GE Medical Systems Information Technologies 2014748-002 Medical Telemetry Transmitter User Manual

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Document ID	881642
Application ID	maTnhnqxAd0JjwUy/T2xFQ==
Document Description	Manual Draft1 Part 6
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Date Submitted	2007-12-19 00:00:00
Date Available	2007-12-19 00:00:00
Creation Date	2007-12-19 14:17:31
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System setup
Option
Graph Setup
Function
NOTE
When changing the Graph Setup options for admitted
patients, the changes do not take effect until the
patients are discharged.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > Graph
Setup.
Default Locations for this
CIC
Set the print location for Manual, Alarm and Print Window.
NOTE
These default locations are only used for telemetry
beds and determine where patient data prints for either
manual or alarm conditions. Since a telemetry patient is
not linked to a patient monitor, these defaults are
necessary to specify the destination for alarm and
manual graph printouts.
Waveforms
Designate the primary ECG lead for printing and enable or
disable printing from subsequent ECG leads.
ECG 1: Designate the primary ECG lead for printing. Lead II
is the default.
af
Waveform 2 to 4: Choose other ECG leads to print or
choose Off to disable printing an ECG lead. Choices are:
Off, I, II, III, V, aVR, aVL and aVF.
Dr
Selecting option V indicates the V lead being monitored,
e.g., V2.
Transmitter Graph
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > Graph
Setup.
Turn on or off the Transmitter Graph printing.
When this option is set to On, a telemetry patient can initiate
a graph by pressing the Graph button on the transmitter.
When this option is set to Off, graphs cannot be initiated at
the transmitter.
This option sets the unit default for all telemetry patients
admitted to the CIC Pro center.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > Graph
Setup.
Turn on or off Alarm Graph printing. Choices are: Always
on or Always off. On is the default.
Alarm Graph
This option sets the unit default for all patients admitted to
the CIC Pro center. It cannot be changed on an individual
patient basis.
4-8
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System setup
Option
Event Marker Graph
Function
Turn on or off Event Marker Graph printing. Off is the
default.
This option allows you to select whether a graph will be
printed when a patient’s event is marked using the event
marker button on the transmitter.
NOTE
This feature is not applicable to all transmitters.
Display Lead
Set the primary ECG lead for display in the patient’s
waveform window. Choices are: I, II, III, V, aVR, aVL and
aVF.
Lead II is the default. Selecting option V indicates the V lead
being monitored, e.g., Va or Vb.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
Arrhythmia
Enable or disable an arrhythmia processing program.
Choices are: Full, Lethal, and Off. Full is the default.
Selecting Off means arrhythmia detection remains off until
you choose another option.
af
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
Designate Single-Lead or Multi-Lead analysis for ECG and
arrhythmia analysis. Multi-Lead is the default.
Dr
Lead Analysis
ST Analysis
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
Enable or disable ST Analysis. Choices are: On or Off. Off
is the default.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
Va Lead
Set the default for the V leads that will be monitored in these
positions. A 6-leadwire set is required for multiple V-lead
monitoring. Choices for Va: V1 to V6. Choices for Vb: V2 to
V6.
Vb Lead
V1 is recommended for arrhythmia detection.
V5 is recommended for ST depression monitoring1.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
NOTE
Correctly labelling V leads is important to facilitate
correct ECG analysis when viewing real-time
waveforms, histories or printouts.
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System setup
Option
Detect Pace
Function
Enable or disable pacer detection. Choices are: Pace 1,
Pace 2, and Off. Off is the default.
NOTE
Selecting Off turns pacemaker detection off. It does not
perform pacemaker detection. Pace 1 or Pace 2 must
be used with pacemaker patients. See Monitoring
pacemaker patients on page 7-13.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Monitor Setup > ECG.
PDS
Enable or disable use of the Patient Data Server (PDS).
The PDS is a rack-mounted server that collects graphic
trend and event data from data acquisition devices on the
Unity MC Network. Data may be collected from both
hardwired and wireless devices and returns the data to a
CIC Pro center for viewing, This data is stored in the PDS for
72 hours, providing temporary patient data history.
af
Additionally, the data is stored under a patient’s PID so that
as the patient is moved from one data acquisition device or
care unit to another, the new data is appended to the
patient’s record, creating one continuous 72-hour string of
data.
Patient Age
Set Patient Age. Choices are: 0-2 Years, 3-11 Years, 11-13
Years, and Adult. See Patient age on page 4-11.
Dr
NOTE
Transmitter Alarm Pause
Temporary changes may be made for a specific patient
via the single patient viewer > Admit.
Enable or disable transmitter alarm pausing. Choices are:
Enable, Disable or Off.
This option sets the unit default for all telemetry patients
admitted to the CIC Pro center.
NOTE
Temporary changes may be made for a specific patient
via the single patient viewer > Alarm Control.
Alarm Pause
Breakthrough
Turn on or off Transmitter Alarm Pause breakthrough.
Choices are: Always On or Always Off. Always On is the
default.
This option sets the unit default for all telemetry patients
admitted to the CIC Pro center. It cannot be changed on an
individual patient basis.
Event Marker
Turn on or off Event Marker alert. Off is the default.
1Barbara
J. Drew, RN, PhD, FAAN (2000). Value of Monitoring a Second Precordial Lead for
Patients in a Telemetry Unit, GE Medical Systems (order document number M04243ME0)
4-10
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System setup
Patient age
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING
AND CALCULATIONS BASED ON PATIENT AGE — After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient’s date of birth matches the patient’s actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
NOTE
The Telemetry Unit Defaults tab sheet settings take precedence when the Patient
Age chosen in the Admit tab sheet and the age default setting from the Telemetry
Unit Defaults tab sheet match.
When the ages do not match, the Admit tab sheet age setting takes precedence.
0-2 years
„
3-10 years
„
11-13 years
af
„
The options found in the pull-down list for the Patient Age field are:
„
Adult (factory default selection)
The Patient Age setting chosen in the Telemetry Unit Defaults tab sheet affects the
alarm settings.
Adult
Age Chosen In The Admit Tab
Sheet When Patient Admitted
Dr
Telemetry Unit Defaults
Tab Sheet Setting
0-2 years
2001989-301A- draft 1
Resulting Limits
Unit Default
Alarm Level (Brady)
Resulting
Alarm Level
Adult
50, 150
Message
Message
0-2 years
90, 200
Message
Crisis
3-10 years
60, 180
Message
Crisis
11-13 years
50, 150
Message
Advisory
Adult
50, 150
Message
Advisory
0-2 years
90, 200
Message
Message
3-10 years
60, 180
Message
Crisis
11-13 years
50, 150
Message
Advisory
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System setup
Telemetry Unit Defaults
Tab Sheet Setting
3-10 years
11-13 years
Age Chosen In The Admit Tab
Sheet When Patient Admitted
Resulting Limits
Unit Default
Alarm Level (Brady)
Resulting
Alarm Level
Adult
50, 150
Message
Advisory
0-2 years
90, 200
Message
Crisis
3-10 years
60, 180
Message
Message
11-13 years
50, 150
Message
Advisory
Adult
50, 150
Message
Advisory
0-2 years
90, 200
Message
Crisis
3-10 years
60, 180
Message
Crisis
11-13 years
50, 150
Message
Message
Factory defaults
These factory defaults are in effect, depending upon the patient’s age, unless they
have been modified through Telemetry Unit Defaults.
ECG Display Lead is II
„
Multi-Lead analysis
„
Heart rate alarm limits (high/low):
„
Adult—150/50
‹
0–2 years—200/90
‹
3–10 years—180/60
‹
11–13 years—150/50
af
‹
ST measurement:
Dr
„
‹
Adult— J+ 60ms
‹
0–2 years— J+ 30ms
‹
3–10 years— J+ 40ms
‹
11–13 years— J+ 50ms
„
PVC limit is 6
„
1X size
„
Pace off
„
Arrhythmia On (arrhythmia changes with age)
„
ST off
„
Graph leads II and V
„
25 millimeters per second speed
„
Alarm Graph location at the CIC Pro center where patient was admitted
„
TTX (manual) graph location at the CIC Pro center where patient was admitted
„
Print window location at the CIC Pro center where patient was admitted
Telemetry alarm control defaults
This option sets the telemetry default alarm limits and alarm level settings. In user
mode, all of the controls are view-only. You must be in Service mode to set the
Telemetry Alarm Control Defaults at the CIC Pro center.
4-12
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System setup
af
To view the telemetry unit default settings, click CIC Setup > Telemetry Alarm
Control Defaults.
