Fukuda Denshi Co DS7100 Patient Monitor User Manual DS71v1 1 FA 06 Parameter 008

Fukuda Denshi Co Ltd Patient Monitor DS71v1 1 FA 06 Parameter 008

Manual 7

6−1Parameter SetupChapter 6− Parameter Setup −Setting the Monitoring Condition ･･････････････2To Display the Parameter Setup Menu･･･････････2Zero Balance of All Pressure Lines (BP1, BP2) ･･･3− ECG −･････････････････････････････････････4ECG Waveform Size and Lead ･････････････････4HR Alarm････････････････････････････････････6Arrhythmia Alarm ･････････････････････････････6Filter Mode Selection･･････････････････････････7HR Average Selection ･････････････････････････8HR Synchronized Indicator (ON/OFF of HRSynchronized Tone)･･･････････････････････････8ECG Source ･････････････････････････････････9Automatic Lead Switching･･････････････････････9Pacemaker Pulse････････････････････････････10QRS Pace Mask･････････････････････････････11ECG Drift Filter ･･････････････････････････････12ON/OFF of Parameter Display･････････････････13− Respiration −･･････････････････････････････14Respiration Waveform Size ･･･････････････････14RR Alarm･･･････････････････････････････････15Apnea Alarm ････････････････････････････････15CVA Detection ･･････････････････････････････16Respiration Source ･･････････････････････････17Impedance Respiration Measurement ･･････････17RR Synchronization Mark ･････････････････････18ON/OFF of Parameter Display･････････････････19− Invasive Blood Pressure (BP1, BP2)−･･････････20BP Scale (BP1, BP2)･････････････････････････20BP Alarm (BP1, BP2)･････････････････････････21Zero Balance of Pressure Lines (BP1, BP2) ･････21Filter Selection (BP1, BP2)････････････････････22Mean BP Display (BP1, BP2)･･････････････････22ECG Source (BP1)･･･････････････････････････23ON/OFF of Parameter Display･････････････････24− SpO2 −････････････････････････････････････25SpO2 Waveform Size･････････････････････････26SpO2 Alarm ･････････････････････････････････26ECG Source ････････････････････････････････27SpO2 Alarm during NIBP Measurement (IgnoreNIBP) ･･････････････････････････････････････27ON/OFF of Parameter Display･････････････････28− Non-Invasive Blood Pressure −･･･････････････29NIBP Automatic Measurement･････････････････29NIBP 1-Minute Interval Measurement･･･････････30Quick SYS Start ･････････････････････････････31NIBP Alarm ･････････････････････････････････31Quick SYS Measurement Duration･････････････32End of Measurement Tone････････････････････33Quick SYS List･･････････････････････････････33PR Display ･････････････････････････････････ 34Mean BP Display････････････････････････････ 341-Minute Measurement Duration･･･････････････ 35NIBP Speed ････････････････････････････････ 35− Temperature −･････････････････････････････36Temperature Alarm ･･････････････････････････ 36ON/OFF of Parameter Display ････････････････37− CO2 Concentration − (DS-7141)････････ 38CO2 Scale ･･････････････････････････････････38EtCO2 (End-Tidal CO2) Alarm ･････････････････ 38InspCO2 (Inspiratory CO2) Alarm ･･･････････････39EtCO2 Average Duration･･････････････････････40Measurement Unit ･･･････････････････････････40CO2 Calibration ･････････････････････････････41Restarting the CO2 Unit ･･････････････････････ 42ON/OFF of Parameter Display ････････････････426Parameter Setup
6−2− Parameter Setup −Setting the Monitoring ConditionThis menu allows setup of measurement condition, waveform size, scale, etc. of ECG, BP, NIBP,SpO2, RESP, TEMP, and CO2.To Display the Parameter Setup MenuPress the Menu → Parameter keys to display the parameter setup menu, and select theparameter. On the parameter setup menu, BP zero balance can be performed.The parameter setup menu for each parameter can be also accessed by pressing the parameterkey where numeric data is displayed. ＜Parameter Setup Menu＞ ＜ECG Parameter Setup Menu＞Parameter Key
6−3Zero Balance of All Pressure Lines (BP1, BP2)1. Open the three-way cock of all pressure transducers to air.2. Press the Zero All BP key.Verify the BP waveform is positioned at zero, and “0”is displayed for the BP value. A message, “BP zerocomplete” will be displayed when the procedure iscomplete. A message, “BP zero failed” will bedisplayed when the process fails. The three-waycock may not be opened to air, artifact may bepresent, or the transducer may be defective.Check the cause and try the zero balance procedureagain.A message, “BP zero drift” will be displayed when theinterface cable is not connected. Check if the cableis firmly connected.3. Close the three-way cock when the zero balance is complete.CAUTION Each time the blood pressure transducer or tubing is replaced, the zerobalance procedure is required to ensure accurate measurements.6Parameter Setup
6−4− ECG −The measurement condition for ECG can be set on this menu.Lead, Size : Sets the waveform size and lead for ECG display and recording.HR Alarm :Sets ON/OFF of HR alarm, and sets upper and lower alarm limit.Arrhy. Alarm :Sets ON/OFF and detection threshold for each arrhythmia alarm.Configuration :Sets the condition for measuring ECG and HR.Arrhy. Learn :The monitor learns the normal QRS at ECG electrode replacement or atmisdetection of the arrhythmia analysis.ECG Waveform Size and Lead1. Press the Lead, Size key to display the size / lead setup menu.2. Select ECG1 or ECG2.If 4-electrode or 5-electrode ECG relay cable is used,2 channels of ECG can be measured.Select ECG1 or ECG2 key to set thewaveform size, lead, baseline position. The keyLED for the selected channel will light.When 3-electrode is used, these keys will not bedisplayed.3. Select the waveform size.Select the waveform size for displaying andrecording.Size ×1/4 ×1/2 ×1×2×4Voltage (10mm) 4mV 2mV 1mV 500uV 250uV
6−5Pressing the Auto key will automatically adjust theECG amplitude to 10mm.The automatic adjustment will function only when thekey is pressed.The automatic adjustment will not function when themonitor is learning arrhythmia.4. Select the lead.The leads can be selected from 3 leads, 6 leads, 7 leads depending on the connected ECG relaycable.ECG Relay Cable Lead3-electrode4-electrode5-electrode5. Set the baseline position.If the waveform is difficult to see due to ECGamplitude, set the 0mV baseline position.The baseline position for the waveform display andrecording will be adjusted.CAUTION? The threshold level for arrhythmia detection changes with ECGwaveform size. Set a proper waveform size for monitoring.When the ECG waveform size is ?1/4, ?1/2, or ?1, the detectionthreshold is 250 µV.When the ECG waveform size is ?2, or ?4, the detection threshold is150 µV.? Automatic size/position of the ECG is effective only at the time the AUTO key is pressed. This does not continually adjust size andposition.6ECG
6−6HR Alarm1. Press the HR Alarm key to display the alarm setup menu.Select ON/OFF of HR/PR alarm, and set the upper and lower alarm limit.The common alarm value for HR measured from ECG, PR measured from SpO2, PR measuredfrom BP can be set.The upper and lower limit can be set in 5 bpm increments.Key Item DescriptionIndividual Alarm Selecting ON will generate the HR/PR alarm.Selecting OFF will not generate the HR/PR alarm.Lower AlarmLimitSets the lower alarm limit (20∼295bpm).Setting a value 20bpm or below will turn OFF thealarm.Upper AlarmLimitSets the upper alarm limit (25∼300bpm).Setting a value 300bpm or above will turn OFF thealarm.AutomaticSetup Automatically sets the upper limit to ＋40bpm, and thelower limit to −40bpm to the current value.Arrhythmia Alarm1. Press the Arrhy. Alarm key to display the arrhythmia alarm setup menu.ON/OFF of each arrhythmia alarm and analysis threshold level can be set.ReferenceRefer to “4. Monitoring Setup Alarm Setup”for details.
