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
Contents
Manual 7
| Download: |  |
| Mirror Download [FCC.gov] | |
| Document ID | 380409 |
| Application ID | wOVnFJBjOncRtHtUy8lSFQ== |
| Document Description | Manual 7 |
| Short Term Confidential | No |
| Permanent Confidential | No |
| Supercede | No |
| Document Type | User Manual |
| Display Format | Adobe Acrobat PDF - pdf |
| Filesize | 232.7kB (2908748 bits) |
| Date Submitted | 2003-12-10 00:00:00 |
| Date Available | 2003-12-10 00:00:00 |
| Creation Date | 2003-12-06 11:58:03 |
| Producing Software | Acrobat PDFWriter 4.0 Windows NT |
| Document Lastmod | 2003-12-08 09:37:09 |
| Document Title | DS71v1-1_FA_06_Parameter_008.PDF |
| Document Creator | Microsoft Word - DS71v1-1_FA_06_Parameter_008.doc |
| Document Author: | ezashi |
Chapter 6 Parameter Setup Quick SYS Measurement Duration ･････････････ 32 End of Measurement Tone････････････････････ 33 Quick SYS List ･･････････････････････････････ 33 PR Display ･････････････････････････････････ 34 Mean BP Display ････････････････････････････ 34 1-Minute Measurement Duration･･･････････････ 35 NIBP Speed ････････････････････････････････ 35 − Temperature −･････････････････････････････ 36 Temperature Alarm ･･････････････････････････ 36 ON/OFF of Parameter Display ････････････････ 37 (DS-7141) ････････ 38 − CO2 Concentration − CO2 Scale ･･････････････････････････････････ 38 EtCO2 (End-Tidal CO2) Alarm ･････････････････ 38 InspCO2 (Inspiratory CO2) Alarm ･･･････････････ 39 EtCO2 Average Duration･･････････････････････ 40 Measurement Unit ･･･････････････････････････ 40 CO2 Calibration ･････････････････････････････ 41 Restarting the CO2 Unit ･･････････････････････ 42 ON/OFF of Parameter Display ････････････････ 42 6−1 Parameter Setup − Parameter Setup − Setting the Monitoring Condition ･･････････････2 To Display the Parameter Setup Menu ･･･････････2 Zero Balance of All Pressure Lines (BP1, BP2) ･･･3 − ECG − ･････････････････････････････････････4 ECG Waveform Size and Lead ･････････････････4 HR Alarm ････････････････････････････････････6 Arrhythmia Alarm ･････････････････････････････6 Filter Mode Selection ･･････････････････････････7 HR Average Selection ･････････････････････････8 HR Synchronized Indicator (ON/OFF of HR Synchronized Tone)･･･････････････････････････8 ECG Source ･････････････････････････････････9 Automatic Lead Switching･･････････････････････9 Pacemaker Pulse ････････････････････････････10 QRS Pace Mask ･････････････････････････････11 ECG Drift Filter ･･････････････････････････････12 ON/OFF of Parameter Display ･････････････････13 − Respiration − ･･････････････････････････････14 Respiration Waveform Size ･･･････････････････14 RR Alarm ･･･････････････････････････････････15 Apnea Alarm ････････････････････････････････15 CVA Detection ･･････････････････････････････16 Respiration Source ･･････････････････････････17 Impedance Respiration Measurement ･･････････17 RR Synchronization Mark ･････････････････････18 ON/OFF of Parameter Display ･････････････････19 − Invasive Blood Pressure (BP1, BP2)−･･････････20 BP Scale (BP1, BP2) ･････････････････････････20 BP Alarm (BP1, BP2)･････････････････････････21 Zero Balance of Pressure Lines (BP1, BP2) ･････21 Filter Selection (BP1, BP2) ････････････････････22 Mean BP Display (BP1, BP2) ･･････････････････22 ECG Source (BP1)･･･････････････････････････23 ON/OFF of Parameter Display ･････････････････24 − SpO2 − ････････････････････････････････････25 SpO2 Waveform Size ･････････････････････････26 SpO2 Alarm ･････････････････････････････････26 ECG Source ････････････････････････････････27 SpO2 Alarm during NIBP Measurement (Ignore NIBP) ･･････････････････････････････････････27 ON/OFF of Parameter Display ･････････････････28 − Non-Invasive Blood Pressure − ･･･････････････29 NIBP Automatic Measurement ･････････････････29 NIBP 1-Minute Interval Measurement ･･･････････30 Quick SYS Start ･････････････････････････････31 NIBP Alarm ･････････････････････････････････31 − Parameter Setup − Setting the Monitoring Condition This menu allows setup of measurement condition, waveform size, scale, etc. of ECG, BP, NIBP, SpO2, RESP, TEMP, and CO2. To Display the Parameter Setup Menu Press the Menu → Parameter keys to display the parameter setup menu, and select the parameter. 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 parameter key where numeric data is displayed. Parameter Key ＜Parameter Setup Menu＞ ＜ECG Parameter Setup Menu＞ 6−2 Zero 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 zero complete” will be displayed when the procedure is complete. A message, “BP zero failed” will be displayed when the process fails. The three-way cock may not be opened to air, artifact may be present, or the transducer may be defective. Check the cause and try the zero balance procedure again. A message, “BP zero drift” will be displayed when the interface cable is not connected. Check if the cable is firmly connected. 3. Close the three-way cock when the zero balance is complete. Each time the blood pressure transducer or tubing is replaced, the zero C A U T I O N balance procedure is required to ensure accurate measurements. Parameter Setup 6−3 − ECG − The measurement condition for ECG can be set on this menu. Lead, Size HR Alarm Arrhy. Alarm Configuration Arrhy. Learn Sets the waveform size and lead for ECG display and recording. Sets ON/OFF of HR alarm, and sets upper and lower alarm limit. Sets ON/OFF and detection threshold for each arrhythmia alarm. Sets the condition for measuring ECG and HR. The monitor learns the normal QRS at ECG electrode replacement or at misdetection of the arrhythmia analysis. ECG Waveform Size and Lead 1. 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 the waveform size, lead, baseline position. The key LED for the selected channel will light. When 3-electrode is used, these keys will not be displayed. 3. Select the waveform size. Select the waveform size for displaying and recording. Size Voltage (10mm) 6−4 ×1/4 4mV ×1/2 2mV ×1 1mV ×2 500uV ×4 250uV Pressing the Auto key will automatically adjust the ECG amplitude to 10mm. The automatic adjustment will function only when the key is pressed. The automatic adjustment will not function when the monitor is learning arrhythmia. 4. Select the lead. The leads can be selected from 3 leads, 6 leads, 7 leads depending on the connected ECG relay cable. ECG Relay Cable Lead 3-electrode 4-electrode 5-electrode 5. Set the baseline position. ECG If the waveform is difficult to see due to ECG amplitude, set the 0mV baseline position. The baseline position for the waveform display and recording will be adjusted. ? The threshold level for arrhythmia detection changes with ECG waveform size. Set a proper waveform size for monitoring. When the ECG waveform size is ? 1/4, ? 1/2, or ? 1, the detection threshold is 250 µV. When the ECG waveform size is ? 2, or ? 4, the detection threshold is CAUTION 150 µV. ? Automatic size/position of the ECG is effective only at the time the AUTO key is pressed. This does not continually adjust size and position. 6−5 HR Alarm 1. 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 measured from BP can be set. The upper and lower limit can be set in 5 bpm increments. Key Item Description Selecting ON will generate the HR/PR alarm. Individual Alarm Selecting OFF will not generate the HR/PR alarm. Sets the lower alarm limit (20∼295bpm). Lower Alarm Setting a value 20bpm or below will turn OFF the Limit alarm. Sets the upper alarm limit (25∼300bpm). Upper Alarm Setting a value 300bpm or above will turn OFF the Limit alarm. Automatically sets the upper limit to ＋40bpm, and the Automatic Setup lower limit to −40bpm to the current value. Arrhythmia Alarm 1. 