Philips Medical Systems North America SRRBV1 Short Range Radio Module User Manual m81059001c

Philips Medical Systems North America Co. Short Range Radio Module m81059001c

User Manual MP5 and MP5T

Patient Monitoring
INSTRUCTIONS FOR USE
IntelliVue Patient Monitor
MP5
Release G.0 with Software Revision G.0x.xx
Part Number M8105-9001C
Printed in Germany 09/08
4512 610 29031
*M8105-9001C*
i
1Table Of Contents
M8105-9001C
1Installation 1
Installation Checklist 1
Unpacking and Checking the Shipment 2
Mounting the Monitor 3
Connecting the Monitor to AC Mains 3
Checking Out The Monitor 3
Loading Paper 4
Operating the Monitor 5
Setting the Date and Time 6
Checking Country-Specific Default Settings 6
Handing Over the Monitor 6
2Basic Operation 9
Introducing the Monitor 9
Operating and Navigating 13
Operating Modes 19
Understanding Screens 20
Using the XDS Remote Display (not MP5T) 21
Using the Visitor Screen 21
Understanding Profiles 22
Understanding Settings 24
Adjusting a Measurement Wave 25
Freezing Waves 26
Using Labels 27
Entering Measurements Manually 29
Changing Monitor Settings 29
Checking Your Monitor Revision 30
Getting Started 30
Disconnecting from Power 32
Networked Monitoring 32
Using the MP5 with a Host Monitor 33
3What’s New? 35
What’s New in Release G.0? 35
What’s New in Release F.0? 36
4Alarms 39
Visual Alarm Indicators 40
Audible Alarm Indicators 41
Acknowledging Alarms 43
Pausing or Switching Off Alarms 44
Alarm Limits 45
Reviewing Alarms 50
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Latching Alarms 52
Testing Alarms 52
Alarm Behavior at On/Off 53
Alarm Recordings 53
5Patient Alarms and INOPs 55
Patient Alarm Messages 55
Technical Alarm Messages (INOPs) 61
6Managing Patients 85
Admitting a Patient 85
Quick Admitting a Patient 87
Editing Patient Information 87
Discharging a Patient 88
Transferring Patients 89
Care Groups 92
7ECG, Arrhythmia, ST and QT Monitoring 99
Skin Preparation for Electrode Placement 99
Connecting ECG Cables 99
Selecting the Primary and Secondary ECG Leads 100
Checking Paced Status 100
Understanding the ECG Display 100
Monitoring Paced Patients 101
Changing the Size of the ECG Wave 103
Changing the Volume of the QRS Tone 103
Changing the ECG Filter Settings 104
Selecting Positions of Va and Vb Chest Leads (for 6-lead placement) 104
Choosing EASI or Standard Lead Placement 105
About ECG Leads 105
ECG Lead Fallback 106
ECG Lead Placements 106
Capture 12-Lead 110
EASI ECG Lead Placement 111
ECG and Arrhythmia Alarm Overview 112
Using ECG Alarms 113
ECG Safety Information 114
About Arrhythmia Monitoring 115
Switching Arrhythmia Analysis On and Off 116
Choosing an ECG Lead for Arrhythmia Monitoring 116
Understanding the Arrhythmia Display 117
Arrhythmia Relearning 120
Arrhythmia Alarms 121
About ST Monitoring 127
Switching ST On and Off 127
Understanding the ST Display 128
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Updating ST Baseline Snippets 129
Recording ST Segments 130
About the ST Measurement Points 130
ST Alarms 132
Viewing ST Maps 133
About QT/QTc Interval Monitoring 137
QT Alarms 140
Switching QT Monitoring On and Off 141
8Monitoring Pulse Rate 143
Entering the Setup Pulse Menu 143
System Pulse Source 143
Switching Pulse On and Off 144
Using Pulse Alarms 144
9Monitoring Respiration Rate (Resp) 147
Lead Placement for Monitoring Resp 147
Understanding the Resp Display 148
Changing Resp Detection Modes 148
Changing the Size of the Respiration Wave 149
Changing the Speed of the Respiration Wave 150
Using Resp Alarms 150
Changing the Apnea Alarm Delay 150
Resp Safety Information 150
10 Monitoring SpO2153
SpO2 Sensors 153
Applying the Sensor 153
Connecting SpO2 Cables 154
Measuring SpO2154
SpO2 Signal Quality Indicator (Fast SpO2 only) 155
Assessing a Suspicious SpO2 Reading 155
Changing the Averaging Time 156
Setting the Measurement Mode 156
Understanding SpO2 Alarms 156
Pleth Wave 157
Perfusion Numeric 158
Perfusion Change Indicator 158
Setting SpO2/Pleth as Pulse Source 158
Setting Up Tone Modulation 158
Setting the QRS Volume 159
11 Monitoring NBP 161
Introducing the Oscillometric NBP Measurement 161
Preparing to Measure NBP 162
Starting and Stopping Measurements 164
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Enabling Automatic Mode and Setting Repetition Time 165
Enabling Sequence Mode and Setting Up The Sequence 165
Choosing the NBP Alarm Source 166
Switching Pulse from NBP On/Off 166
Assisting Venous Puncture 167
Calibrating NBP 167
12 Measuring Predictive Temperature 169
Making a Temperature Measurement 169
13 Monitoring Temperature 173
Making a Temp Measurement 173
Calculating Temp Difference 174
14 Monitoring Invasive Pressure 175
Setting up the Pressure Measurement 175
Zeroing the Pressure Transducer 176
Adjusting the Calibration Factor 178
Displaying a Mean Pressure Value Only 178
Changing the Pressure Wave Scale 178
Optimizing the Waveform 179
Using the Wave Cursor 179
Non-Physiological Artifact Suppression 179
Choosing the Pressure Alarm Source 179
Calibrating Reusable Transducer CPJ840J6 181
Calculating Cerebral Perfusion 182
Calculating Pulse Pressure Variation 182
15 Monitoring Carbon Dioxide 185
Using the CO2 Measurement 186
Measuring Microstream CO2189
Setting up all CO2 Measurements 190
16 Assigning Two Devices to One Patient 195
How Can You Combine Devices? 195
Functions Available When the Telemetry Data Window is Displayed 199
Functions Available For Devices Connected Via SRR 200
General Telemetry-related Functions 201
Use Models With Telemetry 202
17 Enhancing Telemetry Monitoring with the Monitor 205
18 Tre n d s 207
Viewing Trends 207
Setting Up Trends 210
Documenting Trends 213
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Trends Databases 214
Screen Trends 215
19 High Resolution Trend Waves 219
OxyCRG 219
Printing Hi-Res Trend Wave Reports 219
Hi-Res Trend Wave Recordings 220
20 Event Surveillance 221
Event Episodes 221
Events Pop-Up Keys 222
Event Triggers 222
The Events Database 224
Viewing Events 224
Annotating Events 226
Documenting Events 226
21 ProtocolWatch 231
Severe Sepsis Screening 231
22 Recording 237
Starting and Stopping Recordings 237
Overview of Recording Types 238
All ECG Waves Recordings 239
Creating and Changing Recordings Templates 239
Changing ECG Wave Gain 240
Recording Priorities 241
Sample Recording Strip 241
Reloading Paper 243
Recorder Status Messages 243
23 Printing Patient Reports 245
Starting Report Printouts 245
Stopping Reports Printouts 246
Setting Up Reports 246
Setting Up Individual Print Jobs 248
Checking Printer Settings 249
Printing a Test Report 249
Switching Printers On Or Off for Reports 249
Dashed Lines on Reports 249
Unavailable Printer: Re-routing Reports 249
Checking Report Status and Printing Manually 250
Printer Status Messages 251
Sample Report Printouts 252
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24 Using the Drug Calculator 257
Accessing the Drug Calculator 257
Performing Drug Calculations 258
Charting Infusion Progress 260
Using the Titration Table 260
Documenting Drug Calculations 260
25 Using the Timer 261
Viewing the Timer 261
Timer Setup Pop-up Keys 261
Setting Up Timers 262
Displaying a Timer On The Main Screen 263
Displaying A Clock On The Main Screen 264
26 Laboratory Data 265
Viewing Received Data 265
27 Care and Cleaning 267
General Points 267
Cleaning the Monitor 268
Disinfecting the Monitor 268
Sterilizing the Monitor 268
Cleaning, Sterilizing and Disinfecting Monitoring Accessories 269
Cleaning and Disinfecting the Predictive Temperature Accessories 269
Cleaning Batteries and the Battery Compartment 269
28 Using Batteries 271
Battery Power Indicators 271
Checking Battery Charge 274
Replacing a Battery 274
Optimizing Battery Performance 274
Battery Safety Information 275
29 Maintenance and Troubleshooting 277
Inspecting the Equipment and Accessories 277
Inspecting the Cables and Cords 277
Maintenance Task and Test Schedule 278
Troubleshooting 279
Disposing of the Monitor 279
Disposing of Empty Calibration Gas Cylinders 279
30 Accessories 281
ECG/Resp Accessories 281
NBP Accessories 285
Invasive Pressure Accessories 286
SpO2 Accessories 287
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Temperature Accessories 291
Predictive Temperature Accessories 291
Mainstream CO2 Accessories 292
Sidestream CO2 Accessories 292
Microstream CO2 Accessories 292
Recorder Accessories 293
Cable for Direct Connection of a Telemetry Device 294
Battery Accessories 294
31 Installation and Specifications 295
Intended Use 295
Manufacturer’s Information 296
Symbols 296
Installation Safety Information 298
Altitude Setting 300
Monitor Safety Specifications 300
EMC And Radio Regulatory Compliance 301
Out-Of-Hospital Transport - Standards Compliance 302
Monitor Performance Specifications 304
M4605A Battery Specifications 308
Measurement Specifications 309
Safety and Performance Tests 321
32 Default Settings Appendix 327
Country-Specific Default Settings 327
Alarm and Measurement Default Settings 333
Alarm Default Settings 333
ECG, Arrhythmia, ST and QT Default Settings 334
Pulse Default Settings 337
Respiration Default Settings 337
SpO2 Default Settings 338
NBP Default Settings 339
Temperature Default Settings 339
Predictive Temperature Default Settings 340
Invasive Pressure Default Settings 340
CO2 Default Settings 342
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1
1
1Installation
Installation should be carried out by qualified service personnel, either by the hospital’s biomedical
department, or by Philips Support.
If you have purchased a “customer-installable bundle”, it is assumed that your own hospital personnel
will install and, if necessary, configure the monitor. You can contact Philips Support for assistance if
required; any assistance will be associated with additional costs.
For mechanical and electrical installation, you need technically qualified personnel with a knowledge of
english. Additionally, for monitor configuration, you need clinically qualified personnel with a
knowledge of the use environment. For further information on Installation, refer to the Service Guide.
WARNING • Monitor configuration settings must be specified by authorized hospital personnel.
• For installation of the monitor as part of a system, always refer to the Service Guide.
• As the first step in preparing the monitor for use, follow the installation instructions given in this
chapter.
Installation Checklist
Use this checklist to document your installation.
Step Task Check Box
when Task
Done
1 Perform initial inspection of delivery, unpack and check the shipment (see
“Unpacking and Checking the Shipment” on page 2)
❏
2 Mount the monitor as appropriate for your installation (see “Mounting the
Monitor” on page 3)
❏
3 Connect the monitor to AC mains using the supplied power cord (see
“Connecting the Monitor to AC Mains” on page 3)
❏
4 Perform Visual, Power On and Functional test blocks (see “Checking Out
The Monitor” on page 3)
❏
5 Perform Safety Tests, if required by local laws and regulations (see “Checking
Out The Monitor” on page 3)
❏
6 Load paper into the recorder, if present (see “Loading Paper” on page 4) ❏
1 Installation Unpacking and Checking the Shipment
2
Unpacking and Checking the Shipment
The monitor and any supporting options ordered are supplied packed in protective shipping cartons.
Initial Inspection
Before unpacking, check the packaging and ensure that there are no signs of mishandling or damage.
Open the package carefully and remove the monitor and accessories.
Check that the contents are complete and that the correct options and accessories have been delivered.
Claims for Damage
If the shipping cartons are damaged, contact the carrier.
If any of the equipment is damaged, contact both the carrier and your local Philips service organization
for repair or replacement arrangements.
7 Check/set the time and date (see “Setting the Date and Time” on page 6) ❏
8 Check that the country-specific default settings are appropriate (see
“Checking Country-Specific Default Settings” on page 6)
❏
9 Perform System Test as necessary (see the Service Guide)❏
Step Task Check Box
when Task
Done
System Components, Accessories and Supplies Comments
Monitor with options as ordered 1
ECG accessories optional
NBP accessories 1
SpO2 accessories optional
Pressure accessories optional
Temperature accessories optional
Predictive Temperature accessories optional
CO2 Accessories optional
Recorder paper optional
Powercord 1
Telemetry Interface cable optional
Measurement Link (MSL) cable optional
Instructions for Use 1
Quick Guide 1
Documentation CD-ROM (includes Service Guide and Instructions
for Use)
1
Mounting the Monitor 1 Installation
3
Repacking
Retain the original packing carton and material, in case you need to return equipment to Philips for
service. If you no longer have the original packing materials, Philips can advise you on alternatives.
Mounting the Monitor
The monitor can be rested on a flat surface, hung on the bed rail, or mounted on a wall. See the Service
Guide for details.
Connecting the Monitor to AC Mains
The monitor has a wide-range power supply that allows you to operate the monitor from an AC
(alternating current) power source of 100 V to 240 V (± 10%) and 50 to 60 Hz (± 5%).
WARNING • Always use the supplied power cord with the earthed mains plug to connect the monitor to an
earthed AC mains socket. Never adapt the mains plug from the power supply to fit an unearthed AC
mains socket.
• Do not use AC mains extension cords or multiple portable socket-outlets. If a multiple portable
socket-outlet without an approved isolation transformer is used, the interruption of its protective
earthing may result in enclosure leakage currents equal to the sum of the individual earth leakage
currents, so exceeding allowable limits.
• Do not connect any devices that are not supported as part of a system.
• Any non-medical device placed and operated in the patient’s vicinity must be powered via an
approved isolation transformer that ensures mechanical fixing of the power cords and covering of
any unused power outlets.
Checking Out The Monitor
The following table defines which tests and inspections need to be performed, and when they are
required.
Te st Test or Inspection to be Performed
Visual Inspect the monitor, measurement accessories and cables for any damage.
Are they free of damage?
Power On Power on the monitor. Does it start up successfully without errors? Do all alarm
lamps light up during power up?
After start up the monitor sounds a tone, and you can see the monitoring main
screen (normally with measurement wave channels and numeric positions).
Functionality Test After power up, touch the blue Main Screen key at the bottom right of the
screen to test the Touchscreen. The key should turn light blue then after several
seconds return to its standard blue color.