6−7Filter Mode SelectionThe waveform frequency characteristic can be selected from Monitor Mode, ESIS Mode, or STDisplay Mode according to the monitoring purpose. Each mode has different frequencycharacteristic. The AC filter is always set to ON.1. Press the Config. key to display the setup menu for selecting the filter.2. Select a frequency characteristic to monitor ECG from Monitor , ESIS , or ST Display .Monitor ModePatient Type Frequency CharacteristicAdult / Child 0.5∼40HzNeonate 1.6∼40HzThis is the standard mode for ECG monitoring. The upper frequency is set to 40Hz to reduceartifact caused by EMG, etc.ESIS ModePatient Type Frequency CharacteristicAdult / Child 1.6∼15HzNeonate 1.6∼15HzThis mode is for ECG monitoring when using electrosurgical instruments. The upper frequency isset to 15Hz which will largely reduce the artifact caused by surgical knife, EMG, etc. However, asthis may also reduce the QRS amplitude at the same time, do not select this mode unless usingelectrosurgical instruments.ST Display ModePatient Type Frequency CharacteristicAdult / Child 0.05∼40HzSelect this mode if ST measurement is the main purpose of ECG monitoring.As the lower frequency is set to 0.05Hz, ST level can be accurately measured. If “Neonate” isselected as patient type, this mode can not be selectedNOTEWhen the filter setup is changed, a notch will appear on the ECG waveform dueto the change in frequency characteristic.6ECG
6−8HR Average SelectionThe averaging method of HR measured from ECG can be selected.1. Press the Config. key to display the setup menu for HR Average selection.2. Select Instant or Average .Selecting Instant will display the HR measured from RR interval of each heartbeat.Selecting Average will display the HR measured from 6 seconds of heartbeat for adult andchild, and 3 seconds of heartbeat for neonate.HR Synchronized Indicator (ON/OFF of HR Synchronized Tone)The HR mark synchronized to ECG or PR can be displayed inside the parameter key.ON/OFF of HR synchronized tone can be also set.HR Mark1. Press the Config. key to display the setup menu for HR synchronized indicatorselection.2. Select ON or OFF . OFF will not display the synchronized mark. The synchronized tone will not be generated. ON will display the synchronized mark. The synchronized tone will be generated.
6−9ECG SourceThe ECG source to display on the home display can be selected.The alarm will be generated based on this selection.The tabular trend and graphic trend will be also based on this selection.1. Press the Config. key to display the setup menu for selecting the ECG source.2. Select a parameter.Selecting ECG will measure the HR from ECG.“HR” will be displayed inside the parameter key.Selecting SpO2 will measure the PR from SpO2.“PR_SpO2” will be displayed inside the parameter key.Selecting BP1 will measure the PR from BP1.“PR_BP” will be displayed inside the parameter key.Selecting Auto will automatically set the measurable HR source in the priority of ECG＞SpO2＞BP.Automatic Lead SwitchingBy setting the Automatic Lead Switching ON, a new ECG lead will be automatically set when theelectrode comes off. When the lead off condition occurs, the “Check Electrodes” message willbe displayed and a new ECG lead will be automatically set if the Automatic Lead Switching is setto ON.Lead SwitchingAuto Lead SelectedType Electrode Off ECG1 ECG2RA／RA+C Ⅲ ⅢLA／LA+C Ⅱ Ⅱ5-electrode cableCⅡaVRRA Ⅲ Ⅲ4-electrode cable LA Ⅱ Ⅱ6ECG
6−101. Press the Config. → Page Down keys to display the setup menu for setting the autolead switching.2. Select ON or OFF . OFF will not switch the lead when an electrode comes off. ON will automatically switch to another lead when an electrode comes off.Pacemaker PulseThe artificial pace pulse can be displayed by superimposing on the ECG waveform. The artificialpace pulse will be displayed in yellow.Pacemaker Pulse Detection Algorithm①②③①ECG Signal InputInputs ECG signal.②Suspension of Pacemaker Pulse and QRS DetectionSignals with high frequency and large amplitude will bedetected as a pacemaker pulse. When a pacemakerpulse is detected, QRS detection will be suspended for acertain amount of time to prevent the pacemaker pulseerroneously detected as QRS.③Canceling Arrhythmia DetectionArrhythmia detection will be cancelled to avoid detectingthe waveform succeeding the pacemaker pulse as anabnormal beat.CAUTIONPrecautions about Pacemaker Pulse Detection? There are some cases when pacemaker pulse can not be detecteddepending on the pacemaker type, pulse voltage, pulse width, electrodelead type (unipolar, bipolar), or electrode placement which causes thepacemaker pulse amplitude to decrease and disables pacemaker pulsedetection.? If signals similar to a pacemaker pulse are present, such as electricblanket noise or excessive AC frequency noise, these may beerroneously detected and displayed as a pacemaker pulse.? When the spontaneous QRS and pacemaker pulse overlaps (as in afusion beat), QRS detection will be suspended and the heart rate will bereduced.? If a pacemaker pulse is continuously detected due to AC frequencyinterference, QRS detection will be suspended and the heart rate will bereduced. Also arrhythmia detection will not be possible.
6−111. Press the Config. → Page Down key to display the setup menu for pacemaker pulseselection.2. Select ON or OFF . OFF will not display the pacemaker artificial pulse. ON will display the pacemaker artificial pulse in a different color from the ECG waveform.This will automatically set to ON when “Used” is selected for pacemaker use on the patientadmit / discharge menu.QRS Pace MaskFor patients using pacemakers, there are cases when the pacing waveform may not occur in spiteof the pacing stimulus. This condition is called “pacing failure”, or “failure to capture”. To avoiddetecting pacemaker pulses as a QRS complex when this occurs, the monitor has a function tosuspend QRS detection for a fixed amount of time starting from the detection of the pacingstimulus. This function is called “pace mask”. But if the pacemaker does not detect the patient’sspontaneous heartbeat (sensing failure), and the pacing stimulus is applied at the same timing asQRS, this “pace mask” function may erroneously mask the QRS and cause the heart ratemeasurement to decrease. To avoid this, QRS pace mask function can be turned off for correctmeasurement of the heart rate. (default setting : ON)Pacemaker Pulse Pacemaker PulsePacing waveform causedby pacemaker pulse No waveform in spiteof pacing stimulus.Normal Pacing Pacing Failure Sensing FailurePacemaker pulse appliedat the same timing withspontaneous heartbeatWARNINGIf the QRS pace mask function is turned OFF, a decrease in heart rate maynot generate HR or ASYSTOLE alarms due to erroneously detected QRS.Turn this function OFF only if you are sure that pacing failure will not occur,or when the patient can be constantly monitored.6ECG
6−121. Press the Config. → Page Down keys to display the second page of theconfiguration menu.2. Select the pace pulse mask time.Select from 10ms , 20ms , 40ms depending on the pace spike amplitude or presence offusion beat.Selecting OFF will set the mask time to 0ms.Selecting Auto will switch between 20ms and 40ms depending on the pace spikeamplitude.ECG Drift FilterBy setting the ECG drift filter ON, only the amplitude with frequency component under 1Hz will beattenuated to prevent the ECG baseline drift.1. Press the Config. → Page Down keys to display the second page of theconfiguration menu.3. Select ON or OFF for the ECG drift filter.Selecting ON will set the ECG drift filter and controls the baseline drift.When the ECG drift filter is set, the patient signal display will delay about 0.5 seconds.Selecting OFF will not set the ECG drift filter.NOTE When an electrosurgery-proof ECG relay cable is used, ECG drift filter cannot be set to ON .
6−13ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of ECG displaywill appear. 2. Select Display ON or Display OFF .Pressing the Display ON key will display thewaveform and numeric data.Pressing the Display OFF key will not display thewaveform and numeric data.When ECG electrodes are attached to the patient with the ECG display set to OFF, the ECGwaveform and numeric data will be automatically displayed after 30 seconds.CAUTION When the waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.NOTE If ECG source is set to other than ECG, selecting Display OFF willdisplay PR_SpO2 or PR_BP for the HR parameter key.The Display OFF message will bedisplayed inside the parameter key.6ECG
6−14− Respiration −This menu allows setup for the impedance respiration measurement and CO2 respirationmeasurement.Size :Selects the waveform size to display impedance respiration.RR Alarm :Selects ON/OFF of respiration rate alarm, and sets upper and lower alarm limits.APNEA Alarm :Selects ON/OFF of apnea alarm and sets upper alarm limit.Configuration :Sets the respiration monitoring configuration.CAUTION? When the following relay cables are used, respiration can not bemeasured.? Relay Cable CI‐700E_3 (Electrosurgery-proof, 3-electrode)? Relay Cable CI‐700E_4 (Electrosurgery-proof, 4-electrode)? Relay Cable CI‐700E_5 (Electrosurgery-proof, 5-electrode)? When a defibrillator is used during respiration monitoring, a large offsetvoltage will be placed on the ECG electrodes, which may causeinterruption of monitoring for a few seconds.? When the following lead cables are used, respiration cannot bemeasured.? Lead Cable #3382.0648.16 (Electrosurgery-proof, 3-electrode)? Lead Cable #3382.0661.16 (Electrosurgery-proof, 5-electrode)Respiration Waveform Size1. Press the Size key to display the size setup menu.Select the waveform size and baseline position to display and record the impedance respirationwaveform.2. Select the waveform size.Select the size from ×1/4 , ×1/2 , ×1 , ×2 , ×4 .3. Set the baseline position using the ? , ? keys.Adjust the baseline position for 0Ω if the waveform is hard to see due to the waveform amplitude.
