GE Healthcare 6961-MON Novii Intrapartum Maternal/Fetal monitor User Manual Novii FHR Gaps Troubleshooting Guide 107 PT 008 USRev1

GE Healthcare Novii Intrapartum Maternal/Fetal monitor Novii FHR Gaps Troubleshooting Guide 107 PT 008 USRev1

Novii - FHR Gaps Troubleshooting Guide 107-PT-008-USRev1

FHR Gaps Troubleshooting Guide SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA1The patient is ambulatingPOSSIBLE CAUSE ACTION & SOLUTION1HELP/TIPElectrode ‘detached’ or makes poor contact with skin SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA2Patient position/posture SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA3 SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA4Lost MHR and UAas well as FHR SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA5Bypassed red X on electrode/skin checkscreenl Return patient to bedl Consider using a maternity belt to support pannus during ambulation or upright position a) Allow 1015 minutes of monitoring before starting ambulation.b) The patient should not be encouraged to ambulate unless the FHR trace is good and the signal indicator on the Novii Interface shows 3 green squares.l Use a pillow behind back or head to make patient more comfortablel Return patient to a position where Novii worked welll Encourage patient to lie on left or rightl If patient on side, support abdomen with a pillow/rolled blanket to re-position abdomen so that the Patch is centred over the uterusl Check electrodes and move or stick back downl Re-position Patch or electrode to avoid the skin problema) The Interface will alert user with a visual message, but only when electrode is fully detached. b) Check electrodes after a shower, clinical procedure, ambulation or position change.c) Electrode(s) should not be placed over a skin lesion, skin fold, umbilicus, stretch mark, pronounced linea nigra.d) If necessary use a strip of micropore tape to prevent electrode lifting or detachment.l Check Interface for help messagel Interface is ol Exfoliate skin under ‘bad’ electrodel Restart the monitoring session if location of ‘bad’ electrode not known SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREP DO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUAa) If Interface has lost power Bluetooth pairing with POD is lost. Remove POD from Patch, place in charging bay and start new monitoring episode when power is returned. b) Interface does not have a battery back-up.l Start-Screen is displayedPOD has switched o – remove POD from Patch and place in charging well. Start new monitoring session with other POD.a) Peel the X electrode back, remove excess gel from skin and inish with alcohol wipe. Wait until skin is dry then exfoliate skin and reapply electrode. b) May need to use micropore tape to hold in place.Remove POD from Patch, place in charging bay and start new monitoring episode.HELP/TIPHELP/TIPHELP/TIPHELP/TIPHELP/TIPl Faulty ‘Y’ Connector - replaceSignal
SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREPDO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA6Lower electrode is not 2.4"/6cm above the symphysis pubisPOSSIBLE CAUSE ACTION & SOLUTION1HELP/TIPLower electrode may not be optimally placed2SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREPDO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA7SKIN PREPARATION GOODREPEAT SKIN PREPREPEAT SKIN PREPDO NOT BYPASS2.4"/6cm1"/2-3cm1"/2-3cmFHRMHRUA8None of the abovel Re-position electrode a) Peel the electrode back, remove excess gel from skin and inish with alcohol wipe.Wait until skin is dry then exfoliate skin again and reapply electrode in correct position.b) May need to use micropore tape to hold in place.l Remove electrode and place it lower or higher on the abdomen l Alternatively place electrode just below the point where the surface curves back on itself ensuring that the electrode is not foldedl Plug in US transducer for short FHR ‘illing’ and reassuranceWARNING: Novii UA/MHR delayed 10 seconds (5mm) from US FHR - see panels belowHELP/TIPl Swap back to conventional monitoring modality10 Second Trace ExampleNotes: This troubleshooting guide assumes that the patient is supine or semi-supine during Patch placement and Novii set-up.1. CAUTION: any intervention will take 10 seconds before its impact will be seen on the trace.2. The user is familiar with the placement of Patch and lower mid-line electrode in high BMI patients with a pannus.!!6 Second Trace ExampleHigh/Low UA Sensitivity ExplainedSelecting UA Low sensitivity from the Novii display will decrease the UA trace amplitude, suppressing unwanted low amplitude UA, but it will also reduce the contraction duration. There will be no change to the location of the peak.Low amplitude UA is considered to be due to artefact from fetal/maternal movement and unsynchronised myometrial activity. Using US FHR with Novii UA could make a late deceleration appear earlyNovii FHR/MHR/UA are synchronised but all trace 5mm (10 sec) behind US FHR trace.Using TOCO UA with Novii FHR could make an early deceleration appear lateNovii FHR/MHR/UA are synchronised but all trace 3 mm (6 sec) behind TOCO UA trace.Novii FHR(6 sec delay)Novii MHR(6 sec delay)TOCO/IUPC UA –real-timeNovii UA(6 sec delay)10 secNovii FHR(10 sec delay)US FHRNovii MHR(10 sec delay)Novii UA(10 sec delay)10 secNovii FHR(6 sec delay)Novii MHR(6 sec delay)TOCO/IUPC UA –real-timeNovii UA(6 sec delay)10 secNovii FHR(10 sec delay)US FHRNovii MHR(10 sec delay)Novii UA(10 sec delay)10 secUA High8 9 10 11 18171615141312UA LowData (minutes)Pannus covering Symphysis Pubis 107-PT-008-USRev1

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