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. Reference 6−6 Refer to “4. Monitoring Setup for details. Alarm Setup” Filter Mode Selection The waveform frequency characteristic can be selected from Monitor Mode, ESIS Mode, or ST Display Mode according to the monitoring purpose. Each mode has different frequency characteristic. 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 Mode ECG Patient Type Frequency Characteristic Adult / Child 0.5∼40Hz Neonate 1.6∼40Hz This is the standard mode for ECG monitoring. The upper frequency is set to 40Hz to reduce artifact caused by EMG, etc. ESIS Mode Patient Type Frequency Characteristic Adult / Child 1.6∼15Hz Neonate 1.6∼15Hz This mode is for ECG monitoring when using electrosurgical instruments. The upper frequency is set to 15Hz which will largely reduce the artifact caused by surgical knife, EMG, etc. However, as this may also reduce the QRS amplitude at the same time, do not select this mode unless using electrosurgical instruments. ST Display Mode Patient Type Frequency Characteristic Adult / Child 0.05∼40Hz Select 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” is selected as patient type, this mode can not be selected When the filter setup is changed, a notch will appear on the ECG waveform due to the change in frequency characteristic. NOTE 6−7 HR Average Selection The 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 and child, 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 Mark 1. Press the selection. Config. key to display the setup menu for HR synchronized indicator 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. 6−8 ECG Source The 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. ECG 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 ＞BP. Auto will automatically set the measurable HR source in the priority of ECG＞SpO2 Automatic Lead Switching By setting the Automatic Lead Switching ON, a new ECG lead will be automatically set when the electrode comes off. When the lead off condition occurs, the “Check Electrodes” message will be displayed and a new ECG lead will be automatically set if the Automatic Lead Switching is set to ON. Lead Switching Type Electrode Off 5-electrode cable RA／RA+C LA／LA+C 4-electrode cable RA LA Auto Lead Selected ECG1 ECG2 Ⅲ Ⅲ Ⅱ Ⅱ Ⅱ aVR Ⅲ Ⅱ Ⅲ Ⅱ 6−9 1. Press the Config. lead switching. → Page Down keys to display the setup menu for setting the auto 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 Pulse The artificial pace pulse can be displayed by superimposing on the ECG waveform. The artificial pace pulse will be displayed in yellow. Pacemaker Pulse Detection Algorithm ③ ①ECG Signal Input Inputs ECG signal. ②Suspension of Pacemaker Pulse and QRS Detection Signals with high frequency and large amplitude will be detected as a pacemaker pulse. When a pacemaker pulse is detected, QRS detection will be suspended for a certain amount of time to prevent the pacemaker pulse erroneously detected as QRS. ① ③Canceling Arrhythmia Detection ② Arrhythmia detection will be cancelled to avoid detecting the waveform succeeding the pacemaker pulse as an abnormal beat. Precautions about Pacemaker Pulse Detection ? There are some cases when pacemaker pulse can not be detected depending on the pacemaker type, pulse voltage, pulse width, electrode lead type (unipolar, bipolar), or electrode placement which causes the pacemaker pulse amplitude to decrease and disables pacemaker pulse detection. ? If signals similar to a pacemaker pulse are present, such as electric CAUTION blanket noise or excessive AC frequency noise, these may be erroneously detected and displayed as a pacemaker pulse. ? When the spontaneous QRS and pacemaker pulse overlaps (as in a fusion beat), QRS detection will be suspended and the heart rate will be reduced. ? If a pacemaker pulse is continuously detected due to AC frequency interference, QRS detection will be suspended and the heart rate will be reduced. Also arrhythmia detection will not be possible. 6−10 1. Press the selection. Config. → Page Down key to display the setup menu for pacemaker pulse 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 patient admit / discharge menu. QRS Pace Mask For patients using pacemakers, there are cases when the pacing waveform may not occur in spite of the pacing stimulus. This condition is called “pacing failure”, or “failure to capture”. To avoid detecting pacemaker pulses as a QRS complex when this occurs, the monitor has a function to suspend QRS detection for a fixed amount of time starting from the detection of the pacing stimulus. This function is called “pace mask”. But if the pacemaker does not detect the patient’s spontaneous heartbeat (sensing failure), and the pacing stimulus is applied at the same timing as QRS, this “pace mask” function may erroneously mask the QRS and cause the heart rate measurement to decrease. To avoid this, QRS pace mask function can be turned off for correct measurement of the heart rate. (default setting : ON) Normal Pacing Pacing Failure Pacing waveform caused by pacemaker pulse Pacemaker Pulse No waveform in spite of pacing stimulus. Sensing Failure Pacemaker pulse applied at the same timing with spontaneous heartbeat Pacemaker Pulse If the QRS pace mask function is turned OFF, a decrease in heart rate may not generate HR or ASYSTOLE alarms due to erroneously detected QRS. W A R N I N G Turn this function OFF only if you are sure that pacing failure will not occur, or when the patient can be constantly monitored. 6−11 ECG 1. Press the Config. configuration menu. → Page Down keys to display the second page of the 2. Select the pace pulse mask time. Select from 10ms , 20ms , 40ms depending on the pace spike amplitude or presence of fusion beat. Selecting OFF will set the mask time to 0ms. Selecting Auto will switch between 20ms and 40ms depending on the pace spike amplitude. ECG Drift Filter By setting the ECG drift filter ON, only the amplitude with frequency component under 1Hz will be attenuated to prevent the ECG baseline drift. 1. Press the Config. configuration menu. → Page Down keys to display the second page of the 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 6−12 When an electrosurgery-proof ECG relay cable is used, ECG drift filter can not be set to ON . ON/OFF of Parameter Display 1. Press the Display ON/OFF will appear. 2. Select Display ON or key. The confirmation display for ON/OFF of ECG display Display OFF . Pressing the Display ON key will display the waveform and numeric data. Pressing the Display OFF key will not display the waveform and numeric data. The Display OFF message will be displayed inside the parameter key. When ECG electrodes are attached to the patient with the ECG display set to OFF, the ECG waveform and numeric data will be automatically displayed after 30 seconds. When the waveform and numeric data display is set to OFF, the alarm C A U T I O N generation and tabular/graphic trend will be also set to OFF. NOTE If ECG source is set to other than ECG, selecting Display OFF display PR_SpO2 or PR_BP for the HR parameter key. will 6−13 ECG − Respiration − This menu allows setup for the impedance respiration measurement and CO2 respiration measurement. Size RR Alarm APNEA Alarm Configuration Selects the waveform size to display impedance respiration. Selects ON/OFF of respiration rate alarm, and sets upper and lower alarm limits. Selects ON/OFF of apnea alarm and sets upper alarm limit. Sets the respiration monitoring configuration. ? When the following relay cables are used, respiration can not be measured. ? 