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iMEC8 Vet
Portable Multi-Parameter Veterinary
Monitor

Operator’s Manual

Содержание iMEC8 Vet

Страница 1: ...iMEC8 Vet Portable Multi Parameter Veterinary Monitor Operator s Manual ...

Страница 2: ......

Страница 3: ...anual as confidential information Disclosure of the information in this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden Release amendment reproduction distribution rental adaption and translation of this manual in any manner whatsoever without the written permission of Mindray is strictly forbidden and are the registered trademarks or trademarks owne...

Страница 4: ...hat employs this equipment to carry out a reasonable service maintenance plan Neglect of this may result in machine breakdown or personal injury Service Mindray maintains a network of service representatives and factory trained distributors Prior to requesting service perform a complete operational check of the instrument to verify proper control settings If operational problems continue to exist ...

Страница 5: ...d South Hi tech industrial park Nanshan Shenzhen 518057 P R China Website www mindray com E mail Address service mindray com Tel 86 755 81888998 Fax 86 755 26582680 Distributor Mindray DS USA Inc Address 800 MacArthur Boulevard Mahwah New Jersey 07430 USA Tel 1 800 288 2121 1 201 995 8000 Website www mindray com III ...

Страница 6: ... an integral part of the product It should always be kept close to the equipment so that it can be obtained conveniently when needed Intended Audience This manual is geared for clinical professionals who are expected to have a working knowledge of medical procedures practices and terminology as required for monitoring of critically ill patients Illustrations All illustrations in this manual serve ...

Страница 7: ...3 2 3 2 1 Turning Power On 3 2 3 2 2 Starting Monitoring 3 3 3 3 Turning the Monitor Off 3 3 3 4 Using Keys 3 3 3 5 Using the Touchscreen 3 3 3 6 Setting the Screen 3 4 3 7 Using the On screen Keyboard 3 5 3 8 Using the Timer 3 5 3 9 Using the Main Menu 3 6 3 10 Changing General Settings 3 6 3 10 1 Setting up a Monitor 3 6 3 10 2 Changing Language 3 7 3 10 3 Adjusting the Screen Brightness 3 7 3 1...

Страница 8: ...ring the Manage Configuration Menu 5 1 5 3 Setting Default Configuration 5 2 5 4 Saving Current Settings 5 2 5 5 Editing a Configuration 5 2 5 6 Deleting a Configuration 5 3 5 7 Transferring a Configuration 5 3 5 8 Loading a Configuration 5 3 5 9 Restoring the Latest Configuration Automatically 5 4 5 10 Modifying Password 5 4 6 User Screens 6 1 6 1 Tailoring Your Screens 6 1 6 1 1 Changing the Wav...

Страница 9: ...Alarm Delay 7 8 7 5 5 Setting Recording Length 7 8 7 5 6 Intubation Mode 7 8 7 6 Pausing Alarms 7 9 7 7 Switching Off All Alarms 7 9 7 8 Silencing the Alarm Sound 7 10 7 9 Latching Alarms 7 10 7 10 Silencing Technical Alarms 7 10 7 11 Testing Alarms 7 11 7 12 When an Alarm Occurs 7 11 7 13 Using Care Group Alarms 7 11 7 13 1 Care Group Auto Alarms 7 11 7 13 2 Setting Care Group Alert Tone 7 12 7 1...

Страница 10: ...Time 8 10 8 6 10 Adjusting ST Measurement Points 8 11 8 7 About Arrhythmia Monitoring 8 12 8 7 1 Understanding the Arrhythmia Events 8 12 8 7 2 Changing Arrhythmia Alarm Settings 8 13 8 7 3 Changing Arrhythmia Threshold Settings 8 13 8 7 4 Setting the Extended Arrhythmia 8 13 8 7 5 Reviewing Arrhythmia Events 8 14 8 8 ECG Relearning 8 14 8 8 1 Initiating an ECG Relearning Manually 8 14 8 8 2 Autom...

Страница 11: ...Tone Mode 11 6 11 6 Measurement Limitations 11 6 11 7 Masimo Information 11 6 11 8 Nellcor Information 11 7 12 Monitoring NIBP 12 1 12 1 Introduction 12 1 12 2 Safety 12 2 12 3 Measurement Limitations 12 2 12 4 Measurement Methods 12 2 12 5 Setting Up the NIBP Measurement 12 3 12 5 1 Preparing to Measure NIBP 12 3 12 5 2 Starting and Stopping Measurements 12 4 12 5 3 Correcting the Measurement if ...

Страница 12: ... Measuring PAWP 14 7 14 8 1 Preparing to Measure PAWP 14 7 14 8 2 Setting Up the PAWP Measurement 14 7 14 8 3 Understanding the PAWP Setup Menu 14 8 15 Monitoring Carbon Dioxide CO2 15 1 15 1 Introduction 15 1 15 2 Measuring CO2 15 2 15 2 1 Making a Sidestream CO2 Measurement 15 2 15 2 2 Making a Microstream CO2 Measurement 15 3 15 3 Changing CO2 Settings 15 3 15 3 1 Accessing CO2 Menus 15 3 15 3 ...

Страница 13: ... Introduction 18 1 18 2 Dose Calculations 18 1 18 2 1 Performing Calculations 18 1 18 2 2 Selecting the Proper Drug Unit 18 2 18 2 3 Titration Table 18 2 18 2 4 Drug Calculation Formulas 18 3 18 3 Oxygenation Calculations 18 3 18 3 1 Performing Calculations 18 3 18 3 2 Entered Parameters 18 3 18 3 3 Calculated Parameters and Formulas 18 4 18 4 Ventilation Calculations 18 4 18 4 1 Performing Calcul...

Страница 14: ... 20 2 Exporting the Log 20 1 20 3 Transferring Data 20 1 20 3 1 Data Export System 20 1 20 3 2 Transferring Data by Different Means 20 2 20 4 Nurse Call 20 2 20 5 Network Connection 20 3 20 5 1 Setting the Network Type 20 3 20 5 2 Wireless Network 20 3 20 5 3 Setting the IP Address Subnet Mask and Gateway 20 4 21 Batteries 21 1 21 1 Overview 21 1 21 2 Replacing a Battery 21 1 21 3 Battery Guidelin...

Страница 15: ...6 Wireless Network A 5 A 7 Measurement Specifications A 5 B EMC and Radio Regulatory Compliance B 1 B 1 EMC B 1 B 2 Radio Regulatory Compliance B 4 C Default Configurations C 1 C 1 Parameters Configuration C 1 C 2 Routine Configuration C 7 C 3 User Maintenance Items C 9 D Alarm Messages D 1 D 1 Physiological Alarm Messages D 1 D 2 Technical Alarm Messages D 2 E Electrical Safety Inspection E 1 E 1...

Страница 16: ...X F 1 Symbols F 1 F 2 Abbreviations F 2 ...

Страница 17: ...s a potential hazard or unsafe practice that if not avoided could result in death or serious injury CAUTION Indicates a potential hazard or unsafe practice that if not avoided could result in minor personal injury or product property damage NOTE Provides application tips or other useful information to ensure that you get the most from your product ...

Страница 18: ...ould result Do not touch the equipment s metal parts or connectors when in contact with the patient otherwise patient injury may result Before connecting the equipment to the power line check that the voltage and frequency ratings of the power line are the same as those indicated on the equipment s label or in this manual Do not rely exclusively on the audible alarm system for monitoring Adjustmen...

Страница 19: ...er line are the same as those indicated on the equipment s label or in this manual Always install or carry the equipment properly to avoid damage caused by drop impact strong vibration or other mechanical force Dry the equipment immediately in case of rain or water spray 1 1 4 Notes NOTE Put the equipment in a location where you can easily see the screen and access the operating controls Keep this...

Страница 20: ...duct should not be treated as household waste By ensuring that this product is disposed of correctly you will help prevent bringing potential negative consequences to the environment and human health For more detailed information with regard to returning and recycling this product please consult the distributor from whom you purchased it For system products this label may be attached to the main u...

Страница 21: ...e HR respiration Resp temperature Temp SpO2 pulse rate PR non invasive blood pressure NIBP invasive blood pressure IBP and carbon dioxide CO2 WARNING This monitor is intended for use only by clinical professionals or under their guidance It must only be used by persons who have received adequate training in its use Anyone unauthorized or untrained must not perform any operation on it 2 2 Front Vie...

Страница 22: ...5 Battery LED On when the battery is installed and the AC source is connected Off when no battery is installed or the installed battery has a malfunction or no AC source is connected when the monitor is powered off Flash when the monitor is operating on battery power 6 Press to silence all alarm sounds 7 Press to pause or restore alarms 8 Press to freeze or unfreeze waveforms 9 Knob Rotate the Kno...

Страница 23: ...artment 3 CO2 gas outlet 4 Slot for CO2 watertrap sidestream 5 Connector for ECG cable 6 Connector for SpO2 cable 7 Connector for NIBP cuff 8 Connector for Temp probe 1 9 Connector for Temp probe 2 10 Connector for IBP cable 1 2 3 4 5 6 7 8 9 10 ...

Страница 24: ...nals nurse call signals and analogy output signals 4 VGA Connector It connects a secondary display which extends the display capability of your monitor The contents displayed on the secondary display screen accords with those displayed on the monitor screen 5 USB Connector It connects a USB drive for data or configuration transfer 6 Network Connector It is a standard RJ45 connector which connects ...

