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5-4

250cx Series Maternal/Fetal Monitor

Revision C

2036946-001

Fetal Heart Rate Monitoring: FECG (Internal Method)

Alert

This field controls and shows Spectra Alerts. Refer to Appendix C for more
information.

Alarm Volume

This field controls the alarm volume for all fetal alarms.

FECG (Internal Method)

Methodology

This method uses an electrode attached directly to the fetal presenting part. The
electrode is connected to the cable/legplate secured to the mother. The fetal heart
rate is computed based upon the interval between successive R-wave peaks of the
fetal QRS complex.

The fetal heart rate is displayed in bpm and is continuously plotted on the strip chart
recorder paper if the recorder is on. (Refer to “US/US2 Setup Screen” on page 5-3.)
The heartbeat indicator flashes for each detected heartbeat.

Artifact Elimination

An FECG artifact elimination option is available behind the password-protected

Service Lock

screen on all 250cx Series Monitors.

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Summary of Contents for Corometrics 250cx Series

Page 1: ...GE Healthcare Corometrics 250cx Series Monitor Operator s Manual Corometrics 250cx Series Monitor English 2036946 001 C paper 2007 General Electric Company All Rights Reserved...

Page 2: ......

Page 3: ...GE Healthcare Corometrics 250cx Series Monitor Operator s Manual Corometrics 250cx Series Monitor English 2036946 001 C paper 2007 General Electric Company All Rights Reserved...

Page 4: ...s 250cx Series Monitor There are no user apparent differences among these software versions Due to continuing product innovation specifications in this manual are subject to change without notice NOTE...

Page 5: ...The IEC electromagnetic compatibility EN standards require individual equipment components and accessories to be configured as a system for evaluation For systems that include a number of different e...

Page 6: ...g Information Exceptions The Monitor System EMC Immunity Performance None Be aware that adding accessories or components or modifying the medical device or system may degrade the EMI performance Consu...

Page 7: ...magnetic Interference 1 9 Equipment Symbols 1 10 2 Introduction 2 1 About the Manual 2 3 Purpose 2 3 Intended Audience 2 3 Illustrations 2 3 Fetal Monitoring Indications for Use 2 3 Surveillance 2 3 M...

Page 8: ...m Message Area 3 12 Battery Backed RAM Status 3 13 Softkeys 3 13 Mode Title Softkeys 3 13 Waveform Softkeys 3 13 Dedicated Softkey Area 3 14 Rear Panel Description 3 16 4 Setup Procedures 4 1 Loading...

Page 9: ...ctive Signal Quality Alarm 5 8 Resolved Signal Quality Alarm 5 8 100 Signal Loss 5 9 Silencing an Audio Alarm 5 9 Summary 5 10 Single Fetal Heart Rate Monitoring 5 10 Dual Fetal Heart Rate Monitoring...

Page 10: ...7 7 Theory and Methodology 7 7 Pacemaker Safety Information 7 7 MECG Waveform 7 8 8 Maternal Non Invasive Blood Pressure Monitoring 8 1 Blood Pressure Safety Precautions 8 3 Warnings 8 4 NIBP Determin...

Page 11: ...Signal processing 9 4 Masimo SET 9 4 Signal Processing 9 4 Nellcor OxiMax 9 5 Automatic Calibration 9 6 SatSeconds 9 6 SatSeconds Safety Net 9 8 Using SatSeconds 9 8 MSpO2 Setup Screen 9 9 Response T...

Page 12: ...al Patient Alarms 10 7 Active Patient Alarm 10 7 Resolved Patient Alarm 10 7 Signal Quality Alarms 10 7 Active Signal Quality Alarm 10 8 Resolved Signal Quality Alarm 10 8 Silencing a Maternal Audio A...

Page 13: ...t is the Maternal Vital Signs History Screen 12 3 Using the Maternal Vital Signs History Screen 12 4 Displaying the Screen 12 4 Selecting the HX Interval 12 4 Printing the Maternal Vital Signs History...

Page 14: ...General 15 5 Materials 15 5 Procedure 15 5 SpO2 Sensors 15 6 Maternal SpO2 Calibration 15 6 NIBP Maintenance 15 6 Disposal of Product Waste 15 7 Patient Applied Parts 15 7 Packaging Material 15 7 Moni...

Page 15: ...18 4 MECG Ordering Information 18 5 NIBP Ordering Information 18 5 MSpO2 Ordering Information 18 6 Peripheral Device Ordering Information 18 6 A Factory Defaults A 1 Table of Defaults A 3 B Fetal Move...

Page 16: ...e C 7 Suspending Audio Alerts and the Nurse Call Interface C 7 Restoring Audio Alerts and the Nurse Call Interface C 7 Alert Parameters Summary C 9 Resetting Alerts C 12 False Pattern Recognition C 12...

Page 17: ...Revision C 250cx Series Maternal Fetal Monitor 1 1 2036946 001 1 Safety...

Page 18: ...1 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Safety For your notes...

Page 19: ...y persons authorized by GE Medical Systems Information Technologies the electrical installation of the relevant room complies with the requirements of appropriate regulations and the monitor is used i...

Page 20: ...A DANGER notice indicates an imminently hazardous situation which if not avoided will result in death or serious injury Warning A WARNING indicates a potentially hazardous situation which if not avoi...

Page 21: ...TION During defibrillation all personnel must avoid contact with the patient and monitor to avoid a dangerous shock hazard In addition proper placement of the paddles in relation to the electrodes is...

Page 22: ...servation and evaluation of the patient at regular intervals by a qualified care provider who will make diagnoses and decide on treatments and interventions INTERFACING OTHER EQUIPMENT Monitoring equi...

Page 23: ...Series Monitor RF INTERFACE Known RF sources such as cell phones radio or TV stations and two way radios may cause unexpected or adverse operation of this device SIMULTANEOUS DEVICES Do not simultane...