1 Installation Loading Paper
4
For test and inspection information regarding repairs, upgrades and all other service events, refer to the
Service Guide.
Loading Paper
1Use the latch on the right side of the recorder door to pull the door open.
2Remove the empty core.
3Insert a new roll and secure it in place on the paper holder. The paper
feeds from the bottom of the roll and over the top of the recorder door.
Recommended paper: M4816A and M4817A.
4With at least one inch of paper extending beyond the edge of the door,
swing the recorder door up and push it firmly closed.
5To test if paper is loaded correctly, start a recording. If no printing appears, paper may be loaded
backwards. Try reloading the paper.
Safety Tests (1) to (4) Perform safety tests (1) to (4), as described in the Service Guide, for standalone
devices if required by local laws and regulations, and each time you combine
equipment to form a system, or exchange system components. Details of the
safety tests and procedures are described in the Service Guide. These safety
tests are derived from international standards but may not always be
sufficient to meet local requirements.
System Perform the system test according to IEC 60601-1-1, if applicable, after
combining equipment to form a system (see the Service Guide).
Te st Test or Inspection to be Performed
Operating the Monitor 1 Installation
5
Operating the Monitor
To complete installation you will need to operate the monitor. Here is a short introduction for those
not experienced with IntelliVue monitors.
1 Switch on the monitor. After start-up the
monitor display will become active. You operate
the monitor using the touch screen.
2Touch something on the screen to enter a
menu. Touching the time, as shown here,
brings you to the date and time menu
needed for the next section.
3Touch again to select an item on the menu and
work through the menu activities.
4You can touch numerics, waves and any
item on the screen, to get you to the
corresponding menu.
5If you cannot find a menu by touching the
screen you can always use the Main Setup
key which will get you to all menus on the
monitor
1 Installation Setting the Date and Time
6
Setting the Date and Time
To set 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.
Checking Country-Specific Default Settings
Some settings are made in the factory to match the typical requirements in a specific country. Line
frequency, units for weight and height, and ECG cable colors (AAMI or IEC) have been set to
appropriate values. If you suspect that these settings may not match your institution’s requirements,
check the settings and change them if necessary as described in the Configuration Guide.
WARNING Before starting monitoring, check that the current configuration meets your requirements, especially
patient category, alarm limits and paced setting.
If you need to enter configuration mode:
1In the Main Setup menu, select Operating Modes.
2Select Config and enter the passcode.
The passcode for configuration mode is given in the monitor’s service documentation.
The monitor displays Config at the right hand side of the status line and in the center of the Screen
while you are in configuration mode.
Before you leave configuration mode, always be sure to store any changes you made. You must store
changes made to each Settings Block and to each Profile, individually. As it may be difficult to
remember whether the settings you changed belong to a Monitor Settings block or a Measurement
Settings block, we recommend that you store each block before you leave configuration mode.
To leave configuration mode:
♦In the Main Setup menu, select Operating Modes and then select Monitoring.
Handing Over the Monitor
If you are handing over the monitor to the end-users directly after configuration, make sure that it is in
Monitoring mode.
Ensure that the users have access to the following documentation delivered with the monitor:
• Instructions for Use (this book) - for more detailed questions during use
• Quick Guide - for quick reminders during use
Handing Over the Monitor 1 Installation
7
Additionally, we recommend working through the Training Guide for self-training on the monitor
before use (not available in all languages). The part number is M8105-944XB, where X is a digit
dependent on the language. The English training guide is M8105-9441B. An English training video,
M8000-9451E, is also available.
1 Installation Handing Over the Monitor
8
9
2
2Basic Operation
These Instructions for Use are for clinical professionals using the IntelliVue MP5 and MP5T
(M8105A and M8105AT) patient monitors.
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 particular for the MP5T, refer to the table on the following page to see which
sections of this guide are applicable to your monitor.
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.
•Monitor refers to the entire patient monitor. Display refers to the physical display unit. Display
Screen and Screen refer to everything you see on monitor’s display, such as measurements, alarms,
patient data and so forth.
Introducing the Monitor
The MP5 monitor provides a comprehensive set of basic physiological measurements: NBP, SpO2,
and optionally ECG, invasive blood pressure, predictive temperature, standard temperature and CO2.
Through networking it provides information integration, documentation and information access. The
MP5 can be used with adult, pediatric and neonatal patients in a hospital and transport environment.
2 Basic Operation Introducing the Monitor
10
The monitor stores data in trend and event databases. You can see tabular trends (vital signs) and
document them on a central 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.
The MP5 monitor can also be connected to another IntelliVue patient monitor (MP20 to MP90),
where it acts as a multi-measurement module (MMS), acquiring measurements for the host monitor.
When connected to a host monitor, the host controls the MP5 including all alarm functionality. No
alarms are available on the MP5, and the alarm lamps are controlled by the host. You can recognize
when an MP5 is connected to a host monitor by the following indication on the screen:
When the MP5 is disconnected from the original host monitor, it continues to monitor the patient as
a stand-alone monitor with all settings and data. On connection to a new host monitor, the MP5
resumes its role as MMS, transferring all settings and data, ensuring fully continuous monitoring.
When the MP5 is connected to a host monitor it still requires batteries or AC power; it also cannot
charge its batteries via the host monitor’s AC connection.
The MP5T monitor is intended for use together with a telemetry device. It has no ECG measurement
of its own but does have NBP and optionally SpO2 and predictive temperature. When the telemetry
device is directly connected to the MP5T, the measurements from the MP5T are transmitted with
those from the telemetry device (ECG and optionally SpO2) to the Information Center. The MP5T
alone has no network capability (no direct wired or wireless connection to the Information Center).
The following comparison table shows in detail the differences between MP5 and MP5T:
Functionality (including optional features) MP5 MP5T
ECG 3
SpO233
NBP 33
Predictive Temperature 33
Temperatu re 3
Invasive Pressure 3
Carbon Dioxide 3
Direct Telemetry Connection 33
ECG Output signal 31
LAN networking capability 3
WLAN networking capability 3
Short range radio interface 3
IntelliVue Instrument Telemetry networking capability 3
Severe Sepsis Screening 3
OxyCRG high resolution trend 3
Neonatal event review 3
Integrated recorder 33
Drug Calculator 33
Companion Mode
Companion Mode No Alarm Display
Introducing the Monitor 2 Basic Operation
11
The MP5/MP5T patient monitor has an 8.4-inch
TFT LCD flat panel SVGA display. You operate the
monitor with the Touchscreen. There is an optional
built-in recorder.
Gas monitor support 3
Connection to a host monitor (companion mode) 3
Connection to an external display 3
Nurse call capability 3
1.MP5 options without ECG do not have an ECG output signal
Functionality (including optional features) MP5 MP5T
2 Basic Operation Introducing the Monitor
12
MP5/MP5T Major Parts and Keys
1Color-coded alarm lamps
2Alarms off lamp
3Measurement connectors (see
below)
4Predictive Temperature Unit
5ECG out (not MP5T and MP5
options without ECG)
6On/Standby Switch
7Indicator LEDs
US measurement connectors
International measurement connectors
MP5(T) front panel
1On/Standby switch
2On/Standby/Error LED - green when monitor is
switched on, red if there is a problem with the monitor
3Battery status LED - green, yellow or red, see Battery
section for details
4AC power operation LED - green when the monitor is
connected to AC power (mains)
2
4
3
56
1
7
Pressure
and Temp
Noninvasive
Pressure
SpO2ECG/
Respiration
Telemetry
device
CO2
Pressure
and Temp
Noninvasive
Pressure
SpO2ECG/
Respiration
Telemetry
device
12 34
Operating and Navigating 2 Basic Operation
13
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:
NBP
Sys.
Silence
NBP
mmHg
Pulse
12345
Pause
Alarms
Start/
Stop
End Case
Repeat
Time
Main
Setup
Default
Profile
Main
Screen
Resp
Pleth SpO2
RR
II
Doe, John Adult 3 Waves A
ALARMS PAUSED 2:59
HR
Bed 3
Local Recorder out of paper
Delayed
Record
Vitals
Trend
Temp
Auto 10 min
hrs
1mv
1Ohm
678 9
10
17 16 15 14 13 12 11
Monitor information line Other screen elements
1network connection indicator
(documented in Information
Center Instructions for Use)
10 status line - shows information and messages prompting you for action
2bed label 11 close all open menus and windows and return to main screen
3patient identification 12 enter Main Setup menu
4patient category 13 scroll right to display more SmartKeys
5paced status 14 SmartKeys - these change according to your monitor’s configuration
6date and time 15 scroll left to display more SmartKeys
7current screen name/enter
change screen menu 16 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.
2 Basic Operation Operating and Navigating
14
Selecting Screen Elements
Touch a screen element to get to the actions linked to that element. For example, touch the Patient
Identification element to call up the Patient Demographics window, or touch the HR numeric
to call up the Setup ECG menu. Touch the ECG wave segment to call up the ECG lead menu.
Using the Setup Menu
The elements at the top of the Screen are grouped together
for ease of navigation. Touch any item at the top of the
Screen to open the Setup menu; then touch the element
you want.
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.
Moving Windows
You can move windows and menus using the Touchscreen. To move a window
1Select the title of the window and keep your finger on the title.
2Move your finger on the Touchscreen to move the window.
3Take your finger off the screen to place the window in the final position.
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.
8adjust alarm volume/level
indicator 17 Silence - acknowledges all active alarms by switching off audible alarm indicators and
lamps permanently or temporarily, if alarm reminder (ReAlarm) is configured on.
9alarm status area - shows active
alarm messages
Monitor information line Other screen elements
Setup
Alarm Messages
Alarm Limits
Alarm Volume
My Care Group
Change Screen
Profiles
Admit/Dischrg
Paced No
Network
Bed Information
Date, Time
Operating and Navigating 2 Basic Operation
15
Using Keys
The monitor has three 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.
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.
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.
enter profile menu, or
revert to default profile
change Screen, or
revert to default screen
access timers 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
2 Basic Operation Operating and Navigating
16
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 access wedge procedure window
- start/stop manual NBP measurement
- start auto series
- stop current automatic measurement
within series
start/stop 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)
start NBP STAT measurement
set the NBP repeat time zero invasive pressure transducer
start a delayed recording access pop-up recording keys
access Vital Signs recording key access Select Waves recording key
set wide automatic alarm limits set narrow automatic alarm limits
switch CO2 pump off access neonatal event review
review vital signs trend review graph trend
access the calculator access the Drug Calculator
gas analyzer - exit standby mode suppress zero for all gas measurements
Operating and Navigating 2 Basic Operation
17
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 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.
unpair equipment and continue
central monitoring with the monitor
unpair equipment and continue central
monitoring with the telemetry device
start 12-Lead Capture (only available
if Information Center is connected) access ST Map application
set standard or EASI lead placement access patient reports
new lead setup manual data entry
access ProtocolWatch start/stop car seat assessment record
open the histogram window open unit conversion window
2 Basic Operation Operating and Navigating
18
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
-> Calculations -> Calculator.
Calculator
MC MR M+ Back
C/CE
Operating Modes 2 Basic Operation
19
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 this
field to change to a different mode.
When an MP5 is connected to a host monitor (Companion Mode is indicated):
• The MP5 will adopt the operating mode of the host monitor:
• You cannot change the operating mode at the MP5.
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.
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,
Config
2 Basic Operation Understanding Screens
20
♦Select anything on the screen or press any key.
If you connect an 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 MP5
in Standby mode, leaving Standby on the MP5 will also make the host leave Standby.
Understanding Screens
Your monitor comes with a set of preconfigured 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 SmartKeys 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.
Switching to a Different Screen
1To switch to a different Screen, select the monitor info line and then Change
Screen in the Setup Menu, 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
Change HiResTrend, 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.
Using the XDS Remote Display (not MP5T) 2 Basic Operation
21
In the Change Screen menu, the changed Screen is
shown linked to the original Screen and marked with an
asterisk.
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).
Using the XDS Remote Display (not MP5T)
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,
1Select the monitor info line to open the Setup menu
2Select Change Screen
3Select 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,
Change Screen
3 Waves A
Split Screen A
Graph Trends
Vital Signs B
Vital Signs A
Vital Signs A*
2 Basic Operation Understanding Profiles
22
♦Select any element on the Screen to open the Screen menu and select a screen from the list.
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).
• 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
screen/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.
Profiles
Measurement B
Measurement C
Measurement D
Profiles Menu, showing current settings
Available choices in measurement
menu
Profile : Profile A
Patient Category: Adult
Paced : No
Display : S-014
Monitor Settings: Monitor A
Measmt. Settings:Measurement A
Measurement A
Understanding Profiles 2 Basic Operation
23
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 setup 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.
2 Basic Operation Understanding Settings
24
Swapping a Complete Profile
1Select the monitor info line and then Profiles in the Setup menu, 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 the monitor info line and then Profiles in the Setup menu, 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 .
Locked Profiles
Some profiles are locked, so that you cannot change them, even in Configuration Mode. These are
indicated by this lock symbol.
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
Adjusting a Measurement Wave 2 Basic Operation
25
• 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 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 popup list. With this permanent key you can access any setup menu in
the monitor.
• via the Measurement Selection key.
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.
1Enter the measurement’s setup menu and select the measurement.
2Select the measurement name to toggle between on and off. The screen display indicates the active
setting.
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 two groups of wave speed settings,
•RespiratorySpeed, for all respiratory waves: CO2, Resp. anesthetic agents and O2
•Global Speed, for all waves not included in the other group.
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 -> User Interface
2Select Global Speed or RespiratorySpeed, as required
3Select a value from the list of available speeds.
2 Basic Operation Freezing Waves
26
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.
3To set the speed to the wave group speed, select RespiratorySpeed 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 sets 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.
This automatically positions the vertical cursor. The cursor can be repositioned by touching the
required point on the wave, or
2Use 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
and if the pressure wave is a PAP wave, it can also be stored as a PAWP value. The stored value
appears in the trend database as a manually entered value. To return to the vertical cursor use the
<> pop-up key.
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.
Using Labels 2 Basic Operation
27
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
Depending on the monitor options purchased, you may be able to measure two invasive pressures and
temperatures 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 (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.
Resolving Label Conflicts
Each label must be unique, that is, it can only be assigned once. If you have a gas monitor connected to
the monitor there is a potential conflict with the CO2 label.
Depending on your configuration, the monitor will either
2 Basic Operation Using Labels
28
• 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 measurements are depicted in the
Measurement Selection window. If a measurement label is
causing a label conflict it is shown in red.
WARNING When an MP5 with an active measurement, say SpO2, is connected to a host monitor with the same
measurement already active, the SpO2 measurement on the MP5 is deactivated and the
Meas. DEACTIVATED INOP is displayed. The measurement can only be reactivated if the MP5 is
disconnected from the host monitor. The label conflict can be resolved on the host monitor like any
other label conflict.