Страница 25: ...o patient is admitted selecting this area will enter the Patient Setup menu If a patient has been admitted selecting this area will enter the Patient Demographics menu 2 Alarm Symbols indicates alarms are paused indicates alarm sounds are paused indicates alarm sounds are turned off indicates the system is in alarm off status 3 Technical Alarm Area This area shows technical alarm messages and prom...

Страница 26: ...ach parameter is displayed in the same row in the waveform area Select this area and the corresponding measurement setup menu will be displayed 7 Parameter Area B For the parameters displayed in this area their corresponding waveforms are not displayed 8 Prompt Message Area This area shows the current configuration name prompt messages network status icons battery status icons date and time etc Fo...

Страница 27: ...played on the screen Scroll left to display more QuickKeys Scroll right to display more QuickKeys Enter the main menu Enter standby mode Change alarm settings Review the patient s data Enter the NIBP measurement menu Stop all NIBP measurement Zero IBP Silence all alarm sounds Pause or restore alarms Change screen Enter the patient setup menu Trigger a manual event Have a split screen view of minit...

Страница 28: ...nter the privacy mode Enter the night mode Enter the intubation mode You can also select your desired QuickKeys to display on the screen 1 Select Main Menu Maintenance Manage Configuration enter the required password Ok 2 In the Manage Configuration menu select Edit Config 3 In the pop up menu select the desired configuration and then select Edit 4 In the pop up menu select Screen Setup 5 In the S...

Страница 29: ...of leakage currents please consult the manufacturers or else an expert in the field to ensure the necessary safety of patients and all devices concerned will not be impaired by the proposed combination CAUTION The equipment shall be installed by personnel authorized by Mindray NOTE The software copyright of the equipment is solely owned by Mindray No organization or individual shall resort to modi...

Страница 30: ... occur as a result of temperature or humidity difference In this case never start the system before the condensation disappears CAUTION Make sure that the operating environment of the equipment meets the specific requirements Otherwise unexpected consequences e g damage to the equipment could result Put the equipment in a location where you can easily see the screen access the operating controls a...

Страница 31: ...lly or under some special situations This may cause loss of data of the monitor 3 4 Using Keys The monitor has three types of keys Softkey A softkey is a graphic key on the screen giving you fast access to certain menus or functions The monitor has two types of softkeys Parameter keys Each parameter area or waveform area can be seen as a softkey You can enter a parameter setup menu by selecting it...

Страница 32: ...eters and their waveforms When there is no parameter displayed in area C both the parameters and their waveforms will be displayed in area B Otherwise only the parameters will be displayed In Area C you can choose to display Timer and all the parameters whose associated waveforms will not be displayed The screen can automatically adjust to ensure the best view based on your screen setup If no corr...

Страница 33: ...reens window 2 Select Screen Setup tab 3 In Area C select Timer from the drop down list of the desired parameter area Refer to 3 6 Setting the Screen for Area C 4 Select to exit the window The main screen will display the timer Select Start or Pause to start or pause the timing Select Clear to clear current timing result Select Setup to access the Timer Setup window in which you can set the Direct...

Страница 34: ...ation 3 Online help area displays help information for the highlighted menu item 4 select to exit the current menu 3 10 Changing General Settings This chapter covers only general settings such as language brightness date and time etc Measurement settings and other settings can be referred to in respective sections 3 10 1 Setting up a Monitor In situations where you install a monitor or change the ...

Страница 35: ...e help as required 1 Select Main Menu Screen Setup 2 Select Help and toggle between On and Off 3 10 5 Setting the Date and Time 1 Select Main Menu Maintenance System Time 2 Set the date and time 3 Select Date Format and toggle between yyyy mm dd mm dd yyyy and dd mm yyyy 4 Select Time Format and toggle between 24h and 12h If your monitor is connected to a central monitoring system CMS the date and...

Страница 36: ...thers or the SpO2 parameter window 2 Select QRS Volume or Beat Vol and then select the appropriate volume 0 means off and 10 is the maximum volume 3 11 Setting Parameters 3 11 1 Switching the Parameters On Off To switch the parameters on or off 1 Select Main Menu Maintenance User Maintenance enter the required password Others 2 Configure the Para Switch Authority to Unprotected or Protected If Par...

Страница 37: ... the night mode 1 Select Main Menu Screen Setup Night Mode 2 Select Ok in the popup WARNING Before entering night mode confirm the settings of brightness alarm volume QRS volume and key volume Pay attention to the potential risk when the setting value is a bit low 3 12 3 Privacy Mode Privacy mode is only available when a patient who is admitted at a monitor is also monitored by the central station...

Страница 38: ...de In Demo mode the monitor can demonstrate its major functions when a patient or patient simulator is not connected The Demo mode is password protected To enter the Demo mode 1 Select Main Menu Maintenance 2 Select Demo Enter the required password and then select Ok To exit the Demo mode select Main Menu Maintenance Exit Demo WARNING The Demo mode is for demonstration purposes only To avoid simul...

Страница 39: ...lect Yes to apply the data saved in the monitor to the new patient or No to clear the data saved in the monitor 4 In the Patient Demographics menu enter the demographic details of which Patient Cat determines the way your monitor processes and calculates some measurements and what safety and alarm limits are applied for your patient Paced determines whether to show pace pulse marks on the ECG wave...

Страница 40: ... information from HIS through eGateway To query or obtain patient information from HIS 1 Select Main Menu Maintenance User Maintenance enter the required password Gateway Comm Setting and set IP Address and Port Set ADT Query to On 2 Click the patient information area to enter the Patient Demographics menu 3 Select Obtain Patient Info to enter the Obtain Patient Information menu 4 Input the query ...

Страница 41: ...mation To edit the patient information after a patient has been admitted or when the patient information is incomplete or when you want to change the patient information 1 Select the Patient Setup QuickKey or Main Menu Patient Setup 2 Select Patient Demographics and then make the required changes 3 Select Ok 4 6 Discharging a Patient To discharge a patient 1 Select the Patient Setup QuickKey or Ma...

Страница 42: ...d The default is Off WARNING Do not discharge a patient before the patient is successfully transferred After a patient is successfully transferred check if the patient settings especially patient category paced status and alarm limits settings etc on the monitor are appropriate for this patient NOTE The system automatically switches on the HR alarm and lethal arrhythmia alarm after transferring th...

Страница 43: ... loads the configuration according to the patient category Same Patient In the popup dialog box you can Select Yes to merge the patient data in the monitor and storage medium Select No to erase all the current patient data in the monitor and to transfer the patient data from the storage medium 4 Wait until the following message appears Transfer from storage medium successful WARNING The USB drive ...

Страница 44: ...transferred to the CMS All patient information measurement data and settings can be displayed simultaneously on the monitor and CMS For some functions such as editing patient information admitting a patient discharging a patient starting stopping NIBP measurements etc bi directional control can be achieved between your monitor and the CMS For details refer to the CMS s instructions for use ...

Страница 45: ...The configuration management tasks must be performed by clinical professionals The system configuration items can be classified as Parameter configuration items These items relate to parameters e g waveform gain alarm switch alarm limits Conventional configuration items These items define how the monitor works e g screen layout record print and alarm settings User maintenance items These items rel...

Страница 46: ...nitor starts enter the main screen to check the prompt information at the lower part of the screen displayed for about 10 seconds 5 4 Saving Current Settings Current settings can be saved as a user configuration Up to 3 user configurations can be saved To save current settings 1 Select Save Current Settings As in the Manage Configuration menu 2 In the popup dialog box enter the configuration name ...

Страница 47: ...e monitor 1 Connect the USB drive to the monitor s USB port 2 Select Import Config in the Manage Configuration menu 3 In the Import Config menu select the configurations and User Maintenance Settings to import Then select the Import button A status message will report completion of the transfer 5 8 Loading a Configuration You may make changes to some settings during operation However these changes...

Страница 48: ...res the latest configuration if it restarts within 60 seconds after the power failure It will restore the default configuration rather than the latest configuration if it restarts 120 seconds later after the power failure The monitor may load either the latest configuration or the default configuration if it restarts between 60 120 seconds after the power failure 5 10 Modifying Password To modify ...

Страница 49: ...ed measurement and then select a color from the popup menu 6 1 3 Changing Screen Layout Select the Screens QuickKey or Main Menu Screen Setup Screen Layout to enter the Screens menu You can choose the desired screen type in the Choose Screen window You can select the parameters and waveforms you want to view in the Screen Setup window For details please refer to the section Setting the Screen You ...

Страница 50: ...ely displayed at the top and left The time is displayed at the bottom of the minitrends shown view 6 2 2 Setting Minitrends Select the minitrends area From the pop up Minitrend Setup menu you can Select the parameters to be displayed or Select Minitrend Length and then select the appropriate setting 6 3 Viewing OxyCRG To have a split screen view of OxyCRG you can Select the OxyCRG QuickKey or Sele...

Страница 51: ...aveform The trend area can display two parameter trends e g HR trend and RR trend simultaneously 4 Auto Scale Select the Auto Scale button and the system automatically adjusts the scaling 5 Print Select Print to print out the realtime OxyCRG 6 Record With this button you can print out the currently displayed OxyCRG trends by the recorder 6 4 Viewing Other Patients 6 4 1 Care Group You can place up...

Страница 52: ...pears matches its status Red indicates the bed is giving high level physiological alarms or the telemetry is giving alarm such as nurse call or event Yellow indicates the bed is giving medium or low level physiological alarms or medium level technical alarms Blue indicates the bed is giving low level technical alarms Grey indicates the bed fails to be networked or is in the standby mode You can vi...

