Fukuda Denshi Co DS7100 Patient Monitor User Manual DS71v1 1 FA 03 Vital 005

Fukuda Denshi Co Ltd Patient Monitor DS71v1 1 FA 03 Vital 005

User manual 4

3−1Vital ApplicationThis chapter describes the procedure for vital application, etc.Chapter 3− To Acquire ECG Waveform −･････････････････ 2Before Attaching the Electrodes ････････････････ 2Electrode Placement･･････････････････････････ 3Connection to the Patient Monitor･･･････････････ 4About the Arrhythmia Analysis ･････････････････ 5●QRS Classification ･････････････････････････5●Arrhythmia Type ･･･････････････････････････5Filter Selection ･･･････････････････････････････ 6●Filter Mode Setup ･･････････････････････････6●Procedure for Filter Mode Selection･･･････････7●AC Filter ･･････････････････････････････････7Lead Cable Types ････････････････････････････ 7− Respiration (Impedance Measurement) −･･･････ 8− To Measure the SpO2 −･･････････････････････ 9●Functional and Fractional Saturation ････････ 12●Measured Versus Calculated Saturation ･････ 12− To Measure the NIBP−･･････････････････････14Procedure for Periodic Measurement･･･････････ 16− To Measure the BP −･･･････････････････････17−To Measure the CO2 Concentration −(DS-7141) 21Patient Application and Display････････････････ 21Procedure for Calibration (Every 6 Months) ･････22− To Measure the Temperature −･･････････････243Vital Application
3−2− To Acquire ECG Waveform −Before turning ON the power1. Check the grounding. 2. Check the recording paper. 3. Turn ON the power.The magazine will be released by pressing themagazine release button.Properly ground using the3-way AC plug.The grounding is required toprevent AC noise.Open the recorder magazine, andcheck that there is enoughamount of paper installed.Turn ON the power andcheck for appropriatedisplay.Before Attaching the Electrodes1. Clean the electrode sites with an alcohol swab or other skin preparation. If necessary,shave the electrode sites to remove excessive hair.2. Peel off the backing of disposable electrode.Pay attention not to touch the electrode jelly.
3−3Electrode PlacementThere are 3-electrode, 4-electrode, 5-electrode application depending on the cable type.Using the 4-electrode or 5-electrode application allows simultaneous monitoring of 2 ECGwaveforms, and high accuracy of arrhythmia analysis can be attained.Also, the displayed lead type can be changed.For 3-electrode lead (1 waveform monitoring)Lead Type Ⅰ / Ⅱ / ⅢSymbol Color Electrode SiteRAWhite On the right infraclavicular fossaLABlack On the left infraclavicular fossaLL Red On the left midclavicular line, near thesupracrestal line.For 4-electrode lead (Simultaneous 2 waveforms monitoring)Lead Type Ⅰ / Ⅱ / Ⅲ / aVR / aVL / aVFSymbol Color Electrode SiteRAWhite On the right infraclavicular fossaLABlack On the left infraclavicular fossaLL Red On the left midclavicular line, near thesupracrestal line.RL Green On the right midclavicular line at thesame height as F.For 5-electrode lead (Simultaneous 2 waveforms monitoring)Lead Type Ⅰ / Ⅱ / Ⅲ / aVR / aVL / aVF / VSymbol Color Electrode SiteRAWhite On the right infraclavicular fossaLABlack On the left infraclavicular fossaLL Red On the left midclavicular line, near thesupracrestal line.RL Green On the right midclavicular line at thesame height as F.VBrown Chest Lead (V1∼V6)3To Acquire ECG Waveform
3−4Connection to the Patient Monitor1. Connect the lead cable to the electrode.Clip on the lead cable end to the electrode convexpart.CAUTION? The indication for continuous use of the electrode is about one day.? Replace the electrode if the skin contact gets loosen due to perspiring,etc.? When an electrode is attached at the same location for a long time,some patients may develop a skin irritation. Check the patient’s skincondition periodically and change the electrode site as required.2. Connect the lead cable to the relay cable.3. Plug in the relay cable to the ECG input connector (green) of the patient monitor.4. Verify that the ECG waveform is displayed on the monitor.Adjust the waveform size and position. Themonitoring lead can be also changed.ReferenceRefer to “ 6. Parameter Setup ECG” for size / lead setup.