When the MP5 is connected to a host monitor, the Measurement Selection window can be
opened, but only the measurement Setup key is functional. Derived measurements are not active and
cannot be activated, but become active again when the MP5 is disconnected from the host monitor.
Resolve any label conflicts at the host monitor.
To resolve a label conflict,
1Select the measurement selection key or select Main Setup -> Measurement Selection
to display the Measurement Selection window.
2Select the measurement to be deactivated.
3Select the De-activate pop-up key to disable the conflicting measurement. When the
measurement has been deactivated the question marks under the measurement selection key will be
replaced by XXX.
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.
measurement selection key
Entering Measurements Manually 2 Basic Operation
29
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 -> Enter MeasValues
2Select the measurement you want to enter values for. The Edit <Measurement> 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 Confirm.
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 Manual Entry window is set in Configuration
Mode.
No values can be entered manually on the MP5 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 -> 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.
2 Basic Operation Checking Your Monitor Revision
30
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 transport to
conserve battery power. These settings can only be changed in the monitor’s Configuration Mode.
Adjusting Touch Tone Volume
The touch tone volume is the tone you hear when you select any field on the monitor screen. To adjust
the touch tone volume,
1In the Main Setup menu, select User Interface
2Select Touch ToneVolume, then select the appropriate setting for the touch tone volume: 10 is
the loudest and 1 is the quietest. Selecting zero switches the touch tone volume off.
Setting 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.
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.
Checking Your Monitor Revision
1Select Main Setup -> Revision to open the Monitor Revision menu.
2From the Monitor Revision menu, select the monitor component for which you need
revision information.
Getting Started
Once you understand the basic operation principles and have completed the Training Program, you
can get ready for monitoring.
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.
– Check for any mechanical damage.
Getting Started 2 Basic Operation
31
– Check all the external cables, plug-ins and accessories.
2Plug the power cord into the AC power source. If you are using battery power, ensure that the
battery has sufficient power for monitoring. When you use a battery for the first time, you must
charge it, following the instructions given in the section on Charging Batteries.
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 on/off switch on the monitor for one second. The monitor performs a self test and is then
ready to use. If you see a message such as CO2SENSOR WARMUP wait until it disappears before
starting monitoring that measurement.
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.
• When AC mains power is lost, a battery powered monitor continues to run without interruption on
battery power.
• The MP5 switches on automatically when connected to a running host monitor.
• When the MP5 is disconnected from a running host monitor, it continues to run without
interruption on battery power.
Setting up the Measurements
1Decide which measurements you want to make.
2Connect the required patient cables and sensors. The connectors are color-coded to the patient
cables and sensors for easy identification.
WARNING When connecting devices for acquiring measurements, always position cables and tubing carefully to
avoid entanglement or potential strangulation.
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.
3Refer to the appropriate measurement section for details of how to perform the measurements you
require.
2 Basic Operation Disconnecting from Power
32
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. This can be done 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 the 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 the Instructions for Use for your host monitor for viewing
telemetry data on the host.)
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, select the monitor info line to enter the Setup menu, then select
Bed Information.
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.
Using the MP5 with a Host Monitor 2 Basic Operation
33
Using the MP5 with a Host Monitor
Host monitors that can support the MP5 as a multi-measurement module require software revision
F.00.00 or higher. When you connect an MP5 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 from the host monitor.
• Functions you can operate on the MP5 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”.
• Depending on how it is configured, your host monitor can determine whether the user interface of a
connected MP5 is completely disabled or not, and what is displayed (a standard main screen, or a
blank screen similar to the Standby screen indicating “Companion Mode”).
This is controlled by two monitor settings that are applied to the MP5 on connection. You can
change the settings in Configuration Mode.
• Some general settings, such as line frequency, QRS sound, ECG lead colors, from the host monitor
are applied to the MP5 on connection. When disconnected from the host, the MP5 applies its own
settings again.
• No audible alarms are available on an 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. Alarms
become active again as soon as the MP5 is disconnected from the host monitor.
• The host monitor is the master of all ADT information. ADT operations on the MP5 are disabled,
and any pending actions on the MP5 (for example, admit or end case) are cancelled.
• The date and time of the MP5 is synchronized with that of the host monitor.
• Event surveillance in the MP5 is disabled. Main Setup menu operations and SmartKeys are disabled.
While connected to host monitor, no new events are detected in the MP5, and no events are deleted.
There is no transfer of stored events from the MP5 to the host monitor. After disconnection from
the host monitor, event surveillance is enabled again in the MP5, and new events are detected.
The MP5 is connected to the host monitor using the measurement link (MSL) cable:
2 Basic Operation Using the MP5 with a Host Monitor
34
35
3
3What’s New?
This section lists the most important new features and improvements to the monitor and its user
interface introduced with each release. Further information is provided in other sections of this book.
You may not have all of these features, depending on the monitor configuration purchased by your
hospital.
What’s New in Release G.0?
Short Range Radio Interface for MP5
A short range radio interface is now available for the MP5 monitor. This allows a telemetry transceiver
with a short range radio adapter to be assigned to the monitor resulting in a direct connection, as an
alternative to the cable connection. The measurement data from the telemetry transceiver appear
directly on the monitor screen with a minimal delay and are combined with the monitor data in one
sector at the Information Center.
Product Options Without ECG
The monitor now has several options, with varying measurement combinations, without an ECG
measurement.
Microstream CO2 in MP5
The Microstream CO2 measurement method is now available in MP 5 monitors.
Histogram Trend
Trended values can also be viewed in the form of a histogram. The SpO2 histograms can be trend
histograms or realtime histograms with 1 second samples.
Car Seat Assessment Record
In Event Surveillance, in the NER group, you can run a Car Seat Assessment Record (CAR). This is a
special period of event surveillance for neonates during a car seat test. During the CAR period a
realtime SpO2 histogram is also generated with 1 second samples.
IntelliVue XDS Solution
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.
3What’s New? What’s New in Release F.0?
36
New Fields in the Admission Form
A Middle Name field is now available in the admission form - whether it appears is configurable. Two
additional ID fields, Lifetime Id and Encounter Id, can also be configured to appear and their names
can be customized to fit hospital requirements.
SpO2 Enhancements
•Additional SpO2 Labels - SpO2pr and SpO2po labels have been added.
•New manual measurement mode when telemetry devices are connected via a short range radio link.
• Signal Quality Indicator displayed with the SpO2 numerics.
ECG Enhancements
•New */**Afib yellow alarm when an atrial fibrillation waveform is detected.
•QT View window - shows current wave and baseline wave with Q and T points marked so that you
can verify that the QT algorithm detects correct Q and T points.
What’s New in Release F.0?
The SSC Sepsis protocol is now available on the MP5 in the form of the screening option. If a patient
has been screened on arrival with an MP5, then transferred to Intensive Care when Sepsis is confirmed,
the current state, the settings and the log from the SSC Sepsis Protocol can be transferred from the
MP5 by connecting it to the new monitor.
QT/QTc Interval Monitoring
QT interval monitoring is used to assist in the detection of prolonged QT interval syndrome. The QT
interval is measured and the heart-rate corrected QT value, QTc, is calculated. The monitor also
provides a QTc value which tracks variation in the QT interval in relation to a baseline value. High
alarm limits can be set for QTc and QTc enabling alarm notification.
Manual Data Entry
Measurement values (for example lab data or manually measured temperatures) can be entered
manually into the monitor and stored in the database. They can then be used for trends, reports and
also be displayed as a numeric on screen, if required.
Horizon Trend Enhancements
The trend indicator arrow indicates how the patient trend has developed in a set time period. This
period is now configurable and can be set to 10 minutes, 5 minutes or 2 minutes. The horizon (or
baseline) can now be set to a range or to a specific value.
Connecting an MP5 to a Monitor (Companion Mode is indicated)
The MP5 monitor can be connected to one of the MP20 to MP90 monitors (then called the host
monitor) and used like an MMS. This provides monitoring continuity in transport situations allowing
measurement data and patient demographics from the MP5 to be transferred to another monitor.
When the MP5 is connected to a host monitor, no alarms will be announced on the MP5.
Pairing MP5 with another IntelliVue Monitor
The MP5 (with IIT) can be declared as a telemetry device at the Information Center and paired with
another monitor. The data from the MP5 will then be shown on the same sector on the Information
Center as that from the other monitor.
What’s New in Release F.0? 3What’s New?
37
Sending Data To An Information Center Via A Telemetry Device
For the MP5T monitor, or an MP5 monitor without a connection to an Information Center, a small
set of monitoring data can be sent from the monitor to the Information Center via a connected
telemetry device.
NBP - Programmable Measurement Sequence
Up to four measurement cycles can be set up which will run consecutively. For each cycle you can set
the number of measurements and the interval between them. By setting the last cycle to run
continuously you can have regular measurements continue after the sequence has run.
New Printing Options For Reports
Reports can now also be printed via an external PC-based print server or to an internal print database,
when no printer is available (for example, during transport). As soon as a printer becomes available, the
reports stored in the database will print automatically.
Manual Pairing At Monitor
Previously, devices could only be manually paired at the Information Center. You can now pair devices
at the monitor as long as the monitor is already connected to the Information Center.
Moving Windows And Menus
Windows and menus can now be moved on the monitor screen. Using touch or a mouse you can select
the title of a window and then “drag” it across the screen. Some positions on the screen are not allowed,
such as ones overlapping the alarm field or the monitor info line.
Invasive Pressure Changes
Wave cursor - A cursor is now available on the realtime pressure wave to allow you to define a position
and store the corresponding value.
Reduced alarm limit steps in lower ranges - The alarm limits setting in 2 mmHg steps is now possible
in ranges up to 50 mmHg (previously up to 30 mmHg).
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 and when no basic vitals (HR, RR, Pulse, SpO2, NBP) have been measured
for a specified period, whether a new patient is now being monitored. By selecting the Yes pop-up key
you can discharge the previous patient and reset settings.
New Smart Keys
A SmartKey is available for New Lead Setup when a new ECG lead set with fewer leads than
previously is being used.
Better Visibility Of Gridlines
The brightness of the gridlines on the realtime waves has been increased for better visibility.
3What’s New? What’s New in Release F.0?
38
39
4
4Alarms
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 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 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 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
•ECG/ARRH ALARM OFF (yellow only, no red INOP)
• CUFF OVERPRESS
• CUFF NOT DEFLATED
• OCCLUSION
• TELE DISCONNECT.
• 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.
** HR HIGH
4Alarms Visual Alarm Indicators
40
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 the MP5 when connected to a host monitor. Alarms become active again
as soon as the MP5 is disconnected from the host monitor.
• Alarm fields and other visual alarm indicators are disabled on the 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. No Alarm Display is shown in the field for red alarms, Companion
Mode is shown in the yellow alarms field, and the INOPs field is blacked out.
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 “**SpO2 LOW” or
• in numeric form, for example “**SpO2 94<96”, 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:
Companion Mode No Alarm Display
Audible Alarm Indicators 4Alarms
41
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 alarms are available on the MP5 when connected to a host monitor (Companion Mode is
indicated). Alarms become active again as soon as the MP5 is disconnected from the host monitor.
• When connected to a host monitor (Companion Mode is indicated), no alarm tones are available
on the MP5.
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.
INOP Lamp
Color
Modulation (how long the lamp is on or off while flashing)
On Off
Yellow 1.0 seconds 1.0 seconds
Red 0.25 seconds 0.25 seconds
4Alarms Audible Alarm Indicators
42
• One-star yellow alarms (short yellow alarms): The audible indicator is the same as for yellow alarms,
but of shorter duration.
• 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 MP5 screen when the MP5 is 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.
The severe INOPs for which this applies are:
Cuff Not Deflated (configurable to yellow or red)
Alarm
Volume
Acknowledging Alarms 4Alarms
43
NBP Cuff Overpress (configurable to yellow or red)
Power Loss Tone
When power is lost - no power is available from the power cable or from a battery - 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.
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. When an NBP 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. 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.
Alarm Reminder (ReAlarm)
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.
Silence
APNEA
4Alarms Pausing or Switching Off Alarms
44
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 -> 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 labelled Alarms Off, and selecting it
switches alarms off.
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 labelled Alarms Off.
♦Select the Alarms Off 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.
To Switch Individual Measurement Alarms On or Off
1Select the measurement numeric to enter its setup menu.
2Select Alarms to toggle 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 or ALARMS OFF, together with
the alarms paused symbol and the remaining pause
time in minutes and seconds, or alarms off symbol.
Pause
Alarms
Alarms
Off
ALARMS PAUSED 1:28
Alarm Limits 4Alarms
45
• 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, 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 NO SENSOR or NO TRANSDUCER INOP is present and alarms are paused or switched off, the
measurement in question is switched off.
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.
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 Pause Al. 5 min or the pop-up key Pause Al. 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, SpO2), where the value ranges from 100 to 0, setting the high alarm limit
to 100 switches the high alarm 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.
ALARMS OFF
4Alarms Alarm Limits
46
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.
85
120
50
HR
Alarm limits
12
3
Alarm Limits
ST-V4
ST-V5
ST-V6
SpO2
Pulse (SpO2)
ABPs
PAPd
awRR
NBPs
Apnea Time
Off
sec
Alarm Limits 4Alarms
47
♦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 Change Limits window, which you access by
selecting the measurement label in the Alarm Limits window.
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
4Alarms Alarm Limits
48
To change alarm limits,
1Enter the Alarm Limits window.
2To 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.
If you set the yellow alarm limit outside the red alarm limit, the monitor will automatically set the red
alarm to the yellow alarm limit.
When an ST measurement is in the Change 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 toggle 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
4
5
8
2
3
9
10
Alarms
On/Off
HR
1
7
6
Alarm Limits 4Alarms
49
About Automatic Alarm Limits (AutoLimits)
The monitor can automatically set alarm limits suited to your individual patient, using the Automatic
Alarm Limits function. 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 judgement 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 Change 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 Change 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.
Documenting Alarm Limits
The alarm limits pop-up keys appear with the Alarm Limits and Change Limits windows.
♦Select the Print Limits pop-up key to print an overview of all alarm limits on a connected
printer.
1 Wide alarm limits
2 Narrow alarm limits
3Alarm Limits
4 Measurement value
1
2
2
1
4
3
4Alarms Reviewing Alarms
50
♦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 Review Alarms 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 (Source: FMS).
Review Alarms Window
Alarm
Limits
Review
Alarms
Pause Al.
5 Min.
Pause Al.
10 Min.
Alarm Messages
Resp LEADS OFF
LL LEAD OFF
** awRR LOW
Reviewing Alarms 4Alarms
51
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 changes
made to the Alarms On/Off, Standby, Silence or ECG source.