Страница 53: ...nical and prompt messages coming from the currently viewed patient Additionally you can change a waveform or parameter for viewing To change a waveform for viewing select the waveform segment where you want a new waveform to appear and then select the waveform you want from the popup menu To change a parameter for viewing select the parameter window where you want a new parameter to appear and the...

Страница 54: ...6 6 FOR YOUR NOTES ...

Страница 55: ...cal alarms and prompt messages 1 Physiological alarms Physiological alarms also called patient status alarms are triggered by a monitored parameter value that violates set alarm limits or an abnormal patient condition Physiological alarm messages are displayed in the physiological alarm area 2 Technical alarms Technical alarms also called system status alarms are triggered by a device malfunction ...

Страница 56: ...r an improper operation which may compromise a certain monitoring function but will not threaten the patient s life 7 3 Alarm Indicators When an alarm occurs the monitor will indicate it to the user through visual or audible alarm indications Alarm lamp Alarm message Flashing numeric Audible alarm tones 7 3 1 Alarm Lamp If a technical alarm or physiological alarm occurs the alarm lamp will flash T...

Страница 57: ...evel alarms triple beep Low level alarms single beep Mode 1 High level alarms high pitched single beep Medium level alarms double beep Low level alarms low pitched single beep Mode 2 High level alarms high pitched triple beep Medium level alarms double beep Low level alarms low pitched single beep 7 3 5 Alarm Status Symbols Apart from the aforementioned alarm indicators the monitor still uses the ...

Страница 58: ... Volume 2 4 Select Reminder Vol to set the volume of the reminder tone as High Med or Low When alarm volume is set to 0 the alarm sound is turned off and a symbol appears on the screen 7 4 3 Setting the Interval between Alarm Sounds You cannot change the interval between alarm tones if you choose mode 1 or 2 as your desired alarm tone pattern For these two patterns the interval between alarm tones...

Страница 59: ...the monitor issues a periodical reminder tone To set the reminder tones 1 Select Main Menu Maintenance User Maintenance enter the required password 2 Select Alarm Setup to enter the Alarm Setup menu 3 Set the Reminder Tones to On Off or Re alarm When Re alarm is selected the current physiological alarms and technical alarms marked with will be re generated after the Reminder Interval To set the in...

Страница 60: ...w alarm limits based on the measured values Before applying these automatically created alarm limits confirm if they are appropriate for your patient in the mass alarm setup menu If not you can adjust them manually These alarm limits will remain unchanged until you select auto limits again or adjust them manually The monitor calculates the auto limits based on the following rules Module Parameter ...

Страница 61: ...r 80mmHg whichever is smaller 20 to 90 IBP M Mean 15 or 35mmHg whichever is greater Mean 15 or 95mmHg whichever is smaller 25 to 105 PA IBP S SYS 0 75 SYS 1 25 3 to 120mmHg IBP D Dia 0 75 Dia 1 25 IBP M Mean 0 75 Mean 1 25 IBP CVP ICP LAP RAP UVP P1 P4 Venous pressure IBP M Mean 0 75 Mean 1 25 3 to 40mmHg CO2 EtCO2 0 to 32mmHg remains the same 0 to 32mmHg remains the same Same as the measurement r...

Страница 62: ...ight SpO2 Low Signal and SpO2 Interference 7 5 5 Setting Recording Length You can change the length of the recorded waveforms In the Others window of the Alarm Setup menu select Recording Length and toggle between 8 s 16 s and 32 s 8s 4 seconds respectively before and after the alarm or manual event trigger moment 16s 8 seconds respectively before and after the alarm or manual event trigger moment...

Страница 63: ...he hardkey You can set the alarm pause time to 1 min 2 min 3 min 5 min 10 min 15 min or Permanent The default alarm pause time is 2 minutes 1 Select Main Menu Maintenance User Maintenance enter the required password 2 Select Alarm Setup Alarm Pause Time and then select the appropriate setting from the popup list 7 7 Switching Off All Alarms If Alarm Pause Time is set to Permanent the monitor enter...

Страница 64: ... password 2 Select Alarm Setup 3 Select Latching Alarms and toggle between High only Hi Med All and Off If you select High only only high priority alarms are latched if you select Hi Med both high priority alarms and medium priority alarms are latched if you select All all alarms are latched if you select Off the alarm latching is turned off NOTE Changing of alarm priority may affect the latching ...

Страница 65: ...e alarm condition is corrected For troubleshooting specific alarms see appendix Alarm Messages 7 13 Using Care Group Alarms 7 13 1 Care Group Auto Alarms When a Care Group is set up on your monitor a flashing symbol will appear beside the QuickKeys area if any monitor in your Care Group which is not currently viewed by your monitor is alarming The alarm symbol is shown as below The background colo...

Страница 66: ...ce the alarm sound of the currently viewed bed in the View Other Patient window This function can be set in the Alarm Setup menu from the User Maintenance menu only When the alarm silence function for other patients is active and the currently viewed bed is in normal alarm status or alarm sound off status press the Silence button in the View Other Patient window The currently viewed bed will then ...

Страница 67: ...0 seconds if the correct electrodes are used and applied in accordance with the manufacturer s instructions for use Interference from a non grounded instrument near the patient and electrosurgery interference can cause problems with the waveform 8 3 Preparing to Monitor ECG 8 3 1 Preparing the Patient and Placing the Electrodes 1 Skin preparation The quality of ECG waveform displayed on the monito...

Страница 68: ...your hospital 8 3 3 ECG Lead Placements The electrode placement illustrations in this chapter adopt the AHA standard 3 Leadwire Electrode Placement Following is the configuration per the European standard when using three leadwires RA right arm lead on the right foreleg LA left arm lead on the left foreleg LL left leg lead on the left hind leg The chart below shows the label used to identify each ...

Страница 69: ...r code per American AHA and European IEC standards American Standard European Standard Label Color Label Color RA White R Red LA Black L Yellow LL Red F Green RL Green N Black V Brown C White Lead Placement for Surgical Patients The surgical site should be taken into consideration when placing electrodes on a surgical patient e g for open chest surgery the chest electrodes can be placed on the lat...

Страница 70: ...e ECG waveform area To change the paced status you can select either the patient information area or Main Menu Patient Setup Patient Demographics or the ECG parameter window or waveform area Others and then select Paced from the popup menu and toggle between Yes and No If you do not set the paced status the monitor issues a prompt tone when pace pulse is detected At the same time the paced symbol ...

Страница 71: ... Heart beat symbol 8 5 Changing ECG Settings 8 5 1 Accessing ECG Menus By selecting the ECG parameter window or waveform area you can access the ECG Setup menu 8 5 2 Choosing the Alarm Source In most cases the HR and PR numerics are identical In order to avoid simultaneous alarms on HR and PR the monitor uses either HR or PR as its active alarm source To change the alarm source select Alm Source i...

Страница 72: ...ens Quickkey Screen Setup 2 Select ECG1 Casc in the second row A cascaded waveform is displayed in two waveform positions 8 5 5 Changing the ECG Filter Settings The ECG filter setting defines how ECG waves are smoothed To change the filter setting select Filter from ECG Setup and then select the appropriate setting Monitor Use under normal measurement conditions Diagnostic Use when diagnostic qual...

Страница 73: ...er Reject Settings Select ECG Setup Others Pacer Reject and toggle between On and Off When Paced is set to Yes When Pacer Reject is switched on the pace pulses are not counted as extra QRS complexes The pace pulse marks are shown on the ECG wave when pace pulses are detected When Paced is set to No the pace markers are not shown on the ECG wave and the options of Pacer Reject are invalid 8 5 8 Cha...

Страница 74: ...tem will adjust the pitch tone of QRS sound based on the SpO2 value 8 5 12 About the Defibrillator Synchronization If a defibrillator is connected a defibrillator synchronization pulse 100 ms 5V is outputted through the Multifunctional Connector every time the monitor detects an R wave WARNING Improper use of a defibrillator may cause injury to the patient The user should determine whether to perf...

Страница 75: ... analysis is switched off the filter mode automatically switches to the previous manual setting However if you switch Filter to Monitor or Surgery ST segment analysis will turn off automatically In case that you change Monitor or Surgery to Diagnostic or ST ST segment analysis keeps off you can turn it on manually NOTE When the filter mode is switched to Diagnostic the notch filter automatically s...

Страница 76: ...ference segment groups 8 6 6 Deleting a Reference Segment To delete the current ST reference segment select Delete Ref in the ST Analysis menu and then select Ok in the popup 8 6 7 Recording the ST Segment To record the current ST segment and reference segment select Record in the ST Analysis menu 8 6 8 Changing the ST Alarm Limits High and low ST alarm limits can be set individually for each ECG ...

Страница 77: ...nt the ISO J and ST point positions respectively 2 Select View Leads and use the Knob to select an ECG lead with obvious J point and R wave 3 Select ISO J or ST Point and then use the Knob to adjust the position of each point The ISO point isoelectric position is given relative to the R wave peak Position the ISO point in the middle of the flattest part of the baseline between the P and Q waves Th...

Страница 78: ...ess than the extreme bradycardia limit PVCs PVCs min exceeds high limit Nonlethal arrhythmia Pacer not paced No pace pulse detected for 1 75 x average R to R intervals following a QRS complex for paced patients only Pacer not capture No QRS complex detected for 300 milliseconds following a pace pulse for paced patients only PVC One PVC detected in normal heartbeats Couplet Paired PVCs detected in ...