3−5About the Arrhythmia AnalysisArrhythmia Analysis FlowLearnWaveformQRSJudgement VPC?Pattern Matching VPC!ArrhythmiaThe arrhythmia detection algorithm learns the normal waveform of the patient andcompares the waveform (QRS pattern) and RR interval for each heartbeat to determine theVPC. It compares the parameters such as QRS amplitude, QRS width, QRS polarity, RRinterval, and selects abnormal QRS. Then the QRS with suspected VPC is patternmatched to distinguish the noise and VPC. This will finally determine the VPC andgenerate the arrhythmia alarm.●QRS ClassificationEach heartbeat will be classified to the following patterns according to the QRS judgement.N (Normal) Normal QRS beatV (VPC) Ventricular ExtrasystoleS (SVPC) Supraventricular ExtrasystoleP (Pacing Beat) Pacing beatF (Fusion Beat) Fusion beat of pacing and spontaneous beat? (Undetermined Beat) Learning arrhythmia, or beat not matching the pattern●Arrhythmia TypeWith the above QRS judgement, the following 12 types of arrhythmia alarm can be generated.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 and over 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.3To Acquire ECG Waveform
3−6Filter Selection●Filter Mode SetupThe waveform frequency characteristic can be selected from Monitor Mode, ESIS Mode, or STDisplay Mode according to the monitoring purpose.1. Monitor Mode Frequency Characteristic Adult / Pediatric：0.5∼40Hz Neonate：1.6∼40HzThis is the standard mode for ECG monitoring. The upper frequency is set to 40Hz to reduceartifact caused by EMG, etc.2. ESIS Mode Frequency Characteristic Adult / Pediatric：1.6∼15Hz Neonate：1.6∼15HzBy selecting this mode when using electrosurgical instrument, electrical noise can be largelyreduced. Do not select this mode unless using electrosurgical instrument.3. ST Display Mode Frequency Characteristic Adult / Pediatric：0.05∼40HzSelect this mode if ST measurement is the main purpose of ECG monitoring.NOTE If “Neonate” is selected as patient type, ST display mode can not be selectedNOTEWhen the filter setup is changed, a notch will appear on the ECG waveform dueto the change in frequency characteristic.ReferenceRefer to ” 6. Parameter Setup ECG” for details of filter mode.
3−7●Procedure for Filter Mode Selection1. Press the ECG parameter key and display the ECG setup menu.2. Press the Config. key.3. Select the filter mode from 3 selections.●AC FilterIf the ECG waveform is interfered with AC noise, the AC filter cuts off the frequency component(50Hz or 60Hz).The AC filter is always set to ON.ReferenceRefer to “8. System Configuration Hospital Setup AC Filter” for AC filter setup (50Hz or 60Hz).Lead Cable TypesThere are various combinations of lead cable connecting type and electrode material.Contact our service representative for details and select the appropriate electrode.【for 3-electrode】ECG Relay Cable (defibrillation-proof) CI-700D-3ECG Relay Cable (electrosurgery-proof) CI-700E-3ECG Lead Cable 3380.0648.13【for 4-electrode】ECG Relay Cable (defibrillation-proof) CI-700D-4ECG Relay Cable (electrosurgery-proof) CI-700E-4【for 5-electrode】ECG Relay Cable (defibrillation-proof) CI-700D-5ECG Relay Cable (electrosurgery-proof) CI-700E-5ECG Lead Cable 3380.0661.133To Acquire ECG Waveform
3−8− Respiration (Impedance Measurement) −1. Verify that the ECG waveform is properly acquired.The respiration waveform is detected from leadⅡof ECG mentioned in the previous section.Therefore if stable ECG is acquired, therespiration waveform can be acquired at thesame time.2. Verify that the respiration waveform and respiration rate is displayed on the home display.Adjust the waveform size, baseline position andsweep speed.ReferenceRefer to “6. Parameter Setup Respiration” for scale / baseline setup.Refer to ”8. System Configuration Sweep Speed” for sweep speed setup.