Page 24: ...ance of the monitor it is recommended that the calibration accuracy and electrical safety of the monitor be verified on an annual basis by a GE Medical Systems Information Technologies Service Represe...

Page 25: ...performance of this device Refer to the Electromagnetic Immunity information in this product s service manual for EN 60601 1 2 2001 compliance information and safety information for this product This...

Page 26: ...rnal and internal application to the patient excluding direct cardiac application TYPE BF EQUIPMENT Type BF equipment is suitable for intentional external and internal application to the patient exclu...

Page 27: ...Revision C 250cx Series Maternal Fetal Monitor 1 11 2036946 001 Safety Equipment Symbols O POWER OFF disconnection from the mains I POWER ON connection to the mains VGA connection Equipment Symbols...

Page 28: ...1 12 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Safety Equipment Symbols...

Page 29: ...Revision C 250cx Series Maternal Fetal Monitor 2 1 2036946 001 2 Introduction...

Page 30: ...2 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Introduction For your notes...

Page 31: ...n addition unless explicitly stated the display examples do not represent your equipment setup or displayed data Fetal Monitoring Indications for Use A Corometrics 250cx Series Fetal Monitor is used f...

Page 32: ...increase and your budget allows The model of the monitor determines which parameters are in your monitor The 250cx Series Monitor Features The 250cx Series monitor offers the following features Syste...

Page 33: ...set option is provided for the secondary heart rate HR2 trend when using dual ultrasound or ultrasound and direct FECG to separate overlapping FHR trends for easy interpretation A heartbeat coincidenc...

Page 34: ...itored using well known user preferred pulse oximetry brands Masimo SET Nellcor OxiMax or Ohmeda TruSignal MSpO2 may be selected at the time of purchase or changed later as determined by hospital need...

Page 35: ...Revision C 250cx Series Maternal Fetal Monitor 3 1 2036946 001 3 Controls Indicators and Connectors...

Page 36: ...3 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Controls Indicators and Connectors For your notes...

Page 37: ...s of operation in use B Trim Knob Control Operation of the monitor is controlled by using the front panel buttons in conjunction with the Trim Knob control This control selects softkeys on the display...

Page 38: ...strip chart recorder door to add remove or adjust the paper M Power Switch Moving the switch to the on position I turns the monitor on moving the switch to the off position O turns the monitor off N S...

Page 39: ...crease Button The four Volume buttons raise and lower the volume of sound emitted by the rear panel speaker The upper pair controls the volume for FHR1 The lower pair controls the volume for FHR2 Volu...

Page 40: ...operation in use Maternal and Fetal Parameters Primary Labor Parameters Fetal Additional Parameters Maternal Display Summary Display Section Item Mode Primary Labor Parameters upper portion of monito...

Page 41: ...numerics Maternal pulse oximetry is active by presence of pulse amplitude indicator MECG is selected as the heart rates source as indicated by the MECG mode title softkey rather than Pulse The MECG wa...

Page 42: ...te in beats per minute B FHR Alarm Setting Indicator This symbol provides information about the FHR audio alarm and the FHR high low alarm limit settings See Chapter 10 Alarms for more information All...

Page 43: ...ctive Connectors FHR1 Area FHR2 Area FECG FECG INOP FECG US FECG US FECG US2 FECG US2 US US INOP US US2 US US2 US2 US2 INOP INOP INOP FECG US US21 FECG US2 UA Display Name Description A UA Value Up to...

Page 44: ...o three digits displayed as XXX mmHg or XX X kPa All kPa readings are displayed to 1 10 kPa During a determination the instantaneous cuff pressure displays in place of the mean arterial pressure and i...

Page 45: ...Alarm Setting Indicator This symbol provides information about the MHR P audio alarm and the MHR P high low alarm limit settings See Chapter 10 Alarms for more information Maternal alarms cannot be d...

Page 46: ...ar right When a waveform is frozen the message Frozen displays on the far left bottom corner along with the time of activation MSpO2 Display Name Description A MSpO2 Value Up to three digits indicate...

Page 47: ...of the mode titles in the display are also softkeys which give access to corresponding setup screens US US2 FECG NIBP MECG Pulse and MSpO2 Waveform Softkeys The waveform title is a softkey used to sel...

Page 48: ...play Summary 165 172 30 130 85 89 97 MECG MSpO2 NIBP MAP 107 03 15 09 22 06 US2 US TOCO 02 15 Print Freeze Alarms Setup VSHX 25 mm s II Auto HBC MECG 09 21 41 Frozen A B C I D E F G H Display Summary...

Page 49: ...History Screen Softkeys Name Description A Print Softkey Prints one page screen of the table B PrintAll Softkey Prints all pages screens C View Softkey Scrolls through the data Counterclockwise for n...

Page 50: ...C J111 RS232C J101 J104 PUSH H 100 120V 50 60HZ 100W Munzinger Stra e 3 5 D 79111 Freiburg Germany European Representative GE Medical Systems Inc 0086 CANADIAN PATS 1 057 360 1 214 143 U S PATS 3 982...

Page 51: ...tative for more information I ECG Out Connector External recorder receptacle for MECG signals The standard output level is 1 V mV J Fetal Acoustic Stimulator Connector Receptacle for Corometrics Model...

Page 52: ...mply with leakage current requirements of one of the following applicable standards Underwriters Laboratories UL 2601 1 Canadian Standards Associations CSA 22 2 No 125 or International Electrotechnica...

Page 53: ...Revision C 250cx Series Maternal Fetal Monitor 4 1 2036946 001 4 Setup Procedures...

Page 54: ...4 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Setup Procedures For your notes...

Page 55: ...can cause paper jams Follow the instructions carefully PAPER TYPE Do not use non Corometrics paper or paper designed for use with other Corometrics monitors Using incorrect paper may produce inferior...

