Philips Medical Systems North America WLANBV2 WLAN Module IEEE 802.11 a/b/g/n User Manual IntelliVue CL

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User Manual IntelliVue CL

Instructions for Use IntelliVue Cableless MeasurementsCL SpO2 Pod – CL NBP Pod – CL Respiration PodRelease B.02Patient Monitoring

31Table of Contents1Introduction and Basic Operation 5Introducing the IntelliVue Cableless Measurements 62IntelliVue CL SpO2 Pod 9General Operation of the SpO2 Pod 9Connection with Host Systems 16Monitoring SpO2 22Alarms 28SpO2 Default Settings 38Integrated Battery Handling 39Accessories 41Maintenance and Troubleshooting 423IntelliVue CL NBP Pod 43General Operation of the NBP Pod 43Connection with Host Systems 50Monitoring NBP 56Alarms 63NBP Default Settings 72Integrated Battery Handling 73Accessories 74Maintenance and Troubleshooting 784IntelliVue CL Respiration Pod 79General Operation of the Respiration Pod 79Connection with Host Systems 80Monitoring Respiration 84Technical Alarms (INOPs) 88Respiration Default Settings 89Integrated Battery Handling 89Accessories 91Maintenance and Troubleshooting 915Cableless Measurement Auxiliary Devices 93IntelliVue CL Transmitter and IntelliVue CL Hotspot 93IntelliVue CL Transmitter Base Station 97IntelliVue CL Charging Station 97Maintenance and Troubleshooting 99

46Care and Cleaning 101General Points 101Cleaning and Disinfecting the IntelliVue Cableless Measurement Devices 102Disposing of the IntelliVue Cableless Measurement Devices 1037Specifications 105Indications for Use 105Compatible Medical Devices 107Manufacturer's Information 107Symbols 108Safety Specifications 109EMC and Radio Regulatory Compliance 110Safety and Performance Tests 112Electromagnetic Compatibility (EMC) 112Accessories Compliant with EMC Standards 113Electrosurgery Interference/Defibrillation 113IntelliVue CL SpO2 Pod Specifications 113IntelliVue CL NBP Pod Specifications 115IntelliVue CL Respiration Pod Specifications 118Alarm Specifications 119Telemetry Device Battery Runtime Specifications 121IntelliVue CL Transmitter Specifications 121IntelliVue CL Transmitter Base Station Specifications 123IntelliVue CL Hotspot Specifications 124Index 127

151Introduction and Basic OperationThese Instructions for Use are for clinical professionals using the IntelliVue Cableless Measurements and their respective accessories for monitoring and recording arterial oxygen saturation, pulse rate, non-invasive blood pressure and respiration rate of adult patients.Familiarize yourself with all instructions including warnings and cautions, and attend one of the training courses, before starting to make measurements with 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.When using the IntelliVue Cableless Measurements with an IntelliVue Patient Monitor, a telemetry system or IntelliVue GuardianSoftware, refer to and adhere to all warnings in the Instructions for Use of the respective device or software.In these Instructions for Use:•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.IntelliVue Cableless Measurements refers to the IntelliVue Cableless Measurements product family consisting of the IntelliVue CL SpO2 Pod, IntelliVue CL NBP Pod and IntelliVue CL Respiration Pod with their accessories. Also included are the auxiliary devices: the IntelliVue CL Charging Station, IntelliVue CL Transmitter, IntelliVue CL Transmitter Base station and IntelliVue CL Hotspot. Display refers to the physical display of the Cableless Measurement Device. Screen refers to everything you see on the IntelliVue Cableless Measurement's display, such as measurement values, patient data and so forth.IntelliVue CL Transmitter/WLAN functionality may not be available in all countries.

1 Introduction and Basic Operation6Introducing the IntelliVue Cableless MeasurementsThe IntelliVue Cableless Measurement Devices provide measurement values and communicate them to other system components using a wireless short range radio (SRR) interface.The IntelliVue CL SpO2 Pod and the IntelliVue CL NBP Pod can be used together with IntelliVue Patient Monitors MP5/MP5SC/MP5T, MP2/X2, IntelliVue Telemetry System Transceivers TRx4841A/TRx4851A, MX40 wearable patient monitors, and IntelliVue GuardianSoftware. Both devices have an LCD display and three keys for basic operation:IntelliVue CL SpO2 PodThe IntelliVue CL SpO2 Pod is a battery powered, cableless Pulse Oximetry measuring device.IntelliVue CL NBP PodThe IntelliVue CL NBP Pod is a battery powered, cableless, non-invasive blood pressure (NBP) measuring device.1Integrated monochrome LCD display2Hardkeys3Measurement identifier

1 Introduction and Basic Operation7IntelliVue CL Respiration PodThe IntelliVue CL Respiration Pod is a battery powered, cableless respiration rate measuring device which can be used together with IntelliVue Patient Monitors MP5/MP5SC/MP5T, or IntelliVue GuardianSoftware. The device has one multi-color LED for status display and one hardkey for basic operation, e.g. to start a measurement.1Multi-color LED2Hardkey

292IntelliVue CL SpO2 PodThe IntelliVue CL SpO2 Pod is a wrist-worn device; you need a Mobile CL SpO2 Cradle to hold the sensor connector in place and a wristband to fix the cradle to a patient's arm.Specialized single-patient SpO2 sensors are available for use with the IntelliVue CL SpO2 Pod. For details regarding the complete set of single-patient supplies, cradle, wristband and sensors, refer to “IntelliVue CL SpO2 Pod Accessories” on page 41.General Operation of the SpO2 PodThe following sections describe operation on the SpO2 Pod itself. For operation from a patient monitor, see “Controls Available with a Patient Monitor” on page 20. For operation from an Information Center via a telemetry system, see “Controls Available with a Telemetry Device” on page 21. For operation with IntelliVue GuardianSoftware, see “Controls Available with GuardianSoftware” on page 21.The SpO2 Pod has three hardkeys for basic operation and a set of configurable SmartKeys which appear on the screen. These are used to activate and navigate through the on-screen menus and to select individual items. The typical operator's position is such that everything on the device's display can be read clearly and easily.Switching the Device OnThe first time an SpO2 Pod is used, or after the device has been powered off for storage, place it on the IntelliVue CL Charging Station. This will automatically switch the device on.If the SpO2 Pod has only been switched off temporarily (see “Switching the Device Off” on page 13), press any hardkey to turn the device on again.

2 IntelliVue CL SpO2 Pod10When an SpO2 Pod is not operated, it will automatically switch off the screen lighting after a short time. A little later the low-activity screen will be displayed.Screen LayoutThere are three variations of the Main Screen layout depending on the Alarm status and the general activity level.Standard LayoutWhen assigned to a monitor, telemetry device or a patient in GuardianSoftware:1Connection status indicator2Indicator that alarming capability has been transferred to the host (to the monitor or, for the telemetry device, to the Information Center). No patient alarms will be announced on the Cableless Measurement Device.3Battery indicator4Measurement values5Measurement-related symbols (see the measurement chapters for details)6Patient identificationWhen not assigned to a monitor or telemetry device:1Connection status indicator2Battery indicator3Measurement values4Measurement-related symbols (see the Monitoring chapter for details). The Alarms Off symbols indicate that no physiological alarms are available from the Cableless Measurement Devices when not assigned to a host.5Cableless Measurement Device equipment label

