude and click the knob Pressure Label Possible Size Settings Adult Pediatric Default Setting Neonatal Default Setting ART GP1 GP2 50 75 100 300 mmHg 8 12 16 40 kPa 200 mmHg 24 kPa 100 mmHg 16 kPa PA 20 40 50 75 100 150 mmHg 4 6 8 12 16 20 kPa 50 mmHg 8 kPa 50 mmHg 8 kPa CVP 5 10 20 30 40 50 mmHg 1 0 2 4 5 6 8 kPa 20 mmHg 4 kPa 20 mmHg 4 kPa ICP ...

Page 209: ...compliant tubing dampens and distorts the signal 2 Select the shortest possible length of tubing to preserve signal strength and minimize motion artifact 3 Follow your hospital procedures in assembling the tubing system Connect the IBP transducer to the IBP connector on the monitor s left side panel The connector is only available as a hardware upgrade with the purchase of the IBP monitoring optio...

Page 210: ...med The calibration check procedure described in this section consists of adjusting the monitor by entering the calibration factor given by your Biomed if you are using reusable transducers If you are using disposable transducers use 100 as the calibration factor Disposable transducers are all pre calibrated See the table on Zero and Calibration Check Troubleshooting below to help you during the p...

Page 211: ...or rejects the calibration factor that you selected change the transducer or call your Biomed The transducer needs to be calibrated Screen Message Possible Cause Suggested Action IBP Cannot Zero IBP Zero Time out The transducer offset is outside the zero balance range of 190 mmHg The signal is too noisy The waveform is non static more than 3 mmHg variation in 3 seconds The monitor was unable to ze...

Page 212: ... Zero the pressure transducer via the IBP setup menu 2 Click on the IBP1 parameter box 3 Click on Mano Cal 4 Connect the pressure transducer to the mercury manometer 5 Pump the manometer to a value recommended by your hospital protocol 6 Dial in the calibration value to match the mean pressure value and click the knob 7 If you are monitoring two invasive blood pressures repeat these steps for the ...

Page 213: ...15 Temperature Overview 15 2 Temperature Probes 15 2 Placing the Probe 15 2 ...

Page 214: ...ion of reusable and disposable thermistor probes is available Use only Dräger approved probes see the appendix Options and Accessories other probes are not recommended and may produce inaccurate measurement results Placing the Probe Rectal Probes To place the probe follow the clinical techniques of your hospital We also suggest the following 1 Mark the insertion depth 2 to 4 inches with a rubber r...

Page 215: ...ture For placement of the axillary probe proceed as follows 1 Place the probe under the axilla 2 Tape it in place WARNING To prevent burns during electrosurgery take the following precautions z Do not use surface probes z Use only sheathed rectal probes WARNING Temperature probe protective covers contain latex Do not use on persons with latex hypersensitivity ...

Page 216: ...15 4 Infinity Vista VF6 15 TEMPERATURE This page intentionally left blank ...

Page 217: ...equires series access points and wireless LAN PC cards To order components for wireless network operation contact your local Dräger representative for information on approved manufacturers Options A 2 MultiMed NeoMed Pods A 2 ECG A 3 Pulse Oximetry SpO2 A 5 Temperature A 7 Invasive Blood Pressure IBP A 8 Non invasive Blood Pressure NBP A 9 Power Sources A 10 Displays and Display Components A 11 Re...

Page 218: ...reless Network Capability MS 15 068 Nellcor Sensor Compatibility 74 98 392 Masimo Sensor Compatibility 74 98 400 MULTIMED 5 pod long cable 2 5m with large cable clip for ECG 3 and 5 lead patient cable temperature and SpO2 measurements 33 68 391 MULTIMED 5 pod short cable 1 5 m 59 50 196 MULTIMED 6 pod for ECG 3 5 and 6 lead patient cables temperature and SpO2 measurements 51 91 221 NEOMED pod with...

Page 219: ...te LL red LA black 5 lead set RA white LL red LA black RL green V brown 6 lead set RA white LL red LA black RL green V brown V gray and brown ECG ESU Block 5 lead Must be used for patients monitored in OR 59 47 226 ECG ESU Block 6 lead Must be used for patients monitored in OR 74 86 140 ECG 3 lead grabber set IEC1 59 56 433 ECG 3 lead grabber set IEC2 59 56 441 ECG 5 lead grabber set IEC1 1m 59 56...

