Philips Medical Systems North America SRRBV1 Dual SRR Module User Manual ait fm manual en 2011 03 24

Philips Medical Systems North America Co. Dual SRR Module ait fm manual en 2011 03 24

User Manual

Instructions for Use
IntelliVue Patient Monitor
MX600/MX700/MX800
Release H.0 with Software Revision H.1x.xx
Patient Monitoring
Part Number 453564260091
Printed in Germany 05/11
*453564260091*
3
1Table of Contents
1Introduction 13
Introducing the Monitor 13
Devices for Acquiring Measurements 15
Operating and Navigating 24
Operating Modes 31
Understanding Screens 32
Connecting Additional Displays to the Monitor 33
Using the XDS Remote Display 34
Using the Visitor Screen 34
Understanding Profiles 34
Understanding Settings 36
Changing Wave Speeds 37
Freezing Waves 38
Using Labels 39
Entering Measurements Manually 42
Changing Monitor Settings 42
Checking Your Monitor Revision 43
Getting Started 43
Disconnecting from Power 45
Networked Monitoring 45
Using the Integrated PC 46
Using the X2 or MP5 with a Host Monitor 47
2Alarms 49
Visual Alarm Indicators 50
Audible Alarm Indicators 51
Acknowledging Alarms 53
Pausing or Switching Off Alarms 54
Alarm Limits 56
Reviewing Alarms 60
Latching Alarms 61
Testing Alarms 62
Alarm Behavior at Power On 62
Alarm Recordings 63
3Patient Alarms and INOPs 65
Patient Alarm Messages 65
Technical Alarm Messages (INOPs) 70
4
4Managing Patients 95
Admitting a Patient 95
Quick Admitting a Patient 96
Editing Patient Information 97
Discharging a Patient 97
Transferring Patients 98
Data Upload from an MMS 102
Care Groups 105
5ECG, Arrhythmia, ST and QT Monitoring 111
Skin Preparation for Electrode Placement 111
Connecting ECG Cables 111
Selecting the Primary and Secondary ECG Leads 112
Checking Paced Status 112
Understanding the ECG Display 112
Monitoring Paced Patients 113
Changing the Size of the ECG Wave 114
Changing the Volume of the QRS Tone 115
Changing the ECG Filter Settings 115
Selecting Positions of Va and Vb Chest Leads (for 6-lead placement) 116
Choosing EASI or Standard Lead Placement 116
About ECG Leads 116
ECG Lead Fallback 117
ECG Lead Placements 117
Capture 12-Lead 123
EASI ECG Lead Placement 125
ECG and Arrhythmia Alarm Overview 126
Using ECG Alarms 127
ECG Safety Information 128
About Arrhythmia Monitoring 129
Switching Arrhythmia Analysis On and Off 130
Choosing an ECG Lead for Arrhythmia Monitoring 130
Understanding the Arrhythmia Display 132
Arrhythmia Relearning 134
Arrhythmia Alarms 135
About ST Monitoring 139
Switching ST On and Off 140
Understanding the ST Display 141
Updating ST Baseline Snippets 142
Recording ST Segments 142
About the ST Measurement Points 143
ST Alarms 145
Viewing ST Maps 146
About QT/QTc Interval Monitoring 149
QT Alarms 152
Switching QT Monitoring On and Off 153
5
6Monitoring Pulse Rate 155
Entering the Setup Pulse Menu 155
System Pulse Source 155
Switching Pulse On and Off 156
Using Pulse Alarms 156
7Monitoring Respiration Rate (Resp) 159
Lead Placement for Monitoring Resp 159
Understanding the Resp Display 160
Changing Resp Detection Modes 160
Changing the Size of the Respiration Wave 161
Changing the Speed of the Respiration Wave 162
Using Resp Alarms 162
Changing the Apnea Alarm Delay 162
Resp Safety Information 162
8Monitoring SpO2 165
SpO2 Sensors 165
Applying the Sensor 165
Connecting SpO2 Cables 166
Measuring SpO2 166
SpO2 Signal Quality Indicator (Fast SpO2 only) 167
Assessing a Suspicious SpO2 Reading 168
Changing the Averaging Time 168
Understanding SpO2 Alarms 168
Pleth Wave 171
Perfusion Numeric 171
Perfusion Change Indicator 171
Setting SpO2/Pleth as Pulse Source 172
Setting Up Tone Modulation 172
Setting the QRS Volume 172
Calculating SpO2 Difference 172
9Monitoring NBP 173
Introducing the Oscillometric NBP Measurement 173
Preparing to Measure NBP 175
Starting and Stopping Measurements 176
Enabling Automatic Mode and Setting Repetition Time 178
Enabling Sequence Mode and Setting Up The Sequence 178
Choosing the NBP Alarm Source 178
Switching Pulse from NBP On/Off 179
Assisting Venous Puncture 179
Calibrating NBP 179
10 Monitoring Temperature 181
Making a Temp Measurement 181
6
Calculating Temp Difference 182
11 Monitoring Invasive Pressure 183
Setting up the Pressure Measurement 183
Zeroing the Pressure Transducer 184
Adjusting the Calibration Factor 186
Displaying a Mean Pressure Value Only 187
Changing the Pressure Wave Scale 187
Optimizing the Waveform 187
Using the Wave Cursor 187
Non-Physiological Artifact Suppression 188
Choosing the Pressure Alarm Source 188
Calibrating Reusable Transducer CPJ840J6 189
Calculating Cerebral Perfusion Pressure 191
Calculating Pulse Pressure Variation 191
Measuring Pulmonary Artery Wedge Pressure 192
Editing the Wedge 193
Identifying the Pressure Analog Output Connector 193
12 Monitoring Cardiac Output 195
Hemodynamic Parameters 195
Using the C.O. Procedure Window 196
Accessing the Setup C.O. and Setup CCO Menus 197
Entering the HemoCalc Window 198
Measuring C. O. Using the PiCCO Method 198
Measuring C.O. Using the Right Heart Thermodilution Method 203
Documenting C.O. Measurements 206
C.O. Injectate Guidelines 206
C.O./CCO Curve Alert Messages 207
C.O./CCO Prompt Messages 209
C.O./CCO Warning Messages 209
C.O./CCO Safety Information 210
13 Monitoring Carbon Dioxide 213
Measurement Principles 214
Measuring CO2 using M3014A or X2 214
Measuring Mainstream CO2 using M3016A 218
Measuring Microstream CO2 using M3015A/B 220
Setting up all CO2 Measurements 222
14 Monitoring Airway Flow, Volume and Pressure 225
Attaching the Flow Sensor 226
Zero Calibration 228
Automatic Purging 228
Manual Purging 229
Gas Compensation 229
7
Setting up Spirometry 230
15 Monitoring tcGas 233
Identifying tcGas Module Components 233
Setting the tcGas Sensor Temperature 233
Using the tcGas Site Timer 234
Setting the tcGas Barometric Pressure 235
Remembraning the tcGas Transducer 235
Calibrating the tcGas Transducer 235
Applying the tcGas Transducer 237
Finishing tcGas Monitoring 238
TcGas Corrections 238
16 Monitoring Intravascular Oxygen Saturation 241
Selecting a Measurement Label 242
Preparing to Monitor with the M1021A Wide Module 242
Preparing to Monitor with the M1011A Narrow Module 246
Further Information for Both Modules 247
17 Monitoring EEG 249
EEG Monitoring Setup 249
Using the EEG Impedance/Montage Window 250
About Compressed Spectral Arrays (CSA) 252
Changing EEG Settings 253
EEG Reports 254
EEG Safety Information 254
EEG and Electrical Interference 255
18 Monitoring BIS 257
BIS Monitoring Setup 257
BIS Continuous Impedance Check 259
BIS Cyclic Impedance Check 260
BIS Window 260
Changing the BIS Smoothing Rate 261
Switching BIS and Individual Numerics On and Off 262
Changing the Scale of the EEG Wave 262
Switching BIS Filters On or Off 262
BIS Safety Information 262
19 Assigning a Telemetry Device and a Monitor to One Patient 265
How Can You Combine Devices? 265
Functions Available When the Telemetry Data Window is Displayed 267
General Telemetry-related Functions 268
Use Models With Telemetry 269
8
20 Trends 271
Viewing Trends 271
Setting Up Trends 274
Documenting Trends 278
Trends Databases 278
Screen Trends 279
21 Calculations 283
Viewing Calculations 284
Reviewing Calculations 285
Performing Calculations 285
Entering Values for Calculations 286
Documenting Calculations 287
22 High Resolution Trend Waves 289
Changing the Hi-Res Trend Waves Displayed 289
Hi-Res Trend Wave Scales 289
Hi-Res Trend Waves and OxyCRG 289
Printing Hi-Res Trend Wave Reports 290
Hi-Res Trend Wave Recordings 290
23 Event Surveillance 291
Levels of Event Surveillance 291
Event Groups 292
Event Episodes 292
Events Pop-Up Keys 293
Event Triggers 294
The Events Database 298
Viewing Events 298
Annotating Events 301
Documenting Events 301
24 ProtocolWatch 309
SSC Sepsis Protocol 309
25 Recording 317
Central Recording 317
Starting and Stopping Recordings 317
Overview of Recording Types 319
All ECG Waves Recordings 319
Creating and Changing Recordings Templates 320
Changing ECG Wave Gain 321
Recording Priorities 321
Recording Strip 321
Reloading Paper 323
Recorder Status Messages 323
9
26 Printing Patient Reports 325
Starting Report Printouts 325
Stopping Reports Printouts 326
Setting Up Reports 327
Setting Up Individual Print Jobs 328
Checking Printer Settings 329
Printing a Test Report 329
Switching Printers On Or Off for Reports 329
Dashed Lines on Reports 329
Unavailable Printer: Re-routing Reports 330
Checking Report Status and Printing Manually 330
Printer Status Messages 331
Sample Report Printouts 332
27 Using the Drug Calculator 337
Accessing the Drug Calculator 338
Performing Drug Calculations 338
Charting Infusion Progress 340
Using the Titration Table 341
Documenting Drug Calculations 341
28 IntelliBridge EC10 Module 343
Connecting an External Device 343
Changing Waves and Numerics Displayed 344
Viewing the IntelliBridge Device Data Window 344
Using Screens with External Device Data 344
Alarms/INOPs from External Devices 345
Language Conflict with External Device Drivers 345
29 VueLink Modules 347
Connecting an External Device 348
Changing VueLink Waves and Numerics Displayed 348
Viewing the VueLink Device Data Window 349
Using VueLink Screens 349
Switching VueLink On and Off 349
Alarms/INOPs From External Devices 350
Language Conflict with External Device Drivers 350
30 Using Timers 351
Viewing Timers 351
Timer Setup Pop-up Keys 352
Setting Up Timers 352
Displaying a Timer On The Main Screen 353
Displaying A Clock On The Main Screen 354
10
31 Respiratory Loops 355
Viewing Loops 355
Capturing and Deleting Loops 356
Showing/Hiding Loops 356
Changing Loops Display Size 356
Using the Loops Cursor 356
Changing Loops Type 357
Setting Up Source Device 357
Documenting Loops 357
32 Laboratory Data 359
Viewing Received Data 359
33 Care and Cleaning 361
General Points 361
Cleaning the Monitor 362
Disinfecting the Monitor 362
Sterilizing the Monitor 363
Cleaning, Sterilizing and Disinfecting Monitoring Accessories 363
Cleaning the SO2 Optical Module 363
Cleaning the Recorder Printhead (M1116B only) 363
34 Maintenance and Troubleshooting 365
Inspecting the Equipment and Accessories 365
Inspecting the Cables and Cords 366
Maintenance Task and Test Schedule 366
Troubleshooting 367
Disposing of the Monitor 367
Disposing of Empty Calibration Gas Cylinders 367
35 Accessories 369
ECG/Resp Accessories 369
NBP Accessories 372
Invasive Pressure Accessories 375
SpO2 Accessories 376
Temperature Accessories 380
Cardiac Output (C.O.) Accessories 381
Mainstream CO2 Accessories 382
Sidestream CO2 Accessories 382
Mainstream CO2 Accessories (for M3016A) 383
Microstream CO2 Accessories 383
Spirometry Accessories 384
tcGas Accessories 385
EEG Accessories 385
BIS Accessories 385
SO2 Accessories for M1021A 386
11
SO2 Accessories for M1011A 386
Recorder Accessories 386
Battery Accessories 386
36 Specifications 387
Intended Use 387
Manufacturer's Information 387
Symbols 389
Installation Safety Information 390
Monitor Mounting Precautions 393
Altitude Setting 393
Monitor Safety Specifications 393
EMC And Radio Regulatory Compliance 393
Physical Specifications 395
Environmental Specifications 397
Performance Specifications 399
Interface Specifications 401
Measurement Specifications 405
Safety and Performance Tests 424
37 Default Settings Appendix 429
Country-Specific Default Settings 429
Alarm and Measurement Default Settings 436
Alarm Default Settings 436
ECG, Arrhythmia, ST and QT Default Settings 437
Pulse Default Settings 438
Respiration Default Settings 439
SpO2 Default Settings 439
NBP Default Settings 440
Temperature Default Settings 440
Invasive Pressure Default Settings 441
Cardiac Output Default Settings 443
CO2 Default Settings 444
Spirometry Default Settings 444
tcGas Default Settings 445
Intravascular Oxygen Saturation 445
SvO2 Default Settings 446
ScvO2 Default Settings 446
EEG Default Settings 446
BIS Default Settings 447
VueLink Default Settings 447
Index 449
12
1
13
1Introduction
These Instructions for Use are for clinical professionals using the IntelliVue MX600/MX700/MX800
patient monitor.
This basic operation section gives you an overview of the monitor and its functions. It tells you how to
perform tasks that are common to all measurements (such as entering data, switching a measurement
on and off, setting up and adjusting wave speeds, working with profiles). The alarms section gives an
overview of alarms. The remaining sections tell you how to perform individual measurements, and
how to care for and maintain the equipment.
Familiarize yourself with all instructions including warnings and cautions before starting to monitor
patients. Read and keep the Instructions for Use that come with any accessories, as these contain
important information about care and cleaning that is not repeated here.
This guide describes all features and options. Your monitor may not have all of them; they are not all
available in all geographies. Your monitor is highly configurable. What you see on the screen, how the
menus appear and so forth, depends on the way it has been tailored for your hospital and may not be
exactly as shown here.
In this guide:
•A warning alerts you to a potential serious outcome, adverse event or safety hazard. Failure to
observe a warning may result in death or serious injury to the user or patient.
•A caution alerts you to where special care is necessary for the safe and effective use of the
product. Failure to observe a caution may result in minor or moderate personal injury or damage
to the product or other property, and possibly in a remote risk of more serious injury.
Introducing the Monitor
The IntelliVue MX600/MX700/MX800 patient monitor offers a monitoring solution optimized for
the high-end surgical, cardiac, medical and neonatal care environments. Combining patient surveillance
and data management, it allows multi-measurement monitoring by linking separate modules. The
MX600 uses the navigation knob as primary input device and the MX700/MX800 use the touch
screen as primary input device. All monitors have a remote control for convenient access to the five
main keys and numeric data input.
1Introduction
14
The monitor stores data in trend, event, and calculation databases. You can see tabular trends (vital
signs) and document them on a printer. You can view measurement trend graphs, with up to three
measurements combined in each graph, to help you identify changes in the patient's physiological
condition. You can view fast-changing measurement trends with beat to beat resolution and see up to
four high resolution trend segments. Event surveillance enhances documentation and review of
physiologically significant events by automatically detecting and storing up to 50 user-defined clinical
events over a 24 hour period.
With the optional Integrated PC, you have computer functionality directly in the monitor. You can use
standard applications (e.g. Web browsers), connect to the hospital network or intranet, and run a
second independent display with content from the patient monitor.
An IntelliVue X2 or MP5 can be connected to your monitor, where it acts as a multi-measurement
module, acquiring measurements for the host monitor. When the X2 or MP5 is disconnected from the
the original host monitor, it continues to monitor the patient as a fully independent, battery powered
patient monitor, eliminating the need for a separate transport monitor. On connection to a new host
monitor, the X2 or MP5 resumes its role as multi-measurement module, ensuring fully continuous
monitoring.
Major Parts and Keys
MX600/700:
1Color coded alarm lamps
2Alarms Off lamp
3Power on/Standby switch with
integrated LED: Green - On/
Standby, Red - Error
4AC power LED
5Mounting quick-release lever
(when this is pressed the
monitor is not fixed on the
mounting)
6Part number and serial number
7Hardkeys (Silence, Alarms Off,
Main Screen)
8Navigation knob
1 Introduction
15
MX800:
Devices for Acquiring Measurements
The patient monitor acquires patient measurements using the devices described in this section. You
can also extend the measurement capabilities of your monitor with such devices. Of these
measurement devices, only the X2 has its own power on/standby switch, and can be powered from an
external power supply or a rechargeable battery when not directly connected to the monitor (refer to
the IntelliVue X2 Instructions for Use for details). All the rest take their power exclusively from the
monitor, and switch on automatically when you turn on the monitor. A green power-on LED indicates
when they are drawing power from the monitor. A permanently illuminated, or flashing, red LED
indicates a problem with the unit that requires the attention of qualified service personnel.
All symbols used on the front panels are explained in “Symbols” on page 389.
WARNING
When connecting devices for acquiring measurements, always position cables and tubing carefully to
avoid entanglement or potential strangulation.
Flexible Module Rack (M8048A)
The 8-slot flexible module rack (FMS-8) lets you use up to eight plug-in physiological measurement
modules. For the MX800, you can connect two FMSs to use up to 10 measurement modules.
The maximum number of specific module types that can be used simultaneously in an FMS-8 is: five
pressure modules, four temperature modules, four VueLink or IntelliBridge modules (any
combination).
1Color coded alarm lamps
2Alarms Off lamp
3Power on/Standby switch with
integrated LED: Green - On/
Standby, Red - Error
4AC power LED
5Mounting quick-release lever
(when this is pressed the
monitor is not fixed on the
mounting)
6Part number and serial number
1Introduction
16
Connect the FMS to the monitor via the measurement link cable (MSL). Use the MSL connector on
the left-hand side to connect an additional MMS. Use the connector on the right to connect to the
monitor.
4-Slot Flexible Module Rack (FMS-4)
The 4-Slot flexible module rack (FMS-4) lets you use up to four plug-in physiological measurement
modules.
The maximum number of specific module types that can be used simultaneously in an FMS-4 is: four
pressure modules, four temperature modules, four VueLink or IntelliBridge modules (any
combination).
Connect the FMS to the monitor via the measurement link cable (MSL). Use the MSL connector on
the left-hand side (if you have the appropriate option) to connect an additional MMS. Use the
connector on the back to connect to the monitor.
Measurement Modules
You can use up to eight measurement modules with the Flexible Module Rack (M8048A). Available
modules are:
Invasive blood pressure (M1006B)
Temperature (M1029A)
Oxygen saturation of arterial blood (SpO2) (M1020B)
Cardiac output (M1012A), and Continuous cardiac output with M1012A Option #C10
Transcutaneous gas (M1018A)
Mixed venous oxygen saturation - SvO2 (M1021A)
Intravascular Oxygen Saturation - ScvO2 or SvO2 (M1011A)
1X1 Multi-Measurement Module
2Multi-Measurement Module
mount
3Flexible Module Rack FMS-8
4Power on LED
5Interruption indicator
1 Introduction
17
Recorder (M1116B)
VueLink device interface (M1032A)
IntelliBridge EC10
EEG (M1027A)
Bispectral Index - BIS (M1034A)
Spirometry (M1014A)
You can plug in and unplug modules during monitoring. Insert the module until the lever on the
module clicks into place. Remove a module by pressing the lever upwards and pulling the module out.
A measurement automatically switches on when you plug the module in, and switches off when you
unplug it. Reconnecting a module to the same monitor restores its label and measurement settings,
such as alarms limits. If you connect it to a different monitor, the module remembers only its label.
The connector socket on the front of each module is the same color as the corresponding connector
plug on the transducer or patient cable.
Press the Setup key on the module's front to display the measurement's setup menu on the monitor
screen. When the setup menu is open, a light appears above the key. Some modules have a second key.
On the pressure module, for example, it initiates a zeroing procedure.
Example Module (SpO2)
X1 Multi-Measurement Module (M3001A)
The X1 Multi-Measurement Module (MMS) can simultaneously monitor 3-, 5-, 6- or 10-lead ECG
(including arrhythmia and ST monitoring), respiration, SpO2, NBP and either invasive pressure or
temperature.
You can connect it to the monitor via a cable or mount it on the left side of the FMS.
1Module name
2Setup key LED
3Setup key to enter setup menu of measurement modules or
external device data window. Some modules have a second
module-specific key next to this one, for example Zero.
4Connector socket for patient cable/transducer
1Introduction
18
X1 Connectors and Symbols
X2 Multi-Measurement Module (M3002A)
The X2 Multi-Measurement Module (MMS) can simultaneously monitor 3-, 5-, 6- or 10-lead ECG
(including arrhythmia and ST monitoring), respiration, SpO2, NBP and either invasive pressure and
temperature, or CO2. It has a color touchscreen display.
1White ECG/Resp connector
2Blue SpO2 connector
3Red NBP connector
4Combined pressure (red) and temperature
(brown) connector - connect either invasive
pressure transducer or temperature probe.
You might have a version of the MMS that
does not have this connector.
5NBP STAT key - starts NBP STAT series
of measurements
OR
Zero key - initiates a zero procedure for the
connected pressure transducer when
pressed and held for a second
6NBP Start/Stop key - starts or stops NBP
measurements
7Silence: acknowledges all active alarms by
switching off audible alarm indicators and
lamps
1 Introduction
19
The X2 has the added capability to operate as a stand-alone monitor, and can be powered by a
rechargeable battery. This makes it particularly suited to transport situations. When the X2 is
disconnected from the original host monitor, it continues to monitor the patient as a stand-alone
monitor running on battery power, eliminating the need for a separate transport monitor. When the
X2 is connected to a new host monitor, it resumes its role as MMS, ensuring fully continuous
monitoring. For details of using the X2 as a stand-alone monitor, refer to the IntelliVue X2 Instructions
for Use.
When connected to a host monitor (Companion Mode is indicated), the X2 takes power from the
host, including that required for battery charging. The X2 can also be powered by AC mains when not
connected to a host monitor using the optionally available external power supply (M8023A). See the
IntelliVue X2 Instructions for Use for details.
X2 Overview
1On/Standby switch
2Power and battery indicators (see “X2
Controls and Indicators” on page 20)
33.5-inch TFT LCD touchscreen QVGA
display
4Alarm lamps (see “X2 Controls and
Indicators” on page 20)
5Battery eject button
6Hard keys (see “X2 Controls and
Indicators” on page 20)
7Measurement connectors (see “X2 Patient
Connectors, Right Side” on page 21)
8Battery compartment
1Introduction
20
X2 Controls and Indicators
1External power LED. Green when monitor is powered from an external power source.
2Battery status LED. Yellow when charging. Flashing red when battery is empty.
3On/Standby LED. Green when monitor is on. Red indicates an error.
4On/Standby switch. Disabled when X2 is connected to a host monitor
5Main Screen key: closes all open menus/windows and returns to the main screen.
6SmartKeys key: brings up SmartKeys on the screen.
7Alarms key: turns alarms On/Off, or pauses them.
8Silence key
9Active alarm lamp. Red or yellow, depending on alarm level. Blinks until active alarm is
acknowledged.
10 Active INOP alarm lamp in light blue. Blinks until active INOP is acknowledged.
11 Alarms off indicator. When alarms are suspended, the lamp is red, and the alarms off symbol is
shown.
1 Introduction
21
X2 Patient Connectors, Right Side
Showing symbols version (international) - English version has text labels
X2 Left Side
MMS Extensions
The MMS extensions connect to the X1 and X2 MMS and use the MMS settings and power. Trend
data and measurement settings from the measurements in the extensions are stored in the MMS.
WARNING
The MMS extensions can only function when they are connected to an MMS. If the MMS is
removed during monitoring, the measurements from both the MMS and the extension are lost.
Measurements from an MMS extension connected to an X2 are not available when the X2 is
running on its own battery power. They are only available when the X2 is powered from AC mains,
when connected to a host monitor or the external power supply (M8023A), or from the Battery
Extension.
To separate an extension from the MMS, press the release lever down, and push the MMS forward.
1Pressure (option)
2Temperature (option)
3Noninvasive blood pressure
4SpO2
5ECG sync pulse output
6ECG/Respiration
7CO2 (option in place of Pressure and Temperature)
1Loudspeaker
2MSL Connector. Connects to the external power
supply or a host monitor via the MSL cable for AC
mains operation, battery charging, and
communication with a network.
1Introduction
22
M3014A, M3015A, M3015B and M3016A Capnography MMS Extensions
The optional M3014A Capnography extension adds mainstream capnography or sidestream
capnography, and optionally one pressure plus either a pressure or a temperature, Cardiac Output and
Continuous Cardiac Output to the MMS.
M3014A
1Pressure connectors (red)
2Temperature connector (brown)
3Mainstream/sidestream connector CO2
4Cardiac Output connector
1 Introduction
23
The optional M3015A Microstream CO2 extension adds microstream capnography and optionally
either pressure or temperature to the MMS. The optional M3015B Microstream CO2 extension adds
microstream capnography, two pressures and a temperature to the MMS.
The optional M3016A Mainstream CO2 extension adds mainstream capnography and optionally either
pressure or temperature to the MMS.
When a capnography extension is connected to an X2 MMS with CO2, the CO2 from the extension
will be automatically deactivated in favor of the one in the X2. If you prefer to use the CO2
measurement on the extension, you can activate it via the measurement selection key (see “Resolving
Label Conflicts” on page 40).
M3015A M3015B
1Pressure connectors (red) - M3015A optional
2Temperature connector (brown) - M3015A optional
3Inlet
4Microstream connector CO2
5Gas sample outlet
M3016A
1Pressure connectors (red)
2Temperature connector (brown)
3Mainstream/sidestream connector CO2
(optional)
1Introduction
24
The cardiac output measurement in the M3014A is deactivated when the extension is used with an X2
MMS, even if the X2 is connected to an external power supply. The cardiac output measurement is
only available when the X2 is connected to a host monitor.
M3012A Hemodynamic MMS Extension
The M3012A Hemodynamic extension can be connected to the M3001A Multi-Measurement Module
to provide the following additional measurements: Temperature, Pressure, an additional Pressure or
Temperature, and C.O. and CCO measurements.
The cardiac output measurement is deactivated when the extension is used with an X2 MMS unless the
X2 is connected to a host monitor.
Operating and Navigating
Everything you need to operate the monitor is contained on its screen. Almost every element on the
screen is interactive. Screen elements include measurement numerics, waveforms, screen keys,
information fields, alarms fields and menus.
The configurability of the monitor means that often you can access the same element in different ways.
For example, you might be able to access an item through its on-screen setup menu, via a hard key, or
via a SmartKey.