Parameter Limits and Alarm Levels
Low
High
Level
HR
bpm
50
150
Warning
ST-I
mm
-2.0
2.0
Warning
ST-II
mm
-2.0
2.0
Warning
ST-III
mm
-2.0
2.0
Warning
ST-V
mm
-2.0
2.0
Warning
ST-V2
mm
-2.0
2.0
Warning
ST-V3
mm
-2.0
2.0
Warning
ST-V4
mm
-2.0
2.0
Warning
ST-V5
mm
-2.0
2.0
Warning
ST-V6
mm
-2.0
2.0
Warning
ST-aVR
mm
-2.0
2.0
Warning
ST-aVL
mm
-2.0
2.0
Warning
ST-aVF
mm
-2.0
2.0
Warning
NBP-S
mmHg
80
200
Warning
NBP-D
mmHg
20
120
Warning
NBP-M
mmHg
40
140
Warning
SPO2
90
105
Warning
SPO2-R
bpm
50
150
Warning
Dr
2001989-301A- draft 1
501A
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System setup
Parameter Limits and Alarm Levels
Low
High
Level
RR
breaths/min
30
Warning
RR-APNEA
seconds
30
Warning
PVC
#/min
Advisory
Levels
ASYSTOLE1
Crisis
VFIB/VTAC
Crisis
V TACH
Crisis
VT > 2
Crisis
V BRADY
Crisis
ACC VENT
Advisory
PAUSE
Advisory
TACHY
Advisory
BRADY
Advisory
af
Arrhythmia Alarm
Levels
Message
COUPLET
Message
BIGEMINY
Message
TRIGEMINY
Message
PVC
Message
IRREGULAR
Message
ATRIAL FIB
Message
Dr
R ON T
The default alarm level for Asystole and VFIB/VTACH cannot be moved from the
Crisis level.
4-14
System Alarm Levels
Levels
CHANGE BATTERY
System Warning
OFF NETWORK
System Warning
ARR SUSPEND
System Warning
LEADS FAIL
System Warning
PROBE OFF
System Warning
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System setup
Full disclosure defaults
This option sets the full disclosure settings. In user mode, only the full disclosure
Report and Strip settings can be configured. You must be in the Service mode to set
the other full disclosure settings at the CIC Pro center.
Dr
af
To view the full disclosure default settings, click CIC Setup > Full Disclosure
Defaults.
Option
503A
Function
Report
Duration
Designate how much data is included in the report. The
maximum report duration is 72 hours, depending upon
licensing.
To set the report duration, place the cursor on the scroll bar
below the Report Duration display field. Move the scroll bar
to the left for shorter duration or to the right for longer
duration.
Hole Location
Provide space for binding printed reports. Choices are:
none, top, bottom, left, and right.
Include
Set print characteristics. You may set any or none of these
options. Choices are: Graybar, Arrhythmia Annotations,
and Heart Rate.
Line Time
Designate how much data shows on an individual report
line. Choices are: 15sec, 30sec, and 1min.
Strip
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System setup
Option
Duration
Function
Designate how much data is included in the strip. The
maximum strip duration is 60 minutes.
To set the strip duration, place the cursor on the scroll bar
below the Strip Duration display field. Move the scroll bar to
the left for shorter duration or to the right for longer duration.
Hole Location
Provide space for binding printed reports. Choices are:
none, top, bottom, left, and right.
Unit License Default: Full
Disclosure License Type
NOTE
You must be in the Service mode at the CIC Pro center
to modify this setting.
Display a list of the full disclosure license type. Choices are:
none, 24 hours, 48 hours, and 72 hours.
NOTE
If the default does not match the actual license, full
disclosure does not work.
Select a time period to store full disclosure data if contact
with a monitor has been lost. Choices are: 30mins, 1, 2, 4, 8
and 12 hours.
Offline Storage
Dr
af
WARNING
POTENTIAL DATA LOSS — Do not allow a NO COMM
(patient offline) event to exceed the time limit selected in the
Offline Storage setting. The patient’s full disclosure data is
deleted if the time limit is exceeded.
Start Data Storage
Bed List
For more information, refer to the CIC Pro Clinical
Information Center Bedrock Platform Service Manual.
NOTE
You must be in the Service mode at the CIC Pro center
to modify this setting.
Designate how full disclosure is enabled for patients at the
time of admission. Choices are: automatically for all beds,
automatically if listed, and manually.
NOTE
You must be in the Service mode at the CIC Pro center
to modify this setting.
Lists beds for which full disclosure data is automatically
stored.
Restore
Clear any changes you made to the full disclosure default
settings and revert to the previous settings.
Current telemetry listings
NOTE
Refer to the CIC Pro Clinical Information Center Bedrock Platform Service
Manual for important configuration information.
4-16
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System setup
NOTE
Telemetry beds are distinguished from monitoring beds by an asterisk appended
to the end of the bed number.
Dr
af
To view the Current Telemetry Listings, click CIC Setup > Current Telemetry
Listings.
Option
Admitted Telemetry
Patients
2001989-301A- draft 1
364B
Function
Provide a view-only overview of the admitted telemetry
patients.
NOTE
Each row contains information for one telemetry
patient. The second line of an entry shows the current
software level for the patient bed in question.
„
Tower: The telemetry receiver system for this patient
„
Receiver: The receiver for this transmitter.
„
Unit|Bed: The unit and bed assigned to this patient.
„
Type: The type of patient; Tele Bed or Tele Combo.
„
Transmitter: The transmitter’s identification number.
Telemetry Beds
Add, modify or delete a telemetry bed name.
Hardwire Beds
Add, modify or delete a hardwire bed name.
Transmitters
Add, modify or delete a transmitter.
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System setup
Control settings (temporary)
Control settings allow you to make temporary adjustments to some of the system and
clinical application settings of the CIC Pro center. Control settings are temporary,
meaning they apply to a selected patient and are erased when the patient is
discharged.
For detailed control setting information, including displayed waveform, Alarm
Control, parameter control and print settings, refer to the CIC Pro Clinical
Information Center Operator’s Manual.To adjust the Alarm Volume, refer to Alarm
volume on page 4-18.
Alarm volume
To adjust the Alarm Volume for a telemetry patient at the CIC Pro center, follow these
steps:
From the multi-patient viewer, click CIC Setup > CIC Defaults to display the
current alarm volume.
Dr
af
1.
053A
4-18
2.
Click the down arrow next to Minimum and select the desired Alarm Volume.
The minimum Alarm Volume can be set between OFF and 100%.
3.
Click the down arrow next to Current and select the desired Alarm Volume
above the minimum volume setting. The current alarm level determines the
actual alarm volume.
4.
Click Apply.
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2001989-301A- draft 1
Alarms
Dr
af
2001989-301A- draft 1
ApexPro™
5-1
Alarms
Alarm notification
WARNING
ALARM ACTIVATION—No alarms sound or display on the CIC
Pro center until a monitored patient is admitted to the CIC Pro
center. The CIC Pro center will not alarm if an unadmitted patient
enters an alarm condition. You must admit the patient to activate the
alarms, automatic alarm printing, and the Events directory.
WARNING
OUT-OF-UNIT ALARMS—No audible alarms sound on the CIC
Pro center for any viewed out-of-unit patient beds. The CIC Pro
center only displays on-screen alarm indicators for viewed out-ofunit patient beds.
The CIC Pro center notifies you of patient or system status alarm conditions using
audible tones, on-screen indicators, or both audible tones and on-screen indicators.
af
The alarm tones used to identify alarm conditions are identified in Patient status
alarms on page 5-3 and System status alarms on page 5-4.
The following picture shows examples of on-screen alarm indicators:
Dr
058A
On-screen alarm indicators
ADU Alarm buttons
NOTE
Clicking the alarm button displays detailed real-time parameter data for the
alarming patient in a single patient viewer.
5-2
Parameter window
Waveform area alarm message
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Alarms
Alarm categories
The CIC Pro center categorizes alarms into patient status or system status alarms.
NOTE
The system will enunciate the system Warning and system Advisory fog horn for
Leads Fail, as it takes priority over any active patient status Warning, Advisory
and Message alarms.
NOTE
Crisis alarms are never superseded.
NOTE
When in Combo mode, alarm priority may be affected by the monitoring mode,
i.e., USER DEFINED or TELE DEFINED. For more information, refer to
Combo and Rover Combo monitoring on page 6-19.
Patient status alarms
af
Patient status alarms are the highest priority alarm. They are triggered by a patient
condition which exceeds a parameter’s alarm limits or by an arrhythmia condition.
There are four severity levels of patient status alarms:
Crisis: Life-threatening events. Crisis alarms sound until silenced by the user.
„
Warning: Serious but non-life-threatening events. Warning alarms sound until
the condition is resolved.
Dr
„
„
Advisory: Events that require monitoring, but are not serious or life threatening.
Advisory alarms sound until the condition is resolved.
„
Message: Additional information only.
The CIC Pro center’s response to patient status alarms is as follows:
Indicator
Crisis
Warning
Advisory
Message
Alarm tone
Three
beeps
Two beeps
One beep
No
On-screen message
Yes
Yes
Yes
Yes
Colored patient
Red
Yellow
No
No
Automatic graph3
Yes
Yes
No
No
Events
Yes
Yes
Yes
No
window border1 2
1When
using the multi-patient viewer, the patient window border briefly flashes on and off at the
start of the alarm and then stays on until the alarm is silenced or the alarming condition
ends.
2Only patient
status Crisis and Warning alarms and system status Warning alarms activate the
colored border. Patients selected for single patient view have a white border in the multipatient viewer.
2001989-301A- draft 1
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5-3
Alarms
For telemetry patients only, the factory default for this setting is Always on. To change this
setting, see the Telemetry Unit Defaults in the CIC Pro Clinical Information Center
Bedrock Hardware Platform Service Manual.
A graph prints automatically when a patient experiences a Crisis or Warning alarm.