6−15RR Alarm1. Press the RR Alarm key to display alarm setup menu.Set ON/OFF of RR alarm and upper and lower alarmlimit.The alarm will be set common to RR measured fromimpedance respiration waveform or RR measured fromCO2 waveform.The adjustable increment for upper and lower limitdepends on the patient type.Adult / Child :5bpm incrementNeonate :2bpm incrementNOTE If the alarm is based on the RR measured from CO2 waveform, RR alarmwill not generate unless 2 or more respiration is detected within 30 secondsafter power ON or after discharge.Key Item DescriptionIndividual Alarm Selecting ON will generate the RR alarm.Selecting OFF will not generate the RR alarm.Lower AlarmLimit Sets the lower alarm limit (5∼145Bpm／5∼148Bpm).Setting a value 5Bpm or below will turn OFF the alarm.Upper AlarmLimitSets the upper alarm limit (10∼150Bpm／4∼150Bpm).Setting a value 150Bpm or above will turn OFF thealarm.AutomaticSetup Automatically sets the upper limit to ＋20Bpm, and thelower limit to −20Bpm to the current value.Apnea Alarm1. Press the Apnea Alarm key to display the alarm setup menu.Set ON/OFF of apnea alarm and upper limit of apneatime.Apnea will be set common to apnea time measured fromimpedance respiration waveform or apnea timemeasured from CO2 waveform.The upper limit can be set in 1-second increment.There is no lower limit.WARNINGThe purpose of this respiration alarm is to alert the user to evaluate forthe possible occurrence of apnea events by identifying the absence ofrespiration. It is not intended to be classified as an “Apnea Monitor” andwill not identify the condition creating the possible event. (Central,Obstructive or Mixed.)NOTE If the alarm is based on the apnea time measured from CO2 waveform,apnea alarm will not generate unless 2 or more respiration is detectedwithin 30 seconds after power ON or after discharge.6Respiration
6−16Key Item DescriptionIndividual Setup Selecting ON will generate the apnea alarm.Selecting OFF will not generate the apnea alarm.Upper AlarmLimitSets the upper alarm limit (5∼20sec.).Setting a value equal to or above 20sec. will turn OFFthe alarm.AutomaticSetup Sets the apnea alarm value set for the currentlyselected alarm mode.CVA DetectionWhen the amplitude of the respiration waveform decreases due to causes such as respiratorypause, the ECG waveform may be superimposed on to the respiration waveform, making the RRequal to the HR. This condition is called CVA (Cardio-Vascular Artifact), and is detected usingthe CVA detection function.If the ECG waveform is superimposed on to the respiration waveform, with HR (RR) 30bpm, for 20seconds or over (10 seconds or over for neonates) and the CVA detection function set to ON, the“CVA detected” message will be displayed, and an alarm sound will be generated.This function will be effective when Impedance is set as the RR source.1. Press the Configuration key to display the setup menu for setting the CVA detection.2. Select ON or OFF . ON will generate an alarm and display a message when CVA is detected. OFF will not perform CVA detection.
6−17Respiration SourceThe parameter to measure respiration rate and apnea time can be selected from impedance, CO2,or automatic. RR and apnea alarm will be generated according to the selected parameter.These will be also stored as graphic trend or tabular trend.1. Press the Configuration key to display configuration menu for RR source selection.2. Select the parameter. Impedance will measure respiration rate from impedancerespiration curve. The numeric value will be indicated as“RR_IMP” in the respiration parameter key. CO2 will measure respiration rate from CO2 waveform. Thenumeric value will be indicated as “RR_CO2” in the respirationparameter key. Auto will automatically select the parameter to measure the respiration rate with the priorityorder of CO2＞impedance.Impedance Respiration MeasurementThe respiration measurement using the impedance method conducts high-frequency and weakcurrent between the ECG electrodes attached to the patient, and measures the potentialdifference between the electrodes caused by thoracic movement using the synchronousrectification system. For a patient using the adaptive (minute ventilation) pacemaker, thepacemaker measurement signal and the high-frequency current of this equipment interferes witheach other which causes incorrect respiration measurement.If the patient is using an adaptive (minute ventilation) pacemaker, set the impedance respirationmeasurement OFF.1. Press the Configuration key to display the setup menu to set the impedance respirationmeasurement.2. Select ON or OFF . ON will perform standard impedance respiration measurement. OFF will stop the impedance respiration measurement and will not display the impedancerespiration waveform and RR. A high frequency electric discharge which is a measurementsignal will be also ceased.6Respiration
6−18RR Synchronization MarkThe RR mark synchronized to impedance respiration or CO2 waveform will be displayed inside theparameter key.RR Mark1. Press the Configuration key to display the setup menu for setting the RR synchronizedMark.2. Select ON or OFF . OFF will not display the synchronization mark. ON will display the synchronization mark.
6−19ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of RESP displaywill appear.2. Select Display ON or Display OFF .Pressing the Display ON key will display thewaveform and numeric data.Pressing the Display OFF key will not display thewaveform and numeric data.When ECG electrodes are attached to the patient with the respiration display set to OFF, therespiration waveform and numeric data will be automatically displayed after 30 seconds.CAUTION When waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.NOTE If RR source is set to other than Impedance , selecting Display OFFwill display CO2_RR for the RESP parameter key.The Display OFF message will bedisplayed inside the parameter key.6Respiration
6−20− Invasive Blood Pressure (BP1, BP2)−This menu allows setup of the measurement condition for BP1, BP2.Scale :Selects the scale for BP waveform display.BP Alarm :Sets the upper and lower alarm limit of systolic, diastolic, mean blood pressure andON/OFF of the alarm.BP Zero :Performs zero balance.Configuration:Sets the BP monitoring condition.CAUTION When the main power is turned ON, the BP value will not be displayed untilzero balance is performed. Make sure to perform the zero balance.BP Scale (BP1, BP2)1. Press the Scale key to display the BP scale setup menu.Select the full scale for displaying and recording.2. Select the scale.Select from 20 , 50 , 75 , 100 , 150 , 200 , 250 , 300 (mmHg).When the measurement unit is kPa, select from 4 , 8 , 12 , 16 , 20 , 24 , 32 , 40(kPa).CAUTION For telemetry transmission, BP waveform with a scale above theprogrammed scale can not be properly transmitted. Set the BP waveformbelow the programmed scale.
6−21BP Alarm (BP1, BP2)1.Press the BP Alarm key to display the alarm setup menu.Select ON/OFF of BP alarm and set the upper and lower alarm limit for systolic (SYS), diastolic(DIA), and mean (MEAN) BP.The alarm value is to be set for each measurement unit. (mmHg / kPa)The adjustable increment for upper and lower limit changes from 50mmHg / 7kPa.mmHg :0∼50mmHg / 2mmHg increment55∼300mmHg / 5mmHg incrementkPa :0∼7kPa / 0.2kPa increment7.5∼40.0kPa / 0.5kPa incrementKey Item DescriptionIndividual Alarm Selecting ON will generate BP alarm.Selecting OFF will not generate BP alarm.Select from SYS (systolic BP), DIA (diastolic BP),MEAN (mean BP).Lower Alarm Limit Sets the lower alarm limit (0∼295mmHg/0∼39.5kPa).Setting a value equal to or below 0mmHg/0kPa willturn OFF the alarm.Upper Alarm Limit Set the upper limit (2∼300 mmHg/0.2∼40.0kPa).Setting a value equal to or above 300 mmHg/40.0kPawill turn OFF the alarm.Automatic Setup Automatically sets the upper limit to ＋40mmHg/＋5.5kPa, and the lower limit to −20mmHg/−2.5kPa tothe current value.Zero Balance of Pressure Lines (BP1, BP2)1. Open the three-way cock of the pressure transducer to air.2. Press the BP zero key.6 BP
6−22Verify the BP waveform is positioned at zero, and “0” is displayed for the BP value. A message,“BP zero complete” will be displayed when the procedure is complete. A message, “BP zerofailed” will be displayed when the process fails. The three-way cock may not be opened to air,artifact is present, or the transducer may be defective. Check the cause and try the zero balanceprocedure again.A message, “BP zero drift” will be displayed when the interface cable is not connected. Check ifthe cable is firmly connected.3. Close the three-way cock when the zero balance is complete.CAUTION Each time the blood pressure transducer or tubing is replaced, the zerobalance procedure is required to ensure accurate measurements.Filter Selection (BP1, BP2)An artifact may interfere on the BP waveform depending on the combination of BP measurementcircuit.Select an appropriate filter from the low-pass filter of 6Hz, 8Hz, 12Hz, 40Hz.1. Press the Configuration key to display the setup menu for selecting a filter.2. Select the filter.Select an appropriate filter from 6Hz , 8Hz , 12Hz , 40Hz .Mean BP Display (BP1, BP2)The ON/OFF of mean BP display can be selected.1. Press the Configuration key to display the setup menu for selecting ON/OFF of meanBP display.2. Select ON or OFF .Selecting ON will display the mean BP.Selecting OFF will not display the mean BP.