1Cardiac Output (orange; optional)
2Connection to MMS
3Pressure connectors (red)
4Temperature connectors (brown)
1 Introduction
25
Selecting Screen Elements
Select a screen element to tell the monitor to carry out the actions linked to the element. For example,
select the Patient Identification element to call up the Patient Demographics window, or select the
HR numeric to call up the Setup ECG menu. Select the ECG wave segment to call up the ECG Lead
menu.
Note that the space between each line of a menu may be configured to wide or narrow to facilitate
your most common method of operation, either touch, remote control or a pointing device such as a
mouse.
Monitor information line Other screen elements
1network connection indicator
(documented in Information
Center Instructions for Use)
10 alarm status area - shows active alarm messages
2bed label 11 status line - shows information messages and prompting you for action
3patient identification 12 close all open menus and windows and return to main screen
4patient category 13 enter Main Setup menu
5paced status 14 scroll right to display more SmartKeys
6date and time 15 SmartKeys - these change according to your monitor's configuration
7access the Profiles menu 16 scroll left to display more SmartKeys
8current screen name/enter
Change Screen menu 17 Pause Alarms - pauses alarm indicators. Pause duration depends on monitor
configuration. If pause duration is infinite, this key is labeled Alarms Off. Select again
to immediately re-enable alarm indicators.
9adjust alarm volume/level
indicator 18 Silence - acknowledges all active alarms by switching off audible alarm indicators and
lamps permanently or temporarily, if alarm reminder (ReAlarm) is configured on.
1Introduction
26
Using the Touchscreen
Select screen elements by pressing them directly on the monitor's screen.
Disabling Touchscreen Operation
To temporarily disable touchscreen operation of the monitor, press and hold the Main Screen
permanent key. A padlock will appear on the Main Screen permanent key.
Press and hold the Main Screen permanent key again to re-enable the touchscreen operation.
Using a Mouse or Trackball
If you are using a mouse or trackball, select screen elements by clicking on them (press and release the
left mouse button). While you are moving the mouse, a cursor appears and a highlight shows your
current position.
Moving Windows
You can move windows and menus using the Touchscreen or a mouse. To move a window,
1Select the title of the window and keep your finger on the title, or the mouse button pressed.
2Move your finger on the Touchscreen, or move the mouse, to move the window.
3Take your finger off the screen, or release the mouse button, to place the window in the final
position.
The new position is only active until the window or menu is closed. Not all locations on the screen can
be a target position, a window cannot overlap the monitor info line, the alarms and INOPs or the
status line.
Using Keys
The monitor has four different types of keys:
Permanent Keys
A permanent key is a graphical key that remains on the screen all the time to give you fast access to
functions.
Pause Alarms - pauses alarm indicators. Pause duration depends on monitor
configuration. If pause duration is infinite, this key is labeled Alarms Off.
Select again to immediately re-enable alarm indicators.
Silence - acknowledges all active alarms by switching off audible alarm indicators and
lamps.
Main Screen - close all open menus and windows and return to the main screen.
Main Setup - enter main setup menu.
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SmartKeys
A SmartKey is a configurable graphical key, located at the bottom of the main screen. It gives you fast
access to functions. The selection of SmartKeys available on your monitor depends on your monitor
configuration and on the options purchased. If you have an integrated PC (iPC) you may also see
Smartkeys generated by applications on the iPC.
enter profile menu, or revert to
default profile
change Screen, or revert to default
screen
show BIS Sensor previous Screen
freeze waves quick admit a patient
set alarm limits enter patient identification menu to
admit/discharge/transfer
change alarm volume end case to discharge a patient
change QRS volume view information for patients in
other beds
enter standby mode - suspends
patient monitoring. All waves and
numerics disappear from the display.
All settings and patient data
information are retained.
change screen brightness (not for
independent displays)
review beat labels (annotate
arrhythmia wave)
re-learn arrhythmia
change amplitude (size) of ECG
wave
enter cardiac output procedure
- start/stop manual NBP
measurement
- start auto series
- stop current automatic
measurement within series
start NBP STAT measurement
stop automatic or STAT NBP
measurement and measurement
series
start NBP measurement and
measurement series
stop current NBP measurement
start veni puncture (inflate cuff to
subdiastolic pressure)
set the NBP repeat time
access patient reports zero invasive pressure transducer
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start a delayed recording access pop-up recording keys
access Vital Signs recording function access Select Waves recording
function
set wide automatic alarm limits set narrow automatic alarm limits
access wedge procedure window access the Loops window
review vital signs trend review graph trend
access event surveillance access calculations
access the calculator access the Drug Calculator
gas analyzer - exit standby mode suppress zero for all gas
measurements
unpair equipment and continue
central monitoring with the monitor
unpair equipment and continue
central monitoring with the telemetry
device
access the spirometry data window access ST Map application
start 12-Lead Capture (only available
if Information Center is connected)
access remote applications (if
Application Server is connected)
access EEG CSA access the EEG montage
display external device information access timers
access ProtocolWatch set standard or EASI lead placement
switch CO2 pump off new lead setup
enter data manually start/stop car seat assessment record
open the Histogram window open Unit Conversion window
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Hardkeys
A hardkey is a physical key on a monitoring device, such as the zero pressure key on the MMS or a
setup key on a module.
Pop-Up Keys
Pop-up keys are task-related graphical keys that appear automatically on the monitor screen when
required. For example, the Confirm pop-up key appears only when you need to confirm a change.
Using the Remote Control
The remote control provides you with direct access to five hard keys, a navigation knob and a numeric
keypad:
Hardkeys
1Silence - acknowledges all active alarms by switching off audible alarm indicators and lamps.
Behavior follows the Silence permanent key configuration.
2Alarms Off/Pause Alarms - pauses alarm indicators. Behavior follows the Pause Alarms
permanent key configuration.
3Main Screen - close all open menus and windows and return to the main screen.
4SmartKeys - display a block of SmartKeys specially configured for remote tasks (see below)
5Back - go back one step to the previous menu.
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The remote control can be used with a USB cable connection to the monitor or without a cable using
short range radio. When used without a cable, the remote control must be assigned to the monitor.
The assignment is made in Configuration or Service mode.
CAUTION
When using a remote control without a cable, it is important that the user knows which remote control
is assigned to which monitor. Use the tethering cable delivered with the remote control to attach it to a
bed rail or IV pole, or label the remote control with the bed or monitor ID.
Using the SmartKeys Key
The SmartKeys hard key on the remote control displays a block of SmartKeys on the monitor screen.
Nine SmartKeys appear in a 3 by 3 matrix which corresponds to the layout of the numeric pad on the
remote control.
Pressing the 1 key on the remote control selects the top left SmartKey, pressing the 8 key selects the
bottom center SmartKey. The .and the key can be used to select the arrow keys to page up and
down in the available SmartKeys.
The SmartKeys which appear can be configured so that you have the functions available which you
most often need when using the remote control. If no list of SmartKeys has been configured, the
standard SmartKeys will be displayed and you can page through to the key you want.
Using the On-Screen Keyboard
Use this as you would a conventional keyboard. Enter the information by selecting one character after
another. Use the Shift and capital Lock keys to access uppercase letters. Use the Back key to delete
single characters, or use the Clr key to delete entire entries. Select Enter to confirm what you have
entered and close the on-screen keyboard.
If a conventional keyboard is connected to the monitor, you can use this instead of or in combination
with the on-screen keyboard.
Keypad
6 Type numeric data on the keypad and press the Enter key to enter the data on the monitor.
Navigation knob
7 Rotate the knob to highlight screen elements, then press to select the highlighted element.
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Using the On-Screen Calculator
You can use the on-screen calculator to perform any of the standard operations for which you would
normally use a handheld calculator.
To access the on-screen calculator, select the Calculator SmartKey, or select Main Setup then
Calculations followed by Calculator.
Operating Modes
When you switch the monitor on, it starts up in monitoring mode. To change to a different mode:
1Select the Main Setup menu.
2Select Operating Modes and choose the mode you require.
Your monitor has four operating modes. Some are passcode protected.
Monitoring Mode: This is the normal, every day working mode that you use for monitoring
patients. You can change elements such as alarm limits, patient category and so forth. When you
discharge the patient, these elements return to their default values. Changes can be stored
permanently only in Configuration Mode. You may see items, such as some menu options or the
altitude setting, that are visible but ‘grayed out’ so that you can neither select nor change them.
These are for your information and can be changed only in Configuration Mode.
Demonstration Mode: Passcode protected, this is for demonstration purposes only. You must
not change into Demonstration Mode during monitoring. In Demonstration Mode, all stored
trend information is deleted from the monitor’s memory.
Configuration Mode: Passcode protected, this mode is for personnel trained in configuration
tasks. These tasks are described in the Configuration Guide. During installation the monitor is
configured for use in your environment. This configuration defines the default settings you work
with when you switch on, the number of waves you see and so forth.
Service Mode: Passcode protected, this is for trained service personnel.
When the monitor is in Demonstration Mode, Configuration Mode, or Service Mode, this is indicated
by a box with the mode name in the center of the Screen and a symbol in the bottom right-hand
corner. Select the mode box in the center of the screen to change to a different mode.
When an X2 or MP5 is connected to a host monitor (Companion Mode is indicated):
The monitor in companion mode will adopt the operating mode of the host monitor.
You cannot change the operating mode at the monitor in companion mode.
Standby Mode
Standby mode can be used when you want to temporarily interrupt monitoring.
To enter Standby mode,
select the Monitor Standby SmartKey or
•select
Main Setup, followed by Monitor Standby.
The monitor enters Standby mode automatically after the End Case function is used to discharge a
patient.
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Standby suspends patient monitoring. All waves and numerics disappear from the display but all
settings and patient data information are retained. A special Standby screen is displayed. This can be
configured to a moving image or a blank screen. If a patient location is entered at the Information
Center, this will also be displayed on the Standby screen (availability depends on Information Center
revision).
To resume monitoring,
Select anything on the screen or press any key.
If you connect an X2 or MP5 that is powered on (and not in Standby) to a host monitor in Standby
mode, the host will leave Standby mode. When connected to a host monitor, with both the host and
the monitor in companion mode in Standby mode, leaving Standby on the monitor in companion
mode will also make the host leave Standby.
Understanding Screens
Your monitor comes with a set of pre-configured Screens, optimized for common monitoring
scenarios such as OR adult, or ICU neonatal. A Screen defines the overall selection, size and position
of waves, numerics and other elements on the monitor screen when you switch on. You can easily
switch between different Screens during monitoring. Screens do NOT affect alarm settings, patient
category and so forth.
When you switch from a complex to a less complex Screen layout, some measurements may not be
visible but are still monitored in the background. If you switch to a more complex Screen with, for
example, four invasive pressure waves but you have only two pressures connected to the monitor, the
"missing" two pressures are either left blank or the available space is filled by another measurement.
Switching to a Different Screen
1To switch to a different Screen, select the current Screen name in the monitor info line, or select
the Change Screen SmartKey.
2Choose the new Screen from the pop-up list.
Changing a Screen's Content
If you do not want to change the entire Screen content, but only some parts of it, you can substitute
individual waves, numerics, high-res waves, or trends. Be aware that these changes cannot be stored
permanently in Monitoring Mode.
To change the selection of elements on a Screen,
1Select the element you want to change.
2From the menu that appears, select Change Wave, Change Numeric, or ChangeHiResTrend, and
then select the wave or numeric you want, or select the high-resolution trend wave you want from
the list of available waves.
If you do not see Change Numeric in the menu, this Screen may be configured to always display
the numeric beside its wave. Changing the wave will automatically change the numeric.
The changed Screen is shown with an asterisk in the monitor info line.
In the Change Screen menu, the changed Screen is shown linked to the original Screen and marked
with an asterisk.
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Up to three modified Screens can be accessed via the Change Screen menu.
To recall Screens, either
select the name of the Screen in the Change Screen menu
or
use the previous/next arrows at the top of the Change Screen menu to move back and forth in
the Screen history. The ten most recently-used Screens including up to three modified Screens can
be accessed.
After a patient discharge, the monitor's default Screen is shown. Modified Screens are still available in
the Change Screen menu.
If the monitor is switched off and then on again, modified Screens are erased from the monitor's
memory and cannot be recalled. If a modified Screen was the last active Screen when the monitor was
switched off, it is retained (unless Automat. Default is configured to Yes).
Connecting Additional Displays to the Monitor
You can connect a second display, showing the same Screen as the main display, to your monitor, for
viewing only.
If you have the optional independent display interface, you can connect a second display which can be
configured and operated individually using standard input devices.
For monitors with multiple displays and multiple input devices, the usage and behavior can be
configured according to specific requirements at installation (for example, use for two independent
operators or tracking of mouse input across two displays). For details refer to the Service Guide.
When two operators are using two displays, the scope of an action depends on the type of operation:
Patient monitoring operations such as Silence or Pause alarms take effect for the monitor as a
whole, the results will be seen on both displays.
Display operations such as the Main Screen key and Back hardkey will take effect only on the
display being operated.
If you are operating two displays with one remote control, to navigate from one display to another:
1Move the highlight to the Main Screen key and then turn one click further.
The highlighting moves to a special "jump" field at the edge of the Screen.
2Press the navigation knob on the remote control to confirm; the highlighting will automatically
move to the other display.
The content of each Screen can be changed individually as described in the previous section. If you are
operating two displays, you can choose Screens for both displays from one location:
1Select Profiles in the monitor info line of the first display,
2Select Display 1, or Display 2, then select the Screen you want to appear on that display from the
list of available Screens.
When two displays are mounted next to each other or one above the other, a special Screen can be
assigned which spans across both displays. The Screen content for these Tall and Wide Screens can
then use the increased area available with two displays. These Screens appear in the Screen list with a
special Tall Screen or Wide Screen symbol.
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Certain windows (for example: cardiac output procedure) can only be shown on one display at a time.
If you try to open one of these windows when it is already shown on another display, you will see a
blank gray window with a cross through it.
Using the XDS Remote Display
Using the IntelliVue XDS solution it is possible to view an independent monitor screen on an external
display. The XDS solution consists of a medical grade PC-based hardware platform, XDS application
software and the XDS connectivity option on the monitor. Depending on the configuration you can
also operate the monitor from the external display. The XDS must be connected to the same Local
Area Network (LAN) as the monitor.
It is also possible to use an existing PC, connected to the same LAN, to host the XDS Application
software.
For more details, including limitations and restrictions, refer to the Instructions for Use for the XDS
Application.
Using the Visitor Screen
If a visitor Screen is configured for your monitor, you can use it to clear the screen of all waves and
numerics but continue to monitor the patient with active alarms and trend storage at the bedside and
Information Center. You can change the name of the visitor Screen in Configuration Mode.
To activate this Screen, select the Screen name in the monitor info line to open the Change Screen
menu, then select the name of the visitor Screen configured for your monitor from the list of
available Screens.
To select a Screen with waves and numerics again,
Touch the gray box in the center of the screen, showing the visitor Screen's name, to open the
Change Screen menu and select a different Screen to show waves and numerics again.
Understanding Profiles
Profiles are predefined monitor configurations. They let you change the configuration of the whole
monitor so you can adapt it to different monitoring situations. The changes that occur when you
change a complete profile are more far reaching than those made when you change a Screen. Screens
affect only what is shown on the display. Profiles affect all monitor and measurement settings.
The settings that are defined by Profiles are grouped into three categories. Each category offers a
choice of 'settings blocks' customized for specific monitoring situations. These categories are:
Display (screens)
Each profile can have a choice of many different predefined screens.
If you are using a second display, each display can have its own individual screen selection.
When you change the profile, the screen selection configured for the new profile becomes active.
Measurement Settings
Each profile can have a choice of different predefined measurement settings. These relate directly
to individual measurements, for example, measurement on/off, measurement color, alarms limits,
NBP alarm source, NBP repeat time, temperature unit (°F or °C), pressure unit (mmHg or kPa).
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Monitor Settings
Each profile can have a choice of different predefined monitor settings. These relate to the
monitor as a whole; for example, display brightness, alarms off/paused, alarm volume, QRS tone
volume, tone modulation, prompt tone volume, wave speed, resp wave speed, pulse source.
You can change from one complete profile to another or swap individual settings blocks (display/
monitor settings/measurement settings) to change a subset of a profile. Changes you make to any
element within the settings blocks are not saved when you discharge the patient, unless you save them
in Configuration Mode.
Depending on your monitor configuration, when you switch on or discharge a patient the monitor
either continues with the previous profile, or resets to the default profile configured for that monitor.
WARNING
If you switch to a different profile, the patient category and paced status normally change to the setting
specified in the new profile. However some profiles may be set up to leave the patient category and
paced status unchanged. Always check the patient category, paced status, and all alarms and settings,
when you change profiles.
When you leave Demonstration Mode, the monitor uses the default profile.
Swapping a Complete Profile
1Select Profiles in the monitor info line, or select the Profiles SmartKey.
2In the Profiles menu, select Profile.
3Chose a profile from the pop-up list.
4Confirm your selection.
Swapping a Settings Block
1Select Profiles in the monitor info line, or select the Profiles SmartKey.
2In the Profiles menu, select Display or Measmnt.Settings or Monitor Settings to call up a list of
the settings blocks in each category.
3Choose a settings block from the pop-up list.
4Confirm your selection.
Default Profile
Your monitor has a default profile that it uses when you leave Demonstration, or Service modes, or
when you discharge a patient. This profile is indicated by a diamond shaped symbol.
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Locked Profiles
Understanding Settings
Each aspect of how the monitor works and looks is defined by a setting. There are a number of
different categories of settings, including,
Screen Settings, to define the selection and appearance of elements on each individual Screen
Measurement settings, to define settings unique to each measurement, for example, high and low
alarm limits
Monitor settings, including settings that affect more than one measurement or Screen and define
general aspects of how the monitor works, for example, alarm volume, reports and recordings, and
display brightness.
You must be aware that, although many settings can be changed in Monitoring Mode, permanent
changes to settings can only be done in the monitor's Configuration Mode. All settings are reset to the
stored defaults:
when you discharge a patient
when you load a Profile
when the monitor is switched off for more than one minute (if Automat. Default is set to Yes).
Changing Measurement Settings
Each measurement has a setup menu in which you can adjust all of its settings. You can enter a setup
menu:
via the measurement numeric - select the measurement numeric to enter its setup menu. For
example, to enter the Setup ECG menu, select the HR (heart rate) numeric.
via the Setup hardkey (on plug-in modules) - press the Setup hardkey on the module front.
•via the Main Setup permanent key - if you want to setup a measurement when the measurement is
switched off, use the Main Setup permanent key and select Measurements. Then select the
measurement name from the pop-up list. With this permanent key you can access any setup menu
in the monitor.
via the Measurement Selection key.
This guide always describes the entry method using the setup menu. But you can use any method you
prefer.
Some profiles are locked, so that you cannot change them, even in Configuration Mode.
These are indicated by this lock symbol.
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Switching a Measurement On and Off
When a measurement is off, its waves and numerics are removed from the monitor's screen. The
monitor stops data acquisition and alarming for this measurement. A measurement automatically
switches off if you disconnect its module or MMS. If you disconnect a transducer, the monitor
replaces the measurement numeric with question marks. If in this situation alarms are paused or
switched off, the measurement in question may be switched off completely, depending on monitor
configuration.
1Enter the measurement's setup menu and select the measurement.
2Select the measurement name to switch between on and off. The screen display indicates the active
setting.
Switching Numerics On and Off
For some measurements, such as EEG, you can choose which numerics to view on the screen.
In the measurement's setup menu, select the numeric name to toggle between on and off.
For example in the Setup EEG menu, select the EEG numeric name to toggle between on and off.
Adjusting a Measurement Wave
To quickly adjust wave-related measurement settings (such as speed or size), select the measurement
wave itself. This displays the measurement wave menu, which has only wave-related measurement
settings.
Changing Wave Speeds
Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the
speed expands the waveform, giving you a more detailed view.
The monitor distinguishes three groups of wave speed settings,
RespiratorySpeed, for all respiratory waves: CO2, anesthetic agents and O2
EEG Speed, for all EEG and BIS waves
Global Speed, for all waves not included in the other two groups.
Changing the Wave Group Speed
The wave speed group setting defines the speed of all the waves in the group.
To change the wave speed of a wave speed group,
1Select Main Setup, then select User Interface
2Select Global Speed, RespiratorySpeed, or EEG Speed as required
3Select a value from the list of available speeds.
Changing Wave Speed for a Channel
To change the wave speed of an individual wave channel,
1Enter the Wave menu for a measurement by selecting its wave.
2Select Change Speed.
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3To set the speed to the wave group speed, select RespiratorySpeed, EEG Speed, or Global Speed.
To set an individual channel speed, select a numeric value from the list of available speeds. This
overrides the wave group speed setting and set the speed for the individual wave channel on the
monitor Screen. The wave channel speed is independent of the wave (label) depicted in the
channel, if you change the wave, the new wave will retain the set channel speed.
Freezing Waves
You can freeze waves on the screen and measure parts of the wave using cursors. The waves are frozen
with a history of 20 seconds so that you can go back and measure what you have seen.
Freezing An Individual Wave
To freeze a wave,
1Enter the Wave menu for the measurement by selecting the wave on the screen.
2Select Freeze Wave.
The realtime wave is replaced with the frozen wave.
Freezing All Waves
To freeze all waves on the screen,
1Select the Freeze Waves SmartKey.
All realtime waves are replaced with frozen waves.
Measuring Frozen Waves
To measure a frozen wave,
1Select the frozen wave.
If you are using touch, this automatically positions the vertical cursor. The cursor can be
repositioned by touching the required point on the wave, or
2Using the SpeedPoint or another pointing device or touch: use the right/left arrow keys to move
the vertical cursor.
The vertical cursor moves through the time axis and the current value is displayed next to the
cursor.
3Use the up/down arrow keys to activate and move the horizontal cursor.
The horizontal cursor measures the wave value, which is displayed above the cursor line. If the
wave is a pressure wave, the cursor value can be stored as a systolic, diastolic or mean pressure
value; if the pressure wave is a PAP wave it can also be stored as a PAWP value; for pressure waves
P, P1 to P8 it can also be stored as an IAP value. The stored value appears in the trend database as
a manually entered value.
Changing The Wave Speed
Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the
speed expands the waveform, giving you a more detailed view.
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To change the wave speed:
1Select the frozen wave.
2Select Change Speed.
3Select a speed from the list.
Updating The Frozen Wave
To update the wave, that is freeze the current wave:
1Select the frozen wave.
2Select Freeze Again.
Releasing Frozen Waves
To release frozen waves,
1Select a frozen wave.
2Select Unfreeze Waves.
All frozen waves are released.
Using Labels
You may have more than one instance of some measurements, for example pressure, being used
simultaneously. The monitor uses labels to distinguish between them. The default settings defined in
the profile (such as measurement color, wave scale, and alarm settings) are stored within each label.
When you assign a label to a measurement, the monitor automatically applies these default settings to
the measurement. The labels assigned are used throughout the monitor, in reports, recordings, and in
trends.
Changing Measurement Labels (e.g. Pressure)
To change a measurement label of a measurement with multiple labels (e.g. invasive pressure or
temperature),
1Enter the wave menu of the measurement.
2Select Label.
3Choose a label from the list.
The monitor automatically applies the scale, color, etc. settings stored in the Profile for the label you
select. You can change scale settings in Monitoring Mode, but color can only be changed in the
monitor's Configuration Mode.
Any labels already being used in the monitor are shown "grayed-out" in the list and cannot be selected.
About Label Sets
Your monitor may be configured to use a Restricted or Full label set. The Full label set provides extra
labels for Pressure and Temp. See the sections on Pressure and Temperature in these Instructions for
Use for more information.
If you connect an MMS from a monitor using a Full label set to an IntelliVue monitor using a
Restricted label set or an M3/M4 monitor, any additional labels switch to labels available in the target
monitor. This may cause a label conflict with other monitored measurements.
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Be aware that connecting a monitor using the Full label set to an Information Center with certain
software revisions may affect the availability of measurement information from the additional labels on
the Information Center. See the Information Center documentation and your monitor's Configuration
Guide for information on label set compatibility.
Resolving Label Conflicts
Each label must be unique, that is, it can only be assigned once. You cannot monitor two pressures
labeled "ICP" at the same time. If you need to use two identical pressures, you must assign different
labels to them, for example, P and ICP.
Measurement labels are stored in the measurement device (module or MMS). If you try to use two
measurement devices that have identical labels, this causes a label conflict in the monitor.
Measurement selection key with question marks indicating a label conflict.
Depending on your configuration, the monitor will either
resolve the conflict automatically, by assigning a new, generic label to the most recently connected
conflicting label (e.g. a second FAP label could be changed to ABP)
•display the Measurement Selection window automatically for you to resolve the conflict
take no action, you must enter the Measurement Selection window and resolve the conflict.
All the currently available measurement devices, for example MMSs, MMS extensions, measurement
modules, Gas analyzers, devices connected to a host monitor and manually entered measurements
(marked ), are depicted in the Measurement Selection window.
Any measurement labels causing a label conflict are shown in red. If a measurement device is
connected but currently unavailable, for example, because it was deactivated due to a label conflict, the
device is shown "grayed-out".
De-activated devices are grayed-out (here
the Temp measurement on the left)
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When an X2 or MP5 is connected to a host monitor, the measurement selection window looks like
this:
WARNING
When an X2 or MP5 with an active measurement, say SpO2, is connected to a host monitor with the
same measurement already active, the SpO2 measurement on the X2 or MP5 is deactivated and the
Meas. DEACTIVATED INOP is displayed. The measurement can only be reactivated if the X2 or MP5
is disconnected from the host monitor. The label conflict can be resolved on the host monitor like any
other label conflict.
To resolve a label conflict:
1Select the measurement selection key or select Main Setup, then Meas. Selection to display the
Measurement Selection window.
2Select the device whose label you want to correct.
3Use the measurement selection pop-up keys to resolve the conflict. Select either:
Change Label: to assign a different label to the conflicting label
De- Activate: to disable the conflicting device. It retains its label for future use but becomes
invisible to the monitor, as though it had been unplugged. When the device has been
deactivated the question marks under the measurement selection key will be replaced by XXX.
Setup <Measurement Label>: to enter the Setup menu for the measurement and change the
conflicting device's label to a different label.
Modify Driver (VueLink/IntelliBridge only): - to modify the device driver setup to disable the
conflicting device's label.
Label Compatibility
When a new measurement is introduced, or new labels for an existing measurement, these labels will
not be shown on older Information Centers, and consequently not on the Overview screen sourced
from the Information Center.
When a patient is transferred from a monitor with these new labels to one with an older software
revision, the labels will be replaced with a generic label for that measurement. The settings for that
generic label will then be used.
X2 connected to host monitor MP5 connected to host monitor
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If it is critical that the measurement labels are available at the Information Center and after transfers,
the older monitors and the Information Center must be upgraded to the appropriate software revision.
Entering Measurements Manually
You can enter values into the monitor that have been measured with other equipment or manually (for
example, manual temperatures, lab values). These values are then stored in the database, included in
trends and reports, and passed on to the Information Center and central charting systems. There is no
alarm functionality for manually entered measurements.
To enter values,
1Select the Enter Values SmartKey or select Main Setup then select Enter MeasValues.
2Select the measurement you want to enter values for. The Edit window will open.