Page 56: ...e the end of the recorder paper When the black squares appear the strip chart recorder has approximately 20 minutes of paper remaining when running at a speed of 3 cm min 3 Hold the package of paper s...

Page 57: ...p Chart Recorder Paper 4 Unfold two sheets from the top of the package so that they extend toward you Creating Paper Leader 5 Place the pack in the drawer so that the pack is laying flat in the record...

Page 58: ...Biomedical Engineering Department or GE Service Representative Attaching the Power Cord 3 Turn the monitor s power on The green indicator light located near the upper left hand corner of the Light bu...

Page 59: ...ons are performed easily using the front panel Trim Knob control Setup screens for FECG US US2 Maternal NIBP MHR P and MSpO2 are detailed in Chapter 5 Monitor Self Test Routines Test Routine Descripti...

Page 60: ...ob control once to display the selected setup screen 3 While the screen is displayed rotate the Trim Knob control until the desired field is highlighted 4 Press the Trim Knob control again to activate...

Page 61: ...e Volume This field adjusts the temperature completion volume This field is only available when the Exergen protocol is configured Brightness This field allows you to adjust the brightness of the back...

Page 62: ...ime even when the monitor is unplugged from AC power The time is represented by a 24 hour clock in hours minutes and seconds The hour field has a range of 00 23 the minutes field has a range of 00 59...

Page 63: ...sducers 4 Ensure the setup menus are configured appropriately for use on this patient Refer to Setup Screens on page 4 7 5 Turn the recorder on Refer to Chapter 11 Recorder Modes for more information...

Page 64: ...4 12 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Setup Procedures Preparing the Monitor for Patient Use...

Page 65: ...Revision C 250cx Series Maternal Fetal Monitor 5 1 2036946 001 5 Fetal Heart Rate Monitoring...

Page 66: ...5 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Fetal Heart Rate Monitoring For your notes...

Page 67: ...n successive cardiac cycles The fetal heart rate is displayed in bpm and is continuously plotted on the strip chart paper if the recorder is on Refer to the US US2 Setup Screen figure below The heartb...

Page 68: ...senting part The electrode is connected to the cable legplate secured to the mother The fetal heart rate is computed based upon the interval between successive R wave peaks of the fetal QRS complex Th...

Page 69: ...in the above figure the factory default settings are listed in Appendix A Factory Defaults NOTE The FHR1 and FHR2 alarm limits are set independently of each other Audio Alarms This field enables disab...

Page 70: ...low tones CAUTION Prior to monitoring each patient it is recommended that you check the alarm status and alarm limits to ensure they are appropriate for the patient The alarms are disabled if the Ala...

Page 71: ...When data consistently violates the limit the time to alarm is 5 minutes High FHR Alarm Example FHR Low Alarm The simplest example of a low FHR alarm occurs when the FHR value is continuously less th...

Page 72: ...f the FHR violates the alarm limit setting for more time than it stays within the specified acceptable range The time to alarm increases as a greater percentage of data stays within the specified acce...

Page 73: ...percentage of signal loss Figure below shows an example where there is 70 signal loss resulting in a signal quality alarm after 5 minutes 70 Signal Loss Example Silencing an Audio Alarm Press the Alar...

Page 74: ...on of unusual undefined or suspicious patterns that may or may not generate a threshold alarm Single Fetal Heart Rate Monitoring The Corometrics 250cx Series monitor offers three options to monitor a...

Page 75: ...asound or ultrasound and FECG This field provides an alternative to using the front panel Mark Offset button Refer to the service manual for information on enabling disabling fetal HR offset Activatin...

Page 76: ...ting is selected on the password protected Install Options screen the shifted heart rate trace automatically reverts to normal after 10 minutes 2 Press and hold the Mark Offset button for 3 seconds Or...

Page 77: ...Revision C 250cx Series Maternal Fetal Monitor 6 1 2036946 001 6 Uterine Activity Monitoring...

Page 78: ...6 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Uterine Activity Monitoring For your notes...

Page 79: ...he UA Reference button Establishing a Baseline Monitoring uterine activity using a tocotransducer provides relative pressure measurements compared to a baseline or UA reference The quality of measurem...

Page 80: ...ll receive the CHECK TOCO message try a different tocotransducer or contact your GE Service Representative Manually Setting the Baseline at the Default Value Briefly pressing the UA Reference button s...

Page 81: ...line at 100 mmHg 13 3 kPa Why You Must Zero the System When you zero the system you are referencing the pressure to 0 mmHg 0 kPa while the system is open to air to ensure an absolute pressure measure...

Page 82: ...6 6 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Uterine Activity Monitoring Internal Method Intrauterine Pressure IUP...

Page 83: ...Revision C 250cx Series Maternal Fetal Monitor 7 1 2036946 001 7 Maternal Heart Pulse Rate Monitoring...

Page 84: ...7 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Heart Pulse Rate Monitoring For your notes...

Page 85: ...ly MSpO2 values updated continuously NIBP NIBP is available only as an Auto selection the Manual selection is disabled Values updated only when NIBP determinations are taken IMPORTANT MSpO2 AS AN MHR...

Page 86: ...the MHR P source When Auto is selected the monitor checks for parameter availability and use in the following order MECG MSpO2 then NIBP If a source is not available the next available source is autom...

Page 87: ...of the beep sounded with each detected valid heartbeat for MECG and MSpO2 only Alarms These fields adjust the high and low alarm limits for MHR P in increments of 5 bpm The selectable values are shown...

Page 88: ...setting for a patient who has a pacemaker The monitor rejects the pacer spike from the heart rate calculation and replaces the actual pacer spike1 with a pacer event mark in addition the letter P is...

Page 89: ...and for output to external devices such as a central station system The averaged MHR values are used for display and for alarm detection Pacemaker Safety Information The following safety information a...

