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Larsen & Toubro Star 55, Operating Manual

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Larsen & Toubro Star 55 Operating Manual Download Page 148

8.18

Possible Causes:

a.

A leaky or deflated endotracheal or tracheostomy cuff.

b.

An artificial airway that is too small for the patient.

Endotracheal Tube Kinked:

Waveform Evaluation:

a.

Any obstruction will cause an abrupt change in the ascending limb

resulting in either a diminished plateau or no plateau. EtCO

2

 and slope

will depend on the degree of obstruction ( Refer Figure 8.16).

Inadequate Seal Around Endotracheal Tube:

A Capnogram in which the downward slope of the plateau blends in

with the descending limb (Refer Figure 8.17).

Figure 8.16

Figure 8.17

Endotracheal Tube in Esophagus:

Waveform Evaluation:

a.

A normal capnogram is the best available evidence that the Et tube is

correctly positioned and that ventilation is occurring. When the Et tube

is placed in the Esophagus, either no CO

2

 is sensed or any small

transient capnograms are present ( Refer Figure 8.18 ).

Figure 8.18

Summary of Contents for Star 55

Page 1: ......

Page 2: ...Star 55 8 channel multiparameter color monitor Star 55 Operating Manual LARSEN LARSEN LARSEN LARSEN LARSEN T T T T TOUBR OUBR OUBR OUBR OUBRO LIMITED O LIMITED O LIMITED O LIMITED O LIMITED ...

Page 3: ... Hebbal Mysore 570018 Karnataka India All rights reserved L T medical reserves the right to make changes in specifications and features shown herein or discontinue the product described at any time without notice or obligation The contents in this manual are strictly not to be reproduced in any form by any method for any purpose 2010 Larsen Toubro Limited 0843 ...

Page 4: ... waveform display facility for ECG Lead I II III aVR aVL aVF V1 V6 Plethysmograph Respiration Invasive Blood Pressure IBP1 IBP2 IBP3 and IBP4 O2 AA and Capnography CO2 It also displays the digital values of HR PR SpO2 Respiration Rate Non Invasive and Invasive Blood Pressure Systolic Diastolic and Mean Temperature N2 O O2 EtAA FiAA and CO2 EtCO2 and FiCO2 readings Star 55 has graded and colour cod...

Page 5: ...ear Panel 1 5 Left Side Panel 1 7 Right Side Panel 1 9 Procedure To Connect And Disconnect The Connectors 1 11 Recorder Optional 1 15 Remote 1 17 2 Application Guide 2 ECG 2 1 Respiration 2 6 Temperature 2 7 Pulse Oximetry 2 8 Non Invasive Blood Pressure 2 11 Invasive Blood Pressure Optional 2 13 Capnography Optional 2 16 3 Operations And Main Screen 3 Operation 3 1 Main screen 3 2 4 Parameter Set...

Page 6: ...e Oximetry 7 3 Non Invasive Blood Pressure 7 4 Capnography Optional 7 5 Invasive Blood Presure Optional 7 7 Grounding cable 7 7 8 Trouble Shooting And Waveforms 8 Troubleshooting Chart 8 1 Error Messages 8 3 Problems Observed During ECG Monitoring 8 9 Problems Observed During CO2 Monitoring 8 15 9 Technical Specifications 9 Technical Specifications 9 1 Electro Magnetic Capability Information And M...

Page 7: ...s as well as information in this manual are subject to change without prior notice All information in this manual is believed to be correct L T shall not be liable for errors contained herein with the performance or use of this manual Standards This equipment has been designed to meet the following International standards Class 1 equipment requirement of IEC 60601 1 EMI EMC requirements as per IEC...

Page 8: ...ed on the rear panel of the monitor z If any function of the monitor fails then consult L T Medical authorized service engineer z Failure to meet ventilation requirement may cause equipment failure and intern jeopardise the functions of automated monitoring Do not place equipment in an enclosed area that could restrict heat dissipation from the front or rear of the unit z Keep pacemaker patients u...

Page 9: ...h the same mains power distribution line the summation of the resulting leakage currents may exceed the maximum limits z Explosion hazards are possible if used in the presence of flammable anesthetics z Forcontinuedprotectionagainstfirehazard usefusesofonlyspecifiedtypeandrating z Electrical shock hazard Do not remove cover Refer to qualified personnel for servicing z Patient safety and performanc...

Page 10: ...nsportation damage after removing the Patient Monitor from the packing carton Verify the material in the packing carton as per the packing list sent along with the monitor Preserve the packing carton as it may required useful for future use ...

Page 11: ...e connected to an optional External Gas module unit It can also display the digital values of HR PR SpO2 RR Invasive and Non invasive Blood Pressure Systolic Diastolic and Mean EtCO2 FiCO2 and temperature Parameters like N2 O O2 EtAA and FiAA can be displayed when connected to the optional External Gas module unit The user responsible to interpret the monitored data made available will be a profes...

Page 12: ...tion and mechanical shock should be avoided even during moving z Avoid placing in an area where chemicals are stored or where there is danger of gas leakage z The power line source to be applied to the monitor should correspond in frequency and voltage to specifications and have allowable current capacity 3 Before Operation z Check that the monitor is in perfect operating order z Check that the mo...

Page 13: ...e monitor and the patient z Extra care should be taken when the monitor is in use with the HF Surgical Equipment Note The applied parts of NIBP and CO2 are protected against HF surgical burns and the applied parts of ECG SpO2 IBP and Temperature are not protected 5 To Shutdown After Use z Turn power OFF with all controls returned to their original positions z Remove all accessories gently do not u...

Page 14: ...Proof type CF of Applied Part Defibrillation Proof type BF of Applied Part Global Alarm suspended Alarm Acknowledge Indicates valid QRS Pulse detection Indicates detection of PR from Plethysmograph Indicates detection of PR from NIBP Indicates detection of PR from IBP Authorised representative in the european community Manufacturer ...

Page 15: ...eze Defreeze Goto Stand By Home CO2 Pump NIBP Trend ECG Lead selection ECG Gain adjustment Display Format selection Beep and Alarm Volume adjustment PR Source selection NIBP Timer Left Navigator Selection Key Right Navigator Auto Zeroing of IBP Drug Calculation window ix ...

Page 16: ...yed Heart Rate may not be valid More than 30 BPM diff RECORDING Indicates that Recording is in progress PR Pulse Rate RR Respiration Rate EtCO2 End Tidal Carbon dioxide FiCO2 Fractional Inspired Carbon dioxide CVP Central Venous Pressure LVP Left Ventricular Pressure IBP Invasive Blood Pressure ICP Intracranial Pressure PAP Pulmonary Artery Pressure LAP Left Atrial Pressure RAP Right Atrial Pressu...

Page 17: ...Star 55 CNS Central Nursing Station PA PhysiologicalAlarm TA TechnicalAlarm NA NoAlarm CIC Communication Interface Card xi ...

Page 18: ...Star 55 1 1 DISPLAY CONTROLS CONNECTIONS AND OUTPUTS ...

Page 19: ...Figure 1 1 23 15 19 16 17 22 18 21 20 1 234 5 6 7 8 9 10 11 12 13 14 Front Panel 1 1 ...

Page 20: ... screen 8 Record This key is used to Start Stop the recording 9 Goto This key used as a short cut key for Menu option 10 IBP Zero This key is used to make invasive blood pressure value zero Ensure that the IBP transducer is connected to the unit 11 CO2 pump This key is used to ON CO2 pump when in use and OFF when not in use 12 Stand By This key is used for the monitor to go to stand by mode Press ...