3If the measurement is switched off, switch it on by selecting the label.
4Select Value and enter the value.
5Select Date/Time to enter the date and time for the value. The default is always the current date
and time.
6For compound labels, for example ABPs, ABPd and ABPm, select the Format field to select
whether all values are required or a single value.
7Select Save.
When a manually entered value has been configured to display as a numeric on the screen, you can also
enter a new value for this measurement by selecting the numeric, then selecting Enter MeasValues.
Manually entered measurement values are marked with a * on the display, in trends, and so forth. Each
measurement has a defined measurement interval after which a value becomes invalid (no value is then
displayed). Values can be entered up to two hours after they have been measured or up to the
measurement interval, if this is shorter.
The list of measurement labels which appears in the Enter Measurement Values window is set in
Configuration Mode.
No values can be entered manually on a monitor in companion mode when it is connected to a host
monitor.
Switching Manually Entered Measurements On and Off
To switch a manually entered measurement on or off,
1Select the Enter Values SmartKey or select Main Setup then select Enter MeasValues.
2Select the measurement you want to switch on or off.
3Select the measurement label field to switch between On and Off.
Changing Monitor Settings
To change monitor settings such as brightness, or QRS tone volume, select the Main Setup permanent
key and then select User Interface to enter a submenu where you can change these settings.
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Adjusting the Screen Brightness
1Select the Brightness SmartKey.
2Select the appropriate setting for the screen brightness. 10 is the brightest, 1 is the least bright.
Optimum is suitable for most monitoring locations and optimizes power usage for battery
powered monitors.
Your monitor may be configured with a lower brightness for Standby mode and also (for battery
powered monitors) for transport to conserve battery power. These settings can only be changed in the
monitor's Configuration Mode.
If you are using a monitor with an external display, the Brightness SmartKey does not adjust the
brightness of this display. See the instructions supplied with the external display for instructions.
Setting the Date and Time
1Select the Date, Time screen element from the monitor's info line to enter the Date, Time menu.
2Select, in turn, the Year, Month, Day, Hour (in 24 hour format, only) and Minute as necessary.
Select the correct values from the pop-up list.
3Select Store Date, Time to change the date and time.
If your monitor is connected to an Information Center, the date and time are automatically taken from
this. Once it is set, the internal clock retains the setting even when you switch off the monitor.
WARNING
Changing the date or time will affect the storage of trends and events.
Checking Your Monitor Revision
1Select Main Setup then select Revisions to open the Monitor Revision menu.
2Select the correct device from the device pop-up keys.
3From the Monitor Revision menu, select the monitor component for which you need revision
information.
Getting Started
Once you understand the basic operation principles, you can get ready for monitoring. We also
recommend working through the CBT for self-training before using the monitor (not available in all
languages).
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Inspecting the Monitor
WARNING
If the monitor is mechanically damaged, or if it is not working properly, do not use it for any
monitoring procedure on a patient. Contact your service personnel.
1Before you start to make measurements, carry out the following checks on the monitor including
all connected MMSs, modules, or MMS extensions.
Check for any mechanical damage.
Check all the external cables, plug-ins and accessories.
2Plug the power cord into the AC power source.
3Check all the functions of the instrument that you need to monitor the patient, and ensure that the
instrument is in good working order.
Switching On
Press the power on/standby switch on the monitor for one second. The monitor performs a self test
during which all lamps will light up and a tone will be sounded, and is then ready to use. If you see a
message such as CO SENS.WARMUP wait until it disappears before starting to monitor that
measurement. Connected devices usually take their power from the monitor. External devices such as
gas monitors and those connected via VueLink/IntelliBridge have their own power switches.
Power On/Power Off Behavior
The general rules determining the behavior of the monitor when connected to, or disconnected from
power are as follows:
A monitor that was switched on prior to a temporary power loss switches on again when power is
restored.
A monitor that was switched off prior to a temporary power loss remains off when power is
restored.
An X2 or MP5 switches on automatically when connected to a running host monitor.
When an X2 or MP5 is disconnected from a running host monitor, the X2 or MP5 continues to
run without interruption on battery power.
Setting up the Modules
1Decide which measurements you want to make.
2Connect the required modules, MMSs, or MMS extensions.
3Check that you have the correct patient cables and transducers plugged in. The connectors are
color-coded to the patient cables and transducers for easy identification.
Starting Monitoring
After you switch on the monitor,
1Admit your patient to the monitor.
2Check that the profile, alarm limits, alarm and QRS volumes, patient category and paced status and
so forth are appropriate for your patient. Change them if necessary.
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3Refer to the appropriate measurement chapter for further details of how to perform the
measurements you require.
WARNING
During MR imaging, remove all transducers, sensors and cables from the patient. Induced currents
could cause burns.
Disconnecting from Power
The On/Standby switch does not disconnect the monitor from the ac power source. To disconnect,
unplug the power cable.
Monitoring After a Power Failure
If the monitor is without power for less than one minute, monitoring will resume with all active
settings unchanged. If the monitor is without power for more than one minute, the behavior depends
on your configuration. If Automat. Default is set to Yes, the default profile will be loaded when power
is restored. If Automat. Default is set to No, all active settings are retained, if power is restored within
48 hours. The Automat. Default setting is made in Configuration Mode.
Networked Monitoring
You can connect your monitor to an Information Center on a network, using one of the optional
interfaces:
Standard wired LAN
Wireless LAN
IntelliVue Instrument Telemetry System (IIT).
WARNING
Do not connect patient monitors to the standard hospital network.
Additionally, when an IntelliVue X2 or MP5 is equipped with IIT and declared at the Information
Center as a telemetry device, it allows data continuity when paired to a host monitor. After
disconnection from the host monitor, it continues to monitor the patient during transport and
provides continuous data to the same sector on the Information Center. (See “Assigning a Telemetry
Device and a Monitor to One Patient” on page 265.)
If your monitor is connected to a network, a network symbol is displayed in the upper left corner next
to the bed label. To see details about the Care Group, the monitoring equipment, and technical
information about the network,
in the monitor info line, select the bed label.
Be aware that some network-based functions may be limited for monitors on wireless networks in
comparison to those on wired networks.
Printout functionality and data export are not guaranteed when using a standard hospital network.
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46
Using the Integrated PC
If your monitor has the optional integrated PC (iPC), you can run applications on the iPC. The
applications display data on the monitor's display (or on a second independent display) that is
generated on and retrieved from the iPC or externally.
For details about applications, refer to the XDS/iPC Instructions for Use.
The monitor runs independently of the iPC, and vice versa.
WARNING
Some clinical applications may show data from another patient. Be aware that some of the data on
your patient monitor display may not always be from your patient.
Applications running on the iPC cannot act as a primary alarming device and cannot be relied
upon for alarm notification. There may be no audible or visible indications apart from what is
shown on the screen and any data shown may be delayed.
Starting the iPC
Your monitor may be configured to have the iPC start up automatically when the monitor is switched
on. If not:
1Select Main Setup then Internal PC.
2In the Internal PC menu, select Switch PC On to start the iPC.
Viewing the iPC Desktop on the Monitor Display
If the Desktop is not displayed on the monitor display:
1Select the iPC key , or
2Select Main Setup, Internal PC, then Show PC Window.
To hide the Desktop again, select Main Screen.
Adjusting the iPC Audio Volume
The Audio from the iPC is normally configured to be off. However, your monitor may have the iPC
audio configured on for use with specific PC applications.
WARNING
Always minimize the iPC audio volume or mute it completely when it is not needed for an iPC
application. This will avoid iPC tones distracting from or masking tones from the monitor.
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Using Input Devices with the iPC and Monitor
You can connect input devices such as a mouse, trackball and keyboard to the rear of the patient
monitor (using the left hand row of USB connectors) and use them for input to the monitor.
Correspondingly you can connect input devices to the rear of the patient monitor (using the right
hand row of USB connectors) or to the front USB connector and use them for the iPC. Input devices
connected to the iPC can also be shared with the patient monitor. Sharing input devices and
touchscreen input requires a specific software application; refer to the IntelliVue XDS Application
Instructions for Use for details.
If the iPC is switched off when input devices are shared, any input devices connected to it will not be
available for use with the monitor.
Shutting the iPC Down
The iPC will be shut down automatically when the monitor is switched off.
If you want to shut down the iPC when the monitor is on,
1Select Main Setup then Internal PC.
2In the Internal PC menu, select Switch PC Off.
If there is a problem with the shutdown, and you need to switch off the iPC manually,
1Select Main Setup then Internal PC.
2In the Internal PC menu, select Force PC Off to force the iPC to power down.
Special Situations at Shutdown
If you switch the monitor off and then on again immediately, the iPC will continue running and
will not be shut down.
In some situations, shutting down the iPC can take a little time. The monitor will go into Standby
mode until the shutdown is complete. By touching the touchscreen, you can bring the monitor
back into operating mode. If you do this, the iPC will restart when the shutdown is complete.
If the shutdown cannot be completed within a certain time, a window will open giving the reason:
for example, that a file has not been saved, or that updates are being installed. You can then decide
whether to wait (for example, in the case of the updates) or to take action (for example by saving
the unsaved file). You will also have the option to force shutdown, if necessary.
Using the X2 or MP5 with a Host Monitor
When you connect an X2 or MP5 in companion mode to a host monitor, an integrated system is
formed for monitoring a single patient. The following general observations and considerations apply to
such a system:
The host monitor is the "master" of the system, and you have full control over all the system's
operation only via the host monitor.
Functions you can operate on a monitor in companion mode are restricted to measurements
originating in that device. If you try to operate controls that are disabled, you are prompted by the
message Not available in Companion Mode.
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Depending on how it is configured, your host monitor can determine whether the user interface of
a connected monitor in companion mode is completely disabled or not, and what is displayed on
the screen (a standard main screen, or a blank screen indicating Companion Mode).
This is controlled by two monitor settings that are applied to the monitor in companion mode on
connection. You can change the settings in Configuration Mode.
Global settings such as line frequency, QRS sound and ECG lead colors from the host monitor,
are applied to the monitor in companion mode on connection. When disconnected from the host,
the monitor in companion mode re-applies its own global settings.
No audible alarms are available on a monitor in companion mode when connected to a host
monitor. The only visual alarm indication is provided by the alarm lamps which are controlled by
the host monitor. Alarms become active again as soon as the monitor in companion mode is
disconnected from the host monitor.
The host monitor is the master of all ADT information. ADT operations on the monitor in
companion mode are disabled, and any pending actions on the monitor in companion mode (for
example, admit or end case) are canceled.
The date and time of the monitor in companion mode is synchronized with that of the host
monitor.
Event surveillance in the monitor in companion mode is disabled. Main Setup menu operations
and SmartKeys are disabled. While connected to a host monitor, no new events are detected in the
monitor in companion mode, and no events are deleted. There is no transfer of stored events from
the monitor in companion mode to the host monitor. After disconnection from the host monitor,
event surveillance is enabled again in the monitor in companion mode, and new events are
detected.
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2Alarms
The alarm information here applies to all measurements. Measurement-specific alarm information is
discussed in the sections on individual measurements.
The monitor has two different types of alarm: patient alarms and INOPs.
Patient Alarms
Patient Alarms are red and yellow alarms. A red alarm indicates a high priority patient alarm such as a
potentially life threatening situation (for example, asystole). A yellow alarm indicates a lower priority
patient alarm (for example, a respiration alarm limit violation). Additionally there are short yellow
alarms, most of which are specific to arrhythmia-related patient conditions (for example, ventricular
bigeminy).
INOPs
INOPs are technical alarms, they indicate that the monitor cannot measure or detect alarm conditions
reliably. If an INOP interrupts monitoring and alarm detection (for example, LEADS OFF), the monitor
places a question mark in place of the measurement numeric and an audible indicator tone will be
sounded. INOPs without this audible indicator indicate that there may be a problem with the reliability
of the data, but that monitoring is not interrupted.
Most INOPs are light blue, however there are a small number of INOPs which are always yellow or
red to indicate a severity corresponding to red and yellow alarms. The following INOPs can also be
configured as red or yellow INOPs to provide a severity indication:
ECG LEADS OFF
NBP CUFF OVERPRESS
CUFF NOT DEFLATED
OCCLUSION
TELE DISCONNECTED
Replace TeleBatt
All monitors in a unit should have the same severity configured for these INOPs.
Alarms are indicated after the alarm delay time. This is made up of the system delay time plus the
trigger delay time for the individual measurement. See the Specifications section for details.
If more than one alarm is active, the alarm messages are shown in the alarm status area in succession.
An arrow symbol next to the alarm message informs you that more than one message is active.
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The monitor sounds an audible indicator for the highest priority alarm. If more than one alarm
condition is active in the same measurement, the monitor announces the most severe. Your monitor
may be configured to increase alarm indicator volume automatically during the time when the alarm is
not acknowledged.
Visual Alarm Indicators
WARNING
No alarms are available on an X2 or MP5 when connected to a host monitor (Companion Mode
is indicated). Alarms become active again as soon as the X2 or MP5 is disconnected from the host
monitor.
Alarm fields and other visual alarm indicators are disabled on an X2 or MP5 when connected to a
host monitor. The only visual alarm indication is provided by the alarm lamps, which are
controlled by the host monitor.
Alarm Message
An alarm message text appears in the alarm status area at the top of the screen indicating the source of
the alarm. If more than one measurement is in an alarm condition, the message changes every two
seconds, and has an arrow ( ) at the side. The background color of the alarm message matches the
alarm priority: red for red alarms, yellow for yellow alarms, light blue for standard INOPs, red for red
INOPs and yellow for yellow INOPs. The asterisk symbols (*) beside the alarm message match the
alarm priority: *** for red alarms, ** for yellow alarms, * for short yellow alarms. Standard INOPs do
not have a symbol, red and yellow INOPs have exclamation marks beside the alarm message: !!! for
red INOPs and !! for yellow INOPs.
Depending on how your monitor is configured, it may display alarm limit violation messages:
in text form, for example ** SpO LOW or
in numeric form, for example **Pulse xxx>yyy where the first number shows the maximum
deviation from the alarm limit, and the second number shows the currently set limit.
Flashing Numeric
The numeric of the measurement in alarm flashes.
Bright Alarm Limits
If the alarm was triggered by an alarm limit violation, the corresponding alarm limit on the monitor
screen is shown more brightly if Show ALarmLimits is enabled and there is sufficient room on the
screen.
Alarm Lamp
A lamp on the monitor's front panel flashes. The alarm lamp is divided into two sections. The right
one flashes for a patient alarm, except for short yellow alarms where the lamp will light for
approximately six seconds. The color is yellow or red corresponding to the highest priority patient
alarm currently present. The left one lights continuously for a light blue INOP and flashes for yellow
or red INOPs as follows:
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If only patient alarms are present, and no INOPs, the patient alarms will use both left and right
sections to flash (for red and yellow alarms) or light for approximately six seconds (for short yellow
alarms). If only INOPs are present, and no patient alarms, red and yellow INOPs will use both left and
right sections to flash but light blue INOPs will always light continuously in the left section only.
Nurse Call Systems
If configured to do so, red, yellow and light blue alarms are indicated on any device connected to the
nurse call relay.
Audible Alarm Indicators
The audible alarm indicators configured for your monitor depend on which alarm standard applies in
your hospital. Audible alarm indicator patterns are repeated until you acknowledge the alarm by
switching it off or pausing it, or until the alarm condition ceases (if audible alarm indication is set to
non-latching).
WARNING
Do not rely exclusively on the audible alarm system for patient monitoring. Adjustment of alarm
volume to a low level or off during patient monitoring may result in patient danger. Remember
that the most reliable method of patient monitoring combines close personal surveillance with
correct operation of monitoring equipment.
No audible alarm indicators are available on an X2 or MP5 when connected to a host monitor
(Companion Mode is indicated). Alarms become active again as soon as the X2 or MP5 is
disconnected from the host monitor.
Alarm Tone Configuration
The audible alarm indicators of your monitor are configurable. In the monitor's Configuration Mode,
you can:
increase the alarm volume of unacknowledged alarms at regular intervals
change the interval between alarm sounds (ISO/IEC Standard alarms only)
change the base volume of the red and yellow alarm tones and the INOP tones
change the alarm sound to suit the different alarm standards valid in different countries.
Traditional Audible Alarms (HP/Agilent/Philips/Carenet)
Red alarms and red INOPs: A high pitched sound is repeated once a second.
Two-star yellow alarms and yellow INOPs: A lower pitched sound is repeated every two seconds.
One-star yellow alarms (short yellow alarms): The audible indicator is the same as for yellow
alarms, but of shorter duration.
INOP Lamp Color On Off
Yellow 1.0 seconds 1.0 seconds
Red 0.25 seconds 0.25 seconds
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Standard INOPs: an INOP tone is repeated every two seconds.
ISO/IEC Standard Audible Alarms
Red alarms and red INOPs: A high pitched tone is repeated five times, followed by a configurable
pause.
Two-star yellow alarms and yellow INOPs: A lower pitched tone is repeated three times, followed
by a configurable pause.
One-star yellow alarms (short yellow alarms): The audible indicator is the same as for yellow
alarms, but of shorter duration.
Standard INOPs: a lower pitched tone is repeated twice, followed by a pause.
Changing the Alarm Tone Volume
The alarm volume symbol at the top right of the monitor screen gives you an indication of the
current volume.
To change the volume, select the volume symbol and then select the required volume from the
pop-up selection.
If you want to see a numerical indication of the current alarm volume on a scale from zero to 10,
or change the setting, select the Alarm Volume SmartKey.
The volume scale pops up. The current setting is indented. To change the setting, select the
required number on the scale. Any settings that are inactive ("grayed out") have been disabled in
the monitor's Configuration Mode.
When the alarm volume is set to zero (off), the alarm volume symbol reflects this.
If you switch the alarm volume off, you will not get any audible indication of alarm conditions.
There is no alarm volume indication on the screen of an X2 or MP5 when connected to a host monitor
(Companion Mode is indicated).
Minimum Volume for No Central Monitoring INOP
If your monitor is connected to an Information Center, and the connection is interrupted, the INOP
message No Central Monit. will appear within 30 seconds, accompanied by an INOP tone. To help
ensure that this INOP, and any other active alarm, is not overlooked, the INOP and alarm tones may
be configured to have a minimum volume. In this case, INOP and alarm tones will sound even if the
monitor alarm volume is set to zero.
Minimum Volume for Severe Yellow or Red INOPs
Severe yellow or red INOPs require action to ensure the well-being of the patient. Therefore the
minimum volume for the INOP tone is set to at least alarm volume 8, irrespective of the current alarm
volume setting. The INOP tone will sound even if the monitor alarm volume is set to zero.
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The severe INOPs for which this applies are:
CUFF NOT DEFLATED (configurable to yellow or red)
NBP CUFF OVERPRESS (configurable to yellow or red)
!!INSERT BATTERY - X2 (yellow)
Power Loss Tone
When power is lost - no power is available via the power cable - a buzzer will sound, if so configured.
The tone can be silenced by pressing the On/Off power switch.
Acknowledging Alarms
To acknowledge all active alarms and INOPs, select the Silence permanent key. This switches off the
audible alarm indicators and alarm lamps.
Alternatively, you can acknowledge alarms by pressing the Silence hardkey on the MMS or on the
SpeedPoint. The hardkeys follow the behavior configured for the permanent key.
A check mark beside the alarm message indicates that the alarm has been acknowledged . If the
monitor is configured to re-alarm, a dashed check mark will be shown .
If the condition that triggered the alarm is still present after the alarm has been acknowledged, the
alarm message stays on the screen with a check mark symbol beside it, except for NBP alarms and
alarms from other intermittent measurements. When such an alarm is acknowledged the alarm
message disappears.
If the alarm condition is no longer present, all alarm indicators stop and the alarm is reset.
Switching off the alarms for the measurement in alarm, or switching off the measurement itself, also
stops alarm indication.
Acknowledging Disconnect INOPs
Acknowledging an INOP that results from a disconnected transducer switches off the associated
measurement, unless the monitor is configured to not allow this. The only exception is ECG/Resp:
acknowledging a disconnect INOP for ECG leads does not switch off the ECG and Resp
measurements. Acknowledging a disconnect INOP at the Information Center switches off the audible
INOP indicator but does not switch off the measurement.
Unplugging an MMS or a plug-in module automatically switches off its measurements.
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Alarm Reminder
If Alarm Reminder is configured on for your monitor, you will get an audible reminder of alarm
conditions that remain active after you have acknowledged the alarm. This reminder may take the form
of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is
the same as a new alarm). Alarm Reminder is not available for standard, light blue INOPs but for
yellow and red INOPs.
In Configuration Mode, you can set the interval between silencing the alarm and sounding the
reminder tone to one, two, or three minutes.
The alarm reminder behavior at the Information Center is different to that at the monitor. Refer to the
Information Center Instructions for Use for further information.
Pausing or Switching Off Alarms
If you want to temporarily prevent alarms from sounding, for example while you are moving a patient,
you can pause alarms. Depending on your monitor configuration, alarms are paused for one, two, or
three minutes, or infinitely.
To view the alarm pause setting chosen for your unit,
1Select Main Setup, Alarms, then Alarm Settings
2Check the Alarms Off setting.
This setting can only be changed in Configuration Mode.
To Pause All Alarms
Select the Pause Alarms permanent key. If your monitor is configured to infinite pause time, the
permanent key is labeled Alarms Off, and selecting it switches alarms off.
Or press the Alarms hardkey on the SpeedPoint or Navigation Point. The hardkey follows the
behavior configured for the permanent key.
Depending on the configuration, you may need to select Confirm to complete the change.
To Switch All Alarms Off
You can only switch alarms off permanently if your monitor is configured to allow infinite alarms
pause and the permanent key is labeled Alarms Off.
Select the Alarms Off permanent key.
Or press the Alarms hardkey on the SpeedPoint or Navigation Point. The hardkey follows the
behavior configured for the permanent key.
Depending on the configuration, you may need to select Confirm to complete the change.
Pausing alarms infinitely is the same as switching them off.
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To Switch Individual Measurement Alarms On or Off
1Select the measurement numeric to enter its setup menu.
2Select Alarms to switch between on and off.
The alarms off symbol is shown beside the measurement numeric.
While Alarms are Paused or Off
The red Alarms Paused lamp on the monitor front panel is lit.
In the alarm field, the monitor displays the message ALARMS PAUSED 1:28 or ALARMS OFF,
together with the alarms paused symbol or the alarms off symbol.
No alarms are sounded and no alarm messages are shown.
INOP messages are shown but no INOP tones are sounded.
The only exceptions are the INOPs CUFF NOT DEFLATED, NBP CUFF OVERPRESS and INOPs
relating to empty, missing and malfunctioning batteries.
These INOPs switch the alarms on, and the INOP tones are sounded, even if alarms are paused or
off. You need to remove the INOP condition first before you can switch the alarm tones off again.
The nurse call relay is not active.
If a disconnect INOP is present and alarms are paused or switched off, the measurement in question
may be switched off, depending on monitor configuration.
Restarting Paused Alarms
To manually switch on alarm indication again after a pause, select the permanent key Pause Alarms (or
Alarms Off) again.
Alarm indication starts again automatically after the pause period expires. If the monitor is configured
to stay paused infinitely, you must select Alarms Off again to restart alarm indication.
Resetting Arrhythmia Alarm Timeouts
To reset the arrhythmia alarm timeout period, select the Alarms Off or Pause Alarms permanent key
and then reselect it.
Extending the Alarm Pause Time
If your monitor has extended alarm pause enabled, you can extend the alarm pause time. Use this to
prevent alarms being indicated, for example, while you are washing a patient or carrying out a
procedure. Only extend the alarm pause time when you are sure that clinical personnel are available to
monitor the patient's condition closely.
Alarms Paused Alarms Off
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To extend the alarm pause time to five or 10 minutes,
1Select one of the alarm fields. This calls up the Alarm Messages window.
2Select either the pop-up key PauseAl. 5 Min or the pop-up key PauseAl. 10 Min. Each time you
select one of these pop-up keys, the Alarm Pause Time is reset to five (or 10) minutes.
Alarm Limits
The alarm limits you set determine the conditions that trigger yellow and red limit alarms. For some
measurements (for example, BIS and SpO2), where the value ranges from 100 to 0, setting the high
alarm limit to 100 switches the high alarm off, or setting the low alarm limit to 0 switches it off. In
these cases, the alarms off symbol is not displayed.
WARNING
Be aware that the monitors in your care area may each have different alarm settings, to suit different
patients. Always check that the alarm settings are appropriate for your patient before you start
monitoring.
Viewing Individual Alarm Limits
You can usually see the alarm limits set for each measurement next to the measurement numeric on
the main screen.
If your monitor is not configured to show the alarm limits next to the numeric, you can see them in the
appropriate measurement setup menu. Select the measurement numeric to enter the menu and check
the limits.
Viewing All Alarm Limits
The Alarm Limits overview window lists the currently set alarm limits for all measurements. If an
Apnea alarm delay time is set, this is also shown. The alarms off symbol is shown beside the
measurement label of any measurement whose alarm switched off.
To open the Alarm Limits window, either select any alarm field to open the Alarm Messages window,
then select the Alarm Limits pop-up key, or select the Alarm Limits SmartKey, if configured.
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1Measurement labels, with alarms off symbol where appropriate
2Current alarm limits
3Graphic view of current yellow and red alarm limits and currently monitored measurement value.
Off indicates the measurement is switched off
•Select
Show ST Limits to expand the list of ST leads and view the currently set alarm limits.
Selecting Hide ST Limits hides the list again.
You can use the pop-up keys that open with the Alarm Limits window to perform common tasks:
All Al. On/All Al. Off
All Lim. Narrow/All Lim. Wide to set narrow or wide alarm AutoLimits for all measurements.
Print Limits/Record Limits to print a list of all current alarm limit settings on a connected
printer or recorder.
These pop-up keys are not available in the window for changing individual alarm limits which you
access by selecting the measurement label in the Alarm Limits window.
Changing Alarm Limits
To change individual measurement alarm limits using the measurement's Setup Menu,
1In the measurement's setup menu, select the alarm limit you want to change. This calls up a list of
available values for the alarm limit.
2Select a value from the list to adjust the alarm limit.
Alternatively, you can use the keys in the measurement alarm limits window, which you access by
selecting the measurement label in the Alarm Limits window.
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T
To change alarm limits,
1Enter the Alarm Limits window.
2Using touch: to set the high alarm limit, select the high yellow alarm field to open a pop-up list of
high alarm limits. Select a limit from the list. Repeat to set the low yellow alarm field.
Using a SpeedPoint or Navigation Point: position the cursor in the high yellow alarm field,
then press the knob inwards. Rotate the knob to the left or right to adjust the limit. Press the knob
again to set the displayed limit. Repeat to set the low yellow alarm limit.
If you set the yellow alarm limit outside the red alarm limit, the monitor will automatically adapt the
red alarm limit.
When an ST measurement is in the alarm limits window there are also two pop-up keys available
labeled All ST Narrow/All ST Wide. With these keys you can set Auto Limits for all ST Leads.