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) C A U T I O N ? When a defibrillator is used during respiration monitoring, a large offset voltage will be placed on the ECG electrodes, which may cause interruption of monitoring for a few seconds. ? When the following lead cables are used, respiration cannot be measured. ? Lead Cable #3382.0648.16 (Electrosurgery-proof, 3-electrode) ? Lead Cable #3382.0661.16 (Electrosurgery-proof, 5-electrode) Respiration Waveform Size 1. Press the Size key to display the size setup menu. Select the waveform size and baseline position to display and record the impedance respiration waveform. 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. 6−14 RR Alarm 1. Press the RR Alarm key to display alarm setup menu. Set ON/OFF of RR alarm and upper and lower alarm limit. The alarm will be set common to RR measured from impedance respiration waveform or RR measured from CO2 waveform. The adjustable increment for upper and lower limit depends on the patient type. Adult / Child : 5bpm increment Neonate : 2bpm increment NOTE If the alarm is based on the RR measured from CO2 waveform, RR alarm will not generate unless 2 or more respiration is detected within 30 seconds after power ON or after discharge. Key Item Individual Alarm Upper Alarm Limit Automatic Setup Selecting ON will generate the RR alarm. Selecting OFF will not generate the RR alarm. Sets the lower alarm limit (5∼145Bpm／5∼148Bpm). Setting a value 5Bpm or below will turn OFF the alarm. Sets the upper alarm limit (10∼150Bpm／4∼150Bpm). Setting a value 150Bpm or above will turn OFF the alarm. Automatically sets the upper limit to ＋20Bpm, and the lower limit to −20Bpm to the current value. Apnea Alarm 1. Press the Apnea Alarm key to display the alarm setup menu. Set ON/OFF of apnea alarm and upper limit of apnea time. Apnea will be set common to apnea time measured from impedance respiration waveform or apnea time measured from CO2 waveform. The upper limit can be set in 1-second increment. There is no lower limit. The purpose of this respiration alarm is to alert the user to evaluate for the possible occurrence of apnea events by identifying the absence of W A R N I N G respiration. It is not intended to be classified as an “Apnea Monitor” and will 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 detected within 30 seconds after power ON or after discharge. 6−15 Respiration Lower Alarm Limit Description Key Item Individual Setup Upper Alarm Limit Automatic Setup Description Selecting ON will generate the apnea alarm. Selecting OFF will not generate the apnea alarm. Sets the upper alarm limit (5∼20sec.). Setting a value equal to or above 20sec. will turn OFF the alarm. Sets the apnea alarm value set for the currently selected alarm mode. CVA Detection When the amplitude of the respiration waveform decreases due to causes such as respiratory pause, the ECG waveform may be superimposed on to the respiration waveform, making the RR equal to the HR. This condition is called CVA (Cardio-Vascular Artifact), and is detected using the CVA detection function. If the ECG waveform is superimposed on to the respiration waveform, with HR (RR) 30bpm, for 20 seconds 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. 6−16 Respiration Source The 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. Auto will automatically select the parameter to measure the respiration rate with the priority order of CO2＞impedance. Impedance Respiration Measurement The respiration measurement using the impedance method conducts high-frequency and weak current between the ECG electrodes attached to the patient, and measures the potential difference between the electrodes caused by thoracic movement using the synchronous rectification system. For a patient using the adaptive (minute ventilation) pacemaker, the pacemaker measurement signal and the high-frequency current of this equipment interferes with each other which causes incorrect respiration measurement. If the patient is using an adaptive (minute ventilation) pacemaker, set the impedance respiration measurement OFF. 1. Press the Configuration measurement. key to display the setup menu to set the impedance respiration 2. Select ON or OFF . ON will perform standard impedance respiration measurement. OFF will stop the impedance respiration measurement and will not display the impedance respiration waveform and RR. A high frequency electric discharge which is a measurement signal will be also ceased. 6−17 Respiration Impedance will measure respiration rate from impedance respiration curve. The numeric value will be indicated as “RR_IMP” in the respiration parameter key. CO2 will measure respiration rate from CO2 waveform. The numeric value will be indicated as “RR_CO2” in the respiration parameter key. RR Synchronization Mark The RR mark synchronized to impedance respiration or CO2 waveform will be displayed inside the parameter key. RR Mark 1. Press the Mark. Configuration key to display the setup menu for setting the RR synchronized 2. Select ON or OFF . OFF will not display the synchronization mark. ON will display the synchronization mark. 6−18 ON/OFF of Parameter Display 1. Press the Display ON/OFF will appear. 2. Select Display ON or key. The confirmation display for ON/OFF of RESP display Display OFF . The Display OFF message will be displayed inside the parameter key. When ECG electrodes are attached to the patient with the respiration display set to OFF, the respiration waveform and numeric data will be automatically displayed after 30 seconds. When waveform and numeric data display is set to OFF, the alarm C A U T I O N generation and tabular/graphic trend will be also set to OFF. NOTE If RR source is set to other than Impedance , selecting will display CO2_RR for the RESP parameter key. Display OFF 6−19 Respiration Pressing the Display ON key will display the waveform and numeric data. Pressing the Display OFF key will not display the waveform and numeric data. − Invasive Blood Pressure (BP1, BP2)− This menu allows setup of the measurement condition for BP1, BP2. Scale BP Alarm : Selects the scale for BP waveform display. : Sets the upper and lower alarm limit of systolic, diastolic, mean blood pressure and ON/OFF of the alarm. BP Zero : Performs zero balance. Configuration : Sets the BP monitoring condition. When the main power is turned ON, the BP value will not be displayed until C A U T I O N zero 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 , (kPa). 32 , 40 For telemetry transmission, BP waveform with a scale above the C A U T I O N programmed scale can not be properly transmitted. Set the BP waveform below the programmed scale. 6−20 BP 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 increment 55∼300mmHg / 5mmHg increment kPa : 0∼7kPa / 0.2kPa increment 7.5∼40.0kPa / 0.5kPa increment Key Item Individual Alarm BP Description Selecting Selecting ON will generate BP alarm. OFF will not generate BP alarm. Select from SYS (systolic BP), DIA (diastolic BP), MEAN (mean BP). Lower Alarm Limit Upper Alarm Limit Automatic Setup Sets the lower alarm limit (0∼295mmHg/0∼39.5kPa). Setting a value equal to or below 0mmHg/0kPa will turn OFF the alarm. Set the upper limit (2∼300 mmHg/0.2∼40.0kPa). Setting a value equal to or above 300 mmHg/40.0kPa will turn OFF the alarm. Automatically sets the upper limit to ＋40mmHg/＋ 5.5kPa, and the lower limit to −20mmHg/−2.5kPa to the 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. 6−21 Verify 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 zero failed” 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 balance procedure again. A message, “BP zero drift” will be displayed when the interface cable is not connected. Check if the cable is firmly connected. 