Страница 79: ...ts threshold an alarm will be triggered The asystole delay time relates to ECG relearning When HR is less than 30 bpm it is recommended to set the asystole delay time to 10 seconds Arrh event Range Default Step Unit PVCs High 1 to 100 10 1 min Asys Delay 3 to 10 5 1 s Tachy High 60 to 300 180 5 bpm Brady Low 15 to 120 90 5 bpm Extreme Tachy 120 to 300 200 5 bpm Extreme Brady 15 to 60 60 5 bpm Mult...

Страница 80: ...HR value and restore ST measurements To initiate relearning manually select the ECG parameter window or waveform area Relearn When the monitor is learning the message ECG Learning is displayed in the technical alarm area CAUTION Take care to initiate ECG relearning only during periods of normal rhythm and when the ECG signal is relatively noise free If ECG learning takes place during ventricular r...

Страница 81: ...y as respiratory activity in the case of apnea The respiration measurement does not recognize the cause of apneas It only indicates an alarm if no breath is detected when a pre adjusted time has elapsed since the last detected breath Therefore it cannot be used for diagnostic purpose If operating under conditions according to the EMC Standard EN 60601 1 2 Radiated Immunity 3V m field strengths abo...

Страница 82: ...area and the ventricles of the heart with the electrodes line Lead placement 5 lead 9 4 1 Optimizing Lead Placement for Resp If you want to measure Resp and you are already measuring ECG you may need to optimize the placement of the two electrodes between which Resp will be measured Repositioning ECG electrodes from standard positions results in changes in the ECG waveform and may influence ST and...

Страница 83: ...without continuous positive airway pressure CPAP Patients are ventilated except patients with intermittent mandatory ventilation IMV In manual detection mode you adjust the dotted detection level line to the desired level by selecting Upper Line or Lower Line and then selecting or beside them Once set the detection level will not adapt automatically to different respiration depths It is important ...

Страница 84: ...Source to Auto RR source switches back to the valid source if you press the silence hardkey on the monitor s front during an apnea alarm The priority of RR source is from high to low CO2 measurement and impedance respiration measurement The RR Source settings of Resp and CO2 are linked The RR source options and description are shown in the table below Option Description Auto RR source is automatic...

Страница 85: ...atabase and reviewed in the graphic tabular trends in trend graphs as the PR curve is in the same color with the PR source it is unlikely to distinguish the PR source is sent via the network to the central monitoring system if available To set which pulse rate as PR source 1 Enter the SpO2 Setup menu 2 Select PR Source and then select a label or Auto from the popup menu The popup menu displays the...

Страница 86: ...the ECG measurement as the alarm source whenever the ECG measurement is switched on and a valid heart rate is available If the heart rate becomes unavailable for example if leads become disconnected and a pulse source is switched on and available the monitor will automatically switch to Pulse as the alarm source When the Leads Off condition is corrected the monitor will automatically switch back t...

Страница 87: ...alized 2 Oxygen saturation of arterial blood SpO2 percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin 3 Perfusion index PI gives the numerical value for the pulsatile portion of the measured signal caused by arterial pulsation PI is an indicator of the pulsatile strength You can also use it to assess the quality of SpO2 measurement Above 1 is optimal bet...

Страница 88: ... blistering or burns Inspect the sensor site every two hours and move the sensor if the skin quality changes Change the application site every four hours For patients with poor peripheral blood circulation or sensitive skin inspect the sensor site more frequently 11 3 Identifying SpO2 Modules To identify which SpO2 module is incorporated into your monitor see the color of the SpO2 connector and th...

Страница 89: ...t the sensor cable is positioned along the side of the animal s face and body to avoid entanglement with the animal 11 5 Changing SpO2 Settings 11 5 1 Accessing SpO2 Menus By selecting the SpO2 parameter window or waveform area you can access the SpO2 Setup menu 11 5 2 Adjusting the Desat Alarm The desat alarm is a high level alarm notifying you of potentially life threatening drops in oxygen satu...

Страница 90: ... then toggle between 2 4 s 4 6 s 8 s 10 s 12 s 14 s and 16 s 11 5 5 Monitoring SpO2 and NIBP Simultaneously When monitoring SpO2 and NIBP on the same limb simultaneously you can switch NIBP Simul on in the SpO2 Setup menu to lock the SpO2 alarm status until the NIBP measurement ends If you switch NIBP Simul off low perfusion caused by NIBP measurement may lead to inaccurate SpO2 readings and there...

Страница 91: ...Seconds would have been exceeded Saturation levels may fluctuate rather than remaining steady for a period of several seconds Often the patient SpO2 may fluctuate above and below an alarm limit re entering the non alarm range several times During such fluctuation the monitor integrates the number of SpO2 points both positive and negative until either the Sat Seconds limit is reached or the patient...

Страница 92: ...ctrosurgical units Dysfunctional hemoglobin such as carboxyhemoglobin COHb and methemoglobin MetHb Presence of certain dyes such as methylene and indigo carmine Inappropriate positioning of the SpO2 sensor or use of incorrect SpO2 sensor Drop of arterial blood flow to immeasurable level caused by shock anemia low temperature or vasoconstrictor 11 7 Masimo Information Masimo Patents This posting se...

Страница 93: ...s http www covidien com patents No Implied License Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized replacement parts which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device ...

Страница 94: ...11 8 FOR YOUR NOTES ...

Страница 95: ...n pressure This is the most accurate parameter measured by the oscillometric method Once the mean pressure is determined the systolic and diastolic pressures are calculated with reference to the mean Simply stated auscultation measures systolic and diastolic pressures and the mean pressure is calculated The oscillometric method measures the mean pressure and determines the systolic and diastolic p...

Страница 96: ... by alternative means and then verify that the monitor is working correctly 12 3 Measurement Limitations Measurements are impossible with heart rate extremes of less than 40bpm or greater than 240bpm or if the patient is on a heart lung machine The measurement may be inaccurate or impossible If a regular arterial pressure pulse is hard to detect With excessive and continuous patient movement such ...

Страница 97: ...ange If it does not use a larger or smaller cuff that will fit better 5 Connect the cuff to the air tubing and make sure that the air tubing is not compressed and twisted NOTE The use of the equipment is restricted to one patient at a time Details about the cuff sites on different animals are as follows For a FELINE For conscious patients measurements from the coccygeal artery can be taken by wrap...

Страница 98: ...d for good contact it should be clipped 12 5 2 Starting and Stopping Measurements Select the NIBP Measure QuickKey and you can start the desired measurement from the popup menu You can select the Stop All QuickKey to stop all NIBP measurements You can also start and stop measurements by using the hardkey on the monitor s front panel 12 5 3 Correcting the Measurement if Limb is not at Heart Level T...

Страница 99: ...ts WARNING Continuous non invasive blood pressure measurements may cause purpura ischemia and neuropathy in the limb with the cuff Inspect the application site regularly to ensure skin quality and inspect the extremity of the cuffed limb for normal color warmth and sensitivity If any abnormity occurs move the cuff to another site or stop the blood pressure measurements immediately 12 6 Understandi...

Страница 100: ...4 Setting the Pressure Unit Select Unit Setup from the User Maintenance menu In the popup menu select Press Unit and toggle between mmHg and kPa 12 7 5 Switching On NIBP End Tone The monitor can issue a reminder tone at the completion of NIBP measurement The NIBP End Tone is off by default You can switch it on by accessing the NIBP Setup menu 12 8 Assisting Venous Puncture You can use the NIBP cuf...

Страница 101: ...e T1 or T2 connector and the monitor can display the message T1 Sensor Off or T2 Sensor Off and give alarm tones correctly 13 3 Making a Temp Measurement 1 Select an appropriate probe for your patient 2 If you are using a disposable probe connect the probe to the temperature cable 3 Plug the probe or temperature cable to the temperature connector 4 Attach the probe to the patient correctly 5 Check...

Страница 102: ...Temperature unit ºC or ºF 3 T1 Temperature channel 1 Displays the temperature measured at temperature channel 1 4 T2 Temperature channel 2 Displays the temperature measured at temperature channel 2 5 TD Temperature difference namely the difference between temperature 1 and temperature 2 13 5 Setting the Temperature Unit Select Unit Setup from the User Maintenance menu In the popup menu select Temp...

Страница 103: ... frequency surgical procedures ensure that the monitor s cables and transducers never come into contact with the high frequency surgical units When using accessories their operating temperature should be taken into consideration For details refer to instructions for use of accessories 14 3 Zeroing the Transducer To avoid inaccurate pressure readings the monitor requires a valid zero Zero the trans...

Страница 104: ...cy may recommend that the ICP transducer is zeroed less frequently than other transducers 14 4 Setting Up the Pressure Measurement 1 Plug the pressure cable into the IBP connector 2 Prepare the flush solution 3 Flush the system to exhaust all air from the tubing Ensure that the transducer and stopcocks are free of air bubbles WARNING If air bubbles appear in the tubing system flush the system with...

Страница 105: ... 14 5 Understanding the IBP Display The IBP measurement is displayed on the monitor as a waveform and numeric pressures The figure below shows the waveform and numerics for the Art pressure For different pressures this display may be slightly different 1 Waveform 2 Pressure unit 3 Systolic pressure 4 Diastolic pressure 5 Mean pressure 6 PPV measurement Heparinized fluid bag Flushing set Valve Pres...