Page 90: ...nitoring and diagnostic equipment causing the pacemakers to pace at their maximum programmed rate The FDA further recommends precautions to take into consideration for patients with these types of pac...

Page 91: ...Revision C 250cx Series Maternal Fetal Monitor 8 1 2036946 001 8 Maternal Non Invasive Blood Pressure Monitoring...

Page 92: ...8 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Non Invasive Blood Pressure Monitoring For your notes...

Page 93: ...th maternal contractions Finally be aware that the accuracy of measurements can be affected if readings coincide with maternal uterine contractions Refer to Smart BP Feature on page 8 13 CALIBRATION D...

Page 94: ...arameter will not measure blood pressure effectively on patients who are experiencing seizures or tremors Arrhythmias will increase the time required by the NIBP parameter to determine a blood pressur...

Page 95: ...end of a determination these stored data are used to determine systolic mean and diastolic pressures Due to the difference in these methods one cannot be used to check the accuracy of the other Super...

Page 96: ...at cuff pressures higher than the initial target pressure The parameter will inflate the cuff above the initial target pressure to get data in the systolic region The maximum pressure allowed in systo...

Page 97: ...ure for cuff inflation If the NIBP is taken while previous determination is still displayed and within 16 minutes of the previous determination the initial target pressures for subsequent determinatio...

Page 98: ...Cuff is properly placed on patient and connected to the NIBP hose 4 Tubes between the cuff and the monitor are not kinked or blocked Patient Preparation Cuff selection and application are important In...

Page 99: ...ect patient s limb prior to application Precaution Do not apply cuff to areas where skin is not intact or tissue is injured 8 Palpate artery and place cuff so that patient s artery is aligned with cuf...

Page 100: ...antaneous cuff pressure is displayed in place of the mean arterial pressure area and is indicated by the title Cuff If you have the 256 Monitor which does not have the NIBP parameter installed and pre...

Page 101: ...automatic reading scheduled at 12 02 00 The 12 02 00 determination is cancelled and the following reading will resume at 12 04 00 The optional 1 minute interval is an exception When 1 minute is select...

Page 102: ...eld display in place of the countdown timer Refer to NIBP Interval Time Shortcut on page 8 12 3 Continuous pressure on the NIBP Start Stop button cycles through the available intervals 1 2 3 4 5 10 15...

Page 103: ...isabling Smart BP The Smart BP feature is enabled disabled via the password protected Install Options service screen Refer to the 250 250cx Series Monitor Service Manual for more information Methodolo...

Page 104: ...8 14 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Non Invasive Blood Pressure Monitoring Smart BP Feature...

Page 105: ...Revision C 250cx Series Maternal Fetal Monitor 9 1 2036946 001 9 Maternal Pulse Oximetry Monitoring...

Page 106: ...9 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Pulse Oximetry Monitoring For your notes...

Page 107: ...ion of red and infrared light spectrophotometry 2 The amount of arterial blood in tissue changes with your pulse photoplethysmography Therefore the amount of light absorbed by the varying quantities o...

Page 108: ...re transmitted through the tissue at the sensor site and are modulated by arterial blood pulsation The photodetector in the sensor converts the light intensity information into an electronic signal th...

Page 109: ...ition of the patient and aids in determining if any intervention is required Nellcor OxiMax Due to a change in Nellcor technology the SpO2 parameter in the Corometrics 250cx Monitor is migrating from...

Page 110: ...sensor serve as light sources a photo diode serves as the photodetector To identify the oxygen saturation of arterial hemoglobin the monitor uses the pulsatile nature of arterial flow During systole...

Page 111: ...an audible alarm sounds The SatSeconds limit controls the time that the SpO2 level may fall outside the alarm before an audible alarm sounds The method of calculation is as follows The number of perce...

Page 112: ...al range and remains there SatSeconds Safety Net The SatSeconds Safety Net is for patients with saturation levels having frequent excursions below the limit but not staying below the limit long enough...

Page 113: ...e for different levels of patient activity Normal Useful when patient is unavoidably active least affected by patient motion Fast Factory default setting Useful in most clinical situations for relativ...

Page 114: ...es on the strip chart paper O2 Trace This setting enables or disables the printing of the MSpO2 trend on the bottom grid of the strip chart paper On The MSpO2 trend prints in grey and is annotated wit...

Page 115: ...fractional saturation 250cx Series Monitors with Masimo Technology are compatible only with Masimo LNOP and LNCS sensors For additional information refer to Directions for Use supplied with sensor 250...

Page 116: ...h this device fall within the scope of one or more of the patents relating to this device Sensors Before use carefully read the manufacturer s sensor directions for use CAUTIONS TISSUE DAMAGE Tissue d...

Page 117: ...Revision C 250cx Series Maternal Fetal Monitor 10 1 2036946 001 10 Alarms...

Page 118: ...10 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Alarms For your notes...

Page 119: ...etup Master Alarm Setup Screen The figure below is a sample Master Alarm Setup screen Although each of the fields on this screen can be accessed under the individual parameter setup screens the Master...

Page 120: ...tings is used for all alarms CAUTION ALARM SETUP Prior to monitoring each patient it is recommended that you check the alarm limits to ensure they are appropriate for the patient Alarm Silence The fig...

Page 121: ...ell as the maternal NIBP area of the screen Under an alarm condition that affects NIBP both a visual and audible alarm is issued Under an alarm condition that affects MSpO2 or MECG only an audio alarm...

Page 122: ...tion differently than other alarms with a 250cx Series Monitor Resolved Unsilenced FHR Patient Alarm You must acknowledge an FHR patient alarm even if the condition has already been resolved The visua...

Page 123: ...low limit setting For MHR P the value used for analysis comes from the selected MHR P source For Ohmeda and Masimo MSpO2 the value must be out of range for 8 seconds For Nellcor MSpO2 the range depend...