6−23CAUTION If the mean BP display is set to OFF, the mean BP alarm will not begenerated. Also, the mean BP will not be displayed on the tabular trend.Be cautious when setting the mean BP display OFF.ECG Source (BP1)The HR/PR source to display on the home display can be selected.The alarm will be generated based on this selection.The graphic trend and tabular trend will be also stored based on this selection.BP2 can not be set as ECG source.1. Press the Configuration key to display the setup menu to set the ECG source.2. Select a parameter.Selecting ECG will measure the HR from ECG.“HR” will be displayed inside the parameter key.Selecting SpO2 will measure the PR from SpO2.“PR_SpO2” will be displayed inside the parameter key.Selecting BP1 will measure the PR from BP1.“PR_BP” will be displayed inside the parameter key.Selecting Auto will automatically set the measurable HR source in the priority of ECG＞SpO2＞BP1.6 BP
6−24ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of BP display willappear. 2. Select Display ON or Display OFF .Pressing the Display ON key will display thewaveform and numeric data.Pressing the Display OFF key will not display thewaveform and numeric data.CAUTION? When waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.? If BP is set as ECG source, the pulse rate will also not be displayed.The Display OFF message will bedisplayed inside the parameter key.
6−25− SpO2 −This menu allows setup of the measurement condition for the SpO2.Size :Sets the waveform size for SpO2 waveform display.SpO2 Alarm :Sets ON/OFF of alarm, upper and lower alarm limit, and SEC alarm.Configuration:Sets the SpO2 monitoring configuration.CAUTIONTake the following precautions when monitoring over long periods of time.? To avoid skin rash or low-temperature burn, it is recommended tochange the measurement position several times a day.Be especially careful when continuously using on neonates, infants, orpatients with peripheral circulatory disturbance.? Direct sunlight to the sensor area can cause a measurement error.Place a black or dark cloth over the sensor in these environments.When not measuring, unplug the relay cable and sensor from the SpO2connector. Otherwise, the outside light may affect to falsely displaymeasurements.CAUTION? The DS-100A is intended for use on finger of adults weighing over 40kg (approximate). Do not use them on children or neonates. Also donot apply them on the thumb or foot.? The light-emitting part of the sensor should be over the root of thefingernail. Do not insert the finger too far into the sensor as it may hurtthe patient.? The DS-100A is not designed for long term use. Remove the sensorevery 4 hours. If any inhibition is detected in tissue blood flow, replaceit or move the sensor to another finger.? Measuring on a limb with NIBP cuff, arterial catheter, or intracathetermay result in incorrect measurement.? Do not secure the adhesive tape too tight as it may obstruct the bloodflow.6SpO2
6−26SpO2 Waveform Size1. Press the Size key to display the SpO2 waveform size setup menu.Select the waveform size for displaying and recording.2. Select the waveform size.Select the size from ×1/4 , ×1/2 , ×1 , ×2 , ×4 .SpO2 Alarm1. Press the SpO2 Alarm key to display the alarm setup menu.Select ON/OFF of SpO2 alarm, and set the upper and lower alarm limit.Also, when the SpO2 value is unstable around the lower alarm limit, the frequently generatedalarm can be corrected by setting the SEC (second) alarm function.ReferenceRefer to ”4. Monitoring Setup SpO2 SECAlarm Setup” for details of SEC alarm setupprocedure.The upper and lower limits can be set in 1% increment.Key Item DescriptionIndividual Alarm Selecting ON will generate the SpO2 alarm.Selecting OFF will not generate the SpO2 alarm.Lower AlarmLimit Sets the lower alarm limit (50∼99%).Setting a value 50% or below will turn OFF the alarm.Upper AlarmLimit Sets the upper alarm limit (52∼100%).Setting a value 100% or above will turn OFF the alarm.AutomaticSetup Automatically sets the upper limit to OFF, and thelower limit to 95% to the current value.NOTE Whether to use the SEC (second) alarm function and its thresholdselection should be based on the patient’s clinical indication portent andmedical evaluation.
6−27ECG SourceThe HR/PR source to display on the home display can be selected.The alarm will be generated based on this selection.The graphic trend and tabular trend will be also stored based on this selection.1. Press the Configuration key to display the setup menu to set the ECG source.2. Select a parameter.Selecting ECG will measure the HR from ECG.“HR” will be displayed inside the parameter key.Selecting SpO2 will measure the PR from SpO2.“PR_SpO2” will be displayed inside the parameter key.Selecting BP1 will measure the PR from BP1.“PR_BP” will be displayed inside the parameter key.Selecting Auto will automatically set the measurable ECG source in the priority of ECG＞SpO2＞BP1.SpO2 Alarm during NIBP Measurement (Ignore NIBP)This setup is to be made when the SpO2 sensor and NIBP cuff is placed on the same limb formeasurement.During the NIBP measurement, the cuff inflation restricts the blood flow which disables the correctdetection of the SpO2 value and PR, and may generate an improper alarm.Selecting OFF will not generate the alarm until the NIBP measurement is complete. Similarly,when the HR source is set as SpO2 , the PR alarm will not be generated during NIBPmeasurement.1. Press the Configuration key to display the setup menu for setting “Ignore NIBP”.2. Select ON or OFF . ON will generate the alarm during NIBP measurement. OFF will not generate the SpO2/PR alarm during NIBP measurement.6SpO2
6−28ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of SpO2 displaywill appear.2. Select Display ON or Display OFF .Pressing the Display ON key will display thewaveform and numeric data.Pressing the Display OFF key will not display thewaveform and numeric data.When SpO2 sensor is attached to the patient with the SpO2 display set to OFF, and SpO2 can bemeasured for 30 seconds, the SpO2 waveform and numeric data will be automatically displayed.CAUTION? When the waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.? If SpO2 is set as ECG source, the pulse rate will also not be displayed.The Display OFF message will bedisplayed inside the parameter key.
6−29− Non-Invasive Blood Pressure −This menu allows the setup of NIBP monitoring condition.Auto Mode :Sets the automatic interval measurement and starts the 1-minute intervalmeasurement and Quick SYS measurement.NIBP Alarm :Sets the ON/OFF of NIBP alarm and upper / lower limit of systolic, diastolic, andmean BP.Configuration :Sets the NIBP monitoring configuration.CAUTIONFor the following situation, measurements will be terminated.? When the measurement time has exceeded 120 seconds for adult, 90seconds for child, 60 seconds for neonate.? When the inflation value has exceeded 300mmHg for adult, 200mmHgfor child, 150mmHg for neonate.CAUTION If used with the incorrect patient type, it will not only cause erroneousmeasurement, but the inflating level for the adult may be applied to child orneonate causing a dangerous situation to the patient.NIBP Automatic MeasurementNon-invasive blood pressure can be measured automatically at selected time intervals. If QuickSYS measurement is performed during the NIBP automatic measurement, the automaticmeasurement will automatically resume when Quick SYS measurement completes.When NIBP automatic measurement is set, the set interval timewill be displayed inside the parameter key.1. Press the Auto Mode key to display the measurement interval setup menu for theautomatic measurement.Currently selected time interval6NIBP
6−302. Select an interval time.Select from 2 min / 2.5 min / 3 min / 5 min / 10 min / 15 min / 20 min / 30 min / 60 min / 120 min .Select OFF if not performing the interval measurement.The measurement time will be the integral multiple of the selected interval time beginning with 0minute.Ex.）If the present time is 13:14, the measurement time will be as follows for each interval time.2 min. :13:16, 13:18, 13:20, ．．．2.5 min. :13:15, 13:17:30, 13:20, ．．．3 min. :13:15, 13:18, 13:21, ．．．5 min. :13:15, 13:20, 13:25, ．．．NIBP 1-Minute Interval MeasurementThe 1-minute interval measurement will automatically stop after 10 minutes or 20 minutes andreturns to the previous interval mode setup.1. Press the Auto Mode key to display the measurement interval setup menu to start the1-minute interval measurement.2. Press the 1min Start key to start the 1-minute interval measurement.Pressing the NIBP START/STOP key will not stop the 1-minute interval measurement.To cancel the measurement, press the 1min Start key again.The measurement duration of 1-minute interval measurement can be selected on the “1min Auto”of the NIBP configuration menu. 10min. will automatically stop the 1-minute interval measurement after 10 minutes and returnsto the previous interval mode setup. 20min. will automatically stop the 1-minute interval measurement after 20 minutes and returnsto the previous interval mode setup.CAUTION? The 1-minute interval measurement will always start from 00 second.Pressing the 1min Start key will start the measurement from thenext 00 second.? The 1-minute interval measurement will automatically stop after 10minutes or 20 minutes and returns to the previous interval mode setup.The selection of 10min / 20min can be made on the NIBPconfiguration menu. (Refer to “1-Minute Measurement Duration” ofthis section”Measurement Duration
6−31Quick SYS StartThe NIBP measurement can be continuously performed for 3 min. / 5 min. / 10 min.If any abnormality on the cuff hose, etc. is found during the Quick SYS, the continuousmeasurement will be ceased.Only the systolic blood pressure will be measured and displayed.1. Press the Auto Mode key to display the measurement interval setup menu to start theQuick SYS.2. Start the Quick SYS.Pressing the Quick SYS Start key will start the continuous measurement.To cease the measurement, press the NIBP START/STOP key, or press again the Quick SYS Start key.The duration of continuous measurement can be selected on the “Quick SYS” of the NIBPconfiguration menu.The continuous measurement will automatically cease after the selected duration from 3min , 5min , or 10min .CAUTION The alarm function will be ineffective for the BP value measured by QuickSYS regardless of the ON/OFF selection of NIBP alarm.NIBP Alarm1. Press the NIBP Alarm key to display the alarm setup menu.Set ON/OFF of NIBP alarm, upper and lower alarm limits of systolic (SYS), diastolic (DIA), mean(MEAN) NIBP.Set the alarm value for each measurement unit (mmHg / kPa).The upper and lower limit can be set in 5mmHg / 0.5kPa increment.Measurement Duration6NIBP
6−32Key Item DescriptionIndividualAlarm Selecting ON will generate the NIBP alarm.Selecting OFF will not generate the NIBP alarm.Select from SYS (systolic BP), DIA (diastolic BP), orMEAN (mean BP)Lower AlarmLimitSets the lower alarm limit (10∼295mmHg/1.5∼39.5kPa).Setting a value 10mmHg/1.5kPa or below will turn OFFthe alarm.Upper AlarmLimitSets the upper limit (15∼300mmHg /2.0∼40.0kPa).Setting a value 300bpm/40.0kPa or above will turn OFFthe alarm.AutomaticSetupAutomatically sets the upper limit to ＋40mmHg/＋5.5kPa to the current value, and the lower limit to −20mmHg/−2.5kPa to the current value.Quick SYS Measurement DurationThe duration of Quick SYS can be selected from 3 min., 5 min., or 10 min.The long duration of continuous measurement may congest the blood stream of the measuredlocation. Set the duration according to the patient condition.1. Press the Configuration key to display the NIBP configuration menu to set the QuickSYS.2. Select the measurement duration.Select an appropriate time from 3min , 5min , 10min .Quick SYS will automatically cease after the selected duration.