Страница 106: ...icular pressure P1 to P4 Non specific pressure label NOTE When two pressures are deteted having the same label the monitor changes one pressure label to a currently unused one 14 6 2 Setting the Pressure Label Order Select IBP Label Order Setup from the parameter setup menu to set the display order of the pressure labels The default display order is Art pArt CVP pCVP ICP PA AO UAP FAP BAP LV LAP R...

Страница 107: ...RNING This monitor can calculate PPV from beat to beat values of any arterial pulsatile pressure The circumstances under which the calculation of a PPV value is clinically meaningful appropriate and reliable must be determined by a physician The clinical value of the derived PPV information must be determined by a physician According to recent scientific literature the clinical relevance of PPV in...

Страница 108: ...ight Scale and then set the scales for the overlapped waveforms The left scale is for Art LV Ao FAP BAP UAP and the arterial waveforms of P1 P4 the right scale is for CVP ICP LAP RAP UVP and the venous waveforms of P1 P4 Set CVP Scale individually if CVP waveform is combined and CVP unit is different from IBP unit Set PA Scale individually if PA waveform is combined Set Gridlines to On or Off to s...

Страница 109: ...mended 3 Select the PA parameter window or waveform area to enter its setup menu Then select PAWP to enter the PAWP measurement window You can also enter the PAWP measurement window from the P1 P4 parameter window NOTE After entering the PAWP measurement window the monitor will turn off the PA alarm automatically 14 8 2 Setting Up the PAWP Measurement 1 Wedge the flotation catheter into the pulmon...

Страница 110: ...nter the PAWP Setup menu In this menu you can Select a ECG lead wave as the first reference wave Select a respiration wave as the second reference wave Select a sweep speed for the displayed waveform Change the size of the PA waveform by adjusting the scale height ...

Страница 111: ...iratory gas sample is measured with a photodetector From the amount of IR light measured the concentration of CO2 is calculated There are two methods for measuring CO2 in the patient s airway 1 Mainstream measurement uses a CO2 sensor attached to an airway adapter directly inserted into the patient s breathing system 2 Sidestream Microstream measurement samples expired patient gas at a constant sa...

Страница 112: ...ne and therefore prevents them from entering the module If the collected water reaches a certain amount you should drain it to avoid blocking the airway The watertrap has a filter preventing bacterium water and secretions from entering the module After long term use dust or other substances may compromise the performance of the filter or even block the airway In this case replace the watertrap It ...

Страница 113: ...andby mode If the monitor exits the standby mode the CO2 module will also exit the standby mode If the CO2 module enters or exits the standby mode it will not affect the monitor To enter or exit the standby mode manually select Operating Mode in the CO2 Setup menu and then toggle between Standby and Measure When you set the sidestream CO2 module to the strandby mode the CO2 gas sample intake pump ...

Страница 114: ...lect CO2 Setup 2 According to the actual condition set the concentration required for the following compensations O2 Compen N2O Compen Des Compen For the microstream CO2 module gas compensations are not required 15 3 5 Setting up Humidity Compensation Sidestream and microstream CO2 modules are configured to compensate CO2 readings for either Body Temperature and Pressure Saturated Gas BTPS to acco...

Страница 115: ...en Single Breath 10 s 20 s and 30 s for microstream CO2 module only Single Breath EtCO2 and FiCO2 are calculated for every breath 10 s or 20 s or 30 s EtCO2 and FiCO2 are calculated using 10 20 or 30 seconds of data 15 3 8 Setting the Flow Rate For the sidestream CO2 module you can change the sampling rate of respiratory gas in the patient s airway by setting the flow rate To set the flow rate ent...

Страница 116: ...ssure based on the actual situation as follows 1 Select Main Menu Maintenance User Maintenance enter the required password Maintain CO2 Calibrate CO2 2 Select Barometric Pressure and then enter the value of barometric pressure to which the monitor is exposed to 15 6 Measurement Limitations The following factors may influence the accuracy of measurement Leaks or internal venting of sampled gas Mech...

Страница 117: ...sthetics To remove the sample gas to a scavenging system connect an exhaust tube to the gas outlet connector of the module 15 10 Zeroing the Sensor The zero calibration eliminates the effect of baseline drift during CO2 measurement exerted on the readings and therefore maintains the accuracy of the CO2 measurements 15 10 1 For Sidestream and Microstream CO2 Modules For sidestream and microstream C...

Страница 118: ...80 6 437 316 7 488 229 7 726 954 and their foreign equivalents Additional patent applications pending No Implied License Possession or purchase of this device does not convey any express or implied license to use the device with unauthorized CO2 sampling consumables which would alone or in combination with this device fall within the scope of one or more of the patents relating to this device and ...

Страница 119: ... either Select the Scroll button and then rotate the Knob clockwise or counter clockwise or Directly select the or beside the Scroll button using a mouse or through the touchscreen The frozen waveforms will scroll left or right accordingly And meanwhile at the lower right corner of the bottommost waveform there is an upward arrow The freeze time is displayed below the arrow and the initial frozen ...

Страница 120: ... Waveforms 1 In the Freeze menu select in turn Wave 1 Wave 2 and Wave 3 and then select your desired waveforms 2 Select the Record button The selected waveforms and all numerics at the frozen time are printed out by the recorder ...

Страница 121: ...m low level alarm event Green represents manual event In this review window Select Trend Group and you can select a trend group for viewing in the popup menu If Custom 1 or Custom 2 is selected you can further select Define Trend Group Then you can select the parameters for viewing in the popup menu You can set the time length of the review window by selecting Zoom You can set the number of waves ...

Страница 122: ... 15 min 30 min 1 h 2 h or 3 h select to view up to 120 hours of tabular trends at your selected resolution NIBP select to view the tabular trends when NIBP measurements were acquired To browse the tabular trends you can either Select or beside Scroll to drag the scrollbar left or right to navigate through the trend database or Select or to scroll left or right to navigate through the trend databas...

Страница 123: ...ording length respectively before and after the event trigger time are stored In this window You can view the desired events by selecting Event You can view the desired events according to the level by selecting Level After selecting the desired event you can select Details to access the following window In this window the waveform area displays the waveforms related to the event and the parameter...

Страница 124: ...beside the Scroll button to move the cursor one step left or right to navigate through the waveforms or Select or to move the cursor one page left or right to navigate through the waveforms A time indicating your current position is displayed at the top of the waveform area Numeric measurement values corresponding to the cursor location are displayed in the parameter area and change as the cursor ...

Страница 125: ...being monitored by other monitors Any operation in a calculation window does not affect the monitoring by the local monitor WARNING After the calculation is finished verify the entered values are correct and the calculated values are appropriate We assume no responsibility for any consequences caused by wrong entries and improper operations 18 2 Dose Calculations 18 2 1 Performing Calculations To ...

Страница 126: ...s follows Drug A B C Aminophylline Dobutamine Dopamine Epinephrine Isuprel Lidocaine Nipride and NItroglycerin use the unit series g mg and mcg Drug D Heparin and Pitocin use the unit series Unit KU kilo units and MU million units Drug E uses the unit mEq milli equivalents You must select the proper drug name A B C D or E according to the units when you define a drug not listed in this library 18 ...

Страница 127: ...lect Range to view its normal range in the unit field Invalid values are displayed as In the Oxygenation Calculation window you can Change the pressure unit Hb unit and oxygen content unit by selecting Press Unit Hb Unit and OxyCont Unit and then selecting the appropriate settings The changes take effect automatically Trigger a recording by selecting the Record button The currently displayed oxyge...

Страница 128: ...en content Hb 1 34 0 031 PAO2 Qs Qt venous admixture 100 1 34 Hb 1 SaO2 100 0 031 PAO2 PaO2 1 34 Hb 1 SvO2 100 0 031 PAO2 PvO2 18 4 Ventilation Calculations 18 4 1 Performing Calculations To perform a ventilation calculation 1 Select Main Menu Calculations Ventilation or select the Calculations QuickKey Ventilation 2 Enter values for calculation If the monitor is connected to an anesthesia machine...

Страница 129: ...spheric pressure 18 4 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula PAO2 mmHg partial pressure of oxygen in the alveoli ATMP 47 FiO2 100 PaCO2 FiO2 100 1 FiO2 100 RQ AaDO2 mmHg alveolar arterial oxygen difference PAO2 PaO2 Pa FiO2 mmHg oxygenation ratio 100 PaO2 FiO2 a AO2 arterial to alveolar oxygen ratio 100 PaO2 PAO2 MV L min minute volume TV RR 1000 Vd ml volume ...

Страница 130: ...ull spelling HR bpm heart rate PAWP mmHg pulmonary artery wedge pressure Art Mean mmHg artery mean pressure PA Mean mmHg pulmonary artery mean pressure CVP mmHg central venous pressure EDV ml end diastolic volume Height cm height Weight kg weight 18 5 3 Calculated Parameters and Formulas Abbreviation Unit Full spelling Formula BSA m2 body surface area Wt 0 425 Ht 0 725 0 007184 SI ml m2 stroke ind...

Страница 131: ...iew its normal range in the unit field Invalid values are displayed as In the Renal Calculation window you can Trigger a recording by selecting the Record button The currently displayed renal calculations are printed out by the recorder Review the previously performed calculations by selecting Review 18 6 2 Entered Parameters Abbreviation Unit Full spelling URK mmol L urine pstassium URNa mmol L u...