2 IntelliVue CL SpO2 Pod11Alarm LayoutIf an alarm occurs the full alarm message appears at the top of the screen. After the alarm message has been silenced the alarm indicator is shown as a symbol on the right side of the screen.Low-Activity ScreenIf the Cableless Measurement Device has not been operated for a while, the screen lighting will switch itself off and a little later the screen will switch to a pre-configured "low-activity" screen.When a Cableless Measurement Device Cannot be ActivatedIf you cannot activate a device by pressing a key, place it on the IntelliVue CL Charging Station. The device becomes active. Check the battery status. If necessary, leave the device on the charger until the battery is fully charged.Using the HardkeysThe IntelliVue Cableless Measurement Devices have three hardkeys: ◄, , ►.Use ◄ and ► to navigate through SmartKeys and menus and to select items or to silence alarms.The three hardkeys also have an additional function when the key is held down for a couple of seconds:1Full length alarm message2Alarm indicator◄opens the Add To screen to assign a device (or to unassign it when it is already assigned)opens the SmartKeys menu►returns to the Main Screen. If already on the Main Screen, it locks the keys and a lock symbol appears on the screen above the battery symbol. If keys are already locked, it unlocks the keys and the lock symbol disappears

2 IntelliVue CL SpO2 Pod12Using the SmartKeysA SmartKey is a graphical key which appears on the screen and gives you fast access to functions.SmartKeys MenuPress the  hardkey (without any screen element highlighted) to get to the SmartKeys menu.Use the ◄ and ► hardkeys to move along the row of SmartKeys. The highlighted SmartKey is displayed in full above the row of SmartKeys. When you use the ◄ or ► hardkey at the end of the row, an Exit screen appears and then with further presses you move on to the next page of SmartKeys. To leave the SmartKeys menu you can use the Exit screen or press the ► hardkey for a couple of seconds to return to the Main Screen.When the required SmartKey is highlighted, press the  key to activate the corresponding function.To get to the next page of the SmartKeys menu, highlight the rightmost SmartKey then press the ► key.List of Available SmartKeysSmartKey Text LabelsMain Setupstart an SpO2 measurementset the SpO2 repetition timeAdd/Remove deviceenter Battery menuchange Screenenter Profiles menuswitch device off (or power off when pressed for more than two seconds)enter Patient menu

2 IntelliVue CL SpO2 Pod13Using the Main Setup MenuIn addition to the hardkeys and SmartKeys for the most needed functions, the Main Setup menu gets you to all settings that can be adjusted for the respective device. Select the Main Setup SmartKey to get to the Main Setup menu.Switching the Device OffTo switch off a device manually, select the Device Off SmartKey, then Confirm.If you keep Device Off pressed for more than two seconds, you can choose between Device Off or Power Off.•Device Off means that the display is switched off and the measurements are disabled. Use this option if your device is not used temporarily. Press any hardkey to turn the device on again.•Power Off means that the device is switched off completely and can only be switched on again by putting it on a charger. Use this option when the device is not used for a longer time or prepared for storage or shipping.When an IntelliVue Cableless Measurement Device is not operated, it will automatically switch off the screen lighting after a short time. A little later the low-activity screen will be displayed.enters the Alarms menu to access: Alarm Messages, Alarm Limits, Alarms On/Off/Pause, Alarm Volume.Change alarm volumeChange pulse tone volumeSmartKey Text LabelsMain SetupSpO₂PulseAlarmsPatientEquipmentUser InterfaceDevice OffProfilesOperating ModesDate, TimeBatteryRevisions

2 IntelliVue CL SpO2 Pod14Operating ModesYour device has four operating modes. Some are passcode protected.•Monitoring Mode: This is the normal, every day working mode that you use for making measurements. You can change elements such as measurement modes, patient category and so forth. When you remove the patient from the device, 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, that are visible but 'grayed out' so that you can neither select nor change them. These are present for your information only 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.•Configuration Mode: Passcode protected, this mode is for personnel trained in configuration tasks. These tasks are described in the Configuration Guide. During installation the Cableless Measurement Device is configured for use in your environment. This configuration defines the default settings you work with when you switch on.•Service Mode: Passcode protected, this is for trained service personnel.When you switch the device on, it starts up in monitoring mode. To change to a different mode:1Use the Main Setup SmartKey to get to the Main Setup menu.2Select Operating Modes and choose the mode you require.Standby ModeThe IntelliVue Cableless Measurement Devices do not have standby mode. However, when connected to a monitor that is in standby mode, the IntelliVue Cableless Measurement Device will show a standby screen.Using the Patient MenuThe Patient menu allows you to see patient demographics information and to remove a patient from a device. Patient Demographic information is only displayed if the Cableless Measurement Device is assigned to a patient monitor or GuardianSoftware. Patient Category is the only item of patient data which can be changed at the Cableless Measurement Device, but only when the device is not assigned to a patient monitor or telemetry device.Displaying the Patient MenuTo display the Patient menu,• select the Patient SmartKey, or• select the Main Setup SmartKey followed by Patient.Stop Using a Device for a PatientTo remove a patient from the Cableless Measurement Device,•in the Patient menu select Free Device.All patient data is cleared, settings are reset to the defaults and the device is removed from the monitor or telemetry device.

2 IntelliVue CL SpO2 Pod16Connection with Host SystemsThe following sections describe how the IntelliVue Cableless Measurement Devices work together with host systems (Patient Monitors, Telemetry Devices / Information Center or GuardianSoftware).IntelliVue Cableless Measurements Use ModelsWith these patient-worn measurement devices you can measure and transmit a patient's vitals regularly or on an intermittent data collection basis. There are three typical use models:With a Patient MonitorThe IntelliVue Cableless Measurement Devices can be used together with an MP5/MP5SC/MP5T, MP2 or X2 patient monitor (with an SRR interface). They can communicate their measurement values via short range radio to the monitor. The monitor may be assigned to a patient sector at the IntelliVue Information Center (IIC). When assigned to the Information Center, certain actions can be performed at both the patient monitor and the Information Center. See the table “Controls Available with a Patient Monitor” on page 20.In situations where patients are becoming more mobile (for example, in step-down/intermediate care units) the lightweight Cableless Measurement Devices allow increased mobility within the short range radio range, without giving up vital signs monitoring.When assigned to a patient monitor, the Cableless Measurement Device can be selected for use in patient transport at the patient monitor (for details see the Patient Monitor Instructions for Use). In this case, the Cableless Measurement Device will perform local attended monitoring. The patient must be attended by a caregiver during transport, to ensure that alarms on the Cableless Measurement Device are recognized. In local attended monitoring mode, an alarm message text appears in the alarm status area at the top of the screen indicating the source of the alarm and an alarm tone is issued. See “Alarms” on page 28 for details.A telemetry device can be assigned to a patient monitor equipped with short range radio at the same time as any Cableless Measurement Devices are also assigned to this monitor.When assigned to a patient monitor, the admitted patient name is displayed on the SpO2 Pod.If the connection between the monitor and the Cableless Measurement Device is lost, an INOP will be displayed at the monitor: cl SpO₂ Disconnect. A No Host Monitoring INOP will be displayed on the SpO2 Pod, and an INOP tone will sound. In this case, visual and audible alarms are still available at the SpO2 Pod, but it is not possible to change the alarm settings.With a Telemetry DeviceThe Cableless Measurement Devices can be assigned to a patient with the telemetry device TRx4841A/TRx4851A or an MX40 wearable patient monitor. They can communicate their measurement values via short range radio to the telemetry device which communicates them to an IntelliVue Information Center to provide a consolidated set of patient values.Some of the measurement tasks can be performed remotely from the Information Center. See the table “Controls Available with a Telemetry Device” on page 21.If the patient name is available at the Information Center, it will be also displayed on the SpO2 Pod.When a Cableless Measurement Device is assigned to a telemetry device, it is not possible for the telemetry device to be wirelessly assigned or directly connected to a patient monitor.