6−33End of Measurement ToneBy selecting ON for the “End Tone”, a tone will be generated when the NIBP measurementcompletes.1. Press the Configuration key to display the NIBP configuration menu to set ON/OFF forthe End Tone.2. Select ON or OFF . ON will generate a tone when the measurement completes. OFF will not generate a tone when the measurement completes.Quick SYS ListThe systolic blood pressure measured by Quick SYS can be included in the NIBP list.1. Press the Configuration key to display the NIBP configuration menu for setting theQuick SYS List.2. Select ON or OFF . ON will include the systolic blood pressure valueto NIBP list. OFF will not include the systolic blood pressurevalue to NIBP list.QuickSYS6NIBP
6−34PR DisplayThe measured pulse rate can be displayed. This selection is for display only, and alarm functionand tabular trend function will be ineffective.1. Press the Configuration key to display the NIBP configuration menu for setting the PRdisplay.2. Select ON or OFF .Pulse RateSelecting ON will display the pulse rate.Selecting OFF will not display the pulse rate.Mean BP DisplayThe ON/OFF of mean BP display can be selected.1. Press the Configuration key to display the NIBP configuration menu for setting themean BP display.2. Select ON or OFF . ON will display the mean BP. OFF will not display the mean BP.
6−351-Minute Measurement DurationThe duration for 1-minute measurement can be selected from 10 minutes or 20 minutes.When the previous measurement is prolonged due to patient motion, etc, the cuff pressure releasetime until the next measurement will be shortened, and the measured location may congest. Becautious when performing long duration of continuous measurement.1. Press the Configuration → Page Down keys to display the NIBP configuration menufor setting the 1-minute measurement duration.2. Select the measurement duration.Select an appropriate duration from 10min , 20min .The 1-minute measurement will automatically cease after the selected duration.NIBP SpeedThe NIBP cuff inflation speed can be selected from standard or high speed.1. Press the Configuration → Page Down keys to display the second page of theconfiguration menu.2. Select the NIBP speed.Select an appropriate speed from Standard or Hi Speed .When Standard is selected, it will take about 10 seconds to inflate to 300mmHg with 500cctank connected.When Hi Speed is selected, it will take about 6 seconds to inflate to 300mmHg with 500cc tankconnected. (for adult)When an adult cuff is wrapped around an arm with a space allowing one finger fitting in betweenthe cuff and arm, the speed to inflate to 190mmHg is within 11 seconds for normal speed, andwithin 7 seconds for high speed.NOTE The NIBP speed setup is effective only when adult or child is selected forpatient type. The NIBP speed for neonate will be fixed in spite of the speedselection.6NIBP
6−36− Temperature −This menu allows the setup of the temperature monitoring condition.TEMP Alarm :Sets ON/OFF of temperature alarm, and upper and lower alarm limits.Temperature Alarm1. Press the TEMP Alarm key to display the alarm setup menu.Select ON/OFF of temperature alarm, and set the upper and lower alarm limit.The alarm limit can be set for each measurement unit (?C / ?F).The upper and lower limit can be set in increments of 0.5?C / 0.5?F.Key Item DescriptionIndividual Alarm Selecting ON will generate the TEMP alarm.Selecting OFF will not generate the TEMP alarm.Lower AlarmLimitSets the lower alarm limit (30.0∼49.0?C / 86.0∼120.0?F).Setting a value 30.0?C / 86.0?F or below will turn thealarm OFF.Upper AlarmLimitSets the upper alarm limit (31.0∼50.0?C / 88.0∼122.0?F).Setting a value 50.0?C / 122.0?F or above will turn thealarm OFF.AutomaticSetupAutomatically sets the upper limit to ＋2.0?C /＋3.0?Fto the current value, and lower limit to−2?C /−3.0?Fto the current value.
6−37ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of TEMP displaywill appear.2. Select Display ON or Display OFF .Pressing the Display ON key will display thenumeric data.Pressing the Display OFF key will not display thenumeric data.CAUTION When the waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.The Display OFF message will bedisplayed inside the parameter key.6Temperature
6−38− CO2 Concentration − (DS-7141)This menu allows setup of CO2 concentration measurement.Scale :Sets the CO2 waveform scale.EtCO2 Alarm :Sets ON/OFF of EtCO2 alarm, and upper and lower alarm limits.InspCO2 Alarm:Sets ON/OFF of InspCO2 alarm and upper alarm limit.Configuration :Sets CO2 monitoring conditions.CO2 Scale1. Press the Scale key to display the scale setup menu. ＜Scale setup menu for the unit in mmHg＞2. Select the CO2 waveform scale for displaying and recording.For the measurement unit in mmHg, select the scale from 50 , 100 .For the measurement unit in kPa and %, select the scale from 4 , 8 , 10 .EtCO2 (End-Tidal CO2) Alarm1. Press the EtCO2 Alarm key to display the alarm setup menu.Select ON/OFF of EtCO2 alarm, and set the upperand lower alarm limits.Set the alarm condition for each measurement unit(mmHg / kPa / %).Upper and lower alarm limits can be set in incrementsof 1mmHg, 0.1kPa, 0.1%.NOTE EtCO2 alarm will not generate unless 2 or more respiration is detectedwithin 30 seconds after power ON or after discharge.
6−39Key Item DescriptionIndividualAlarm Selecting ON will generate the EtCO2 alarm.Selecting OFF will not generate the EtCO2 alarm.Lower AlarmLimitSets the lower alarm limit (1∼98mmHg, 0.1∼13.1kPa,0.1∼13.1%). Setting a value equal to or below1mmHg, 0.1kPa, 0.1% will turn the alarm OFF.Upper AlarmLimitSets the upper alarm limit (3∼100mmHg, 0.4∼13.3kPa, 0.3∼13.3%). Setting a value equal to orabove 100mmHg, 13.3kPa, 13.3% will turn the alarmOFF.AutomaticSetupAutomatically sets the upper alarm limit to ＋10mmHg,＋1.3kPa, ＋1.3% to the current value, and the loweralarm limit to −10mmHg, −1.3kPa, −1.3% to thecurrent value.InspCO2 (Inspiratory CO2) Alarm1. Press the InspCO2 Alarm key to display the alarm setup menu.Select ON/OFF of InspCO2 alarm, and set the upperalarm limit.Set the alarm condition for each measurement unit(mmHg / kPa / %).Upper alarm limit can be set in increments of 1mmHg,0.1kPa, 0.1%. Lower alarm limit can not be set.NOTE InspCO2 alarm will not generate unless 2 or more respiration is detectedwithin 30 seconds after power ON or after discharge.Key Item DescriptionIndividual Alarm Selecting ON will generate the InspCO2 alarm.Selecting OFF will not generate the InspCO2alarm.Upper AlarmLimitSets the upper alarm limit (1∼4mmHg, 0.1∼0.4kPa,0.1∼0.4%). Setting a value equal to or above4mmHg, 0.4kPa, 0.4% will turn the alarm OFF.AutomaticSetup Automatically sets the upper alarm limit to ＋3mmHg,＋0.4kPa, ＋0.4% to the current measurement.6CO2 Concentration
6−40EtCO2 Average DurationThe duration to average the EtCO2 value can be selected from 10 sec., 20 sec., 30 sec., or OFF.1. Press the Configuration key to display configuration menu for EtCO2 average durationselection.2. Select the average duration.Select the duration to average the EtCO2 value from 10sec , 20sec , 30sec .If OFF is selected, EtCO2 value for each respiration will be displayed.As the EtCO2 value display is updated each second, EtCO2 value for each respiration can not bedisplayed if respiration rate is above 60 Bpm.Measurement UnitThe measurement unit can be selected from mmHg, kPa, or %.Measurement Unit1. Press the Configuration key to display the configuration menu for measurement unitselection.2. Select the measurement unit from mmHg , kPa , % .The graphic trend and tabular trend will be displayed with the selected measurement unit.If the measurement unit is changed frequently, the continuity of the graphic trend and tabular trendmay be lost.When the measurement unit is changed, make sure to set the alarm condition for that unit. Thealarm setup is necessary for each measurement unit.