Page 124: ...SIGNAL or REPAIR Refer to Chapter 16 Troubleshooting for more information on these messages MSpO2 System Problem When there is a malfunction with the monitor s built in MSpO2 parameter one of the foll...

Page 125: ...gh alarm activates after 5 minutes a low alarm activates after 30 seconds About Latching Alarms The FHR limit alarms are latching alarms which means that a clinician must acknowledge the alarm using t...

Page 126: ...abled MSpO2 b MSPO2 limit high or low actively being violated Issued after about 8 seconds MSpO2 numeric flashes MSpO2 value and pulse rate print on the strip chart Alternating high low tones if audio...

Page 127: ...Revision C 250cx Series Maternal Fetal Monitor 11 1 2036946 001 11 Recorder Modes...

Page 128: ...11 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Recorder Modes For your notes...

Page 129: ...12 Maternal Vital Signs History and Chapter 14 Waveforms for more information On Mode When the recorder is on the yellow Record indicator continuously illuminates and the recorder runs at the selecte...

Page 130: ...filled diamond marker indicates the data is provided by an external device interfaced to the monitor The date is printed when the maternal only mode is first activated when the date time is changed a...

Page 131: ...er the monitor s maternal only mode acts as a paper saver turning the strip chart recorder on and off as needed However the QS System overrides the maternal only mode by storing the entire patient rec...

Page 132: ...rt with five traces printed simultaneously Up to three heart pulse rate trends can be printed in the top or left channel of the strip chart paper two FHR trends as well as the MHR P trend The primary...

Page 133: ...ption configures the MSpO2 trend to always plot at a fixed scale of 0 100 Annotations Several standard annotations are printed by the monitor to help analyze the strip chart data and complete the pati...

Page 134: ...lt in blood pressure parameter The vital signs print below the diamond See Figure on page 11 8 An unfilled diamond with a slash indicates a blood pressure reading was cancelled delayed The marks the t...

Page 135: ...he diamond prints at the time of the reading however the vital signs data prints as soon as a line becomes available The pulse rate value determined by MSpO2 always prints along with MSpO2 Annotations...

Page 136: ...age reprints every 10 minutes at the 10 minute mark until the clock is reset TEST ARE ALL DOTS PRINTED This annotation prints across the width of the top strip chart grid when you press the Test butto...

Page 137: ...ntifies an external device as the source The diamond prints on the bottom two lines of the bottom grid of the strip chart paper and marks the time of the reading The vital signs data prints in one of...

Page 138: ...prints in the top two lines of the upper grid indicating the cessation of heartbeat coincidence This annotation prints on the bottom two lines of the upper grid indicating that active telemetry signal...

Page 139: ...e arrow prints each time the mother presses the FM Remote Marker button Note A horizontal bar prints as a tail on the arrow for as long as the button is held down The Remote Marker is an accessory tha...

Page 140: ...Description 30 240 bpm Scale Paper 50 210 bpm Scale Paper Small Eight annotation lines are available Time date modes and annotations all print using the small font size See Figure on page 11 14 Four...

Page 141: ...s set to 60 minutes and the sensor is connected at 9 42 a m Whereas the first real time printing would occur at 10 42 the first chart style printing is done at 10 00 Subsequent values are printed at 1...

Page 142: ...corder speed set at 3 cm min As shown in Figure on Page 11 17 a dark line is printed every 3 cm which represents 1 minute in time at a speed of 3 cm min In other countries the most common grid may be...

Page 143: ...eries Maternal Fetal Monitor 11 17 2036946 001 Recorder Modes Strip Chart Paper Strip Chart Paper with 30 240 bpm Heart Rate Scale Pre printed HR Scale Pre printed UA Scale Bottom Grid Primary Annotat...

Page 144: ...eries Monitor alerts you when paper is running low or when the recorder is completely out of paper To protect against paper jams the recorder also contains a paper loading sensor which notifies you if...

Page 145: ...off once every second Continues to print until paper runs out Two short tones every 30 seconds 1 Cancels the alarm PAPER OUT Out Only Off Automatically stops printing Three short tones every 30 secon...

Page 146: ...11 20 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Recorder Modes Paper Low Paper Out and Paper LoadING Error Conditions...

Page 147: ...Revision C 250cx Series Maternal Fetal Monitor 12 1 2036946 001 12 Maternal Vital Signs History...

Page 148: ...12 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Vital Signs History For your notes...

Page 149: ...ior to powering off the monitor in order to retain a hard copy for your files The monitor stores up to 8 hours of data on a first in first out basis available for review and printing at any time After...

Page 150: ...val The maternal Vital Signs History screen can be configured to display different columns of data by adjusting the HX Interval field The interval choices are Event to display all events and 1 5 10 15...

Page 151: ...e maternal vital signs history for printing on the strip chart paper The information is printed in the upper portion of the top or left grid of the strip chart paper at a high speed mode If the record...

Page 152: ...12 6 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maternal Vital Signs History Using the Maternal Vital Signs History Screen Vital Signs History Print Example...

Page 153: ...Revision C 250cx Series Maternal Fetal Monitor 13 1 2036946 001 13 Heartbeat Coincidence...

Page 154: ...13 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Heartbeat Coincidence For your notes...

Page 155: ...zes the combinations of heart rate sources that are continuously compared for the possibility of coincidence Using the Heartbeat Coincidence Feature Enabling Disabling Heartbeat Coincidence Detection...

Page 156: ...cenario if three channels are picking up the same signal the heart rate numerics for all three heart rates display in inverse video If you disconnect a transducer while coincidence is detected any val...

Page 157: ...erlaid hearts print in the upper portion of the top grid of the strip chart paper the hearts print every 4 5 cm for as long a coincidence is detected Once coincidence is resolved two side by side hear...