2 IntelliVue CL SpO2 Pod18appears in the alarm status area at the top of the screen indicating the source of the alarm and an alarm tone is issued. See “Alarms” on page 28 for details.•When assigned to a telemetry device: Measurement values sent via the telemetry device to the IntelliVue Information Center can generate alarms at the Information Center when the values meet the criteria set there for alarms. The alarms will be announced in the same way as measurements from other sources. See the Instructions for Use of the Information Center for details.•When assigned to GuardianSoftware: Measurement values sent via transmitters or hotspots to IntelliVue GuardianSoftware will be visualized in GuardianSoftware. Since IntelliVue GuardianSoftware is a data management system, no alarms are announced. The IntelliVue Cableless Measurement Devices will also not generate physiological alarms when connected to IntelliVue GuardianSoftware. See the Instructions for Use of GuardianSoftware.Assigning an IntelliVue Cableless Measurement Device to a HostWhen an IntelliVue CL SpO2 Pod is used with a host system (patient monitor, telemetry device or GuardianSoftware), the Pod must be assigned to that host system.The assignment can be done at the CL SpO2 Pod itself or at the host system (patient monitor or GuardianSoftware).WARNINGAlways make sure that the applied CL SpO2 Pod is assigned to the correct patient.WARNINGShort Range Radio connections are subject to interruption due to interference from other radio sources in the vicinity, including microwaves, bluetooth devices, WLAN devices (802.11b,g,n) and cordless phones. Depending on the strength and duration of the interference, the interruption may occur for an extended period. A loss of connection, due to moving out-of-range, interference, or for other reasons, is indicated with a No Host Monitoring INOP on the SpO2 Pod, or a cl SpO₂ Disconnect INOP at the host monitor. Correct channel configuration is important, refer to the Configuration Guide for details.Assignment at the Measurement DeviceTo make an assignment, select:•the Add/Remove SmartKey , or• hold the ◄key pressed.This opens the Add To menu which lists the available patient monitors and telemetry devices within the SRR range. In order to save power, the list is only visible for a short time; the menu is automatically closed after 40 seconds.Telemetry device: A telemetry device must be put into assignment mode by pressing the  key on the telemetry device before it can appear in the list. Pressing the  key starts an SRR channel

2 IntelliVue CL SpO2 Pod19search to find the clearest channel available. During the search all 4 LEDs will blink once per second. The search will take approximately 20-25 seconds. Once a channel is identified, the first LED will light up and blink once per second to indicate that the telemetry device is ready for assignment.1Select a patient monitor or telemetry system using the ◄ and ► keys.If you select a patient monitor, the measurement selection key on that monitor will change to show the type of measurement device.2Activate the assignment by pressing the  key twice on the measurement device.The Cableless Measurement Device is assigned to the selected patient monitor or telemetry device. A telemetry device plays the assignment tone when the assignment is successful. A patient monitor issues an assignment prompt message.If the internal measurement in the patient monitor is active (the measurement selection key has a yellow frame), you will need to confirm that it should be deactivated in favor of the Cableless Measurement Device you want to assign. To do this:1Select the measurement selection key on the monitor.A prompt message appears with the Confirm and Cancel keys.2Select Confirm to deactivate the internal measurement.When the Cableless Measurement Device is assigned, the symbol appears on its display indicating that alarming capability has been transferred to the host (to the monitor or, for the telemetry device, to the Information Center). No patient alarms will be announced on the Cableless Measurement Device.To unassign the measurement device from the monitor or telemetry system, select the Add/Remove SmartKey, then select Remove From. After confirmation the SRR connection is disconnected.Assignment at the Patient MonitorPrepare the Pod for assignment by activating the Add/Remove SmartKey.At the patient monitor,1Select the Measurement Selection key.2Select the Add cl Msmt pop-up key.This opens the Add Cableless window, which shows the available Cableless Measurement Devices:Add ToMon 1Mon 2Tele 33Tele 44

2 IntelliVue CL SpO2 Pod203Select the device which you want to assign to the patient in the monitor.4The monitor displays the assignment prompt message.If the internal measurement in the patient monitor is active, you will need to confirm that it should be deactivated in favor of the Cableless Measurement Device you want to assign.When the Cableless Measurement Device is assigned, the symbol appears on its display indicating that alarms from the device will be sent to the patient monitor.An assigned Cableless Measurement Device can be removed in the Measurement Selection window. For more details see the Instructions for Use for your patient monitor.Assignment with GuardianSoftwareTo assign a Cableless Measurement Device to a patient in GuardianSoftware:1Select the patient on the Chalkboard.2Take the Cableless Measurement Device from the charger.3On the Equipment List tab, select the Cableless Measurement Device on the Available Equipment list, highlighted in green on top of the list. The device on top of the list is always the one with the most recent user interaction (taken off the charger, put on the charger, or key pressed).4Click Use for Patient to assign the device to the patient.Controls Available with a Patient MonitorThe controls available when the Cableless Measurement Device is assigned to a patient monitor are described in the table below.* except when SRR connection to host is lostWARNINGIf a patient being monitored by Cableless Measurement Devices moves out of range of the patient monitor, the measurements are not transmitted to the patient monitor or the Information Center. The measurements are available on the Cableless Measurement Device only. If this occurs, the No Host Action At the Cableless Measurement DeviceAt the Patient MonitorAt the IICStart SpO2Yes Yes NoChange SpO2 Mode Yes Yes NoSelect SpO2 Repetition Time Yes Yes NoAssign SpO2 Pod Yes Yes NoRemove SpO2 Pod Yes Yes NoChange Alarm Limits Yes* Yes NoPlace Device in Standby No Yes YesAlarm Silence Yes Yes YesAlarm Off/Pause Yes Yes Yes

2 IntelliVue CL SpO2 Pod21Monitoring message is displayed on the measurement device. The measurement device will also sound the INOP tone.Controls Available with a Telemetry DeviceThe controls available when the Cableless Measurement Device is assigned to a TRx4841/TRx4851A Transceiver or MX40 wearable patient monitor with a short range radio adapter (SRRA) are described in the table below.NOTEWhen you unplug the ECG cable from the telemetry device and plug it into the monitor associated with the same patient, the ECG source will automatically be from the monitor. The SpO2 measurement devices assigned to the telemetry device will continue to source data to the telemetry device and the Information Center. You may need to change screens on the patient monitor to see the measurements.NOTEThe SpO2 measurement sourced from the telemetry device (label: SpO2T) has priority over the IntelliVue CL SpO2 measurement. The SpO2T measurement is sent to the Information Center as long as it is available and the IntelliVue CL SpO2 measurement is available on the measurement device only.Controls Available with GuardianSoftwareThe controls available when the Cableless Measurement Device is assigned to GuardianSoftware are described in the table below.Action At the Cableless Measurement DeviceAt the IICStart SpO2Yes YesChange SpO2 Mode Yes YesSelect SpO2 Repetition Time Yes NoAssign SpO2 Pod Yes NoRemove SpO2 Pod Yes YesChange Alarm Limits No YesPlace Device in Standby No NoAlarm Silence No YesAlarm Off/Pause No YesAction At the Cableless Measurement DeviceAt GuardianSoftwareStart SpO2Yes Yes Change Mode Yes YesSelect SpO2 Repetition Time Yes YesAssign SpO2 Pod Yes Yes

