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2

Introduction

2.2

Functional overview

Page 14 

A

rt.

 no.

: 2.

510

474 rev.

: d

ARGUS LCM/PLUS

2.2.3

Description of display

Alarms

(1) Status field for physiological alarms
(2) Status field for technical alarms

Curve field

(3) 1 or 3 channel leads display. With 

enter

 display 1 or 3 leads, with

 

up/down

 select the following/previous lead/lead group.

System status field

(4) System status field
(5) Symbol for battery operation.
(6) Loudness (3-step) for alarm- and QRS-sound. Adjust with

 left

 button.

(7) Symbol of the selected patient type.

Blood pressure

(8)

< 0:12 A 

= remaining time (h/min) to the next automatic blood pressure meas-

urement.

> 0:12

 =  Time since the last manual blood pressure measurement

Remark: During blood pressure measuring the actual system pressure in mmHg
will be displayed.

Measurement field

(9) Various displayed values e.g. HR, Sp0

2

, IBP, CO

2

, RRi, temperature.

HR

/ min

60

98
60

SpO

2

PP

/ min

%

10

RRi

/ min

R

P
P

I

II

III

11 :04

28-10-04

127/77

(100

)

36.8

T

1

°C

Alarm HR Low

ECG lead off

I

I

II

III

I,II, …

aVR, III,...

> 0: 12

1

2

3

5

6

7

8

PM ON

SYS/DIA

(MAP)

4

PM detection

RRi Alarm
switch off

NIBP

mmHg
< 0: 12 A

9

Summary of Contents for ARGUS LCM

Page 1: ...ARGUS LCM Operating Instruction Art no 2 510474 rev d Patient monitor ARGUS LCM and ARGUS LCM PLUS ...

Page 2: ...ation The SCHILLER sales and service centre network is world wide For the address of your local distributor contact your nearest SCHILLER subsidiary In case of dif ficulty a complete list of all distributors and subsidiaries is provided on our internet site http www schiller ch Sales information can also be obtained from sales schiller ch Article no 2 510474 rev d Issue date 10 04 06 ...

Page 3: ...unctional overview 12 2 2 1 Buttons of the Argus LCM PLUS 12 2 2 2 Description of buttons 13 2 2 3 Description of display 14 3 Operation 15 3 1 Start up 15 3 1 1 Connecting and power on 15 3 1 2 Battery operation 15 3 1 3 Operation with external dc voltage 16 3 2 Switching off and disconnecting from mains 16 3 2 1 Interruption of the mains supply 16 3 3 Inserting printing paper 17 3 4 Initial sett...

Page 4: ...ains voltage 33 5 4 Cleaning the device cable and sensors 34 5 4 1 Cleaning the device cables and sensors 34 5 5 Zero and two point CO2 calibration 35 5 5 1 Starting the zero point calibration 35 5 5 2 Starting the two point calibration 35 5 6 Trouble shooting 36 5 6 1 Accessories and disposables 37 6 Technical Data 38 6 1 System data 38 6 2 Technical data measured values 40 6 2 1 ECG 40 6 2 2 Res...

Page 5: ...lts and children 48 7 3 6 10 lead ECG patient cable 49 7 3 7 Electrodes identification and colour code IEC AHA 50 7 4 CO2 settings 51 7 4 1 Description of CO2 parameters 51 7 4 2 Compensation settings 51 7 4 3 Combination of N2O and O2 compensation 52 7 4 4 Environmental pressure compensation 52 8 Index 53 ...

Page 6: ...Page 4 Art no 2 510474 rev d ARGUS LCM PLUS ...

Page 7: ...2 non invasive blood pres sure temperature and respiration V The system is suitable for internal hospital transport V There is no danger for patients with pacemaker V The device is only intended for single patient use V Only operate the device in accordance with the specified technical data V The system is not designed for sterile use nor is it designed for outdoor use V Do not use this unit in ar...

Page 8: ...placed with the same type and rating as the orig inal V Use only accessories and other parts recommended or supplied by SCHILLER AG Use of other than recommended or supplied parts may result in injury inac curate information and or damage to the unit V Ancillary equipment connected to the analogue and or digital interfaces must be certified according to the respective IEC standards e g IEC EN 6095...

Page 9: ...cian authorised by Schiller AG V Before cleaning and to isolate the mains power supply switch the unit off and dis connect it from the mains by removing the plug V Do not use high temperature sterilisation processes such as autoclaving Do not use E beam or gamma radiation sterilisation V Do not use solvent or abrasive cleaners on either the unit or cable assemblies V Do not under any circumstances...