Page 220: ...onoLeads with MulitMed 5 6 pods Adapter MonoLead to MultiMed 5 MS 14 679 Adapter MonoLead to MultiMed 6 MS 14 680 ECG MonoLead 3 Dual Pin IEC1 MS 16 160 ECG MonoLead 3 Dual Pin IEC2 MS 16 233 ECG MonoLead 5 Limb Lead Dual Pin IEC1 MS 16 161 ECG MonoLead 5 Limb Lead Dual Pin IEC2 MS 16 229 ECG Monolead 5 Chest Lead Dual Pin IEC1 MS 16 232 ECG Monolead 5 Chest Lead Dual Pin IEC2 MS 16 230 ECG electr...

Page 221: ...er Disposable SpO2 Sensor vinyl pediatric MS 16 448 Dräger Disposable SpO2 Sensor foam pediatric MS 16 444 Pod and Kit Masimo SET SpO2 Pod Kit Includes pod connection to monitor and mounting hardware MS 16 900 Masimo SET SpO2 Pod MS 16 356 Reusable Sensors MASIMO LNOP DCI adult SpO2 adult sensor for finger or toe application Patient weight 30 kg 66 lb 72 70 312 MASIMO LNOP DCIP pediatric SpO2 pedi...

Page 222: ...Pod LNCS Sensor Cable 3m Connects Masimo LNCS Sensor to Masimo SET SpO2 Pod MS 17 522 Masimo Pod LNOP Sensor Cable 3m Connects Masimo LNOP Sensor to Masimo SET SpO2 Pod MS 17 041 SpO2 Masimo ProCal Cable 2m 74 92 601 SpO2 Masimo ProCal Cable 1 5m MS 13 926 Masimo SET SpO2 Pod Mount MS 17 085 Monitor Sideplate with USB Connector MS 17 428 Reusable Sensors Nellcor Durasensor DS 100A SpO2 Sensor adul...

Page 223: ...diatric 24 pcs SpO2 pediatric sensor for finger or toe application Patient weight 10 50 kg 22 110 lb MX50066 Cables SpO2 blue latched Nellcor extension cable shielded 1 m 33 68 433 SpO2 blue latched Nellcor extension cable shielded 2 m 33 75 834 Temp adapter cable 51 98 333 WARNING Temperature probe protective covers contain latex Do not use on persons with latex hypersensitivity Temp probe adult ...

Page 224: ... to connect reusable disposable OHMEDA transducers to monitor 33 75 933 IBP intermediate cable SensoNor 3 7m 43 21 563 IBP intermediate Y Cable Edwards 3 7m 52 06 607 IBP intermediate Y Cable OHMEDA 3 7m 52 06 581 IBP intermediate Y Cable Abbott Medex 3 7m 52 06 573 IBP intermediate Y Cable SensoNor 3 7m 51 95 180 IBP disposable set for SensoNor 844 10 pcs 74 89 433 IBP Adapter 10 pin to 7 pin con...

Page 225: ...2 75 275 NBP connection hose neonatal 2 4m 28 70 298 NBP cuff child 12 19 cm MS 14 430 NBP cuff small adult 17 25 cm MS 14 427 NBP cuff adult 23 33 cm MS 14 428 NBP cuff large adult 31 40 cm MS 14 425 NBP cuff adult thigh 38 50 cm MS 14 426 NBP cuff neonatal 1 3 1 5 7 cm 28 70 181 NBP cuff neonatal 2 4 3 8 0 cm 28 70 199 NBP cuff neonatal 3 5 8 10 9 cm 28 70 207 NBP cuff neonatal 4 7 1 13 1 cm 28 ...

Page 226: ... 47 697 Vista Lithium Ion battery 57 32 354 Power Cord Cont Europe CEE7 43 21 712 Power Cord North America 5 15R 43 21 720 Power Cord Australia New Zealand AS 3112 18 51 705 Power Cord Great Britain BS 1363 18 51 713 Power Cord China GB 1002 18 59 714 Power Cord Great Britain AS 1363 43 21 654 Power Cord Switzerland SEV 1011 43 21 613 Power Cord Denmark 18 51 721 ...