No entries are made in the Review Alarms window of the MP5 while it is connected to a host
monitor, except the time when the MP5 was connected to the host (Companion Entered), and
when it was disconnected (Companion Left). Alarms can be reviewed on the host monitor.
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.
Alarm
Limits
Active
Alarms
Pause Al.
5 Min.
Pause Al.
10 Min.
5 Apr 16:55:18 ** ABPs HIGH (120 >95)
5 Apr 16:55:18 Alarms On
5 Apr 16:45:15 ** SpO2 NON-PULSAT.
5 Apr 16:44:57 Alarms Off
5 Apr 16:44:46 ** awRR LOW (14<15)
5 Apr 16:44:39 ** SpO2 LOW (95<99)
5 Apr 16:44:28 ** ABPs HIGH (120>95)
5 Apr 16:55:18 *** Apnea
Review Alarms
4Alarms Latching Alarms
52
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:
R = red alarms, Y = yellow alarms
Alarm Latching Behavior
All INOPs are non-latching. See “Yellow Arrhythmia Alarms” on page 122 for information on one-star
yellow alarms latching behavior.
Te s t i n g A l a r m s
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.
Visual Latching R&Y R&Y R&Y RROff
Audible latching R&Y ROffROffOff
Red and 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 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 condition
no longer present.
Audible and visual alarm indicators automatically stop.
Alarm Behavior at On/Off 4Alarms
53
Alarm Behavior at On/Off
When you switch alarms on, the settings defined in the currently active Profile are used.
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 either the alarm settings from the monitor's configured default Profile, or the most recently
used alarm settings. After any of these situations, you should check that the alarm settings are
appropriate for your patient, and if necessary, select the correct Profile and patient category.
If power is lost for less than one minute, the alarm settings prior to the power loss are restored.
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&Yell: both yellow and red alarms will trigger an alarm recording.
Off: disables automatic alarm recording.
Refer to the chapter “Recording” for details of how to set up a recording.
4Alarms Alarm Recordings
54
55
5
5Patient Alarms and INOPs
This chapter lists patient alarms and technical alarms (INOPs) alphabetically, irrespective of their
priority. INOPs start on page 61. 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 module 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 module.
Alarm Message From Condition Indication
*/**AFIB ECG/
Arrhythmia
Atrial fibrillation waveform detected yellow alarm lamp, short
yellow audible alarm.
***APNEA or
***APNEA mm:ss sec
or
***APNEA >10min
CO2, Resp,
Spirometry
Respiration has stopped for longer than
the preset apnea time. “mm:ss” 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.
5 Patient Alarms and INOPs Patient Alarm Messages
56
**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.
***BRADY/P xxx<yyy
or
***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.
**CCO/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/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 or
***DESAT xxx<yyy
SpO2The SpO2 value has fallen below the
desaturation alarm limit. xxx denotes
the lowest measured value, and yyy is
the desaturation limit.
numeric flashes, red alarm
lamp, alarm tone.
**etCO2 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.
**etCO2 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.
**etO2 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.
**etO2 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:<GRP>
Event
surveillance
An event has occurred and the event
notification is configured to alarm.
<GRP> is the event group
event group name flashes,
yellow or red alarm lamp and
alarm tone
*/**/*** 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
***EXTREME BRADY ECG The bradycardia limit has been
exceeded.
numeric flashes and alarm
limit is highlighted, red alarm
lamp, alarm tone.
***EXTREME TACHY ECG The tachycardia limit has been
exceeded.
numeric flashes and alarm
limit is highlighted, red alarm
lamp, alarm tone.
Alarm Message From Condition Indication
Patient Alarm Messages 5 Patient Alarms and INOPs
57
**HR HIGH ECG The heart rate high alarm limit has
been exceeded.
numeric flashes and high limit
is highlighted, yellow alarm
lamp, alarm tone. If configured
to short yellow, the sound
switches off after 5 seconds if
Arrhythmia is On.
**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 On.
*/**IRREGULAR HR ECG/
Arrhythmia
Consistently irregular heart rhythm. numeric flashes, yellow alarm
lamp, short yellow audible
alarm.
*/**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 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 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 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 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 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 ECG/
Arrhythmia
No beat detected for a period greater
than the pause threshold.
numeric flashes, yellow alarm
lamp, short yellow audible
alarm.
Alarm Message From Condition Indication
5 Patient Alarms and INOPs Patient Alarm Messages
58
***<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 pressures (P, ABP,
ART, Ao, BAP, FAP, PAP, UAP, P1, P2,
P3, P4).
numeric flashes, red alarm
lamp, alarm tone.
***<Pressure> 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.
**<Pressure> 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.
***<Pressure> 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.
**<Pressure> 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
SpO2
The pulse rate has exceeded the high
alarm limit.
numeric flashes and high limit
is highlighted, yellow alarm
lamp, alarm tone.
**Pulse LOW PRESS
SpO2
The pulse rate has dropped below the
low alarm limit.
numeric flashes and low limit
is highlighted, yellow alarm
lamp, alarm tone.
*/**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.
**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 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.
Alarm Message From Condition Indication
Patient Alarm Messages 5 Patient Alarms and INOPs
59
**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 ECG/
Arrhythmia
A run of PVCs greater than 2 was
detected.
numeric flashes, yellow alarm
lamp, short yellow audible
alarm.
**<SO2 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.
**<SO2 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.
**<SpO2 label> HIGH SpO2The arterial oxygen saturation has
exceeded the high alarm limit.
numeric flashes and high limit
is highlighted, yellow alarm
lamp, alarm tone.
**<SpO2 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.
**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.
**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 for more
details about which leads are affected.
(on monitor) numeric flashes,
yellow alarm lamp, alarm tone
*/**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.
***TACHY/P xxx>yyy
or
***TACHY xxx>yyy
Press, SpO2The heart rate from the Pulse signal has
exceeded the tachycardia limit. xxx
denotes the highest measured value; yyy
is the tachycardia limit.
numeric flashes, alarm limit is
highlighted, red 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.
**tcpO2 HIGH/
**tcpCO2 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.
**tcpO2 LOW/
**tcpCO2 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.
Alarm Message From Condition Indication
5 Patient Alarms and INOPs Patient Alarm Messages
60
*/**/***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
**<Temperature
label> HIGH
TEMP The temperature has exceeded the high
alarm limit.
numeric flashes and high limit
is highlighted, yellow alarm
lamp, alarm tone.
**<Temperature
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 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 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 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
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, alarm tone
Alarm Message From Condition Indication
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
61
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 and SpO2 INOP messages are
explained in the individual chapters.
INOP Message, Indication Source What to do
ABP INOPS PRESS See <Pressure label> INOPS (under Pressure).
ALL ECG ALARMS OFF ECG/
Arrhythmia
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 alarms source.
Ao INOPS PRESS See <Pressure label> INOPS (under Pressure).
ART INOPS PRESS See <Pressure label> INOPS (under Pressure).
AWF CHANGE SCALE Spirometry Airway flow signal exceeds range of selected scale. Adjust scale
to display complete wave.
AWP CHANGE SCALE Spirometry Airway pressure signal exceeds range of selected scale. Adjust
scale to display complete wave
AWV CHANGE SCALE Spirometry Airway volume signal exceeds range of selected scale. Adjust
scale to display complete wave.
Bad Serverlink
INOP tone
Monitor 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.
BAP INOPS PRESS See <Pressure label> INOPS (under Pressure).
BATT EMPTY
INOP tone, battery LED flashes
During this INOP, alarms cannot be
paused or switched off.
Battery 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 INCOMPAT
INOP tone
Battery The battery cannot be used with this monitor. Replace with the
correct battery (M4607A).
BATT LOW
INOP tone
Battery 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.
Battery 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 or BATT 1/
BATT 2 EMPTY
INOP tone, battery LED flashes
During this INOP, alarms cannot be
paused or switched off.
Batteries 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.
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
62
BATTERIES INCOMP or BATT 1/
BATT 2 INCOMPAT
INOP tone
Batteries 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 or BATT 1/
BATT 2 LOW
INOP tone
Batteries The estimated battery-powered operating time remaining is less
than 20 minutes.
BATTERIES MALFUNC. or
BATT 1/BATT 2/ BATTERY
MALFUNCT.
INOP tone, battery LED flashes
During this INOP, alarms cannot be
paused or switched off unless the
monitor is connected to mains power.
Batteries 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.
BATTERY LOW T Telemetry The battery in the Telemetry device is low and must be
replaced soon.
BATT 1/BATT 2 MISSING
INOP tone.
During this INOP, alarms cannot be
paused or switched off.
Batteries The monitor requires two batteries but can detect only one
battery. Insert the missing battery immediately.
BIS CABLE INCOMPAT
INOP tone.
BIS 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.
BIS The semi-reusable sensor cable has exceeded the maximum
number of uses. Replace the cable.
BIS DSC DISCONN
INOP tone
BIS 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
BIS 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 BIS 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
BIS 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.
BIS ELECTR. DISC
INOP tone.
BIS One or more electrodes are not connected to the semi-reusable
sensor cable. Check all electrode connections.
BIS ENGINE DISCONN
INOP tone
BIS 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.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
63
BIS ENGINE INCOMPT
INOP tone
BIS 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
BIS Malfunction in the BIS engine hardware. Disconnect and
reconnect the BIS engine. If the INOP persists, replace BIS
engine.
BIS EQUIP MALF
INOP tone
BIS 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
BIS 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
BIS 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 BIS 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
BIS 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
BIS 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
BIS 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
BIS Unsupported sensor connected or sensor type unknown or not
supported by your software revision. Replace the sensor, using
only Philips supported sensors.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
64
BIS SENSOR MALFUNC
INOP tone
BIS 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
BIS Excessive sensor usage. Replace sensor.
A Cyclic Impedance Check will start automatically.
BIS SQI < 15% (INOP tone)
OR
BIS SQI < 50% (no INOP tone)
BIS 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).
BIS UNPLUGGED
INOP tone
BIS Plug in the BIS module. Silencing this INOP switches off the
measurement.
BISx DISCONNECTED
INOP tone
BIS 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
BIS 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
BIS 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.
CANNOT ANALYZE ECG ECG/
Arrhythmia
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 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 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.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
65
CCI NO BSA
CCI numeric unavailable
INOP tone
C.O. 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
C.O. 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 <Pressure label>
numeric is replaced by -?-
INOP tone may sound
C.O. 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,
B A P, FA P, o r U A P.
CCO NO CALIBRATION
numeric is replaced by -?-
C.O. The CCO measurement is currently not calibrated.
CCO NO PRESS
at Information Center
C.O. 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,
B A P, FA P, o r U A P.
CCO NOT SUPPORTED
numeric is replaced by -?-
INOP tone
C.O. 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/CCI OVERRANGE
numeric is replaced by -?-
INOP tone
C.O. The measured CCO or CCI value is not within the specified
range for CCO/CCI measurement.
CCO <Pressure label>
INVALID
numeric is replaced by -?-
INOP tone may sound
C.O. 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 INVALID
at Information Center
C.O. 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
C.O. 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
C.O. The pulse rate of the pressure used for pulse contour
calculation for CCO is below 30 bpm or above 240 bpm.
CCO/Tbl NO TRANSD
Numeric is replaced by -?-
INOP tone
C.O. No transducer attached to the module or catheter
disconnected.
CCO RECALIBRATE
numeric is replaced by -?-
C.O. 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.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
66
CENTRAL:TELE ONLY
INOP tone
Monitor 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.
Charge BATT1/BATT2 now
INOP tone
Batteries Battery must be charged. Connect the monitor to mains power
or exchange the battery.
CHARGER MALFUNC
INOP tone, battery LED may flash
Batteries There is a problem with the battery charger in the monitor.
Connect the monitor to mains power and contact your service
personnel.
Check Alarm Lamps
INOP tone.
Monitor 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 BATT TEMP
INOP tone
Battery 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.
Check DrugSettings
INOP tone
Monitor There was a problem loading the drug settings. Check that the
settings are complete and correct.
Check ECG Settings
INOP tone
Telemetry Synchronization of ECG settings between the monitor and
Information Center has failed. Check that the ECG settings in
use are appropriate.
!!CHECK ECG SOURCE
INOP tone
Monitor 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.
Check Flex Texts
INOP tone
Monitor 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.
CheckInternVoltage
at Information Center
Monitor Potential problem with alarm lamps, display or interfaces
detected. Contact your service personnel. This INOP will
appear on the monitor as Check Monitor Func.
Check Keyboard
INOP tone
Monitor Perform a visual and functional check of the keyboard. Contact
your service personnel.
Check Main Board 2
INOP tone.
Monitor There is a problem with the second main board in the monitor.
Contact your service personnel.
Check Monitor Func
INOP tone.
Monitor Potential problem with alarm lamps, display or interfaces
detected. Contact your service personnel. This INOP may
appear on the Information Center as
CheckInternVoltage.
Check Monitor Temp
INOP tone
Monitor 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.
Monitor Perform a visual and functional check of the mouse input
device. Contact your service personnel.
Check MSL Voltage
INOP tone
Monitor/
Multi-
Measuremt
Module
There is a problem with the voltage of the Measurement Link
(MSL). Contact your service personnel.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
67
Check Network Conf
INOP tone
Monitor 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 Nurse Relay
INOP tone
Monitor There is a problem with the connection to the nurse relay.
Contact your service personnel.
!!Check Pairing
INOP tone
Monitor There is a problem with device pairing. Check that the monitor
and telemetry device are correctly paired.
Check Screen Res
INOP tone
Monitor 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
Monitor 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.
Monitor Perform a visual and functional check of the SpeedPoint input
device. Contact your service personnel.
Check Touch Input
INOP tone
Monitor Perform a visual and functional check of the touch input
device. Contact your service personnel.
Check Waves
INOP tone
Monitor 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
Monitor The ECG Sync is detecting an invalid signal, or the ECG Sync
cable is disconnected.
Chk IndepDsp Cable Monitor The monitor cannot communicate with the D80 Intelligent
Display. Check the MSL coupling cable. The end with the grey
connector must be connected to the Intelligent Display.
CHK MSL Connection
INOP tone
Monitor Check that the MSL connector or cable are properly
connected. Check the cable and connector for damage.
Chk SpO2T Settings
INOP tone
Telemetry Synchronization of SpO2T settings between the monitor and
Information Center has failed. Check that the SpO2T settings
in use are appropriate.
C LEAD OFF
HR Numeric is replaced by -?- for 10
seconds. INOP tone.
ECG 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.
CO2 AUTO ZERO
Numeric is replaced by a -?-
if the Autozero lasts >15 sec, INOP
tone sounds.
CO2The 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.
CO2 CAL MODE
CO2 numeric displays current CO2
value for accuracy check
CO2Currently 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 a -?-
CO2Wait until calibration is finished.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
68
CO2 CHANGE SCALE CO2The CO2 wave is clipped. Select a more appropriate wave scale
to display the whole wave.