Page 21: ...tion for patient related alarms e g when the value of any parameter being monitored goes above or below the set alarm limits Audio frequency AAMI 4 1 2 1 i Red alarm 1 7 K Hz Yellow alarm 1 4 K Hz Video frequency Red alarm 2 Hz 250ms ON 250ms OFF Yellow alarm 0 5 Hz 1s ON 1s OFF Fixed 3 minutes realarm facility is present Crossed bell indication for alarm silence 20 Parameter Numeric Displaysnumer...

Page 22: ...Star 55 Left blank intentionally 1 4 ...

Page 23: ...Star 55 0843 1 2 Figure 1 2 Rear Panel 1 5 3 4 ...

Page 24: ...C 50 Hz 3 CIC Communication Interface Card 4 AGM CO2 Connecting to Gas Monitoring Module Rear Panel Description 1 6 CIC available in Star 55 CIC Connectors CIC 2 VGA PC Dump CIC 4 PC Dump CNS CIC 5 VGA CNS CIC 7 Wi Fi CNS Usage of the connectors as shown below Connector Description DB9 For PC Dump USB For Central Nursing Station ...

Page 25: ...Left Side Panel Figure 1 3 4 7 6 8 9 3 2 5 1 1 7 ...

Page 26: ...CG To interface ECG 3lead or 5lead cable with monitor 6 NIBP To interface NIBP cuff to the monitor with the help of hose tube 7 TEMP To interface Temperature probe to the monitor 8 USB To connect external Printer Refer Figure 1 4 for software upgradation for trend down load and upload 9 SD Memory To transfer the trend data from one monitor to another Use 1GB or 512 MB of Sandisk make Use 1GB 2GB o...

Page 27: ...Figure 1 5 1 Right Side Panel 2 3 1 9 ...

Page 28: ...Side Panel Description Connector Function 1 Recorder To print the waveform with the digital values 2 Nurse Call Configurable relay to activate nurse call 3 Defib Sync For synchronizing monitor with defibrillator 1 10 ...

Page 29: ...rd from the unit panel of the unit as shown in as shown in Figure 1 7 Figure 1 6 ECG Connect Disconnect Align the notch of the ECG cable Hold the unit with one hand connector with the connector and gently pullout the ECG cable slot on the side panel of the connector as shown in Figure 1 9 unit and insert the cable as shown in Figure 1 8 Note Follow similar procedure to connect disconnect IBP conne...

Page 30: ...ature in the slot Temp 1 Temp 2 connector as shown in Figure1 11 provided on the side panel of the unit as shown in Figure1 10 NIBP Connect Disconnect Insert the NIBP connector in the Press the NIBP connector on the slot provided on the side panel side panel of the unit and remove of the unit as shown in Figure1 12 connector as shown in Figure1 13 ...

Page 31: ...or in clockwise direction b Gently pull out the CO2 connector to lock as shown in Figure 1 14 as close the inlet shutter Figure 1 14 Figure 1 16 Figure 1 15 Figure 1 17 SpO2 Connect Disconnect Allign the SpO2 connector with the Press the release notch of the D type connector slot on the side connector and remove the panel of the unit Press the release connector as shown in the notch and insert as ...

Page 32: ...onnect Disconnect Insert the grounding connector Hold the unit with one hand and in the slot provided on the pull out the connector as shown rear panel as shown in the in the Figure 1 19 Figure 1 18 Figure 1 18 Figure 1 19 1 14 ...

Page 33: ...ected for recording in tabular format as shown in the Figure 1 22 iii NIBP data recording The status of NIBP along with any two other parameters can be selected for recording in tabular format as shown in the Figure 1 23 Green LED Feed Key Red LED Function Green LED Indicates Power ON Red LED It blinks if recorder cover is not properly closed or paper is not present Feed Key Step feeding of paper ...

Page 34: ...T 06 20 74 08 55 30 LOW 26 OCT 06 20 100 08 54 35 LOW 26 OCT 06 20 100 08 54 40 LOW 26 OCT 06 20 74 08 53 05 LOW 26 OCT 06 20 74 08 53 45 LOW 26 OCT 06 20 100 08 52 50 LOW 26 OCT 06 20 100 08 52 55 LOW ii Trend data recording NIBP TREND DATE 26 OCT 2006 TIME 08 58 NAME SMITH JOHN ID NO 21119 99979 BED NO 302 SEX M AGE 0 Y 0 M 0 D WT 111 8 kg HT 28 12 inch PR SOURCE SpO2 PR SOURCE NIBP RR SOURCE EC...

Page 35: ...sensor IR detector is 12ft Maximum distance at 62 degree to IR detector is 5ft on each side Maximum distance at 21 degree to IR detector is 10ft on each side Figure 1 24 Caution The Remote is based on IR technology and is common for all 55 Series monitors Use the Remote in straight line Preferably with the remote sensor in the monitor keyboard to avoid changes in other monitors 55 Series kept near...

Page 36: ...Star 55 2 APPLICATION GUIDE 2 ...

Page 37: ...icular line about F Green 12 15 mm above the iliac crest or the left edge of the backbone about 12 15 mm above the iliac crest Right midclavicular line at the N RF Black same level as F Any of the chest electrode C White positions ECG ELECTRODE PLACEMENT 3 LEAD LL LA RA Figure 2 1 Figure 2 2 Lead I Figure 2 3 Lead II Figure 2 4 Lead III Position Symbol IEC AAMI AAMI IEC Colour Coding Colour Coding...

Page 38: ...ior axillary line at the same level as C4 V4 C6 V6 Left midaxillary at the same level as C4 V4 Figure 2 5 Position Symbol IEC AAMI AAMI IEC colour coding colour coding Right intraclavicular fossa RA R Red White Left intraclavicular fossa LA L Yellow Black Between 6th and 7th intercostal space on the LL F Green Red left midclavicular line Between 6th and 7th intercostal space on the RL N Black Gree...

Page 39: ...55 Bipolar Limb Leads Unipolar Limb Leads Unipolar Chest Leads Figure 2 9 Lead II Figure 2 10 Lead aVL Figure 2 6 Lead I Figure 2 7 Lead aVR Figure 2 8 Lead V1 6 Figure 2 11 Lead III Figure 2 12 Lead aVF 2 3 ...

Page 40: ...h with new tape Replace incase of disposable electrodes This monitor meets the safety requirements for direct cardiac monitoring Steps for application of ECG electrodes Proper skin preparation is necessary for good quality signal pick up and display Please follow the guidelines as listed below 1 Wash electrode site and shave surface hair 2 Gently rub skin surface with a prep pad to remove outer ep...

Page 41: ...nsure that the disinfecting cleaning solutions do not come in contact with ECG electrodes Figure 2 13 Clinical Limitations Shivering patients or patients giving exceptionally low signals can be difficult to monitor Although the monitor is provided with exceptionally good filters against the effects of electrosurgery this technique can affect readings Defibrillation causes temporary disruption of t...

Page 42: ...om ECG When measured from ECG respiration measurement is based on impedance pneumography This method comprises of passing a low current high frequency carrier signal between two ECG electrodes on either side of the chest wall The impedance or resistance of the chest changes as the lungs expand and contract and as the volume of air in the lung changes The change in impedance creates a change in vol...

Page 43: ... of body where temperature is monitored Extremities are always at lower temperature than core temperature z Body temperature change throughout the day z Menstrual cycle A rise of about 0 3 o C takes place during ovulation The three zones most commonly used for measuring temperature are 1 Rectal typically 37 o C 2 Oral typically 37 o C 3 Axillary underarm typically 36 o C Preference is given to rec...