1Parameter label
2High red alarm (view only)
3High yellow alarm field. Select to open a pop-up list of high alarm limits
4Alarms On/Off key - select to switch between alarms on or off
5Preview Alarm AutoLimits for a measurement before applying
6Select to apply wide AutoLimits
7Select to apply narrow AutoLimits
8Low yellow alarm field. Select to open a pop-up list of low alarm limits
9Low red alarm (view only)
10 Graphic view of alarm limits with currently measured value
11 15-min trend, showing alarm limits and monitored measurement values
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About Automatic Alarm Limits
The monitor can automatically set alarm limits suited to your individual patient, using the Automatic
Alarm Limits function (AutoLimits). This tells the monitor to adapt the alarm limits of selected
measurements to the measured vital signs within a defined safe limit. The monitor calculates safe
AutoLimits for each patient based on the measured values from the last 12 seconds.
The wide and narrow limits have a fixed relationship to the measured value within the non-
pathological range. Outside of this range, no auto limits are calculated. To set values outside of the
non-pathological range, limits must be changed manually, based on the clinician's judgment about the
specific patient.
Limits Narrow sets limits close to the currently measured values for situations where it is critical for
you to be informed about small changes in your patient's vital signs.
Limits Wide sets limits further away from the currently measured values for situations where small
changes are not so critical.
Use the keys in the measurement alarm limits window to apply AutoLimits for individual
measurements. These keys are not available if AutoLimits have been disabled for the measurement in
the monitor's Configuration Mode.
AutoLimits are not available for all measurements. The list of measurements for which AutoLimits can
be used is defined in the monitor's Configuration mode.
Use the measurement alarm limits window to check AutoLimits before you apply them to ensure that
they are appropriate for your individual patient and their clinical condition. Once applied, AutoLimits
are shown on the monitor screen just like manually-set alarm limits. If the AutoLimits are not
appropriate for your patient, you must set alarm limits manually. The limits remain unchanged until
you set them again or change them manually.
About Smart Alarm Delays
The monitor can be configured to apply a delay before announcing limit alarms. The delay is calculated
using an intelligent algorithm. This capability can be used to suppress alarms which occur because a
limit is exceeded for a short time or by a small amount. Currently, Smart Alarm Delays are available
only for SpO2 limit alarms and are not available in the U.S.A. or in clinical environments under FDA
control. See the Monitoring SpO2 chapter for details.
1Wide alarm limits
2Narrow alarm limits
3Alarm Limits
4Measurement value
2 Alarms
60
WARNING
Before using Smart Alarm Delays, make sure that you fully understand how the delay is applied and
what the consequences are.
Documenting Alarm Limits
The alarm limits pop-up keys appear with the Alarm Limits and measurement alarm limits windows.
Select the Print Limits pop-up key to print an overview of all alarm limits on a connected printer.
Select the Record Limits pop-up key to send a recording of the alarm limits to a recorder.
Reviewing Alarms
You can see which alarms and INOPs are currently active in the respective alarms and INOPs fields at
the top of the screen.
To see the currently active alarms and INOPs listed in one place, select any of the alarm status areas on
the monitor screen. The Alarm Messages window pops up.
All alarms and INOPs are erased from the Alarm Messages window when you discharge a patient, or
if you change to Demonstration Mode.
Alarm Messages Window
The Alarm Messages window shows all the currently active alarms and INOPs sorted by priority,
beginning at the top with the most recent. INOPs are shown on the left hand side and patient alarms
are shown on the right hand side. Any active red alarms are shown first, followed by yellow alarms.
Acknowledged alarms or INOPs are shown with the check mark symbol.
The Alarm Messages window pop-up keys appear when the window is opened. If alarm pause
extension is disabled, the pause pop-up keys are inactive ("grayed-out"). Selecting the Review Alarms
pop-up key opens the Review Alarms window.
If you do not immediately understand an INOP or alarm message, refer to its help text.
•In the Alarm Messages window, select the INOP message. This calls up a help window with an
explanation of the INOP message and, where appropriate, a suggested solution for the problem.
If the alarm or INOP was generated in a device other than the monitor (for instance, in an MMS
or FMS), this source is specified at the end of the help text.
Review Alarms Window
The Review Alarms window contains a list of the most recent alarms and INOPs with date and time
information.
If configured to do so, each alarm is shown with the alarm limit active when the alarm was triggered
and the maximum value measured beyond this limit. The Review Alarms window also shows when the
monitor was switched on (after being switched off for longer than 1 minute) and any actions related to
switching alarms on and off, entering or leaving Standby mode, silencing alarms or changing the ECG
source.
2 Alarms
61
When you select an item from the list, you can get additional information about that item. If you select
a high or low limit alarm in the list, the Graphical Trends window will open to provide further data. If
you select an alarm resulting from an event alarm notification, the Event Episode window for that
event will open. If you select an alert other than a high or low alarm, a help text window opens with
more information. This is the same as the help text window that opens in the Alarm Messages
window. Some items in the list are simply log items not related to a patient alert as such (for example,
Alarms On or Alarms Off). You cannot see any further information if you select one of these items.
When you close these windows you will return to the Review Alarms window.
The information in the Review Alarms window is deleted when a patient is discharged, and when you
leave Demonstration Mode.
The Review Alarms window pop-up keys appear when the window is opened. If alarm pause
extension is disabled, the pause pop-up keys are inactive. Selecting the Active Alarms pop-up key
opens the Alarm Messages window.
Latching Alarms
The alarm latching setting for your monitor defines how the alarm indicators behave when you do not
acknowledge them. When alarms are set to non-latching, their indicators end when the alarm condition
ends. Switching alarm latching on means that visual and/or audible alarm indications are still displayed
or announced by the monitor after the alarm condition ends. The indication lasts until you
acknowledge the alarm.
Viewing the Alarm Latching Settings
To see the alarm latching setting for your monitor
1In the monitor's Main Setup menu, select Alarms.
2Select Alarm Settings, and see the Visual Latching and Audible Latching settings.
This setting can only be changed in Configuration Mode. You should be aware of the settings chosen
for your unit. There are three possible choices each for visual and audible latching, red, red and yellow,
and off. These choices can be combined to give the following settings:
Visual Latching Audible Latching
Red&Yellow Red&Yellow
Red&Yellow Red Only
Red&Yellow Off
Red Only Red Only
Red Only Off
Off Off
2 Alarms
62
Alarm Latching Behavior
All INOPs are non-latching. See “Yellow Arrhythmia Alarms” on page 136 for information on one-
star yellow alarms latching behavior.
Testing Alarms
When you switch the monitor on, a selftest is started. You must check that the alarms lamps light, one
after the other, and that you hear a single tone. This indicates that the visible and audible alarm
indicators are functioning correctly. For further testing of individual measurement alarms, perform the
measurement on yourself (for example SpO2 or CO2) or use a simulator. Adjust alarm limits and check
that appropriate alarm behavior is observed.
Alarm Behavior at Power On
If the monitor is switched off for longer than one minute and then switched on again (or after a loss of
power lasting longer than one minute, or when a patient is discharged), the monitor can be configured
to:
restore the alarm settings from the monitor's configured default Profile,
restore the most recently used alarm settings, or
switch the alarms off.
After any of these situations, you should check that the alarm settings are appropriate for your patient
and monitoring situation, and if necessary, select the correct Profile and patient category.
If power is lost for less than one minute, the alarm on/off condition prior to the power loss is
restored.
Red & Yellow Measurement
Alarms
Non-latching alarms Visual and audible latching Visual latching, audible
non-latching
Alarm has not
been
acknowledged.
Alarm condition
still present.
Alarm tone on. Alarm lamp on.
Alarm message. Flashing
numerics.
Alarm tone on. Alarm lamp
on. Alarm message. Flashing
numerics.
Alarm tone on. Alarm lamp
on. Alarm message. Flashing
numerics.
Alarm condition
no longer present.
All audible and visual alarm
indicators automatically stop.
Alarm tone on.
Alarm lamp on.
Alarm message.
Flashing numerics.
Alarm message. Flashing
numerics.
Audible alarm indicators
automatically stop.
Alarm has been
acknowledged.
Alarm condition
still present.
Alarm tone off. Alarm lamp off.
Alarm message. Flashing
numerics. Audible alarm
reminder (if configured).
Alarm tone off. Alarm lamp
off. Alarm message. Flashing
numerics. Audible alarm
reminder (if configured).
Alarm tone off. Alarm lamp
off. Alarm message. Flashing
numerics. Audible alarm
reminder (if configured).
Alarm condition
no longer present.
Audible and visual alarm
indicators automatically stop.
Audible and visual alarm
indicators automatically stop.
Audible and visual alarm
indicators automatically stop.
2 Alarms
63
Alarm Recordings
You can set up your monitor so that it automatically triggers alarm recordings at the Information
Center, or if configured, to a printer as a realtime report.
1Press the Main Setup SmartKey.
2Select Alarms from the Main Setup menu.
3Select Alarm Recording from the Alarms menu to open the Alarm Recordings menu.
4Select a measurement from those listed for which you want to change the alarm condition that
triggers an alarm recording. This opens a pop-up list.
5For the desired measurement(s), choose the alarm condition to trigger an alarm recording:
Red Only: an alarm recording will automatically be triggered when the measurement enters a red
alarm condition.
Red&Yellow: both yellow and red alarms will trigger an alarm recording.
Off: disables automatic alarm recording.
Refer to the Recording chapter for details of how to set up a recording.
2 Alarms
64
3
65
3Patient Alarms and INOPs
This chapter lists patient alarms alphabetically, and technical alarms (INOPs) arranged by the source of
the INOP and then alphabetically, irrespective of their priority. All alarms and INOPs are listed here;
the ones which can appear on your monitor will depend on the model and the individual options.
For information on alarms and INOPs from the gas modules refer to your Gas Module Instructions
for Use.
Patient Alarm Messages
The measurement labels and abbreviations for pressure, temperature, SpO2, and anesthetic agent
alarms are explained in the individual chapters.
Some alarms may be shown at the Information Center in shortened form, when transferred through
IntelliVue Instrument Telemetry. These shortened alarm texts are included in the list and identified
with the note "at Information Center".
Note that yellow arrhythmia alarms may be shown with one or with two stars, depending on your
monitor configuration and the Information Center revision you are using.
Refer to your IntelliBridge Device Driver Instructions for Use for patient alarms from connected
external devices.
Refer to your Gas Module Instructions for Use for patient alarms and INOPs from the gas modules.
Alarm Message From Condition Indication
* AFIB
** AFIB
ECG/Arrhythmia Atrial fibrillation waveform detected yellow alarm lamp, short yellow
audible alarm
*** APNEA
*** APNEA x:yy
*** APNEA >10min
CO2, Resp,
Spirometry
Respiration has stopped for longer than the
preset apnea time. "x:yy" denotes the Apnea
duration in minutes and seconds
numeric flashes, red alarm lamp,
alarm tone
*** ASYSTOLE ECG No QRS detected for a period greater than the
asystole threshold (in the absence of Vfib or
chaotic ECG)
numeric flashes, red alarm lamp,
alarm tone
** awRR HIGH CO2, Resp, AGM The airway respiration rate has exceeded the
high alarm limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** awRR LOW CO2, Resp, AGM The airway respiration rate has dropped below
the low alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
3 Patient Alarms and INOPs
66
** BIS HIGH BIS The Bispectral Index value has exceeded the
high alarm limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** BIS LOW BIS The Bispectral Index value has dropped below
the low alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
** CCO HIGH
** CCI HIGH
CCO Continuous Cardiac Output or CC Index is
above the high alarm limit.
numeric flashes and high alarm
limit is highlighted, yellow alarm
lamp, alarm tone
** CCO LOW
** CCI LOW
CCO Continuous Cardiac Output or CC Index is
below the low alarm limit.
numeric flashes and low alarm limit
is highlighted, yellow alarm lamp,
alarm tone
** CPP HIGH CPP The CPP value has exceeded the high alarm
limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** CPP LOW CPP The CPP value has fallen below the low alarm
limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
*** DESAT
*** DESAT xx < yy
SpO2The SpO2 value has fallen below the
desaturation alarm limit. xx denotes the lowest
measured value, and yy is the desaturation limit.
numeric flashes, red alarm lamp,
alarm tone
** EC10 ALARM
*** EC10 ALARM
at Information Center
EC10 Intellibridge A yellow (**) or red (***) patient alarm is
present on the IntelliBridge module. Check the
monitor display for more detailed alarm
information.
(on monitor) yellow or red alarm
lamp; the alarm text is defined by
the Intellibridge device driver
** etCO HIGH CO2, Resp, AGM The end tidal CO2 high alarm limit has been
exceeded.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** etCO LOW CO2, Resp, AGM The end tidal CO2 value has fallen below the
low alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
** etO HIGH O2, AGM The end tidal O2 high alarm limit has been
exceeded.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** etO LOW O2, AGM The end tidal O2 value has fallen below the low
alarm limit.
numeric flashes, and low limit is
highlighted, yellow alarm lamp,
alarm tone
* EVENT
** EVENT
*** EVENT
at Information center
Event surveillance An event has occurred and the event
notification is configured to alarm. Check on
the monitor for more details on event group.
(on monitor) event group name
flashes, yellow or red alarm lamp
and alarm tone
* EVENT:<Event
Group>
** EVENT:<Event
Group>
*** EVENT:<Event
Group>
Event surveillance An event has occurred and the event
notification is configured to alarm.
event group name flashes, yellow or
red alarm lamp and alarm tone
*** EXTREME BRADY ECG The bradycardia limit has been exceeded. numeric flashes and alarm limit is
highlighted, red alarm lamp, alarm
tone
Alarm Message From Condition Indication
3 Patient Alarms and INOPs
67
** HR LOW ECG The heart rate has fallen below the low alarm
limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone. If configured to short
yellow, the sound switches off after
5 seconds if Arrhythmia is switched
on.
* IRREGULAR HR
** IRREGULAR HR
ECG/Arrhythmia Consistently irregular heart rhythm. numeric flashes, yellow alarm lamp,
short yellow audible alarm
* MISSED BEAT
** MISSED BEAT
ECG/Arrhythmia No beat detected for 1.75*R-R interval, or if
HR>120bpm no beat detected for one second
(non-paced patients only).
numeric flashes, yellow alarm lamp,
short yellow audible alarm
* MULTIFORM PVCs
** MULTIFORM PVCs
ECG/Arrhythmia Two differently shaped Vs detected, each
occurring at least twice within the last 300 beats
and at least once within the last 60 beats.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
** NBP HIGH NBP The measured NBP value is above the high
alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** NBP LOW NBP The measured NBP value is below the low
alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
* NON-SUSTAIN VT
** NON-SUSTAIN VT
ECG/Arrhythmia A run of Vs having a ventricular HR>V-Tach
HR limit, but lasting for less than the V-Tach
Run limit has been detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
* PACER NOT CAPT
** PACER NOT CAPT
ECG/Arrhythmia
(paced patients
only)
A missed beat with a pace pulse was detected. numeric flashes, yellow alarm lamp,
short yellow audible alarm
* PACER NT PACING
** PACER NT PACING
ECG/Arrhythmia
(paced patients
only)
A missed beat without a pace pulse was
detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
* PAIR PVCs
** PAIR PVCs
ECG/Arrhythmia A non-ventricular contraction, followed by two
ventricular contractions, followed by a non-
ventricular contraction has been detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
* PAUSE
** PAUSE
ECG/Arrhythmia No beat detected for a period greater than the
pause threshold.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
*** <Press Label> HIGH PRESS The measured pressure value is above the
extreme high alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes, high limit is
highlighted, red alarm lamp, alarm
tone
** <Press Label> HIGH PRESS The measured pressure value is above the high
alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes, high limit is
highlighted, yellow alarm lamp,
alarm tone
Alarm Message From Condition Indication
3 Patient Alarms and INOPs
68
*** <Press Label> LOW PRESS The measured pressure value is below the
extreme low alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes and low limit is
highlighted, red alarm lamp, alarm
tone
** <Press Label> LOW PRESS The measured pressure value is below the low
alarm limit.
s, d, or m after the label indicates whether the
systolic, diastolic or mean pressure has crossed
the limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
** Pulse HIGH PRESS, SpO2The pulse rate has exceeded the high alarm
limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** Pulse LOW PRESS, SpO2The pulse rate has dropped below the low
alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
* PVCs/min HIGH
** PVCs/min HIGH
ECG/Arrhythmia More premature ventricular contractions have
been detected in a minute than the limit.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
** QTc HIGH ECG/QT QTc value has exceeded the QTc high limit for
more than 5 minutes
numeric flashes, yellow alarm lamp,
alarm tone
* R-ON-T PVCs
** R-ON-T PVCs
ECG/Arrhythmia For HR <100, a PVC with R-R interval < 1/3
the average interval followed by a
compensatory pause of 1.25 x average R-R
interval or two such Vs without compensatory
pause occurring within 5 minutes of each other.
(When HR >100, 1/3 R-R interval is too short
for detection.).
numeric flashes, yellow alarm lamp,
short yellow audible alarm
** RR HIGH RESP The respiration rate has exceeded the high
alarm limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** RR LOW RESP The respiration rate has dropped below the low
alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
* RUN PVCs HIGH
** RUN PVCs HIGH
ECG/Arrhythmia A run of PVCs greater than 2 was detected. numeric flashes, yellow alarm lamp,
short yellow audible alarm
** <SO Label> HIGH SvO2/SO2The the measured intravascular oxygen
saturation has exceeded the high limit.
numeric flashes and high alarm
limit is highlighted, yellow alarm
lamp, alarm tone
** <SO Label> LOW SvO2/SO2The measured intravascular oxygen saturation
has fallen below the low limit.
numeric flashes and low alarm limit
is highlighted, yellow alarm lamp,
alarm tone
** <SpO Label> HIGH SpO2The arterial oxygen saturation has exceeded the
high alarm limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** <SpO Label> LOW SpO2The arterial oxygen saturation has fallen below
the low alarm limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
** ST-<n> HIGH ECG/ST The ST elevation in lead <n> is higher than the
limit.
numeric flashes and high alarm
limit is highlighted, yellow alarm
lamp, alarm tone
Alarm Message From Condition Indication
3 Patient Alarms and INOPs
69
** ST-<n> LOW ECG/ST The ST depression in lead <n> is lower than
the limit.
numeric flashes and low alarm limit
is highlighted, yellow alarm lamp,
alarm tone
* SVT
** SVT
ECG/Arrhythmia A run of supraventricular beats greater than the
SVT run limit has been detected and the HR
has exceeded the SVT HR limit.
numeric flashes, yellow alarm lamp,
alarm tone
** Tblood HIGH C.O. The blood temperature value has exceeded the
high alarm limit.
numeric flashes, high alarm limit is
highlighted, yellow alarm lamp,
alarm tone
** Tblood LOW C.O. The blood temperature value has fallen below
the low alarm limit.
numeric flashes, low alarm limit is
highlighted, yellow alarm lamp,
alarm tone
** tcpO HIGH
** tcpCO HIGH
tcGas The tcpO2 or tcpCO2 value has exceeded the
high alarm limit.
numeric flashes, high alarm limit is
highlighted, yellow alarm lamp,
alarm tone
** tcpO LOW
** tcpCO LOW
tcGas The tcpO2 or tcpCO2 value has fallen below
the low alarm limit.
numeric flashes, low alarm limit is
highlighted, yellow alarm lamp,
alarm tone
* TELE ALARM
** TELE ALARM
*** TELE ALARM
Telemetry This is a generic alarm from the telemetry
system. The specific alarm cause is indicated in
the alarm message in the Telemetry Data
Window.
yellow or red alarm lamp and alarm
tone
** <Temp Label> HIGH TEMP The temperature has exceeded the high alarm
limit.
numeric flashes and high limit is
highlighted, yellow alarm lamp,
alarm tone
** <Temp Label> LOW TEMP The temperature has fallen below the low alarm
limit.
numeric flashes and low limit is
highlighted, yellow alarm lamp,
alarm tone
* VENT BIGEMINY
** VENT BIGEMINY
ECG/Arrhythmia A dominant rhythm of N, V, N, V (N =
supraventricular beat, V = ventricular beat) was
detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
*** VENT FIB/TACH ECG A fibrillatory waveform for 4 consecutive
seconds was detected.
numeric flashes, red alarm lamp,
alarm tone
* VENT RHYTHM
** VENT RHYTHM
ECG/Arrhythmia A dominant rhythm of adjacent Vs > vent
rhythm limit and ventricular HR < VTach HR
limit was detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
* VENT TRIGEMINY
** VENT TRIGEMINY
ECG/Arrhythmia A dominant rhythm of N, N, V, N, N, V (N =
supraventricular beat, V = ventricular beat) was
detected.
numeric flashes, yellow alarm lamp,
short yellow audible alarm
*** VTACH ECG, Arrhythmia Ventricular tachycardia has been detected
(Consecutive PVCs exceed V-Tach Run limit
and HR exceeds V-Tach HR limit).
numeric flashes, red alarm lamp,
alarm tone
** VueLink ALARM
*** VueLink ALARM
at Information Center
VueLink A yellow (**) or red (***) patient alarm is
present on the VueLink module. Check the
monitor display for more detailed alarm
information.
(on monitor) yellow or red alarm
lamp; the alarm text is defined by
the VueLink device driver
** ΔQTc HIGH ECG/QT ΔQTc value has exceeded the ΔQTc high limit
for more than 5 minutes
numeric flashes, yellow alarm lamp,
alarm tone
Alarm Message From Condition Indication
3 Patient Alarms and INOPs
70
Technical Alarm Messages (INOPs)
If an INOP interrupts monitoring and alarm detection, the measurement numeric will be replaced
by -?-. If an INOP may lead to unreliable measurement values, a ?appears next to the numeric.
The measurement labels and abbreviations for pressure, temperature, SpO2, and VueLink INOP
messages are explained in the individual measurement chapters.
Monitor INOPs
***BRADY/P xxx<yyy
***BRADY xxx < yyy
Press, SpO2The heart rate from the Pulse signal has fallen
below the bradycardia limit. xxx denotes the
lowest measured value; yyy is the bradycardia
limit.
numeric flashes and alarm limit is
highlighted, red alarm lamp, alarm
tone
***<Pressure>
DISCONNECT
PRESS The pressure is non-pulsatile and the mean
pressure is continuously less than 10mmHg
(1.3kPa). This alarm occurs only with arterial
pres su re s (P, AB P, ART, A o, BA P, FA P, PA P,
UAP, P1, P2, P3, P4).
numeric flashes, red alarm lamp,
alarm tone
**ST MULTI <n>,<n> ECG/ST The ST depression or elevation is outside of
the limit in two or more leads <n> and <n>.
numeric flashes, yellow alarm lamp,
alarm tone
**ST MULTI
at Information Center
ECG/ST The ST depression or elevation is outside of
the limit in two or more leads. Check on the
monitor
(on monitor) numeric flashes,
yellow alarm lamp, alarm tone
***TACHY xxx > yy ECG The tachycardia limit has been exceeded numeric flashes and alarm limit is
highlighted, red alarm lamp, alarm
tone
***TACHY/P xxx>yy
or
***TACHY xxx > yy
Press, SpO2, ECG The tachycardia limit has been exceeded. xxx
denotes the highest measured value; yy is the
tachycardia limit.
numeric flashes, alarm limit is
highlighted, red alarm lamp, alarm
tone
Alarm Message From Condition Indication
INOP Message, Indication What to do
!! CHECK PAIRING
INOP tone
There is a problem with device pairing. Check that the monitor and telemetry device are correctly
paired.
Bad Server Link
INOP tone
1) An MMS with an incompatible software revision is connected to the monitor. This combination
does not allow monitoring, OR
2) You cannot use this combination of monitor, MMS and cable. Switch off the monitor and contact
your service personnel.
CENTRAL: TELE ONLY
INOP tone
System connectivity via telemetry device is limited (No alarms, only local numerics) when in
companion mode and host monitor does not have system connectivity. Only telemetry device
parameters can be displayed at central station.
Check Alarm Lamps
INOP tone
Perform a visual check of the alarm lamp to establish whether there is a problem. Contact your service
personnel to check the internal connections to the alarm lamps.
Check DrugSettings
INOP tone
There was a problem loading the drug settings. Check that the settings are complete and correct.
!!CHECK ECG SOURCE
INOP tone
The telemetry device and the monitor both have valid ECG signals. Unpair the telemetry device and
the monitor if they are no longer used for the same patient.
3 Patient Alarms and INOPs
71
Check Flex Texts
INOP tone
Check the names of the monitor menus, for example the labels for screens, profiles, event or trend
group names, before you resume monitoring. If they are unexpected, there may be a problem with the
monitor software. Contact your service personnel.
Check Keyboard
INOP tone
Perform a visual and functional check of the keyboard. Contact your service personnel.
Check Main Board 2
INOP tone
There is a problem with the second main board in the monitor. Contact your service personnel.
Check Monitor Func
INOP tone
Potential problem with alarm lamps, display or interfaces detected. Contact your service personnel.
Check Monitor Temp
INOP tone
The temperature inside the monitor is too high. Check that the monitor ventilation is not obstructed.
If the situation continues, contact your service personnel.
Check Mouse Device
INOP tone
Perform a visual and functional check of the mouse input device. Contact your service personnel.
Check MSL Voltage
INOP tone
There is a problem with the voltage of the Measurement Link (MSL). Contact your service personnel.
Check Network Conf
INOP tone
The monitor is receiving network topology information from more than one source, e.g. the Database
Server and an Application Server. Contact your service personnel.
Check Screen Res.
INOP tone
The Screen you have selected uses a resolution which is not supported by the display. The monitor will
show a generic Screen instead until you select a different Screen.
Contact your service personnel if you want the Screen deleted from the Profile(s) to avoid this in
future.
Check Settings
INOP tone
If this INOP appears, check the monitor and patient settings before you resume monitoring. If the
settings are unexpected, there may be a problem with the monitor software. Contact your service
personnel.
Check SpeedPoint
INOP tone
Perform a visual and functional check of the SpeedPoint input device. Contact your service personnel.
Check Touch Input
INOP tone
Perform a visual and functional check of the touch input device. Contact your service personnel.
Check Waves
INOP tone
The options purchased with this monitor may not support the number of waves required to show the
selected Screen, so some waves or high resolution trends are missing from the Screen. Select a
different Screen with fewer waves.
Contact your service personnel if you want the Screen deleted from the Profile(s) to avoid this in
future.
CHK ECG Sync Cable
INOP tone
The ECG Sync is detecting an invalid signal, or the ECG Sync cable is disconnected.
Chk IndepDsp Cable The monitor cannot communicate with the D80 Intelligent Display. Check the MSL coupling cable.
The end with the gray connector must be connected to the Intelligent Display.
Chk MSL Connection
INOP tone
Check that the MSL cable is properly connected. If this is the case, try using another MSL cable, to
check if your cable is defective. If this does not help, the device connected via the MSL cable may be
defective, contact your service personnel.
ECG EQUIP MALF T
Numeric is displayed with a -?-
INOP tone
Contact your service personnel.
The ECG in the Telemetry device is faulty.
Internal.Comm.Malf
INOP tone
There is a problem with I2C Bus communication in the monitor. Contact your service personnel.