CO2 CHK ADAPTER
Numeric is replaced by a -?-
INOP tone.
CO2Check 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.
CO2 CHECK CAL
Numeric is replaced by a -?-
INOP tone.
CO2The CO2 value is outside the measurement range. Perform an
accuracy check for both calstick cells and, if necessary,
recalibrate the transducer.
CO2 DEACTIVATED
INOP tone.
CO2The 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.
C.O. DEACTIVATED
INOP tone.
C.O. 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 a -?-
INOP tone.
C.O. There is a problem with the C.O. hardware. Contact your
service personnel.
CO2 EQUIP MALF
Numeric is replaced by -?-
INOP tone.
CO2The 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.
CO2 FAILED CAL
Numeric is replaced by -?-
INOP tone.
CO2Make 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.
CO2 NO SENSOR
Numeric is replaced by -?-
INOP tone.
CO2There is no CO2 sensor connected. If you silence this INOP
the CO2 measurement will be switched off.
CO2 NO TRANSDUC
Numeric is replaced by -?-
INOP tone.
CO2There 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.
CO2 NO TUBING
Numeric is replaced by -?-
INOP tone.
CO2Either 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.
(!!/!!!)CO2 OCCLUSION
Numeric is replaced by a -?-
INOP tone.
CO2The 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.
CO2 OVERRANGE
Numeric is replaced by -?-
INOP tone.
CO2The CO2 value is higher than the measurement range. If you
suspect a false high value, contact your service personnel.
CO2 PUMP OFF
Numeric is replaced by a -?-.
CO2The pump has been switched off for fifteen minutes. To switch
it on again, select Pump On in the Setup CO2 menu.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
69
CO2 PURGING
Numeric is replaced by a -?-
INOP tone.
CO2The 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 CO2 OCCLUSION is
displayed.
CO2 SENS. WARMUP
Numeric is displayed with a -?-
Microstream CO2: INOP tone.
Mainstream CO2: no INOP tone
CO2Wait until the sensor reaches operating temperature and the
INOP disappears.
C.O. UNPLUGGED
numeric is replaced by -?-
INOP tone.
C.O. Plug in the C.O. module. Silencing this INOP switches off the
measurement.
CO2 UPDATE FW
Numeric is replaced by a -?-
INOP tone.
CO2The software in the Measurement Extension does not match
the software in the MMS. Contact your service personnel.
CO2 WAIT CAL2
Numeric is replaced by a -?-
CO2Calibration on the first calstick cell is complete. Place the
transducer on the other calstick cell and start the CAL2
calibration cycle.
CO2 ZERO FAILED
Numeric is replaced by a -?-
INOP tone.
CO2An 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.
CO2 ZERO REQU’D
Numeric is replaced by a -?-
INOP tone
CO2Perform zero calibration for the CO2 sensor. If the INOP
persists, contact your service personnel.
CO2 ZERO RUNNING CO2Wait until zero calibration is finished.
CPP CHK SOURCES
Numeric is replaced by a -?-
CPP Not all measurements or values required to perform the
calculation are available. Check the measurement sources.
CPP CHK UNITS
Numeric is replaced by a -?-
CPP The monitor has detected a conflict in the units used for this
calculation. Check the unit settings.
!!/!!!CUFF NOT DEFLAT
Numeric is displayed with a -?-
Severe yellow/red INOP tone.
During this INOP, alarms cannot be
paused or switched off.
NBP 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
15mmHg (2kPa) for more than 3 minutes.
Neonatal patients: The NBP cuff pressure has exceeded 5mmHg
(0.7kPa) for more than 90 seconds.]
!!/!!!CUFF OVERPRESS
Numeric displayed with -?- ;
Severe yellow/red INOP tone.
During this INOP, alarms cannot be
paused or switched off.
NBP 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.
CVP INOPS PRESS See <Pressure label> INOPS (under Pressure).
DEVICE CHECK SETUP
INOP tone. IntelliBridge Device identification completed, but communication could
not be established due to timeout.
IntelliBridge INOP abbreviations may differ slightly depending
on the device category.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
70
DEVICE CHECK CONF.
INOP tone. IntelliBridge Device identification completed, but communication could
not be established due to error.
IntelliBridge INOP abbreviations may differ slightly depending
on the device category.
DEVICE DEMO DATA
INOP tone
IntelliBridge The device connected to the IntelliBridge module reports demo
data but the monitor is not in DEMO mode.
DEVICE REAL DATA
INOP tone
IntelliBridge The monitor is in DEMO mode but the device connected to
the IntelliBridge module reports data that are not flagged as
demo data.
<Device> UNPLUGGED
INOP tone. IntelliBridge 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.
DEVICE UNSUPPORTED
INOP tone. IntelliBridge 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. IntelliBridge Malfunction in the IntelliBridge module. If this message
appears repeatedly, the module must be replaced. Contact your
service personnel.
ECG/ARRH ALARM OFF
!!ECG/AR ALARM OFF
ECG 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 EQUIP MALF
Numeric is displayed with a -?-
INOP tone.
ECG Contact your service personnel.
The ECG hardware is faulty.
ECG EQUIP MALF T
Numeric is displayed with a -?-
INOP tone.
Monitor Contact your service personnel.
The ECG in the Telemetry device is faulty.
(!!/!!!)<ECG LEAD> LEAD
OFF
Numeric is displayed with a -?-
INOP tone.
ECG 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 EL. NOISY <ECG LEAD> ECG 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 LEADS OFF ECG Check that all of the required ECG leads are attached, and that
none of the electrodes have been displaced.
ECG NOISY SIGNAL
INOP tone.
ECG 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.
EcgOut EQUIP MALF
INOP tone
ECG Check that the ECG out cable is securely connected. Contact
your service personnel.
EEG EQUIP MALF
INOP tone
EEG The EEG hardware is faulty. Contact your service personnel.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
71
EEG IMPEDANCE HIGH or
EEG1 and/or EEG2 IMPED. HIGH
EEG 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<X> LEAD OFF <n>
[X = channel, n = electrode]
EEG Reconnect specified electrode.
EEG<X> LEAD OFF
[X = channel]
at Information Center
EEG 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.
EEG<X> LEADS OFF
[X = channel]
EEG Two or more electrodes are not connected. Check in the EEG
Impedance/Montage window which electrodes are
affected and reconnect the electrodes.
EEG LINE NOISE
EEG 1 or 2 LINE NOISE
EEG 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
EEG 1 or 2 MUSCLE NOISE
EEG 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 TRANSDUCER
INOP tone
EEG 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
EEG Plug in module. Silencing this INOP switches off the
measurement.
EEG OVERRANGE, or
EEG<X> OVERRANGE
EEG Input signal is too high in one or both channels. This is usually
caused by interfering signals such as line noise or electro-
surgery. X denotes the EEG channel.
FAP INOPS PRESS See <Pressure label> INOPS (under Pressure).
FMS UNPLUGGED
INOP tone.
FMS 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.
FMS The Flexible Module Rack is not supported by your monitor.
Contact your service personnel.
IC1/IC2 INOPS PRESS See <Pressure label> INOPS (under Pressure).
ICP INOPs PRESS See <Pressure label> INOPS (under Pressure).
Indep.Dsp Malfunc. Display A problem has occurred with the second main display. Contact
your service personnel.
Indep.Dsp NotSupp. Display The monitor does not support a second main display. The
monitor software is incompatible. Contact your service
personnel.
!!INSERT BATTERY
Severe yellow INOP tone.
During this INOP, alarms cannot be
paused or switched off.
Battery 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.
Intell.Dsp Malf.
INOP tone
Display There is a problem with the Intelligent Display. Check the
MSL coupling cable then contact your service personnel.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
72
Intell.Dsp Missing Display The monitor has lost contact with the connected Intelligent
Display. Contact your service personnel.
Intell.Dsp Unsupp. Display The monitor does not support the connected Intelligent
Display. The monitor software is incompatible.
Internal.Comm.Malf
INOP tone
Monitor There is a problem with I2C Bus communication in the
monitor. Contact your service personnel.
INVALID LEADSET Telemetry
LA LEAD OFF
Numeric is replaced by -?- for 10
seconds; INOP tone.
ECG 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.
LAP INOPs PRESS See <Pressure label> INOPS (under Pressure).
LEADSET UNPLUGGED Telemetry The leadset has been unplugged from the telemetry device.
LL LEAD OFF
Numeric is replaced by -?- for 10
seconds; INOP tone.
ECG 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.
MCC Reversed
INOP tone
Monitor The MSL coupling cable is reversed. Connect the end with the
grey connector to the Intelligent Display.
MCC Unsupported
INOP tone
Monitor An MSL coupling cable has been connected to a device which
does not support MSL coupling.
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.
MEASSRV UNSUPPORTD
INOP tone
MMS The Multi-Measurement module is not supported by the
monitor. Contact your service personnel.
MMS Ext. EQUIP MALF
INOP tone
MMS
Extension
Loss of communication between the Multi-Measurement
Module and the MMS extension. Contact your service
personnel.
MMS Ext. UNPLUGGED
INOP tone
MMS
Extension
The MMS extension has been disconnected from the Multi-
Measurement Module.
MMS Ext. Unpowered
INOP tone
MMS
Extension
The MMS extension cannot operate while the Multi-
Measurement Module is running on battery power.
MMSExt.Unsupported
INOP tone
MMS
Extension
The MMS extensions not supported by your monitor. Contact
your service personnel.
MMS UNPLUGGED
INOP tone.
MMS Make sure that the Multi-Measurement Module is connected
to the monitor. All MMS measurements are off while the MMS
is unplugged.
MMS UNSUPPORTED
INOP tone.
MMS The Multi-measurement Module is not supported by your
monitor. Contact your service personnel.
!!/!!!MORE BED ALARMS
At Information Center
Monitor 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.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
73
MSL Power High Monitor 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.
Monitor 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.
Monitor 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.
NBP Deactivated
INOP tone.
NBP 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.
NBP 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.
NBP 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.
NBP 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.
No Central Monit.
INOP tone
Monitor There is a problem with the communication to the network.
Central monitoring is currently not possible (no patient alarms
or information). Check the connection. Contact your service
personnel.
!!/!!! NO DEVICE DATA
NO DEVICE DATA
IntelliBridge Communication with connected device has been lost.
NO ECG AT CENTRAL Monitor The ECG measured with the monitor ECG is not being sent to
the Information Center via the telemetry device.
NO ECG SOURCE Telemetry A telemetry device is paired with the monitor but the
Information Center is not detecting a valid ECG signal from
either of them.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
74
NO PPV FROM MeasSrv
at Information Center
MMS or
FMS
The measurement device does not supply a beat-to-beat arterial
pressure value. Contact your service personnel.
NO PPV FROM <Device> MMS or
FMS
The measurement device does not supply a beat-to-beat arterial
pressure value. Contact your service personnel.
OUT OF AREA Telemetry The telemetry device has left the access point coverage area.
P/P1/P2/P3/P4 INOPS PRESS See <Pressure label> INOPS (under Pressure).
PAP INOPS PRESS See <Pressure label> INOPS (under Pressure).
PPV BAD <Pressure Label>
SIGNAL
PPV The arterial pressure source selected for PPV is not providing a
pulsatile signal.
PPV BAD SIGNAL
at Information Center
PPV The arterial pressure source selected for PPV is not providing a
pulsatile signal.
PPV CHK SOURCES PPV 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.
<Pressure label> ARTIFACT
Numeric questionable
PRESS A non-physiological event is detected (for example, a flush or
blood sample). A resulting high limit alarm will be suppressed.
<Pressure label>
DEACTIVATED
INOP tone
PRESS 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.
<Pressure label> EQUIP
MALF
Numeric is replaced by -?-
INOP tone.
PRESS Contact your service personnel.
The pressure hardware is faulty.
<Pressure label> NO
TRANSDUCER
Numeric is replaced by -?-
INOP tone.
PRESS 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.
<Pressure label> NOISY
SIGNAL
Pulse numeric is replaced by -?-
INOP tone.
PRESS 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.
<Pressure label> NON-
PULSATILE
Pulse numeric is replaced by -?-
INOP tone.
PRESS 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.
<Pressure label>
OVERRANGE
Numeric is replaced by -?-
INOP tone.
PRESS 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.
<Pressure label> REDUCE
SIZE
PRESS Increase the scale for the pressure wave.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
75
<Pressure label>
UNPLUGGED
INOP tone.
PRESS 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.
<Pressure label>
ZERO+CHECK CAL
Numeric is replaced by -?-
PRESS Perform a zero and check the calibration of the transducer.
<pTemp label> CHECK PROBE
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
Check that the probe holder is correctly installed and that a
compatible probe is in use. If the INOP does not clear, remove
the probe from the holder then replace it. If the INOP still does
not clear, disconnect and reconnect the probe.
<pTemp label> DEACTIVATED
INOP tone.
Predictive
Temp
The Predictive temperature has been deactivated.
<pTemp label> EQUIP MALF
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
The Predictive Temperature hardware is defective. Contact
your service personnel.
<pTemp label> INCOMPAT. Predictive
Temp
The Predictive Temperature version is not supported by the
monitor.
<pTemp label> MEAS FAILED
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
The ambient temperature is outside the specified range (10 to
40°C /50 to 104°F). Bring the temperature into range to
continue monitoring. If the INOP does not clear, disconnect
and reconnect the probe.
<pTemp label> NO PROBE
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
Connect a probe to the Predictive temperature unit.
<pTemp label> OVERRANGE
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
The temperature at the measurement site is out of range. Check
that the probe is correctly located. If the INOP does not clear,
disconnect and reconnect the probe.
<pTemp label> PROBE MALF
Numeric is replaced by -?-
INOP tone.
Predictive
Temp
The connected probe may be defective. Disconnect and
reconnect the probe. If the INOP does not clear, try another
probe.
pTaxil INOPS Predictive
Temp
See <pTemp label> INOPS
pToral INOPS Predictive
Temp
See <pTemp label> INOPS
pTrect INOPS Predictive
Temp
See <pTemp label> INOPS
(!!)PW:Action Required Protocol
Watch
The protocol currently running requires a user response. Check
which pop-up window is displayed and provide the appropriate
response.
PW:Check Settings Protocol
Watch
Contact your service personnel. Settings could not be loaded or
interpreted correctly
PW in conflict Protocol
Watch
There is a patient information mismatch which has not yet
been resolved (>15 minutes).
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
76
RA LEAD OFF
Numeric is replaced by -?-
INOP tone.
ECG 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.
RAP INOPS PRESS See <Pressure label> INOPS (under Pressure).
Rem.Alarmdev.Malf
INOP tone
Monitor 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.
Rem. Display Malf. Remote
display
There is a problem with an input device at the remote display.
Perform a visual and functional check of all input devices.
Contact your service personnel.
!!/!!! REPLACE BATTERY T
Severe yellow/red INOP tone.