Page 44: ...t a pulse of oxygenated arterial blood flows to the sensor site This oxygenated hemoglobin differs from deoxygenated hemoglobin in the amount of red and infrared light that it absorbs The Star 55 measures absorption of both red and infrared light and uses those measurements to determine the percentage of functional hemoglobin that is saturated with oxygen Initially light absorption is determined w...

Page 45: ...nt activity whether sterility is required the anticipated duration of monitoring and the adequacy of the patient s perfusion z DS 100 DURA SENSOR for adults above 40 Kg DURA Y for patients above 1 Kg to 80 Kg z Prepare the application site remove nailpolish clean surface area of contact and apply the oxygen transducer using the sensor application guide of pulse oximetry transducer z The perfusion ...

Page 46: ... following possible solutions z Check whether the sensor is properly placed on the patient z Use a new sensor with fresh adhesive backing z Move the sensor to a most stable site Although the Star 55 is designed to minimize any effects of electrosurgical interference if such interference gives a problem evaluate the following solutions z Move the cables of the Star 55 and the cautery unit as far as...

Page 47: ...t if the patient has irregular cardiac rhythm 5 Cuff size selection is a very important criteria to get accurate blood pressure readings 6 Avoid compression or restriction of the NIBP pressure tube Note Cuffs become soft after use They sometimes develop folds which are permanent and hence leave temporary marks on the limb Any cuffs that exhibit this effect should be replaced If NIBP is used with S...

Page 48: ...en the cuff and the limb It can be fastened using the VELCRO strap z The usual application sites of the cuff is the brachial artery The right size of cuff should be wrapped around the arm to achieve the best result z The cuff is designed to inflate only when it is wrapped on the limbs Do not inflate the cuff when not supported by the extremity WARNING The cuff should not be applied on a limb being...

Page 49: ...n the catheter This is achieved by continuous flushing with the saline solution The rate of flow is limited to 3 to 5 ml hr by a flushing device which does not alter the pressure being recorded Prepare the pressure line and transducer by flushing saline solution through the system Ensure that the system is free of air bubbles Even small bubbles will distort reading 3 The fluid to be infused should...

Page 50: ...rom SETUP menu SLOW NORMAL and FAST options are provided 8 Close the venting stopcock to atmosphere and open the stopcock to the patient 9 You are now ready to start monitoring Following accessories can be used for measuring IBP z Disposable Blood Pressure Transducer z Reusable Blood Pressure Transducer z Reusable Interface Cable The IBP set up is as shown in Figure 2 15 2 14 ...

Page 51: ...Star 55 Figure 2 15 2 15 ...

Page 52: ... CO2 bench Expired air is aspirated into measuring chamber CO2 bench by a small pump The amount of light passing through a sample cell varies according to the concentration of CO2 in the sample cell When concentration of CO2 in sample cell is high more light is absorbed by the sample and therefore a small amount of light reaches the detector as compared to low concentration of CO2 The amount of li...

Page 53: ...centration point i e the point at the end of the expiration phase at which EtCO2 is measured D E The onset of the inspiration phase of the respiration cycle The production transportation and elimination of CO2 CO2 is produced by all the cells in all the tissues in body as a by product of metabolism From the cell CO2 diffuses into capillary blood from where CO2 is transported into venous circulatio...

Page 54: ...sed as well as they are ventilated In such case when patient exhales CO2 gas from the unperfused part of the lungs will dilute the CO2 rich alveolar gas coming from rest of the lungs lowering the EtCO2 hence aADCO2 increases This is known as alveolar dead space ventilation Arterial Blood CO2 PaCO2 Alveolar CO2 PACO2 Arterial to alveolar difference aADCO2 which is normally 3 4 mmHg Technology Used ...

Page 55: ... after entering measurement mode periodically for durations of typically 15 seconds at a rate which limits the total time consumed by auto zeros to less than 2 of the time in which active measurements are taken Following the first hour after entering measurement mode periodically for durations of typically 15 seconds at a rate of at most once per hour z If a change of 80 C from the last auto zero ...

Page 56: ...ever it detects an occlusion in the FilterLine or in the airway adapter The module informs the host of the purge situation by setting the Purging in progress bit in the Wave Message While purging the CO2 values are invalid The duration of the purging is up to 30 seconds The module recovers from occlusion when FilterLine is replaced The module then shifts to initialization mode for typically less t...

Page 57: ... connection to the unit with the help of FilterLine and T Connector 3 Machine takes approx 30 seconds for its initialization During this time sensor gets warm up and INITIALIZING MODULE message will appear on the screen 4 Then monitor will perform Auto Zero if required and AUTO ZERO message will appear on the screen 5 Monitor is ready for Capnography monitoring Patient Preparation 1 Prepare the pa...

Page 58: ...ing the measurement Connection should be done in such a way that FilterLine will not surround any part of the body z Ensure that the FilterLine does not have blockage or occlude with moisture before use WARNING CO2 accessories are for single use only use new accessories for new patients Figure 2 18 Patient with T connector connected to Endotrachial tube Figure 2 19 Patient with Nasal Prong Adult P...

Page 59: ...Star 55 OPERATIONS AND MAIN SCREEN 3 3 ...

Page 60: ... 55 to switch ON Amber color indicator LED on the front panel turns ON Press ON OFF switch on the front panel so that green indicator turns ON and the unit runs the self test and displays main home screen Use the Optical Encoder on right side to move the cursor highlighted small rectangular block and select the desired functions by pressing optical encoder OPERATION 3 1 ...

Page 61: ...3 2 MAIN SCREEN 1 Figure 3 1 Note Main screen when maximum i e eight waveforms are present ...

Page 62: ...Star 55 MAIN SCREEN 2 Figure 3 2 Note Main screen when maximum ECG waveforms are present 3 3 ...

Page 63: ...MAIN SCREEN 3 Figure 3 3 Note Main screen when single ECG waveform and three digital fields are present 3 4 ...

Page 64: ...g Cal Exit Alarm Vol Beep Vol Exit Exit ECG SpO2 CO2 RESP NIBP TEMP IBP1 IBP2 IBP3 IBP4 EXIT New Patient Patient Mode Patient CLR Exit Display Edit Exit SD Card Transfer USB Download Exit ECG Filt Mode Waveform Speed RESP Speed Default Pacer Det PR Source Alarm Vol Beep Vol Limit Display Exit Confirm Cancel Resolution Display Exit Duration Display Exit Parameter 1 Parameter 2 Display Exit Scroll C...

Page 65: ... PR low limit Present HR PR x 8 10 2 SpO2 SpO2 high limit 100 SpO2 low limit Present SpO2 Value 8 or 80 whichever is greater IBP Systolic high limit Present Systolic value 8 Systolic low limit Present Systolic value 8 Diastolic high limit Present Diastolic value 8 Diastolic low limit Present Diastolic value 8 Respiration Respiration high limit Present Respiration rate 5 Respiration low limit Prese...

Page 66: ...menu IBP4 Select this to enter into IBP4 menu RESP Select this to enter into RESPIRATION menu SpO2 Select this to enter into SpO2 menu NIBP Select this to enter into NIBP menu CO2 Select this to enter into CAPNOGRAPHY menu TEMP Select this to enter into TEMPERATURE MENU WARNING Check if the current alarm preset value is appropriate prior to use on each patient 3 7 ...