6−41CO2 CalibrationCO2 calibration can be performed using calibration gas. Calibration should be conducted every 6months or when any measurement error is found.1. Press the Configuration key to display the configuration menu for CO2 Cal. keydisplay.2. Press the CO2 Cal. key to display the calibration menu.Due to precision matter, CO2 calibration can not be started until 20 minutes has elapsed after thepower is turned ON.During this time, Start Cal key will be displayed in gray which indicates that the key isineffective.The message, “Calibration not ready” and the remaining time for preparation will be displayed.＜Preparing for calibration＞ ＜Start calibration＞3. Press the Start Cal key and conduct calibration according to the displayed messages.4. The message, “Feed CAL. GAS” will be displayed. Press the injection button to inject thecalibration gas.5. The message, “Calc. Gas can be removed” will be displayed. Stop pressing the injectionbutton to cease the injection.6. The message, “CAL. OK” will be displayed. “Last Cal. Date” will be updated to the currentdate.If any of the following messages is displayed, start the procedure again from step 2.“CAL. error”, “CAL GAS error”, “Auto Zero fail”, “No stable gas flow”, “CAL. failure”7. Press the Cal Complete key to end the calibration.CAUTION? Perform calibration after 20 minutes from turning ON the power of theDS-7100 system.? Do not disconnect the sampling tube during calibration.If disconnected, calibration will cease.6CO2 Concentration
6−42Restarting the CO2 UnitThe sampling tube will cease functioning when erroneous condition such as blocking of exhausttube, sampling tube or nasal prong is detected. When the pump ceases functioning, “Check CO2unit” message will be displayed. After resolving the problem, press the Restart CO2 key andrestart the measurement.1. Press the Configuration key to display the configuration menu for Restart CO2 keydisplay.2. Press the Restart CO2 key for 2 seconds.If the “Check CO2 unit” message is not displayed, the Restart CO2 key will not function.3. Check that the unit is restarted.The sampling pump will start to function, and the “Check CO2 unit” message will disappear.Check that the message has disappeared and the measurement data is displayed.NOTE If the “Check CO2 unit” message does not disappear after restarting the unit, thereplacement of CO2 unit part may be necessary. Contact our servicerepresentative.ON/OFF of Parameter Display1. Press the Display ON/OFF key. The confirmation display for ON/OFF of CO2 displaywill appear.
6−432. Select Display ON or Display OFF .Pressing the Display ON key will display thewaveform and numeric data.Pressing the Display OFF key will not display thewaveform and numeric data.When filter line is attached to the patient with the CO2 display set to OFF, and 2 or morerespiration is detected within 30 seconds, the CO2 waveform and numeric data will beautomatically displayed.CAUTION? When the waveform and numeric data display is set to OFF, the alarmgeneration and tabular/graphic trend will be also set to OFF.? If CO2 is set as RR source, the pulse rate will also not be displayed.The Display OFF message will bedisplayed inside the parameter key.6CO2 Concentration
6−44Blank Page
7−1FunctionThis chapter describes the functions such as arrhythmia analysis, trend, and recall.Chapter 7− Arrhythmia Analysis −Definition, etc. ･････ 2Arrhythmia Definition･･････････････････････････ 2●QRS Classification ･････････････････････････2●Arrhythmia Type ･･･････････････････････････2To Set the Arrhythmia Alarm ･･･････････････････ 3To Perform Arrhythmia Learning････････････････ 4− Graphic Trend Data−Display / Record ･････ 6To Display the Graphic Trend ･･････････････････ 6The Description of the Display･････････････････ 10− Tabular Trend −Display / Record ････････････ 11To Display the Tabular Trend ･････････････････11The Description of the Display･････････････････ 12Parameter Setup for Tabular Trend ････････････13− Recall Data−Display / Record ･････････････14To Display the Recall Menu･･･････････････････ 14●Recall List Display････････････････････････ 14●To Display and Record the Enlarged RecallWaveform･････････････････････････････････ 15To Set the Recall Condition ･･･････････････････17− OCRG −Display ･･･････････････････････19− ST Display − ST Display, Alarm Setup, etc.･20To Display the ST Measurement Menu ･････････20●To Set the Reference Waveform ･･･････････ 21●ST Alarm Setup ･･････････････････････････ 22− NIBP List −Display / Record ･････････････23To Display the NIBP List･･････････････････････23The Description of the Display･････････････････ 24− Other Bed ―Display / Alarm ･･････････････ 25Other Bed Display ･･･････････････････････････ 25Other Bed Alarm Setup･･･････････････････････ 267Function
7−2− Arrhythmia Analysis −Definition, etc.This section explains the arrhythmia analysis and alarm setup procedure.Arrhythmia DefinitionThe arrhythmia detection is performed by learning the normal waveform of the patient anddetermining VPC by comparing the waveform (QRS pattern) and R-R interval of each heart beat.A pattern matching is performed with the VPC detected from R-R interval, QRS amplitude, QRSarea, QRS polarity, etc., and determines as VPC after discriminating the noise and VPC.●QRS ClassificationThe QRS analysis is performed by comparing with the learned waveform and QRS patternmatching.N (Normal) Normal QRS beatV (VPC) Ventricular Extrasystole? (Undetermined beat) Learning arrhythmia, or beat not matching the patternP (Pacing beat) Pacing beatF (Fusion beat) Fusion beat of pacing and spontaneous beatS (SVPC) Supraventricular Extrasystole●Arrhythmia TypeThe alarm is generated according to the arrhythmia classification by the pattern or HR of normalQRS and VPC determined QRS.Type Meaning Detection CriteriaASYSTOLE Cardiac Arrest Cardiac arrest is detected for more thanpreprogrammed time.VF Ventricular Fibrillation A random, rapid electrical activity of the heart isdetected.VT Ventricular Tachycardia 9 or more continuous ventricular beats are detected.(HR: 140bpm / 120bpm or over)SLOW_VT 9 or more continuous ventricular beats are detected.(HR: under 140bpm / 120bpm)TACHY Tachycardia HR is over the upper alarm limit.BRADY Bradycardia HR is below the lower alarm limit.RUN Consecutive VPC Continuous VPC exceeding the preprogrammedvalue is detected.COUPLET Couplet VentricularExtrasystole 2 continuous beats of VPC is detected.PAUSE Cardiac arrest of 1.5 seconds or more is detected.BIGEMINY Ventricular Bigeminy QRS pattern of V-N-V-N-V-N is detected.TRIGEMINY Ventricular Trigeminy QRS pattern of V-N-N-V-N-N is detected.FREQUENT Frequent VPC VPC exceeding the preprogrammed value isdetected within 1 minute.ReferenceRefer to “8. System Configuration Ward Setup” for setup of HR reference for VT analysis.