2 IntelliVue CL SpO2 Pod22TrendingThe IntelliVue Cableless Measurement Devices provide data for trending of parameters. The trended data are only available via a host system. For details on trends see the Instructions for Use of your host system.When the connection to the host is lost during measurement, the IntelliVue Cableless Measurement Devices are able to collect data in a local memory. These data can be uploaded to GuardianSoftware, but not to other host systems, when a connection is established at a later stage.Monitoring SpO2Philips pulse oximetry uses a motion-tolerant signal processing algorithm, based on Fourier artifact suppression technology (FAST). A sensor is used that transmits light of two different wavelengths through the tissue of the patient. The measurement principle of pulse oximetry is based on the specific absorption characteristics of oxyhemoglobin and deoxyhemoglobin and the pulsating arteriolar vascular bed at the measurement site. It provides four measurements:• Oxygen saturation of arterial blood (SpO2) - percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin (functional arterial oxygen saturation).• Pleth waveform - auto-scaled visual indication of patient's pulse which is not directly proportional to the pulse volume (only on patient monitor, GuardianSoftware or Information Center, if assigned).• Pulse rate (derived from pleth wave) - detected pulsations per minute.• Perfusion indicator - numerical value for the pulsatile portion of the measured signal caused by arterial pulsation (only on patient monitor, if assigned).NOTENo alarms are generated for SpO2 and Pulse when measuring SpO2 with the SpO2 Pod not assigned to a patient monitor or telemetry device.SpO2 SensorsSpecialized SpO2 Sensors are available for use with the IntelliVue CL SpO2 Pod. See the “Accessories” chapter for details.Familiarize yourself with the Instructions for Use supplied with your sensor before using it. In particular, check that the sensor being used is appropriate for your patient category and application site.Remove SpO2 Pod Yes YesPlace Device in Standby No NoTechnical Alarm Silence No YesAlarm Off/Pause No NoAction At the Cableless Measurement DeviceAt GuardianSoftware

2 IntelliVue CL SpO2 Pod23Additional InformationThe following documents contain additional information, depending on which accessories you are using:• Mobile CL Single-Patient SpO2 Sensor Instructions for Use• Mobile CL Reusable SpO2 Sensor1 Instructions for Use• Mobile CL SpO2 Wristband Instructions for Use1 may not be available in all geographiesConnecting SpO2 Sensors1Connect the sensor to the single patient Mobile CL SpO2 Cradle (if not already connected).2Insert the SpO2 Pod into the Mobile CL SpO2 Cradle. The correct orientation is indicated by a matching blue dot inside the cradle.CAUTIONMake sure that the contacts of the SpO2 Pod and the sensor are dry and free of residues.3Secure the cradle on the patient's arm using the wristband.a. Feed the free end of the wristband through the slot in the cradle, starting from the underside of the cradle.b. Slide the wristband onto the patient's arm and pull the free end until the wristband fits snugly.c. Close the wristband using the Velcro patch on the free end of the band.

2 IntelliVue CL SpO2 Pod24Removing the Pod from the CradleTo remove the SpO2 Pod from the cradle, pull on the Pod at the opening in the cradle, while holding the cradle in place on the patient's arm.Applying the Sensor1Choose a finger of the patient that matches the sensor dimension in a way that the sensor optical components are properly aligned and the sensor is neither too loose nor applies too much pressure to the finger. For small pediatric patients consider the thumb.2Remove colored nail polish from the application site.3Apply the sensor to the patient. The application site should match the sensor size so that the sensor can neither fall off, nor apply excessive pressure. See the sections below for details on applying the different sensors.4Check that the light emitter and the photodetector are directly opposite each other. All light from the emitter must pass through the patient's tissue.WARNINGProper Sensor Fit: If a sensor is too loose, it might compromise the optical alignment or fall off. If it is too tight, for example because the application site is too large or becomes too large due to edema, excessive pressure may be applied. This can result in venous congestion distal from the application site, leading to interstitial edema, hypoxemia and tissue malnutrition. Skin irritations or lacerations may occur as a result of the sensor being attached to one location for too long. To avoid skin irritations and lacerations, periodically inspect the sensor application site and change the application site regularly.Venous Pulsation: Do not apply sensor too tightly as this results in venous pulsation which may severely obstruct circulation and lead to inaccurate measurements.Ambient Temperature: At elevated ambient temperatures be careful with measurement sites that are not well perfused, because this can cause severe burns after prolonged application. All listed sensors operate without risk of exceeding 41°C on the skin if the initial skin temperature does not exceed 35°C.Extremities to Avoid: Avoid placing the sensor on extremities with an arterial catheter, an NBP cuff or an intravascular venous infusion line.

2 IntelliVue CL SpO2 Pod25Measuring SpO2During measurement, ensure that the application site:– has a pulsatile flow, ideally with a perfusion indicator value above 1.0 or, if the perfusion indicator is not available, with signal quality indicator of at least medium.– has not changed in its thickness (for example, due to edema), causing an improper fit of the sensor.WARNING• For fully conscious pediatric or adult patients, who have a normal function of perfusion and sensory perception at the measurement site:To ensure skin quality and correct optical alignment of the sensor, inspect the application site when the measurement results are suspicious or when the patient complains about pressure at the application site, but at least every 24 hours. Correct the sensor alignment if necessary. Move the sensor to another site, if the skin quality changes.• For all other patients:Inspect the application site every two to three hours to ensure skin quality and correct optical alignment. Correct the sensor alignment if necessary. If the skin quality changes, move the sensor to another site.Change the application site at least every four hours.• Injected dyes such as methylene blue, or intravascular dyshemoglobins such as methemoglobin and carboxyhemoglobin may lead to inaccurate measurements.• Inaccurate measurements may result when the application site for the sensor is deeply pigmented or deeply colored, for example, with nail polish, artificial nails, dye or pigmented cream.• Interference can be caused by:– High levels of ambient light (including IR warmers) or strobe lights or flashing lights (such as fire alarm lamps). (Hint: cover application site with opaque material.)– Another SpO2 sensor in close proximity (e.g. when more than one SpO2 measurement is performed on the same patient). Always cover both sensors with opaque material to reduce cross-interference.– Electromagnetic interference, especially at perfusion indicator values below 1.0 or signal quality indicator below medium.– Excessive patient movement and vibration.

2 IntelliVue CL SpO2 Pod26Selecting Measurement ModesThere are three different modes available for making SpO2 measurements:•Continuous mode - SpO2 is measured continuously until the measurement is switched off.•Manual mode - a single SpO2 measurement is made when the Start SpO₂ SmartKey or the Start SpO₂ menu item is selected. One set of values is then displayed with the time the measurement was made.•Automatic mode - a series of measurements is made with an interval between them. The interval is selected using the Repeat Time SmartKey or the Repeat menu item. The measurement starts automatically when automatic mode is selected.The values measured in manual mode or automatic mode will be displayed for a configurable time span. After that the values are regarded as invalid and are no longer displayed. Battery power usage will be appreciably higher when measuring in continuous mode, in comparison to manual or automatic mode, resulting in a reduced battery runtime.Starting and Stopping MeasurementsUse the setup menu or SmartKeys to start measurements manually:When manual measurements are made, there will be no continuous SpO2 monitoring or alarming. The manual measurement value reflects a momentary status. The numerics from SpO2 measurements made in manual mode will remain for a time on the main screen. They are annotated with the time that the measurement was made to distinguish them from continuously measured values.Action to be Performed SpO2 menu SmartKeysStart manual measurement Start SpO₂Start

2 IntelliVue CL SpO2 Pod27Understanding SpO2 Numerics and SymbolsSpO2 Signal Quality IndicatorThe SpO2 numeric is displayed together with a signal quality indicator (if configured and enough space is available) which gives an indication of the reliability of the displayed values.The level to which the triangle is filled shows the quality of the signal; the indicator below shows a medium signal quality, the signal quality is at a maximum when the triangle is completely filled.Assessing a Suspicious SpO2 ReadingTraditionally, pulse rate from SpO2 was compared with heart rate from ECG to confirm the validity of the SpO2 reading. With newer algorithms, such as FAST-SpO2, this is no longer a valid criteria because the correct calculation of SpO2 is not directly linked to the correct detection of each pulse.When pulse rate is very low, or strong arrhythmia is present, the SpO2 pulse rate may differ from the heart rate calculated from ECG but this does not indicate an inaccurate SpO2 value.If you doubt the measured SpO2, use the signal quality indicator (if available) or, when used with a patient monitor, the pleth wave and perfusion indicator on the monitor to assess the signal quality.WARNINGWith pulse oximetry, sensor movement, ambient light (especially strobe lights or flashing lights) or electromagnetic interference can give unexpected intermittent readings when the sensor is not 1SpO2 numeric2Pulse rate numeric3Symbol indicating pulse rate4Measurement mode - indicates here that Auto mode is active and shows the time to the next measurement.5Alarms Off symbol for Pulse6Timestamp7Alarms Off symbol for SpO2Note: The Alarms Off symbols indicate that no physiological alarms are available from the Cableless Measurement Devices when not assigned to a host.1SpO2 Quality Indicator