Arrhythmia alarm graphs run until the end of the alarm event or manually stopped by
the user. The printer prints the 10 seconds of data that occurred immediately before
the event, and prints for the duration of the event. The printer stops printing when the
patient returns to a normal rhythm. If a printer is not available at the time of the alarm
event, a 20-second graph is saved. This saved graph will print when a printer becomes
available.
You can temporarily adjust patient status alarm levels and limits. See Adjusting alarm
control settings on page 5-8.
System status alarms
System status alarms are triggered by network or equipment problems. They are of
lesser priority than patient status alarms.
There are three severity levels of system status alarms:
System Warning: Serious network or equipment problems.
„
System Advisory: Network or equipment problems.
„
System Message: Additional information only.
af
„
The CIC Pro center’s response to system status alarms is as follows.
System Warning
Dr
Indicator
System Advisory
System Message
Alarm tone
Repeating foghorn
Single foghorn
No
On-screen message
Yes
Yes
Yes
Colored patient
Yellow
No
No
window border1 2
When using the multi-patient viewer, the patient window border briefly flashes on and off at the
start of the alarm and then stays on until the alarm is silenced or the alarming condition
ends.
Only patient status Crisis and Warning alarms and system status Warning alarms activate the
colored border. Patients selected for single patient view have a white border in the multipatient viewer.
Managing patient alarms
To support a patient’s unique arrhythmia or parameter condition, you can temporarily
adjust a patient’s Parameter Limits And Alarm Levels. See Adjusting alarm control
settings on page 5-8.
5-4
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Alarms
The bedside monitors automatically stores a 10-second strip for all Advisory,
Warning, or Crisis arrhythmia events. The CIC Pro center can retrieve and display
the 10-second strip stored at the bedside monitor.
When configured for it, your CIC Pro center automatically prints patient alarm
graphs. See Printing patient alarm graphs on page 5-17.
Enable transmitter pause
The Enable Transmitter Pause check box, when checked, allows alarms to be paused
by pressing both transmitter buttons simultaneously.
To enable the transmitter pause option for a telemetry patient admitted to the CIC Pro
center, click in the Enable Transmitter Pause check box. A check mark appears in
the check box.
To disable the transmitter pause option, click in the Enable Transmitter Pause
checkbox. The check mark is removed from the check box and the option is disabled.
NOTE
If Off is selected for the Transmitter Alarm Pause option in the Telemetry Unit
Defaults tab sheet, no check box appears on the tab.
af
To make the Enable Transmitter Pause option active (check box available),
either Enabled or Disabled must be selected for the Transmitter Alarm Pause
option in the Telemetry Unit Defaults tab sheet.
Dr
Pausing alarms at the transmitter
WARNING
Alarms do not sound and alarm graphs do not print during an
ALARM PAUSE condition.
CAUTION
All alarms, except Crisis alarms, are ignored while the alarm pause
is active.
NOTE
The Enable Transmitter Pause option for a telemetry patient admitted to the CIC
Pro center must be enabled before the patient can initiate an alarm pause from the
transmitter.
To pause the alarms for five minutes, press the Verify Leads and Graph buttons
simultaneously. When the Pause Alarm combination is pushed, the following takes
place:
2001989-301A- draft 1
„
The top row of LEDs will flash twice, indicating the buttons were pushed.
„
The Pause Alarm LED will flash at a 1 second rate until the pause alarm
condition times out (5 minutes by default, but settable through the programming
box).
ApexPro™
5-5
Alarms
„
ALARM PAUSE displays in the patient’s waveform window on the CIC Pro
center screen.
After five minutes, the LED on the transmitter will no longer flash and alarms will be
reactivated.
Reactivating alarms at the transmitter
To reactivate the alarms before the five minute time period has elapsed, press both
transmitter buttons simultaneously again.
Alarm pause breakthrough
NOTE
For more information on the Alarm Pause Breakthrough feature in Combo
mode, refer to Combo and Rover Combo monitoring on page 6-19.
NOTE
af
The Alarm Pause Breakthrough feature defaults to Always On. It can be set to
Always Off in the Telemetry Unit Defaults tab sheet BEFORE admitting a
telemetry patient if you do not wish to have Crisis level alarms break through
alarm pauses.
This feature cannot be set on an individual patient basis. It is either on or off for
all telemetry patients admitted to the CIC Pro center. A status message on each
patient’s Alarm Control tab sheet indicates whether it is enabled (on) or disabled
(off).
Dr
The Alarm Pause Breakthrough feature allows any Crisis level alarm to break
through (interrupt) an alarm pause and sound at the CIC Pro center.
In other words, when this feature is turned on in the Telemetry Unit Defaults tab
sheet, Crisis level alarms will sound at the CIC Pro center, even if an alarm pause is in
effect.
The chart below illustrates the function of the Alarm Pause Breakthrough feature
during the various alarm states.
Alarm Pause State
Alarm Pause Breakthrough Feature Enabled
Alarms on
No Alarm Pause Breakthrough; all alarms are on.
Alarms off
No Alarm Pause Breakthrough; all alarms are off.
Alarm off reason (X-ray,
shower, etc.)
Alarms are paused; Crisis level alarms will break through
the alarm off reason if the patient is in antenna range.
Alarms paused from the
transmitter
Alarms are paused; Crisis level alarms will break through
the alarm pause.
After a Crisis level alarm has broken through an alarm pause, the telemetry system
does not return to an alarm pause state. All alarms at any alarm level will sound at the
CIC Pro center.
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Alarms
If you wish to continue pausing alarms after an Alarm Pause Breakthrough occurs,
you must re-initiate the alarm pause:
1.
To re-initiate an alarms off with reason condition, select the alarms off reason in
the telemetry patient’s Alarm Control tab sheet.
2.
To re-initiate an alarm pause from the transmitter, press both transmitter buttons
simultaneously twice.
NOTE
The transmitter buttons must be pressed once to end the alarm pause at the
transmitter, then a second time to start a new alarm pause at the transmitter
(see below).
The Pause Alarm LED on the transmitter continues to flash after an Alarm Pause
Breakthrough occurs. This is because there is no communication from the CIC Pro
center back to the transmitter to indicate that the alarm pause has ended.
After an Alarm Pause Breakthrough occurs, you can turn off the flashing Pause
Alarm LED by pressing both transmitter buttons simultaneously.
Silencing alarms
af
Temporarily silencing alarms from the CIC Pro center
Dr
WARNING
Do not continuously try to silence audible alarms. You may
inadvertently silence new patient alarms.
Once you are notified of an alarm condition, you can silence audible alarms from the
CIC Pro center for one minute by clicking the Silence Alarms button located on the
display screen or by pressing the Silence Alarms key located on the keyboard.
This sends a silence notification to the bedside monitor. For most GE monitors, this
silence notification will silence the alarms for up to one minute. However, the bedside
monitors must be configured to allow bedside alarms to be silenced from the CIC Pro
center.
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Alarms
NOTE
The following conditions apply when you silence alarms at the CIC Pro center:
„
The alarms remain silent for one minute unless a new patient alarm
condition occurs.
‹
ApexPro telemetry beds: If a patient alarm condition of any severity
level occurs, the alarm silence condition is cancelled and the alarm will
break through.
‹
Monitors and CD Telemetry-LAN telemetry beds: If a patient alarm
condition of equal or greater severity level occurs, the alarm silence
condition is cancelled and the alarm will break through.
„
The alarms for all patients are silenced simultaneously. You cannot silence
patient alarms one at a time.
„
The CIC Pro center displays a filled alarm silence icon when alarms are
silenced at the CIC Pro center or at a monitor.
Alarm silence indicator
af
When active alarms are silenced at the CIC Pro center or at a monitor, the CIC Pro
center displays an alarm silence icon in the ECG parameter window.
This icon remains displayed for the duration of the alarm silence condition or until a
new alarm condition occurs.
Dr
Adjusting alarm control settings
When viewing a single, in-unit patient from the CIC Pro center, you may temporarily
adjust the monitor Alarm Control settings.
WARNING
ALARM CONTROL SETTINGS—If you adjust parameter limits or
alarm levels at the CIC Pro center, these setting changes are also
implemented by the bedside monitor. You must notify the bedside
caregiver that you changed the parameter limit or alarm levels of
that bedside monitor.
5-8
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Alarms
NOTE
The following guidelines apply to changing Alarm Control settings at the CIC
Pro center:
„
The changes you make to the settings apply to the selected patient only and
are adopted by the patient’s monitor.
„
Some control settings for non-GE acquisition devices that are interfaced via
the Unity Network Interface Device or the OCTANET interface device are
not adjustable.
„
It may be necessary to use the scroll bar at the right side of the window to
view the appropriate alarm.
„
The control settings that are blue in color indicate this setting has already
been adjusted from the default value.
„
The patient or the acquisition device must be located in-unit.
„
Any out-of-unit patient alarm settings can be viewed, but not changed.
Monitor alarm control settings
Complete the following procedures to temporarily adjust the following monitor
Alarm Control settings for a selected patient:
Low/high parameter alarm limits and alarm levels.
„
Arrhythmia Alarm Levels.
af
„
NOTE
All changes are temporary and return to the default settings when the patient is
discharged.
Dr
To permanently change the Alarm Control settings for telemetry patients, see the
Telemetry Alarm Control Defaults section of the CIC Pro Clinical Information
Center Bedrock Hardware Platform Service Manual.