7−3WARNINGObjective and constant arrhythmia detection is possible through the fixedalgorithm incorporated in this monitor.However, excessive waveform morphology change, motion artifact, orthe inability to determine the waveform pattern may cause an error, or failto make adequate detection. Therefore, physicians should make finaldecisions using manual recording, alarm recording and recall waveformfor evaluation.CAUTIONFor proper arrhythmia detection and ECG monitoring, verify properelectrode placement, lead selection, and ECG waveform size. Ifnecessary, turn ON the AC filter. Improper electrode placement, leadselection, and ECG waveform size can cause errors in detection.To Set the Arrhythmia AlarmON/OFF of arrhythmia alarm and reference of arrhythmia analysis can be set.1. Press the Menu → Alarm → Arrhy. keys. ＜Arrhythmia Alarm Setup (1/3) Menu＞The arrhythmia alarm setup menu consists of 3 pages.Page 1/3 : ASYSTOLE, VF, VT, SLOW_VTPage 2/3 : RUN, BIGEMINY, TRIGEMINY, PAUSEPage 3/3 : COUPLET, TACHY, BRADY, FREQUENTUse the Page Down or Page Up keys to switch the pages.2. Set the reference range.Pressing the reference value key will display the ? ? keys.Use the ? ? keys to set the reference value.After setting the reference value, press the Closekey.7Arrhythmia Analysis
7−4＜Arrhythmia Reference Range＞Arrhythmia Reference Range DefaultASYSTOLE 3 sec.∼10 sec. 5 sec.RUN 2 beats∼8beats 3 beatsPAUSE 1.5 sec. ∼5 sec. 3 sec.FREQUENT 1 beat∼50 beats/min. 10 beats/min.3. Select ON or OFF for the alarm.Alarm will generate. Alarm will not generate4. Select ON or OFF for recall factor.ON/OFF of recall factor can be set on the alarm setup menu.Will be selected as recall factor.Will not be selected as recall factor.Pressing the Recall key will switch the ON/OFF selection.To Perform Arrhythmia LearningLearning of normal ECG largely affects the accuracy of arrhythmia analysis.If any error occurs in arrhythmia detection and QRS judgement, performing arrhythmia learningwill recover the original analyzing accuracy.Arrhythmia learning will be performed for about 20 beats for the normal ECG, but it may takelonger if the heartbeat is unstable.During arrhythmia learning, arrhythmia alarm other than ASYSTOLE, TACHY, BRADY will not begenerated.1. Press the Menu → Parameter → ECG keys. ＜ECG Parameter Setup Menu＞2. Start arrhythmia learning.Learning arrhythmiaPressing the key with the LED off will start arrhythmia learning.Pressing the HR parameter key will also displaythe ECG parameter setup menu.
7−5Pressing the key while learning arrhythmia will not stop the learning.3. During arrhythmia learning, a message will be displayed.7Arrhythmia Analysis
7−6− Graphic Trend Data−Display / RecordThis section explains the graphic trend function and recording procedure.To Display the Graphic TrendThe graphic trend menu can be accessed from the menu, or from the preprogrammed user key.The 24 hours of graphic trend data in 1-minute interval will be automatically stored and displayed ifthe data is displayed on the home display.1. Press the Menu → Graphic Trend keys to display the graphic trend menu.To display from the menu To display from the user key.
7−72. Select the parameter to display.Pressing the parameter selection key will display theselection for display.Select a parameter and press the Close key.Parameter DescriptionHR HR, PR (SpO2, BP)ST ST1, ST2VPC VPC beatsBP1 BP1 (SYS / Mean / DIA)BP2 BP2 (SYS / Mean / DIA)NIBP NIBP (SYS / DIA)SpO2SpO2 valuePR_ SpO2SpO2 pulse rateTEMP TemperatureRR Respiration Rate (Impedance, CO2)APNEA Apnea Time (Impedance, CO2)CO2EtCO2 / InspCO2EVENT1 ASYSTOLE, VF, VT, SLOW_VT, RUN,BIGEMINYEVENT2 TRIGEMINY, PAUSE, COUPLET, TACHY,BRADY, FREQUENT3. Select the scale for display.Pressing the Scale key will switch the scaleaccording to the displayed parameter as shownbelow.7Graphic Trend Data
7−8Parameter Scale UnitHR 100, 200, 300 bpm±0.2, ±0.5, ±1.0, ±2.0 mVST ±2, ±5, ±10, ±20 mmVPC 20, 50, 100 beat20, 50, 100, 150, 200, 300 mmHgBP1, BP2 4, 8, 16, 20, 24, 40 kPa100, 150, 200, 300 mmHgNIBP 16, 20, 24, 40 kPaSpO20∼100, 50∼100, 80∼100 %PR_ SpO2100, 200, 300 bpm20∼45, 30∼40 ?CTEMP 68∼113, 86∼104 ?FRR 50, 100, 150 BpmAPNEA 15, 30 Sec4.0, 8.0, 10.0 %, kPaCO250, 100 mmHgEVENT none4. Select the display time range.Pressing the time range key will sequentially changethe key as follows; 1H→2H→4H→8H→12H→24H→1HTime Range Resolution1 hour 1 min.2 hour 1 min.4 hour 1 min.8 hour 1 min,12 hour 3 min.24 hour 3 min,5. Select the time span.Scrolls to past Scrolls to presentScrolls the graphic trend display to past or present datawith the selected time range.Pressing the ? key will scroll to the past data.Pressing the ? key will scroll to the present data.
7−96. Move the cursor.Scrolls to past Scrolls to presentThe data of selected time can be displayed by movingthe cursor.Pressing the ? key will scroll to the past data withthe selected time range.Pressing the ? key will scroll to the present data.7. Enlarge the display.Pressing the Zoom key will display the 1-hourdata with the cursor time in center.Directly pressing the graphic trend display area willalso display the 1-hour data with the pressed time incenter.8. Store the graphic trend data.The displayed graphic trend data will be stored. 7Graphic Trend Data
7−10The Description of the DisplayThe measured data will be compressed for the 12-hour / 24-hour display.Parameter Compressed FormHR Mean ValueST Mean ValueVPC Maximum ValueBP1, BP2 Mean ValueNIBP Current ValueSpO2Mean ValuePR Mean ValueTEMP Mean ValueRR Mean ValueAPNEA Maximum ValueCO2Mean ValueEVENT Logical SumCursorScaleCursor TimeMeasurement Data at Cursor TimeReal time scale
7−11− Tabular Trend −Display / RecordThis section explains the tabular trend function and recording procedure.To Display the Tabular TrendThe tabular trend menu can be accessed from the menu, or from the preprogrammed user key.The 24 hours of data in 1-minute interval will be automatically stored and displayed if the data isdisplayed on the home display.1. Press the Menu → Tabular Trend keys to display the tabular trend.2. Select the time interval.Pressing the key will sequentially select the timeinterval as follows; 1M→5M→10M→15M→30M→60M→1MSelecting 5M will display the data in real time such as 10:00, 10:05, 10:25.Selecting 60M will display the data in real time such as 10:00, 11:00, 12:00.If the list is displayed at 10:35, the data from 10:00 will be displayed.Display from the menu Display from the user key.7Tabular Trend
7−123. Shift the page.Shift to past Shift to presentThe page can be shifted past or present by page withthe selected time range.Pressing the ? key will shift one page to the pastdata.Pressing the ? key will shift one page to thepresent data.The data will be listed in 8 columns.If 5-minute time range is selected and the starting time on the list is 10:00, 35 minutes from 10:00to 9:25 will be listed in 1 page.Pressing the ? key will display the list from 9:20 to 8:45.4. Shift the displayed column.Shift to past Shift to presentThe list data can be shifted in displayed columns.Pressing the ? key will shift the display to past.Pressing the ? key will shift the display to present.5. Store the list data.The displayed list data will be stored.The Description of the DisplayIf the data is within 24 hours or if the monitoring is suspended, the time will be displayed as “??:??”.Also, if the data is not displayed on the home display, or the BP is not zero balanced, the data willbe displayed as “ｰ ｰ ｰ”.Starting TimeStarting Date
7−13Parameter Setup for Tabular TrendThe parameters for tabular trend can be selected.1. Press the List Setup key on the tabular trend menu to display the tabular trend setupmenu.2. Select the position on the list.Select the position.There are 12 positions on the list to set the parameter.3. Select the parameter for display.Select the parameter to display for the previouslyselected position. The position will automatically shiftdownward so that consecutive parameter selection ispossible.7Tabular Trend
7−14− Recall Data−Display / RecordThis section explains the recall menu function and recording procedure.To Display the Recall MenuThe recall menu can be accessed from the menu, or from the preprogrammed user key.When the alarm factor assigned on the recall setup occurs, the assigned waveform and thenumeric data at alarm occurence can be stored for up to 100 data.The recall data to be displayed can be selected on the display selection menu.On the recall list display, 5 compressed recall waveform will be displayed. Pressing one of thecompressed recall waveform will enlarge the waveform.●Recall List Display1. Press the Menu → Recall keys to display the recall menu.The alarm occurrence time, the recall factor occurred at the same time, and the compressedwaveform of recall waveform 1 will be displayed.Recall Waveform (Compressed)Recall FactorTime at Alarm OccurrenceDisplay from the menu Display from the user key
7−152. Select the recall factor to display on the recall list.Press the Display Selection key and select the recall factor.Select the numeric data, arrhythmia to display as recall factor.If the key LED is lighted, recall data will be displayed.If the key LED extinguished, recall data will not be displayed.3. Shift the recall list display.The newest 5 data will be displayed from the recall list.Shift the recall list to newer data by 1 page (5 data).Shift the recall list to older data by 1 page (5 data).4. Press the Recall Setup key. The recall factor and recall waveform can be selected onthe recall setup menu.●To Display and Record the Enlarged Recall WaveformOn the recall list display, pressing one of the recall factor will display the enlarged recall waveform.On the enlarged recall waveform display, the recall waveform will be displayed in 25mm/s and byusing the cursor, the data before and after the alarm occurrence can be checked.Recall Selection7Recall Data