3. Close the three-way cock when the zero balance is complete. Each time the blood pressure transducer or tubing is replaced, the zero C A U T I O N balance 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 measurement circuit. 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 BP display. 2. Select 6−22 ON or key to display the setup menu for selecting ON/OFF of mean OFF . Selecting ON Selecting OFF will display the mean BP. will not display the mean BP. If the mean BP display is set to OFF, the mean BP alarm will not be C A U T I O N generated. 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. BP 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 ＞BP1. Auto will automatically set the measurable HR source in the priority of ECG＞SpO2 6−23 ON/OFF of Parameter Display 1. Press the appear. 2. Select Display ON/OFF Display ON or key. The confirmation display for ON/OFF of BP display will Display OFF . Pressing the Display ON key will display the waveform and numeric data. Pressing the Display OFF key will not display the waveform and numeric data. The Display OFF message will be displayed inside the parameter key. CAUTION 6−24 ? When waveform and numeric data display is set to OFF, the alarm generation 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. − 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. SpO2 Take the following precautions when monitoring over long periods of time. CAUTION ? To avoid skin rash or low-temperature burn, it is recommended to change the measurement position several times a day. Be especially careful when continuously using on neonates, infants, or patients 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 SpO2 connector. Otherwise, the outside light may affect to falsely display measurements. ? The DS-100A is intended for use on finger of adults weighing over 40 kg (approximate). Do not use them on children or neonates. Also do not apply them on the thumb or foot. ? The light-emitting part of the sensor should be over the root of the fingernail. Do not insert the finger too far into the sensor as it may hurt the patient. C A U T I O N ? The DS-100A is not designed for long term use. Remove the sensor every 4 hours. If any inhibition is detected in tissue blood flow, replace it or move the sensor to another finger. ? Measuring on a limb with NIBP cuff, arterial catheter, or intracatheter may result in incorrect measurement. ? Do not secure the adhesive tape too tight as it may obstruct the blood flow. 6−25 SpO2 Waveform Size 1. 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 Alarm 1. 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 generated alarm can be corrected by setting the SEC (second) alarm function. Reference Refer to ”4. Monitoring Setup SpO2 SEC Alarm Setup” for details of SEC alarm setup procedure. The upper and lower limits can be set in 1% increment. Key Item Individual Alarm Lower Alarm Limit Upper Alarm Limit Automatic Setup NOTE 6−26 Description Selecting ON will generate the SpO2 alarm. Selecting OFF will not generate the SpO2 alarm. Sets the lower alarm limit (50∼99%). Setting a value 50% or below will turn OFF the alarm. Sets the upper alarm limit (52∼100%). Setting a value 100% or above will turn OFF the alarm. Automatically sets the upper limit to OFF, and the lower limit to 95% to the current value. Whether to use the SEC (second) alarm function and its threshold selection should be based on the patient’s clinical indication portent and medical evaluation. ECG Source 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. 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. SpO2 Selecting BP1 will measure the PR from BP1. “PR_BP” will be displayed inside the parameter key. Selecting ＞BP1. Auto will automatically set the measurable ECG source in the priority of ECG＞SpO2 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 for measurement. During the NIBP measurement, the cuff inflation restricts the blood flow which disables the correct detection 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 NIBP measurement. 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. 6−27 ON/OFF of Parameter Display 1. Press the Display ON/OFF will appear. 2. Select Display ON or key. The confirmation display for ON/OFF of SpO2 display Display OFF . Pressing the Display ON key will display the waveform and numeric data. Pressing the Display OFF key will not display the waveform and numeric data. The Display OFF message will be displayed inside the parameter key. When SpO2 sensor is attached to the patient with the SpO2 display set to OFF, and SpO2 can be measured for 30 seconds, the SpO2 waveform and numeric data will be automatically displayed. CAUTION 6−28 ? When the waveform and numeric data display is set to OFF, the alarm generation 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. − 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 interval measurement and Quick SYS measurement. NIBP Alarm : Sets the ON/OFF of NIBP alarm and upper / lower limit of systolic, diastolic, and mean BP. Configuration : Sets the NIBP monitoring configuration. NIBP For the following situation, measurements will be terminated. CAUTION ? When the measurement time has exceeded 120 seconds for adult, 90 seconds for child, 60 seconds for neonate. ? When the inflation value has exceeded 300mmHg for adult, 200mmHg for child, 150mmHg for neonate. If used with the incorrect patient type, it will not only cause erroneous C A U T I O N measurement, but the inflating level for the adult may be applied to child or neonate causing a dangerous situation to the patient. NIBP Automatic Measurement Non-invasive blood pressure can be measured automatically at selected time intervals. If Quick SYS measurement is performed during the NIBP automatic measurement, the automatic measurement will automatically resume when Quick SYS measurement completes. Currently selected time interval When NIBP automatic measurement is set, the set interval time will be displayed inside the parameter key. 1. Press the Auto Mode key to display the measurement interval setup menu for the automatic measurement. 6−29 2. Select an interval time. Select from 2 min / 2.5 min / 3 min / 5 min / 10 min 30 min / 60 min / 120 min . Select OFF if not performing the interval measurement. 15 min 20 min The measurement time will be the integral multiple of the selected interval time beginning with 0 minute. 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 Measurement The 1-minute interval measurement will automatically stop after 10 minutes or 20 minutes and returns to the previous interval mode setup. 1. Press the Auto Mode key to display the measurement interval setup menu to start the 1-minute interval measurement. Measurement Duration 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 returns to the previous interval mode setup. 20min. will automatically stop the 1-minute interval measurement after 20 minutes and returns to the previous interval mode setup. ? The 1-minute interval measurement will always start from 00 second. Pressing the 1min Start key will start the measurement from the next 00 second. ? The 1-minute interval measurement will automatically stop after 10 CAUTION minutes or 20 minutes and returns to the previous interval mode setup. The selection of 10min / 20min can be made on the NIBP configuration menu. (Refer to “1-Minute Measurement Duration” of this section” 6−30 Quick SYS Start The 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 continuous measurement will be ceased. Only the systolic blood pressure will be measured and displayed. 