MCC Reversed
INOP tone
The MSL coupling cable is reversed. Connect the end with the gray connector to the Intelligent
Display.
MCC Unsupported
INOP tone
An MSL coupling cable has been connected to a device which does not support MSL coupling.
INOP Message, Indication What to do
3 Patient Alarms and INOPs
72
Meas. DEACTIVATED An X2 or MP5 has been connected to a host monitor (companion mode) and all derived
measurements have been deactivated and/or measurements with a label conflict. The measurements
can only be reactivated by disconnecting the measurement device from the host monitor.
!!MORE BED ALARMS
!!!MORE BED ALARMS
at Information Center
The monitor is associated with a telemetry device and is sending data to the Information Center via
the telemetry device. There are currently more alarms at the bedside than can be transmitted to the
Information Center.
MSL Power High The power consumption of the devices connected to the Measurement Link (MSL) cable is too high.
If this situation continues, the MSL will be switched off. Contact your service personnel.
MSL Power Off
INOP tone
The power consumption of the devices connected to the Measurement Link (MSL) cable was too high
for too long and the MSL has been switched off. Contact your service personnel.
MSL Power Overload
INOP tone
The power consumption of the devices connected to the Measurement Link (MSL) cable is much too
high or there has been a short circuit. The MSL has been switched off. Contact your service personnel.
No Central Monit.
INOP tone
There is a problem with the communication to the network. Central monitoring is currently not
possible (no patient alarms or information). Check the connection. In case the connection is via a
telemetry device, the current telemetry use model does not support central monitoring. Contact your
service personnel.
NO ECG AT CENTRAL The ECG measured with the monitor ECG is not being sent to the Information Center via the
telemetry device.
Rem.AlarmDev.Malf.
INOP tone
There is a problem with the connection to the remote alert device. Contact your service personnel to
check the remote alert device and its connections.
Settings Malfunc.
INOP tone
The monitor cannot use the predefined settings for monitoring. Contact your service personnel.
Speaker Malfunct. Contact your service personnel to check the speaker and the connection to the speaker.
SRR INTERFERENCE
INOP tone
The short range radio connection has interference from another device. Try using another channel.
SRR INVALID CHAN
INOP tone
The channel configuration of the Short Range Radio is invalid. Check channel and channel mask
configuration.
SRR MALFUNCTION Malfunction in the short range radio device. If the INOP persists contact your service personnel.
TAAP DISABLED
INOP tone
The currently selected telemetry configuration on the monitor does not allow connection of telemetry
devices to the monitor.
TELE CONFIG UNSUPP
INOP tone
Telemetry device not supported (companion mode)
TELE EQUIP MALF
INOP tone
The telemetry device has a malfunction. Disconnect and reconnect the telemetry device. If the INOP
reappears, replace the telemetry device.
TELE INCOMPATIBLE SRR-enabled telemetry device is not supported by this central software revision. Please check
configuration.
TELE UNSUPPORTED
INOP tone
This telemetry device is not supported for direct connection to the monitor.
TimeExpired:<Timer
Label>
INOP tone
The time has expired for the timer indicated in the INOP text. Clearing the timer clears the INOP.
Unsupported LAN
INOP tone
There is a problem with the communication to the network and central monitoring is currently not
possible. Check the connection. If the INOP persists, switch off the monitor and contact your service
personnel.
User I/F Malfunct.
INOP tone
Perform a visual and functional check of all the monitor input devices. Contact your service personnel.
INOP Message, Indication What to do
3 Patient Alarms and INOPs
73
Battery INOPs
INOP Message, Indication What to do
Batt 1 MISSING
Batt 2 MISSING
INOP tone
During this INOP, alarms cannot
be paused or switched off.
The monitor requires two batteries but can detect only one battery. Insert the missing battery
immediately.
Batt EMPTY
INOP tone, battery LED flashes
During this INOP, alarms cannot
be paused or switched off.
The estimated remaining battery-powered operating time is less than 10 minutes. Replace the battery
immediately.
If the condition persists and the monitor is not connected to mains power, this INOP is re-issued two
minutes after you acknowledge it.
BATT EXTENSN MALF
INOP tone
There is a hardware error in the Battery Extension. Contact your service personnel.
Batt INCOMPAT.
INOP tone
The battery cannot be used with this monitor. Replace with the correct battery (M4607A).
Batt LOW
INOP tone
The estimated battery-powered operating time remaining is less than 20 minutes.
Batt MALFUNCTION
INOP tone, battery LED flashes
During this INOP, alarms cannot
be paused or switched off unless
the monitor is connected to
mains power.
The monitor cannot determine the battery status. If this INOP persists, replace the faulty battery. If
the condition persists and the monitor is not connected to mains power, this INOP is re-issued two
minutes after you acknowledge it.
Place the battery in a different monitor or in a battery charger. If the same INOP is shown, contact
your service personnel.
BATTERIES EMPTY
Batt 1 EMPTY
Batt 2 EMPTY
INOP tone, battery LED flashes
During this INOP, alarms cannot
be paused or switched off.
The estimated remaining battery-powered operating time of the indicated battery or batteries is less
than 10 minutes. Replace the batteries immediately.
If the condition persists and the monitor is not connected to mains power, this INOP is re-issued two
minutes after you acknowledge it.
BATTERIES INCOMPAT
Batt 1 INCOMPAT.
Batt 2 INCOMPAT.
INOP tone
The indicated battery or batteries cannot be used with this monitor. Replace with the correct battery or
batteries as specified in this book.
BATTERIES LOW
Batt 1 LOW
Batt 2 LOW
INOP tone
The estimated battery-powered operating time remaining is less than 20 minutes.
BATTERIES MALFUNC.
Batt 1 MALFUNCTION
Batt 2 MALFUNCTION
INOP tone, battery LED flashes
During this INOP, alarms cannot
be paused or switched off unless
the monitor is connected to
mains power.
The monitor cannot determine the battery status. If this INOP persists, replace the faulty battery or
batteries. If the condition persists and the monitor is not connected to mains power, this INOP is re-
issued two minutes after you acknowledge it.
Place the batteries in a different monitor or in a battery charger. If the same INOP is shown, contact
your service personnel.
Charge Batt 1 Now
Charge Batt 2 Now
INOP tone
Battery must be charged. Connect the monitor to mains power or exchange the battery.
CHARGER MALFUNC.
INOP tone, battery LED may
flash
There is a problem with the battery charger in the monitor. Connect the monitor to mains power and
contact your service personnel.
3 Patient Alarms and INOPs
74
MMS, MMS Extensions and FMS INOPs
CHECK BATT TEMP
INOP tone
The temperature of one or both batteries is too high. Check that ventilation openings (if applicable)
are not blocked and monitor is not exposed to heat.
Chk MSL Connection Check the MSL connection between X2/MP2 and the battery extension for damage or loose
connections. Check also if a second X1 or X2 has been connected accidentally (e.g. in companion
mode).
ExtBat EMPTY The estimated battery-powered operating remaining time is less than 10 minutes. Replace the battery in
the battery extension immediately.
ExtBat INCOMPAT. The battery in the battery extension cannot be used.
ExtBat LOW The estimated battery-powered operating time remaining is less than 20 minutes.
ExtBat MALFUNCTION The monitor cannot determine the status of the battery in the battery extension. If this INOP persists,
replace the faulty battery in the battery extension. If the condition persists and the monitor is not
connected to mains power or a host monitor, this INOP is re-issued two minutes after you
acknowledge it.
ExtBat MISSING There is no battery in the Battery Extension
!!INSERT BATTERY
Severe yellow INOP tone
During this INOP, alarms cannot
be paused or switched off.
X2/MP2 only: There is no battery in the battery compartment. You cannot operate the monitor on
AC mains while the battery compartment is open (not sealed with a battery). Load a battery
immediately.
MSL Power High The power consumption of the devices connected to the Battery Extension is too high. If this
situation continues, the Battery Extension will be switched off. Contact your service personnel.
MSL Power Off The power consumption of the devices connected to the Battery Extension was too high for too long.
The Battery Extension has been switched off. Contact your service personnel.
INOP Message, Indication What to do
INOP Message, Indication What to do
FMS UNPLUGGED
INOP tone
Make sure that the Flexible Module Rack is connected to the monitor. All FMS measurements are off
while the FMS is unplugged.
FMS UNSUPPORTED
INOP tone
The Flexible Module Rack is not supported by your monitor. Contact your service personnel.
MEASSRV UNSUPPORTD
INOP tone
The Multi-Measurement module is not supported by the monitor. Contact your service personnel.
MMS Ext. UNPLUGGED
INOP tone
The MMS extension has been disconnected from the Multi-Measurement Module.
MMS Ext. Unpowered
INOP tone
The MMS extension cannot operate while the Multi-Measurement Module is running on battery
power.
MMS Ext.EQUIP MALF
INOP tone
Loss of communication between the Multi-Measurement Module and the MMS extension. Contact
your service personnel.
MMS UNPLUGGED
INOP tone
Make sure that the Multi-Measurement Module is connected to the monitor. All MMS measurements
are off while the MMS is unplugged.
3 Patient Alarms and INOPs
75
Display INOPs
ECG, Arrhythmia, QT and ST INOPs
MMS UNSUPPORTED
INOP tone
The Multi-measurement Module is not supported by your monitor. Contact your service personnel.
MMSExt.Unsupported
INOP tone
The MMS extensions not supported by your monitor. Contact your service personnel.
NO PPV FROM FMS The measurement device does not supply a beat-to-beat arterial pressure value. Contact your service
personnel.
NO PPV FROM MMS The measurement device does not supply a beat-to-beat arterial pressure value. Contact your service
personnel.
INOP Message, Indication What to do
INOP Message, Indication What to do
Indep.Dsp Malfunc. There is a problem with the Independent Display. Check the MSL coupling cable then contact your
service personnel.
Indep.Dsp NotSupp. The monitor does not support a second main display. The monitor software is incompatible. Contact
your service personnel.
Intell.Dsp Malf. There is a problem with the Intelligent Display. Check the MSL coupling cable then contact your
service personnel.
Intell.Dsp Missing The monitor has lost contact with the connected Intelligent Display. Contact your service personnel.
Intell.Dsp Unsupp. The monitor does not support the connected Intelligent Display. The monitor software is
incompatible.
INOP Message, Indication What to do
C LEAD OFF
HR Numeric is replaced by -?-
for 10 seconds.
INOP tone
The C electrode (AAMI: V electrode) has become detached from the patient or the lead set has been
changed. Reattach the electrode or select New Lead Setup in the Setup ECG menu to confirm the
new lead set.
CANNOT ANALYZE ECG The arrhythmia algorithm cannot reliably analyze the ECG data. Check the ECG signal quality of the
selected primary and secondary leads. If necessary, improve lead position or reduce patient motion.
If you have arrhythmia analysis on, and you are not getting a reliable HR because the signal is below a
minimum amplitude, unstable, or contains artifact, and you have tried to improve the system
performance by choosing another lead and changing electrodes, you should consider turning
arrhythmia analysis off.
CANNOT ANALYZE QT The QT algorithm cannot generate a valid QT value for more than 10 minutes, or 1 minute in the
initial phase.
CANNOT ANALYZE ST The ST algorithm cannot generate a valid ST value. Possible causes are large variations in the measured
ST values for consecutive beats, or ventricular paced beats. Review the ECG signal quality and the ST
measurement points.
If the patient has a ventricular pacemaker, ST analysis is not possible.
ECG EL. NOISY <ECG
Lead>
The ECG signal from the named ECG electrodes [RA, LA, LL, RL, V (or C)] is noisy. Check the ECG
connections and make sure that the electrode indicated is attached.
ECG EQUIP MALF
Numeric is replaced by -?-
INOP tone
Contact your service personnel.
The ECG hardware is faulty.
3 Patient Alarms and INOPs
76
Pulse INOPs
<ECG Lead> LEAD OFF
!! <ECG Lead> LEAD OFF
!!! <ECG Lead> LEAD OFF
Numeric is replaced by -?-
INOP tone
Not all the required leads for ECG monitoring are connected. Check the ECG connections and make
sure that the electrode indicated by <ECG lead> [RA, LA, LL, RL, V or C] electrodes is attached. In
EASI mode, all 5 electrodes must be connected.
ECG LEADS OFF
!! ECG LEADS OFF
!!!ECG LEADS OFF
Check that all of the required ECG leads are attached, and that none of the electrodes have been
displaced.
ECG NOISY SIGNAL
INOP tone
The ECG signal is too noisy. Check that the electrodes are properly placed and have not dried out.
Remove any possible sources of signal noise (such as power cords) from the area around the cable and
the patient.
The ECG signal may be saturated or overloaded.
!!ECG/AR ALARM OFF All ECG alarms have been switched off, or the HR alarm source is not ECG. To resume ECG alarm
generation, switch ECG alarms on or select ECG as the alarm source.
ECG/ARRH ALARM OFF
!!ECG/AR ALARM OFF
All ECG alarms have been switched off, or the HR alarm source is not ECG. To resume ECG alarm
generation, switch ECG alarms on or select ECG as the alarm source.
EcgOut EQUIP MALF
INOP tone
There is a problem with the device connected to the ECG Out connector. Contact your service
personnel.
LA LEAD OFF
Numeric is replaced by -?- for 10
seconds.
INOP tone
The LA electrode has become detached from the patient or the lead set has been changed. Reattach
the electrode or select New Lead Setup in the Setup ECG menu to confirm the new lead set.
LL LEAD OFF
Numeric is replaced by -?- for 10
seconds.
INOP tone
The LL electrode has become detached from the patient or the lead set has been changed. Reattach the
electrode or select New Lead Setup in the Setup ECG menu to confirm the new lead set.
RA LEAD OFF
Numeric is replaced by -?-
INOP tone
The RA electrode has become detached from the patient or the lead set has been changed. Reattach
the electrode or select New Lead Setup in the Setup ECG menu to confirm the new lead set.
RL LEAD OFF
Numeric is replaced by -?- for 10
seconds.
INOP tone
The RL electrode has become detached from the patient or the lead set has been changed. Reattach
the electrode or select New Lead Setup in the Setup ECG menu to confirm the new lead set.
SOME ECG ALRMS OFF This message appears (if configured to do so) when the on/off settings of the yellow arrhythmia
alarms differ from the current Profile.
V LEAD OFF
Numeric is replaced by -?- for 10
seconds.
INOP tone
The V electrode (IEC: C electrode) has become detached from the patient or the lead set has been
changed. Reattach the electrode or select New Lead Setup in the Setup ECG menu to confirm the
new lead set.
INOP Message, Indication What to do
INOP Message, Indication What to do
PULSE NO ALARMING
Numeric is replaced by -?-
INOP tone
Pulse has no alarming because the system pulse is measured by an external device. Select another pulse
source to enable pulse alarming.
3 Patient Alarms and INOPs
77
Resp INOPs
NBP INOPs
INOP Message, Indication What to do
Resp EQUIP MALF
Numeric is replaced by -?-
INOP tone
Contact your service personnel. The RESP hardware is faulty.
Resp ERRATIC
Numeric is replaced by -?-
The monitor has detected too many artifacts in the measured Resp signal. Check that the RA and LL
electrodes are correctly attached and have not dried out.
Resp LEADS OFF
Numeric is replaced by -?-
INOP tone
Not all the required leads for Resp monitoring are attached. Make sure that the RA and LL leads are
attached.
INOP Message, Indication What to do
!! CUFF NOT DEFLAT
!!!CUFF NOT DEFLAT
Numeric is displayed with a -?-
Severe yellow/red INOP tone
During this INOP, alarms cannot
be paused or switched off.
Remove the cuff from the patient. Make sure that the tubing is not kinked or twisted and that the
correct patient category is selected. Try repeating the measurement.
You can silence the INOP, but the INOP message remains visible until the next NBP measurement is
started or the Stop All SmartKey is selected.
[Adult or pediatric patients: The NBP cuff pressure has exceeded 15 mmHg (2kPa) for more than 3
minutes.
Neonatal patients: The NBP cuff pressure has exceeded 5mmHg (0.7kPa) for more than 90 seconds.]
!! CUFF OVERPRESS
!!!CUFF OVERPRESS
Numeric displayed with -?-
Severe yellow/red INOP tone
During this INOP, alarms cannot
be paused or switched off.
The NBP cuff pressure exceeds the overpressure safety limits. Remove the cuff from the patient. Make
sure that the tubing is not kinked or twisted and that the correct patient category is selected. Try
restarting the measurement.
You can silence this INOP, but the INOP message remains visible until the next measurement is
started or the Stop All SmartKey is selected.
NBP DEACTIVATED
INOP tone
The NBP measurement label in the measurement device has been deactivated by deactivating the label
in the Measurement Selection window. The measurement automatically disappears from the
display. To switch the measurement on again, reactivate the measurement label in the Measurement
Selection window.
NBP EQUIP MALF
Numeric is replaced by -?-
INOP tone
Remove the cuff from the patient. The NBP hardware is faulty. Contact your service personnel.
You can silence this INOP, but the INOP message remains visible until the next measurement is
started or the Stop All SmartKey is selected.
NBP INTERRUPTED
Numeric is replaced by -?-
INOP tone
Check the tubing and cuff for leakages or kinks. Check that you are using the correct cuff size and
placement, and that the correct patient category is selected. Try restarting the measurement.
If the INOP occurs repeatedly, contact your service personnel.
You can silence this INOP, but the INOP message remains visible until the next measurement is
started or the Stop All SmartKey is selected.
This INOP arises when the measurement needed longer than the maximum time for inflation,
deflation or the total measurement.
NBP MEASURE FAILED
Numeric may be displayed with a
-?-
INOP tone
Check that you are using the correct cuff size and placement, and that the correct patient category is
selected. Try restarting the measurement.
You can silence this INOP, but the INOP message remains visible until the next measurement is
started or the Stop All SmartKey is selected.
Check the condition and suitability of the patient for NBP monitoring. Use another cuff to continue
measuring.
3 Patient Alarms and INOPs
78
Temperature INOPs
INOP Message, Indication What to do
T1, T2, T3, T4 INOPs See <Temp Label> INOPs
Tamb INOPs See <Temp Label> INOPs
Tart INOPs See <Temp Label> INOPs
Tcereb INOPs See <Temp Label> INOPs
Tcore INOPs See <Temp Label> INOPs
<Temp Label>
DEACTIVATED
INOP tone
A Temp measurement label in the measurement device has been deactivated, either by connecting a
Pressure transducer in the shared Press/Temp socket, or by deactivating the label in the
Measurement Selection window.
The measurement automatically disappears from the display.
To switch the measurement on again, either reconnect a Temp transducer or reactivate the
measurement label in the Measurement Selection window.
<Temp Label> EQUIP
MALF
Numeric is replaced by -?-
INOP tone
Contact your service personnel.
The temperature hardware is faulty.
<Temp Label> NO
TRANSDUC
Numeric is replaced by -?-
INOP tone
Make sure the TEMP probe is connected to the MMS or module.
If you silence this INOP, the measurement will be switched off.
<Temp Label>
OVERRANGE
Numeric is replaced by -?-
INOP tone
Try changing the application site of the transducer.
[The temperature is less than -1°C, or greater than 45°C.]
<Temp Label>
UNPLUGGED
INOP tone
A Temp measurement label has been deactivated, either by unplugging a module, or by deactivating
the label in the Measurement Selection window.
The measurement automatically disappears from the display.
To switch the measurement on again, either replug the module or reactivate the measurement label in
the Measurement Selection window.
Tesoph INOPs See <Temp Label> INOPs
Tnaso INOPs See <Temp Label> INOPs
Trect INOPs See <Temp Label> INOPs
Tskin INOPs See <Temp Label> INOPs
Ttymp INOPs See <Temp Label> INOPs
Tven INOPs See <Temp Label> INOPs
Tvesic INOPs See <Temp Label> INOPs
3 Patient Alarms and INOPs
79
SpO2 INOPs
INOP Message, Indication What to do
<SpO Label>
DEACTIVATED
INOP tone
The SpO2 measurement label in the measurement device has been deactivated by deactivating the label
in the Measurement Selection window. The measurement automatically disappears from the
display. To switch the measurement on again, reactivate the measurement label in the Measurement
Selection window.
<SpO Label> EQUIP MALF
Numeric is replaced by -?-
INOP tone
The MMS or module is faulty. Unplug and replug the MMS or module. If the INOP persists, contact
your service personnel.
<SpO Label> ERRATIC
Numeric is replaced by -?-
INOP tone
Check the sensor placement. Try another adapter cable and sensor. If the INOP persists, contact your
service personnel.
<SpO Label>
EXTD.UPDATE
Numeric is replaced by -?-
(questionable numeric)
The update period of displayed values is extended due to an NBP measurement on the same limb or
an excessively noisy signal.
<SpO Label>
INTERFERNCE
Numeric is replaced by -?-
INOP tone
There is too much interference, caused by a high level of ambient light and/or electrical interference.
Cover the sensor to minimize ambient light. If the INOP persists, make sure that the sensor cable is
not damaged or positioned too close to power cables.
<SpO Label> LOW PERF
Numeric is replaced by -?-
(questionable numeric)
Accuracy may be compromised due to very low perfusion. Stimulate circulation at sensor site. If INOP
persists, change the measurement site.
<SpO Label> NO SENSOR
Numeric is replaced by -?-
INOP tone
Make sure the SpO2 sensor is connected. If the INOP persists, try another adapter cable and sensor. If
you silence this INOP, the measurement will be switched off.
<SpO Label> NOISY SIGN.
Numeric is replaced by -?-
INOP tone
Excessive patient movement or electrical interference is causing irregular pulse patterns. Try to reduce
patient movement or to relieve the cable strain on the sensor.
<SpO Label> NON-
PULSAT.
Numeric is replaced by -?-
INOP tone
Check the perfusion at measurement site. If necessary, stimulate circulation or change measurement
site. If the INOP is due to NBP measurement on the same limb, wait until the NBP measurement is
finished.
<SpO Label> POOR
SIGNAL
Numeric is replaced by -?-
(questionable numeric)
The signal condition of the SpO2 measurement is poor and measurement accuracy may be
compromised.
<SpO Label> PULSE?
Numeric is replaced by -?-
INOP tone
The detectable pulsations of the SpO2 signal are outside the specified pulse rate range.
<SpO Label> SEARCHING
Numeric unavailable
SpO2 is analyzing the patient signal to derive Pulse, SpO2 and Perf values. Please wait until the search
analysis is complete.
<SpO Label> SENSOR
MALF
Numeric is replaced by -?-
INOP tone
The SpO2 sensor or adapter cable is faulty. Try another adapter cable and sensor. If the INOP persists,
contact your service personnel.
3 Patient Alarms and INOPs
80
Pressure INOPs
<SpO Label> SENSOR
OFF
Numeric is replaced by -?-
INOP tone
The SpO2 sensor is not properly applied to the patient. Apply the sensor following the instructions
supplied by the manufacturer.
<SpO Label>
UNKN.SENSOR
Numeric is replaced by -?-
The connected sensor or adapter cable is not supported by the SpO2 measurement. Use only specified
sensors and cables.
<SpO Label>
UNPLUGGED
Numeric is replaced by -?-
INOP tone
An SpO2 measurement label has been deactivated, either by unplugging a module, or by deactivating
the label in the Measurement Selection window.
The measurement automatically disappears from the display.
To switch the measurement on again, either replug the module or reactivate the measurement label in
the Measurement Selection window.
<SpO Label> UPGRADE
Numeric is replaced by -?-
Numeric is unavailable
The SpO2 measurement is currently in upgrade mode. Monitoring is not possible in this mode.
INOP Message, Indication What to do
INOP Message, Indication What to do
ABP INOPs See <Press Label> INOPs
Ao INOPs See <Press Label> INOPs
ART INOPs See <Press Label> INOPs
BAP INOPs See <Press Label> INOPs
CPP CHK SOURCES
Numeric is replaced by -?-
INOP tone
Not all measurements or values required to perform the calculation are available. Check the
measurement sources.
CPP CHK UNITS
Numeric is replaced by -?-
The monitor has detected a conflict in the units used for this calculation. Check the unit settings.
CPP UNPLUGGED With the default profile settings, the CPP measurement is disabled in the adult profile and enabled in
the pediatric and neonatal profiles. When changing from a pediatric or neonatal profile to an adult
profile, this INOP can occur. Enable CPP in the adult profile to clear the INOP.
CVP INOPs See <Press Label> INOPs
FAP INOPs See <Press Label> INOPs
IC1 / IC2 INOPs See <Press Label> INOPs
ICP INOPs See <Press Label> INOPs
LAP INOPs See <Press Label> INOPs
P / P1 / P2 / P3 / P4 INOPs See <Press Label> INOPs
PAP INOPs See <Press Label> INOPs
PPV BAD <Press Label>
SIGNAL
The arterial pressure source selected for PPV is not providing a pulsatile signal.
PPV BAD SIGNAL
at Information Center
The arterial pressure source selected for PPV is not providing a pulsatile signal.
PPV CHK SOURCES The arterial pressure source selected for PPV is unplugged or switched off. When this INOP has
displayed for 1 minute PPV will be switched off.
<Press Label> ARTIFACT
Numeric questionable
A non-physiological event (flush or blood sample) is detected. A resulting limit alarm or non-pulsatile
INOP will be suppressed.
3 Patient Alarms and INOPs
81
<Press Label>
DEACTIVATED
INOP tone
A Pressure measurement label in the measurement device or extension has been deactivated, either by
connecting a Temp transducer in the shared Press/Temp socket, or by deactivating the label in the
Measurement Selection window.
The measurement automatically disappears from the display.
To switch the measurement on again, either reconnect a Pressure transducer or reactivate the
measurement label in the Measurement Selection window.
<Press Label> EQUIP
MALF
Numeric is replaced by -?-
INOP tone
Contact your service personnel.
The pressure hardware is faulty.
<Press Label> NO
TRANSDUCER
Numeric is replaced by -?-
INOP tone
Make sure that the pressure transducer is connected to the measurement device or module.
If you silence this INOP, the measurement will be switched off.
<Press Label> NOISY
SIGNAL
Pulse numeric is replaced by -?-
INOP tone
This INOP can only arise when a pressure is selected as the pulse source. It occurs when the pulse
detector finds a pulse rate above 350bpm. This is usually caused by movement artifact or electrical
interference.
<Press Label> NON-
PULSATILE
Pulse numeric is replaced by -?-
INOP tone
This INOP can only arise when a pressure is selected as the pulse source. It occurs when the pulse rate
being measured is less than 25 beats per minute or the amplitude is less than three mmHg.
Check the catheter and connections to the patient.
<Press Label>
OVERRANGE
Numeric is replaced by -?-
INOP tone
Make sure that the measurement has been properly prepared and zeroed, and that the transducer is
level with the heart. If this INOP persists, try another transducer.
Possible causes are a measured pressure outside the allowed pressure range, or a broken wire to the
transducer.
<Press Label> REDUCE
SIZE
Increase the scale for the pressure wave.
<Press Label>
UNPLUGGED
INOP tone
A Pressure measurement label has been deactivated, either by unplugging a module, or by deactivating
the label in the Measurement Selection window.
The measurement automatically disappears from the display.