Page 227: ...S and European power cable MS 16 470 Mount Kit TFT LCD Display Compatible with GCX or Wesbrook wall mounting system MS 14 583 Adapter Cable 3 m 47 26 084 Adapter Cable 25 m 51 94 910 Adapter cable 23 m required 57 36 173 Wall Mount Mount for remote display with 33 cm 13 inch extension arm Adjust able height on a 48 cm 19 inch vertical track 47 20 152 R50 Universal Recorder 59 52 630 R50 Network Re...

Page 228: ...ista VF6 A OPTIONS AND ACCESSORIES Miscellaneous Data Memory PC Card 47 18 248 Alarm Output Cable with Relay 43 14 626 Infinity QRS Synchronization Output Cable 3 m 43 14 667 RS232 Diagnostic UART cable 3 m 47 14 346 ...

Page 229: ...Cleaning and Disinfecting B 2 Monitor B 2 Patient Cables B 2 Reusable ECG Electrodes B 3 Reusable SpO2 Sensor B 3 NBP Cuff B 3 Temperature probes and cables B 3 Reusable Pressure Transducers and Cables B 4 Masimo SET SpO2 Pod B 4 ...

Page 230: ...uze pad moistened with a soap solution z Dry thoroughly with a lint free cloth z To disinfect patient cables wipe the cables with a gauze moistened with diluted alcohol z Dry thoroughly with a lint free cloth CAUTION Do not use disinfectants that contain phenol as they can spot plastics Do not autoclave or clean accessories with strong aromatic chlorinated ketone ether or ester solvents Never imme...

Page 231: ...e excessive pressure or flex the cables as this can stretch the covering and break the internal wires z Clean the probes with a 3 hydrogen peroxide or 70 alcohol z Quickly immerse the cables in a detergent solution z Make sure the probe s tip is firmly connected CAUTION The NBP cuff can be immersed in cleaning solution but do not allow the solution to enter the NBP hose Warranty claims can be forf...

Page 232: ...an the pod with a gauze moistened in enzymatic detergent or a solution of green tinctured soap and water 3 Dry thoroughly with a lint free cloth CAUTION Observe the following precautions when cleaning or sterilizing all pressure accessories z Avoid applying excessive pressure to a transducer diaphragm z Use disposable pressure accessories only once and then discard them z Do not subject transducer...

Page 233: ... Support C 8 Startup Tests C 8 Checking the NBP Calibration C 9 Biomed Menu C 10 Saving a Patient Setup C 11 Locked Options and Demo Mode C 11 Diagnostic Logs C 13 Changing Units of Measure C 13 Parameter Colors C 14 NBP SpO2 Interlock C 16 ASY VF Alarms C 16 Pacer Mode C 17 ...

Page 234: ...ost settings called patient settings are remembered by the monitor while others return to their factory defaults If the user chooses to save the current patient setup many factory settings are changed to patient settings and is active for the next patient of that category Whether or not a setting returns to its factory default between patients or can be saved as a monitoring configuration is noted...

Page 235: ... Off Off Previous Patient Pacer Detect Off Off N A Saved Setup QRS Marks Off Off Off Factory ECG Processing ECG 1 2 ECG 1 2 ECG 1 Previous Patient ECG Leads 5 Lead 5 Lead 3 Lead Previous Patient Arrhythmia ASY VF Alarms Always On Always On n a Previous Patient VT RUN AIVR SVT CPT BGM Alarm BRDY TACH PAUS ARTF Alarm On Off On Off n a n a Saved Setup ASY and VF Alarm Recording Other Events Record Of...

Page 236: ... Off Off On Saved Setup Alarm Limits upper lower 30 5 80 20 80 20 Saved Setup Alarm Recording Off Off Off Saved Setup Rsp Mode Auto Auto Auto Saved Setup Rsp Marker Off Off On Saved Setup Apnea Time Off Off 15 seconds Saved Setup Coincidence Alarm Off Off On Saved Setup SpO2 Alarm Off Off Off Saved Setup Alarm Limits upper lower 100 90 100 90 95 85 Saved Setup Alarm Recording Off Off Off Saved Set...

Page 237: ... 50 80 50 70 40 60 25 Saved Setup Alarm Recording Off Off Off Saved Setup Interval Mode Off Off Off Saved Setup Calibration Mode Off Off Off Previous Patient Inflation Mode Adult 270 Ped 180 Neo 140 Previous Patient Measurement Tone Off Off Off Saved Setup IBP1 IBP2 Alarm Off Off Off Saved Setup Alarm Limits upper lower Systolic Mean Diastolic 160 90 125 60 110 50 160 90 125 60 110 50 120 50 85 40...