Page 67: ... Gateway Exit ON OFF Exit Date Format HR Alarm Con ON SpO 2 For NIBP Language NIBP Test CO 2 Cal ECG TEM Cal Alarm Type Unit Default Setting Non Disp Para Alm Exit Audio Led ON Audio Led OFF Exit Hospital Factory Exit Verify Low Cal High Cal Exit DD MM YYYY DD MMM YYYY MM DD YYYY Exit Start Cal Exit Latched Non Latched Exit NIBP CO 2 TEMP Height Weight IBP1 IBP2 IBP3 IBP4 Exit English French Spani...

Page 68: ...IBP Test Access for L T Medical s authorised personnel only CO2 Cal Access for L T Medical s authorised personnel only ECG TEMP Cal Access for L T Medical s authorised personnel only Alarm Type SelectthistochooseeitherlatchedorNonlatchedasAlarmtype o Unit Select this to choose the measurement unit for the parameter from the list The different parameters and the units in the list are as given below...

Page 69: ...e Speed 25 mm sec HR Upper Limit 150 A 160 P 80 N HR Lower Limit 50 A 60 P 80 N Pacer OFF SpO2 Alarm Disable Gain X1 Response Normal Trace Speed 25 mm sec HR Upper Limit 100 A 100 P 100 N HR Lower Limit 85 A 85 P 85 N CO2 Alarm Disable Scale 40 Unit mmHg Trace Speed 12 5 mm sec EtCO2 Upper Limit 40 A 40 P 40 N EtCO2 Lower Limit 25 A 25 P 25 N FiCO2 Upper Limit 4 A 4 P 4 N RR Upper Limit 30 A 100 P...

Page 70: ...imit 100 A 100 P 80 N DIA Lower Limit 65 A 65 P 20 N Unit mmHg Temp Delta T Disable Alarm Disable Unit F Upper Limit 104 0 A 104 0 N Lower Limit 89 6 A 89 6 N Resp Alarm Disable Gain X4 No Breath 30 sec If enabled RR Upper Limit 30 A 100 P 100 N RR Lower Limit 10 A 10 P 50 N Resp Speed 12 5 mm sec A Adult P Pediatric N Neonatal 3 11 ...

Page 71: ...l be OFF 3 12 ALARMS NEONATAL LABEL SYSTOLIC DIASTOLIC MIN MAX MIN MAX IBP 45 80 20 45 CVP 09 16 04 09 PAP 04 08 02 04 LAP 09 16 04 09 RAP 09 16 04 09 LVP 22 40 10 22 ART 45 80 20 45 PCW 04 08 02 04 ICP 09 16 04 09 LABEL SYSTOLIC DIASTOLIC MIN MAX MIN MAX IBP 60 140 50 130 CVP 12 28 10 26 PAP 6 14 5 13 LAP 12 28 10 26 RAP 12 28 10 26 LVP 30 70 25 65 ART 60 140 50 130 PCW P 6 14 5 13 ICP 10 26 6 12...

Page 72: ...et 1 2 Select this to set MAC ID IP Config Subnet Mask and Default Gateway by alphanumeric key pad Serial Select this to choose PC Dump Nurse call and barcode Exit Select this to go back to the screen DEMO Access for L T Medical s authorised personnel only EXIT Select this to save and exit from the Configuration mode Future upgrade Tabular Trend resolution will be 30 sec Graphical trend scale will...

Page 73: ...Star 55 4 PARAMETER SETTING 4 ...

Page 74: ... in 3 Lead setup and select any number of leads in 5 lead setup based on the selection of number of ECG waveforms in display format OK Select this to save the settings and exit from Lead setup Exit Select this to exit from the Lead setup without saving the settings Gain Allowstheusertochangetheamplitude oftheECGwaveforminscales X0 2 X0 5 X0 75 X1 X2 X5 and Auto X0 2 will provide the lowest amplitu...

Page 75: ... lower alarm limits for HR from the Numeric keypad To use this function ensure that HR alarm is enabled Cal Allows the user to enable switch ON or disable switch OFF Cal option When it is selected square pulses of 1mV will be displayed Cable Mode Select this to choose 3 5 Lead ECG cable Exit Select this to exit from ECG Setup window Note Select ECG gain so that entire ECG waveform should appear wi...

Page 76: ...options are provided in SETUP menu and displays value after window averaging of last eight QRS peaks ECG recording not possible when CAL is selected Notch filter in the monitor automatically gets set to 50 or 60 Hz after sensing the line frequency Power on the monitor with AC mains during installation for the appropriate notch filter selection 4 3 ...

Page 77: ...c keypad To use this function ensure that alarm is enabled Low Limit Select this to set lower alarm limits for Respiration Rate from Numeric keypad To use this function ensure that alarm is enabled Gain Select this to change the height of the respiration waveform in scales of X1 X2 X3 X4 and Auto X1 will provide lowest amplitude and X4 will have maximum amplitude Default setting for Respiration ga...

Page 78: ...ct this to set upper alarm limit for Temperature alarm from Numeric keypad To use this function ensure that alarm is enabled Low Limit Select this to set lower alarm limit for Temperature alarm from Numeric keypad To use this function ensure that alarm is enabled Delta T Allows the user to Enable or Disable Delta T Cal Select this to Enable or Disable calibration of temperature Exit Select this to...

Page 79: ...ble switch ON or disable switch OFF the SpO2 alarm by drop down list High Limit Select this to set upper alarm limits of SpO2 from Numeric keypad To use this function ensure that alarm is enabled Low Limit Select this to set lower alarm limits of SpO2 from Numeric keypad To use this function ensure that alarm is enabled Gain Allows the user to change the amplitude of the SpO2 waveform in scales of...

Page 80: ...lly at set intervals Timer set Press START on the front panel to take the first reading Next NIBP reading starts after the set time interval The time left before the next measurement to begin is displayed on screen This displayed time is decremented every minute Timer can be set only if Automatic is selected Stat Allows the user to take as many readings of NIBP as possible in 5 minutes of continuo...

Page 81: ...Limit Select this to set upper alarm limit for Diastolic alarm from Numeric keypad To use this function ensure that alarm is enabled Dia Low Limit Select this to set lower alarm limit for Diastolic alarm from Numeric keypad To use this function ensure that alarm is enabled Timer Becomes operational after selecting AUTOMATIC mode This function allows the user to set the time interval 2 3 4 5 10 15 ...

Page 82: ... alarm is enabled RR Low Limit Select this to set lower alarm limit for RR alarm from Numeric keypad To use this function ensure that RR alarm is enabled FiCO2 High Limit Select this to set upper alarm limit for FiCO2 alarm from Numeric keypad To use this function ensure that CO2 alarm is enabled EtCO2 High Limit Select this to set upper alarm limit for EtCO2 alarm from Numeric keypad To use this ...

Page 83: ...rom the drop down list RR Source Select this to choose the source of Respiration either from the CO2 if connected or from ECG RA LA or RA LL Pump Select this to ON OFF the CO2 pump No Breath Select this to choose time limit for No breath detection Exit Select this to exit from CO2 Setup window 4 10 ...

Page 84: ...igh Limit Select this to set upper alarm limits for Diastolic value To use this function ensure that RR alarm is enabled Dia Low Limit Select this to set lower alarm limits for Diastolic value To use this function ensure that RR alarm is enabled Scale Select this to choose scale from the drop down list Label Select this to choose label for pressure waveform from the drop down list Add Label Select...

Page 85: ...art of using a new pressure measurement it is necessary to ZERO the transducer to atmospheric pressure Sometimes it is also necessary to ZERO the transducer during the pressure measurement if required for better results Zeroing Procedure To ensure accurate pressure readings the transducer must be zeroed to atmospheric pressure Note The transducer must be ZEROED whenever the ZERO message is display...