To switch the measurement on again, either replug the module or reactivate the measurement label in
the Measurement Selection window.
<Press Label>
ZERO+CHECK CAL
Numeric is replaced by -?-
Perform a zero and check the calibration of the transducer.
RAP INOPs See <Press Label> INOPs
UAP INOPs See <Press Label> INOPs
UVP INOPs See <Press Label> INOPs
INOP Message, Indication What to do
3 Patient Alarms and INOPs
82
CO2 INOPs
INOP Message, Indication What to do
!! CO OCCLUSION
!!! CO OCCLUSION
Numeric is replaced by -?-
INOP tone
The sample line or exhaust tube is blocked. Check the tubing, then disconnect and reconnect the
sample line. If the INOP persists, connect a new sample line.
CO AUTO ZERO
Numeric is replaced by -?-
if the Autozero lasts >15 sec,
INOP tone sounds.
The automatic zero calibration is in progress. This typically takes 10 seconds. During this time the CO2
values may not be updated, or they may be replaced by -?-. Wait until the zero calibration is complete
to resume monitoring.
CO CAL MODE
CO2 numeric displays current
CO2 value for accuracy check
Currently no calibration is running. Accuracy can be checked by placing the transducer on the two cells
of the calstick and starting calibration. To start monitoring, leave Cal. Mode.
CO2 CAL RUNNING
Numeric is replaced by -?-
Wait until calibration is finished.
CO CHECK CAL
Numeric is replaced by -?-
INOP tone
The CO2 value is outside the measurement range. Perform an accuracy check for both calstick cells
and, if necessary, recalibrate the transducer.
CO CHK ADAPTER
Numeric is replaced by -?-
INOP tone
Check that the sensor is connected to the airway adapter, clean the airway adapter, if necessary.
Perform a zero calibration. If the INOP persists, contact your service personnel.
CO DEACTIVATED
INOP tone
The CO2 measurement label in the measurement device has been deactivated by deactivating the label
in the Measurement Selection window. The measurement automatically disappears from the
display. To switch the measurement on again, reactivate the measurement label in the Measurement
Selection window.
CO EQUIP MALF
Numeric is replaced by -?-
INOP tone
The Measurement Extension is faulty. Unplug and replug the Multi-Measurement Module with
Extension. If you are using the mainstream method, unplug and replug the transducer or try another
transducer. If the INOP persists, contact your service personnel.
CO FAILED CAL
Numeric is replaced by -?-
INOP tone
Make sure that the Cal cell was changed between CAL1 and CAL2. Repeat the calibration. If the
INOP reappears, try another transducer. If the INOP persists, contact your service personnel.
CO NO SENSOR
from M3014A
Numeric is replaced by -?-
INOP tone
There is no CO2 sensor connected. If you silence this INOP the CO2 measurement will be switched
off.
CO NO TRANSDUC
from mainstream CO2 (except
M3014A)
Numeric is replaced by -?-
INOP tone
There is no CO2 transducer connected. If you replace the transducer, the new transducer must be
calibrated. If you silence this INOP the CO2 measurement will be switched off.
CO NO TUBING
Numeric is replaced by -?-
INOP tone
Either the sample line is disconnected, or an incorrect line is attached. Check the connection. If
necessary, connect another sample line (Use only the approved accessories).
If you silence this INOP, the measurement will be switched off.
CO OVERRANGE
Numeric is replaced by -?-
INOP tone
The CO2 value is higher than the measurement range. If you suspect a false high value, contact your
service personnel.
CO PUMP OFF
Numeric is replaced by -?-.
The pump has been switched off for fifteen minutes. To switch it on again, select Pump On in the
Setup CO menu.
CO PURGING
Numeric is replaced by -?-
INOP tone
The Filterline is being purged to remove an occlusion in the line or airway adapter. If the occlusion is
removed, the INOP will disappear. If not, the INOP CO OCCLUSION is displayed.
3 Patient Alarms and INOPs
83
SO2 INOPs
CO SENS.WARMUP
Numeric is replaced by -?-
Microstream CO2: INOP tone
Mainstream CO2: no INOP tone
Wait until the sensor reaches operating temperature and the INOP disappears.
CO UPDATE FW
Numeric is replaced by -?-
INOP tone
The software in the Measurement Extension does not match the software in the MMS. Contact your
service personnel.
CO WAIT CAL2
Numeric is replaced by -?-
Calibration on the first calstick cell is complete. Place the transducer on the other calstick cell and start
the CAL2 calibration cycle.
CO ZERO FAILED
Numeric is replaced by -?-
INOP tone
An error occurred during the last zero calibration. Check the airway adapter and clean, if necessary.
Perform another zero calibration. If the INOP persists, contact your service personnel.
CO ZERO REQU'D
Numeric is replaced by -?-
INOP tone
Perform zero calibration for the CO2 sensor. If the INOP persists, contact your service personnel.
COCHANGE SCALE The CO2 wave is clipped. Select a more appropriate wave scale to display the whole wave.
COZERO RUNNING Wait until zero calibration is finished.
INOP Message, Indication What to do
INOP Message, Indication What to do
<SO Label> CAL FAILED
Numeric is replaced by -?-
INOP tone
The calibration failed. Check the catheter-to-Optical-Module connection. Manually restart the
calibration. Try another catheter and Optical Module. If the catheter is already inserted, perform an in-
vivo calibration.
<SO Label> CAL MODE
Numeric is replaced by -?-
INOP tone
Pre-insertion calibration is complete, but the catheter tip is still inside the optical reference. The
catheter is now ready for insertion.
<SO Label> CANNOT
MEAS
Numeric is replaced by -?-
INOP tone
The signal is out of the normal range, and no oxygen saturation can be derived. Perform an in-vivo
calibration. If the INOP persists, try another Optical Module and catheter.
<SO Label> CONN
OPTMOD
Numeric is replaced by -?-
INOP tone
The Optical Module was disconnected during data storage. Reconnect the Optical Module for at least
20 seconds.
<SO Label> EQUIP MALF
Numeric is replaced by -?-
INOP tone
The SO2/SvO2 Module or Optical Module is faulty. Unplug and replug the Optical Module and SO2/
SvO2 module. Exchange the modules. If the INOP persists, contact your service personnel.
<SO Label> INCOMPAT.
INOP tone
The SO2 Module or Optical Module is not supported. Contact your service personnel.
<SO Label> IN-VIVO CAL The in-vivo calibration is not yet complete. Lab values must be stored to the Optical Module to
complete the calibration. Either continue with the next steps of the current calibration or recall the
previous calibration.
<SO Label> LOW LIGHT
Numeric is replaced by -?-
INOP tone
The optical signal levels are too low. Check that the catheter is either in the optical reference or
inserted into the patient. Check the catheter-to-Optical Module connection. If INOP persists, try
another catheter and Optical Module.
<SO Label> NO OPTMOD
Numeric is replaced by -?-
INOP tone
Connect the Optical Module. If the INOP persists, try another Optical Module. Silencing this INOP
switches the measurement off.
3 Patient Alarms and INOPs
84
C.O. INOPs
<SO Label> OPTMOD
MALF
The Optical Module memory is faulty, and calibration data cannot be stored for transport or during
power failure. If this capability is needed, use another Optical Module.
<SO Label> PRE-INS CAL
Numeric is replaced by -?-
INOP tone
The pre-insertion calibration is running. This typically takes one minute. During this time alarms are
switched off. Wait until the calibration is complete.
<SO Label> UNPLUGGED
Numeric is replaced by -?-
INOP tone
Measurement switched on and SO2/SvO2 module unplugged from the rack.
<SO Label> UPGRADE
INOP tone
The SO2 module is currently in upgrade mode.
Monitoring is not possible in this mode.
<SO Label> WARMUP
Numeric is replaced by -?-
The Optical Module has not yet reached the operating temperature. Wait a few minutes until warm-up
is finished.
<SO Label>CAL
REQUIRED
Numeric is replaced by -?-
INOP tone
There is no valid calibration data in the Optical Module. Perform either a pre-insertion or an in-vivo
calibration.
<SO Label>CONFIG
ERROR
Numeric is replaced by -?-
INOP tone
The Optical Module has been configured to SaO2 Mode. Use Change to Venous in the setup
menu to reconfigure to venous saturation mode.
<SO Label>LIGHT INTENS
Numeric is replaced by -?-
INOP tone
The intensity changed considerably since the last light intensity calibration. This may indicate that the
catheter tip is positioned against a blood vessel wall or that there is low blood flow. Reposition the
catheter (and perform a Light Intensity Calibration).
INOP Message, Indication What to do
INOP Message, Indication What to do
C.O. DEACTIVATED
INOP tone
The Cardiac Output measurement label in the measurement device has been deactivated by
deactivating the label in the Measurement Selection window. The measurement automatically
disappears from the display. To switch the measurement on again, reactivate the measurement label in
the Measurement Selection window.
C.O. EQUIP MALF
Numeric is replaced by -?-
INOP tone
There is a problem with the C.O. hardware. Contact your service personnel.
C.O. UNPLUGGED
Numeric is replaced by -?-
INOP tone
Plug in the C.O. module. Silencing this INOP switches off the measurement.
CCI NO BSA
CCI numeric unavailable
INOP tone
CCI cannot be calculated because the patient's body surface area is unknown. Enter the patient weight
and height to provide the BSA for CCI calculation.
CCO BAD PRESS SIGN
Numeric is replaced by -?-
INOP tone
The arterial pressure wave can currently not be used for pulse contour calculation for CCO or CCI
measurement. Possible causes are air bubbles in the tubing or a physiological condition, for example
severe arrhythmia.
CCO NO CALIBRATION
Numeric is replaced by -?-
The CCO measurement is currently not calibrated.
CCO NO <Press Label>
Numeric is replaced by -?-
INOP tone may sound
CCO/CCI cannot be calculated. Make sure that the pressure chosen in the Setup CCO menu under
CCO From matches the pressure measured with the arterial catheter for CCO measurement. A
pressure from an external device cannot be used. Select another pressure label, either ABP, Ao, ART,
BA P, FA P, or UAP.
3 Patient Alarms and INOPs
85
CCO NO PRESS
at Information Center
CCO/CCI cannot be calculated. Make sure that the pressure chosen in the Setup CCO menu under
CCO From matches the pressure measured with the arterial catheter for CCO measurement. A
pressure from an external device cannot be used. Select another pressure label, either ABP, Ao, ART,
BA P, FA P, or UAP.
CCO NOT SUPPORTED
Numeric is replaced by -?-
INOP tone
A catheter for transpulmonary C.O. measurements has been unplugged and replaced with a Right
Heart C.O. catheter, or the measurement mode has been changed manually. Silencing this INOP
switches the measurement off.
CCO OVERRANGE
CCI OVERRANGE
Numeric is replaced by -?-
INOP tone
The measured CCO or CCI value is not within the specified range for CCO/CCI measurement.
CCO PRESS INVALID
at Information Center
The arterial pressure selected for pulse contour calculation for CCO is available but currently invalid.
Make sure the pressure transducer is connected and the zero calibration is valid.
CCO <Press Label>
INVALID
Numeric is replaced by -?-
INOP tone may sound
The arterial pressure selected for pulse contour calculation for CCO is available but currently invalid.
Make sure the pressure transducer is connected and the zero calibration is valid.
CCO PRESS OVERRANG
Numeric is replaced by -?-
INOP tone
The mean value of the arterial pressure values used for pulse contour calculation for CCO is below 0
mmHg or above 300 mmHg.
CCO PULSE OVERRANG
Numeric is replaced by -?-
INOP tone
The pulse rate of the pressure used for pulse contour calculation for CCO is below 30 bpm or above
240 bpm.
CCO RECALIBRATE
Numeric is replaced by -?-
The most recent CCO or CCI calibration was made over 8 hours ago or the arterial pressure
measurement used for CCO calculation has been zeroed after the CCO calibration was performed.
You should recalibrate CCO or CCI with transpulmonary C.O. measurements at least every 8 hours or
when the hemodynamic condition of the patient has changed. The pressure measurement must be
zeroed before a CCO calibration.
CCO/Tbl NO TRANSD.
Numeric is replaced by -?-
INOP tone
No transducer attached to the module or catheter disconnected.
Tblood NO TRANSDUC
Numeric is replaced by -?-
INOP tone
No transducer attached to the module or catheter disconnected.
Tblood OVERRANGE
Numeric is replaced by -?-
Tblood out of range 17°C - 43°C.
INOP Message, Indication What to do
3 Patient Alarms and INOPs
86
tcGas INOPs
INOP Message, Indication What to do
<tcGas Label> CAL FAILED
Numeric is replaced by -?-
INOP tone
A calibration failed. Check the calibration unit, gas pressure, and tubing connections, then restart the
calibration. If the calibration has failed more than once, remembrane the transducer and restart the
calibration. If this INOP persists, contact your service personnel.
<tcGas Label> CAL
REQUIRD
Numeric is replaced by -?-
INOP tone
Calibration is required before applying the transducer to the patient.
Insert a membraned transducer into the calibration chamber on the module, connect the calibration
unit to the calibration chamber, open the gas valve and start the calibration. If this INOP occurs
during a calibration, there may be a module or transducer malfunction: contact your service personnel.
<tcGas Label> CAL
RUNNING
Numeric displays first -?-, then
numeric is displayed with a ?
Wait until the tcpO2/tcpCO2 calibration is finished.
<tcGas Label> CHANGE
SITE
If Heat Switch Off is
configured to Yes, numeric is
replaced by -?-
INOP tone
Site Timer has timed out. Change the application site to avoid skin burns. To reset the Site Timer,
either calibrate and change the measurement site, or change the measurement site and reset the Site
Timer manually by selecting the appropriate site time from the Setup tcGas menu.
<tcGas Label> CHECK
TIME
Site Timer due to time out in 15 minutes or less.
<tcGas Label> EQUIP
MALF
Numeric is replaced by -?-
INOP tone
There is a malfunction in the transducer or module. Connect another transducer. If this INOP persists,
contact your service personnel.
<tcGas Label> NO
TRANSDUC
Numeric is replaced by -?-
INOP tone
No transducer is connected to the tcpO2/tcpCO2 module. Silencing the alarm switches off the
measurement.
<tcGas Label>
STABILIZING
Numeric is replaced by ?
The transducer has not yet reached the selected temperature and/or skin hyperemization is not yet
finished. This INOP will disappear within three minutes.
<tcGas Label>
UNPLUGGED
Numeric is replaced by -?-
INOP tone
The measurement is switched on but the module is unplugged.
The measurement automatically disappears from the display. Silencing this INOP switches off the
measurement.
3 Patient Alarms and INOPs
87
EEG INOPs
BIS INOPs
INOP Message, Indication What to do
EEG EQUIP MALF
INOP tone
The EEG hardware is faulty. Contact your service personnel.
EEG IMPEDANCE HIGH
EEG1 IMPED. HIGH
EEG2 IMPED. HIGH
The signal electrode in one or both channels exceeds the user-selected impedance limit, or the
impedance of a single electrode exceeds the limit. Check the impedance. If the impedance is too high,
reconnect the electrodes according to the EEG monitoring setup guidelines. If the INOP persists,
contact your service personnel.
EEG LINE NOISE
EEG1 LINE NOISE
EEG2 LINE NOISE
Excessive line noise has been detected in either channel EEG1 or EEG2, or in both EEG channels.
Keep all cables together and away from metallic bodies, other cables & radiated fields.
EEG MUSCLE NOISE
EEG1MUSCLE NOISE
EEG2MUSCLE NOISE
Too much power above 30 Hz has been detected in channel EEG1 or EEG2, or both.
Check the Electrode-to-Skin Impedance and reposition the electrode away from possible muscle
activity, if necessary.
EEG NO TRANSDUC
INOP tone
The trunk cable is disconnected from the EEG plug-in module. Reconnect the trunk cable. Silencing
this INOP switches the measurement off.
EEG UNPLUGGED
INOP tone
Plug in module. Silencing this INOP switches off the measurement.
EEG1 LEAD OFF <n>
EEG2 LEAD OFF <n>
[n = electrode]
Reconnect specified electrode.
EEG1 LEAD OFF
EEG2 LEAD OFF
at Information Center
One or more electrodes are not connected. Check in the EEG Impedance / Montage window on
the monitor which electrode(s) are affected and reconnect the electrodes.
EEG1 LEADS OFF
EEG2 LEADS OFF
Two or more electrodes are not connected. Check in the EEG Impedance / Montage window
which electrodes are affected and reconnect the electrodes.
EEG1 OVERRANGE
EEG2 OVERRANGE
Input signal is too high in one or both channels. This is usually caused by interfering signals such as
line noise or electrosurgery.
INOP Message, Indication What to do
BIS CABLE INCOMPAT
INOP tone
The semi-reusable sensor cable connected is unknown or not supported by your software revision.
Replace it with a Philips-supported sensor cable.
BIS CABLE USAGE
INOP tone
The semi-reusable sensor cable has exceeded the maximum number of uses. Replace the cable.
BIS DSC DISCONN
INOP tone
DSC is not properly connected OR either DSC or BIS engine may be faulty.
Make sure that the DSC is properly connected to the BIS Engine. If INOP persists, replace DSC with
a known good one of the same type.
If INOP persists replace BIS engine.
Silencing this INOP switches the measurement off.
BIS DSC INCOMPT
INOP tone
DSC is not supported by the BIS engine or new DSC connected to an old BIS engine. A software
upgrade may be required. Contact your service personnel.
BIS DSC MALFUNC Electrocautery used during self-test OR malfunction in the DSC hardware.
Make sure not to use electrocautery during the self-test procedure. Disconnect and reconnect the DSC
to the BIS engine. If the INOP persists, replace the DSC or contact your service personnel.
BIS DSC UPDATE
INOP tone
DSC update currently being carried out. This INOP will disappear when the DSC update is finished.
Do not disconnect the DSC during the update. No action is needed.
3 Patient Alarms and INOPs
88
BIS ELECTR. DISC.
INOP tone
One or more electrodes are not connected to the semi-reusable sensor cable. Check all electrode
connections.
BIS ENGINE DISCONN
INOP tone
BIS engine not connected OR Module Cable defective.
Make sure that the Module Cable is properly connected. If INOP persists, replace the Module Cable.
Silencing this INOP switches the measurement off.
BIS ENGINE INCOMPT
INOP tone
BIS engine software is not supported. A software upgrade may be required. Contact your service
personnel.
MP20/30 - BIS engine not supported.
BIS ENGINE MALFUNC
INOP tone
Malfunction in the BIS engine hardware. Disconnect and reconnect the BIS engine. If the INOP
persists, replace BIS engine.
BIS EQUIP MALF
INOP tone
There is a malfunction in the BIS hardware. Unplug and replug the BIS module. If the INOP persists,
contact your service personnel.
BIS HIGH IMPEDANCE
INOP tone may sound
Impedance of one or more electrode(s) is above the valid range, most often caused by bad skin
preparation. Check the sensor montage and press the electrode pads firmly. If this INOP persists,
replace the sensor(s) in question using correct skin preparation.
If INOP persists, contact your service personnel.
BIS IMPEDANCE CHCK
INOP tone may sound
The Cyclic Impedance check is running. It will stop automatically if all impedances are within the valid
range. If any electrodes do not pass the impedance test, check the sensor montage and press the
electrode pads firmly.
To manually stop the Cyclic Impedance Check, select Cyclic Check off in the Setup BIS menu.
BIS ISOELECTRC EEG No discernible EEG activity is detected for longer than one minute.
Check the patient. Check that the electrodes are properly connected.
BIS LEAD OFF
INOP tone may sound
One or more electrodes have no skin contact and therefore impedances cannot be measured. Check
the sensor montage and press the electrode pads firmly.
If this INOP persists, replace the sensor(s) in question, using correct skin preparation.
BIS OVERCURRENT
INOP tone
Unplug and replug the BIS module or, f or the MP20/MP30, disconnect and reconnect the BISx from
the Interface board. If the INOP persists, contact your service personnel.
BIS SENSOR DISCONN
INOP tone
The sensor is not properly connected to the patient interface cable (PIC) and/or the PIC is not
properly connected to the DSC or BISx, or the sensor or PIC or DSC or BISx may be faulty.
Check all the connections.
Disconnect and reconnect the sensor, PIC, DSC, BISx.
If the INOP persists, replace the sensor.
If the INOP persists, replace PIC. If INOP persists, contact your service personnel.
Silencing this INOP switches the measurement off.
BIS SENSOR INCOMPT
INOP tone
Unsupported sensor connected or sensor type unknown or not supported by your software revision.
Replace the sensor, using only Philips supported sensors.
BIS SENSOR MALFUNC
INOP tone
Malfunction in the sensor hardware, most often caused by liquids permeating into the connectors OR
patient interface cable (PIC) or DSC or BISx may be faulty.
Replace the sensor. Manually initiate a Cyclic Impedance Check. Make sure all electrodes pass the test.
Make sure that the both sides of the PIC connector (between PIC and sensor) are dry. If you are not
sure that the connector is dry, replace the PIC until it has dried. If this INOP persists, contact your
service personnel.
BIS SENSOR USAGE
INOP tone
Excessive sensor usage. Replace sensor.
A Cyclic Impedance Check will start automatically.
BIS SQI < 15% (INOP tone)
OR
BIS SQI < 50% (no INOP
tone)
If the signal quality is below 50%, BIS numerics cannot be reliably derived.
If the signal quality is below 15%, no BIS numerics can be derived.
This may occur as a result of artifacts such as those generated from motion or the presence of
electrocautery devices. Make sure the sensor is properly attached to the patient. Manually initiate a
Cyclic Impedance Check. Make sure all electrodes pass the test. Make sure the patient is completely
relaxed (even small motions of the facial muscles affect the signal quality).
INOP Message, Indication What to do
3 Patient Alarms and INOPs
89
Spirometry INOPs
BIS UNPLUGGED
INOP tone
Plug in the BIS module. Silencing this INOP switches off the measurement.
BISx DISCONNECTED
INOP tone
The BISx is not connected to the BIS module or the BIS interface board. Silencing this INOP switches
the measurement off.
BISx INCOMPATIBLE
INOP tone
The BISx software is not compatible with the BIS module or with the MP20/MP30 monitor software.
A software upgrade may be required. Contact your service personnel.
BISx MALFUNCTION
INOP tone
The BISx is faulty. Disconnect and reconnect it to the module or BIS interface board. If the INOP
persists, replace the BISx.
MP20/MP30 - Malfunction on interface board. If the INOP persists, contact your service personnel.
INOP Message, Indication What to do
INOP Message, Indication What to do
AWFCHANGE SCALE Airway flow signal exceeds range of selected scale. Adjust scale to display complete wave.
AWPCHANGE SCALE Airway pressure signal exceeds range of selected scale. Adjust scale to display complete wave.
AWVCHANGE SCALE Airway volume signal exceeds range of selected scale. Adjust scale to display complete wave.
SPIRO ALARMS SUPPR Alarming is suppressed for the spirometry module.
SPIRO CANNOT MEAS Measurement is at its limit, e.g. ambient pressure out of range.
SPIRO GAS COMPENS? Gas compensation is set to Gas Analyzer but not all gases necessary for compensation are
measured by a gas monitor. Some of the fall-back values provided by the user are used. Measurement
accuracy might be reduced.
SPIRO INCOMPATIBLE Module revision not compatible with the host monitor software revision. Contact your service
personnel.
SPIRO MALFUNCTION Module failure detected. Contact your service personnel.
SPIRO NO BREATH No breath was detected for more than 25 seconds. Breath derived numerics are not available.
SPIRO NO SENSOR No sensor detected. Make sure the correct sensor is attached to the breathing circuit.
SPIRO PATIENT CAT. Mismatch of patient size configured in the host monitor and sensor type plugged into the module.
Check the instructions on selecting the correct sensor in the chapter on Spirometry.
SPIRO PURGE FAILED The purge operation could not be completed successfully. Check for kinked sensor tubings, hard
occlusions and make sure that the pump is running and all valves are switching.
SPIRO PURGING A purge operation is in progress - no data update on the screen. Wait until purge is complete.
SPIRO UNKN. SENSOR An unknown sensor ID code was detected. Use only the sensors listed in the Accessories chapter.
SPIRO UPGRADE The module is running a firmware upgrade. Wait until upgrade is completed before resuming
monitoring.
3 Patient Alarms and INOPs
90
VueLink INOPs
IntelliBridge INOPs
INOP Message, Indication What to do
VueLink ALARM
at Information Center
A technical alarm is present on the VueLink module. The INOP text on the monitor is defined by the
VueLink device driver.
<VueLink Option> CHECK
SETUP
INOP tone
No information was received from the external device. The device may be switched off or
disconnected.
VueLink INOP abbreviations may differ slightly depending on the device category.
<VueLink Option> CHK
CABLE
INOP tone
No cable or the wrong cable connected to the VueLink module, or incorrect device selected. Silencing
this INOP switches the measurement off.
VueLink INOP abbreviations may differ slightly depending on the device category.
<VueLink Option> CHK
CONF.
INOP tone
The wrong external device has been selected on the VueLink module, or the external device has not
been correctly setup, or the wrong cable has been used to connect the device to the VueLink module.
VueLink INOP abbreviations may differ slightly depending on the device category.
<VueLink Option> EQUIP
MALF
INOP tone
Malfunction in the VueLink module. If this message appears repeatedly, the module must be replaced.
Contact your service personnel.
VueLink INOP abbreviations may differ slightly depending on the device category.
<VueLink Option> NO
CONFIG
INOP tone
The VueLink module has not been configured during installation. The installation process should be
completed by either your biomedical engineering department or the Philips service engineer.
VueLink INOP abbreviations may differ slightly depending on the device category.
<VueLink Option>
UNPLUGGED
INOP tone
The VueLink module has been unplugged from the rack, or the whole rack has been disconnected.
The measurement automatically disappears from the display. Silencing this INOP switches off the
measurement.
VueLink INOP abbreviations may differ slightly depending on the device category.
INOP Message, Indication What to do
DEVICE CHECK CONF.
INOP tone
Device identification completed, but communication could not be established due to error.
IntelliBridge INOP abbreviations may differ slightly depending on the device category.
DEVICE CHECK SETUP
INOP tone
Device identification completed, but communication could not be established due to timeout.
IntelliBridge INOP abbreviations may differ slightly depending on the device category.
DEVICE DEMO DATA
INOP tone
The device connected to the IntelliBridge module reports demo data but the monitor is not in DEMO
mode.
DEVICE REAL DATA
INOP tone
The monitor is in DEMO mode but the device connected to the IntelliBridge module reports data that
are not flagged as demo data.
DEVICE UNSUPPORTED
INOP tone
Device identification completed, but no appropriate device driver installed.
IntelliBridge INOP abbreviations may differ slightly depending on the device category.
<EC10 / EC40> EQUIP
MALF
INOP tone
Malfunction in the IntelliBridge module. If this message appears repeatedly, the module must be
replaced. Contact your service personnel.
3 Patient Alarms and INOPs
91
Telemetry INOPs
EC10 INOP
!! EC10 INOP
!!! EC10 INOP
at Information Center
A technical alarm is present on the IntelliBridge EC10 module.