Displaying the alarm control window
1.
From the multi-patient viewer, click on the patient you want to view. The single
patient viewer displays.
2.
From the single patient viewer, click Monitor Setup > Alarm Control. The
Alarm Control window displays.
056A
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Alarms
You may change any of the undimmed setting options. When an option appears
dimmed, you cannot change it.
Adjusting the parameter limit values
WARNING
ALARM CONTROL SETTINGS—If you adjust parameter limits or
alarm levels at the CIC Pro center, these setting changes are also
implemented by the bedside monitor. You must notify the bedside
caregiver that you changed the parameter limit or alarm levels of
that bedside monitor.
1.
From the Alarm Control window, click on the alarm limit Low or High field.
2.
Click the up or down arrows to increase or decrease the alarm limit value. You
may also type the values directly into the highlighted data field.
3.
Repeat the previous steps to adjust additional alarm limit values.
4.
After making your selections, complete one of the following tasks:
Choose a different control setting to adjust.
„
Click the
window.
„
af
(close button) on the top right side of the window to close the
Adjusting the alarm levels
Dr
WARNING
ALARM CONTROL SETTINGS—If you adjust parameter limits or
alarm levels at the CIC Pro center, these setting changes are also
implemented by the bedside monitor. You must notify the bedside
caregiver that you changed the parameter limit or alarm levels of
that bedside monitor.
1.
From the Alarm Control window, click on the alarm Level field.
2.
Click the down arrow to display a list of alarm levels.
3.
Select the desired alarm level.
4.
Repeat step 1 to step 3 to adjust additional alarm level settings.
5.
After making your selections, complete one of the following tasks:
„
Choose a different control setting to adjust.
„
Click the
window.
(close button) on the top right side of the window to close the
Adjusting telemetry Alarms On/Off control settings
5-10
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Alarms
WARNING
Alarms do not sound, alarm histories are not stored, and alarm
graphs do not print during an alarms off with reason condition.
NOTE
The patient must be in antenna range for the alarm pause state to cease. After the
patient has returned to antenna range and/or alarms have been turned back on,
verify that the patient’s waveforms are displayed at the CIC Pro center or bedside
monitor
NOTE
Refer to Alarm pause breakthrough on page 5-6 for important alarm pause
information.
The telemetry Alarm Pause - Smart Alarms feature reduces false patient alarms and
works as follows:
When a patient is re-connected to the telemetry device and continuous ECG data
is recorded, the alarm pause condition automatically clears.
„
Selecting any reason establishes an alarm pause state for 5 minutes in the
presence of a valid waveform. After 5 minutes, alarms will reactivate if the
patient is within range of the antenna system for 15 seconds or longer and
continuous ECG data is detected. If the patient remains out of antenna range, the
alarm pause state will continue until the patient re-enters antenna range for 15
seconds or longer.
af
„
When a patient is re-connected to the telemetry device and continuous ECG data
is recorded, the Alarm Pause condition automatically clears.
„
The alarms off reason displays in the event trend for Graphic Trends.
„
If the patient is in LEADS FAIL or NO TELEM and an alarms off reason is
selected, the reason is displayed in the waveform window.
Dr
„
Complete the following procedure to adjust the Alarms On/Off control settings:
1.
2001989-301A- draft 1
To temporarily pause this telemetry patient’s alarm to complete a procedure,
click Alarm Pause - Smart Alarms. Then, complete the following steps:
a.
Click the down arrow to display a list of reasons for pausing the alarm.
b.
Select the desired reason. This text is displayed in addition to the ALARMS
OFF message in the patient’s window at the CIC Pro center.
Alarms Off Reason
Text Displayed At CIC Pro center
On
(no text)
(no text)
Off1
ALARMS OFF
OFF
X-ray
XRAY
X-RAY
Shower
SHOWER
SHOWER
Surgery
SURGERY
SURGERY
Physical therapy
P.T.
PHYSICAL THERAPY
ApexPro™
Text Printed On Graph
5-11
Alarms
Alarms Off Reason
Text Displayed At CIC Pro center
Text Printed On Graph
Cardiac rehab
CAR REHAB
CARDIAC REHAB
GI Lab
GI LAB
GI LAB
Occupational therapy
O.T.
OCCUPATIONAL THERAPY
Off unit
OFF UNIT
OFF UNT
Cath Lab
CATH LAB
CARDIAC CATH LAB
OFF appears dimmed and is not selectable when the following service-level default is set: CIC
Setup > CIC Defaults > Allow Alarms OFF on this CIC > No. To be able to turn off alarms
for a telemetry patient, you must change the Allow Alarms OFF on this CIC service-level
default to Yes. For more information, refer to the CIC Pro Clinical Information Center
Bedrock Hardware Platform Service Manual.
2.
To turn off alarms for this telemetry patient, click OFF.
af
Telemetry bed alarm control defaults
WARNING
The telemetry alarms remain off until you manually select ON again.
You cannot adjust the Telemetry Alarm Control Defaults. These settings are servicelevel defaults and are password protected.
Dr
To view the settings, from the multi-patient viewer, click CIC Setup > Telemetry
Alarm Control Defaults.
To permanently change the Telemetry Alarm Control Defaults, see the CIC Pro
Clinical Information Center Bedrock Hardware Platform Service Manual.
Alarm unit default settings
Telemetry alarm control defaults
You can set Telemetry Unit Defaults for Parameter Limits And Alarm Levels, as
well as for Arrhythmia Alarm Levels. These defaults are in effect for all telemetry
patients admitted to your unit, unless they are modified in an individual patient’s
Alarm Control tab sheet.
To set Telemetry Alarm Control Defaults, follow the steps below:
5-12
1.
Click CIC Setup. A set of tabs displays.
2.
Click on the Service Password tab to bring it to the front.
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Alarms
318B
Use the keyboard to enter the service password, then click the Apply button. The
Current Permission entry changes from User to Service.
3.
Dr
af
CAUTION
The service mode is intended for use only by qualified personnel
with training and experience in its use. The consequences of misuse
include loss of patient data, corruption of the CIC Pro center
operating system software, or disruption of the entire Unity network.
4.
2001989-301A- draft 1
Click on the Telemetry Alarm Control Defaults tab to bring it to the front.
ApexPro™
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Alarms
af
Parameter limits
319D
To change the unit defaults for Parameter Limits and Alarm Levels, use the
mouse to click in the Low or High field for the parameter you wish to edit. The
field is framed by a rectangle, and up and down arrow buttons appear in the field.
Dr
1.
2.
329A
To increase or decrease the limit by 5, click on the up or down arrow button.
To increase or decrease the limit in increments other than 5, use the keyboard to
enter a new limit value.
3.
Once you have set the desired limit, click on the Apply button for the changes to
take effect.
NOTE
If you make only one change, you do not need to click on the Apply button.
The change will take effect automatically, and the Apply button will appear
dimmed.
4.
5-14
If you are finished making changes to the Telemetry Alarm Control Defaults tab
sheet, click the OK button.
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Alarms
Parameter alarm levels
To make a change in the telemetry unit default alarm level for a parameter, first access
the Telemetry Alarm Control Defaults tab as described in the Telemetry Alarm
Control Defaults section in this chapter. Then follow the procedure below.
1.
In Telemetry Alarm Control Defaults tab, use the mouse to click in the Level
field of the parameter for which the alarm level is to be changed. A down arrow
button appears in the field.
2.
Click on the down arrow button. A popup list of alarm level selections appears.
3.
Click on the desired alarm level to select it.
4.
Once you have set the desired level, click the Apply button for the changes to
take effect.
5.
If you are finished making changes to the Telemetry Alarm Control Defaults tab
sheet, click the OK button.
af
331A
Arrhythmia alarm levels
Dr
To make a change in the telemetry unit default alarm level for arrhythmia alarms, first
access the Telemetry Alarm Control Defaults tab as described in the Telemetry
Alarm Control Defaults section in this chapter. Then follow the procedure below.
1.
In the Telemetry Alarm Control Defaults tab, the Arrhythmia Alarm Levels for
which unit defaults can be set appears on the right side of the window:
2.
Click in the Level field of the arrhythmia alarm you wish to modify. A down
arrow button appears in the field.
333C
NOTE
The Arrhythmia Alarm Levels for ASYSTOLE and VFIB/VTAC cannot be
changed. Therefore, the text in the Level field for these alarms always
appears dimmed.
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Alarms
3.
Click on the down arrow button. A popup list of alarm level selections appears.
4.
Click on your choice to select it.
5.
Once you have set the desired level, click the Apply button for the changes to
take effect.
If you are finished making changes to the Telemetry Alarm Control Defaults tab
sheet, click the OK button.
System alarm levels
af
WARNING
ADJUSTING SYSTEM ALARM LEVELS — The Leads Fail
alarm indicates that one or more electrodes are not connected to the
patient and, as a result, there is loss of all waveforms and arrhythmia
analysis. The ARR SUSPEND alarm indicates that arrhythmia
conditions are not being detected and therefore alarms associated
with arrhythmias will not occur. The Leads Fail and ARR
SUSPEND alarms should be adjusted to a lower priority level only
by experienced qualified personnel and with great caution.
Adjusting these alarms to a lower priority level may result in
reduced awareness of conditions that indicate the loss of patient
monitoring.