Страница 132: ...r Cr BUN Cr is a ratio under the unit of mol 18 7 Understanding the Review Window With the review feature you can review oxygenation ventilation hemodynamic and renal calculations The review window for each calculation is similar Take the hemodynamic calculations review window for example you can access it by selecting Review in the Hemodynamic Calculation window In this review window You can sele...

Страница 133: ...n the monitor is switched off Flashes if an error occurred to the recorder e g the recorder runs out of paper 3 Paper outlet 4 Latch 5 Recorder door 19 2 Overview of Recording Types By the way recordings are triggered the recordings can be classified into the following categories Manually triggered realtime recordings Timed recordings Alarm recordings triggered by an alarm limit violation or an ar...

Страница 134: ...lly stopped recording print two columns of at the end of the report Manually or abnormally stopped recording print one column of at the end of the report 19 4 Setting up the Recorder 19 4 1 Accessing the Record Setup Menu By selecting Main Menu Record Setup you can access the Record Setup menu 19 4 2 Selecting Waveforms for Recording The recorder can record up to 3 waveforms at a time You can sele...

Страница 135: ...All Tasks All queued recording tasks are cleared and the current recording is stopped 19 5 Loading Paper 1 Use the latch at the upper right of the recorder door to pull the door open 2 Insert a new roll into the compartment as shown below 3 Close the recorder door 4 Check if paper is loaded correctly and the paper end is feeding from the top CAUTION Use only specified thermal paper Otherwise it ma...

Страница 136: ...e deposits of paper debris may collect on the printhead compromising the print quality and shortening the lifetime of the roller Follow this procedure to clean the printhead 1 Take measures against the static electricity such as Disposable Wrist Strap for the work 2 Open the recorder door and take out the paper 3 Gently wipe around the printhead using cotton swabs dampened with alcohol 4 After the...

Страница 137: ... a USB drive To export the log 1 Connect a USB drive to the monitor s USB connector 2 Select Main Menu Maintenance User Maintenance enter the required password Others 3 Select Export Log 20 3 Transferring Data You can transfer the patient data saved in the monitor to a PC via a crossover network cable or within a LAN for data management review or print 20 3 1 Data Export System You must install th...

Страница 138: ...e same LAN and acquire the PC s IP address 2 Make sure that the data export system is active on the PC Follow the same procedure as via a crossover network cable to transfer data 20 4 Nurse Call The monitor provides a nurse call connector to output nurse call signal when a userdefined alarm occurs To obtain nurse call signal use the nurse call cable PN 009 003116 00 we supply to connect the hospit...

Страница 139: ...st reliable alarm notification combines audible and visual alarm indications with the patient s clinical condition NOTE If no setting is selected from Alm Lev or Alarm Cat no nurse call signal will be triggered whatever alarms occur 20 5 Network Connection 20 5 1 Setting the Network Type The monitor supports both wired and wireless network To set the network type you can select Main Menu Maintenan...

Страница 140: ...e monitor s IP address randomly If you want to know details about IP address setup contact the technical personnel in charge of the CMS NOTE The design installation restruction and maintenance of the wireless network s distribution shall be performed by authorized service personnel of our company The existence of obstacles such as wall will exert impact on data transferring or even cause network i...

Страница 141: ...o be charged In this case the monitor provides an alarm message Indicates that the battery is almost depleted and needs to be charged immediately Otherwise the monitor will shut down automatically Indicates that no battery is installed The capacity of the internal battery is limited If the battery charge is too low a technical alarm will be triggered and the message or displayed At this moment app...

Страница 142: ...tal power In 6 months the battery power must be depleted before the Lithium Ion battery is fully charged Then run the monitor on this fully charged battery When its battery power becomes 50 of the total power take out the battery from the monitor and store it WARNING Keep the battery out of the reach of children Use only the battery specified by the manufacturer If the battery shows signs of damag...

Страница 143: ...re monitor repairs or whenever the battery is suspected as being the source of the problems The performance of a rechargeable battery may deteriorate over time To check the performance of a battery follow this procedure 1 Disconnect the monitor from the patient and stop all monitoring or measuring 2 Apply AC power to the monitor and allow the battery to charge uninterrupted for 10 hours 3 Remove A...

Страница 144: ...21 4 WARNING Do not disassemble batteries or dispose of them in fire or cause them to short circuit They may ignite explode leak or heat up causing personal injury ...

Страница 145: ...s Always dilute according the manufacturer s instructions or use lowest possible concentration Do not immerse part of the equipment into liquid Do not pour liquid onto the equipment or accessories Do not allow liquid to enter the case Never use abrasive materials such as steel wool or silver polish or erosive cleaners such as acetone or acetone based cleaners WARNING Be sure to shut down the syste...

Страница 146: ...t cloth dampened with the cleaner 4 Wipe off all the cleaning solution with a dry cloth after cleaning if necessary 5 Dry your equipment in a ventilated cool place 22 3 Disinfecting Disinfection may cause damage to the equipment and is therefore not recommended for this monitor unless otherwise indicated in your hospital s servicing schedule Cleaning equipment before disinfecting is recommended Th...

Страница 147: ...monitor is repaired or upgraded a thorough inspection should be performed by qualified service personnel to ensure the reliability Follow these guidelines when inspecting the equipment Make sure that the environment and power supply meet the requirements Inspect the equipment and its accessories for mechanical damage Inspect all power cords for damage and make sure that their insulation is in good...

Страница 148: ...e measurement is incorrect 2 Following any repairs or replacement of relevant module 3 At least once every two years Note At least once a year is recommended for NIBP and CO2 Resp performance test SpO2 test NIBP test Pressure check Leakage test Temp test IBP test Performance test Sidestream and Microstream CO2 tests Leakage test Performance test Nurse call function test If the user suspects that t...

Страница 149: ... out the square wave and wave scale and then measure the difference between them if necessary If the difference exceeds 5 contact your service personnel 23 5 NIBP Leakage Test The NIBP leakage test checks the integrity of the system and of the valve It is required at least once a year or when you doubt the measured NIBP Contact your service personnel to perform NIBP leakage test 23 6 NIBP Accuracy...

Страница 150: ... appear at different positions of the screen 3 Select each as it appears on the screen 4 After the calibration is completed the message Screen Calibration Completed is displayed Select Ok to confirm the completion of the calibration 23 9 Electrical Safety Tests Refer to E Electrical Safety Inspection ...

Страница 151: ...tamination and affect the measurement accuracy Check the accessories and their packages for any sign of damage Do not use them if any damage is detected 24 1 ECG Accessories ECG Electrodes Model Quantity Patient Category Part No Crocodile clip 9101 20 58104 12 Pin Separable Trunk Cables Leadwire supported Compatible with Type Part No 3 leadwire AHA Defibrillation proof 0010 30 42720 3 leadwire AHA...

Страница 152: ...e Remarks Part No Nellcor 8 pins 0010 20 42712 SpO2 Sensors The SpO2 sensor material that patients or other staff will come into contact with has undertaken the bio compatibility test and is verified to be in compliance with ISO 10993 1 Nellcor SpO2 Module Reusable VetSat V Sat 1 1 m clip 9101 10 58134 The extension cable must be used with the matching SpO2 sensor Wavelength emitted by the sensors...

Страница 153: ...Bladder Width cm Part No CM1500A 3 1 to 5 7 2 2 001B 30 70692 20 pcs box CM1500B 4 3 to 8 0 2 9 001B 30 70693 20 pcs box CM1500C 5 8 to 10 9 3 8 001B 30 70694 20 pcs box CM1500D 7 1 to 13 1 4 8 001B 30 70695 20 pcs box 10 to 19 7 2 0683 14 0001 01 18 to 26 9 8 0683 14 0002 01 25 to 35 13 1 0683 14 0003 01 33 to 47 16 5 0683 14 0004 01 46 to 66 20 5 0683 14 0005 01 25 to 35 0683 14 0006 01 33 to 47...

Страница 154: ...lable from our company If you want to purchase other accessories contact respective manufacturers and make sure if these accessories are approved for sale in local Manufacturer Accessories Smith Medical Medex MX961Z14 Logical Cable to be used in connection with the Adapter Cable 0010 20 42795 MX960 Reusable Transducer Kit MX261 Logical Clamp For Transducer Bracket MX262 Logical Clamp For 2 Transdu...

Страница 155: ...4 Disposable Holder for DPT 24 6 CO2 Accessories Sidestream CO2 module Material Remark Part No DRYLINE Watertrap Reusable 9200 10 10530 DRYLINE Watertrap 9200 10 10574 Sampling Line 2 5m Disposable 9200 10 10533 Sampling Line 2 5m 9200 10 10555 Nasal CO2 Sample Cannula M02A 10 25937 Nasal CO2 Sample Cannula M02A 10 25938 Nasal CO2 Sample Cannula M02B 10 64509 DRYLINE Airway Adapter Straight dispos...

Страница 156: ...utput cable 009 003117 00 Synchronization cable 009 003118 00 LCD display 17 0000 10 11284 USB drive 4G 023 000218 00 Recorder TR6F 30 67306 Thermal paper A30 000001 Wall mount bracket for external display 045 000936 00 Transport stand for rolling stand 045 003428 00 Quick Release for wall mount 045 003424 00 M series wall mount with Quick Release 045 003427 00 ...