During this INOP, alarms cannot be
paused or switched off.
Telemetry The battery in the telemetry device is almost empty and must
be replaced.
RESP EQUIP MALF
Numeric is replaced by -?-
INOP tone.
RESP Contact your service personnel. The RESP hardware is faulty.
RESP ERRATIC
Numeric is replaced by -?-
RESP 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.
RESP Not all the required leads for Resp monitoring are attached.
Make sure that the RA and LL leads are attached.
RL LEAD OFF
Numeric is replaced by -?- for 10
seconds; INOP tone.
ECG 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.
Settings Malfunc.
INOP tone.
Monitor The monitor cannot use the predefined settings for
monitoring. Contact your service personnel.
<SO2 Label> CAL FAILED
Numeric is replaced by -?-
INOP tone.
SO2The 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.
<SO2 Label> CAL MODE
Numeric is replaced by -?-
INOP tone.
SO2Pre-insertion calibration is complete, but the catheter tip is still
inside the optical reference. The catheter is now ready for
insertion.
<SO2 Label>CAL REQUIRED
Numeric is replaced by -?-
INOP tone.
SO2There is no valid calibration data in the Optical Module.
Perform either a pre-insertion or an in-vivo calibration.
<SO2 Label> CANNOT MEAS
Numeric is replaced by -?-
INOP tone.
SO2The 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.
<SO2 Label>CONFIG ERROR
Numeric is replaced by -?-
INOP tone.
SO2The Optical Module has been configured to SaO2 Mode. Use
Change to Venous in the setup menu to reconfigure to venous
saturation mode.
<SO2 Label> CONN OPTMOD
Numeric is replaced by -?-
INOP tone.
SO2The Optical Module was disconnected during data storage.
Reconnect the Optical Module for at least 20 seconds.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
77
<SO2 Label> EQUIP MALF
Numeric displays -?-.
INOP tone
SO2The 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.
SO2 INCOMPATIBLE
INOP tone
SO2The SO2 Module or Optical Module is not supported. Contact
your service personnel.
<SO2 Label> IN-VIVO CAL SO2The 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.
<SO2 Label>LIGHT INTENS
Numeric is replaced by -?-
INOP tone.
SO2The 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).
<SO2 Label> LOW LIGHT
Numeric is replaced by -?-
INOP tone.
SO2The 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.
<SO2 Label> NO OPTMOD
Numeric is replaced by -?-
INOP tone.
SO2Connect the Optical Module. If the INOP persists, try another
Optical Module. Silencing this INOP switches the
measurement off.
<SO2 Label> OPTMOD MALF SO2The 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.
<SO2 Label> PRE-INS CAL
Numeric displays -?-
INOP tone
SO2The pre-insertion calibration is running. This typically takes
one minute. During this time alarms are switched off. Wait
until the calibration is complete.
<SO2 Label> UNPLUGGED
Numeric displays -?-.
INOP tone
SO2Measurement switched on and SO2/SvO2 module unplugged
from the rack.
SO2 UPGRADE
INOP tone
SO2The SO2 module is currently in upgrade mode.
Monitoring is not possible in this mode.
<SO2 Label> WARMUP
Numeric is displayed with ?
SO2The Optical Module has not yet reached the operating
temperature. Wait a few minutes until warm-up is finished.
SOME ECG ALRMS OFF Arrhythmia This message appears (if configured to do so) when the on/off
settings of the yellow arrhythmia alarms differ from the current
Profile.
Speaker Malfunct.
INOP tone
Monitor Contact your service personnel to check the speaker and the
connection to the speaker.
SPIRO MALFUNCTION Spirometry Module failure detected. Contact your service personnel.
SPIRO INCOMPATIBLE Spirometry Module revision not compatible with the host monitor
software revision. Contact your service personnel.
SPIRO UPGRADE Spirometry The module is running a firmware upgrade. Wait until upgrade
is completed before resuming monitoring.
SPIRO CANNOT MEAS Spirometry Measurement is at its limit, e.g. ambient pressure out of range.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
78
SPIRO PURGE FAILED Spirometry 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 UNKN. SENSOR Spirometry An unknown sensor ID code was detected. Use only the sensors
listed in the Accessories chapter.
SPIRO ALARMS SUPPR Spirometry Alarming is suppressed for the spirometry module.
SPIRO PURGING Spirometry A purge operation is in progress - no data update on the screen.
Wait until purge is complete.
SPIRO NO SENSOR Spirometry No sensor detected. Make sure the correct sensor is attached to
the breathing circuit.
SPIRO NO BREATH Spirometry No breath was detected for more than 25 seconds. Breath
derived numerics are not available.
SPIRO GAS COMPENS? Spirometry 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 PATIENT CAT. Spirometry 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 Spirometry chapter.
SpO2 CHK SOURCES
Numeric is replaced by -?-
SpO2
Difference
Not all measurements or values required to perform the
calculation are available. Check measurement sources.
SpO2 CHK UNITS
Numeric is replaced by -?-
SpO2
Difference
The monitor has detected a conflict in the units used for this
calculation. Check the unit settings.
<SpO2 label> DEACTIVATED
INOP tone
SpO2The 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.
<SpO2 label> EQUIP MALF
Numeric is replaced by -?-
INOP tone.
SpO2The MMS or module is faulty. Unplug and replug the MMS or
module. If the INOP persists, contact your service personnel.
<SpO2 label> ERRATIC
Numeric is replaced by -?-
INOP tone.
SpO2Check the sensor placement. Try another adapter cable and
sensor. If the INOP persists, contact your service personnel.
<SpO2 label> EXTD. UPDATE
Label is displayed with a -?-
(questionable numeric)
SpO2The update period of displayed values is extended due to an
NBP measurement on the same limb or an excessively noisy
signal.
<SpO2 label> INTERFERNCE
Numeric is replaced by -?-
INOP tone.
SpO2There 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.
<SpO2 label> LOW PERF
Label is displayed with a -?-
(questionable numeric)
SpO2Accuracy may be compromised due to very low perfusion.
Stimulate circulation at sensor site. If INOP persists, change
the measurement site.
<SpO2 label> NOISY SIGN.
Numeric is replaced by -?-
INOP tone.
SpO2Excessive patient movement or electrical interference is causing
irregular pulse patterns. Try to reduce patient movement or to
relieve the cable strain on the sensor.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
79
<SpO2 label> NON-PULSAT.
Numeric is replaced by -?-
INOP tone.
SpO2Check 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.
<SpO2 label> NO SENSOR
Numeric is replaced by -?-
INOP tone.
SpO2Make 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.
<SpO2 LABEL> POOR SIGNAL
Label is displayed with a -?-
(questionable numeric)
SpO2The signal condition of the SpO2 measurement is poor and
measurement accuracy may be compromised.
<SpO2 LABEL> PULSE?
Numeric is replaced by -?-
INOP tone
SpO2The detectable pulsations of the SpO2 signal are outside the
specified pulse rate range.
<SpO2 LABEL> SEARCHING
Numeric unavailable
SpO2SpO2 is analyzing the patient signal to derive Pulse, SpO2 and
Perf values. Please wait until the search analysis is complete.
<SpO2 label> SENSOR MALF
Numeric is replaced by -?-
INOP tone.
SpO2The SpO2 sensor or adapter cable is faulty. Try another adapter
cable and sensor. If the INOP persists, contact your service
personnel.
<SpO2 LABEL> SENSOR OFF
Numeric is replaced by -?-
INOP tone
SpO2The SpO2 sensor is not properly applied to the patient. Apply
the sensor following the instructions supplied by the
manufacturer.
<SpO2 LABEL> UNKN.SENSOR
Numeric is replaced by a -?-
SpO2The connected sensor or adapter cable is not supported by the
SpO2 measurement. Use only specified sensors and cables.
<SpO2 LABEL> UNPLUGGED
Numeric is replaced by -?-
INOP tone
SpO2An 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.
<SpO2 LABEL> UPGRADE
Label is displayed with a -?-, numeric is
unavailable
SpO2The SpO2 measurement is currently in UPGRADE mode.
Monitoring is not possible in this mode.
Sp - vO2 CHK SOURCES
Numeric is replaced by -?-
Sp - vO2Not all measurements or values required to perform the
calculation are available. Check measurement sources.
Sp - vO2 CHK UNITS
Numeric is replaced by -?-
Sp - vO2The monitor has detected a conflict in the units used for this
calculation. Check the unit settings.
SRR INTERFERENCE
INOP tone
Monitor The short range radio connection has interference from
another device. Try using another channel.
SRR INVALID CHAN
INOP tone
Monitor 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.
SVR/SVRI CHK SOURCES
Numeric is replaced by -?-
SVR/SVRI Not all measurements or values required to perform the
calculation are available. Check measurement sources.
SVR/SVRI CHK UNITS
Numeric is replaced by -?-
SVR/SVRI The monitor has detected a conflict in the units used for this
calculation. Check the unit settings.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
80
SVR/SVRI SET CVP USED
Numeric is replaced by -?-
SVR/SVRI 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.
T/T1/T2/T3/T4 INOPs TEMP See <Temp label> INOPs (under Temp)
TAAP DISABLED
INOP tone
Monitor The currently selected telemetry configuration on the monitor
does not allow connection of telemetry devices to the monitor.
Tamb INOPs TEMP See <Temp label> INOPs (under Temp)
Tart INOPs TEMP See <Temp label> INOPs (under Temp)
Tblood NO TRANSDUC
Numeric is replaced by -?-
INOP tone
C.O. No transducer attached to the module or catheter
disconnected.
Tblood OVERRANGE
Numeric is replaced by -?-
C.O. Tblood out of range 17°C - 43°C.
Tcereb INOPS TEMP See <Temp label> INOPs (under Temp)
Tcore INOPs TEMP See <Temp label> INOPs (under Temp).
tcpO2 (or tcpCO2 or tcGas)
CAL FAILED
Numeric is replaced by -?-
INOP tone.
tcGas 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.
tcpO2 (or tcpCO2 or tcGas)
CAL REQUIRD
Numeric is replaced by -?-
INOP tone.
tcGas 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.
tcpO2 (or tcpCO2 or tcGas)
CAL RUNNING
Numeric displays first -?- , then
numeric is displayed with a ?
tcGas Wait until the tcpO2/tcpCO2 calibration is finished.
tcpO2 (or tcpCO2 or tcGas)
CHECK TIME
tcGas Site Timer due to time out in 15 minutes or less.
tcpO2 (or tcpCO2 or tcGas)
CHANGE SITE
If Heat Switch Off is configured to Yes,
numeric is replaced by -?-
INOP tone.
tcGas 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.
tcpO2 (or tcpCO2 or tcGas)
EQUIP MALF
Numeric is replaced by -?-
INOP tone.
tcGas There is a malfunction in the transducer or module. Connect
another transducer. If this INOP persists, contact your service
personnel.
tcpO2 (or tcpCO2 or tcGas)
NO TRANSDUC
Numeric is replaced by -?-
INOP tone.
tcGas No transducer is connected to the tcpO2/tcpCO2 module.
Silencing the alarm switches off the measurement.
tcpO2 (or tcpCO2 or tcGas)
STABILIZING
Numeric is displayed with a ?
tcGas The transducer has not yet reached the selected temperature
and/or skin hyperemization is not yet finished. This INOP will
disappear within three minutes.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
81
tcpO2 (or tcpCO2 or tcGas)
UNPLUGGED
Numeric is replaced by -?-
INOP tone.
tcGas The measurement is switched on but the module is unplugged.
The measurement automatically disappears from the display.
Silencing this INOP switches off the measurement.
TELE CONFIG UNSUPP
INOP tone
Monitor Telemetry device not supported (companion mode)
!!/!!!TELE DISCONNECT
INOP tone
Telemetry 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 EQUIP MALF
INOP tone
Monitor The telemetry device has a malfunction. Disconnect and
reconnect the telemetry device. If the INOP reappears, replace
the telemetry device.
TELE INCOMPATIBLE Monitor SRR-enabled telemetry device is not supported by this central
software revision. Please check configuration.
!!/!!! TELE INOP
Severe yellow/red INOP tone.
Telemetry Check for further details at the Information Center or in the
Telemetry Data window on the monitor.
Tele Sync Unsupp.
INOP tone
Telemetry 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.
TELE UNSUPPORTED
INOP tone
Monitor This telemetry device is not supported for direct connection to
the monitor.
<Temp> CHK SOURCES
Numeric is replaced by -?-
TEMP
Difference
Not all measurements or values required to perform the
calculation are available. Check measurement sources.
<Temp> CHK UNITS
Numeric is replaced by -?-
TEMP
Difference
The monitor has detected a conflict in the units used for this
calculation. Check the unit settings.
<Temp label> DEACTIVATED
INOP tone
TEMP 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.
TEMP Contact your service personnel.
The temperature hardware is faulty.
<Temp label> NO
TRANSDUCER
Numeric is replaced by -?-
INOP tone.
TEMP Make sure the TEMP probe is connected to the MMS or
module.
If you silence this INOP, the measurement will be switched off.
INOP Message, Indication Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
82
<Temp label> UNPLUGGED
INOP tone
TEMP 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.
<Temp label> OVERRANGE
Numeric is replaced by -?-
INOP tone.
TEMP Try changing the application site of the transducer.
[The temperature is less than -1C, or greater than 45C.]
Tesoph INOPS TEMP See <Temp label> INOPs (under Temp).
TEXT UPLOAD FAILED
INOP tone IntelliBridge 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.
TimeExpired:<timer label>
INOP tone
Monitor The time has expired for the timer indicated in the INOP text.
Clearing the timer clears the INOP.
Tnaso INOPS TEMP See <Temp label> INOPs (under Temp).
Trect INOPS TEMP See <Temp label> INOPs (under Temp).
Tskin INOPS TEMP See <Temp label> INOPs (under Temp).
Ttymp INOPS TEMP See <Temp label> INOPs (under Temp)
Tven INOPS TEMP See <Temp label> INOPs (under Temp).
Tvesic INOPS TEMP See <Temp label> INOPs (under Temp)
UAP INOPS PRESS See <Pressure label> INOPS (under Pressure).
Unsupported LAN
INOP tone
Monitor 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.
Monitor Perform a visual and functional check of all the monitor input
devices. Contact your service personnel.
UVP INOPS PRESS See <Pressure label> INOPS (under Pressure).
V LEAD OFF
Numeric is replaced by -?- for 10
seconds; INOP tone.
ECG 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.
<VueLink option> CHK
CABLE
INOP tone.
VueLink 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.
VueLink 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.
INOP Message, Indication Source What to do
Technical Alarm Messages (INOPs) 5 Patient Alarms and INOPs
83
<VueLink option> CHECK
SETUP
INOP tone.
VueLink 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.
VueLnk EQUIP MALF
INOP tone.
VueLink 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.