Page 10: ...onal injury or death For a possibly dangerous situation which could lead to heavy bodily injury or death For a possibly dangerous situation which could lead to personal injury This symbol is also used to indicate possible damage to property For general safety notes as listed in this chapter Used for electrical dangers warnings and other notes in regarding operation with electricity NOTE For possib...

Page 11: ...unauthorised or unqualified per sons attempt to make repairs In case of a defect send the apparatus to your dealer or directly to the manufacturer The manufacturer can only be held responsible for the safety reliability and perform ance of the apparatus if assembly operations extensions readjustments modifications or repairs are car ried out by persons authorised by him and the ARGUS LCM PLUS and ...

Page 12: ...m serial number 781 1000 and higher The ARGUS LCM BASIC with the microprocessor MK19 11 has a new ECG amplifier 3p It is now possible to to display 6 leads with a 3p lead cable The 3p lead cable is marked with a black connector housing instead of green This works only with software 1 24 and higher ARGUS LCM ECG SpO2 NIBP Basic device Only with 3 leads display one lead II x x Options printer additi...

Page 13: ...on Temperature etCO2 IBP A x x x X 1x B x x x x 1x x D x x x x 1x x E x x x x x x a Diagnostic amplifier only with 3 or 5 or 10 lead cable 1 or 7 or 12 lead display Options for all versions printer additional battery and nurse call or vehicle power supply Version A can be upgrade with etCO2 module printer and additional battery Version B C D E can be upgrade with printer and additional battery ...

Page 14: ... s 2 Trend display 3 Print 4 Setting alarm limits tart stop Menu access button LED indicating battery operation LCM ON OFF button LED indicating main supply operation Navigation buttons down up left right Program and enter button Alarm OFF ECG SPO2 NIBP CO IBP 2 C F i Access to the menu IBP and NIBP alarm on off and IBP calibration IBP connection instead of CO2 This is the LCM plus version E This ...

Page 15: ... Opens the main menu Navigate through the menus with the right left buttons Press the menu button to again leave the menu Enter Navigation The navigation and enter buttons have different functions dependent on operating mode Normal single lead display Pressing the enter button shows the first 3 leads instead of the single lead display By pressing the up down buttons the next lead or lead group is ...

Page 16: ...nd QRS sound Adjust with left button 7 Symbol of the selected patient type Blood pressure 8 0 12 A remaining time h min to the next automatic blood pressure meas urement 0 12 Time since the last manual blood pressure measurement Remark During blood pressure measuring the actual system pressure in mmHg will be displayed Measurement field 9 Various displayed values e g HR Sp02 IBP CO2 RRi temperatur...

Page 17: ...being damaged 1 Voltage setting 2 115 or 230 V Refer to chapter 5 3 for the mains voltage Con nect the power cable at the rear of the unit 2 2 Connect the potential equalisation cable 3 to the central potential equalisation socket 3 Press the on off button 4 Check that all LEDs flash shortly and there is a beep on start up 5 Check the settings according to sections 3 4 and 7 1 Important The Batter...

Page 18: ... that the polarity is correct 1 Press the on off button A dialogue window appears 2 Select with the left button YES and confirm the selection with the enter button 3 Remove the mains cable from the mains supply socket 2 see Fig 3 1 to isolate the device from the mains Important If no dialogue window appears it is possible to switch off the device by keeping the On Off button pressed for 10 seconds...

Page 19: ...aper installed Only use original SCHILL ER printing paper The thermo paper is sensitive to heat humidity and chemical va pours Store the paper in a cool and dry area 1 Press the locking catch 1 upwards The printer door opens downward 2 Insert paper and pull it up Be sure that the paper lies behind the cover 2 3 Close the cover Be sure that the paper lies exactly between the rails 3 1 3 2 ...

Page 20: ... Device 2 Select Factory Defaults and confirm with the enter button The factory defaults will be loaded 3 Press the menu button to exit the programming mode V Only authorised personnel trained in the operation of this device are permitted to do the setups in the following menu The extended menu is displayed by pressing the following button combination Press select About press and then 1 Open the m...

Page 21: ...confirm with the enter button 4 Press the up down or left right buttons to select other parameters or press the alarm limit button to exit the menu Alarm Low High Unit a Prio a High priority audible signal with 2 x 5 impulses Low priority audible signal with 1 x 2 impulses and 20 s pauses between the impulse sequences b Print b Print On Default printout containing a warning message when the min ma...