NOTE
Dr
Some alarm conditions may have a higher priority level at the bedside monitor. In
Combo mode, the alarm levels come from the telemetry settings. For example,
LEADS FAIL can be set to Crisis at a bedside monitor, but the telemetry setting
is a system Warning.
To make a change in the telemetry unit default alarm level for system alarms, first
access the Telemetry Alarm Control Defaults tab as described in the Telemetry
Alarm Control Defaults section in this chapter. Then follow the procedure below.
1.
In the Telemetry Alarm Control Defaults tab, the System Alarm Levels for
which unit defaults can be set appears on the right side of the window:
2.
Click in the Level field of the system alarm you wish to modify. A down arrow
button appears in the field.
3.
Click on the down arrow button. A popup list of alarm level selections appears.
4.
Click on your choice to select it.
430A
5-16
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Alarms
5.
Once you have set the desired level, click the Apply button for the changes to
take effect.
If you are finished making changes to the Telemetry Alarm Control Defaults tab
sheet, click the OK button.
Recalling unit defaults
To recall the preset telemetry patient unit defaults for all options in the Alarm Control
tab, simply click on the Recall Unit Defaults button on the bottom right side of the
Alarm Control tab sheet. All data on the tab sheet will clear, and after a moment the
preset unit defaults will appear.
In addition, clicking on the Recall Unit Defaults button also restores the default graph
locations and settings on the patient’s ECG tab sheet.
Alarm help
Dr
af
For additional information about alarms, click on the Alarm Help button at the
bottom right side of the Alarm Control tab sheet. An Alarm Help window displays.
323A
You can click on the buttons in this window to hear how each type of alarm sounds.
When you are finished browsing the window, click on the Close Window button to
close the window and return to the single patient viewer.
Printing patient alarm graphs
An automatic alarm graph prints the 10 seconds of data that occurred before the alarm
event, then continues to print for the duration of the event. When the printer is not
available, the bedside monitor stores the event data until the printer becomes
available.
Configure the automatic printing of alarm graphs
The automatic printing of alarm graphs for telemetry beds must be enabled in the
Service mode. For more information, refer to Telemetry alarm control defaults on
page 5-12.
2001989-301A- draft 1
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5-17
Alarms
Printing alarm settings
A telemetry patient’s Alarm Control tab sheet can be printed, showing all current
alarm settings and limits. Click on the Print button in the main menu to start a
printout of the Alarm Control tab sheet.
The Alarm Control tab sheet prints at the Print Window location. For more
information about setting the Print Window location, refer to Chapter 9 in this
manual.
NOTE
The Alarm Control tab sheet must be the front tab of the single patient viewer in
order to print it. Click on the Alarm Control tab to bring it to the front if
necessary.
Stop printing an alarm graph
You can stop the printing of an alarm graph from any in-unit CIC Pro center
displaying the alarming patient bed.
Stop printing to a laser printer
af
Complete the following procedure to stop printing all print jobs sent to the laser
printer:
From the multi-patient viewer, click CIC Setup > CIC Defaults. The CIC
Defaults window displays.
2.
Under Printer/Writer, click Cancel Print Jobs for the printer you want to stop
printing to.
3.
After making your selection, complete one of the following tasks from the CIC
Defaults window:
Dr
1.
„
Click OK to apply your changes and close the CIC Defaults window.
„
Click Cancel to cancel your changes and close the CIC Defaults window.
„
Click Apply to apply your changes without closing the CIC Defaults
window.
Stop printing to a local digital writer
Complete the following procedure to stop printing the current print job sent to a local
digital writer:
5-18
1.
Locate the digital writer.
2.
Press the
(Graph Stop) button located on the front of the digital writer to
stop the print job.
ApexPro™
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Managing patients
Dr
af
2001989-301A- draft 1
ApexPro™
6-1
Managing patients
Introduction
Prior to admitting a telemetry patient to the CIC Pro center, several steps need to be
performed:
1.
Transmitter setup on page 3-2.
2.
Skin preparation on page 6-2.
3.
Electrode placement on page 6-2.
You can manage in-unit patients from the CIC Pro center or from a networked
monitor. When managing in-unit patients from the CIC Pro center, you can complete
the following tasks:
Admit patients.
„
Change patient demographic information.
„
Adjust parameter settings.
„
View stored data.
„
Move patients to different beds.
„
Discharge patients.
„
af
Skin preparation
The quality of ECG information displayed on the monitor is a direct result of the
quality of the electrical signal received at the electrode. Proper skin preparation is
necessary for good signal quality at the electrode.
Dr
Choose flat, non-muscular areas to place electrodes, then follow the established prep
protocol for your unit. Below is a suggested guideline for skin preparation:
1.
Shave or clip hair from skin at chosen sites.
2.
Thoroughly cleanse the site with alcohol or a mild soap and water solution. Be
sure to remove all oily residue, dead skin cells, and abrasives.
3.
Dry the skin completely before applying the electrodes.
Regardless of patient age, all electrodes should be replaced on a regular basis, AT
LEAST every 48 hours, to maintain quality signals during long-term monitoring. If
they are not, increased noise can occur. Over the course of 48 hours, the electrode gel
will start to dry out and the adhesive will age. After a long period of time, the patient’s
skin may also be irritated by the gel or adhesive, causing discomfort.
Electrode placement
WARNING
CONTAMINATED LEADWIRES— Contaminated leadwires may
cause infection. Always follow the skin preparation guidelines and
leadwire cleaning instructions provided in this manual.
6-2
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Managing patients
The following chart shows the label used to identify each leadwire. Included also is
its associated color code per AHA (American Heart Association) and IEC
(International Electrotechnical Commission) standards.
Leadwire
(Software
Label)
AHA Color
AHA Label
IEC Color
IEC Label
white
RA
red
LA (left arm)
black
LA
yellow
RL (right leg)
green
RL
black
LL (left leg)
red
LL
green
V1 (precordial)
brown
V1
white
C1
V2 (precordial)
yellow
V2
yellow
C2
V3 (precordial)
green
V3
green
C3
V4 (precordial)
blue
V4
brown
C4
V5 (precordial)
orange
V5
black
C5
V6 (precordial)
purple
V6
purple
C6
RA (right arm)
af
6-leadwire electrode placement
Dr
The following is a suggested configuration for a 6-leadwire electrode placement for
all patients, including pacemaker and implantable cardiac defibrillator (ICD) patients:
6-leadwire AHA Electrode Placement
6-leadwire IEC Electrode Placement
100B, 101B
Right arm and left arm electrodes should be placed just below the right and left
clavicle.
Right leg and left leg electrodes should be placed on a non-muscular surface on the
lower edge of the rib cage.
NOTE
When using a 6-leadwire set, the V leads must be labelled correctly. Choices for
Va: V1 to V6. Choices for Vb: V2 toV6. For more information, refer to Userlevel defaults (persistent) on page 4-7.
2001989-301A- draft 1
ApexPro™
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Managing patients
NOTE
The V1 lead is recommended for arrhythmia detection, and the V5 lead is
recommended for ST depression monitoring.1
NOTE
For telemetry monitoring, any two precordial electrodes may be placed according
to the clinician or physician’s preference.
5-leadwire electrode placement
af
The following is a suggested configuration for a 5-leadwire electrode placement:
5-leadwire Electrode AHA Placement
5-leadwire Electrode IEC Placement
633B, 634B
Dr
Right arm and left arm electrodes should be placed just below the right and left
clavicle.
Right leg and left leg electrodes should be placed on a non-muscular surface on the
lower edge of the rib cage.
The precordial electrode should be placed according to the clinician or physician’s
preference.
3-leadwire electrode placement
WARNING
Do not monitor patients with a 3-leadwire set when reliable pacer
detection is required. Pacer pulse detection can be erratic when only
a single vector is monitored. Always use a 5- or 6-leadwire set when
reliable pacer detection is required.
When a 5-leadwire electrode configuration is not desirable, a 3-leadwire set can be
used. The following is a suggested configuration for a 3-leadwire electrode
placement:
1Barbara
J. Drew, RN, PhD, FAAN (2000). Value of Monitoring a Second Precordial Lead for Patients
in a Telemetry Unit, GE Medical Systems (order document number M04243ME0).
6-4
ApexPro™
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Managing patients
LA
RA
LL
3-leadwire AHA Electrode Placement
3-leadwire IEC Electrode Placement
370A, 373A
Right arm and left arm electrodes should be placed just below the right and left
clavicle.
Left leg electrode should be placed on a non-muscular surface on the lower edge of
the rib cage.
When using the standard 3-leadwire configuration, the following operating conditions
occur:
Lead Analysis automatically switches to Single-Lead analysis. If an attempt is
made to change to Multi-Lead analysis, a message will appear briefly on the
monitor, indicating that Multi-Lead analysis is not possible, and no change will
occur.
af
„
The choices for displayed leads are limited to I, II, and III. Any options usually
allowing more than one ECG lead selection are disallowed.
„
Respiration can be monitored from either lead I or II. It is not dependent on the
displayed lead. Respiration is not available for telemetry patients. For more
information, refer to SpO2 control settings on page 7-24.