2 IntelliVue CL SpO2 Pod28attached. Especially bandage-type sensor designs are sensitive to minimal sensor movement that might occur when the sensor is dangling.Changing the Averaging TimeDepending on the monitor configuration, you may be able to change the averaging time for the SpO2 values.The averaging time represents the approximate time period used for the calculation. The exact averaging time also depends on the signal conditions. The longer the averaging time, the longer the time needed until the SpO2 values reflect the physiological event. The same averaging is applied to all numerical values: SpO2, pulse rate and Perfusion Index (only available at the patient monitor). Fast averaging is useful for situations where an extremely fast measurement is required or few artifacts are expected. Use slow averaging where you expect the number of artifacts to be relatively high.1In the SpO₂ menu, select Average.2Select the required averaging time from the list.Understanding SpO2 AlarmsThere is a delay between a physiological event at the measurement site and the corresponding alarm at the host system. This delay has two components:• The general system delay time is the time between the occurrence of the physiological event and when this event is represented by the displayed numerical values. This delay depends on the algorithmic processing and the configured averaging time. The longer the averaging time configured, the longer the time needed until the numerical values reflect the physiological event.• The time between the displayed numerical values crossing an alarm limit and the alarm indication on the device. This delay depends on the Cableless Measurement Device or connected host system.Refer to the Alarms chapter for information about the SpO2 and pulse rate alarms.Perfusion Numeric (only available on the Patient Monitor)The perfusion numeric (Perf) gives a value for the pulsatile portion of the measured signal caused by the pulsating arterial blood flow.You can also use the perfusion numeric as a quality indicator for the SpO2 measurement. Above 1 is optimal, between 0.3-1 is acceptable. Below 0.3 is marginal; reposition the sensor or find a better site.AlarmsThe IntelliVue Cableless Measurements have two different types of alarm: patient alarms and INOPs.Patient AlarmsPatient Alarms are high priority alarms (such as a potentially life threatening situation), also called red alarms, or medium priority alarms, also called yellow alarms.Technical Alarms (INOPs)Technical alarms, also known as INOPs, indicate that the measuring device cannot measure reliably. If an INOP interrupts monitoring, there will be a question mark in place of the measurement numeric.

2 IntelliVue CL SpO2 Pod29An INOP tone sounds at the Cableless Measurement Device only when there is no SRR connection to a host.Most INOPs are low priority, however there are a small number of INOPs which, due to their severity, are medium or high priority.Alarm DelaysThere is a delay between a physiological event at the measurement site and the corresponding alarm indication at the Cableless Measurement Device. This delay has two components:• The general measurement delay time is the time between the occurrence of the physiological event and when this event is represented by the displayed numerical values. This delay depends on the algorithmic processing.• The time between the displayed numerical values crossing an alarm limit and the alarm indication on the device is the system alarm delay. The system alarm delay is the processing time the system needs for any alarm on the Cableless Measurement Device to be indicated after the measurement has triggered the alarm. See the performance specifications in the Specifications chapter for the system alarm delay specification.The alarm delay configured for a specific measurement is normally a fixed time.Multiple AlarmsIf 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.The Cableless Measurement Device sounds an audible indicator for the highest priority alarm. If more than one alarm condition is active in the same measurement, the Cableless Measurement Device announces the most severe.NOTEIf you want to use local attended monitoring, make sure to have all Cableless Measurement Devices upgraded to Rev. B.02.Visual Alarm IndicatorsWARNING• No patient alarms are available on the CL devices when assigned to a host monitor (unless they are selected for use in patient transport at the monitor they are assigned to) or GuardianSoftware.• Visual patient alarm indicators are disabled on the CL device when connected to a host monitor (unless they are selected for use in patient transport at the monitor they are assigned to) or GuardianSoftware.Alarm MessageAlarm messages are displayed in black on a light gray background in the alarm status area at the top of the screen indicating the source of the alarm and coded according to their severity. If more than one measurement is in an alarm condition, the message changes every few seconds, and has an arrow ( ) at the side. The asterisk symbols (*) beside the alarm message match the alarm priority: *** for red alarms, ** for 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.

2 IntelliVue CL SpO2 Pod30An alarm message that appears is automatically highlighted. Use the  key to silence the message. A Silence message is displayed at the bottom of the screen and highlighted. Press  again to confirm the acknowledgment of the alarm. After the confirmation, any ongoing alarm message is displayed in the icon tray of the screen.Alarm StatesDepending on the alarm state of your Cableless Measurement Device, the following icons may be displayed on the device:Audible Alarm IndicatorsAudible 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).Cableless Measurements Devices alone (without host, e.g. a patient monitor) are not suitable for unattended monitoring due to their limited alarm volume.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 patient alarms are available on the Cableless Measurement Device when connected to a host monitor (unless they are selected for use in patient transport at the monitor they are assigned to) or to GuardianSoftware.• When connected to a host monitor or GuardianSoftware, no alarm tones are available on the Cableless Measurement Device (unless they are selected for use in patient transport at the monitor they are assigned to).Icon DescriptionNo local alarming on Cableless Measurement Device. The device is connected to a host monitor or telemetry device and has no visual or audible patient alarm indicators. The device will only display INOP messages.Alarms are switched off.Alarm volume is set to 0.

2 IntelliVue CL SpO2 Pod31Silencing an AlarmTo silence an alarm, select the alarm message and press the  key.This will silence the alarm tone and clear the alarm message. If the condition which caused the alarm is still present, the alarm indicator will be displayed in the icon tray of the screen.When using a Cableless Measurement Pod with an IntelliVue Information Center iX Release A, make sure to remove the pod at the telemetry device and only when in SRR range of the telemetry device. Otherwise you will get a technical alarm (cl SpO₂ Disconnect) that can not be silenced at the telemetry device. You will then have to reboot the telemetry device to remove the message.Displaying a List of Current AlarmsTo display a list of the currently active alarms,1Select the Alarms SmartKey or Main Setup SmartKey, followed by Alarms.2Select Alarm Messages.Setting the Volume of the Alarm ToneTo set the volume for the Alarm tone,1Select the Alarms SmartKey or Main Setup SmartKey, followed by Alarms.2Select AlarmVol and select a volume setting. The maximum is 10 and the minimum depends on your configuration.If the volume of the Alarm tone is set to zero, the following symbol is displayed on the right icon tray of the Cableless Measurement Device screen: NOTENo Alarm tone will sound at the device as long as it is within the SRR range.Minimum Volume for No Host Monitoring INOPIf your device is connected to a host monitor, and the connection is interrupted, the INOP message No Host Monitoring 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 device alarm volume is set to zero.1Full length alarm message2Alarm indicator

2 IntelliVue CL SpO2 Pod32Alarm ReminderIf Reminder is configured on your device, you will get an audible reminder of alarm conditions that remain active after you have silenced 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.Pausing or Switching Off AlarmsIf you want to temporarily prevent alarms from sounding, for example while you are moving a patient, you can pause alarms. Depending on your device configuration, alarms are paused for one, two, or three minutes, or infinitely. Infinite alarm pause is equivalent to switching the alarms off.To view the alarm pause setting chosen for your unit,1In the SmartKeys Menu select Main Setup, Alarms, then OffDurat.2Check the setting.This setting can only be changed in Configuration Mode.To Pause or Switch Off AlarmsSelect the key in the SmartKeys Menu followed by Alarms On/Off. If your device is configured to infinite pause time, selecting this key switches alarms off.Press the  hardkey to complete the change.Restarting Paused AlarmsTo manually switch on alarm indication again after a pause, select the key again.Alarm indication starts again automatically after the pause period expires. If the device is configured to stay paused infinitely, you must select again to restart alarm indication.Alarm LimitsThe alarm limits you set determine the conditions that trigger yellow and red limit alarms. For 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.WARNINGBe aware that the devices 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.