1. Press the Auto Mode Quick SYS. key to display the measurement interval setup menu to start the Measurement Duration NIBP 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 NIBP configuration menu. The continuous measurement will automatically cease after the selected duration from 3min , 5min , or 10min . The alarm function will be ineffective for the BP value measured by Quick C A U T I O N SYS regardless of the ON/OFF selection of NIBP alarm. NIBP Alarm 1. 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. 6−31 Key Item Individual Alarm Description Selecting Selecting ON will generate the NIBP alarm. OFF will not generate the NIBP alarm. Select from SYS (systolic BP), DIA (diastolic BP), or MEAN (mean BP) Lower Alarm Limit Upper Alarm Limit Automatic Setup Sets the lower alarm limit (10∼295mmHg/1.5∼ 39.5kPa). Setting a value 10mmHg/1.5kPa or below will turn OFF the alarm. Sets the upper limit (15∼300mmHg /2.0∼40.0kPa). Setting a value 300bpm/40.0kPa or above will turn OFF the alarm. Automatically 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 Duration The 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 measured location. Set the duration according to the patient condition. 1. Press the SYS. Configuration key to display the NIBP configuration menu to set the Quick 2. Select the measurement duration. Select an appropriate time from 3min , 5min , 10min . Quick SYS will automatically cease after the selected duration. 6−32 End of Measurement Tone By selecting ON for the “End Tone”, a tone will be generated when the NIBP measurement completes. 1. Press the Configuration the End Tone. key to display the NIBP configuration menu to set ON/OFF for 2. Select ON or OFF . ON will generate a tone when the measurement completes. OFF will not generate a tone when the measurement completes. NIBP Quick SYS List The systolic blood pressure measured by Quick SYS can be included in the NIBP list. 1. Press the Configuration Quick SYS List. 2. Select Quick SYS ON or key to display the NIBP configuration menu for setting the OFF . ON will include the systolic blood pressure value to NIBP list. OFF will not include the systolic blood pressure value to NIBP list. 6−33 PR Display The measured pulse rate can be displayed. This selection is for display only, and alarm function and tabular trend function will be ineffective. 1. Press the display. 2. Select Configuration ON or key to display the NIBP configuration menu for setting the PR OFF . Selecting Selecting Pulse Rate ON will display the pulse rate. OFF will not display the pulse rate. Mean BP Display The ON/OFF of mean BP display can be selected. 1. Press the Configuration mean BP display. 2. Select ON or key to display the NIBP configuration menu for setting the OFF . ON will display the mean BP. OFF 6−34 will not display the mean BP. 1-Minute Measurement Duration The 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 release time until the next measurement will be shortened, and the measured location may congest. Be cautious when performing long duration of continuous measurement. 1. Press the Configuration → Page Down keys to display the NIBP configuration menu for 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 NIBP Speed The NIBP cuff inflation speed can be selected from standard or high speed. 1. Press the Configuration configuration menu. → Page Down keys to display the second page of the 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 500cc tank connected. When Hi Speed is selected, it will take about 6 seconds to inflate to 300mmHg with 500cc tank connected. (for adult) When an adult cuff is wrapped around an arm with a space allowing one finger fitting in between the cuff and arm, the speed to inflate to 190mmHg is within 11 seconds for normal speed, and within 7 seconds for high speed. NOTE The NIBP speed setup is effective only when adult or child is selected for patient type. The NIBP speed for neonate will be fixed in spite of the speed selection. 6−35 − 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 Alarm 1. 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 Individual Alarm Lower Alarm Limit Upper Alarm Limit Automatic Setup 6−36 Description Selecting ON will generate the TEMP alarm. Selecting OFF will not generate the TEMP alarm. Sets 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 the alarm OFF. Sets 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 the alarm OFF. Automatically sets the upper limit to ＋2.0?C /＋3.0?F to the current value, and lower limit to−2?C /−3.0?F to the current value. ON/OFF of Parameter Display 1. Press the Display ON/OFF will appear. 2. Select Display ON or key. The confirmation display for ON/OFF of TEMP display Display OFF . The Display OFF message will be displayed inside the parameter key. When the waveform and numeric data display is set to OFF, the alarm C A U T I O N generation and tabular/graphic trend will be also set to OFF. 6−37 Temperature Pressing the Display ON key will display the numeric data. Pressing the Display OFF key will not display the numeric data. − CO2 Concentration − (DS-7141) This menu allows setup of CO2 concentration measurement. Scale EtCO2 Alarm : InspCO2 Alarm : Configuration : Sets the CO2 waveform scale. Sets ON/OFF of EtCO2 alarm, and upper and lower alarm limits. Sets ON/OFF of InspCO2 alarm and upper alarm limit. Sets CO2 monitoring conditions. CO2 Scale 1. 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) Alarm 1. Press the EtCO2 Alarm NOTE 6−38 key to display the alarm setup menu. Select ON/OFF of EtCO2 alarm, and set the upper and lower alarm limits. Set the alarm condition for each measurement unit (mmHg / kPa / %). Upper and lower alarm limits can be set in increments of 1mmHg, 0.1kPa, 0.1%. EtCO2 alarm will not generate unless 2 or more respiration is detected within 30 seconds after power ON or after discharge. Key Item Individual Alarm Lower Alarm Limit Upper Alarm Limit Automatic Setup Description Selecting ON will generate the EtCO2 alarm. Selecting OFF will not generate the EtCO2 alarm. Sets the lower alarm limit (1∼98mmHg, 0.1∼13.1kPa, 0.1∼13.1%). Setting a value equal to or below 1mmHg, 0.1kPa, 0.1% will turn the alarm OFF. Sets the upper alarm limit (3∼100mmHg, 0.4∼ 13.3kPa, 0.3∼13.3%). Setting a value equal to or above 100mmHg, 13.3kPa, 13.3% will turn the alarm OFF. Automatically sets the upper alarm limit to ＋10mmHg, ＋1.3kPa, ＋1.3% to the current value, and the lower alarm limit to −10mmHg, −1.3kPa, −1.3% to the current value. InspCO2 (Inspiratory CO2) Alarm 1. Press the InspCO2 Alarm Key InspCO2 alarm will not generate unless 2 or more respiration is detected within 30 seconds after power ON or after discharge. Item Description Selecting ON will generate the InspCO2 alarm. Individual Alarm Selecting OFF will not generate the InspCO2 alarm. Sets the upper alarm limit (1∼4mmHg, 0.1∼0.4kPa, Upper Alarm 0.1∼0.4%). Setting a value equal to or above Limit 4mmHg, 0.4kPa, 0.4% will turn the alarm OFF. Automatically sets the upper alarm limit to ＋3mmHg, Automatic Setup ＋0.4kPa, ＋0.4% to the current measurement. 6−39 CO2 Concentration NOTE key to display the alarm setup menu. Select ON/OFF of InspCO2 alarm, and set the upper alarm 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. EtCO2 Average Duration The duration to average the EtCO2 value can be selected from 10 sec., 20 sec., 30 sec., or OFF. 1. Press the selection. Configuration key to display configuration menu for EtCO2 average duration 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 be displayed if respiration rate is above 60 Bpm. Measurement Unit The measurement unit can be selected from mmHg, kPa, or %. Measurement Unit 1. Press the selection. Configuration key to display the configuration menu for measurement unit 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 trend may be lost. When the measurement unit is changed, make sure to set the alarm condition for that unit. The alarm setup is necessary for each measurement unit. 6−40 CO2 Calibration CO2 calibration can be performed using calibration gas. Calibration should be conducted every 6 months or when any measurement error is found. 