Dr
„
Electrode placement for pediatric patients
Typically, pediatric patients are large enough for a 5- or 6-leadwire electrode
configuration. This is the preferred monitoring setup for receiving the benefits of
Multi-Lead analysis. However, if the patient is too small for five or six electrodes, the
3-leadwire electrode configuration can be used. The right arm and left arm electrodes
are positioned on the right and left sides of the chest. The right leg electrode can be
placed on either the right or left side of the abdomen. Refer to 3-leadwire electrode
placement on page 6-4.
Electrode placement for neonate patients
Because neonatal patients are small, there is usually only enough room for a 3leadwire electrode configuration. A 3-leadwire neonatal ECG cable is available, and
Multi-Link DIN adapter is available for the 5-leadwire Multi-Link cable. The right
arm and left arm or right arm and left leg electrodes are positioned on the right and
left sides of the chest. The third electrode (right leg) can be placed on either the right
or left side of the abdomen.
2001989-301A- draft 1
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Managing patients
Lead II
Lead I
Neonatal AHA Electrode Placement
Lead II
Lead I
Neonatal IEC Electrode Placement
883B, 884B
Verify status
After the transmitter leadwires have been properly attached to the patient's electrodes,
verify lead quality, electrode status and transmitter function.
For more information, refer to Maintaining quality ECG signal on page 6-6.
„
For more information, refer to Transmitters on page 2-2.
„
af
Maintaining quality ECG signal
Dr
Electrodes are disposable and applied only once. Attempts to replace a loose
electrode guarantees excessive motion artifact and results in false alarms. Regardless
of patient type, electrodes should be replaced at least every 48 hours to maintain
quality signals during long-term monitoring. Over the course of 48 hours, the
electrode gel will start to dry out and the adhesive will age. This may irritate the
patient’s skin.
The transmitter must be carried securely on the patient. Stabilize the electrode and
leadwire with a leadwire stress loop near the electrode. Tape the stress loop to the
patient. A secured stress loop prevents the leadwire rotation about the electrode snap,
leadwire tugging at the electrode and ECG artifact.
306A
If the transmitter is allowed to dangle or jostle as the patient moves, then the weight
of the device will tug on the electrodes, causing degradation of the signal. Even if the
electrodes are in good contact, excessive tugging on the electrodes will change the
physical structure of the gel, thereby generating motion artifact signals. Transmitters
6-6
ApexPro™
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Managing patients
can be carried securely is inserted into pouches or placed into a patient’s gown
pocket.
Special considerations for 6-leadwire monitoring
V FAIL message
CAUTION
The CIC Pro center does not detect 6-leadwire monitoring until a
signal from the sixth lead is received at the CIC Pro center.
Therefore, if the sixth lead on the transmitter has failed before the
telemetry patient is admitted to the CIC Pro center, the CIC Pro
center will not generate a V FAIL message for the sixth lead.
At the patient’s transmitter, verify that the sixth lead on the transmitter is good. Press
the Verify Leads button on the transmitter and ensure that all the good lead LEDs
illuminate.
Relearn
af
If a telemetry patient is switched from 6-leadwire monitoring to 5-leadwire
monitoring while admitted to the CIC Pro center, a V FAIL message will appear. The
CIC Pro center assumes that the telemetry patient is being monitored for six leads and
that the sixth lead has failed.
Dr
In situations where the admitted telemetry patient has been switched from 6- to 5leadwire monitoring, the associated V FAIL message can be cleared by clicking on
the Relearn button in the telemetry patient’s ECG tab sheet. For more information,
refer to ECG on page 7-11.
Admitting
Prior to admitting a telemetry patient to the CIC Pro center, several steps need to be
performed:
1.
2001989-301A- draft 1
Transmitter setup on page 3-2.
„
Battery installation on page 3-3.
„
Leadwire installation on page 3-4.
„
Electrode attachment on page 3-5.
„
Verify transmitter/leadwires status on page 3-6.
2.
Skin preparation on page 6-2.
3.
Electrode placement on page 6-2.
ApexPro™
6-7
Managing patients
Terminology
Term
Definition
Locked and unlocked beds
The CIC Pro center can be configured with the bed names in
either locked or unlocked mode. When locked, the bed
names are permanently assigned to specific windows.
For information about locked and unlocked beds, refer to the
CIC Pro Clinical Information Center Bedrock Hardware
Platform Service Manual.
NOTE
It is possible to admit a patient to a window with a bed
name that is locked to NONE. To avoid duplication of
patient waveforms, a window locked to NONE should
not be used to admit a patient.
Each transmitter has a transmitter TTX ID number that
corresponds to a frequency and service type. The TTX ID
number is found in parenthesis on the back of the
transmitter.
Dr
af
TTX ID number
Telemetry monitoring occurs when patient vital signs data is
transmitted by a transmitter to a telemetry receiver system
over an established antenna system and viewed at a CIC
Pro center. The CIC Pro center identifies a telemetry bed by
placing an asterisk next to the bed name (e.g., IMC|BED4*).
ECG data is processed by the telemetry receiver system.
Telemetry monitoring
6-8
ApexPro™
When the TTX ID number is entered for a patient at the CIC
Pro center, the CIC Pro center recognizes the transmitter
type and translates the information into an alpha-numeric
number. The alpha-numeric number of the transmitter is
displayed under the ECG parameter window.
NOTE
The TTX ID number is a five digit number.
2001989-301A- draft 1
Managing patients
Term
Definition
Bedside monitoring
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA
PROCESSING AND CALCULATIONS BASED ON
PATIENT AGE — After manually updating or automatically
retrieving patient demographic information from a network
database, always confirm that the entered patient’s date of
birth matches the patient’s actual date of birth. Otherwise
the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
(hard-wired)
A bedside monitor is a stationary monitor (user-configured or
factory-configured). These monitors are connected directly
to the patient via an ECG cable. They are set up with a unit
name as well as a bed name (e.g., IMC|BED4). For a userconfigured monitor, ECG data is processed by an acquisition
module. For a factory-configured monitor, ECG data is
processed within the monitor itself. For more information,
refer to the CIC Pro Clinical Information Center Operator’s
Manual.
This application provides the option to acquire ECG from
either the monitor or from a telemetry receiver system. This
ECG data acquisition capability enhances basic telemetry
monitoring by providing additional access to all of the
available parameters from the monitor. A Unity Network
connection is required.
af
Combo monitoring
Dr
Factors guiding the admit process
WARNING
ALARM ACTIVATION—No alarms sound on the CIC Pro center
until a patient is admitted to the monitor or CIC Pro center. The CIC
Pro center or monitor will not alarm if an unadmitted patient enters
an alarm condition. You must admit the patient to activate alarms,
alarm graphs, and the Events directory.
You can admit a patient from the CIC Pro center or from a networked monitor. You
only have to admit a patient once.
The steps you must complete to admit a patient at the CIC Pro center may vary
resulting from the following factors:
2001989-301A- draft 1
„
The source of the ECG data.
„
The source of the patient demographic information.
„
The mobility level of the monitor. Does the monitor move (rove) from room-toroom?
„
The permanent assignment (locking) of beds in the multi-patient viewer.
ApexPro™
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Managing patients
The source of the ECG data
You can admit patients to the CIC Pro center when the source of their ECG data
comes from either a monitor or a transmitter.
The source of the ECG data determines the monitoring mode the CIC Pro center uses.
The monitoring mode is configured during installation.
The CIC Pro center supports one of the following monitoring modes:
Monitoring Modes
Mode
Description
Standard
Rover
„
The patient is not connected to a transmitter.
„
The monitor moves (roves) from room to room.
„
The patient is not connected to a transmitter.
„
The monitor (or transmitter) and patient always stay in
one room.
„
The patient is connected to either a stationary monitor or
to a transmitter.
„
The monitor (or transmitter) moves (roves) from room to
room.
af
Rover Combo
The monitor and patient always stay in one room.
Combo
„
„
The patient is connected to either a stationary monitor or
to a transmitter.
Dr
The source of the patient demographic information
Depending on the configuration of your CIC Pro center, you may use one of the
following methods to enter patient demographic information:
„
Enter search criteria (e.g., patient name) to retrieve matching patient
demographic information from a networked database.
„
Manually type patient demographic information into data entry fields and choose
demographic information from a list.
The monitor moves (roves) from room to room
When the monitor moves (roves) from room to room and is not a transmitter, always
admit the patient at the monitor.
NOTE
Before you admit a patient at a monitor that moves (roves), you must complete
the following procedure (in the order it is presented) to ensure the correct bed
number is identified at the CIC Pro center:
6-10
1.
Turn off the monitor when you are storing it.
2.
Keep the monitor turned off when you bring it into the patient room.
3.
Verify the monitor is on the network.
ApexPro™
2001989-301A- draft 1
Managing patients
4.
Connect the monitor to an appropriate power outlet.
5.
Turn on the monitor.
6.
Wait 30 seconds, then verify the monitor displays the correct Unit Name and Bed
Name. If the Unit Name and Bed Name do not appear, refer to To manually enter
the patient demographic information on page 6-14.
7.
Admit the patient to the monitor following the monitor’s operator instructions.
The permanent (locked) beds in the multi-patient viewer
During the installation of the CIC Pro center, qualified personnel may configure the
CIC Pro center to permanently display bed names in specific multi-patient viewer
locations (windows). These beds are locked into position and are always displayed
whether a patient is admitted to them or not. To change the display of locked beds,
contact your biomedical engineering department.