Page 86: ...ter adjustment come out of CAL by pressing again CAL then close the transducer to air 2 Open pressure line to the patient 3 Complete pressure line connections and adjustments Then open the pressure line between the patient and the transducer The screen will now display the patient pressure waveform and the systolic diastolic and mean readings 4 Select appropriate waveform label 5 To help identify ...

Page 87: ...rm size can be adjusted by selecting a different pressure gain scale You can adjust waveform size by selecting the pressure gain by pressing the GAIN option in IBP menu 10 Scales available Auto 300 240 200 180 150 120 100 80 60 30 20 10 and 5 The table below identifies the labels available Label IBP Invasive Blood Pressure ICP Intracranial Pressure CVP Central Venous Pressure PAP Pulmonary Artery ...

Page 88: ...eight independent drug is selected Drop factor should be given as input only when drop infusion pump is used for infusing the drug Dose Enter the dose of drug from the Numeric key pad On clicking unit a drop down menu containing mg kg min mcg kg min mg kg hr mcg kg hr etc is displayed when weight dependent drug is selected mg min mcg min mg hr mcg hr etc is displayed when weight independent drug i...

Page 89: ...elect this to go to the previous page Select this to go the next page Record Select this to record the current page Exit Select this to return to the previous screen Note Concentration Concentration of the drug that will be administered to the patient Flow Rate It is the rate at which the drug has to be administered to the patient The flow rate has to be set in the syringe infusion pump The unit i...

Page 90: ...age to be given before infusing the drug based on the patients condition the laws of the country of use and the expected benefit which should be the primary source of decision making This medical device is to be used only as a secondary source of information WARNING The default drug in the list is 25 no s among which 15 are weight dependent and 10 are weight independent drugs The user can addition...

Page 91: ...Star 55 SYSTEM FUNCTIONS 5 5 ...

Page 92: ...g Cal Exit Alarm Vol Beep Vol Exit Exit ECG SpO2 CO2 RESP NIBP TEMP IBP1 IBP2 IBP3 IBP4 EXIT New Patient Patient Mode Patient CLR Exit Display Edit Exit Trend Monitor setting Format SD Card Exit ECG Filt Mode Waveform Speed RESP Speed Default Pacer Det PR Source Alarm Vol Beep Vol Limit Display Exit Confirm Cancel Resolution Display Exit Duration Display Exit Parameter 1 Parameter 2 Display Exit S...

Page 93: ...recorded Display Select this to choose the Display Formats Volume Select this to adjust the Alarm Volume and Beep Volume Recall Select this to Recall alarm and ECG trend Autoset Select this to set alarm limits automatically for all parameters except NIBP Menu Trend Display Volume Recall Autoset System Functions 5 2 ...

Page 94: ...the Alpha Numeric keypad Bed No Select this to enter patient s bed number fromAlpha English key board First Name Select this to enter patient s first name from Alpha English keyboard Maximum 9 characters Last Name Select this to enter patient s last name from Alpha English keyboard Maximum 9 characters Age Select this to enter patient s age from Numeric keypad The age will be in years for adults a...

Page 95: ...ded trend data of selected patient from drop down list Confirmation window will be displayed Exit Select this to save return to the Patient Info Menu System Select this to view all system information and alarm information All Info Select this to view the information about the settings of the monitor Alarm Info Select this to view the information about the status of alarm conditions Enable Disable ...

Page 96: ...al time 2 seconds after pressing recorder hot key Continuous Select this to record real time data for 30 seconds after pressing recorder hot key Print to Default will be recorder Waveform 1 Select this to record waveforms from the drop down list Waveform 2 Alarm Record Select this to ON OFF recording during patient alarm condition Timer Select this to choose the time interval between two consecuti...

Page 97: ...or choosing the device The window will appear as shown in Figure 5 5 SD Card Transfer Select this to transfer the trend data between similar patient monitors The following window will appear when SD Card Transfer is selected Trend Download Select this to download the trend to the SDCard When Trend Download is selected the window will appear as shown in Figure 5 7 Figure 5 4 Figure 5 5 Figure 5 6 ...

Page 98: ...d Wait till the data is transferred into the SD Card On completion message Patient data transferred to SD Card will appear Cancel Select Cancel to exit from the window Trend Upload Select this to upload the trend to the monitor A Confir mation window with the message as shown in Figure 5 9 Select Confirm to proceed further or Cancel to exit from the window Figure 5 7 Figure 5 8 Figure 5 9 Caution ...

Page 99: ... upload and down load the settings of the monitor between two monitors using USB thumb drive Format SD Card Select this to format SD Card Confirmation message All data in the SD Card will be deleted will appear Select Confirm to proceed further Exit Select this to return to the main Menu Color Select this to choose the color of the parameter from the color box Setup Select this to set the general ...

Page 100: ...e Select this to choose PR Source either NIBP SpO2 IBP or Auto from drop down list Alarm Vol Select this to adjust alarm volume Star 55 will display volume menu Select this to increase the alarm volume Select this to decrease the alarm volume Exit Select this to return to the Setup panel Beep Vol Select this to adjust beep volume Star 55 will display volume menu Select this to increase the beep vo...

Page 101: ... as shown in Figure 5 12 Scroll Select this to scroll through the graphical trend Zoom Select this to view the zoomed graphical trend Rec Select this to record the trend data if USB printer is connected Exit Select this to return to the Graphical Trend Duration menu Exit Select this to return to the Trend menu Figure 5 11 Graphical Tabular NIBP OXY CRG Patient Parameter PC Dump Exit Exit Select th...

Page 102: ...Star 55 Tachy High Figure 5 12 The Graphical Trend taken from the External Printer is as shown in the Figure 5 13 5 11 ...

Page 103: ...Figure 5 13 5 12 ...

Page 104: ...end taken from the External Printer is as shown in the Figure 5 15 Figure 5 14 Tabular Select this to view tabular representation of the selected parameters not applicable for NIBP Resolution Select this to choose resolution from the drop down list Display Select this to view tabular trend of the parameters selected Star55 will display Tabular Trend screen as shown in Figure 5 14 Select this to go...

Page 105: ... Figure 5 16 Select this to go to the previous page of the trend Select this to go to the next page of the trend Rec Select this to record the current page of the tabular trend Exit Select this to return to the NIBP Parameter Selection menu TABULAR TREND DATE 05 NOV 2006 TIME 03 55 NAME Patient 67 ID NO BED NO SEX F AGE 1Y 1M 1D WT 1Kg HT PR SOURCE SpO2 PR SOURCE NIBP RR SOURCE ECG PR SOURCE IBP D...

Page 106: ...to the Trend menu Note When the external USB Printer is connected with the monitor internal recorder will be disabled All prints will be obtained on the external printer The data will be printed in internal recorder if printer is not connected 5 15 ...

Page 107: ...arameter Select this to choose parameters from parameter selection panel for which the trend is required Three parameters can be selected in the parameter selection panel at a time from drop down list Exit Select this to save and return to the Trend menu PC Dump Select this to Start Stop PC Dump Connect PC dump port DB9 of Star 55 to PC serial port through RS 232 cable Run exe file in the PC PC wi...

Page 108: ...indow Stop Press Stop to end the downloading data The file will be saved as CSV format and can be opened in Microsoft Excel The down loaded data is as shown below and it includes all parameters Note PC Dump application should exist in the computer Contact L T authorised service personnel for installation of software Date and Time will be the default file name if the file name is not entered Exit S...