2 IntelliVue CL SpO2 Pod33Adjusting the Alarm Limits1Select the Alarms SmartKey followed by Alarm Limits (or select Main Setup followed by SpO₂):2Select High Lim then choose the high alarm limit.3Select Low Lim then choose the low alarm limit.WARNINGHigh oxygen levels may predispose a premature infant to retrolental fibroplasia. If this is a consideration do NOT set the high alarm limit to 100%, which is equivalent to switching the high alarm off.Adjusting the Desat Limit AlarmThe Desat alarm is a high priority (red) alarm notifying you of potentially life threatening drops in oxygen saturation.1In the SpO₂ menu, select DesatLim.2Adjust the limit.Setting Up Tone ModulationOnly when the CL device is not connected to a host: If tone modulation is on, the pulse tone pitch lowers when the SpO2 level drops.Select Main Setup followed by User Interface. In this menu, select Tone Modulation to switch between Yes (for on) and No (for off).NOTEIf the SpO2 level drops below 52%, two short tones will be issued rather than one long tone.Tone modulation is licensed under USpatent US 4.653.498 from Nellcor Puritan Bennett Incorporated.Latching AlarmsThe alarm latching setting for your device 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 device after the alarm condition ends. The indication lasts until you acknowledge the alarm.Viewing the Alarm Latching SettingsTo see the alarm latching setting for your device1In the Main Setup menu, select Alarms.2Here you can 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 only, red and yellow, and off. These choices can be combined to give the following settings:

2 IntelliVue CL SpO2 Pod35Reference List of Patient AlarmsReference List of all INOPsAlarm Message, Indication Source Condition*** Brady (Pulse) SpO2The heart rate from the Pulse signal has fallen below the bradycardia limit.*** Desat SpO2The SpO2 value has fallen below the desaturation alarm limit.** Pulse High SpO2The pulse rate has exceeded the high alarm limit.** Pulse Low SpO2The pulse rate has dropped below the low alarm limit.** <SpO₂ Label> High SpO2The arterial oxygen saturation has exceeded the high alarm limit.** <SpO₂ Label> Low SpO2The arterial oxygen saturation has dropped below the low alarm limit.*** Tachy (Pulse) SpO2The Pulse Rate from the Pleth signal has exceeded the tachycardia limitINOP Message, Indication Source What to doBatt IncompatibleINOP toneBattery Battery cannot be used with this Cableless Measurement Device. Replace battery with one that has been approved for use with this Cableless Measurement Device. Contact your service personnel.Batt MalfunctionINOP toneBattery Malfunction of the battery system detected (charger circuit or battery). Contact your service personnel.Battery EmptyINOP toneBattery The remaining monitoring time is below 30 minutes. Charge battery.Battery LowINOP toneBattery The remaining monitoring time is below 2 hours.Check Batt TempINOP toneBattery The temperature of the battery is critically high. Check that Cableless Measurement Device is not covered and not exposed to a heat source. If INOP persists, remove Cableless Measurement Device from patient and contact your service personnel.Check BatteryINOP toneBattery The maximum number of charge/discharge cycles of the battery will be reached in less than 50 cycles. Contact your service personnel to replace the battery.Check Charger I/FINOP toneBattery Overvoltage or undervoltage detected at the charger interface. Clean contacts of charger interface at Cableless Measurement Device and charging station. If the INOP persists, contact your service personnel.

2 IntelliVue CL SpO2 Pod36cl SpO₂ Chk SettINOP toneCableless Measurement DeviceIf this INOP appears and an INOP tone sounds, check the Cableless Measurement Device and patient settings before you resume making measurements. If the settings are unexpected, there may be a problem with the Cableless Measurement Device software. Contact your service personnel.If this INOP is acknowledged at the Cableless Measurement Device, it is cleared. If it is silenced remotely, only the tone is cleared.cl SpO₂ Disconnectonly at the hostCableless Measurement DeviceThe SpO2 Pod has lost the SRR connection to the telemetry device or the patient monitor.No Host MonitoringINOP toneCableless Measurement DeviceThere is a problem with the communication to the assigned patient monitor or telemetry device and monitoring is currently not possible (no patient alarms or information). Check the connection. Contact your service personnel.No System Cableless Measurement DeviceThere is a problem with the communication to the assigned IntelliVue GuardianSoftware and monitoring is currently not possible (no patient alarms or information). Check the connection. Contact your service personnel.Remove From PatINOP toneCableless Measurement DeviceDisplayed on the Cableless Measurement Device. The temperature of the battery is too high. Remove the Cableless Measurement Device from the patient and contact service personnel.Service BatteryINOP toneBattery Maximum number of charge/discharge cycles for battery exceeded. Charging of the battery is inhibited. Contact your service personnel to replace battery.<SpO₂ Label> Equip MalfNumeric is replaced by -?-INOP toneSpO2The SpO2 Pod is faulty. Contact your service personnel.<SpO₂ Label> ErraticNumeric is replaced by -?-INOP toneSpO2Check the sensor placement. Try another adapter cable and sensor. If the INOP persists, contact your service personnel.<SpO₂ Label> Extd.UpdateNumeric is replaced by -?-SpO2The update time for displayed values is extended due to an NBP measurement on the same limb or an excessively noisy signal.<SpO₂ Label>InterferenceNumeric is replaced by -?-INOP toneSpO2There 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 PerfNumeric is replaced by -?-SpO2Accuracy may be compromised due to very low perfusion. Stimulate circulation at sensor site. If INOP persists, change the measurement site.INOP Message, Indication Source What to do

2 IntelliVue CL SpO2 Pod37<SpO₂ Label> NeoPatient?Numeric is replaced by -?-INOP toneSpO2The patient monitor the SpO2 Pod is assigned to is in neonatal mode. The INOP will remain active until the monitor is changed to adult or pediatric mode.<SpO₂ Label> No PulseNumeric is replaced by -?-INOP toneSpO2Check the perfusion at the measurement site. If necessary, stimulate circulation or change the measurement site. If the INOP is due to an NBP measurement on the same limb, wait until the NBP measurement is finished.<SpO₂ Label> No SensorNumeric is replaced by -?-INOP toneSpO2Make sure the SpO2 sensor is connected. If the INOP persists, try another sensor. If you acknowledge this INOP, the measurement will be switched off.<SpO₂ Label> NoisySignalNumeric is replaced by -?-INOP toneSpO2Excessive patient movement or electrical interference is causing irregular pulse patterns. Try to reduce patient movement or to relieve the cable strain on the sensor.<SpO₂ Label> Poor Signal SpO2The signal quality of the SpO2 measurement is poor. The accuracy may be compromised.<SpO₂ Label> Pulse?Numeric is replaced by -?-INOP toneSpO2The detectable pulsations of the SpO2 signal are outside the specified pulse rate range.<SpO₂ Label> SearchingNumeric is unavailableSpO2The patient signal is analyzed, but no valid numerics are available yet.<SpO₂ Label> Sensor MalfNumeric is replaced by -?-INOP toneSpO2The SpO2 sensor is faulty. Try another sensor. If the INOP persists, contact your service personnel.<SpO₂ Label> Sensor OffNumeric is replaced by -?-INOP toneSpO2The algorithm has determined that a sensor is connected, but not properly applied to the patient. The ability of the algorithm to detect this condition depends on the used sensor type.<SpO₂ Label> Unkn.SensorNumeric is replaced by -?-INOP toneSpO2The connected SpO2 sensor is not supported by this measurement hardware.<SpO₂ Label> UpgradeNumeric is replaced by -?-SpO2SpO2 in upgrade mode, no patient monitoring possible.INOP Message, Indication Source What to do