VueLnk NO CONFIG
INOP tone.
VueLink 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.
VueLnk UNPLUGGED
INOP tone.
VueLink 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 Source What to do
5 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
84
85
6
6Managing 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 the MP5 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/Dischrge SmartKey to open the
Patient Demographics window.
6 Managing Patients Admitting a Patient
86
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.
–Last Name: Enter the patient’s last name (family name), for example Smith.
–First Name: Enter the patient’s first name, for example Joseph.
–Middle Name (if configured to appear): Enter the patient’s middle name.
–Lifetime Id, Encounter Id: Whether these fields appear and how they are labelled can
be configured for your hospital. One or both fields may be displayed and the labels may read:
MRN, Case Id, Visit Id, etc. Enter the appropriate data for the fields displayed.
–Patient Cat: Choose the patient category, either Adult, Pediatric, or Neonatal.
–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: Enter any extra information about the patient or treatment.
5Select Confirm. The patient status changes to admitted.
Last Name
First Name
Middle Name
Lifetime Id
Encounter Id
Patient Cat.
Paced
Height
Weight
BSA (D)
DOB
Age
Gender
Notes (1):
Notes (2):
Adult
No
Patient Demographics
Quick Admitting a Patient 6 Managing Patients
87
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 Category 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.
1Select the Quick Admit SmartKey.
2Enter the required data (ID fields or Last Name depending on configuration) with the keyboard.
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.
6 Managing Patients Discharging a Patient
88
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 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 central printer is available before you use End Case.
To discharge a patient,
1Select the patient name field or select the Admit/Dischrge SmartKey to open the
Patient Demographics window and associated pop-up keys.
2Select the pop-up key for either:
–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 ->
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 the section on AutoReports 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 6 Managing Patients
89
Transferring Patients
To save you from having to enter the same patient data multiple times and enable patient transfer
without loss of data, patient demographic information is shared between patient monitors and
Information Centers.
Transferring a Centrally-Monitored Patient using IIT
Scenario: A centrally-monitored patient is moved with the MP5 to another monitoring location on the
same Information Center database server without interrupting the collection of patient trend
information. The 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 MP5 is connected to a host monitor (Companion
Mode is indicated).
1Remove the MP5 from the host monitor.
2Move the patient using the MP5 as the transport monitor.
3At the new location, just before connecting the MP5 to the new host monitor:
– open the Patient Demographics window.
– select the Transfer pop-up key.
–wait until the transfer has completed.
4Connect the 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 MP5 to the receiving monitor.
Verify that the settings for patient category and paced mode are correct.
Transferring a Centrally-Monitored Patient with the Monitor
Scenario: A centrally-monitored patient is moved with the monitor to another monitoring location on
the same Information Center database server without interrupting the collection of patient trend
information.
1Select 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.
2At the new location, connect the monitor to the network (only needed for wired networks). If the
monitor detects a patient mismatch, a window will open showing your patient’s data and asking
Complete transfer of this patient?.
3Select Yes to complete the transfer.
4Verify that the settings for patient category and paced mode are correct.
6 Managing Patients Transferring Patients
90
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.
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.
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 Category, 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
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.
Transferring Patients 6 Managing Patients
91
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.
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 monitor. 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, choose
the data set you want to continue using for
this patient by selecting one of the sectors in
the Select Patient window.
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 Patient
DOE, JOHN F
1234HG9556, 2008/00123
Adult Non-Paced
MILLER,
Adult Paced
Same Patient
New Patient
6 Managing Patients Care Groups
92
♦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.
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.
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.
Bed 1 Bed 2 Bed 3 Bed 4 Bed 5 Bed 6 Bed 7 Bed 8 Bed 9 Bed11 Bed 12 Bed 13 Bed 14
Care Groups 6 Managing Patients
93
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
The alarms at this monitor are suspended
The monitor is in standby mode
The monitor is in Demonstration mode
The current monitor
Bed 8 Bed 8
Bed 5 Bed 5
Bed 14 Bed 14
Bed 9 Bed 9
Bed 7 Bed 7
Bed 11 Bed 11
Bed 6 Bed 6
Bed 4
Bed 12
Bed 3 Bed 3
Care Group Symbols (used in the Care Group overview bar
and the My Care Group window)
This is a telemetry bed
6 Managing Patients Care Groups
94
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 (shown here)
shows first the beds of the Information Center
this bed is connected to. By selecting the
Information Center name 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.
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 Patient 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.
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 (used in the Care Group overview bar
and the My Care Group window)
Beds From:
Room 2
Room 4
Bed 2
Bed 4
Bed 8
Room 1
Room 3
Room 5
Smith, Mary
Jones, Paul
Murphy, Sarah
Miller, John
Baker, Jane
Green, Liza
Scott, James
Black, Harald
My Care Group
Care Groups 6 Managing Patients
95
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 popup 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 popup:
1Select Main Setup > Network > Auto Window
2Select Disabled
When automatic popup 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 .
To open the Other Bed window,
♦select any field in the monitor info line to enter the Setup menu, then select My CareGroup
and select the required bed, or
♦Select the Other Patients SmartKey, if configured, and select the required 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.
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.
Bed Label
VTACH
ABP
HR
ST-II
ST-V
ABP
CVP
RESP
PAP
PULSE
T1
PVC
Bed Label
VTACH
HR
PVC
ABP PAP NBP
Sys
6 Managing Patients Care Groups
96
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.
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:
Care Groups 6 Managing Patients
97
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.
6 Managing Patients Care Groups
98
99
7
7ECG, 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
page 115), ST monitoring (see page 127) and QT monitoring (see page 137).
Skin Preparation for Electrode Placement
Good electrode-to-skin contact is important for a good 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 on the monitor. An ECG waveform and
numeric appears on the monitor display.
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.
7 ECG, Arrhythmia, ST and QT Monitoring Selecting the Primary and Secondary ECG Leads
100
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.
To select a lead as primary or secondary lead:
♦In the Setup ECG menu, select Primary Lead or Secondary Lead, 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.
You should choose a lead as primary or secondary lead that
has the following characteristics:
• 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
Monitoring Paced Patients 7 ECG, Arrhythmia, ST and QT Monitoring
101
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, 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.
If so configured, the monitor can supply its own synchronization marks; in this case the
synchronization marks from a defibrillator will not be shown.
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:
1 Lead label of the displayed wave
2 1 mV calibration bar
3Pacer spikes
4 Pace pulse markers
5 Current heart rate
6 Current heart rate alarm limits
7 EASI lead placement label
8 ECG Filter label
1 Pacer spikes configured to have a fixed size
EASI
M
HR bpm
4
8
1
6
5
7
3
Paced Rhythm
2
1
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You should choose a lead as primary or secondary lead that has these characteristics:
• 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.
1Normal Beats
2 Pace Pulses/Beats
2
1
♦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
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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.
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 AutoSize, 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 AutoSize lets the monitor choose the optimal adjustment factor for all displayed 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).
1 Repolarization tail
(note width)
1
7 ECG, Arrhythmia, ST and QT Monitoring Changing the ECG Filter Settings
104
♦To change the QRS volume, in the Setup ECG menu select QRS Volume and then select the
appropriate volume from the pop-up list.
There will be no QRS tone when the MP5 is connected to a host monitor.
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 for pediatric and neonatal patients 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 electro-surgical units. Under normal measurement conditions, 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.
When you are using a telemetry transmitter connected via short range radio to the monitor, the
upper bandwidth for all filter settings is limited to 40 Hz.
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.
Choosing EASI or Standard Lead Placement 7 ECG, Arrhythmia, ST and QT Monitoring
105
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 1mV 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 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.
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.
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
7 ECG, Arrhythmia, ST and QT Monitoring ECG Lead Fallback
106
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.
Electrode labels Electrode colors
AAMI EASI IEC AAMI IEC
RA I RWhite Red
LA S LBlack Yellow
LL A FRed Green
RL N N Green Black
V E CBrown White
V1 C1 Brown/Red White/Red
V2 C2 Brown/Yellow White/Yellow
V3 C3 Brown/Green White/Green
V4 C4 Brown/Blue White/Brown
V5 C5 Brown/Orange White/Black
V6 C6 Brown/Violet White/Violet
ECG Lead Placements 7 ECG, Arrhythmia, ST and QT Monitoring
107
Standard 3-Lead Placement
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 ECG Setup
Menu to ensure correct labeling.
1 RA placement: directly below the clavicle
and near the right shoulder
2 LA placement: directly below the
clavicle and near the left shoulder
3 LL placement: on the left lower
abdomen
12
3
RA placement: directly below the clavicle and
near the right shoulder
LA placement: directly below the clavicle and
near the left shoulder
RL placement: on the right lower abdomen
LL placement: on the left lower abdomen
V placement: on the chest, the position depends
on your required lead selection
2
4
1
V
3
I
III
II
aVR
aVL
aVF
5
7 ECG, Arrhythmia, ST and QT Monitoring ECG Lead Placements
108
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.
V1 placement: on the fourth
intercostal space at the right sternal
border
V2 placement: on the fourth
intercostal space at the left sternal
border
V3 placement: midway between the
V2 and V4 electrode positions
V4 placement: on the fifth
intercostal space at the left
midclavicular line
V5 placement: on the left anterior
axillary line, horizontal with the V4
electrode position
V6 placement: on the left midaxillary line, horizontal with the V4 electrode position
V3R to V6R placement: on the right side of the chest in positions corresponding to those on the left
VE placement: over the xiphoid process
V7 placement: on posterior chest at the left posterior axillary line in the fifth intercostal space
V7R placement: on posterior chest at the right posterior axillary line in the fifth intercostal space
VE
V1 V2 V3 V4 V5 V6
V7
V3R
V4R
2
3
4
Angle of
Lewis
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109
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.
Conventional 12-Lead ECG
1 - V1 - V6
2 - LA
3 - LL
4 - RL
5 - RA
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
52
1
43
7 ECG, Arrhythmia, ST and QT Monitoring Capture 12-Lead
110
Modified 12-Lead ECG
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.Lead Placment to On in the monitor. To do this,
♦in the Setup ECG menu, select Mod.LeadPlacment to toggle between On and Off.
–When Mod.Lead Placment is set to On, 12 Lead ECG Reports will be labelled 12 Lead
ECG Report (Mason-Likar), and captured 12-lead ECGs will be labelled 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 labelled 12 Lead
ECG Report, 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.
Capture 12-Lead
If the monitor is connected to an Information Center via a wired network, the Capture 12-Lead
SmartKey may be configured. Selecting this exports 12-Lead ECG information to the Information
Center for analysis. For details see the Instructions for Use supplied with the Information Center.
1 - LA
2 - V1 - V6
3 - LL
4 - RL
5 - RA
6 - Angle of Lewis
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.
1
3
5
4
6
2
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111
EASI ECG Lead Placement
Using a standard 5-electrode set in EASI lead placement you can monitor up to 12 standard ECG leads
simultaneously and continuously at the bedside. EASI provides a monitoring method for trending ST
segment changes that can provide an early indication of ischemia.
WARNING EASI-derived 12-lead ECGs and their measurements are approximations to conventional 12-lead
ECGs. As the 12-lead ECG derived with EASI is not exactly identical to the 12-lead conventional
ECG obtained from an electrocardiograph, it should not be used for diagnostic interpretations.
Respiratory monitoring is also possible with the EASI placement; respiration is measured between the I
and A electrodes.
Place the electrodes as accurately as possible to obtain the best quality EASI measurements.
When EASI lead placement is selected, EASI is shown beside the 1mV calibration bar on the ECG
wave on the display, and EASI is marked on any recorder strips and printouts.
EASI Monitoring During INOP Conditions If one of the derived EASI leads has an INOP
condition (for example, LEAD OFF), a flat line is displayed. After 10 seconds, the directly acquired
EASI AI, AS, or ES lead (depending on which is available) is displayed with the corresponding lead
label. This causes an arrhythmia relearn.
EASI Electrode Placement
1E (V) on the lower sternum at the level of
the fifth intercostal space
2A (LL) on the left midaxillary line at the
same level as the E electrode
3S (LA) on the upper sternum
4I (RA) on the right midaxillary line at the
same level as the E electrode
5Nreference electrode - can be anywhere,
usually below the sixth rib on the
right hip
1
2
3
4
5
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ECG and Arrhythmia Alarm Overview
The ECG and arrhythmia alarms available depend on which measurements are switched on, and the
arrhythmia option enabled for your monitor.
• Cardiotach alarms are available when HR is on and the active alarm source is ECG, but arrhythmia
is switched off
• Basic arrhythmia alarms are available when Arrhythmia is switched on
• Advanced arrhythmia alarms are available when Arrhythmia is switched on and the Advanced
Arrhythmia option has been enabled for your monitor
Cardiotach Alarms Additional Alarms with Basic
Arrhythmia Option
Additional Alarms with
Enhanced Arrhythmia
Option
***Asystole
***Ventricular Fibrillation/
Tachycardia
***Extreme Bradycardia
***Extreme Tachycardia
**High heart rate
**Low heart rate
***Ventricular Tachycardia
**Pacer Not Capture
**Pacer Not Pacing
**PVCs/min HIGH(PVC >
limit/min)
**Afib
**Supraventricular Tach
**Missed Beat
**Pause
**Irregular HR
**Ventricular Rhythm
**Run PVCs High
**Pair PVCs
**R-on-T PVCs
**Ventricular bigeminy
**Ventricular trigeminy
**Non-sustain VT
**Multiform PVCs
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Using ECG Alarms
ECG alarms can be switched on and off and the high and low alarm limits changed just like other
measurement alarms, as described in the Alarms section. Special alarm features which apply only to
ECG are described here.
Extreme Alarm Limits
The extreme rate alarms, Extreme Tachy and Extreme Brady, generated by the active alarm source,
either HR or Pulse, are set in Configuration Mode by adding a set value (the value) to the high and
low alarm limits.
You need to know which value has been configured for your monitor. Changing the high and low
alarm limits automatically changes the extreme alarm limits within the allowed range.
♦To see the extreme rate alarms set for your monitor, in the Setup ECG menu, see the menu items
ExtrTachy and ExtrBrady.
ECG Alarms Off Disabled
Be aware that your hospital department may have decided to disable the setting ECG Alarms Off in
the monitor’s Configuration Mode. In this case, HR alarms cannot be switched off in Monitoring
Mode. If you try to switch off the HR alarms, you will see the message To activate enter
Config and enable Alarms Off.
HR Alarms When Arrhythmia Analysis is Switched Off
When arrhythmia analysis is switched off, only these HR-related alarms will be detected:
• the asystole alarm
• the ventricular fibrillation/tachycardia alarm
• the extreme tachycardia and extreme bradycardia alarms
• the high heart rate and low heart rate alarms.