Page 158: ...13 6 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Heartbeat Coincidence Using the Heartbeat Coincidence Feature...

Page 159: ...Revision C 250cx Series Maternal Fetal Monitor 14 1 2036946 001 14 Waveforms...

Page 160: ...14 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Waveforms For your notes...

Page 161: ...screen to select FECG MECG MSpO2 or Off Refer to Figure on page 14 4 Waveform Speed All waveforms are displayed at a rate of 25mm sec This speed is not adjustable The speed is displayed at the top ri...

Page 162: ...w the most recent data is displayed on the screen for analysis The message Frozen for any waveform along with the time of activation is displayed at the lower left of the waveform All numerics continu...

Page 163: ...e top or left grid A vertical tick mark is printed at the start 3 second mark and end or 6 second mark for reference If the waveform is frozen 6 seconds of historical data are printed ending with the...

Page 164: ...etween different types of waveforms without cancelling any printing that is in progress NOTE The monitor must collect 6 seconds of new data following completion of a print function before it can print...

Page 165: ...Revision C 250cx Series Maternal Fetal Monitor 15 1 2036946 001 15 Maintenance...

Page 166: ...15 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maintenance For your notes...

Page 167: ...leaning solutions per manufacturers recommendations 2 Wipe off cleaning solutions with a clean dry cloth 3 Do not use a cleaning substance containing wax 4 Do not pour or spray water or any cleaning s...

Page 168: ...Dampen a cloth or paper towel with one of the following products then wring out until only slightly wet Sodium Hypochlorite 5 25 Bleach diluted 10 1 Cidex Sporicidin Soap and water 2 Rub soiled area u...

Page 169: ...ater 10 solution of household bleach 5 25 sodium hypochlorite in distilled water Soft cloths and soft bristled brushes Spray bottles Procedure 1 Prepare the enzymatic detergent according to the manufa...

Page 170: ...n this appendix To clean or disinfect the sensor 1 Saturate a clean dry gauze pad with the cleaning solution Wipe all surfaces of the sensor and cable with this gauze pad 2 Saturate another clean dry...

Page 171: ...d be cleaned according to instructions Inspect reusable applied parts for wear replace as necessary and dispose of used product as medical waste in accordance with regional body controlled guideline P...

Page 172: ...15 8 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Maintenance Disposal of Product Waste...

Page 173: ...tion of the manual provides a troubleshooting guide for the most basic 250cx Series Monitor operational problems If the response to a specific question is not found contact Technical Support Inside th...

Page 174: ...16 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Troubleshooting For your notes...

Page 175: ...e Record indicator is off the message PAPER INCORRECTLY LOADED RELOAD WITH BLACK SQUARES DOWN is shown in maternal waveform area Recorder does not function and the Record indicator is on Recorder is o...

Page 176: ...r Wait before moving transducer FHR often returns Reposition transducer Apply more gel Replace transducer Use alternate technique Auscultate FHR Call Biomedical Engineering Department Check maternal p...

Page 177: ...neering Department Rate in FHR area of the display and the FHR trend on the strip chart paper do not correlate Monitor is set for 30 bpm cm vertical scale and 20 bpm cm vertical scale strip chart reco...

Page 178: ...ducer Do not overtighten belt Press UA Reference button again between contractions See Out of Range Condition on page 6 4 for further information Replace transducer Call Biomedical Engineering Departm...

Page 179: ...systolic Ensure electrodes are firmly secured to patient Blood Pressure Troubleshooting Problem Probable Cause Possible Solution High reading Measurement taken during uterine contraction Annotate char...

Page 180: ...ashes shown in MSpO2 display area Monitor unable to make a determination due to insufficient signal Improperly applied sensor Excessive maternal movement Excessive ambient light Damaged sensor Check p...

Page 181: ...Revision C 250cx Series Maternal Fetal Monitor 17 1 2036946 001 17 Technical Specifications This section contains a detailed list of the technical specifications for the 250cx Series Monitor...

Page 182: ...17 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Technical Specifications For your notes...

Page 183: ...to 104 F 10 C to 40 C 80 F 26 5 C 30 to 70 non condensing 45 to 65 non condensing 700 1060 mbar 525 795 mmHg 700 1060 mbar 525 795 mmHg Certification ANSI AAMI EC13 1992 UL 2601 1 CUL Complies with al...

Page 184: ...ble 110 dB at mains frequency 10 V peak to peak 10 M 20 M 40 dB 60 A at 254 VAC electrically isolated 4 kVAC Ultrasound Mode Technique Transducer Type Pulse Repetition Frequency Single Ultrasound Mode...

Page 185: ...chnical Tachycardia Response Time Peak detecting beat to beat cardiotachometer Medtronic 1700 003 or equivalent I II and III 30 240 bpm 1 bpm 1 update per second 0 5 mV to 5 mV peak to peak 0 5 mV RTI...

Page 186: ...tion time is exceeded not to exceed AAMI ANSI SP10 1992 limit of 180 s or safety timer detects microprocessor failure Auto mode minimum 30 second delay from the end of one determination to the beginni...

Page 187: ...lts Resolution Saturation SpO2 Pulse Rate bpm Low Perfusion Performance4 0 02 Pulse Amplitude and Transmission 5 Alarms Visual Audio Spectrophotometry and plethysmography LNOP DC I LNOP Adt LNCS PC I...

Page 188: ...ion equals plus or minus one standard deviation Plus or minus one standard deviation encompasses 68 of the population Masimo SET technology with LNOP and LNCS sensors have been validated with human bl...

Page 189: ...he ages ranged from 19 to 35 years old The weights ranged from 120 to 185 lb with a mean weight of 158 lb The skin tones were as follows 2 African American and Jamaican subjects with dark pigmentation...