2 IntelliVue CL SpO2 Pod38SpO2 Default SettingsThese are the most important default settings of your IntelliVue CL SpO2 Pod as they are delivered from the factory. For a comprehensive list and explanation of default settings, see the Configuration Guide supplied with your devices. The default settings can be permanently changed in Configuration Mode. When the Pod is assigned to a patient monitor, the settings defined at the patient monitor will overwrite the settings defined at the Pod.SpO2 Settings Factory DefaultsAdult Pedi NeoMode Continuous Continuous ContinuousRepeat Time 15 min 15 min 15 minAlarms On On OnQRS Volume 111ToneMod. Yes Yes YesPerfusion OnOnOnAverage 10 sec 10 sec 10 secNBP Alarm Suppr. On On OnAging Time 10 min 10 min 10 minColor Cyan (light blue) Cyan (light blue) Cyan (light blue)Average in Mon. No No NoSignal Quality OnOnOnLabel SpO₂SpO₂SpO₂SpO2 Alarm Default SettingsSetting Adult Pedi NeoDesatLim 80 80 80Low Lim 90 90 85High Lim 100 100 95Desat Delay 20 sec 20 sec 20 secHigh Alarm Delay 10 sec 10 sec 10 secLow Alarm Delay 10 sec 10 sec 10 secPulse Settings Factory DefaultsAdult Pedi NeoPulse OnOnOnAlarms On On OnHigh Lim 120 160 200Low Lim 50 75 100Δ Brady 202020

2 IntelliVue CL SpO2 Pod39Integrated Battery HandlingBattery CareBattery care begins when you receive a new IntelliVue Cableless Measurement Device with built-in battery and continues throughout the life of the device. The table below lists battery care activities and when they should be performed.Handling PrecautionsLithium ion batteries store a large amount of energy in a small package. Use caution when handling the IntelliVue Cableless Measurement Devices with built-in battery; misuse or abuse could cause bodily injury and/or property damage.• Handle with care.• Do not expose the device to liquids.• Do not attempt to disassemble the device.• Do not put device in autoclave.• Damaged devices should not be used anymore.WARNING• Do not crush or puncture - mechanical abuse can lead to internal damage and internal short circuits which may not be visible externally.• Do not incinerate the devices or expose them to temperatures above 60°C (140°F).Brady Clamp 404050Δ Tachy 202020Tachy Clamp 200 220 240Pulse Settings Factory DefaultsAdult Pedi NeoActivity When to performPerform a visual inspection Before using the IntelliVue Cableless Measurement DeviceCharge the battery Upon receipt, after use, or if a low battery state is indicated. To optimize performance, a fully (or almost fully) discharged battery should be charged as soon as possible.Store the device in a state of charge in the range of 40-50% and power off the device completely.When not in use for an extended period of time, or when the device is shipped.

2 IntelliVue CL SpO2 Pod40StorageIf unused IntelliVue Cableless Measurement Devices are stored for an extended period of time:• they should be powered off for storage• they should be stored in a cool place, ideally between 15°C and 25°C (60°F and 77°F)• the state of charge should be between 40 and 50%• they should be recharged every six monthsStoring in a cool place slows the aging process of the batteries. They should be fully charged prior to use. Do not store the device at a temperature outside the range of -20°C (-4°F) to 60°C(140°F).Do not store cableless devices in direct sunlight.NOTEStoring the devices at temperatures above 40°C (104°F) for extended periods of time could significantly reduce the battery's life expectancy.Battery Lifetime ManagementThe lifetime of a Lithium Ion battery depends on the frequency and duration of use. When properly cared for, the useful life is approximately 4 years or 400 complete charge-discharge cycles, whichever comes first. In addition, experience indicates that the incidence of failure may increase with battery service life due to the accumulated stresses of daily use. We therefore strongly recommend that lithium ion batteries be replaced after 4 years or 400 complete charge-discharge cycles.To see the date of manufacture and the number of charge-discharge cycles:1Select the Battery Smartkey or Main Setup followed by Battery.2Press the  hardkey to view the battery details.The date of manufacture and the number of charge-discharge cycles are listed with other battery data on the screen. Use the ◄ hardkey to scroll through the list.The age of a lithium ion battery begins at the date of manufacture.

2 IntelliVue CL SpO2 Pod41AccessoriesYou can order parts and accessories from Philips supplies at www.medical.philips.com or consult your local Philips representative for details.WARNINGReuse: Never reuse single-patient sensors, accessories and so forth that are intended for single use, or single patient use only. Reuse may compromise device functionality and system performance and cause a potential hazard, in particular with regard to cross-contamination.Philips’ approval: Use only Philips-approved accessories. Using non-Philips-approved accessories may compromise device functionality and system performance and cause a potential hazard.IntelliVue CL SpO2 Pod AccessoriesAll listed sensors operate without risk of exceeding 41°C on the skin, if the initial skin temperature does not exceed 35°C.Make sure that you use only the accessories that are specified for use with this device, otherwise patient injury can result.1 May not be available in all geographiesOrder Number Description Contents989803165941 Mobile CL 20 single patient SpO2 Sensors and Cradles for use on pediatric and adult patients >10 kg20 Single-Patient Mobile CL DSpO2-1A Sensors20 Single-Patient Wristbands20 Single-Patient Cradlespre-assembled989803165921 Mobile CL 20 single patient SpO2 Sensors for use on pediatric and adult patients >10 kg20 Single-Patient Mobile CL DSpO2-1A Sensors9898031659311Mobile CL reusable SpO2 sensor and Cradles for use on pediatric and adult patients > 15 kg1 Reusable Mobile CL RSpO2-1A Sensor20 Single-Patient Cradles with pre-attached Wristbands989803165951 Mobile CL 20 SpO2 Cradles (single patient) 20 Single-Patient Cradles with pre-attached Wristbands989803165961 Mobile CL 50 SpO2 Wristbands (single patient)50 Single-Patient Wristbands989803168861 Mobile CL SpO2 Battery Kit 1 Battery1 disassembly tool1 front housing

2 IntelliVue CL SpO2 Pod42Maintenance and TroubleshootingWARNINGSchedule: Failure on the part of the responsible individual hospital or institution employing the use of this equipment to implement a satisfactory maintenance schedule may cause undue equipment failure and possible health hazards.Contact: If you discover a problem with any of the equipment, contact your service personnel, Philips, or your authorized supplier.Inspecting the Equipment and AccessoriesYou should perform a visual inspection before every use, and in accordance with your hospital's policy. With the device switched off:1Examine unit exteriors for cleanliness and general physical condition. Make sure that the housings are not cracked or broken, that everything is present, that there are no spilled liquids and that there are no signs of abuse.2Inspect all accessories (cables, sensors and so forth). If any show signs of damage, do not use them.WARNINGIf the IntelliVue Cableless Measurement Device 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.Maintenance Task and Test ScheduleAll maintenance tasks and performance tests are documented in detail in the service documentation supplied on the IntelliVue Cableless Measurements documentation DVD. These tasks are for Philips-qualified service professionals only.Ensure that these tasks are carried out as indicated by the device's maintenance schedule, or as specified by local laws. Contact a Philips-qualified service provider if your device needs a safety or performance test. Clean and disinfect equipment to decontaminate it before testing or maintaining it.TroubleshootingIf a device will not switch on when you press a key, place it onto a charger slot on the charging station.If you suspect a problem with an individual measurement device, read the Instructions for Use and double check that you have set up the measurement correctly. Check also that the measurement has not been switched off at the patient monitor that the device is assigned to.If you suspect an intermittent, system-wide problem call your service personnel.

