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

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Document ID	3684200
Application ID	JuJERaoZ2KE3dUGTJrrsug==
Document Description	Novii - FHR Gaps Troubleshooting Guide 107-PT-008-USRev1
Short Term Confidential	No
Permanent Confidential	No
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Document Type	User Manual
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Filesize	59.84kB (748030 bits)
Date Submitted	2017-12-19 00:00:00
Date Available	2017-12-14 00:00:00
Creation Date	2016-01-25 11:04:57
Producing Software	Adobe PDF Library 10.0.1
Document Lastmod	2016-02-08 16:08:55
Document Title	Novii - FHR Gaps Troubleshooting Guide 107-PT-008-USRev1
Document Creator	Adobe InDesign CS6 (Macintosh)

FHR Gaps Troubleshooting Guide
POSSIBLE CAUSE
ACTION & SOLUTION1
l Return patient to bed
l Consider using a maternity belt to support pannus during
ambulation or upright position
2.4"/6cm
HELP/TIP
1"/2-3cm
1"/2-3cm
a) Allow 10-15 minutes of monitoring before starting ambulation.
The patient is ambulating
b) The patient should not be encouraged to ambulate unless the FHR
trace is good and the signal indicator on the Novii Interface shows
2.4"/6cm
2.4"/6cm
3 green squares.
l Use a pillow behind back or head
to make patient more comfortable
Signal
1"/2-3cm
2.4"/6cm
l Return patient to a position where
Novii worked well
1"/2-3cm
1"/2-3cm
l Encourage patient to lie on left or right
Patient position/posture
l If patient on side, support abdomen with
a pillow/rolled blanket to re-position
abdomen so that the Patch is centred
over the uterus
l Check electrodes and move or stick back down
1"/2-3cm
SKIN PREP
SKIN PREPARATION GOOD
SKIN PREPARATION GOODREPEAT SK
REPEAT SKIN PREP
REPEAT SK
REPEAT SKIN PREP
REPEAT SKIN PREP
DO NOT BY
REPEAT
SKIN
PREP
DO NOT BYPASSGOOD
SKIN
DOPREPARATION
NOT BYPASS
l Re-position Patch or electrode to avoid the skin problem
REPEAT SKIN PREP
HELP/TIP
REPEAT SKIN PREP
a) The Interface will alert user with a visual message, but only when electrode isDOfully
NOT detached.
BYPASS
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.
Electrode ‘detached’ or makes
poor contact with skin
FHR
FHR
MHR
FHR
MHR
UA
FHR
UA
MHR
MHR
UA
UA
1"/2-3cm
Lost MHR and UA
2.4"/6cm
as well as FHR
d) If necessary use a strip of micropore tape to prevent electrode lifting or detachment.
l Check Interface for help message
l Interface is off
HELP/TIP
FHR
MHR
UA
a) 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 displayed
HELP/TIP
POD has switched off – remove POD from Patch and place in charging well.
Start new monitoring session with other POD.
1"/2-3cm
l Faulty ‘Y’ Connector - replace
l Exfoliate skin under ‘bad’ electrode
SKIN PREPARATION GOOD
REPEAT SKIN PREP
REPEAT SKIN PREP
DO NOT BYPASS
HELP/TIP
a) Peel the X electrode back, remove excess gel from skin and finish 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.
l Restart the monitoring session if location of ‘bad’ electrode not known
HELP/TIP
Bypassed red X on
electrode/skin checkscreen
Remove POD from Patch, place in charging bay and start new monitoring episode.
POSSIBLE CAUSE
ACTION & SOLUTION1
l Re-position electrode
1"/2-3cm
HELP/TIP
2.4"/6cm
2.4"/6cm
b) May need to use micropore tape to hold in place.
Lower electrode is not
2.4"/6cm above the
symphysis pubis
1"/2-3cm
a) Peel the electrode back, remove excess gel from skin and finish with alcohol wipe.
Wait until skin is dry then exfoliate skin again and reapply electrode in correct position.
1"/2-3cm
1"/2-3cm
Pannus covering Symphysis Pubis
1"/2-3cm
l Remove electrode and place it lower or higher on the abdomen
SKIN PREPARATION GOOD
2.4"/6cm
REPEAT SKIN PREP
l Alternatively
place electrode just below the point where
SKIN PREPARATION GOOD
the surface curves back on itself ensuring that the electrode
isREPEAT
notSKIN
folded
PREP
REPEAT SKIN PREP
DO NOT BYPASS
REPEAT SKIN PREP
DO NOT BYPASS
1"/2-3cm
Lower electrode may not
be optimally placed2
SKIN PREPARATION GOOD
l Plug in US transducer for short
FHR ‘filling’ and reassurance
8REPEAT SKIN PREP
REPEAT SKIN PREP
DO NOT BYPASS
l Swap back to conventional
FHR
monitoring modalityNovii
(10 sec delay)
US FHR
HELP/TIP
WARNING: Novii UA/MHR delayed
10 seconds (5mm) from US FHR - see panels below
Novii MHR
(10 sec delay)
10 sec
Novii UA
sec delay)
Using TOCO UA with Novii FHR(10could
make an early deceleration appear late
Using US FHR with Novii UA could
make a late deceleration appear early
Novii FHR
(6 sec delay)
Novii FHR
(10 sec delay)
US FHR
None of the above
Novii MHR
(6 sec delay)
Novii MHR
(10 sec delay)
10 sec
10 sec
TOCO/IUPC UA –
real-time
Novii UA
(6 sec delay)
Novii UA
(10 sec delay)
Novii FHR/MHR/UA are synchronised
FHR trace.
but all trace 5mm (10 sec) behind Novii
US FHR
Novii FHR/MHR/UA are synchronised
but all trace 3 mm (6 sec) behind TOCO UA trace.
10 Second Trace Example
6 Second Trace Example
(6 sec delay)
Novii MHR
(6 sec delay)
High/Low UA Sensitivity Explained
UA High
10 sec
TOCO/IUPC UA –
real-time
Novii UA
(6 sec delay)
UA Low
10
11
12
13
14
15
16
17
18
Data (minutes)
Selecting 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.
Notes:
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.
107-PT-008-USRev1

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