Page 190: ...y certain environmental and patient physiological conditions as discussed in the operator s manual for the monitor Use Nellcor sensors only with 250cx Series Monitors containing Nellcor oximetry Consu...

Page 191: ...l 7 cm 8 cm 30 bpm cm 20 bpm cm 30 240 bpm 50 210 bpm 1 bpm 1 bpm Uterine Activity Scale Chart Width Scaling Range Resolution Strain Gauge Tocotransducer 4 cm 4 cm 25 mmHg 3 3 kPa cm 25 mmHg 3 3 kPa c...

Page 192: ...17 12 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Technical Specifications Strip Chart Recorder...

Page 193: ...ories This section provides an overall listing of supplies and accessories for use with 250cx Series Monitors To order any of the supplies and accessories listed in this manual Inside the United State...

Page 194: ...18 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Supplies Accessories For your notes...

Page 195: ...er Pack 50 210 bpm Heart Rate Scale 40 carton 4305DAO Ultrasound Supplies Item Catalog Number REF Loop Style Ultrasound Transducer Nautilus 8 foot Cord 5700LAX Button Style Ultrasound Transducer Nauti...

Page 196: ...tem Catalog Number REF Loop Style Tocotransducer Nautilus 8 foot Cord 2264LAX Button Style Tocotransducer Nautilus 8 foot Cord 2264HAX Reusable Belt for Loop Style Transducer Mesh Style 10 carton 4425...

Page 197: ...31 inches 412682 001 Multi Link Grabber Leadwires Set of 5 Individually Detachable 31 inches 414556 001 Leadwire Adapter 3 Lead Multi Link to 3 Lead DIN 414371 001 Electrodes Round Foam Pouches of 30...

Page 198: ...350 001 Intermediate Cable for Masimo LNOP Sensors 2017002 003 Intermediate Cable for Ohmeda Sensors OXY ES3 Nellcor Durasensor Adult Reusable Finger Probe 407705 006 Masimo Sensor LNOP Adult Reusable...

Page 199: ...Revision C 250cx Series Maternal Fetal Monitor A 1 2036946 001 A Factory Defaults Factory Defaults are found in the table that follows Factory defaults settings are dependent upon the model purchased...

Page 200: ...A 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Factory Defaults For your notes...

Page 201: ...1 9 NIBP Initial Target Pressure 135 mmHg 18 0 kPa 100 250 mmHg 13 3 33 3 kPa in increments of 5 mmHg 0 7 kPa Mode Manual Manual 1 2 3 4 5 10 15 20 30 40 45 60 90 120 min NIBP Done Vol 5 0 9 Alarm mm...

Page 202: ...inutes O2 Trace Off On Off Alarms MSpO2 MHR P High Low 100 95 120 50 bpm High Low 85 100 80 99 100 250 35 120 Volume 5 1 9 MHR P Source Auto Auto MECG MSpO2 NIBP MHR P Trace Off On Off Volume 0 0 9 Al...

Page 203: ...General Setup Play Song Off Off Happy Birthday Brahms Lullaby Rock a Bye Baby All Song Volume 5 0 9 Temp Done Volume 5 0 9 Brightness 9 0 9 nine brightest Paper Speed United States 3 cm min Internati...

Page 204: ...nited States 30 240 bpm International 50 210 bpm Recorder Font Size Medium Small Medium Large FECG Artifact Elimination Off On Off Paper Chime Out Only Off Low out Out only Paper Chime Volume 5 1 9 HB...

Page 205: ...al Real Time Real Time Chart Style Default TOCO Reference 10 in mmHg mode or 1 3 in kPa modes 5 10 15 20 or 25 relative units in mmHg mode or 0 7 1 3 2 0 2 7 or in 3 3 kPa mode Smart BP On On Off NIBP...

Page 206: ...A 8 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Factory Defaults Table of Defaults...

Page 207: ...tor B 1 2036946 001 B Fetal Movement Detection Each monitor in the 250cx Series can be upgraded to include fetal movement detection This feature is designed to detect gross fetal body movements and bo...

Page 208: ...B 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Fetal Movement Detection For your notes...

Page 209: ...E DETECTION The following may be automatically detected as fetal movement transducer movement and maternal movement such as coughing laughing repositioning mother poking her abdomen in addition to eme...

Page 210: ...the bottom of the upper grid for the duration of the detected movement Refer to Figure Simulated Fetal Movement Detection Trace on page B 5 Using the FM Remote Marker to Complement the Patient Record...

Page 211: ...ection While Monitoring The annotation resulting from the FM Remote Marker can be configured as one of the following commonly used to record a general event or commonly used as an indication that the...

Page 212: ...B 6 250cx Series Maternal Fetal Monitor Revision C 2036946 001...

Page 213: ...Series can be upgraded to include Spectra Alerts Contact your Sales Representative for more information This feature analyzes heart rate and uterine activity data to detect certain abnormal trends an...

Page 214: ...C 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Spectra Alerts For your notes...

Page 215: ...in labor The absence of an alert does not indicate fetal or maternal well being The alert message and priority level are only a means to direct the staff s attention to the patient since more than on...

Page 216: ...chart paper prior to the active FHR mode annotation s Refer to the Figure Spectra Alert Enabled Annotation on page C 5 and the Figure Example of a Level One Decelerations Alert on page C 6 This icon...

Page 217: ...m bradycardia 90 99 bpm late decelerations severe variable or sporadic decelerations tachycardia with flat variability mild sporadic decelerations with decreased variability moderate variable decelera...

Page 218: ...el one decelerations Example of a Level One Decelerations Alert Silencing Alerts Press the Alarm Silence button to cancel the audio The alert level stops flashing and displays in normal video however...

Page 219: ...t suspension feature must be enabled disabled on the password protected Install Options service screen Refer to the 250cx Series Service Manual for more information The alert suspension feature has tw...