7−161. Pressing one of the recall factors will display the enlarged recall waveform.2. Shift the waveform left or right.The recall waveform display can be shifted to left orright. ? key will shift to the older data. ? key will shift to the newer data.3. The alarm factor occurred at the same time will be displayed.Pressing the recall factor key will display the recallfactor occurred at the same time.4. Store the recall waveform.Pressing the Rec. key will store the displayedrecall waveform and numeric data.QRS ClassificationRecall Waveform 1Recall Waveform 2Scale in secondsMeasured Data
7−175. Erase the recall waveform.Erase the unnecessary recall waveform.Pressing the Erase key will display theconfirmation message. YES will erase the waveform and displays therecall list display. NO will return to the previous display.To Set the Recall ConditionOn the recall menu, the storing condition at alarm occurrence can be set.The recall waveform and recall factor (numeric data, arrhythmia) can be selected.1. Select the recall waveform.Pressing the Wave key will display the menu toselect the recall waveform.Up to 2 waveforms can be selected for recallwaveform.Select the recall waveform from No. 1 waveform andNo. 2 waveform. The key with the LED lighted is theselected waveform.2. Select the recall factor (numeric data).Pressing the Numeric key will display the menu toselect the numeric data recall factor.7Recall Data
7−18Select the recall factor by pressing the keys.The key with the LED lighted will be the recall factor.3. Select the recall factor (arrhythmia).Pressing the Arrhy. key will display the menu toselect the arrhythmia alarm factor.Select an arrhythmia for recall factor. The key withLED lighted will be the recall factor.The recall waveform will start with the following delay time tracing back fromthe alarm occurrence.NeonateAdult Child Meas. Data Alarm Arrhy. AlarmDelay Time 12sec. 12sec. 8sec. 12sec.NOTE
7−19− OCRG −DisplayThis section describes the procedure for OCRG display.The OCRG display can be accessed from the menu, or from the preprogrammed user key.On the OCRG display, compressed respiration waveform, HR trend and SpO2 trend are displayedsimultaneously.1. Press the Menu → OCRG keys to display the OCRG menu.The trend scale is a fixed scale.HR :0∼300bpmSpO2:70∼100%2. Select the respiration waveform.Select RESP or CO2 to display thecompressed respiration waveform from impedancerespiration (RESP) or CO2 waveform.3. Select the displaying duration.Select a displaying duration from 4min or 8min .4. Select the waveform size for compressed respiration waveform.Pressing the size key will sequentially change thewaveform size.Respiration Waveform Size, ScaleImpedance, RESP ×1/4→×1/2→×1→×2→×4→×1/4100→50→100 (unit : mmHg)CO24→8→10→4 (unit : % or kPa)Display from the menu Display from the user keySpO2 trendHR trendCompressedrespirationwaveform7OCRG
7−20− ST Display − ST Display, Alarm Setup, etc.This section describes the operation procedure for the ST display and alarm setup. To Display the ST Measurement MenuThe ST display can be accessed from the menu, or from the preprogrammed user key.On the ST display, the averaged ECG waveform of 16 beats will be superimposed for 5 minutes.3 frames of superimposed waveform will be displayed. Also, HR and ST level will besimultaneously displayed as graphic trend. ST1 will be measured from ECG1, and ST2 will bemeasured from ECG2. On the ST display, ST alarm limit and ST reference point / measurementpoint can be set.1. Press the Menu → ST Display keys to access the ST display.2. Select the superimposed waveform.Press the ST1 or ST2 key to select thesuperimposed waveform.3. Select the waveform size for the superimposed waveform.Pressing the key will sequentially change the key asfollows; ×1/4→×1/2→×1→×2→×4→×1/4.NOTE The selection of displayed waveform size for the superimposed waveforminterlocks with ECG waveform size.Display from the menu Display from the user key
7−214. Select the trend scale.Select the displayed scale for the trend.Trend Scale UnitHR 100, 200, 300 bpm±0.2, ±0.5, ±1.0, ±2.0 mVST ±2, ±5, ±10, ±20 mm●To Set the Reference WaveformSet the reference waveform for the ST display and set the reference point and measurement pointon the reference waveform.1. Press the Menu → ST Display → Reference keys to display the referencewaveform setup menu.2. Read the waveform by pressing the Wave Set key.16 beats average of the ECG judged as normal QRSby arrhythmia analysis will be read. If duringarrhythmia learning, or if VPC is present, thereference waveform setup will take for more than 16beats.During the reference waveform setup, the key LEDwill light.3. Set the reference point on the ST display.The reference point can be set in the range of -240ms∼0ms in increments of 10mS from the peak of QRSto the P wave direction.4. Set the measurement point on the ST display.The measurement point can be set in the range of0ms∼560ms in increments of 10mS from the peak ofQRS to the T wave direction.MeasurementPointReferencePointSize / Lead 7ST Measurement
7−22●ST Alarm SetupThe ST upper value and lower value compared with the reference waveform will be set.The alarm value is to be set for each measurement unit (mm / mV). The upper and lower limitcan be set in 1mm / 0.1mV increment.1. Press the Menu → ST Display → Alarm keys to display the alarm setup menu.2. Set the upper and lower alarm limit.Use the ? , ? keys to adjust the alarm limit.Item DescriptionLower Alarm Limit Select the lower alarm limit (±20mm / ±2.0mV).Alarm will be set to OFF if the value −20mm / −2.0mV orlower is selected.Upper Alarm Limit Select the upper alarm limit (±20mm / ±2.0mV).Alarm will be set to OFF if the value ＋20mm／＋2.0mV orabove is selected.3. Select ON/OFF of ST alarm. ON will generate the ST alarm. OFF will not generate the ST alarm.4. Select “Auto” for automatically setting the alarm limit.Pressing the Auto key will automatically set theupper alarm limit to current ST value +0.2mV (+2mm),and lower alarm limit to current ST value -0.2mV(-2mm).Selecting “Auto” will automatically turn ON the STalarm.If the upper or lower limit is OFF, the limits will remainto be OFF.Upper limit cursorLower limit cursor
7−23− NIBP List −Display / RecordThis section explains the NIBP list function and recording procedure.To Display the NIBP ListThe NIBP list display can be accessed from the menu, or from the preprogrammed user key.On the NIBP list, NIBP data and HR, SpO2 pulse rate, SpO2 value at the commencement of NIBPmeasurement will be stored and displayed for 120 NIBP measurements.1. Press the Menu → NIBP List keys to display the NIBP list display.2. Shift the displayed column.Displays the newest 10 data of the NIBP list.Shifts the display to newer data by 1 page (10 data).Shifts the display to older data by 1 page (10 data).3. Record the NIBP list.All the data stored on NIBP list will be recorded.Currently displayed NIBP list will be recorded.Display from the menu Display from the user key 7NIBP List
7−24The Description of the DisplayThe mean BP will be displayed on the NIBP list only ifit is displayed on the home display.If HR or SpO2 is not measured, or not correctlymeasured at the commencement of NIBPmeasurement, the measured data will be displayedas “? ? ?”.For Quick SYS measurement, only the SYS (highestBP value) will be displayed.NOTE If the NIBP measurement was not completed, the data will not be displayed onthe NIBP list. At the telemetry center, the time and measurement will bedisplayed as “00:00” and “? ? ?” respectively.
7−25− Other Bed ―Display / AlarmThis section explains about the function to display the waveform and numeric data and to setalarms for other bedside monitors.To use this function, wired network connection is required.Other Bed DisplayThe other bed display can be accessed from the menu or from the preprogrammed user key.Also, by setting the other bed alarm ON, Other Bed Alarm key will be displayed when otherbedside monitor generates an alarm. By pressing this Other Bed Alarm key, the display forthe other bed can be accessed.1. Press the Menu → Other Bed keys to display the other bed selection menu.On the other bed selection menu, select theRoom / Bed ID to display from the 48 bedsconnected to the wired network.The Room / Bed ID for the alarm generatingbed will be displayed in red.The bed displaying this menu will be displayedin gray.The key LED for the bed selected as the otherbed alarm generating bed will be lighted.2. Press the Room / Bed ID key and access the display for the other bed.ECG waveform and numeric data for theselected bed will be displayed.If an alarm is generated for this bed, thephysiological alarm / arrhythmia alarmmessage will be displayed.By pressing the Alarm Silence key on theother bed display, the alarm sound for thedisplayed bed can be silenced.Display from the Other Bed Alarmkey.Display from the menu Display from the user key7Other Bed
7−26Other Bed Alarm SetupFrom the 48 bedside monitors, the bed to generate the other bed alarm and ON/OFF of other bedalarm display can be performed.1. Select the bed to generate the other bed alarm.Press the Set other alarm key to display theother bed alarm setup menu.Select the bed to generate the other bed alarm.The key LED for the bed selected as the otherbed alarm generating bed will be lighted.2. Select ON for the other bed alarm.Press the Prev. Disp. key and display theother bed selection menu.Selecting ON will generate the other bedalarm when an alarm generates at the otherbed.Selecting OFF will not generate the otherbed alarm.

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