Enhanced Asystole Detection
In order to improve alarming on asystole under certain conditions, you can set Asystole
Detect. in Configuration Mode to Enhanced. In enhanced mode an asystole alarm will be
suppressed for up to five seconds if a valid beat-to-beat Pulse is detected from a Pressure.
Extreme
Brady Limit Low
Limit
High
Limit
Extreme
Tachy Limit
Extreme Brady Extreme Tachy
7 ECG, Arrhythmia, ST and QT Monitoring ECG Safety Information
114
ECG Safety Information
CAUTION Interference from instruments near the patient and ESU interference can cause problems with the
ECG wave. See the monitor specifications for more information.
WARNING Defibrillation and Electrosurgery: Do not touch the patient, or table, or instruments, during
defibrillation.
After defibrillation, the screen display recovers within 10 seconds if the correct electrodes are used and
applied in accordance with the manufacturers instructions.
ECG cables can be damaged when connected to a patient during defibrillation. Check cables for
functionality before using them again.
According to AAMI specifications the peak of the synchronized defibrillator discharge should be
delivered within 60 ms of the peak of the R wave. The signal at the ECG output on the IntelliVue
patient monitors is delayed by a maximum of 30 ms. Your biomedical engineer should verify that your
ECG/Defibrillator combination does not exceed the recommended maximum delay of 60 ms.
When using electrosurgical (ES) equipment, never place ECG electrodes near to the grounding plate of
the ES device, as this can cause a lot of interference on the ECG signal.
General: When you are connecting the electrodes or the patient cable, make sure that the connectors
never come into contact with other conductive parts, or with earth. In particular, make sure that all of
the ECG electrodes are attached to the patient, to prevent them from contacting conductive parts or
earth.
During surgery: Use the appropriate orange electrode ECG safety cable, or lead cable with an orange
connector, for measuring ECG in the operating room. These cables have extra circuitry to protect the
patient from burns during cautery, and they decrease electrical interference. This also reduces the
hazard of burns in case of a defective neutral electrode at the HF device. These cables cannot be used
for measuring respiration.
Pacemaker failure: During complete heart block or pacemaker failure to pace/capture, tall P-waves
(greater than 1/5 of the average R-wave height) may be erroneously counted by the monitor, resulting
in missed detection of cardiac arrest.
Patients exhibiting intrinsic rhythm: When monitoring paced patients who exhibit only intrinsic
rhythm, the monitor may erroneously count pace pulses as QRS complexes when the algorithm first
encounters them, resulting in missed detection of cardiac arrest.
The risk of missing cardiac arrest may be reduced by monitoring these patients with low heart rate limit
at or slightly above the basic/demand pacemaker rate. A low heart rate alarm alerts you when the
patient’s heart rate drops to a level where pacing is needed. Proper detection and classification of the
paced rhythm can then be determined.
Filtered ECG signal from external instruments: Instruments such as defibrillators or telemetry units
produce a filtered ECG signal. When this signal is used as an input to the bedside monitor, it is filtered
again. If this twice-filtered signal is passed to the arrhythmia algorithm, it may cause the algorithm to
fail to detect pace pulses, pacemaker non-capture, or asystole, thus compromising paced patient
monitoring performance.
About Arrhythmia Monitoring 7 ECG, Arrhythmia, ST and QT Monitoring
115
External pacing electrodes: When a pacemaker with external pacing electrodes is being used on a
patient, arrhythmia monitoring is severely compromised due to the high energy level in the pacer pulse.
This may result in the arrhythmia algorithm’s failure to detect pacemaker noncapture or asystole.
Fusion beat pacemakers: Pacemakers that create fusion beats (pace pulse on top of the QRS complex)
cannot be detected by the monitor’s QRS detector.
Rate adaptive pacemakers: Implanted pacemakers which can adapt to the Minute Ventilation rate
may occasionally react on the Impedance measurement used by patient monitors for the determination
of the Resp value and execute pacing with the maximum programmed rate. Switching off the Resp
measurement can prevent this.
About Arrhythmia Monitoring
Arrhythmia analysis provides information on your patient’s condition, including heart rate, PVC rate,
rhythm, and ectopics. The monitor uses the user-selected primary and secondary ECG leads for single-
lead or multi-lead arrhythmia analysis. During arrhythmia analysis, the monitor continuously
• optimizes ECG signal quality. This is important for arrhythmia analysis. The monitor continuously
filters the ECG signal to remove baseline wander, muscle artifact, and signal irregularities. Also, if
the Patient Paced status is set to Yes, pace pulses are filtered out to avoid processing them as QRS
beats.
• detects beats, for example, QRS complexes, identifying them for further analysis.
• measures signal features such as R-wave height, width, and timing.
• creates beat templates, and classifies and labels beats to aid in rhythm analysis and alarm detection.
• examines the ECG signal for ventricular fibrillation, asystole, and noise.
Arrhythmia Options
Your monitor has either the basic or the enhanced arrhythmia option. Both options provide rhythm
and ectopic status messages and beat labelling. The number of rhythms being classified, events being
detected, and alarms generated differs according to the option. The alarms available with the different
options are listed in the section “ECG and Arrhythmia Alarm Overview” on page 112, the rhythm and
ectopic messages detected are listed in “Arrhythmia Status Messages” on page 119.
Where Can I Find More Information?
See the Application Notes on ST and Arrhythmia supplied on your documentation DVD for detailed
information on the arrhythmia algorithm and its clinical application.
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Switching Arrhythmia Analysis On and Off
1In the Setup Arrhy menu, select Arrhythmia to toggle between On and Off.
2Select the Confirm pop-up key which appears at the bottom of the screen.
Be aware that when arrhythmia analysis is switched off,
–the message Arrhythmia Off appears beside the ECG wave, if configured to do so
– only the HR-related alarms are detected (the asystole alarm, the ventricular fibrillation/
tachycardia alarm, the extreme tachycardia and extreme bradycardia alarms, the high heart rate
and low heart rate alarms)
– HR High and HR Low alarms behave like normal yellow alarms, no timeout periods are active.
Choosing an ECG Lead for Arrhythmia Monitoring
It is important to select a suitable lead for arrhythmia monitoring.
Guidelines for non-paced patients are:
– QRS complex should be tall and narrow (recommended amplitude > 0.5 mV)
– R-Wave should be above or below the baseline (but not bi-phasic)
– T-wave should be smaller than 1/3 R-wave height
– the P-wave should be smaller than 1/5 R-wave height.
For paced patients, in addition to the above, the pace pulse should be:
– not wider than the normal QRS
– the QRS complexes should be at least twice the height of pace pulses
– large enough to be detected, with no re-polarization.
To prevent detection of P-waves or baseline noises as QRS complexes, the minimum detection level for
QRS complexes is set at 0.15 mV, according to AAMI-EC 13 specifications. Adjusting the ECG wave
size on the monitor display (gain adjustment) does not affect the ECG signal which is used for
arrhythmia analysis. If the ECG signal is too small, you may get false alarms for pause or asystole.
Aberrantly-Conducted Beats
As P-waves are not analyzed, it is difficult and sometimes impossible for the monitor to distinguish
between an aberrantly-conducted supraventricular beat and a ventricular beat. If the aberrant beat
resembles a ventricular beat, it is classified as ventricular. You should always select a lead where the
aberrantly-conducted beats have an R-wave that is as narrow as possible to minimize incorrect calls.
Ventricular beats should look different from these ‘normal beats’. Instead of trying to select two leads
with a narrow R-wave, it may be easier to just select one lead and use single lead arrhythmia
monitoring. Extra vigilance is required by the clinician for this type of patient.
Atrial Fibrillation Alarm
The monitor performs atrial fibrillation analysis using information about the RR irregularity, PR
interval variability and P wave variability.
In order to generate an Afib alarm the following criteria must be detected for 1 minute:
• normal beat RR intervals must be irregular
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117
• PR interval deviation must be large
• P-wave region must not match well
Atrial fibrillation analysis is only available for adult patients and atrial fibrillation detection cannot be
performed on PVCs or Paced beats.
Since most atrial flutters have regular RR intervals, they cannot be detected by the atrial fibrillation
algorithm.
An Afib alarm can be falsely detected in the presence of:
• sinus arrhythmia,
• muscle noise, or
• electrode motion artifact.
If you also have monitors with earlier software revisions, the Afib alarm will not be generated after a
transfer to one of these monitors. Always leave the Irregular HR alarm switched on, so that this alarm
can be generated in such situations.
See the Application Note on Arrhythmia/ST supplied on your documentation DVD for detailed
information on the arrhythmia algorithm and ECG analysis.
Intermittent Bundle Branch Block
Bundle branch and the other fascicular blocks create a challenge for the arrhythmia algorithm. If the
QRS during the block changes considerably from the learned normal, the blocked beat may be
incorrectly classified as ventricular, causing false PVC alarms. You should always select a lead where the
bundle branch block beats have an R-wave that is as narrow as possible to minimize incorrect calls.
Ventricular beats should look different from these ‘normal beats’. Instead of trying to select two leads
with a narrow R-wave, it may be easier to just select one lead and use single lead arrhythmia
monitoring. Extra vigilance is required by the clinician for this type of patient.
Understanding the Arrhythmia Display
Your monitor screen may look slightly different from the illustration.
PP P
Delayed
1mV
II
M
45
7
13
Pair PVCs
6
Paced Rhythm
75
HR
2
PVC
2
1 Beat label
2 Pace pulse marks
3 Rhythm status message
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Viewing Arrhythmia Waves
♦To review arrhythmia beat labels, in the Setup Arrhythmia menu, select Annotate
Arrhy.
The wave showing the primary ECG lead will be delayed by six seconds and shown on a grey
background. Beat labels will be annotated above the ECG wave and Delayed will be written
beside it.
♦To return to the normal ECG primary lead display, select Annotate Arrhy again.
Arrhythmia Beat Labels
Arrhythmia beat labels tell you how the monitor is classifying beats.
N = Normal
V = Ventricular Ectopic
S = Supra-ventricular Premature
P = Paced
' = Pacer spike
“ = Biventricular Pacer Spike
L = Learning patient's ECG
A = Artifact (noisy episode)
? = Insufficient information to classify beats
I = Inoperative condition (e.g., LEADS OFF)
M = Pause or missed beat
4PVC Numeric
5HR Numeric
6 Ectopic status message
7 Delayed arrhythmia wave
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Arrhythmia Status Messages
The monitor displays two types of status messages:
• Rhythm Status Messages -- to indicate the patient’s rhythm.
• Ectopic Status Messages -- to indicate the presence of ectopic beats.
These status messages are shown on the right hand side of the primary ECG wave. They are updated
every second, with the exception of the Sinus and Supraventricular (SV) rhythm messages.
The Sinus and SV rhythm messages are updated based on the current heart rate, taking into account
the patient category (adult, pediatric, or neonatal). For the message to change from one rhythm status
to another, the HR must be in the new range for five beats.
If you have basic arrhythmia capability, you will get only messages for the alarms provided with this
level.
Rhythm Status Messages
The label B or E indicates basic (B) or enhanced (E) arrhythmia capability.
Rhythm Status Message Description B or E
ASYSTOLE No QRS for 4 consecutive seconds in absence of vent fib or chaotic
signal
B, E
VENT FIB/TACH A fibrillatory wave for 4 consecutive seconds B, E
V-TACH A dominant rhythm of adjacent Vs and a HR > the V-Tach Heart
Rate Limit
B, E
SUSTAINED V-TACH Ventricular tachycardia rhythm for more than 15 seconds E
VENT RHYTHM A dominant rhythm of adjacent PVCs and a HR the V-Tach HR
Limit
E
VENT BIGEMINY A dominant rhythm of N, V, N, V E
VENT TRIGEMINY A dominant rhythm of N, N, V, N, N, V E
PACED RHYTHM A dominant rhythm of paced beats B, E
IRREGULAR HR Consistently irregular rhythm E
SINUS BRADY
SINUS RHYTHM
SINUS TACHY
A dominant rhythm of SV beats preceded by P-waves B, E
SV BRADY
SV RHYTHM
SV TACHY
A dominant rhythm of SV beats not preceded by P-waves B, E
UNKNOWN ECG RHYTHM Rhythm cannot be determined B, E
LEARNING ECG Algorithm is learning the ECG beat morphology B, E
LEARNING RHYTHM Algorithm is learning the rhythm of the classified beats B, E
CANNOT ANALYZE ECG ECG signal is predominantly invalid and therefore cannot be
analyzed
B, E
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Ectopic Status Messages
The label B or E indicates basic (B) or enhanced (E) arrhythmia capability.
Arrhythmia Relearning
During a learning phase:
• Alarm timeout periods are cleared
• Stored arrhythmia templates are cleared
•Asystole, Vfib, and HR alarms (when there are enough beats to compute the HR) are active. No other
alarms are active.
Initiating Arrhythmia Relearning Manually
1To initiate relearning manually, in the Setup Arrhythmia menu, select Relearn Arrhy.
– While the monitor is learning, the delayed arrhythmia wave displays the beat label L and the
rhythm status message Learning ECG.
– Next, the monitor determines the dominant rhythm. The beats are labeled N, and the rhythm
status message changes to Learning Rhythm.
2After relearning is complete, you should check the delayed arrhythmia wave to ensure that the
algorithm is labeling the beats correctly.
3If beats are still not classified correctly, check that the ECG is optimized for arrhythmia
monitoring. You may need to select a different lead or change the electrodes or electrode positions
if there is excessive noise, unstable voltage, low amplitude, or large P- or T-waves.
Ectopic Status Message Explanation B or E
(No message displayed) No ectopic activity within the last minute
RUN PVCs More than 2 consecutive PVCs within the last minute E
PAIR PVCs Pair PVCs within the last minute E
PACER NOT CAPT Pause with pace pulse (paced patient only) within the last minute B, E
PACER NT PACING Pause without pace pulse (paced patient only) within the last minute B, E
PAUSE No beat detected for 1.75 x average R-R interval for HR <120, or
No beat for 1 second with HR >120 (non-paced patient only), or
No beat detected for more than the set pause threshold.
E
R-ON-T PVCs R-ON-T detected within the last minute E
MULTIFORM PVCs Multiform PVCs detected within the last minute E
FREQUENT SVPBs SVPB count within last minute is greater than 5 E
SVPBs 1-5 SVPBs in the last minute with a sinus rhythm and no Vs E
SV BEATS SV count within last minute and rhythm status is PACED B, E
PACED BEATS Paced beat count within last minute and rhythm status is NOT
PACED
B, E
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Automatic Arrhythmia Relearn
Arrhythmia relearning is initiated automatically whenever:
• ECG monitoring is switched on
• The ECG Lead or Lead Label of the primary/secondary lead is changed manually, or when fallback
occurs
•A Leads Off INOP condition (that has been active for > 60 seconds) ends.
• A telemetry device is directly connected to the monitor, or disconnected.
If you are monitoring multi-lead arr