Page 109: ...er as shown in Figure 5 19 Format 1 Displays 8 parameter waveforms Format 2 Displays 7 waveforms and maximum 4 digital values Format 3 Displays 4 6 12 waveforms and 2 3 digital values Format 4 Displays 1 3 waveforms and 4 6 digital values Format 5 Displays 1 3 waveforms and 1 3 digital values Standard User 1 User2 User3 User4 User5 User6 Drug Cal Exit Note In field 1 only ECG can be selectable Cas...

Page 110: ...meters in the waveform field 1 to field 3 from the drop down list Select the number of ECG waveforms from the drop down list Select the number of digital values 2 3 LW SW and SW LW in row 1 and row 2 and select the parameters in the digital fields from the drop down list Format 5 Select 1 3 parameters in the waveform field 1 to field 3 from the drop down list Select the number of ECG waveforms fro...

Page 111: ...t this to decrease the alarm volume Exit Select this to return to the Volume Setup menu Beep Vol Select this to adjust beep volume Star55 displays volume menu Select this to increase the beep volume Select this to decrease the beep volume Exit Select this to return to the Volume Setup menu Exit Select this to return to the Main screen Figure 5 20 Volume Alarm Vol BeepVol Exit 5 20 ...

Page 112: ...this to go to the previous page Select this to go to the next page Rec Select this to record the current page Exit Select this to return to the Main menu ECG Select this to recall 30sec of freezed ECG waveforms with heart rate as shown in Figure 5 22 Each 30 sec strip stores in the form of 5 individual strips Each individual strip duration will be 6 sec There will be maximum of eight pages with fi...

Page 113: ...evious page Select this to go to the next page Rec Select this to record the current page Exit Select this to return to the Main menu Figure 5 22 Autoset Select this to set alarm limits for all the parameters except for NIBP 5 22 ...

Page 114: ...Star 55 6 MAINTENANCE SCHEDULE 6 ...

Page 115: ...e carried out in routine maintenance Aestrix indicate that the following action is required Action General ECG RESP SpO 2 TEMP NIBP IBP CO 2 A B 1 Check patient connections and accessories 2 Cleaning and sterilization of accessories 3 Clean monitor exterior 4 Check power cord 5 Check battery 6 Check monitor operation 7 Check monitor calibration Caution Maintenance involving removal of the outer ca...

Page 116: ...ong with the accessories for any specific cleaning procedures NIBP a Cuffs reusable may be cleaned in any of the two ways 1 Sponge the outer surface of the cuff with a moist cloth 2 Remove the cuff s bladder Wash the cuff in water with soap or detergent disinfectant Rinse the cuff and allow it to air dry b Hoses clean the hose by wiping it with a cloth moistened with soap water WARNING Do not use ...

Page 117: ...horoughly before use Do not use chemicals or abrasive cleaning agents 4A Inspect the power cord for any signs of damage to cable or connectors If damaged replace with a L T replacement part Do not attempt to repair 5A Isolate monitor from the mains supply Switch ON the monitor and observe the green LED If green LED is ON the battery status is acceptable and no further action is required If the gre...

Page 118: ...rend view Selection of ECG Resp SpO2 IBP and CO2 gains Selection of SpO2 response Selection of IBP label Selection of no breath detect duration Selection of TEMP unit either 0 C or 0 F Selection of NIBP mode Return all adjustments to the desired settings after the checks 7B Perform the following checks to ensure that the monitor is calibrated correctly i ECG Select CAL option from the menu list of...

Page 119: ...rom Scott Medical Calibration gas contains 5 CO2 21 O2 and balance N2 Switch ON the Monitor Procedure for calibrating Capnography Module Switch ON the monitor Go to set up screen by pressing optical encoder during self test Press CO2 CAL from the Setting menu Connect filter line from calibration kit to the monitor Press start CAL and Confirm for further proceedings Message Keep pressing cylinder k...

Page 120: ...henever the monitor is not in use or stored for an extended period it is recommended to remove the batteries from the monitor to avoid permanent battery damage fire hazard or complete discharge Due to self discharge characteristics the recommended shelf life for the Li Ion batteries without charging is six months above which the battery characteristics may change leading to reduction or even compl...

Page 121: ...Star 55 ACCESSORIES 7 7 ...

Page 122: ...Refer Figure 7 2 Respiration Respiration can be monitored through same ECG cables 3 5 lead or through Capnography Priority for respiration is given to Capnography if the option is installed 7 1 Figure 7 1 Figure 7 2 3 Lead ECG Cable 5 Lead ECG Cable Figure 7 3 Figure 7 4 3 Lead ECG Cable 5 Lead ECG Cable Optional Figure 7 5 Adult Pediatric Filter line ...

Page 123: ...temperature probe Adult Refer Figure 7 6 YSI 402 Rectal Esophageal temperature probe Neonatal Refer Figure 7 7 YSI 409A Tape on skin probe Refer Figure 7 8 Figure 7 6 Rectal Esophageal Temperature Probe Adult Figure 7 8 Tape on Skin Probe Figure 7 7 Rectal Esophageal Temperature Probe Neonatal Optional 7 2 ...

Page 124: ...ra YTM Optional Pulse Oximetry Accessories for Pulse Oximeter DS 100 DURA SENSOR from NELLCOR for adults application patients above 40 Kg Refer Figure 7 9 DURA Y for universal application patients above 1 Kg to 80 Kg Refer Figure 7 10 Extension cable Refer Figure 7 11 7 3 ...

Page 125: ...ube Non Invasive Blood Pressure NIBP basic configuration comprises of following accessories Adult cuff 14 cm x 37 cm Reusable Refer Figure 7 12 Child cuff 9 cm x 27 cm Reusable Refer Figure 7 13 Neonate cuff 3 cm x 9 cm Disposable Refer Figure 7 14 Hose tube 3 meters Reusable Refer Figure 7 15 ...

Page 126: ...raphy Optional Following accessories are provided for Capnography Microstream along with Star 55 monitor Capno Line Adult Refer Figure 7 16 Paediatric Refer Figure 7 17 Infant Neonate Refer Figure 7 18 Figure 7 17 Capno Paediatric Figure 7 16 Capno Adult ...

Page 127: ...fer Figure 7 19 H set Adult Paediatric Refer Figure 7 20 H set Infant Neonatal Refer Figure 7 21 Figure 7 19 Adult Paediatric Filter Line Figure 7 20 Adult Paediatric H Set filter Line Figure 7 21 Infant Neonatal H set filter Line 7 6 ...

Page 128: ...essure Transducer Medex Refer Figure7 22 z Reusable Blood Pressure Transducer Medex z Reusable Interface Cable Refer Figure 7 23 Figure 7 22 Disposable Blood Pressure Figure 7 23 Reusable Interface Transducers Cable Grounding Cable This cable is used for grounding the unit Refer Figure 7 24 Figure 7 24 Grounding Cable ...

Page 129: ...ff Grounding Cable Optional Accessories ECG 5 Lead Cable CO2 Capnoline H Adult Filterline H Set Adult Pediatric Filterline H Set Infant Neonatal Temperature Rectal Esophageal probe Adult Rectal Esophageal probe Neonatal Tape on skin probe SpO2 Dura Y Sensor IBP IBP Interface Cable IBP Transducer 7 8 ...

Page 130: ...Star 55 8 TROUBLE SHOOTING AND WAVEFORM 8 ...