1. Press the display. Configuration key to display the configuration menu for CO2 Cal. key ＜Preparing for calibration＞ 3. Press the Start Cal ＜Start calibration＞ key and conduct calibration according to the displayed messages. 4. The message, “Feed CAL. GAS” will be displayed. Press the injection button to inject the calibration gas. 5. The message, “Calc. Gas can be removed” will be displayed. Stop pressing the injection button to cease the injection. 6. The message, “CAL. OK” will be displayed. “Last Cal. Date” will be updated to the current date. 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. ? Perform calibration after 20 minutes from turning ON the power of the DS-7100 system. C A U T I O N ? Do not disconnect the sampling tube during calibration. If disconnected, calibration will cease. 6−41 CO2 Concentration 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 the power is turned ON. During this time, Start Cal key will be displayed in gray which indicates that the key is ineffective. The message, “Calibration not ready” and the remaining time for preparation will be displayed. Restarting the CO2 Unit The sampling tube will cease functioning when erroneous condition such as blocking of exhaust tube, sampling tube or nasal prong is detected. When the pump ceases functioning, “Check CO2 unit” message will be displayed. After resolving the problem, press the Restart CO2 key and restart the measurement. 1. Press the Configuration key to display the configuration menu for Restart CO2 key display. 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, the replacement of CO2 unit part may be necessary. Contact our service representative. ON/OFF of Parameter Display 1. Press the Display ON/OFF will appear. 6−42 key. The confirmation display for ON/OFF of CO2 display 2. Select Display ON or Display OFF . Pressing the Display ON key will display the waveform and numeric data. Pressing the Display OFF key will not display the waveform and numeric data. The Display OFF message will be displayed inside the parameter key. When filter line is attached to the patient with the CO2 display set to OFF, and 2 or more respiration is detected within 30 seconds, the CO2 waveform and numeric data will be automatically displayed. CAUTION ? When the waveform and numeric data display is set to OFF, the alarm generation 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. CO2 Concentration 6−43 Blank Page 6−44 Chapter 7 Function This chapter describes the functions such as arrhythmia analysis, trend, and recall. Definition, etc. ･････ 2 − Arrhythmia Analysis − Arrhythmia Definition･･････････････････････････ 2 ●QRS Classification ･････････････････････････2 ●Arrhythmia Type ･･･････････････････････････2 ●Recall List Display････････････････････････ 14 ●To Display and Record the Enlarged Recall Waveform ･････････････････････････････････ 15 To Set the Recall Condition ･･･････････････････ 17 Display ･･･････････････････････ 19 − OCRG − ST Display, Alarm Setup, etc.･ 20 − ST Display − To Display the ST Measurement Menu ･････････ 20 ●To Set the Reference Waveform ･･･････････ 21 ●ST Alarm Setup ･･････････････････････････ 22 Display / Record ･････････････ 23 − NIBP List − To Display the NIBP List･･････････････････････ 23 The Description of the Display･････････････････ 24 Display / Alarm ･･････････････ 25 − Other Bed ― Other Bed Display ･･･････････････････････････ 25 Other Bed Alarm Setup･･･････････････････････ 26 7−1 Function To Set the Arrhythmia Alarm ･･･････････････････ 3 To Perform Arrhythmia Learning ････････････････ 4 Display / Record ･････ 6 − Graphic Trend Data− To Display the Graphic Trend ･･････････････････ 6 The Description of the Display･････････････････ 10 − Tabular Trend − Display / Record ････････････ 11 To Display the Tabular Trend ･････････････････ 11 The Description of the Display･････････････････ 12 Parameter Setup for Tabular Trend ････････････ 13 Display / Record ･････････････ 14 − Recall Data− To Display the Recall Menu ･･･････････････････ 14 − Arrhythmia Analysis − Definition, etc. This section explains the arrhythmia analysis and alarm setup procedure. Arrhythmia Definition The arrhythmia detection is performed by learning the normal waveform of the patient and determining 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, QRS area, QRS polarity, etc., and determines as VPC after discriminating the noise and VPC. ●QRS Classification The QRS analysis is performed by comparing with the learned waveform and QRS pattern matching. N (Normal) V (VPC) ? (Undetermined beat) P (Pacing beat) F (Fusion beat) S (SVPC) Normal QRS beat Ventricular Extrasystole Learning arrhythmia, or beat not matching the pattern Pacing beat Fusion beat of pacing and spontaneous beat Supraventricular Extrasystole ●Arrhythmia Type The alarm is generated according to the arrhythmia classification by the pattern or HR of normal QRS and VPC determined QRS. Type Meaning ASYSTOLE Cardiac Arrest VF Ventricular Fibrillation VT Ventricular Tachycardia SLOW_VT TACHY BRADY Tachycardia Bradycardia RUN Consecutive VPC COUPLET Couplet Ventricular Extrasystole PAUSE BIGEMINY TRIGEMINY Ventricular Bigeminy Ventricular Trigeminy FREQUENT Frequent VPC Reference 7−2 Detection Criteria Cardiac arrest is detected for more than preprogrammed time. A random, rapid electrical activity of the heart is detected. 9 or more continuous ventricular beats are detected. (HR: 140bpm / 120bpm or over) 9 or more continuous ventricular beats are detected. (HR: under 140bpm / 120bpm) HR is over the upper alarm limit. HR is below the lower alarm limit. Continuous VPC exceeding the preprogrammed value is detected. 2 continuous beats of VPC is detected. Cardiac arrest of 1.5 seconds or more is detected. QRS pattern of V-N-V-N-V-N is detected. QRS pattern of V-N-N-V-N-N is detected. VPC exceeding the preprogrammed value is detected within 1 minute. Refer to “8. System Configuration Ward Setup” for setup of HR reference for VT analysis. WARNING Objective and constant arrhythmia detection is possible through the fixed algorithm incorporated in this monitor. However, excessive waveform morphology change, motion artifact, or the inability to determine the waveform pattern may cause an error, or fail to make adequate detection. Therefore, physicians should make final decisions using manual recording, alarm recording and recall waveform for evaluation. CAUTION For proper arrhythmia detection and ECG monitoring, verify proper electrode placement, lead selection, and ECG waveform size. If necessary, turn ON the AC filter. Improper electrode placement, lead selection, and ECG waveform size can cause errors in detection. To Set the Arrhythmia Alarm ON/OFF of arrhythmia alarm and reference of arrhythmia analysis can be set. 1. Press the Menu → Alarm → Arrhy. keys. Arrhythmia Analysis ＜Arrhythmia Alarm Setup (1/3) Menu＞ The arrhythmia alarm setup menu consists of 3 pages. Page 1/3 : ASYSTOLE, VF, VT, SLOW_VT Page 2/3 : RUN, BIGEMINY, TRIGEMINY, PAUSE Page 3/3 : COUPLET, TACHY, BRADY, FREQUENT Use 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. ? keys to set the reference value. Use the ? After setting the reference value, press the Close key. 7−3 ＜Arrhythmia Reference Range＞ Arrhythmia Reference Range Default ASYSTOLE 3 sec.∼10 sec. 5 sec. RUN 2 beats∼8beats 3 beats PAUSE 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 generate 4. 