Page 22: ...ible alarm and QRS sound 1 Press the alarm limit button 2 Press the print button The displayed table is printed 1 Select normal monitor mode Press menu if in programming mode or trend if in trend display 2 Press the left button to adjust the loudness The pictogram in the status display on the bottom left shows the current setting ...

Page 23: ...ed alarms can be printed out by pressing the print button The displayed graph cannot be printed Table display 1 Press the trend button The trend will be displayed in a table in 1 5 15 30 60 120 or 240 minute intervals Change the displayed interval using the up down button Move the display forward backward on the time axis using the left right button Graph display cannot be printed 2 To display the...

Page 24: ...ering alarm OFF password V When the acoustic alarm is switched off the patient acoustic physiological alarms are silenced and suppressed indefinitely Use this function only if discon necting a sensor from the patient for a long period of time When the alarm off button is pressed the audible alarm for the respective param eter is suppressed This is indicated by the LED above the button and a messag...

Page 25: ...time in the menu About Alarm 1 Alarm stop off suppression This function suppresses an audible alarm for a defined period of time However the flashing measurement field red measured value and coloured field will remain The audible alarm is reactivated after the defined period of time has elapsed 2 Alarm stop on acknowledging This function will suppress an audible alarm as long as the defined limits...

Page 26: ...or no Sensor is displayed Press the alarm suppressing button The alarm is deleted and the measurement and wave field is no longer displayed Alarm abbreviation Description Asys limit Asystole time limit exceeded SpO2 Low High Oxygen saturation of the blood PP Low High Peripheral pulse of SpO2 RRi Low High Respiration rate impedance from ECG electrode Apnea limit Apnea time limit exceeded CO2i low h...

Page 27: ...d by the HF protection in the ECG cable Values are only displayed when the ECG cable or at least one sensor is connected If a sensor is disconnected a technical alarm is issued The measured value will no longer be displayed if the sensor is disconnected and the alarm is acknowledged V In order to minimise interference and the danger of burns to the patient only use the original SCHILLER HF ECG cab...

Page 28: ...se will be filtered by the HF protection in the ECG cable Set the PM monitoring in the menue ECG Pacemaker On to display the pacemaker pulses as vertical lines 1 on the ECG display When pacemaker signals are detect ed the heart symbole is replaced by a diamond 2 These vertical lines represent neither magnitude nor duration of the pacemaker pulse but are purely time relative The RRi curve field is ...

Page 29: ...checked reg ularly for signs of ischaemia purpura and or neuropathy V The cuff must not be attached to a limb that is already used for interventions such as infusions V To prevent incorrect measurement results make sure that the tube is not com pressed V Applie the cuff always on the same level as the right atrium to be able to measure a correct arterial pressure To prevent errors if the SpO2 satu...

Page 30: ...ith the Argus LCM Other oxygen transducers sensors may lead to improper per formance V The information in this manual does not overrule any instructions given in the Masimo operating manual which must be consulted for full instructions V Do not use the pulsoximeter or Masimo sensors during magnetic resonance im age scanning Induced current could potentially cause burns and the pulsoxime try may af...

Page 31: ...r for blood pressure measurement is introduced into an ar terial vessel the circulation in the terminal vessels must be checked in regular in tervals V Single use sensors and valves must not be reused V To grant the patient s safety it must be ensured that neither the electrodes nor the patient or persons touching the patient come into contact with conducting objects even if these are earthed V Pr...

Page 32: ...cordance with the manufacturer s instructions open the relevant valve s to equalise the system pressures as is shown in this example 2 Press the IBP alarm button or NIBP alarm button with LCM version E 3 Select Start IBP Calibration 4 Confirm with enter V Side stream waste products and the CO2 watertrap should be treated as hazard ous waste V To ensure that children and neonates have sufficient ai...

Page 33: ...ying documents Maintenance work not described in this chapter e g battery replacement may only be accomplished by a qualified technician authorised by SCHILLER AG The following table indicates the intervals and responsibilities of the maintenance work required Country specific regulations can prescribe additional or other intervals and examinations Interval Maintenance Responsible Every two weeks ...

Page 34: ...in charged during storage If the storage period exceeds three months recharge the battery Important A totally discharged battery requires approx 5 hours to be 90 recharged It is possible to use the unit when the battery is being charged However when this is the case the charging time of the battery will be substantially extended 1 Connect the device to the mains but do not switch it on 2 The LED f...

Page 35: ...tage range Number Fuse types 220 240 VAC 2 250 V 200 mA T 100 115 VAC 2 115 V 315 mA T Changing the fuse 1 Disconnect the device from the mains and remove the mains plug See chapter 3 2 2 Loosen the fuse using a screwdriver and remove it 3 Replace both fuses see Fuse types table 4 Reinsert the fuse inset Changing the mains voltage 1 Disconnect the device from the mains and remove the mains plug Se...