Admitting a patient
This section covers the following tasks:
Look for an empty patient window displaying an Admit button.
„
Enter the patient demographics.
af
„
„
Enter the bed number.
„
Enter the source of the ECG data.
„
Admit the patient.
Dr
NOTE
When the monitor moves from room to room and is not a transmitter, always
admit the patient at the monitor. See The monitor moves (roves) from room to
room on page 6-10.
Look for an empty patient window displaying an Admit
button
1.
2001989-301A- draft 1
From the multi-patient viewer, look for an empty patient window displaying an
Admit button.
ApexPro™
6-11
Managing patients
a.
When you see an empty patient window displaying an Admit button, go to
step 2.
b.
If you do not see an empty patient window displaying an Admit button, click
Auto Display in the menu bar. When the Auto Display button is enabled, the
multi-patient viewer rearranges itself and should add at least one empty
patient window with an Admit button:
NOTE
To enable or disable the Auto Display feature, from the multipatient viewer, click Setup CIC > CIC Defaults > Display
Configuration > Auto Display.
i.
When you see an empty patient window displaying an Admit button, go
to step 2.
„
See Removing viewed out-of-unit patient beds on page 7-6.
„
ii. If the message, Reconfiguration Failed appears, the multi-patient
viewer is full of admitted patient windows and no empty patient
windows are available. Use the following procedures (in the order
presented) to remove displayed patient beds from the multi-patient
viewer before you can admit a new patient:
af
See Viewing patient beds from another in-unit CIC Pro center on
page 7-5.
„
See Discharging an admitted patient on page 6-19.
When a Discharged message is displayed in an unlocked patient window,
you must clear the discharged bed from this unlocked window before you
can admit a patient to this window. To clear the discharged bed, complete the
following procedure:
Dr
c.
i.
Right click in the patient window you need to clear. The right click
menu displays.
ii. From the right click menu, click Select Care Unit then Bed Number >
None. The patient window should now be empty except for an Admit
button. Go to step 2.
2.
Click Admit to display the Admit window.
057A
To automatically enter the patient demographics
6-12
ApexPro™
2001989-301A- draft 1
Managing patients
To bypass the manual entry of the patient demographic information, you can search
for and retrieve the information from a networked database.
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING,
AND CALCULATIONS BASED ON PATIENT AGE—After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient's date of birth matches the patient's actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
NOTE
Retrieving patient demographic information from a networked database requires
a Hospital Information System (HIS). You may also know the HIS as an Aware
Gateway or as a Quantitative Sentinel (QS).
NOTE
af
NOTE
When using the patient’s last name or first name as your search criteria,
remember to delete the default patient identification number 999999999 from the
Patient ID data field.
Dr
When using a patient identification number as your search criteria, the CIC Pro
center cannot successfully search for and match patient identification numbers
containing lowercase letters. The CIC Pro center can successfully search for and
match patient identification numbers containing all numbers or a combination of
numbers and upper case letters.
Complete the following procedure to retrieve patient demographic information from a
networked database:
1.
2.
From the Admit window, type one of the following patient search criteria into the
appropriate data field:
„
Medical record number (patient identification number)
„
Last name
„
Room number
„
Bed number
Click Request Admit Info to display a list of possible patient matches and their
demographic information.
070A
2001989-301A- draft 1
ApexPro™
6-13
Managing patients
NOTE
If the message, Server off network is displayed, the Hospital Information
System (HIS) is either not available or not present.
3.
Review the displayed list of patients and demographic information to find the
demographic information that matches the patient you are admitting.
4.
When the demographic information from the list does not match your patient,
click Clear. You must now manually enter the patient demographic information.
See To manually enter the patient demographic information on page 6-14.
5.
When demographic information from the list matches your patient, complete the
following steps:
a.
Click on the patient to highlight it.
b.
Click Select to retrieve the demographic information.
af
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING,
AND CALCULATIONS BASED ON PATIENT AGE—After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient's date of birth matches the patient's actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
Verify you selected the correct information by reviewing the displayed
demographic information.
Dr
c.
i.
When this is the correct demographic information, go to Enter the bed
number on page 6-15.
ii. When this is not the correct demographic information, click Clear.
iii. Repeat step 2 to step 5 of this procedure.
To manually enter the patient demographic information
Complete the following procedure to manually enter patient demographic information
into data entry fields or select options from a list:
NOTE
Patient information entered here may be truncated on the CIC Pro center display
based on limitations of the associated monitoring device.
6-14
1.
Under Last Name, type the patient’s last name.
2.
Under First Name, type the patient’s first name.
3.
Under Patient ID, type the patient’s medical record number (patient
identification number).
4.
Under Age, click the down arrow to display the list of age ranges. Choose the
patient’s age range from the displayed list.
ApexPro™
2001989-301A- draft 1
Managing patients
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING,
AND CALCULATIONS BASED ON PATIENT AGE—After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient's date of birth matches the patient's actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
Enter the bed number
Complete the following procedure to enter the bed number:
NOTE
You must choose a bed number before you can admit a patient. Make sure the bed
you want to select is on the network.
Next to Bed, click the down arrow to display a list of available patient beds.
2.
Choose a bed number from the displayed list:
When the patient windows in the multi-patient viewer are assigned to
specific windows (locked), only the current bed number is displayed.
Complete the procedure, To automatically enter the patient demographics on
page 6-12 or To manually enter the patient demographic information on
page 6-14.
af
„
1.
When the bed is a telemetry bed, select the bed name displaying an asterisk
(e.g., ICU4*).
„
When the bed is a monitor, select the bed number identifying the monitor.
„
When the bed is a monitor or in Combo mode, select the bed number
identifying the monitor.
Dr
„
Enter the source of the ECG data
Complete the following procedure to enter the source of the ECG data:
NOTE
You must choose the source of the ECG data before you can admit a patient.
1.
Under ECG From, click the down arrow to display the list of ECG data sources.
2.
Choose the source of the ECG data:
„
When the source of the ECG data is a transmitter, choose the TTX ID
number matching the TTX ID number label located on the back of the
transmitter.
„
When the source of the ECG data is a monitor, choose Monitor.
Admit the patient
Complete the following procedure to admit the patient:
1.
2001989-301A- draft 1
Click Admit to admit the patient.
ApexPro™
6-15
Managing patients
If the message Would you like to start Full Disclosure? is displayed, the full
disclosure data collection method is set to Manual. To complete the admit
process, you must select Yes or No.
3.
If an Admit Information Mismatch window displays while you are trying to
establish the Combo monitoring mode, the CIC Pro center has detected a
mismatch of patient data between the hardwired bed and the telemetry bed. To
resolve this issue, complete the following steps:
Compare the patient data displayed in the Admit Information Mismatch
window.
af
a.
2.
To choose the correct patient information, click Select under the correct
patient information.
c.
To cancel admitting this patient, click Cancel to close this window and
return to the Admit window. Make any necessary corrections to the patient
information before trying to re-establish the Combo monitoring mode.
Dr
b.
4.
Verify the patient’s window (located in the multi-patient viewer) is displaying
parameter data and waveforms:
„
When the patient’s data appears in the patient window, the patient is being
monitored by the CIC Pro center.
„
When no patient information is displayed in the patient window, the patient
is not being monitored by the CIC Pro center. See Troubleshooting on page
D-1.
Changing patient demographic information
Once a patient is admitted, you may add or change patient demographic information:
6-16
1.
From the multi-patient viewer, click on the patient you want to change. The
single patient viewer displays.
2.
From the single patient viewer, click Admit to display the Admit window.
3.
Make changes to the patient demographic information.
ApexPro™
2001989-301A- draft 1
Managing patients
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING,
AND CALCULATIONS BASED ON PATIENT AGE—After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient's date of birth matches the patient's actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
4.
Click Save.
Moving a patient to a different bed
You can move a patient to another bed in the same care unit.
The following guidelines apply when moving an in-unit patient between locked and
unlocked beds:
You can move an unlocked bed to another available unlocked bed.
„
You can move a locked bed to another available locked bed.
„
You can move an unlocked bed to an available locked bed.
„
af
NOTE
You cannot move a patient to an unlocked bed if an empty patient window is not
available. When the message Patient not monitored displays, you will not be
allowed to move the patient.
Dr
Move a patient to a different bed
Complete the following procedure to move an in-unit patient to a different bed:
2001989-301A- draft 1
1.
From the multi-patient viewer, click on the patient you want to move. The single
patient viewer displays.
2.
From the single patient viewer, click Admit to display the Admit window.
3.
Click on the down arrow next to Bed to display a list of available beds. Choose
the bed you want to move the patient to:
„
Make sure the bed is on the network.
„
When the bed is a telemetry bed, select the bed name with an asterisk
appended to the name (e.g., ICU4*).
„
When the bed is a monitor, select the bed number identifying the monitor.
4.
Click Move to move the patient to the bed you selected. The message Are you
sure you want to move this patient? displays.
5.
Verify you are moving the correct patient:
„
When this is the patient you want to move, click Yes.
„
When this is not the patient you want to move, click No to cancel this action
and display the multi-patient viewer.
ApexPro™
6-17
Managing patients
Move a patient to telemetry monitoring
To discharge a patient from the bedside monitor, but remain on telemetry monitoring,
complete the following procedure:
1.