Страница 157: ...r IPX1 A 1 2 Environmental Specifications Main unit Item Operating conditions Storage conditions Temperature 0 to 40 20 to 60 Relative humidity noncondensing 15 to 95 10 to 95 Barometric mmHg 427 5 to 805 5 120 to 805 5 Microstream CO2 module Item Operating conditions Storage conditions Temperature 0 to 40 20 to 60 Relative humidity noncondensing 15 to 95 10 to 95 Barometric mmHg 430 to 790 430 to...

Страница 158: ... hours to 100 Shutdown delay at least 5 min after a low battery alarm first occurs Battery optional configuration Battery Type Chargeable Lithium Ion 11 1DVC 4 5 Ah Run time 4 h when powered by a new fully charged battery 25 SpO2 cable connected ECG cable and Temp cable not connected auto NIBP measurements at an interval of 15 minutes Charge time Less than 7 5 hours to 90 Less than 8 hours to 100 ...

Страница 159: ... waveform channels Maximum 3 A 4 3 LEDs Alarm lamp 1 two color coded yellow and red Power on LED 1 green AC power LED 1 green Battery LED 1 green A 4 4 Audio Indicator Speaker Give alarm tones 45 to 85 dB key tones QRS tones support PITCH TONE and multi level tone modulation alarm tones comply with IEC60601 1 8 A 4 5 Monitor Interface Specifications Power 1 AC power input connector Wired network 1...

Страница 160: ...ing and falling time 1 ms Defib Sync Pulse Output impedance 100 Ω Max time delay 35 ms R wave peak to leading edge of pulse Amplitude High level 3 5 to 5 V providing a maximum of 10 mA output current Low level 0 5 V receiving a maximum of 5 mA input current Pulse width 100 ms 10 Rising and falling time 1 ms Alarm output Network connector Alarm delay time from the monitor to remote equipment The al...

Страница 161: ...ostic mode Monitor mode Surgical mode ST mode 0 05 to 150 Hz 0 5 to 40 Hz 1 to 20 Hz 0 05 to 40 Hz Common mode rejection ratio with Notch off Diagnostic mode Monitor mode Surgical mode ST mode 90 dB 105 dB 105 dB 105 dB with Notch on Notch 50 60 Hz Differential input impedance 5 MΩ Input signal range 8 mV peak to peak value Accuracy of reappearing input signal Based on EC11 to determine system tot...

Страница 162: ...ichever is greater Sensitivity 200μV lead II HR averaging method In compliance with the requirements in Clause 4 1 2 1 d of ANSI AAMI EC13 the following method is used If the last 3 consecutive RR intervals are greater than 1200 ms the 4 most recent RR intervals are averaged to compute the HR Otherwise heart rate is computed by subtracting the maximum and minimum ones from the most recent 12 RR in...

Страница 163: ...use Irr Rhythm ST Segment Analysis Not available in USA Measurement range 2 0 to 2 0 mV RTI Accuracy 0 8 to 0 8 mV Beyond this range 0 02 mV or 10 whichever is greater Not specified Refreshing rate 10 s Resolution 0 01 mV A 7 2 Resp Technique Trans thoracic impedance Lead Options are lead I and II The default is lead II Respiration excitation waveform 300 µA RMS 62 8 kHz 10 Baseline impedance rang...

Страница 164: ...n 1 Accuracy 70 to 100 3 0 to 69 Not specified Refreshing rate 1 s PI measurement range 0 05 to 20 Masimo SpO2 Module Standards Meet standards of ISO9919 SpO2 measurement range 1 to 100 Resolution 1 Accuracy 70 to 100 3 measured without motion 70 to 100 3 measured with motion 1 to 69 Not specified Refreshing rate 1 s SpO2 averaging time 2 4 s 4 6 s 8 s 10 s 12 s 14 s 16 s Low perfusion conditions ...

Страница 165: ...easurement range 25 to 240 bpm Resolution 1 bpm Accuracy 3 bpm measured without motion 5 bpm measured with motion Refreshing rate 1 s SPO2 averaging time 2 4 s 4 6 s 8 s 10 s 12 s 14 s 16 s Low perfusion conditions Pulse amplitude 0 02 Light penetration 5 Low perfusion PR accuracy 3 bpm PR from Nellcor SpO2 Module Measurement range 20 to 300 bpm Resolution 1 bpm Accuracy 20 to 250 bpm 3 bpm 251 to...

Страница 166: ...deviation 8 mmHg Resolution 1mmHg Initial cuff inflation pressure range mmHg Big Medium Small 80 to 280 80 to 210 60 to 140 Default initial cuff inflation pressure mmHg Big Medium Small 160 140 90 Software overpressure protection Big Medium Small 297 3 mmHg 240 3 mmHg 147 3 mmHg PR Measurement range 40 to 240 bpm Resolution 1 bpm Accuracy 3bpm or 3 whichever is greater Alarm limit Range mmHg Step ...

Страница 167: ...n 0 1 Accuracy 0 1 without probe Refreshing rate 1 s Minimum time for accurate measurement Body surface 100 s Body cavity 80 s Alarm limit Range Step T1 T2 High low limit 1 to 50 0 1 T1 T2 Low 0 1 to high limit 1 TD High 0 1 to 50 A 7 7 IBP Standards Meet standard of EN60601 2 34 IEC60601 2 34 Technique Direct invasive measurement IBP Measurement range 50 to 300 mmHg Resolution 1 mmHg Accuracy 2 o...

Страница 168: ... 2 5 meter sampling line 400 ms 70 ml min 330 ms 100 ml min 300 ms 120 ml min 240 ms 150 ml min Gas sampling delay time Measured with a watertrap and a 2 5 meter sampling line 4 s 100 ml min 4 5 s 70 ml min awRR measurement range 0 to 120 rpm awRR measurement precision 2 rpm Apnea time 10 s 15 s 20 s 25 s 30 s 35 s 40 s Note The response time is the sum of the rise time and the delay time Effect o...

Страница 169: ...ce of interfering gases the above accuracy is maintained to within 4 Resolution 1 mmHg Sample flow rate 7 5 15 50 ml min Initialization time 30 s typical Response time Measured with a FilterLine of standard length 2 9 s typical 4 5 s Maximum The response time is the sum of the rise time and the delay time Rise time 190 ms 10 to 90 Delay time 2 7 s typical awRR measurement range 0 to 150 rpm awRR m...

Страница 170: ...A 14 FOR YOUR NOTES ...

Страница 171: ...mplitude provided in technical specifications erroneous measurements could result Portable and mobile communication equipment may affect the performance of this device Other devices that have RF transmitter or source may affect this device e g cell phones PDAs and PCs with wireless function Guidance and Declaration Electromagnetic Emissions The device is intended for use in the electromagnetic env...

Страница 172: ...put output lines 2 kV for power supply lines 1 kV for input output lines Mains power quality should be that of a typical commercial or hospital environment Surge IEC 61000 4 5 1 kV line s to line s 2 kV line s to earth 1 kV line s to line s 2 kV line s to earth Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 5 UT 95 dip in UT for 0 5 cycle 40 UT 6...

Страница 173: ... with the following symbol Note 1 At 80 MHz to 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Note 3 The device that intentionally receives RF electromagnetic energy at the exclusion band 2395 825MHz 2487 645MHz is e...

Страница 174: ...paration distance d in metres m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer Note 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies Note 2 These guidelines may not apply in all situations Electromagnetic propag...

Страница 175: ...not expressly approved by Mindray may cause harmful radio frequency interference and void your authority to operate this equipment The maximum antenna gain permitted complies with the e i r p limits as stated in RSS 210 The maximum antenna gain permitted complies with the e i r p limits specified for point to point operation as stated in RSS 210 The radio device used in this product is in complian...

Страница 176: ...B 6 FOR YOUR NOTES ...

Страница 177: ... monitor s operating mode Column C refers to the settings that can be changed in configuration management Column M refers to the settings that can be changed in monitoring mode C 1 Parameters Configuration C 1 1 ECG ECG Setup Item Name O M General User Defaults C M Lead Set Auto Alm Source HR Alarm On Alm Lev Med HR PR High 200 HR PR Low 100 Sweep 25 mm s Beat Vol 2 Paced No Notch Filter Weak Gain...

Страница 178: ...chy 160 Extreme Brady 35 Vbrd Rate 40 Vbrd PVCs 5 Pause Time 2 Arrhythmia Alarm Settings PVCs min Alarm Off R on T Alarm Off Nonsus Vtac Alarm Off Vent Rhythm Alarm Off Bigeminy Alarm Off Trigeminy Alarm Off Asystole Alarm On VFib VTac Alarm On Vtac Alarm On Vent Brady Alarm On Extreme Tachy Alarm On Extreme Brady Alarm On X Alarm Off Asystole Alm Lev High VFib VTac Alm Lev High Vtac Alm Lev High ...

Страница 179: ...hythmia event Refer to the Specifications chapter for details The X in X Alm Lev refers to all arrhythmia events except for those specially marked ones C 1 2 RESP Item Name O M General User Defaults C M Alarm On Alm Lev Med Sweep 6 25 mm s Lead II Gain X2 RR High 100 RR Low 30 Apnea Delay 15 Detection Mode Auto RR Source Auto C 1 3 PR Item Name O M General User Defaults C M Alarm On Alm Lev Med HR...