3−9− To Measure the SpO2 −1. Prepare an appropriate probe or sensor for the patient.Sensor Types Probe Type (Reusable type, for adult finger)DS-100AFor adult with weight of 40kg and over.This is for temporary use. When continuously using for long periodof time, use the following single-use type. Single Use TypeOXISENSORⅢ N-25 (for neonate toe)For neonate with weight of 3kg and over.OXISENSORⅢ I-20 (for pediatric toe)For pediatric with weight of 3kg∼20kgOXISENSORⅢ D-20 (for pediatric finger)For pediatric or adult with weight of 10kg∼50kgOXISENSORⅢ D-25 (for adult finger)For adult with weight of 30kg and over.MAX Fast (for adult forehead)For adult with weight of 40kg and over.With the use of new technology of NELLCOR®, OXIMAX, stablemonitoring during body motion / low perfusion is possible.3To Measure the SpO2
3−102. Connect the sensor to the patient monitor.(1) Connect the SpO2 relay cable (DOC-10) tothe SpO2 connector on the patient monitor.(2) Insert the sensor into the SpO2 relay cableconnector, and lock with the transparentpart.3. Attach the sensor to the patient.CAUTION If the nail is rough, dirty, or manicured, accurate measurement will not bepossible. Change the finger or clean the nail before attaching the probeand sensor.【Probe Type Sensor】(1) Attach the probe as shown on left.The probe cable should be on the nail side.(2) Adjust the sensor so that the light-emittingpart (on cable side) touches the root of thenail, and close the probe.Light Reception PartLight Emitting Part
3−11(3) Press the probe lightly so that the finger andthe rubber cover are appressed.This is to stabilize the probe, and to avoidambient light.【Single-use Type】(1)Clean the attachment site with alcohol, etc.(2)Align the light emitting element and lightreceiving element of the sensor with themeasuring site in between when attaching thesensor to patient.(3)Fixate the cable with surgical tape so that the sensor does not come off when a cable is pulled. Attachment to the toe Attachment to the finger4. Verify that the SpO2 is displayed.Press the HOME key on the lower part ofthe display.Verify that the SpO2 measurement and SpO2waveform are displayed on the home display.Light Receiving ElementLight Emitting Element3To Measure the SpO2
3−12●Functional and Fractional SaturationThe DS-7100 measures functional SpO2 and may therefore produce measurements that differfrom devices measuring fractional SpO2. "Functional" SpO2 is the amount of oxygenatedhemoglobin expressed as a percentage of the total amount of hemoglobin capable of transportingoxygen. By utilizing the light of two different wavelengths, the DS-7100 can analyze for bothoxygenated and deoxygenated hemoglobin, and consequently, can determine the functional SpO2.The DS-7100 does not detect the presence of abnormal hemoglobin, such as carboxyhemoglobinor methemoglobin.●Measured Versus Calculated SaturationWhen SpO2 is calculated from a blood gas measurement of the partial pressure of arterial oxygen(PaO2), the calculated value may differ from the DS-7100 SpO2 measurement. This is becausethe calculated SpO2 may not have been corrected for the effects of variables that shift therelationship between PaO2 and SpO2 : temperature, pH, the partial pressure of carbondioxide(PaCO2), and the concentrations of 2, 3-DPG and fetal hemoglobin.WARNING? When measuring the SpO2 of patient with high fever or peripheralcirculatory insufficiency, check the sensor attachment periodically andchange the attachment site. The temperature of attachment site willrise 2∼3?C due to the sensor heat which may result in burn injury.? For the following case, accurate measurement may not be possible.? Patient with excessive abnormal hemoglobin (HbCO, MetHb)? Patient with the pigment injected to the blood? Patient receiving CPR treatment? When a sensor is applied to a limb with NIBP cuff, arterial catheter, orintracatheter? When measuring at site with venous pulse? Patient with body motion? Patient with small pulse
3−13CAUTION? If irritation such as skin reddening or skin fit appears with the sensoruse, change the attachment site or stop using the sensor.? When fixating the sensor with a tape, do not wind the tape too strong.At the same time, check the blood flow constantly so that congestionis not generated at the peripheral.? Even a short duration of attachment may inhibit the blood flow andgenerate compression necrosis and burn injury.? Change the sensor attachment site constantly (every 4 hours). Asthe temperature of sensor attachment site normally rises 2∼3?C,compression necrosis and burn injury may generate.? As the skin of neonate / low birth weight infant is immature, changethe sensor attachment site more frequently depending on thecondition.? Direct sunlight to the sensor area can cause a measurement error.Place a black or dark cloth over the sensor.? When not performing the measurement, unplug the relay cable andsensor from the SpO2 connector. Otherwise, the measurement datamay be erroneously displayed by the ambient light.3To Measure the SpO2

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