From the multi-patient viewer, click on the patient you want to move. The single
patient viewer displays.
2.
From the single patient viewer, click Admit to display the Admit window.
3.
Click on the down arrow next to Bed to display a list of available telemetry beds.
4.
Choose the bed you want to move the patient to. Be sure to choose a bed name
with an asterisk appended to the name (e.g., ICU4*).
5.
Click Move to move the patient to the bed you selected. The message Are you
sure you want to move this patient? displays.
6.
Verify you are moving the correct patient:
When this is the patient you want to move, click Yes. This will discharge the
patient from the monitor.
„
When this is not the patient you want to move, click No to cancel this action
and display the multi-patient viewer.
„
af
Move a telemetry patient to a different transmitter
At some time, you may need to replace an admitted patient’s transmitter with a
different transmitter.
Dr
Complete the following procedure to start telemetry monitoring using a replacement
transmitter:
1.
Exchange the transmitters.
2.
From the Admit window, under ECG From, click the down arrow to display a
list of ECG data sources.
3.
Choose the TTX ID number matching the TTX ID number label located on the
back of the transmitter.
4.
Click Save.
Switching transmitters
If you wish to switch an transmitter while a patient is admitted from a CD TelemetryLAN transmitter (Apex S, Apex 5, Apex 3 or CD transmitter) or vice versa, you must
follow this procedure:
„
Discharge the patient (losing stored data).
„
Switch transmitters.
„
Re-admit the patient.
Monitoring will stop if you switch transmitters while a patient is admitted.
Attempting to change the TTX ID number for an admitted telemetry patient at the
CIC Pro center with generate the message Invalid TTX.
6-18
ApexPro™
2001989-301A- draft 1
Managing patients
Discharging an admitted patient
Discharging a patient at the CIC Pro center completes the following tasks:
„
Discharges a telemetry patient from CIC Pro center.
„
Discharges a hard-wired patient from both the CIC Pro center and from the
monitor.
„
Deletes the discharged patient’s locally stored patient data from the CIC Pro
center.
Complete the following procedure to discharge an admitted patient from the CIC Pro
center:
Disconnect all patient cables.
2.
From the multi-patient viewer, click in the patient’s window you want to
discharge. The single patient viewer displays for this patient.
3.
From the single patient viewer, click Admit to display the Admit window.
4.
Click Discharge. A window displays the patient name, patient ID, and bed
number. The message Are you sure you want to discharge this patient? also
displays.
5.
Verify you are discharging the correct patient:
When this is the patient you want to discharge, click Yes. This will discharge
the patient.
af
„
1.
Dr
The CIC Pro center displays a message similar to the following in the patient
window, Discharging patient... and then displays the multi-patient viewer.
In the multi-patient viewer, the discharged patient window displays one of
the following types of information:
„
‹
When a telemetry patient is discharged from a locked patient window,
the message Discharged is displayed in the patient window.
‹
When a telemetry patient is discharged from an unlocked patient
window, an Admit button is displayed in the patient window.
‹
When a hard-wired patient is discharged, the message Discharged and
the bed name are displayed in the patient window.
When this is not the patient you want to discharge, click No to cancel this
action and display the multi-patient viewer.
Combo and Rover Combo monitoring
Guidelines
The following are guidelines to remember when monitoring in Combo or Rover
Combo monitoring modes.
„
When monitoring ECG from telemetry:
‹
2001989-301A- draft 1
ECG limits and Arrhythmia Alarm Levels are not your monitor defaults, but
are the telemetry defaults from the central station. You can adjust these
settings at the monitor.
ApexPro™
6-19
Managing patients
„
‹
The alarm pause feature (if available on your transmitter) is honored at the
monitor.
‹
You should not turn off the monitor until you have discharged the patient
from the monitor.
‹
Second V lead data is not sent to the monitor from the transmitter. If you
wish to see telemetry second V lead data, you must view the telemetry
patient.
When switching ECG monitoring from the monitor to telemetry:
‹
Arrhythmia alarm histories from the monitor are merged in the telemetry
system. CD Telemetry-LAN software version 5 or later is required.
‹
If you discharge the monitor, the telemetry Arrhythmia Alarm Levels will be
the same as the Arrhythmia Alarm Levels supported by the monitor.
Therefore, when the monitor uses the BASIC software package, only lethal
Arrhythmia Alarm Levels will be detected from telemetry. If the monitor
has the CARDIAC software package, full Arrhythmia Alarm Levels will be
detected from telemetry.
When switching ECG monitoring from telemetry to the monitor:
‹
Telemetry is automatically discharged and the most recent 36 alarm histories
are transferred to the monitor.
‹
The ECG limits, Arrhythmia Alarm Levels and display defaults are recalled
from the monitor defaults.
af
NOTE
„
It is not likely that the Combo or Rover Combo monitoring modes are used when
the patient-monitor type is OPERATING ROOM.
NOTE
Constraints
Dr
Users should be aware of a possible time discrepancy between the waveforms
from the telemetry device and the waveforms from the monitor. Users should not
consider these waveforms to be synchronous. If absolute synchronicity is desired,
Combo mode should be discontinued and the ECG waveforms should be
acquired via the hard-wired monitor.
For bedside monitors that allow the ECG parameter to be turned off, the following
constraints apply.
6-20
„
SpO2 becomes the primary parameter for patient monitoring.
„
The patient’s heart rate is determined from pulse oximetry.
„
The SpO2 and SpO2 Rate parameter alarm levels become Warning.
„
The SpO2 pulse search and probe off system status alarm levels become
Warning.
„
Connecting the ECG cable to the monitor will not automatically turn the ECG
parameter on.
„
When the monitor is connected to a Dash Responder defibrillator, the ECG
parameter will either automatically turn on or remain turned on.
ApexPro™
2001989-301A- draft 1
Managing patients
„
When the monitor alarms are paused and the ECG parameter is turned off, the
following network devices will not display an ALARM PAUSE text message for
that monitor.
‹
CIC Pro center using software version 3.0 or earlier.
‹
Centralscope central station using any version of software.
ECG setting source
Selecting ECG setting source
When the monitor is in Combo mode, you can select whether the monitor uses its own
ECG settings or the telemetry ECG settings.
„
TELE DEFINED — Use the telemetry ECG settings. This is the factory default.
„
USER DEFINED — Use the monitor’s ECG settings if telemetry is not
admitted. Use the telemetry ECG settings if telemetry IS admitted.
The following ECG settings are affected when you select an ECG setting source:
Arrhythmia Alarm Levels
„
HR, PVC and ST parameter alarm levels
„
ECG SIZE
„
DETECT PACE
„
ARRHYTHMIA
„
ST ANALYSIS
„
LEAD ANALYSIS
„
HR HIGH LIMIT and HR LOW LIMIT
„
PVC LIMIT and PVC state
Dr
af
„
„
Beat Pause interval
„
ST Limit
For more information, refer to the appropriate bedside monitor’s operator’s manual.
ECG setting source when entering Combo mode
WARNING
INCORRECT ALGORITHMS, ARRHYTHMIA PROCESSING
AND CALCULATIONS BASED ON PATIENT AGE — After
manually updating or automatically retrieving patient demographic
information from a network database, always confirm that the
entered patient’s date of birth matches the patient’s actual date of
birth. Otherwise the appropriate age-related algorithms, arrhythmia
detection, and calculations will not be applied.
NOTE
It is possible (but not a normal operation), to admit a patient to both a telemetry
bed and a hardwired bed before entering Combo mode. For example, bed101*
(telemetry) and bed101 (monitor) are two separate beds for the same patient.
When you enter Combo mode in this situation, the ECG setting source is always
telemetry.
2001989-301A- draft 1
ApexPro™
6-21
Managing patients
The following tables indicate the source (monitor or telemetry) of ECG settings when
entering Combo mode.
Tele Defined
Monitor
Telemetry
Entering Combo Mode
Not admitted
Not admitted
Admitted
Not admitted
Not admitted
Admitted
ECG Setting Source
Telemetry
User Defined
Monitor
Telemetry
Entering Combo Mode
Not admitted
Not admitted
Admitted
Not admitted
Not admitted
Admitted
ECG Setting Source
Monitor
Telemetry
af
Notice that selecting Tele Defined means the ECG setting source is always telemetry
when entering Combo mode, while the ECG setting source for User Defined depends
on whether the patient is admitted to the monitor or telemetry when entering Combo
mode.
ECG setting source when exiting combo mode
Dr
When discharging from telemetry, but remaining admitted to the monitor (exiting
Combo mode), the ECG setting source (monitor or telemetry) depends on the
COMBO DEFAULT SOURCE selection.
„
TELE DEFINED — When exiting Combo mode, the ECG settings return to the
monitor’s ECG custom defaults.
„
USER DEFINED — When exiting Combo mode, the ECG settings for the
current patient persist until the patient is discharged from the monitor.
For both the TELE DEFINED and USER DEFINED options, when discharging
from the monitor (exiting Combo mode), but remaining admitted to telemetry, the
ECG settings for the current patient persist until the patient is discharged from
telemetry.
6-22
ApexPro™
2001989-301A- draft 1
Viewing real-time
patient data
Dr
af
2001989-301A- draft 1
ApexPro™
7-1

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