Page 238: ... SpO2 SpO2 Saved Setup Size SpO2 50 Rsp 50 IBP1 IBP2 0 200 mmHg SpO2 50 Rsp 50 IBP1 IBP2 0 200 mmHg SpO2 50 Rsp 50 IBP1 IBP2 0 100 mmHg Saved Setup Main Menu Patient Category Adult Pediatric Neonate Previous Patient Bottom Channel NBP NBP NBP Saved Setup Date Time current current current Previous Patient Speaker Volume 100 100 100 Previous Patient Trend Setup HR SpO2 NBP HR SpO2 NBP HR SpO2 NBP Sa...

Page 239: ...ollow HR Follow HR Previous Patient Pacer Mode Basic Basic Basic Previous Patient ST segment analysis is available as an option in the adult and pediatric monitoring modes Service Monitor Setup password protected settings Language English English English Previous Patient Data Collection Off Off Off Previous Patient Line Frequency 60 Hz 60 Hz 60 Hz Previous Patient Adult Settings Pediatric Settings...

Page 240: ...n and call DrägerService CAUTION Verify that the monitor s line frequency under the Service menu is set to match the 50 or 60 Hz mains power line frequency of your hospital The line frequency determines the center frequency of the ECG notch filter The filter greatly reduces line frequency noise on the ECG waveform Refer to the Service manual for details how to change frequency NOTE The monitor sto...

Page 241: ...alues on the monitor should be within 3 mmHg of the manometer readings 7 Close the release valve on the bulb and pump the manometer until the overpressure release valve opens This should happen at 300 mmHg 30 mmHg and the mercury column should fall rapidly to zero If the release valve does not open or if it opens at a value lower than 300 mmHg 30 mmHg the overpressure system may be faulty Remove t...

Page 242: ...te the demo mode and optional features of the monitor Each option requires a password to unlock z Diagnostic Logs to display and to print the diagnostic log z Units to change the units that Temperature Pressures and ST segment analysis use z Service to access various service functions including Update Software Test Pulse ECG Baseline Date and Time Monitor Setup Language Data Collection Line Freque...

Page 243: ...6 Click on Save Setup select Confirm or Cancel and click the knob The monitor saves the current monitoring setup for future use The setup is available even after the current patient has been discharged from this monitor Locked Options and Demo Mode The Locked Options menu gives you access to the Demo mode and to a number of monitoring options that are available for purchase These options and their...

Page 244: ... the monitor is connected to the network the central station shows the bedside monitor as having Simulated Data and the Admit function at the central station is disabled To disable the Demo Mode turn the monitor off and on again or enter the Standby mode and discharge the patient upon resuming monitoring WARNING If the monitor is connected to the network alarms generated by the monitor during simu...

Page 245: ...ostic Log 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Biomed 4 Enter the Biomed password and click the knob 5 Click on Diagnostic Logs 6 The monitor displays the diagnostic log Turn the rotary knob clockwise to scroll back to previous messages Turn the knob counterclockwise to scroll forward to current messages Changing Units of Measure You can change the units of measure for th...

Page 246: ...Biomed password and click the knob 5 Click on Units 6 Change the units for the desired parameter and click the knob 7 Click on New Patient Yes Parameter Colors Select the parameter display colors as follows 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Biomed 4 Enter the Biomed password and click the knob again 5 Click on Monitor Setup 6 Click on Parameter Colors ...

Page 247: ...l parameters click on More NOTE z The ST parameter takes on the color selection for ECG z The ST reference complex is always purple Therefore if you choose purple as the parameter color for ECG ST you won t be able to distinguish the ST waveform from the ST reference complex NOTE External alarm lights are not available on the Vista monitors ...

Page 248: ... Interlock 7 Turn the function ON or OFF ASY VF Alarms Set alarms for asystole and ventricular fibrillation as either Always ON or Follow HR If you select Follow HR ASY and VF alarm settings follow those settings selected for heart rate alarms in the Alarm Limits table If you select Always ON the monitor always alarms for asystole and ventricular fibrillation even if HR alarms and arrhythmia monit...