Page 36: ...anufacturer recommends using 70 alcohol to clean the cable and sensor Dry the sensor before reuse Notes regarding the cleaning of the ECG cable and electrodes The cable can be wiped with a mild cleaning agent or with 70 alcohol If required sterilisation should be carried out with gas only Alhydex or Vygon but not with steam Electrodes can be cleaned with soapy water after every use Make sure that ...

Page 37: ... as soon as the menu is closed 1 Connect the watertrap 1 to the CO2 socket 2 In the CO2 screen select Start zero point calibration and confirm with enter The pump is started 3 Continue with enter You are prompted to connect the CO2 scrubber 4 Connect the CO2 scrubber 2 to the watertrap 1 5 Press enter to continue The pump must run five min before the calibration is car ried out automatically 6 Whe...

Page 38: ...5 m NIBP pressure range Pressure min 15 mm Hg max 310 mm Hg below or above the limit Check cuff and connection NIBP time too long Pumping running time exceeded 40 s for neonates 60 s for adults Check cuff and connection for leaks Pressure approx 50 mmHg when pump is running check valve Internal tubings CO2 No watertrap Watertrap not connected Microswitch defective Check the watertrap Check the mic...

Page 39: ...pressure 30 mmHg during calibration Check tube system sensor and ventil Set the sensor to ambient pressure Calibrate the sensor Paper insert Paper finished Insert new paper Check paper Paper jammed Check the paper Battery low Battery capacity too low Connect the device to the mains and recharge the bat tery Respiration curve field is not shown Pacemaker is On and respiration source is ECG Set resp...

Page 40: ... ºC 40 Cº relative humidity at 25 95 noncondensing 10 ºC 50 Cº relative humidity at 25 95 noncondensing 700 1060 hPa Display Resolution Dimension diagonal Colour TFT LCD backlit SVGA 800 x 600 dots 27 cm 10 4 Printer Resolution Paper Print speed Printout length Recording tracks High resolution thermo printer 8 dots mm amplitude axis 40 dots mm time axis at 25 mm s Thermoreactive Z folded 72 mm wid...

Page 41: ...ular or graphical form in intervals of 1 5 15 30 60 120 or 240 minutes The upper and lower limits can be defined freely for all vital data exception for temperature only numerical display Safety standard IEC EN 60601 1 protection class I CF classified with internal power supply IEC EN 60601 2 27 EMC IEC EN 60601 1 2 Additional requirements EN 1060 1 and 3 non invasive blood pressure recorders part...

Page 42: ...ression of superimposed 50 or 60 Hz sinusoidal interferences by means of adaptive digital filtering 0 5 mV Amplitude 1 2 mV atrial and ventricular ECG Filters Diagnostic Hardware filter Monitoring 1 Hardware filter Monitoring 2 Hard Software Artefact Hard and Software Mains filter High low pass hp 0 05 Hz lp 150 Hz for LCMplus and LCMbasic SN 1000 High low pass hp 0 5 Hz lp 40 Hz for LCMbasic SN 1...

Page 43: ...surement range 15 C to 45 C Resolution 0 1 C Minimum measurement duration 2 min until a measured value is achieved Measurement Automatic or manual Measuring method Oscillometric Measurement range 15 to 300 mmHg Accuracy Max mean error Max standard deviation 5 mmHg 8 mmHg Deflation rate 3 to 9 mmHg Measurement range 20 300 mmHg Sampling rate 500 Hz Accuracy 1 mmHg at 0 100 mmHg or 1 at 100 300 mmHg...

Page 44: ... 3 digits PP 30 199 min 4 digits Calibrated range 70 100 calibraton is fixed no calibration required Measurement range SpO2 1 100 PP 25 240 min Displayed range 1 100 PP calculation 8 s Measuring method Side stream Displayed range 0 99 mmHg Suction rate 90 120 200 ml min Accuracy 3 mmHg at 0 40 mmHg 8 mmHg at 41 76 mmHg 10 mmHg at 77 99 mmHg Respiration rate 0 99 inspirations min Environmental pres...

Page 45: ...aker Off On If pacemaker on it is no RRi measuring possible RRi Alarm On Off Cable mode Automatic 3 5 10 or 3p electrodes Mains filter Off 50 or 60 Hz NIBP Initial pressure Adult 180 pediatric 150 neonatal 120 mmHg 0 300 Autom measuring Off On Interval time 2 3 5 10 15 30 60 min Deflation speed 5 3 9 SpO2 suppression Off On IBP Scale 0 300 200 100 50 30 Auto Start IBP Calibration Function CO2 Flow...