On the monitor the indication is a red (!!!), yellow (!!) or cyan alarm lamp (as appropriate) and an INOP
text that is defined by the IntelliBridge EC10 device driver.
<External Device>
UNPLUGGED
INOP tone
The IntelliBridge module has been unplugged from the rack, or the whole rack has been disconnected.
Silencing this INOP switches off the measurement.
IntelliBridge INOP abbreviations may differ slightly depending on the device category.
NO DEVICE DATA Communication with connected device has been lost.
TEXT UPLOAD FAILED
INOP tone
Incoming text from the IntelliBridge modules exceeds the maximum limit. Try unplugging one of the
IntelliBridge modules. If the INOP occurs repeatedly contact your service personnel; a software
upgrade may be necessary.
INOP Message, Indication What to do
INOP Message, Indication What to do
!! REPLACE BATT. T
!!!REPLACE BATT. T
Severe yellow/red INOP tone
During this INOP, alarms cannot
be paused or switched off.
The battery in the telemetry device is almost empty and must be replaced.
!! TELE INOP
!!! TELE INOP
Severe yellow/red INOP tone
Check for further details at the Information Center or in the Telemetry Data window on the monitor.
BATTERY LOW T The battery in the Telemetry device is low and must be replaced soon.
Check ECG Settings
INOP tone
Synchronization of ECG settings between the monitor and Information Center has failed. Check that
the ECG settings in use are appropriate.
!!CHECK ECG SOURCE Both the telemetry device and the monitor have valid ECG signals
Chk SpOT Settings
INOP tone
Synchronization of SpO2T settings between the monitor and Information Center has failed. Check
that the SpO2T settings in use are appropriate.
INVALID LEADSET The leadset plugged in cannot be used with the telemetry device.
LEADSET UNPLUGGED The leadset has been unplugged from the telemetry device.
NO ECG SOURCE A telemetry device is paired with the monitor but the Information Center is not detecting a valid ECG
signal from either of them.
!!TELE DISCONNECT
!!!TELE DISCONNECT
INOP tone
Telemetry transceiver was disconnected or short range radio link was lost.
For cable connections; check Telemetry interface, cable connection and setup.
For short range radio connections: if the telemetry transceiver has not moved out-of-range, check for
interference sources close to the monitor (bluetooth devices, DECT phones, cellular phones,
microwaves, etc.). If this INOP persists, ask your service personnel to survey the interference sources.
Tele Sync Unsupp.
INOP tone
The MMS in use does not support synchronization of ECG and SpO2 settings between the monitor
and central station after a telemetry device has been paired. Use an MMS with revision E.0 or above.
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92
ProtocolWatch INOPs
Calculated Values INOPs
Cableless Measurement Device INOPs
INOP Message, Indication What to do
PW In Conflict There is a patient information mismatch which has not yet been resolved (>15 minutes).
PW: Check Settings Contact your service personnel. Settings could not be loaded or interpreted correctly.
PW:Action Required The protocol currently running requires a user response. Check which pop-up window is displayed and
provide the appropriate response.
INOP Message, Indication What to do
Sp-vO CHK SOURCES
Numeric is replaced by -?-
Not all measurements or values required to perform the calculation are available. Check measurement
sources.
Sp-vO CHK UNITS
Numeric is replaced by -?-
The monitor has detected a conflict in the units used for this calculation. Check the unit settings.
SVR CHK SOURCES
SVRI CHK SOURCES
Numeric is replaced by -?-
Not all measurements or values required to perform the calculation are available. Check measurement
sources.
SVR CHK UNITS
SVRI CHK UNITS
Numeric is replaced by -?-
The monitor has detected a conflict in the units used for this calculation. Check the unit settings.
SVR SET CVP USED
SVRISET CVP USED
A CVP value is required for this calculation, but is not currently being measured. The monitor is using
the CVP value preset in the Setup SVR menu.
ΔSpO CHK SOURCES
Numeric is replaced by -?-
Not all measurements or values required to perform the calculation are available. Check measurement
sources.
ΔSpO CHK UNITS
Numeric is replaced by -?-
The monitor has detected a conflict in the units used for this calculation. Check the unit settings.
ΔTemp CHK SOURCES
Numeric is replaced by -?-
Not all measurements or values required to perform the calculation are available. Check measurement
sources.
ΔTemp CHK UNITS
Numeric is replaced by -?-
The monitor has detected a conflict in the units used for this calculation. Check the unit settings.
INOP Message, Indication What to do
cl NBP Batt Empty The remaining battery time of the NBP Pod is below 30 minutes. Change the battery.
cl NBP Batt Incomp The battery in use with the NBP Pod is incompatible. Replace it with one approved for use with the
NBP Pod.
cl NBP Batt Low The remaining battery time of the NBP Pod is below 2 hours.
cl NBP Batt Malf There is a malfunction in the NBP Pod's battery system. Contact your service personnel.
cl NBP Batt Temp The temperature of the battery in the NBP Pod is critically high. Check that the Pod is not covered or
exposed to a heat source. If the INOP persists, remove the Pod from the patient and contact your
service personnel.
cl NBP Check Batt The battery in the NBP Pod is nearing the end of its useful life. Only 50 charge/discharge cycles
remain. Contact your service personnel to replace the battery.
cl NBP Disconnect The NBP Pod has lost the connection to the monitor.
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93
cl NBP No Cradle The NBP Pod is not in its cradle.
cl NBP Remove The temperature of the battery in the NBP Pod is too high. Remove the Cableless Measurement
Device from the patient and contact service personnel.
cl NBP Serv Batt The battery in the NBP Pod has reached the end of its useful life. It can no longer be charged. Contact
your service personnel to replace the battery.
cl SpO Batt Empty The remaining battery time of the SpO2 Pod is below 30 minutes. Change the battery.
cl SpO Batt Incmp The battery in use with the SpO2 Pod is incompatible. Replace it with one approved for use with the
SpO2 Pod.
cl SpO Batt Low The remaining battery time of the SpO2 Pod is below 2 hours.
cl SpO Batt Malf There is a malfunction in the SpO2 Pod's battery system. Contact your service personnel.
cl SpO Batt Temp The temperature of the battery in the SpO2 Pod is critically high. Check that the Pod is not covered or
exposed to a heat source. If the INOP persists, remove the Pod from the patient and contact your
service personnel.
cl SpO Check Batt The battery in the SpO2 Pod is nearing the end of its useful life. Only 50 charge/discharge cycles
remain. Contact your service personnel to replace the battery.
cl SpO Disconnect The SpO2 Pod has lost the connection to the monitor.
cl SpO No Cradle The SpO2 Pod is not in its cradle.
cl SpO Remove The temperature of the battery in the SpO2 Pod is too high. Remove the SpO2 Pod from the patient
and contact service personnel.
cl SpO Serv Batt The battery in the SpO2 Pod has reached the end of its useful life. It can no longer be charged. Contact
your service personnel to replace the battery.
INOP Message, Indication What to do
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4
95
4Managing Patients
Use the Patient Demographics window and its associated pop-up keys to admit, discharge, and
transfer (ADT) patients.
All patient demographic and ADT information is shared between the patient monitor and the
Information Center, for example, patients admitted to the monitor are automatically admitted to a
connected Information Center.
Note that when an X2 or MP5 monitor is connected to a host monitor, its ability to admit or discharge
a patient is disabled, and the host monitor controls patient demographic and ADT information.
Admitting a Patient
The monitor displays physiological data and stores it in the trends as soon as a patient is connected.
This lets you monitor a patient who is not yet admitted. It is however important to admit patients
properly so that you can identify your patient on recordings, reports, and networked devices.
During admission you enter data that the monitor needs for safe and accurate operation. For example,
the patient category setting determines the algorithm the monitor uses to process and calculate some
measurements, the safety limits that apply for some measurements, and the alarm limit ranges.
NOTE
It is strongly recommended that the same patient data fields be configured to be mandatory at the
monitor and the Information Center.
To admit a patient,
1Select the patient name field or select the Admit/Dischrg SmartKey to open the Patient
Demographics window.
2Clear any previous patient data by selecting the Dischrge Patient or End Case pop-up key and
then Confirm.
If you do not discharge the previous patient, you will not be able to distinguish data from the
previous and current patients, for example, in the trend database.
3Select Admit Patient.
4Enter the patient information: select each field and use the on-screen keyboard or choose from the
pop-up list of alternatives to input information.
If a conventional keyboard or a barcode scanner is connected to the monitor you can use this to
enter patient information.
Last Name: Enter the patient's last name (family name), for example Doe.
First Name: Enter the patient's first name, for example Doe, John.
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Middle Name (if configured to appear): Enter the patient's middle name.
Lifetime Id, Encounter Id: Whether these fields appear and how they are labeled can be
configured for your hospital. One or both fields may be displayed and the labels may read:
MRN, Case Id, Visit Id, or other alternatives. Enter the appropriate data for the fields
displayed.
Patient Cat.: Choose the patient category, either Adult, Pedi, or Neo.
Paced: Choose Yes or No (You must use Yes if your patient has a pacemaker).
Height: Enter the patient's height.
Weight: Enter the patient's weight.
BSA: The monitor calculates the body surface area automatically.
Date Of Birth: Enter the patient's date of birth. Enter this in the form dd/mm/yyyy.
Age: The monitor calculates the patient age automatically.
Gender: Choose Male or Female.
Notes (1) / Notes (2): Enter any extra information about the patient or treatment.
Select Confirm. The patient's name appears on the monitor info line at the top of the screen.
Patient Category and Paced Status
The patient category setting determines the algorithm the monitor uses to process and calculate some
measurements, the safety limits that apply for some measurements, and the alarm limit ranges.
The paced setting determines whether the monitor shows pacemaker pulses or not. When Paced is set
to No, pace pulses are filtered and therefore do not show in the ECG wave.
WARNING
Patient Cat. and Paced status will always contain a value, regardless of whether the patient is fully
admitted or not. If you do not specify settings for these fields, the monitor uses the default settings
from the current profile, which might not be correct for your patient.
Patient category
Changing the patient category may change the arrhythmia and NBP alarm limits. Always check alarm
limits to make sure that they are appropriate for your patient.
Paced status
For paced patients, you must set Paced to Yes. If it is incorrectly set to No, the monitor could mistake
a pace pulse for a QRS and fail to alarm during asystole.
Admitting a Centrally-Monitored Patient
You can admit a patient at either the bedside or the Information Center. When you admit a patient, the
patient's name appears on the bedside monitor and the Information Center.
If you do not fill in all patient information required by the Information Center, the Information Center
may reject the admission. Complete all the required fields and try again to admit the patient.
Quick Admitting a Patient
Use Quick Admit only if you do not have the time or information to fully admit a patient. Complete
the rest of the patient demographic details later.
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1Select the Quick Admit SmartKey.
2Enter the required data (ID fields or last name depending on configuration) with the keyboard or a
barcode scanner.
3Select Enter.
4In the confirmation window, select Confirm to discharge the previous patient (if confirmation is
configured).
5Check that patient category and paced status are correct for the new patient.
If the monitor is connected to an Information Center and only the ID field is entered, the patient name
is set to - - - at the Information Center. Complete the rest of the demographic details as soon as
possible to fully identify the patient on the network, on the monitor and on printed reports. To
complete the details, select Admit Patient again and complete all required fields.
Editing Patient Information
To edit the patient information after a patient has been admitted, select the patient name field on the
Main Screen to open the Patient Demographics window, and make the required changes.
Discharging a Patient
WARNING
Always perform a discharge before starting monitoring for a new patient, even if your previous patient
was not admitted. Failure to do so can lead to data being attributed to the wrong patient.
A discharge:
clears the information in the Patient Demographics window
erases all patient data (such as trend, event, and calculation data) from the monitor,
measurement modules and Information Center. This ensures that data from a previous patient
are not mixed with data from the new patient.
resets patient category and paced settings to the settings defined in the default Profile
resets all monitor and measurement settings as well as the active Screen to the settings defined
in the default Profile
discharges the patient from the Information Center.
When a patient is discharged from the monitor or from an Information Center, all patient data is
deleted. Make sure that you have printed out any required reports before discharging. Check that a
functioning local or central printer is available before you use End Case.
To Discharge a Patient
1Select the patient name field or select the Admit/Dischrg SmartKey to open the Patient
Demographics window and associated pop-up keys.
2Select the pop-up key for either:
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End Case - to print any configured end case reports or vital signs recording, discharge the
patient and clear the patient database, then enter standby mode. If an End Case SmartKey is
configured for your monitor, you can also select this instead and then confirm.
To see which end case reports are set up for your monitor, select Main Setup, Reports, then
Auto Reports. For each auto report, if End Case Report is set to On, this report will be
printed when you select End Case. See “Setting Up Auto Reports” on page 327 for
information on setting up end case reports.
Dischrge Patient - to discharge the patient without printing any reports.
New Patient Check
The monitor can be configured to ask you in certain situations:
after a specified power-off period
after a specified standby period
when no basic vitals (HR, RR, Pulse, SpO2, NBP) have been measured for a specified period
whether a new patient is now being monitored. The pop-up window is entitled Is This A New
Patient?. The monitor offers a Yes key to discharge the previous patient and begin monitoring a new
patient and a No key to continue monitoring with the current patient data and settings.
The time periods for the three conditions can be configured independently.
Transferring Patients
To save you from having to enter the same patient data multiple times and enable patient transfer
without loss of data, information can be shared between Multi-Measurement Modules (MMS), patient
monitors, and Information Centers.
patient demographic information is shared between connected MMSs, patient monitors, and
Information Centers
measurement settings and calibration data can be uploaded from an MMS to a patient
monitor, if configured
trend information can be uploaded from an MMS to a patient monitor, if configured.
Different sets of patient and measurement-related data are stored in the monitor and the Multi-
Measurement Module. Understanding this will help you to understand what happens to patient data
when you transfer patients.
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WARNING
If the monitor is not battery-powered, you cannot monitor during transport.
Transferring a Centrally-Monitored Patient
Scenario: A centrally-monitored patient is moved to another monitoring location on the same
Information Center database server without interrupting the collection of patient trend information.
1Before you disconnect the MMS from the monitor, select the patient name field or select the
Admit/ Dischrge SmartKey to open the Patient Demographics window, then select the Transfer
pop-up key. If the patient is not admitted or not monitored by an Information Center, the
Transfer key is inactive ("grayed-out").
This step preserves the patient's demographic data during the transfer.
2Remove the MMS and any connected extensions from the monitor.
3Connect the MMS to the transfer monitor and monitor your patient during the move.
4At the new location, connect the MMS to the monitor. If the monitor detects a patient mismatch,
a window will open showing your patient's data and asking whether to Complete Transfer Of
This Patient?.
5Select Yes to complete the transfer. This re-admits the patient from the transfer list to the new
monitor. This will upload the patient demographics, and, if configured, the measurement settings
and trend data stored in the MMS to the receiving monitor.
6Verify that the settings for patient category and paced mode are correct.
Patient Information Stored in Monitor Stored in MMS and
extensions
Patient demographics (name,
DOB, patient IDs)
yes yes
Monitor settings (alarm
pause time, alarm volume)
yes no
Measurement settings for all
measurements (alarm limits,
measurement on/off, etc.)
yes yes, for all MMS and extensions
measurements
Trend data yes, for all MMS and extensions
measurements (up to a
maximum of 16 or 32,
depending on your database
configuration)
most recent 8 hours of
information, for all MMS and
extensions measurements
Calculation data (HemoCalc
data)
yes no
Events data yes no
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Transferring a Centrally-Monitored Patient with X2 or MP5
WARNING
Measurements from a MMS extension connected to an X2 are not available when the X2 is running on
battery power. They are only available when the X2 is running on external power, either when
connected to a host monitor or the external power supply (M8023A).
Scenario: A centrally-monitored patient is moved to another monitoring location on the same
Information Center database server without interrupting the collection of patient trend information.
1Before you disconnect the X2/MP5 from the host monitor, select the patient name field or select
the Admit/ Dischrge SmartKey to open the Patient Demographics window, then select the
Transfer pop-up key. If the patient is not admitted or not monitored by an Information Center,
the Transfer key is inactive ("grayed-out").
This step preserves the patient's demographic data during the transfer.
2Remove the X2/MP5 and any connected extensions from the monitor.
3Move the patient using the X2/MP5 as the transport monitor.
4At the new location, connect the X2/MP5 to the new host monitor. If the monitor detects a
patient mismatch, a window will open showing your patient's data and asking Complete Transfer
Of This Patient?.
5Select Yes to complete the transfer. This re-admits the patient from the transfer list to the new
monitor. This will upload the patient demographics, and, if configured, the measurement settings
and trend data stored in the X2/MP5 to the receiving monitor.
6Verify that the settings for patient category and paced mode are correct.
Transferring a Centrally-Monitored Patient with X2 or MP5 using IIT
WARNING
Measurements from a MMS extension connected to an X2 are not available when the X2 is running on
battery power. They are only available when the X2 is running on external power, either when
connected to a host monitor or the external power supply (M8023A).
Scenario: A centrally-monitored patient is moved with an X2 or MP5 to another monitoring location
on the same Information Center database server without interrupting the collection of patient trend
information. The X2/MP5 has an IntelliVue Instrument Telemetry interface (IIT), is connected to a
host monitor, and is declared as a telemetry device at the Information Center.
NOTE
The Transfer key is not available while the X2/MP5 is connected to a host monitor (Companion
Mode is indicated).
1Remove the X2/MP5 and any connected extensions from the host monitor.
2Move the patient using the X2/MP5 as the transport monitor.
3At the new location, just before connecting the X2/MP5 to the new host monitor:
–open the Patient Demographics window.
select the Transfer pop-up key.
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wait until the transfer has completed.
4Connect the X2/MP5 to the new host monitor. The monitor detects a patient mismatch and a
window will open showing your patient's data and asking Complete Transfer Of This Patient?.
5Select Yes to complete the transfer. This re-admits the patient from the transfer list to the new
monitor. This will upload the patient demographics, and, if configured, the measurement settings
and trend data stored in the X2/MP5 to the receiving monitor.
6Verify that the settings for patient category and paced mode are correct.
If you accidentally transfer a patient, use Re-Admit to restore this patient's data to the Information
Center. If you are not connected to the network, select Clear Transfer to leave transfer mode. The
patient data remains in the monitor.
Transferring a Patient with an X1 (no Information Center)
Scenario: A patient is moved to another monitoring location using a transport monitor and re-admitted
at the new monitor.
1Disconnect the X1 from the original monitor and silence the resulting UNPLUGGED INOP.
If you are sure that the patient will not be returning to this monitor, you should perform a
discharge or end-case. This prevents data from the next patient accidentally being mixed up with
your current patient's data.
2Connect the X1 to the transport monitor and move the patient.
3At the new monitoring location, remove the X1 from the transport monitor and connect it to the
new monitor.
4If prompted, re-admit the patient to the new monitor: in the Select Patient window, select the
patient in the X1 to retain the data in the X1. This will upload the patient demographics, and, if
configured, the measurement settings and trend data stored in the X1 to the monitor. Verify that
the settings for patient category and paced mode are correct.
Transferring a Patient with an X2 or MP5 (no Information Center)
WARNING
Measurements from a MMS extension connected to an X2 are not available when the X2 is running on
battery power. They are only available when the X2 is powered from AC mains, either when connected
to a host monitor or the external power supply (M8023A).
Scenario: A patient is moved to another monitoring location using the X2 or MP5 and re-admitted at
the new monitor.
1Disconnect the X2/MP5 from the original host monitor and silence the resulting UNPLUGGED
INOP.
If you are sure that the patient will not be returning to this monitor, you should perform a
discharge or end-case. This prevents data from the next patient accidentally being mixed up with
your current patient's data.
2Move the patient using the X2/MP5 as the transport monitor.
3At the new monitoring location, connect the X2/MP5 to the new host monitor.
4If prompted, re-admit the patient to the new monitor: in the Select Patient window of the new
monitor, select the patient in the X2/MP5 to retain the data in the X2/MP5. This will upload the
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patient demographics, and, if configured, the measurement settings and trend data stored in the
X2/MP5 to the monitor. Verify that the settings for patient category and paced mode are correct.
Data Upload from an MMS
The Multi-Measurement Module stores eight hours of patient trend data at one-minute resolution. It
also stores patient demographic information and the measurement settings (including the ST baseline)
and calibration data for the measurements carried out by the MMS and any connected extensions. This
data can be uploaded to an IntelliVue patient monitor, if your monitor is configured to do so and if at
least five minutes of trend information is stored in the MMS.
Your monitor's data upload settings are defined in Configuration Mode to suit your patient transfer use
model.
How data is uploaded to the host monitor depends on the configuration mode settings MMS Trend
Upload and MMS Sett. Upload.
If there is a patient mismatch and you select Continue Monitor, no data will be uploaded from the
MMS.
Data Exchange Between Information Centers
You can transfer demographic data and trend data from one IIC to another by selecting Transfer on
the patient monitor. Trend data is not shared between Information Centers and monitors.
Resolving Patient Information Mismatch
When you connect together devices which store patient demographic data, for example:
an MMS and a monitor,
an X2 or MP5 and a host monitor,
a monitor and an Information Center,
the system compares patient category, paced status, and unique patient identification in order to
synchronize this information. If configured to do so, the monitor indicates a mismatch if the
information is not identical.
Depending on your monitor's configuration, this mismatch may be automatically resolved or you may
have to resolve it manually. If your monitor is configured to resolve mismatches automatically,
depending on the configuration, either the monitor or the Multi-Measurement Module data is
automatically retained.
WARNING
1When a monitor is connected to an Information Center by the wireless IntelliVue Instrument
Telemetry interface, the patient data will automatically be merged in the case of a transfer. This
means there is no patient discharge at the monitor and settings and trend data will be retained. You
will see a message on the monitor and the Patient Demographics window will automatically
appear so that you can check the data and change it if necessary.
2It is important to resolve the mismatches as soon as they are identified. Failure to do so could
result in using incorrect/confusing data to make clinical decisions. Certain settings, for example
Paced and Patient Cat., may not match between the Information Center and the monitor. If the
Paced status is set incorrectly, the system could mistake a pace pulse for a QRS and fail to alarm in
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the case of asystole. It is important that the patient category is set correctly so the ECG can be
analyzed correctly and initial arrhythmia alarm limits set.
In the case where an MP5 or X2 with an IntelliVue Instrument Telemetry interface is declared as a
"telemetry device" at the Information Center and is connected to a host monitor, it is important to
resolve an existing mismatch between the monitor and the Information Center before
disconnecting the MP5/X2. Failure to do so discharges the MP5/X2 and synchronizes the
demographics and settings to the Information Center.
Manually Resolving Patient Mismatch
The patient mismatch is indicated by question marks (???) beside the questionable fields in the Monitor
Info Line and in the Select Patient window. The monitor displays a message such as Different
patients in Central and Monitor.
The Select Patient window automatically opens so you can decide which patient data to use. You do
not have to resolve the mismatch immediately, but the indicators remain until you do.
For some common mismatch situations, the monitor will simplify the resolution by suggesting a
solution for the mismatch. For example, when a patient arrives after transport and the Transfer key
has been selected, the monitor will show this patient's data and ask Complete Transfer Of This
Patient?. You can then select Yes to complete the transfer. If you select No you will go to the Select
Patient window.
There can be up to three sets of demographic data in the Select Patient window if the patient is
different in the Information Center, monitor, and MMS.
After you resolve the mismatch, the monitor displays a confirmation window that shows the patient
that has been selected and where data will be erased, if applicable. Confirm your choice. The monitor
automatically displays the Patient Demographics window after confirmation. Verify that the settings
shown are correct for the patient.
Gender, date of birth, height, weight, and nursing notes do not generate a mismatch. If these fields are
different on different devices, the monitor resolves them itself. For example, it may take date of birth
from the Information Center, whilst taking gender from the MMS. Always check the Patient
Demographics after combining patients, to ensure that you are satisfied with the results. Change them
if necessary.
WARNING
After resolving a patient mismatch, check that the monitor settings (especially patient category, paced
status and alarm limits) are correct for the patient.
Patient Mismatch - If One Set of Patient Data is Correct
If there is a mismatch between an Information Center and a monitor, or a monitor and an MMS,
choose the data set you want to continue using for this patient by selecting one of the sectors in the
Select Patient window.
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1Patient demographics
2Patient category and paced status
3Same Patient - see “Patient Mismatch - If Both Patient Data Sets Are Correct” on page 104.
4New Patient - see “Patient Mismatch - If Neither Patient Data Set is Correct” on page 104.
After you resolve the mismatch, the monitor displays a confirmation window that shows the patient
that has been selected and where data will be erased, if applicable. Confirm your choice. The monitor
automatically displays the Patient Demographics window after confirmation. Verify that the settings
shown are correct for the patient.
Patient Mismatch - If Neither Patient Data Set is Correct
A patient mismatch where neither set of patient data is correct might occur if you connect a new MMS
to a monitor in order to prepare for a new patient, before you actually start measuring.
Select New Patient if you are sure that none of the information is correct. This discharges all patients,
erases all data in both the monitor and MMS, resets all settings to the default Profile, and lets you
admit a new patient.
Patient Mismatch - If Both Patient Data Sets Are Correct
A patient mismatch where both sets of patient data are correct might occur if you admit a new patient
at the monitor (or Information Center) before the patient arrives at your unit and then connect the
MMS that was used during the patient transport to the monitor.
Select Same Patient if the patient information is different, but you are sure it is the same patient. This
merges the demographics and updates them in the Information Center, monitor, and MMS, according
to this table. Be aware that your monitor may be configured to merge trend data from the MMS and
the monitor, and to upload measurement settings from the MMS to the monitor.
Patient Information This information is taken from...
Patient name the monitor, if the patient was admitted there. For centrally-admitted
patients, this information is taken from the Information Center.
Patient IDs
Screen Notes
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Automatically Resolving Patient Mismatch
Your monitor can be configured to automatically resolve mismatches in one of two ways.
continue using the patient in the MMS, and delete the old data in the monitor. This is suitable for
transport monitors.
continue with the patient in the monitor, and delete the data in the MMS.
Care Groups
If your monitor is connected to an Information Center, you can group bedside monitors into Care
Groups. This lets you:
view information on the monitor screen from another bed in the same or in a different Care
Group.
be notified of yellow or red alarm conditions at the other beds in the Care Group.
see the alarm status of all the beds in the Care Group on each monitor screen.
There are two main types of Care Groups:
standard care group (Bed-based Care Group) - up to 12 patients monitored by up to 4
Information Centers
unit group (Unit-based Care Group) - for a complete unit with up to 64 patients monitored by
up to 4 Information Centers
Monitors must be assigned to these Care Groups at the Information Center. There is a third care
group which can be assigned locally at the bedside. This is the My Central care group which includes
all beds (up to 16) from the Information Center your bed is connected to. This care group setting is
typically used in facilities with only one Information center. The selection of beds is automatic and
cannot be changed.
The functions available with Care Groups depend on the Information Center revision your monitors
are connected to. See your Information Center Instructions for Use for further details.
Patient Category the Multi-Measurement Module, if connected, otherwise the data is
taken from the monitor.
Date of Birth
Height
Weight
Gender
Paced Status Paced status is always set to Yes where there is a mismatch in patient
information.