Page 249: ...the ECG menu The advanced mode adds the selection Fusion which offers increased detection sensitivity for fused paced beats Enable the basic or advanced pacer detection mode as follows 1 Press the Menu fixed key 2 Click on Monitor Setup 3 Click on Biomed 4 Enter the Biomed password and click the knob again 5 Click on Monitor Setup 6 Click on Pacer Mode 7 Click on Basic or Advanced ...

Page 250: ...C 18 Infinity Vista VF6 C DEFAULT SETTINGS AND BIOMEDICAL SUPPORT This page intentionally left blank ...

Page 251: ...D Technical Data Overview D 2 Regulatory Compliance D 2 Basic System Components D 3 Monitoring Specifications D 7 Electromagnetic Compatibility D 15 ...

Page 252: ... of serviceable items available to qualified technical personnel For specifications of wireless monitoring accessories such as wireless LAN PC cards and access points please refer to the documentation of the wireless component s manufacturer Cisco Systems Inc Regulatory Compliance Regulatory Standards Compliance z Medical Device Directive MDD 93 42 EEC z IEC 60601 1 and applicable collateral and p...

Page 253: ...T121R8PU or equivalent Li ion Dräger Li Battery Pack Protection Class Internally powered for use with specified Class I power supply Mode of Operation Continuous with AC adapter DC Input 11 15 VDC 2 5A Max Power Consumption 52 Watts Battery Operating Time with ECG SpO2 Respiration waveforms and NBP in a 15 minute interval mode starting with a fully charged battery Lead acid 75 minutes Lithium ion ...

Page 254: ...Cooling Convection and cooling chimney no fan Temperature Operating 0 qC to 45 qC without recorder Storage 20 qC to 50 qC Relative Humidity Operating 10 and 95 non condensing Storage 10 and 95 non condensing Altitude Operating 381 to 3048 m 1250 to 10000 ft 525 to 795 mmHg 70 to 106 kPa Storage 381 to 5486m 1250 to 18000 ft 375 to 795 mmHg 50 to 106 kPa Transportation with shipping package Per Nat...

Page 255: ...onnector Infinity Network R50 Recorder Potential Equalization Connector Cooling Convection Input voltage range 100 240 VRMS Mains frequency 50 60 Hz Power Consumption 1 0 A max Protection Class Class I Chassis Leakage Current 300 mA 120VAC 500 mA 220VAC Mode of Operation Continuous Water Resistance Ordinary Environmental Requirements Temperature Operating 15 C to 40 C 55 F to 104 F Storage 20 C to...

Page 256: ...um of 50 G 11 ms half sine Vibration Sinusoidal IEC 68 2 6 0 040 double amplitude displacement 5 32 Hz 2 G peak 32 500 Hz Random Vibration IEC 68 2 34 20 500 Hz ASD 0 02G2 Hz Low reproducibility 9 minutes Mode of Operation Continuous Environmental Requirements Temperature operating 5 to 45qC 41 to 113qF storage 20 to 60qC 4 to 140qF Relative Humidity operating 10 to 95 non condensing storage 10 to...

Page 257: ...1 min 13 seconds for a step change of 80 to 40 1 min Response time is measured from the onset of the first QRS complex of the new rate to the time the measurement reads a value that is the original rate plus 63 of the change Report Interval nominal 2 1 seconds Notch Filter Frequency 50 60 Hz Monitor 3 dB Bandwidth 0 5 Hz to 28 Hz 50 Hz 0 5 Hz to 40 Hz 60 Hz Dynamic Range AC 10 mV minimum Dynamic R...

Page 258: ...acy 5 beats minute or 10 of the rate whichever is greater Response Time 4 seconds ST Segment Analysis Measurement Range 15 mm to 15 mm 1 5 mV to 1 5 mV Accuracy 1mm 0 1mV RTI Isoelectric Point Range From start of the averaged ST complex to Fiducial Point in increments of 4 ms ST Point Range From Fiducial Point to end of the averaged ST complex in increments of 4 ms Display Resolution 0 1 mm 0 01mV...

Page 259: ...inute Report Interval 2 seconds Total resistance 0 to 3600 Input Dynamic Range AC 17 3 10 DC 0 to 3 6 k internal check for high impedance Bandwidth 0 25 Hz to 3 5 Hz Impedance Measuring Current 65 PA RMS 10 nominal at 48kHz 1 rectangular wave Pulse Oximetry SpO2 Parameter Display Saturation SpO2 pulse rate Measuring Method Absorption spectrophotometry Measuring Range SpO2 1 100 Pulse rate 30 250 1...