Page 46: ... via the ECG is not possible The respi ration wave field is not displayed in this case Respiration speed 6 25 12 5 mm s SpO2 Pulse 4 8 or 16 s SpO2 sensitivity Low High NIBP adult Initial 180 NIBP pediatric Initial 150 NIBP neonatal Initial 120 NIBP MAP On Temperature unit C F CO2 mmHg kPA Vol Trend View time 1 5 15 30 60 120 240 min Device Language English Deutsch bFrançais Svenska American Ital ...

Page 47: ...30 Pulse min High 80 220 5 Low 140 180 200 min Low 15 100 5 50 70 90 Pulsoximetry SpO2 High 80 101 1 High 101 101 98 Low 70 99 1 90 89 88 PP min High 80 220 5 Low 140 180 200 min Low 15 100 5 50 70 90 Capnography eC02 Vol High 4 5 10 0 1 Low 6 0 6 0 6 0 Vol Low 0 6 0 0 1 4 5 4 5 4 5 CO2i Vol High 0 1 1 5 0 1 Low 0 2 0 2 0 2 Vol Low 0 1 0 1 0 0 0 eCO2 kPa High 4 5 10 0 1 Low 6 0 6 0 6 0 kPa Low 0 6...

Page 48: ... high frequncy signals is not possible The used HF signal for the RRi measuring will be filtered by the HF protection in the ECG cable Pacemaker monitoring with HF ECG cable Pacemaker monitoring with HF ECG cable against high frequncy signals is not pos sible The used pacemaker impulse will be filtered by the HF protection in the ECG cable V Danger of destroying the device during defibrillation Th...

Page 49: ... 2 510474 rev d ARGUS LCM PLUS Note When the signal amplitude is 0 5 mV place the yellow electrode according the fol lowing picture instead to adjust the resolution to 40 mm V Because of that the ar tefacts can be reduzed The signal amplitude is influenced by the electrical heart ax is ...

Page 50: ...6 leads with a 3p lead ca ble The 3p lead cable is marked with an black connector housing instead of green This works only with software 1 24 and higher 7 3 5 Three and five lead cables for adults and children Red RA Green LL Yellow LA Yellow L white Green F Black N Red R The colours shown here are according to code 1 European requirements In par agraph 7 3 7 you can find a table with the colour c...

Page 51: ... d ARGUS LCM PLUS 7 3 6 10 lead ECG patient cable The following illustration indicates the placement locations for the electrodes of a ten lead patient cable 1 2 3 4 5 1 2 3 4 5 Red R Black N White red C1 Yellow L White Green C3 White Braun C4 White Black C5 White Violet C6 Green F White Yellow C2 ...

Page 52: ...e equivalent code 2 colours are given below CODE 1 usually European CODE 2 usually American System Electrode identifier Colour code Electrode identifier Colour code R Red RA white Limb L Yellow LA Black F Green LL Red C white V Brown C1 White red V1 Brown red Chest C2 White yellow V2 Brown yellow according C3 White green V3 Brown green to Wilson C4 White brown V4 Brown blue C5 White black V5 Brown...

Page 53: ...cule s absorption energy The CO2 molecule can therefore absorb more energy IR radiation Desflurane Comp Off On Correction factor for desflurane 0 952 as for N2O The compensation is activated when the desflurane concentration is greater than 12 However it has the same effect as N2O compensation Steam Compensation On Off Steam affects the IR absorption by CO2 molecules Its influence is calculat ed m...

Page 54: ... on O2 the influences can cancel each other out in a gas mixture of 25 N2O and 75 O2 In that case both compensations can be deactivated The overall correction when both compensations are active is 0 99 7 4 4 Environmental pressure compensation The environmental pressure is automatically compensated when the unit is switched on or the watertrap is connected ...

Page 55: ...ery operation14 Language18 Loudness14 Normal21 Patient type14 E Entering alarm OFF password22 F Factory defaults18 Fuse types33 I Initial settings18 L Language18 Language setup18 Loudness of audible alarm and QRS sound20 M Maintenance interval31 N NIBP Switch between auto and manual13 P Print Alarms not confirmed21 Trend table21 Printing alarm limits20 R Restore defaults18 S Save as default18 T Tw...

Page 56: ...8 Index Page 54 Art no 2 510474 rev d ARGUS LCM PLUS ...

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