Page 131: ...ttach properly Faulty ECG cable Replace patient cable Noise in ECG trace area Noise pickup due to Check the mains plug for improper grounding proper ground connections Check that grounding cable is connected properly Poor respiration waveform Electrode sites RA LA Clean the area and resite RA LL are incorrect electrodes Poor electrode contact Resite electrodes Dried electrodes Remove electrodes Ap...

Page 132: ...mb and must not be loosely attached Temperature alarms not Alarm is disabled Enable the alarm responding Not recording and red Recorder paper roll Insert recorder paper roll indicator in recorder module empty is blinking Recorder cover is open Close the recorder cover Recorder module not Call L T authorized service connected personnel Blood pressure alarms Alarm is disabled Enable the alarm not re...

Page 133: ...on 30 BPM NA Communication Module not responding Call L T authorized Error service personnel TA Leads OFF Cable not connected Connect the cable properly to the unit properly to the unit TA Fault messages Respective leads are Connect respective i LA Fault disconnected from the leads properly ii RA Fault patient iii LL Fault iv RL Fault v CL1 CL6 Fault TA Respiration Patient RR value Patient needs m...

Page 134: ...it TA Range has exceeded Patient needs medical attention NA SpO2 Patient SpO2 value Patient needs medical exceeding higher alarm attention Acknowledge limit the alarm Reset the limit if require PA PatientSpO2 valuebelow Patient needs medical the lower alarm limit attention Acknowledge the alarm Reset the limit if require PA Check Probe Site Sensor not connected Connect the sensor properly to the p...

Page 135: ...s medical value below the lower attention Acknowledge alarm limit the alarm Reset the limit if require PA Time Exceeded Measurement time Restart the NIBP exceeded measurement TA Air leak Removal of NIBP tube Check the connections from the unit and tighten if required Leakage in tube or cuff Replace the tube or cuff if required TA Pneumatic Bent or block in NIBP Replace the tube if Blockage tube re...

Page 136: ...e line TA Change sample Purging continues for Change the sample line line more than 30 Sec TA No breath RR is zero Patient needs medical attention Acknowledge the alarm Reset the limit if require PA IBP Patient systolic pressure Patient needs medical value exceeding higher attention Acknowledge alarm limit the alarm Reset the limit if require PA Patient systolic pressure Patient needs medical valu...

Page 137: ...libration CO2 Calibration Calibration is Service screen Success successful CO2 Calibration Error Calibration failed Service screen CO2 CO2 Warm Up When the CO2 module Service screen is preparing itself for operation CO2 CO2 Ready Before the first Real time Screen measurement of CO2 after the filterline is connected and before patient breathing is sensed CO2 Ready will replace the CO2 Warm up messa...

Page 138: ...ECG and PR taken from SPO2 is more than 30 HR RR coincidence When HR and RR Real time screen alarm difference is less than 30 RR No Breath When RR value is zero Real time screen and RR source is CO2 PC Dumping PC Dumping During data dumping Real time screen IBP SENSOROFF When IBP transducer Real time screen is not connected to the The message will display channel 1 2 3 4 Depends on IBP monitor whi...

Page 139: ...height and width of the spikes Refer Figure 8 1 CORRECTIVE ACTION Involuntary movement is usually a result of patient discomfort and is caused by chill or muscle tremors coughing or other nervous reactions Assuring the patient that the procedure will not hurt and setting his mind at ease will help relieve natural anxieties Ensure the room temperature is warm enough for the patient B VOLUNTARY MOVE...

Page 140: ... application C POOR SKIN PREPARING IDENTIFICATION Failure to prep a patient with oily skin will cause low amplitude wandering base line and 60 50 Hz frequency interference Poor skin preparation may not show problems immediately but effects the signal in long term monitoring Refer Figure 8 3 CORRECTIVE ACTION Cleaning the body oils and dead tissues are essential for proper adhesion and contact of e...

Page 141: ... 8 4 Line Transients When electrodes or lead wires are loose or detached the transients may be transmitted to the monitor through patient cable and can resemble ECG waveform This may also inhibit heart rate alarms and may indicate false information CORRECTIVE ACTION Electrodes should be placed on fleshy areas which will help to place electrodes properly Check that the patient cables are not pullin...

Page 142: ... ACTION Check the electrode to make sure that the electrolyte is moist and is in sufficient quantity and is in proper contact with the electrode and skin EQUIPMENT RELATED A POOR CONNECTION IDENTIFICATION Poor connection will indicate muscle artifact on entire trace Refer Figure 8 6 CORRECTIVE ACTION Check lead wires junction of cable and electrode to ensure proper connection B BROKEN LEAD WIRE Fi...

Page 143: ...al cords and fluorescent bed lamps near the bed may also cause 60 50 Hz frequency interference Figure 8 8 IDENTIFICATION Broken lead wire or completely detached electrode will cause pure 60 50 Hz frequency interference The QRS complex is almost masked by the extremely wide base line Refer Figure 8 7 CORRECTIVE ACTION Check the lead wires cables and connections Replace with new cable if required Th...

Page 144: ...ually recentre itself within few seconds Refer Figure 8 9 CORRECTIVE ACTION Synthetic fabrics in bed sheets and clothing may generate static electricity This can disturb the trace abruptly without patient movement especially when cables without proper shieldings are used Figure 8 9 D STATIC ELECTRICITY ...

Page 145: ...o heart rate b May be observed in paediatric patients mechanically ventilated at low respiratory rates with prolonged expiratory times Hyperventilation A decrease in the level of the End Tidal CO2 from previous levels Refer Figure 8 11 Possible Causes a Increase in respiratory rate b Increase in Tidal Volume c Decrease in metabolic rate d Fall in body temperature Figure 8 10 Figure 8 11 NOTE Expon...

Page 146: ...he level of the End Tidal CO2 from previous levels Refer Figure 8 12 Possible Causes a Decrease in respiratory rate b Decrease in tidal Volume c Increase in metabollic rate d Rapid rise in body temperature malignant hyperthermia Figure 8 12 Figure 8 13 Characteristics a Depth of the cleft is inversely proportional to the degree of drug activity b Position fairly constant on same patient but may no...

Page 147: ...orber system e Partial rebreathing circuits Obstruction in Breathing Circuit or Airway An obstruction to the expiratory gas flow noted as a change in the slope of the ascending limb of the capnogram The expiratory portion may diminish without a plateau Refer Figure 8 15 Possible Causes a Partial obstruction in the expiratory limb of the breathing circuit b Presence of a foreign body in the upper a...

Page 148: ...e degree of obstruction Refer Figure 8 16 Inadequate Seal Around Endotracheal Tube A Capnogram in which the downward slope of the plateau blends in with the descending limb Refer Figure 8 17 Figure 8 16 Figure 8 17 Endotracheal Tube in Esophagus Waveform Evaluation a A normal capnogram is the best available evidence that the Et tube is correctly positioned and that ventilation is occurring When th...

Page 149: ...e Waveform Evaluation a Baseline elevated b Sloping descending limb of capnogram c Allows patient to rebirth exhaled gas Refer Figure 8 19 Paediatric Capnogram Typical Capnogram for a Paediatric Patient Refer Figure 8 20 Figure 8 19 Figure 8 20 ...

Page 150: ...Star 55 TECHNICAL SPECIFICATIONS 9 9 ...

Page 151: ...IPX1 2 Universal Power Supply Voltage 95 265V AC 50Hz 60Hz at 5 tolerance Fuse 3 15A Fast blow 2 no s Indicator Amber LED ON indicates Mains ON Green LED ON indicates Monitor ON Amber LED OFF and green LED ON indicates unit is in battery mode Current 0 7 A max Wattage 100 watts 3 Battery Type 14 8 V 4AH 8AH Lithium ion No of battery One pack Two packs Charging time min 12 Hrs one pack Discharge ti...