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 Learning Learning of normal ECG largely affects the accuracy of arrhythmia analysis. If any error occurs in arrhythmia detection and QRS judgement, performing arrhythmia learning will recover the original analyzing accuracy. Arrhythmia learning will be performed for about 20 beats for the normal ECG, but it may take longer if the heartbeat is unstable. During arrhythmia learning, arrhythmia alarm other than ASYSTOLE, TACHY, BRADY will not be generated. 1. Press the Menu → Parameter → ECG keys. Pressing the HR parameter key will also display the ECG parameter setup menu. ＜ECG Parameter Setup Menu＞ 2. Start arrhythmia learning. Learning arrhythmia Pressing the key with the LED off will start arrhythmia learning. 7−4 Pressing the key while learning arrhythmia will not stop the learning. 3. During arrhythmia learning, a message will be displayed. Arrhythmia Analysis 7−5 − Graphic Trend Data− Display / Record This section explains the graphic trend function and recording procedure. To Display the Graphic Trend The graphic trend menu can be accessed from the menu, or from the preprogrammed user key. To display from the user key. To display from the menu The 24 hours of graphic trend data in 1-minute interval will be automatically stored and displayed if the data is displayed on the home display. 1. Press the 7−6 Menu → Graphic Trend keys to display the graphic trend menu. 2. Select the parameter to display. Pressing the parameter selection key will display the selection for display. Select a parameter and press the Parameter EVENT1 EVENT2 key. Description HR, PR (SpO2, BP) ST1, ST2 VPC beats BP1 (SYS / Mean / DIA) BP2 (SYS / Mean / DIA) NIBP (SYS / DIA) SpO2 value SpO2 pulse rate Temperature Respiration Rate (Impedance, CO2) Apnea Time (Impedance, CO2) EtCO2 / InspCO2 ASYSTOLE, VF, VT, SLOW_VT, RUN, BIGEMINY TRIGEMINY, PAUSE, COUPLET, TACHY, BRADY, FREQUENT Graphic Trend Data HR ST VPC BP1 BP2 NIBP SpO2 PR_ SpO2 TEMP RR APNEA CO2 Close 3. Select the scale for display. Pressing the Scale key will switch the scale according to the displayed parameter as shown below. 7−7 Parameter Scale HR ST VPC BP1, BP2 NIBP SpO2 PR_ SpO2 TEMP RR APNEA CO2 EVENT Unit 100, 200, 300 ±0.2, ±0.5, ±1.0, ±2.0 bpm mV ±2, ±5, ±10, ±20 20, 50, 100 20, 50, 100, 150, 200, 300 4, 8, 16, 20, 24, 40 100, 150, 200, 300 16, 20, 24, 40 0∼100, 50∼100, 80∼100 100, 200, 300 20∼45, 30∼40 mm beat mmHg kPa mmHg kPa bpm 68∼113, 86∼104 50, 100, 150 15, 30 4.0, 8.0, 10.0 50, 100 none ?F Bpm Sec %, kPa mmHg ?C 4. Select the display time range. Pressing the time range key will sequentially change the key as follows; 1H→2H→4H→8H→12H→24H→ 1H Time Range Resolution 1 hour 2 hour 4 hour 8 hour 12 hour 24 hour 1 min. 1 min. 1 min. 1 min, 3 min. 3 min, 5. Select the time span. Scrolls to past 7−8 Scrolls to present Scrolls the graphic trend display to past or present data with the selected time range. Pressing the ? key will scroll to the past data. Pressing the ? key will scroll to the present data. 6. Move the cursor. Scrolls to past Scrolls to present The data of selected time can be displayed by moving the cursor. Pressing the ? key will scroll to the past data with the selected time range. Pressing the ? key will scroll to the present data. 7. Enlarge the display. Pressing the Zoom key will display the 1-hour data with the cursor time in center. Directly pressing the graphic trend display area will also display the 1-hour data with the pressed time in center. 8. Store the graphic trend data. The displayed graphic trend data will be stored. Graphic Trend Data 7−9 The Description of the Display Cursor Time Cursor Scale Measurement Data at Cursor Time Real time scale The measured data will be compressed for the 12-hour / 24-hour display. Parameter HR ST VPC BP1, BP2 NIBP SpO2 PR TEMP RR APNEA CO2 EVENT 7−10 Compressed Form Mean Value Mean Value Maximum Value Mean Value Current Value Mean Value Mean Value Mean Value Mean Value Maximum Value Mean Value Logical Sum − Tabular Trend − Display / Record This section explains the tabular trend function and recording procedure. To Display the Tabular Trend The 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 is displayed on the home display. 1. Press the Menu Tabular Trend Display from the user key. Display from the menu → Tabular Trend keys to display the tabular trend. 2. Select the time interval. Pressing the key will sequentially select the time interval as follows; 1M→5M→10M→15M→30M→ 60M→1M Selecting 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. 7−11 3. Shift the page. Shift to past Shift to present The page can be shifted past or present by page with the selected time range. Pressing the ? key will shift one page to the past data. Pressing the ? key will shift one page to the present 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 10:00 to 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 present The 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 Display Starting Date Starting Time If 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 will be displayed as “ｰ ｰ ｰ”. 7−12 Parameter Setup for Tabular Trend The parameters for tabular trend can be selected. 1. Press the menu. List Setup key on the tabular trend menu to display the tabular trend setup 2. Select the position on the list. 3. Select the parameter for display. Select the parameter to display for the previously selected position. The position will automatically shift downward so that consecutive parameter selection is possible. 7−13 Tabular Trend Select the position. There are 12 positions on the list to set the parameter. − Recall Data− Display / Record This section explains the recall menu function and recording procedure. To Display the Recall Menu The recall menu can be accessed from the menu, or from the preprogrammed user key. Display from the menu Display from the user key When the alarm factor assigned on the recall setup occurs, the assigned waveform and the numeric 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 the compressed recall waveform will enlarge the waveform. Time at Alarm Occurrence Recall Factor Recall Waveform (Compressed) ●Recall List Display 1. Press the Menu → Recall keys to display the recall menu. The alarm occurrence time, the recall factor occurred at the same time, and the compressed waveform of recall waveform 1 will be displayed. 7−14 2. 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). 4. Press the Recall Setup the recall setup menu. key. The recall factor and recall waveform can be selected on ●To Display and Record the Enlarged Recall Waveform On 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 by using the cursor, the data before and after the alarm occurrence can be checked. Recall Selection 7−15 Recall Data Shift the recall list to older data by 1 page (5 data). 1. Pressing one of the recall factors will display the enlarged recall waveform. QRS Classification Recall Waveform 1 Recall Waveform 2 Scale in seconds Measured Data 2. Shift the waveform left or right. The recall waveform display can be shifted to left or right. ? 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 recall factor occurred at the same time. 4. Store the recall waveform. Pressing the Rec. key will store the displayed recall waveform and numeric data. 7−16 5. Erase the recall waveform. Erase the unnecessary recall waveform. Pressing the Erase key will display the confirmation message. YES will erase the waveform and displays the recall list display. NO will return to the previous display. To Set the Recall Condition On the recall menu, the storing condition at alarm occurrence can be set. The recall waveform and recall factor (numeric data, arrhythmia) can be selected. Recall Data 1. Select the recall waveform. Pressing the Wave key will display the menu to select the recall waveform. Up to 2 waveforms can be selected for recall waveform. Select the recall waveform from No. 1 waveform and No. 2 waveform. The key with the LED lighted is the selected waveform. 