Page 260: ...whichever is greater Notes 1 SpO2 accuracy specification is at 1 SD standard deviation and is expressed as X digits absolute for the established range 2 Accuracy of saturation measurements on neonates is increased by 1 digit as compared to accuracy on adult patients to account for the theoretical effect on oximeter measurements of fetal hemoglobin in neonatal blood SpO2 Alarms High Adjustable 20 t...

Page 261: ...mplitude of 2 to 3 cm in induced hypoxia studies in the range of 70 100 SpO2 against a laboratory co oximeter and ECG monitor This variation equals plus or minus one standard deviation Plus or minus one standard deviation encompasses 68 of the population 3 The Masimo SET pod with LNOP Neo and Neo Pt sensors has been validated for motion and no motion accuracy in human blood studies on healthy adul...

Page 262: ...econds Linearity Linearity calculations to 0 02 qC by the software algorithm Excitation Signal DC source Power to Probe 50 PW causing a potential self heat error factor of 0 05 qC Test Signals 5 qC and 50 qC 0 1 qC with nominal thermistor Filter Characteristic Low pass filtering to minimize noise pickup Error Detection 50 C high temperature possibly caused by a shorted thermistor 3 C low temperatu...

Page 263: ...Previous SYS 30 mmHg 10 Inflation Pressure After a Technical 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 mmHg Neonatal 140 142 mmHg 10 mmHg Minimum Inflation Pressure Adult 270 110 mmHg 10 mmHg Pediatric 180 90 mmHg 10 mmHg Neonatal 140 70 mmHg 10 mmHg Maximum Measuremen...

Page 264: ...monitor Number of Channels 2 max requires IBP options Sweep Speed 25 mm s Measured Parameters Systolic Mean and Diastolic blood pressure Measurement Range 50 mmHg to 399 mmHg Measurement Accuracy 2 mmHg or 3 whichever is greater after successful zero and calibration exclusive of transducer Resolution 1 mmHg or 0 1 kPa Response Time d35 s to reach 90 of the change of the lowest pulse rate of 25 1 m...

Page 265: ... 2 4 GHz range Other equipment even if compliant with CISPR emission requirements could interfere with reception of wireless data When selecting new wireless systems e g cell phones pager systems cordless phones etc for use in installations where wireless networking is used care should always be used to insure that operating frequencies are compatible For example selecting cordless phones that ope...

Page 266: ...ed above See the documentation that accompanies the wireless products for further details Electromagnetic Immunity Immunity against IEC 60601 1 2 test level Compliance level of this device Electromagnetic environment electrostatic discharge ESD IEC 61000 4 2 contact discharge r 6 kV air discharge r 8 kV r 6 kV r 8 kV Floors should be wood concrete or ceramic tile If floors are covered with synthet...

Page 267: ... rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site surveya should be less than the compliance level in each frequency rangeb Interference may occur in the vicinity of equipment marked with the following symbol a Field strengths fr...

Page 268: ... 10 3 8 3 8 7 3 100 12 12 23 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 NOTE 1 At 80 MHz and 800 MHz the separation distance for ...

Page 269: ... saved in battery backed memory BRDY Bradycardia Care Unit Group of devices that have the same department identification e g CCU ICU SICU CCU Cardiac Care Unit CVP Central Venous Pressure D or Dia Diastolic pressure ECG Electrocardiogram ESU Electro surgical unit Ethernet A popular baseband local area network LAN standard Dräger s Infinity network is an Ethernet LAN based network Fixed keys Keys l...

Page 270: ...tional functions available on your monitor Menu option An alternative for an operational function available on your monitor min Minute mm Millimeter mm s Millimeter per second mmHg Millimeters of mercury Monitoring Unit Group of devices sharing patient data in a network installation ms Millisecond MultiMed 5 The pod that receives the following patient cables ECG leadset SpO2 extension cable and a ...

Page 271: ...ace plate the CPS or IDS RA Right arm RL Right leg S or Sys Systolic pressure sec Second ST ST Segment Standalone Bedside monitor operating independently of a monitoring network Strip chart The paper copy of patient data from a recorder SYNC or sync Synchronization TCP IP Acronym for Transaction Control Protocol Internet Protocol Communication protocol for the Infinity network See also Infinity ne...