Page 220: ...ctra Alerts Alert Indications Spectra Alert Suspended Icon Spectra Alert Suspend Restore Annotations 138 12 87 98 MECG MSpO2 NIBP 15 52 58 US FECG TOCO Print Freeze Alarms Setup VSHX 25 mm s II 2x MEC...

Page 221: ...ossible results which can appear in the Alert Parameters summary NOTEParameters displayed in inverse video are contributing to an active alert Items displayed in normal video may indicate an alert is...

Page 222: ...nformation The following figure shows an example of alert parameters for a level one decelerations alert for FECG Duration of Last UC of seconds Tetanic Signal Quality Good Moderate Poor Unknown Summa...

Page 223: ...ters for the US Setup screen when the FHR is not associated with any alert Alert Parameters Example US is not associated with any alert Items listed in inverse video are contributing factors to the al...

Page 224: ...system may recognize accelerations as baseline Mode Switching During dual FHR monitoring the system may confuse the FHRs following mode switches after delivery of the presenting twin To guard against...

Page 225: ...ss and a level one decelerations alert Trend Screen Example Uterine Contraction Frequency The Spectra Alerts option includes a uterine contraction UC frequency display When enabled the UA screen provi...

Page 226: ...e TOCO or IUP 2 Set the UA Display field to the desired setting UA or UA UCF Refer to the Figure UC Frequency Histogram on page C 15 UC Frequency in UA Display Area When enabled On the UC frequency pe...

Page 227: ...he UA Setup screen contains a UC Chime field When enabled a low frequency chime sounds at the onset of a contraction a high frequency chime sounds at the conclusion This audio contraction indicator is...

Page 228: ...is 0 5 When connected to a Nurse Call System the monitor will activate the system each time a Spectra Alert is issued This interface simulates pressing the button on a bedside Nurse Call System allow...

Page 229: ...past 10 minutes High BASELINE Alert pending FHR 160 bpm for 5 minutes Alert has not been silenced Reflects the detection of baseline FHR 160 bpm for 10 minutes Alert silenced Low BASELINE Alert pendi...

Page 230: ...ability which is 4 5 beats peak to peak for approximately 10 minutes Alert will be issued 20 40 minutes after decreased variability is detected The time to alert depends on whether or not any other al...

Page 231: ...o determine when to alert The alert message is issued on the basis of 1 2 or 3 decelerations depending on the size shape onset duration etc and related baseline rate and variability Examples An alert...

Page 232: ...d Alert silenced and question resolved The alert is deleted after uterine activity is 35 mmHg 4 7 kPa for 5 minutes UC Uterine con tractions in 10 min of uterine contractions Tachysyst Six uterine con...

Page 233: ...deleted after 3 minutes of satisfactory data Poor With UC SIGNAL QUALITY Data unsatisfactory with uterine contractions present Alert has not been silenced Data between uterine contractions is acceptab...

Page 234: ...C 22 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Spectra Alerts Alert Parameters...

Page 235: ...Revision C 250cx Series Maternal Fetal Monitor D 1 2036946 001 Frequently Asked Questions D Frequently Asked Questions...

Page 236: ...D 2 250cx Series Maternal Fetal Monitor Revision C 2036946 001 Frequently Asked Questions...

Page 237: ...again to return to the main monitoring display screen NOTE When the monitor is powered off then on again the settings revert back to the factory default settings or can be saved if you choose Store Cu...

Page 238: ...and 250 bpm Note The MHR P alarm settings are also available through the Pulse legend or the MSpO2 legend on the main monitoring screen You may optionally change the MHR P Low select a value between...

Page 239: ...im Knob to highlight the Source setting It will read Auto MSpO2 MECG 4 Once the Source setting is highlighted press the Trim Knob again The current setting displays in blinking inverse video 5 Now rot...

Page 240: ...or the NIBP legend on the main monitoring screen You may optionally change the MHR P Low select a value between 35 bpm and 120 bpm The MHR P alarm settings are also available via the Pulse legend or...

Page 241: ...nitoring display screen Option 2 1 If the MHR P Source setting is set to Auto and MECG is currently enabled plugged in OR MHR P Source is set to MECG then from the main monitor screen rotate the Trim...

Page 242: ...the current legend 3 Now rotate the Trim Knob to highlight the FHR1 Audio Alarms setting This is at the bottom of the flat panel display slightly above the menu bar on the left half of the screen The...

Page 243: ...current setting as desired With each setting change an audio tone indicative of the alarm volume will be emitted from the speaker 10 Once you set the desired alarm value press the Trim Knob to confirm...

Page 244: ...peaker 7 Now rotate the Trim Knob to select highlight the Exit item on the bottom menu 8 Press the Trim Knob again to return to the main monitoring display screen How do I enable or change alarm volum...

Page 245: ...rim Knob to select highlight the Exit item on the bottom menu 8 Press the Trim Knob again to return to the main monitoring display screen How do I change the volume for FHR2 audio or heart beat tones...

Page 246: ...light the Exit item on the bottom menu 8 Press the Trim Knob again to return to the main monitoring display screen How do I change the volume for NIBP completion indication 1 Rotate the Trim Knob to h...

Page 247: ...Press and hold the Mark Offset button over the recorder on the front panel of the 250cx Series Monitor for 2 seconds You will hear a short two tone audio beep from the monitor when offset is activated...

Page 248: ...to be set 9 Now rotate the Trim Knob to select highlight the Exit item on the bottom menu How do I enable the maternal only recorder mode 1 From the On state The yellow LED above the recorder is illum...

Page 249: ......

Page 250: ...bH Munzinger Stra e 3 5 D 79111 Freiburg Germany Tel 49 761 45 43 0 Fax 49 761 45 43 233 Asian Headquarters GE Medical Systems Information Technologies Asia GE China Co Ltd 24th Floor Shanghai MAXDO C...

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