Page 152: ...y capacities at two in stances 1 When the monitor is operated on battery Green LED ON and Amber LED OFF with no alarm condition battery capacity is more than 20 2 When the monitor shows low battery Battery status area blinks with red bar the monitor continues to work for 10 15 mins depending upon the load on the battery Monitor turns OFF when the battery reaches cut off voltage 4 Controls Front Pa...

Page 153: ...ples sec for Respiration fixed 10 samples sec for Capnography Patient Modes Adult Neonate Pediatric Recording indication RECORDING message in the white message area indicate recording in progress Alarm detection status Selected limits shown if enabled Crossed Bell symbol shown if disabled Depends on mode default alarm settings will be set 6 Trends Data storage 5 sec for 72 hours HR PR SpO2 IBP 72 ...

Page 154: ...s Provided for HR SpO2 IBP RR EtCO2 FiCO2 and TEMP Formulae Used HR high limit Present HR value X 8 10 76 HR low limit Present HR value X 8 10 2 SpO2 high limit 100 SpO2 low limit Present SpO2 value 8 or 80 whichever is greater IBP systolic high limit Present systolic value 8 IBP systolic low limit Present systolic value 8 IBPdiastolichighlimit Presentdiastolicvalue 8 IBPdiastoliclowlimit Presentd...

Page 155: ...x Allowable noise for 3V p p applied sine wave of 20Hz Patient applied leakge current 10uA Isolated Normal condition 50uA Isolated single fault condition Overload recovery 8 Sec Fault indication Individual lead fault indication on screen Calibration Cal indicator for all the gains in lead II III and V for 5 lead ECG cable and lead II and III for 3 lead ECG cable Patient isolation 4KV rms for 1 min...

Page 156: ...of the alarm and activation is 14 seconds Heart rate meter response time Change from 80 to 120 BPM 6 to 7 sec Change from 80 to 40 BPM 11 to 12 sec Pacemaker pulse rejection When pacer is ON the monitor will display detection capability the HR for all single and double pacemaker pulses either 150 or 250 msec apart with a pulse width of 0 1 to 2msec and amplitudes 2 mV to 500 mV without overshoot L...

Page 157: ...s of Temperature input T value displayed in place of T2 T is the difference between T1 and T2 Warm up 10 min Excluding probe Accuracy 0 2 0 C or 0 4 0 F Alarms Temperature limits adjustable Upper 12 0 0 C to 47 0 0 C Lower 15 0 C to 55 0 0 C Unit 0 C or 0 F user selectable Probe fault Display shows OFF if the probe not connected Display shows out of range condition in the event of short circuit or...

Page 158: ...n and up 0 38 mmHg 4 mmHg 39 99 mmHg 5 of reading 0 08 for every 1 mmHg above 38 mmHg 12 SpO2 Tone variation with change in SpO2 Provided Measurement range 1 100 Accuracy Adults 1 Std Dev 70 100 2 digits 0 69 unspecified Neonates 1 Std Dev 70 100 3 digits 0 69 unspecified Alarms Adjustable alarm limits Upper 50 to 95 Lower 55 to 100 9 8 RR 0 150 BPM Units mmHg or kPa or Vol Scale 20 40 60 80 or 10...

Page 159: ...rorafter4000operatinghours whichever comes first 14 NIBP Method Oscillometric Display Systolic Diastolic and Mean Modes of measurement Manual Auto and Stat mode In Auto mode intervals of 2 3 4 5 10 15 30 60 and 90 minutes are user selectable In Stat mode unit will take as many readings as possible in 5 minutes Duration between measurements is 10 12 sec Unit User selectable mmHg or kPa Range 20 250...

Page 160: ...lculation 25 Standard default drug details are as follows Aminophylline Diltiazem Dobutamine Dopamine Epinephrine Esmolol HCL Fentanyl Citrate Heparin Sodium Inamrinone Lactate Insulin Regular Isoproterenol HCL LabetolHCL Lorazepam Midazolam Milrinone Nicardipine Nitroglycerin Nitroprusside Norepinephrine Phenylephrine Procainamide HCL Propofol Vasopressin Lidocaine HCL and Pitocin Apart from abov...

Page 161: ...80 200 240 300 and Auto mmHg Measurement range 40 to 300mmHg Calibration 100mmHg signal injected into the screen Alarms Adjustable alarm limits PR range 30 350 BPM Accuracy 3 BPM LABEL SYSTOLIC DIASTOLIC MIN MAX MIN MAX IBP 60 140 50 130 CVP 12 28 10 26 PAP 6 14 5 13 LAP 12 28 10 26 RAP 12 28 10 26 LVP 30 70 25 65 ART 60 140 50 130 PCW P 6 14 5 13 ICP 10 26 6 12 User Defined 12 6 10 26 PRESSURETAB...

Page 162: ...shing Red LED alarms and message indication Re alarm 3 min after an alarm is acknowledged Alarms suspend Continuous Yellow LED to indicate Alarms Suspend condition with display of alarm cross mark Alarm volume control 12 steps min to high 18 Outputs ECG Sync Provides 5V P P pulse for synchronizing with defibrillator External monitor 15 pin D type sub connector Female USB type RS485 communication E...

Page 163: ...Communicating with Skyline L T s CNS USB USB connector Ethernet port RJ45 connector Future Upgrade PCDUMP Dumping of all trend data 9 pin D type 21 General Dimensions H W D 280 mm 320 mm 158 mm Weight 5 5 Kg approx with battery and recorder without accessories Mounting option GCX option Operating temperature 5 to 40 0 C Operating humidity 10 to 90 RH Non condensing Storage and Transportation 10 to...

Page 164: ...s CO2 Microstream filter lines Remote Infrared 23 Standards Designed to confirm to the following international standards Class 1 equipment requirement of IEC 60601 1 EMI EMC requirements as per IEC 60601 1 2 IEC 60601 2 27 requirements for ECG IEC 60601 2 30 requirements for NIBP IEC 60601 2 34 requirements for IBP IEC 60601 1 8 requirements for alarm systems IEC 60601 2 49 requirements for multif...

Page 165: ...gnetic field IEC 61000 4 8 Conducted RF Immunity IEC 61000 4 6 Immunity test IEC 60601 test level Compliance level 6 KV Contact 8 KV Air 3 V m Field Strength 80 MHz 2 5 GHz Frequency 2 KV for power supply lines 1 KV for input output lines 1 KV line s to line s 2 KV line s to earth 5 UT 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles 5 UT 95 dip in UT for...

Page 166: ...Star 55 10 WARRANTY AND WARRANTY SERVICE 10 ...

Page 167: ...rs are carried out by L T s Engineer or Authorised Service Franchisee The warranty shall not apply to defects resulting from 1 Unauthorised modification misuse mishandling of the equipment 2 Operation of the equipment outside the environmental specifications of the product e g Temperature Electrical requirement etc as specified in the operating manual 3 Improper site preparation and maintenance 4 ...

Page 168: ...el 00 1 847 230 1058 Suite 470 Schaumburg IL 60173 Fax 00 1 847 517 9138 USA INDIA Larsen Toubro Limited Medical Equipment Systems Tel 91 22 67051223 Powai campus Annexe Building 91 22 67053226 Gate No 7 Saki Vihar Road Fax 91 22 67051276 Mumbai 400 072 Website www lntmedical com For immediate assistance please contact our Customer Interaction Center CIC Toll Free No 1800 200 5858 1800 233 5858 Te...

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