Page 272: ...E 4 Infinity Vista VF6 E GLOSSARY This page intentionally left blank ...

Page 273: ...Apnea Time 11 9 Arrhythmia alarms 9 6 basic functions 9 3 full functions 9 3 On Off 9 4 rate and count 9 6 recordings 9 7 relearning 9 7 setup 9 5 Arrhythmia Classification Expert 9 1 ART pressure 14 2 Auto Set 5 5 AV Sequential Pacemakers 8 19 Averaging Mode SpO2 12 11 Axillary Probes 15 3 B Back Panel 1 10 Bar Graph NBP 13 8 SpO2 12 11 Battery 1 17 2 3 charging 2 6 gauge 2 3 inserting into monit...

Page 274: ...2 Defibrillators safety 1 6 8 17 Demo Mode C 11 Device Markings 1 7 Diagnostic Log C 13 Diastolic Pressure IBP 14 3 NBP 13 2 Discharge 4 7 Disinfecting B 2 cables B 2 electrodes B 3 monitor B 2 Display 1 13 battery gauge 2 3 bottom channel 2 11 cascade 8 9 channels 1 23 colors 1 13 1 14 configuration 2 10 IBP 14 3 RESP 11 5 Rsp markers 11 8 screen brightness 2 4 SpO2 12 6 sync marks 8 14 Display A...

Page 275: ...Pumps safety 8 17 Inspection monitor 1 5 Interface Plate 1 13 7 3 Interval Mode NBP 13 6 Invasive Blood Pressure see IBP Isoelectric Point ST 10 5 K Keys monitor operation 1 15 Knob 1 14 L Labels Device Markings 1 7 Labels IBP 14 2 Laser Printer 7 5 Latex 15 3 Lead Acid Battery 2 3 Lead Sets A 3 Leads ECG 8 7 8 8 Life Threatening Alarms 5 2 Limits alarms 5 5 Line Frequency C 8 Lithium Ion Battery ...

Page 276: ...lection 13 4 inflation limit 13 8 interval mode 13 6 measurement tone 13 10 measurements 13 6 menu 1 25 neonatal monitoring 13 2 safety 13 3 13 6 units C 13 Nellcor sensors and cables A 7 NeoMed Pod 1 18 cable assembly 2 8 order number A 2 Neonates 4 4 ECG monitoring 8 15 NPB monitoring 13 2 OxyCRG 11 12 Network alarm groups 5 11 central alarms 5 12 functions 3 2 messages 3 7 operation 3 3 recorde...

Page 277: ...k 7 5 OxyCRG 7 12 11 14 printing stored recordings 7 15 saving stored recordings 7 15 storing 7 13 timed 7 6 trends 7 10 types of 7 6 Rectal Probes 15 2 Reference Complex ST 10 6 Regulatory Compliance D 2 Relearning 9 7 11 11 Remote Displays 1 19 Respiration apnea time 11 9 coincidence 11 10 display 11 5 electrode placement 11 2 functions 11 2 markers 11 8 menu 1 24 OxyCRG 11 12 patient preparatio...

Page 278: ...afety 12 5 sensor application 12 4 sensor cleaning B 3 signal strength 12 11 SpO2 Sensor 12 4 ST alarms 10 7 description 10 2 display 10 3 functions 10 4 isoelectric point 10 5 measuring point 10 5 menu 1 25 reference complex 10 6 setup 10 4 units C 13 ST Segment Analysis see ST Standards D 2 Standby 2 14 Startup 2 9 Startup Tests C 8 messages C 8 Sterilizing B 2 Stored Recordings 7 13 Strip Recor...

Page 279: ... ST C 13 temperature 15 2 C 13 V VGA displays 1 19 Volume 2 13 8 12 pulse tone 12 10 W Wall Mount A 12 Waveform Configuration 2 10 Wireless Card 3 4 Wireless Network bed label 3 5 care unit 3 5 functions 3 5 messages 3 7 safety 3 6 Z Zeroing IBP 14 6 Zoom fast access 1 22 ...

Page 280: ... 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 MS17727 RI 06 en Drägerwerk AG Co KGaA Edition 5 2015 03 Edition 1 2007 10 Dräger reserves the right to make modifi cations to the equipment without prior notice Manufactured by Draeger Medical Systems Inc 3135 Quarry Road Telford PA 18969 1042 U S A 215 721 5400 800 4DRAGE...

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