Trend data if there is newer trend data stored in the MMS, it is uploaded to the
monitor.
Patient Information This information is taken from...
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Understanding the Care Group Overview Bar
The Care Group monitors' status is shown in symbol form in the Care Group overview bar. Flashing
symbols indicate active alarms, symbols that are not flashing indicate alarms that have been
acknowledged. Selecting a bed symbol calls up the window for that bed or a setup window to select
this.
The Care Group overview bar must be configured to display on the monitor Screen. If it is not visible
on your monitor, select a Screen which has been configured to show the bar. Some screens may show
the Care Group monitors grouped together in a tabular format on the right hand side of the screen.
Care Group Symbols (four alternative display possibilities
depending on space available)
No data from this bed
The alarms are on but there are no currently
active alarms at this monitor
The highest priority alarm at this monitor is a
standard INOP
The highest priority alarm at this monitor is a
short yellow alarm
The highest priority alarm at this monitor is a
yellow alarm
The highest priority alarm at this monitor is a
red alarm
The highest priority alarm at this bed is a
yellow INOP
The highest priority alarm at this bed is a red
INOP
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Viewing the My Care Group Window
This window shows the alarm status, bed name, and patient name for every bed in the Care Group.
The window for the Unit group shows first the beds of the Information Center this bed is connected
to. By selecting the Information Center name at the top of the list, you can display a list of all
Information Centers associated with the Unit group, and select another Information Center to view.
To enter the My Care Group window,
select the Other Patients SmartKey, if configured, or
•in the Main Setup menu, select My Care Group.
The alarms at this monitor are suspended
The monitor is in standby mode
The monitor is in Demonstration mode
The current monitor
Care Group Symbols (used in the Care Group overview bar and
the My Care Group window)
This is a telemetry bed
This bed is on a wireless network.
This bed is on a wired network.
This is a "paired" bed, with a bedside
monitor and a telemetry transmitter
assigned.
Care Group Symbols (four alternative display possibilities
depending on space available)
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Use the My Care Group pop-up keys to navigate through the Care Groups:
My Unit lets you view a list of all the Information Centers in your Care Unit. Select an Information
Center to see a list of the monitors connected to it. Select any monitor to see the Other Patient
window for that bed.
Other Units lets you view a list of all the Care Units in your Care Domain. Select any Care Unit to
view a list of the Information Centers connected to it. Select an Information Center to see a list of
the monitors connected to it. Select any monitor to see the Other Bed window for that bed.
Alarming Beds lets you view a list of all beds in your care group with an unacknowledged alarm.
The beds are listed in order of alarm severity.
Viewing the Other Bed Window
The Other Bed window lets you view a subset of the waveform and numeric information from another
bed on the same network. Waves and numeric information from another bed are delayed. If
configured, Other Bed information is displayed in color, using the colors defined by the Information
Center.
The Other Bed window can be configured to pop-up automatically when an alarm occurs at another
bed. To avoid too many windows appearing (for example, in large care groups) and covering the
monitor's own bed data on the screen, you can temporarily disable this automatic pop-up:
1Select Main Setup then Network followed by Auto Window
2Select Disabled
When automatic pop-up is disabled in this way, an icon will appear as a reminder in the Care Group
Overview Bar next to the monitor's own bed label . Depending on the configuration, the
automatic pop-up is disabled for five minutes or until you set it to Enabled again.
To open the Other Bed window, select the required bed label or patient name in the Care Group
Overview Bar. If you are in a Unit Group with many beds, the My Care Group window may open
for you to select the bed.
The Other Bed window may be configured to display embedded in a specially designed Screen.
To display the embedded Other Bed screen element, in the Change Screen menu, select a Screen
designed to show the Other Bed information permanently.
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Note that a Screen with an embedded Other Bed screen element cannot be displayed on the D80
Intelligent Display.
Changing the Screen may automatically change the bed shown in the other bed window. If you switch
to a different Screen, you should check that the correct other bed is displayed.
Other Bed Pop-Up Keys
Select the Other Patients SmartKey or the Other Bed window or embedded screen element to access
the associated pop-up keys:
Next Wave lets you view waveforms not currently shown in the other bed window.
More Vitals lets you view more numerics not currently shown in the other bed window.
Next Bed lets you view waveforms and numerics from the next available bed in the Care Group.
My Care Group lets you call up the Care Group window to select another bed.
Alarming Beds lets you view a list of all beds in your care group with an unacknowledged alarm.
The beds are listed in order of alarm severity.
Silence Bed lets you silence active alarms at the other bed. (Whether you see this key depends on
the revision and configuration of the Information Center your monitors are connected to.)
WARNING
The Silence Bed pop-up key in the Other Bed window silences alarms at a remote bed. Be aware that
accidental use of this key could silence alarms for the wrong patient.
To silence own bed alarms use the Silence permanent key on screen.
Visual Alarm Status Information in the Other Bed Window
If individual alarms are switched off at the other bed, this is indicated by the crossed alarm symbol
beside the measurement numeric.
If alarms are switched off at the other bed, the message Alarms Off is shown in the other bed
window.
In the embedded Other Bed window, the crossed speaker symbol in the upper right hand indicates
that the volume of the audible alarm status change notification for the other beds in the care group
is set to zero at the overview monitor.
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Care Group Alarms
Changes in the alarm status of beds in a Care Group are announced visually and audibly at all other
beds in the same Care Group. The visual and audible indicators used depend on the monitor and
Information Center configuration.
When an alarm is detected at another bed in the Care Group,
the alarm status is shown in the Care Group overview bar as an icon.
a message informing you about the care group alarm is shown in the monitor status line.
if configured, the Other Bed window, the Alarming Beds window or the My Care Group window
may pop up on the Screen (if automatic alarm notification is enabled at the bedside monitor and at
the Information Center). The automatic alarm notification is suppressed when a window, menu or
pop-up keys are active.
if configured, an audible status change notification is issued. The tone type and volume can be
configured.
Automatic alarm notification can be switched off permanently in the monitor's Configuration Mode or
at the Information Center. To temporarily disable and re-enable automatic alarm notification at the
bedside monitor, for example if you want to carry out a procedure, in Monitoring Mode:
1Select the network symbol on the monitor screen to call up the Network menu.
2Select Auto Window to toggle between the settings Enabled and Disabled.
This setting resets to the default at discharge and when the monitor is switched on. Always re-enable
the Auto Window as soon as possible.
5
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5ECG, Arrhythmia, ST and QT
Monitoring
The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the
monitor as a waveform and a numeric. This section also tells you about arrhythmia monitoring (see
“About Arrhythmia Monitoring” on page 129), ST monitoring (see “About ST Monitoring” on
page 139) and QT monitoring (see “About QT/QTc Interval Monitoring” on page 149).
Skin Preparation for Electrode Placement
Good electrode-to-skin contact is important for a good, noise-free ECG signal, as the skin is a poor
conductor of electricity.
1Select sites with intact skin, without impairment of any kind.
2Clip or shave hair from sites as necessary.
3Wash sites thoroughly with soap and water, leaving no soap residue.
We do not recommend using ether or pure alcohol, because this dries the skin and increases the
resistance.
4Dry skin thoroughly.
5Gently abrade the skin using ECG skin preparation paper to remove dead skin cells to improve the
conductivity of the electrode site.
Connecting ECG Cables
1Attach the clips or snaps to the electrodes before placing them. If you are not using pre-gelled
electrodes, apply electrode gel to the electrodes before placement.
2Place the electrodes on the patient according to the lead placement you have chosen.
3Attach the electrode cable to the patient cable.
4Plug the patient cable into the white ECG connector. An ECG waveform and numeric appears on
the monitor display.
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CAUTION
To protect the monitor from damage during defibrillation, for accurate ECG information and to
protect against noise and other interference, use only ECG electrodes and cables specified by Philips.
Selecting the Primary and Secondary ECG Leads
The monitor uses the primary and secondary lead to compute HR and to analyze and detect cardiac
arrhythmias. They are also available for recordings and for display on the Information Center.
The secondary lead is only used if your monitor is configured for multi-lead (instead of single-lead)
arrhythmia analysis.
You should choose a lead as primary or secondary lead that has the following characteristics:
To select a lead as primary or secondary lead:
•In the Setup ECG menu, select Primary or Secondary, then select the appropriate lead. You can
assign any available lead whether it is currently displayed or not.
Checking Paced Status
It is important to set the paced status correctly when you start monitoring ECG.
To change the paced status in the Setup ECG menu, select Paced to toggle between Yes or No.
WARNING
Pace pulse rejection must be switched on for paced patients by setting Paced to Yes. Switching pace
pulse rejection off for paced patients may result in pace pulses being counted as regular QRS
complexes, which could prevent an asystole event from being detected. When changing profiles, and at
admission/discharge, always check that paced status is correct for the patient.
Some pace pulses can be difficult to reject. When this happens, the pulses are counted as a QRS
complex, and could result in an incorrect HR and failure to detect cardiac arrest or some arrhythmias.
Make sure that pace pulses are detected correctly by checking the pace pulse markers on the display.
Keep pacemaker patients under close observation.
Understanding the ECG Display
Your display may be configured to look slightly different.
the QRS complex should be either completely above or
below the baseline and it should not be biphasic
the QRS complex should be tall and narrow
the P-waves and T-waves should be less than 0.2 mV
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1Lead label of the displayed wave
21 mV calibration bar
3Pacer spikes
4Pace pulse markers
5Current heart rate
6Current heart rate alarm limits
7EASI lead placement label (located here when present)
8ECG Filter label
ECG HR numeric: This is the heart rate derived from the monitored ECG.
Pace pulse markers: These are shown if the Paced status has been set to Yes, the pacer spikes are not
configured to have a fixed size, and the patient has a paced signal.
Pacer Spikes: The pacer spikes are shown in white, unless the ECG wave is white, then they will be
green. If the pacer spikes have been configured to have a fixed size, they will be displayed in the
background as a dotted line.
Defibrillator synchronization marks: If an HP/Agilent/Philips defibrillator is connected, or the 2nd
Sync Out channel is configured to ECG SyncPuls and a sync cable is plugged in, the synchronization
marks (vertical lines on the ECG wave) are shown on the ECG wave. The synchronization marks will
be shown in yellow, unless the ECG wave is yellow, then they will be green.
ST numerics in ECG wave: ST numerics can be configured to show underneath the ECG wave on
the left side.
Monitoring Paced Patients
An ECG optimized for monitoring a paced patient should look like this:
You should choose a lead as primary or secondary lead that has these characteristics:
1Pacer spikes configured to have a fixed size
1Normal Beats
2Pace Pulses/Pace Beats
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the normal QRS complex should be either completely above or below the baseline and it should
not be biphasic. For paced patients, the QRS complexes should be at least twice the height of pace
pulses.
the QRS complex should be tall and narrow
the P-waves and the T-waves should be less than 0.2 mV.
For ease of identification on the screen, the pacer spikes can be configured to have a fixed size. They
are then shown in the background as a dotted lines. The length of the dotted line is fixed to the wave
channel height and is independent of the actual pacer amplitude.
Setting the Paced Status (Pace Pulse Rejection)
Avoiding Pace Pulse Repolarization Tails
Some unipolar pacemakers display pace pulses with repolarization tails. These tails may be counted as
QRSs in the event of cardiac arrest or other arrhythmias.
If you note a visible repolarization tail, choose a lead that decreases the size of the repolarization tail.
Changing the Size of the ECG Wave
If any of the displayed ECG waves is too small or clipped, you can change the size of one or all of the
ECG waves on the screen.
Changing the adjustment factor only changes the visual appearance of the ECG wave on the screen. It
does not affect the ECG signal analyzed by the monitor.
In the Setup ECG menu, select Paced to toggle between Yes and No.
You can also change the paced status in the Patient Demographics window.
When Paced is set to Yes:
Pace Pulse Rejection is switched on. This means that pacemaker
pulses are not counted as extra QRS complexes.
pace pulse marks are shown on the ECG wave as a small dash (only
when the pacer spikes are not configured to have a fixed size).
The paced symbol is displayed on the main screen.
When Paced is set to No, pacer spikes are not shown in the ECG wave. Be
aware that switching pace pulse rejection off for paced patients may result in
pace pulses being counted as regular QRS complexes, which could prevent an
asystole event from being detected.
Paced
Non-Paced
1Repolarization tail (note width)
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Comparing the wave size to the 1 mV calibration bar on the ECG wave segment can help you to get an
idea of the true ECG signal strength. If you choose a fixed adjustment factor, the 1 mV calibration bar
will be the same size for all the displayed ECG waves. If you choose Auto Size, or an individual size
using the Size Up/Size Down keys, the calibration bar may be a different size for each wave.
To Change the Size of an Individual ECG Wave
1Select the wave segment you want to change. This calls up the lead menu for this segment.
2In the lead menu, select Size Up to increase wave size or Size Down to decrease the size.
Selecting Auto Size lets the monitor choose the optimal adjustment factor for all available ECG
waves.
To Change the Size of all the ECG Waves
To change the size of all the ECG waves on the screen by a fixed adjustment factor,
1In the Setup ECG menu, select Adjust Size.
2Select the required adjustment factor from the line of pop-up keys.
Size X0.5 to halve the wave size
Size X1 to display the wave without zoom
Size X2 to double the wave size
Size X4 to multiply the wave size by four
Previous Size: to return one step to the previous size
Auto Size: to let the monitor choose the optimal adjustment factor for all the ECG waves.
Changing the Volume of the QRS Tone
The QRS tone is derived from either the HR or Pulse, depending on which is currently selected as the
alarm source. The QRS volume can be set from 0 to 10 (0 means off).
To change the QRS volume, in the Setup ECG menu select QRS Volume and then select the
appropriate volume from the pop-up list.
Changing the ECG Filter Settings
The ECG filter setting defines how ECG waves are smoothed. An abbreviation indicating the filter
type is shown underneath the lead label on the monitor display. Filter settings do not affect ST
measurement.
To change the filter setting, in the Setup ECG menu, select Filter and then select the appropriate
setting.
Monitor: Use under normal measurement conditions.
Ext. Monitor: Use when diagnostic quality is required but low frequency interference or a
wandering baseline may be expected. The upper edge frequency is the same as the Diag setting
and the lower edge frequency is the same as the Monitor setting.
Filter: The filter reduces interference to the signal. It should be used if the signal is distorted
by high frequency or low frequency interference. High frequency interference usually results in
large amplitude spikes making the ECG signal look irregular. Low frequency interference
usually leads to a wandering or rough baseline. In the operating room, the Filter reduces
artifacts and interference from electrosurgical units. Under normal measurement conditions,
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selecting Filter may suppress the QRS complexes too much and thus interfere with the clinical
evaluation of the ECG displayed on the monitor. This does not affect the ECG analysis
performed by the monitor.
If AutoFilter is set to On in Configuration Mode, the filter setting will automatically be set to
Filter if electromagnetic interference is detected.
Diag: Use when diagnostic quality is required. The unfiltered ECG wave is displayed so that
changes such as R-wave notching or discrete elevation or depression of the ST segments are
visible.
The setting Diag selects the highest available ECG bandwidth which is 0.05 to 150 Hz for the
Adult, Pedi and Neo patient category. The term "diagnostic" relates only to the ECG
bandwidth requirements for diagnostic electrocardiographic devices as outlined in the ANSI/
AAMI standard EC11-1991.
Selecting Positions of Va and Vb Chest Leads (for
6-lead placement)
The two chest leads for the 6-lead placement can be positioned at any two of the V1 to V6 positions.
Select the positions you have used in the Setup ECG menu, so that the chest leads will be correctly
labeled.
1In the Setup ECG menu, select Va Lead.
2Select the position used from the list.
3Select Vb Lead and select the position used from the list.
Choosing EASI or Standard Lead Placement
You must enable either standard lead placement or EASI lead placement.
•In the Setup ECG menu, select Lead Placement and then Standard or EASI.
EASI is shown beside the 1 mV calibration bar on the ECG wave on the display, and EASI is marked on
any recorder strips and printouts.
See the section on “EASI ECG Lead Placement” on page 125 for electrode placement diagrams.
About ECG Leads
To make it possible to compare measured ECG signals, the electrodes (or lead sets) are placed in
standardized positions, forming so-called "leads". To obtain ECG signals optimized for use in
diagnosis and patient management in different care environments, different lead sets in varying lead
placements can be used. You can use either standard lead placements or EASI lead placements with
this monitor.
When placing electrodes, choose a flat, non-muscular site where the signal will not be interfered with
by either movement or bones. Correct lead placement is always important for accurate diagnosis.
Especially in the precordial leads, which are close to the heart, QRS morphology can be greatly altered
if an electrode is moved away from its correct location.
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ECG Leads Monitored
Changing Lead Sets
To change the ECG lead set,
When adding leads: place the additional electrodes as required - the monitor automatically
recognizes the new lead placement.
When removing leads: there are two possibilities - removing the complete chest leads block or
removing individual leads. If you unplug the chest lead block from the trunk cable connector, the
monitor will automatically recognize the new lead placement. Remove individual leads by
removing the electrodes. The monitor will issue a LEAD OFF INOP message; select New Lead
Setup in the Setup ECG menu and the INOP message will disappear.
ECG Lead Fallback
If fallback is configured on and there is a leads off INOP in the primary lead (and in the secondary
lead, if you are using multi-lead monitoring) for longer than 10 seconds, and if another lead is available,
this available lead automatically becomes the primary lead. This is known as lead fallback. When the
Leads Off condition is corrected, the leads are automatically switched back.
This setting can only be changed in Configuration Mode.
ECG Lead Placements
The labels and colors of the ECG electrodes differ according to the standards that apply for your
hospital. The electrode placement illustrations in this chapter use the AAMI labels and colors.
If you are using these leads are available: Resp is measured
between electrodes:
a 3-electrode set I, II, III RA and LL
a 5-electrode set I, II, III, aVR, aVL, aVF, V and MCL RA and LL
a 6-electrode set I, II, III, aVR, aVL, aVF, Va, Vb RA and LL
a 10-electrode set I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6 RA and LL
an EASI 5-electrode set I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6 I and A
Electrode labels Electrode colors
AAMI EASI IEC AAMI IEC
RA I R White Red
LA S L Black Yellow
LL A F Red Green
RL N N Green Black
VECBrown White
V1 C1 Brown/Red White/Red
V2 C2 Brown/Yellow White/Yellow
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Standard 3-Lead Placement
V3 C3 Brown/Green White/Green
V4 C4 Brown/Blue White/Brown
V5 C5 Brown/Orange White/Black
V6 C6 Brown/Violet White/Violet
Electrode labels Electrode colors
AAMI EASI IEC AAMI IEC
1RA placement: directly below the clavicle and
near the right shoulder
2LA placement: directly below the clavicle and
near the left shoulder
3LL placement: on the left lower abdomen
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Standard 5-Lead Placement
6-Lead Placement
For a 6-lead placement use the positions from the 5-lead diagram above but with two chest leads. The
two chest leads, Va and Vb, can be positioned at any two of the V1 to V6 positions shown in the chest
electrode diagram below. The Va and Vb lead positions chosen must be selected in the Setup ECG
Menu to ensure correct labeling.
1RA placement: directly below the clavicle and
near the right shoulder
2LA placement: directly below the clavicle and
near the left shoulder
3RL placement: on the right lower abdomen
4LL placement: on the left lower abdomen
5V placement: on the chest, the position
depends on your required lead selection
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Chest Electrode Placement
For accurate chest electrode placement and measurement, it is important to locate the fourth
intercostal space.
1Locate the second intercostal space by first palpating the Angle of Lewis (the little bony
protuberance where the body of the sternum joins the manubrium). This rise in the sternum is
where the second rib is attached, and the space just below this is the second intercostal space.
2Palpate and count down the chest until you locate the fourth intercostal space.
10-Lead Placement
When monitoring 12-leads of ECG, using a 10-Electrode Lead Placement, it is important to correctly
place electrodes and to label all 12-lead ECG reports with the correct lead placement.
V1 on the fourth intercostal space at the right
sternal border
V2 on the fourth intercostal space at the left
sternal border
V3 midway between the V2 and V4 electrode
positions
V4 on the fifth intercostal space at the left
midclavicular line
V5 on the left anterior axillary line, horizontal
with the V4 electrode position
V6 on the left midaxillary line, horizontal with the
V4 electrode position
V3R -V6R on the right side of the chest in
positions corresponding to those on the left
VE over the xiphoid process
V7 on posterior chest at the left posterior axillary
line in the fifth intercostal space
V7R on posterior chest at the right posterior
axillary line in the fifth intercostal space
A - Angle of Lewis
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Conventional 12-Lead ECG
In conventional 12-Lead ECG using 10 electrodes, an electrode is placed on the right arm, left arm,
right leg, and left leg. Six V- electrodes are placed on the chest. The right leg electrode is the reference
electrode.
Limb electrodes:
Place arm electrodes on the inside of each arm, between the wrist and the elbow.
Place leg electrodes inside of each calf, between the knee and the ankle.
Chest electrodes:
V1 - on the 4th intercostal space at the right sternal border
V2 - on the 4th intercostal space at the left sternal border
V3 - midway between the V2 and V4 electrode positions
V4 - on the 5th intercostal space at the left midclavicular line
V5 - on the left anterior axillary line, horizontal with the V4 electrode position
V6 - on the left midaxillary line, horizontal with the V4 electrode position
1V1 - V6
2LA
3RA
4RL
5LL
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Modified 12-Lead ECG
If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System),
place the four limb electrodes close to the shoulders and lower abdomen.
The six V electrodes are placed on the chest in the same position as the conventional 12-lead
placement.
Choosing Standard or Modified Electrode Placement
If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System),
you must switch Mod.LeadPlacment to On in the monitor. To do this,
•in the Setup ECG menu, select Mod.LeadPlacment to toggle between On and Off.
When Mod.LeadPlacment is set to On, 12 Lead ECG Reports will be labeled 12 Lead ECG
Report (Mason-Likar), and captured 12-lead ECGs will be labeled Mason-Likar to the right
of the bandwidth annotation at the Information Center.
When Mod.LeadPlacment is set to Off, 12 Lead ECG Reports will be labeled 12 Lead ECG
Report (Standard), and captured 12-lead ECGs will not be annotated at the Information
Center.
WARNING
Do not use ECG analysis interpretation statements and measurements for 12-lead ECGs obtained
using the modified (Mason-Likar) limb electrode placement. This may lead to misdiagnosis since the
modified (Mason-Likar) limb electrode placement does not look the same as the conventional 12-lead
ECG and may mask inferior infarction due to calculated axis, R, P and T wave magnitudes shifts and
ST slope.
Do not export 12-lead ECGs obtained using the modified (Mason-Likar) limb electrode placement.
Captured 12-Lead ECGs using the modified (Mason-Likar) limb electrode placement exported from
the Information Center are not annotated with the Mason-Likar label.
1LA
2V1-V6
3LL
4RL
5RA
6Angle of Lewis
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Capture 12-Lead
You can view a 12-Lead ECG on the screen, capture a 12-Lead ECG episode, preview the captured
ECG data and then store it and send it to a connected Information Center for analysis. You can also
print a 12-Lead report.
The monitor can store one 12-Lead ECG episode at any time.
Viewing the Realtime 12-Lead ECG
To open the 12-Lead ECG window and view the realtime ECG waves,
Select the Capture 12 Lead SmartKey, or
•Select
Main Screen, then Capture 12 Lead.
If a previously viewed 12-Lead ECG was not stored, a window will pop up asking whether you want to
keep it or not. The title bar of the window shows the date and time when this 12-Lead ECG was
captured. If you do not need the ECG, select No to discard it, otherwise, select Yes and then select
Store & Send to store that 12-Lead ECG and send it to an Information Center (if one is connected).
If your patient is not admitted, you will be prompted to enter at least the age and gender of the patient.
This information is needed for analysis of the 12-Lead ECG at the Information Center but is not
essential if you only want to capture the 12-Lead ECG without sending it for analysis. To enter this
information:
1Select the Admit Patient pop-up key, then
2Enter the information in the Patient Demographics window.
3Open the 12-Lead ECG window again as described above.
The age and gender will now be displayed in the title bar of the pop-up keys.
To change the way the realtime waves are displayed, select the Change View pop-up key or select the
wave area. You can switch between a one or two column display. The two column display lets you see
a larger representation of the waves.
While the realtime 12-Lead waves are being viewed in the window, the ECG filter mode (see
“Changing the ECG Filter Settings” on page 115) is changed to the 12-Lead filter setting (see “Setting
Up the 12-Lead ECG” on page 124).
Capturing the 12-Lead ECG
To capture the last 10 seconds of ECG data, select the Capture Waves pop-up key. The pop-up key is
active as soon as enough wave data is available; until then a progress bar is displayed in the title bar of
the pop-up keys. A preview of the captured data appears on the screen (unless your monitor is
connected to an Information Center with software release earlier than Revision M — then the
captured data is automatically stored and sent to the Information Center).
The title bar of the pop-up keys will now show the current filter setting and, if you are using EASI lead
placement, an EASI indicator (see “EASI ECG Lead Placement” on page 125).
You can at any time return to the realtime 12-Lead ECG view by selecting the Show Waves pop-up
key. From there, you return to the preview window by selecting the Show Preview pop-up key.
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Setting Up the 12-Lead ECG
In the Preview window, select the Setup 12 Lead pop-up key to choose settings for filter, gain, etc., if
changes are needed. All changes apply to both the display and the printed 12-Lead report.
Storing and Sending the 12-Lead ECG
You can enter an order number that will then be associated with the 12-Lead ECG. To enter an order
number, select the Enter OrderNo. pop-up key. The order number will be displayed in the title bar of
the pop-up keys.
To store the previewed data on the monitor and send it to a connected Information Center for storage
and analysis, select the Store & Send pop-up key. If the monitor is connected to an Information
Center, use the Store & Send function before patient transport to store the 12-Lead ECG centrally, as
the 12-Lead ECG data will not be uploaded from the MMS to another monitor after transport.
If the connection to the Information Center is not active while storing, the 12-Lead ECG will be
automatically sent as soon as the connection is established or restored. If a previously stored 12-Lead
ECG is waiting to be sent to the Information Center, it will be overwritten when a new 12-Lead ECG
is stored and can then not be sent to the Information Center.
Printing the 12-Lead ECG
Print a dedicated 12-Lead ECG report by selecting the Print Report pop-up key.
Filter Applies a filter to the waveforms.
Choices are 0.05-150Hz D, 0.5-150Hz eM, 0.5-40Hz M (or 0.5-55Hz M for
pediatric and neonatal patient categories), 0.5-20Hz F. The selected filter will be
displayed in the title bar of the pop-up keys.
Gain Defines the gain used for the waveforms.
Choices are 2.5 mm/mV, 5 mm/mV, 10 mm/mV and 20 mm/mV.
Chest Gain Defines the gain for the chest leads relative to the standard gain setting.
Choices are Full and Half.
Paper Speed Defines the waveform speed.
Choices are 25 mm/sec and 50 mm/sec.
Format Defines the page layout.
Choices are 12X1, 6X2, 3X4, 3X4 1R and 3X4 3R. 1R and 3R refer to 1 or 3 rhythm
leads.