2. Select the recall factor (numeric data). Pressing the Numeric key will display the menu to select the numeric data recall factor. 7−17 Select 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 to select the arrhythmia alarm factor. Select an arrhythmia for recall factor. The key with LED lighted will be the recall factor. The recall waveform will start with the following delay time tracing back from the alarm occurrence. NOTE Delay Time 7−18 Adult Child 12sec. 12sec. Neonate Meas. Data Alarm Arrhy. Alarm 8sec. 12sec. − OCRG − Display This section describes the procedure for OCRG display. The OCRG display can be accessed from the menu, or from the preprogrammed user key. Display from the menu Display from the user key On the OCRG display, compressed respiration waveform, HR trend and SpO2 trend are displayed simultaneously. Menu → OCRG OCRG 1. Press the keys to display the OCRG menu. The trend scale is a fixed scale. SpO2 trend HR trend HR : 0∼300bpm SpO2 : 70∼100% Compressed respiration waveform 2. Select the respiration waveform. Select RESP or CO2 to display the compressed respiration waveform from impedance respiration (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 the waveform size. Respiration Waveform Impedance, RESP CO2 Size, Scale ×1/4→×1/2→×1→×2→×4→×1/4 100→50→100 (unit : mmHg) 4→8→10→4 (unit : % or kPa) 7−19 − 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 Menu The ST display can be accessed from the menu, or from the preprogrammed user key. Display from the menu Display from the 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 be simultaneously displayed as graphic trend. ST1 will be measured from ECG1, and ST2 will be measured from ECG2. On the ST display, ST alarm limit and ST reference point / measurement point 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 the superimposed waveform. 3. Select the waveform size for the superimposed waveform. Pressing the key will sequentially change the key as follows; ×1/4→×1/2→×1→×2→×4→×1/4. NOTE 7−20 The selection of displayed waveform size for the superimposed waveform interlocks with ECG waveform size. 4. Select the trend scale. Select the displayed scale for the trend. Trend HR ST Scale Unit 100, 200, 300 ±0.2, ±0.5, ±1.0, ±2.0 bpm mV ±2, ±5, ±10, ±20 mm ●To Set the Reference Waveform Set the reference waveform for the ST display and set the reference point and measurement point on the reference waveform. 1. Press the Menu → waveform setup menu. ST Display → Reference Size / Lead keys to display the reference Measurement Point ST Measurement Reference Point 2. Read the waveform by pressing the Wave Set key. 16 beats average of the ECG judged as normal QRS by arrhythmia analysis will be read. If during arrhythmia learning, or if VPC is present, the reference waveform setup will take for more than 16 beats. During the reference waveform setup, the key LED will 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 QRS to the P wave direction. 4. Set the measurement point on the ST display. The measurement point can be set in the range of 0ms∼560ms in increments of 10mS from the peak of QRS to the T wave direction. 7−21 ●ST Alarm Setup The 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 limit can be set in 1mm / 0.1mV increment. 1. Press the Menu → ST Display → Alarm keys to display the alarm setup menu. Upper limit cursor Lower limit cursor 2. Set the upper and lower alarm limit. Use the Item Lower Alarm Limit Upper Alarm Limit ?, keys to adjust the alarm limit. Description Select the lower alarm limit (±20mm / ±2.0mV). Alarm will be set to OFF if the value −20mm / −2.0mV or lower is selected. Select the upper alarm limit (±20mm / ±2.0mV). Alarm will be set to OFF if the value ＋20mm／＋2.0mV or above 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 the upper 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 ST alarm. If the upper or lower limit is OFF, the limits will remain to be OFF. 7−22 − NIBP List − Display / Record This section explains the NIBP list function and recording procedure. To Display the NIBP List The NIBP list display can be accessed from the menu, or from the preprogrammed user key. Display from the menu On the NIBP list, NIBP data and HR, SpO2 pulse rate, SpO2 value at the commencement of NIBP measurement 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. 7−23 NIBP List Display from the user key The Description of the Display The mean BP will be displayed on the NIBP list only if it is displayed on the home display. If HR or SpO2 is not measured, or not correctly measured at the commencement of NIBP measurement, the measured data will be displayed as “? ? ? ”. For Quick SYS measurement, only the SYS (highest BP value) will be displayed. NOTE 7−24 If the NIBP measurement was not completed, the data will not be displayed on the NIBP list. At the telemetry center, the time and measurement will be displayed as “00:00” and “? ? ? ” respectively. − Other Bed ― Display / Alarm This section explains about the function to display the waveform and numeric data and to set alarms for other bedside monitors. To use this function, wired network connection is required. Other Bed Display The 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 other bedside monitor generates an alarm. By pressing this Other Bed Alarm key, the display for the other bed can be accessed. Display from the Other Bed Alarm key. 1. Press the Menu → Other Bed Display from the menu Display from the user key Other Bed keys to display the other bed selection menu. On the other bed selection menu, select the Room / Bed ID to display from the 48 beds connected to the wired network. The Room / Bed ID for the alarm generating bed will be displayed in red. The bed displaying this menu will be displayed in gray. The key LED for the bed selected as the other bed 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 the selected bed will be displayed. If an alarm is generated for this bed, the physiological alarm / arrhythmia alarm message will be displayed. By pressing the Alarm Silence key on the other bed display, the alarm sound for the displayed bed can be silenced. 7−25 Other Bed Alarm Setup From the 48 bedside monitors, the bed to generate the other bed alarm and ON/OFF of other bed alarm display can be performed. 1. Select the bed to generate the other bed alarm. Press the Set other alarm key to display the other bed alarm setup menu. Select the bed to generate the other bed alarm. The key LED for the bed selected as the other bed alarm generating bed will be lighted. 2. Select ON for the other bed alarm. Press the Prev. Disp. key and display the other bed selection menu. Selecting ON will generate the other bed alarm when an alarm generates at the other bed. Selecting OFF will not generate the other bed alarm. 7−26
Source Exif Data:
File Type : PDF File Type Extension : pdf MIME Type : application/pdf PDF Version : 1.4 Linearized : No Create Date : 2003:12:06 11:58:03Z Modify Date : 2003:12:08 09:37:09+09:00 Page Count : 70 Creation Date : 2003:12:06 11:58:03Z Author : ezashi Producer : Acrobat PDFWriter 4.0 Windows NT Mod Date : 2003:12:08 09:37:09+09:00 Metadata Date : 2003:12:08 09:37:09+09:00 Title : DS71v1-1_FA_06_Parameter_008.PDF Creator : ezashiEXIF Metadata provided by EXIF.tools