Страница 180: ...imo 8 s Sat Seconds Nellcor 0 s PI Zoom No C 1 5 Temp Item Name O M General User Defaults C M Alarm On Alm Lev Med T1 T2 High ºC 38 0 T1 T2 Low ºC 35 0 TD High ºC 2 0 C 1 6 NIBP Item Name O M General User Defaults C M Alarm On Alm Lev Med Interval 15 min NIBP End Tone Off Clock On Cuff Press mmHg Big 80 Medium 60 Small 40 Initial Pressure mmHg Big 160 Medium 140 Small 90 Alarm Limits NIBP S High B...

Страница 181: ...Small 20 C 1 7 IBP Item Name O M General User Defaults C M IBP 1 Label Art IBP 2 Label CVP Alarm On Alm Lev Med P1 Measure All P2 Measure All P3 Measure Mean P4 Measure Mean PPV Measurement Off PPV Source Auto Sensitivity Med Sweep 25 mm s Sweep PAWP measurement window 12 5 mm s Filter 12 5 Hz Gridlines Off IBP Label Order Setup Art pArt CVP pCVP ICP PA AO UAP FAP BAP LV LAP RAP UVP P1 P2 P3 P4 Ar...

Страница 182: ...PA M Low mmHg 12 PA D High mmHg 4 PA D Low mmHg 4 CVP LAP RAP ICP UVP P3 P4 Venous Pressure Alarm Limits IBP M High mmHg 4 IBP M Low mmHg 0 Art Ao BAP FAP LV P1 P2 Arterial Pressure Scale Scale mmHg 0 160 PA Scale Scale mmHg 0 30 CVP LAP RAP ICP UVP Scale Scale mmHg 0 20 UAP P3 P4 Venous Pressure Scale Scale mmHg 0 80 IBP Overlapping Left Scale Scale mmHg 0 160 IBP Overlapping Right Scale Scale mm...

Страница 183: ... BTPS Compen Off N2O Compen 0 O2 Compen 21 Des Compen 0 Microstream CO2 Setup BTPS Compen Off Max Hold 20 s Auto Standby min 0 Alarm Limits EtCO2 High mmHg 45 EtCO2 Low mmHg 30 FiCO2 High mmHg 4 RR High 100 RR Low 30 C 2 Routine Configuration C 2 1 Alarm Item Name O M General User Defaults C M Alm Volume 2 Reminder Vol Low Recording Length 16 s Apnea Delay 15 s Alarm Delay 6 s ST Alarm Delay 30 s ...

Страница 184: ... ECG2 3 SpO2 PR 4 Any IBP 5 Any IBP 6 CO2 11 Resp Select Parameters for Big Numerics Screen Parameter 1 ECG Parameter 2 SpO2 PR Parameter 3 Resp Parameter 4 NIBP C 2 3 Waveform Item Name O M General User Defaults C M Parameter Wave Colour ECG Green NIBP White SpO2 Cyan PR Cyan TEMP White Art Ao UAP FAP BAP LV P1 P4 arterial pressure Red PA Yellow CVP ICP P1 P4 venous pressure Blue LAP Purple RAP O...

Страница 185: ...orm 1 II Waveform 2 I Waveform 3 Pleth C 2 6 Record Item Name O M General User Defaults C M Length 8 s Interval Off Paper Speed 25 mm s Alm Rec X Off X represents a parameter label C 2 7 Others Item Name O M General User Defaults C M Brightness 5 Key Volume 2 View Other Patient Auto Alarm On C 3 User Maintenance Items Item Name O M General User Defaults C M Changing Bed No Protected Atmospheric Pr...

Страница 186: ... Lethal Arrh OFF Disable Silence Other Bed On Extended Arrh Enable Wave Line Mediate ECG Standard AHA Notch Freq 50 Hz Data Transfer Method USB Drive Transferred Data Length 4 h Para Switch Authority Unprotected Parameter Switch When Para Switch Authority is set to Protected Unselected When Para Switch Authority is set to Unprotected Selected SpO2 Tone Mode 1 Signal Type Continuous Contact Type No...

Страница 187: ...a measurement or parameter label such as ECG NIBP HR ST I PVCs RR SpO2 PR etc In the Cause and Solution column corresponding solutions are given instructing you to troubleshoot problems If the problem persists contact your service personnel D 1 Physiological Alarm Messages Measurement Alarm Messages L Cause and Solution XX XX Too High M XX value has risen above the high alarm limit or fallen below...

Страница 188: ...respiration signal was so weak that the monitor cannot perform respiration analysis Check the patient s condition and the RM connections D 2 Technical Alarm Messages Measurement Alarm Message L I Cause and Solution XX XX SelfTest Err H C An error occurred to the XX module or there is a problem with the communications between the module and the monitor Re plug the module and restart the monitor or ...

Страница 189: ...d L A The respiration circuit is disturbed Restart the monitor Temp Temp Cal Err H C A calibration failed Restart the monitor T1 Sensor Off L A The Temp sensor has become detached from the patient or the module Check the sensor connections T2 Sensor Off L A SpO2 SpO2 Sensor Off L B The SpO2 sensor has become detached from the patient or the module or there is a fault with the SpO2 sensor or an uns...

Страница 190: ...orm analysis correctly Check the patient s condition and NIBP connections or replace the cuff NIBP Timeout L A NIBP Measure Failed L A NIBP Illegally Reset L A An illegal reset occurred during NIBP measurement Check if the airway is occluded IBP YY Sensor Off L A Check the sensor connection and reconnect the sensor YY Disconnected H C The liquid way is disconneted from the patient or the three way...

Страница 191: ...s connected CO2 Main Board Err H C There is a problem with the CO2 module Re plug the module or restart the monitor CO2 Checking Sensor L C CO2 Replace Scrubber Pump L C CO2 15V Overrange H C CO2 Hardware Err H C Power 12V Too High H C There is a problem with the system power supply Restart the monitor 12V Too Low H C 5V Too High H C 5V Too Low H C 3 3V Too High H C 3 3V Too Low H C Battery Too Lo...

Страница 192: ...ad Hot L C The recorder has been working for too long time Stop the recording and resume the recording till the recorder s printhead cools down Rec Paper Wrong Pos L A Re load the recorder paper System System Watchdog Err H C An error occurred to the system Restart the monitor System Software Err H C System CMOS Full H C System CMOS Err H C System FPGA Err H C System Err N H C N is within 2 to 12 ...

Страница 193: ... analyzer also proves to be an excellent troubleshooting tool to detect abnormalities of line voltage and grounding as well as total current loads E 1 Power Cord Plug Test Item Acceptance Criteria The power plug The power plug pins No broken or bent pin No discolored pins The plug body No physical damage to the plug body The strain relief No physical damage to the strain relief No plug warmth for ...

Страница 194: ...tective earth terminal and protective earth terminal of the AC power cord 2 Test the earth resistance with a current of 25 A 3 Verify the resistance is less than limits LIMITS For all countries R 0 2 Ω Maximum E 5 Earth Leakage Test Run an Earth Leakage test on the device being tested before performing any other leakage tests The following outlet conditions apply when performing the Earth Leakage ...

Страница 195: ...on LIMITS For CF applied parts 10μA in Normal Condition 50μA in Single Fault Condition For BF applied parts 100μA in Normal Condition 500μA in Single Fault Condition E 7 Mains on Applied Part Leakage The Mains on Applied Part test applies a test voltage which is 110 of the mains voltage through a limiting resistance to selected applied part terminals Current measurements are then taken between the...

Страница 196: ...ity Normal Condition normal polarity with open neutral Single Fault Condition reverse polarity with open neutral Single Fault Condition normal polarity with open earth Single Fault Condition reverse polarity with open earth Single Fault Condition LIMITS For CF applied parts 10μA in Normal Condition 50μA in Single Fault Condition For BF applied parts 100μA in Normal Condition 500μA in Single Fault ...

Страница 197: ...re hour bpm beats per minute BrPM breaths per minute centigrade cc cubic centimeter cm centimeter dB decibel fahrenheit g gram GTT gutta hr hour hPa hundred pascal Hz hertz inch inch kg kilogram kPa kilopascal l litre lb pound m meter mcg micrograms mEq milli equivalents mg milligrams min minute ml milliliter mm millimeters mmHg millimeters of mercury ms millisecond mV millivolt mW milliwatt ...

Страница 198: ...bbreviations AAMI Association for Advancement of Medical Instrumentation AC altenating current AHA American Heart Association ANSI American National Standard Institue AP access point ARR arrhythmia ART arterial AUX Auxiliary output AwRR Air way respiratory rate BTPS body temperature and pressure saturated CCU critical care unit CH channel CISPR International Special Commmittee on Radio Interferenn...

Страница 199: ...rate HT height IEC International Electrotechnical Commission ID IM IS invasive diastolic brood pressure invasive mean brood pressure invasive systolic brood pressure Ins INS Inspired Minimum InsCO2 Inspired Minimum carbon dioxide ISO International organization for standardization LA L left arm LAP left artria pressure LCD liquid crystal display LED light emitting diode LL F left leg Loop loop read...

Страница 200: ...C premature ventricular complex QRS interval of ventricular depolarization RA R right arm RAM random access memory RAP right atrial pressure Reg test NE2000 registers fail RESP respiration RL N right leg ROM read only memory RR respiration rate S systolic SpO2 arterial oxygen saturation from pulse oximetry SYNC synchronization SYS systolic TEMP temperature TFT Thin Film Technology V C precordial l...

Страница 201: ......

Страница 202: ...PN 046 008143 00 3 0 ...

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