3433IntelliVue CL NBP PodTo measure NBP, you need Philips standard cuffs, a Mobile CL NBP Cradle and a pouch and extension air hose, or a Mobile CL NBP Cradle and Mobile CL Cuffs. When using Mobile CL Cuffs, the cradle is used to attach the Pod to the cuffs and to allow easy removal of the Pod.Standard Philips cuffs and specialized single-patient and reusable NBP cuffs are available for use with the IntelliVue CL NBP Pod. For details regarding the cuffs and single-patient cradle, refer to “IntelliVue CL NBP Pod Accessories” on page 74.General Operation of the NBP PodThe following sections describe operation on the NBP Pod itself. For operation from a patient monitor, see “Controls Available with a Patient Monitor” on page 54. For operation from an Information Center via a telemetry system, see “Controls Available with a Telemetry Device” on page 55. For operation with IntelliVue GuardianSoftware, see “Controls Available with GuardianSoftware” on page 55.The NBP Pods have three hardkeys for basic operation and a set of configurable SmartKeys which appear on the screen. These are used to activate and navigate through the on-screen menus and to select individual items. The typical operator's position is such that everything on the device's display can be read clearly and easily.

3 IntelliVue CL NBP Pod44Switching the Devices OnThe first time an NBP Pod is used, or after the device has been powered off for storage, place it on the IntelliVue CL Charging Station. This will automatically switch the device on.If the NBP Pod has only been switched off temporarily (see “Switching the Device Off” on page 13), press any hardkey to turn the device on again.When an NBP Pod is not operated, it will automatically switch off the screen lighting after a short time. A little later the low-activity screen will be displayed.Screen LayoutThere are three variations of the Main Screen layout depending on the Alarm status and the general activity level.Standard LayoutWhen assigned to a monitor, telemetry device or a patient in GuardianSoftware:1Connection status indicator2Indicator that alarming capability has been transferred to the host (to the monitor or, for the telemetry device, to the Information Center). No patient alarms will be announced on the Cableless Measurement Device.3Battery indicator4Measurement values5Measurement-related symbols (see the measurement chapters for details)6Patient identificationWhen not assigned to a monitor or telemetry device:1Connection status indicator2Battery indicator3Measurement values4Measurement-related symbols (see the Monitoring chapter for details). The Alarms Off symbols indicate that no physiological alarms are available from the Cableless Measurement Devices when not assigned to a host.5Cableless Measurement Device equipment label

3 IntelliVue CL NBP Pod45Alarm LayoutIf an alarm occurs the full alarm message appears at the top of the screen. After the alarm message has been silenced the alarm indicator is shown as a symbol on the right side of the screen.Low-Activity ScreenIf the Cableless Measurement Device has not been operated for a while, the screen lighting will switch itself off and a little later the screen will switch to a pre-configured "low-activity" screen.When a Cableless Measurement Device Cannot be ActivatedIf you cannot activate a device by pressing a key, place it on the IntelliVue CL Charging Station. The device becomes active. Check the battery status. If necessary, leave the device on the charger until the battery is fully charged.Using the HardkeysThe IntelliVue Cableless Measurement Devices have three hardkeys: ◄, , ►.Use ◄ and ► to navigate through SmartKeys and menus and to select items or to silence alarms.The three hardkeys also have an additional function when the key is held down for a couple of seconds:Using the SmartKeysA SmartKey is a graphical key which appears on the screen and gives you fast access to functions.SmartKeys MenuPress the  hardkey (without any screen element highlighted) to get to the SmartKeys menu.1Full length alarm message2Alarm indicator◄opens the Add To screen to assign a device (or to unassign it when it is already assigned)opens the SmartKeys menu►returns to the Main Screen. If already on the Main Screen, it locks the keys and a lock symbol appears on the screen above the battery symbol. If keys are already locked, it unlocks the keys and the lock symbol disappears

3 IntelliVue CL NBP Pod46Use the ◄ and ► hardkeys to move along the row of SmartKeys. The highlighted SmartKey is displayed in full above the row of SmartKeys. When you use the ◄ or ► hardkey at the end of the row, an Exit screen appears and then with further presses you move on to the next page of SmartKeys. To leave the SmartKeys menu you can use the Exit screen or press the ► hardkey for a couple of seconds to return to the Main Screen.When the required SmartKey is highlighted, press the  key to activate the corresponding function.To get to the next page of the SmartKeys menu, highlight the rightmost SmartKey then press the ► key.List of Available SmartKeysSmartKey Text LabelsMain Setup- start/stop manual NBP measurement- start auto series- start measurement sequence- stop current automatic measurement within seriesstop any NBP measurement and measurement seriesstart NBP STAT measurementstart venipuncture (inflate cuff to subdiastolic pressure)set the NBP repetition timeAdd/Remove deviceenter Battery menuchange Screenenter Profiles menuswitch device off (or power off when pressed for more than two seconds)

3 IntelliVue CL NBP Pod47Using the Main Setup MenuIn addition to the hardkeys and SmartKeys for the most needed functions, the Main Setup menu gets you to all settings that can be adjusted for the respective device. Select the Main Setup SmartKey to get to the Main Setup menu.Switching the Device OffTo switch off a device manually, select the Device Off SmartKey, then Confirm.If you keep Device Off pressed for more than two seconds, you can choose between Device Off or Power Off.•Device Off means that the display is switched off and the measurements are disabled. Use this option if your device is not used temporarily. Press any hardkey to turn the device on again.•Power Off means that the device is switched off completely and can only be switched on again by putting it on a charger. Use this option when the device is not used for a longer time or prepared for storage or shipping.When an IntelliVue Cableless Measurement Device is not operated, it will automatically switch off the screen lighting after a short time. A little later the low-activity screen will be displayed.enter Patient menuenters the Alarms menu to access: Alarm Messages, Alarm Limits, Alarms On/Off/Pause, Alarm Volume.change alarm volumechange pulse tone volumeaccess NBP mode selection and setup, with direct start/stop functionSmartKey Text LabelsMain SetupNBPAlarmsPatientEquipmentUser InterfaceDevice OffProfilesOperating ModesDate, TimeBatteryRevisions

3 IntelliVue CL NBP Pod48Operating ModesYour device has four operating modes. Some are passcode protected.•Monitoring Mode: This is the normal, every day working mode that you use for making measurements. You can change elements such as measurement modes, patient category and so forth. When you remove the patient from the device, 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, that are visible but 'grayed out' so that you can neither select nor change them. These are present for your information only 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.•Configuration Mode: Passcode protected, this mode is for personnel trained in configuration tasks. These tasks are described in the Configuration Guide. During installation the Cableless Measurement Device is configured for use in your environment. This configuration defines the default settings you work with when you switch on.•Service Mode: Passcode protected, this is for trained service personnel.When you switch the device on, it starts up in monitoring mode. To change to a different mode:1Use the Main Setup SmartKey to get to the Main Setup menu.2Select Operating Modes and choose the mode you require.Standby ModeThe IntelliVue Cableless Measurement Devices do not have standby mode. However, when connected to a monitor that is in standby mode, the IntelliVue Cableless Measurement Device will show a standby screen.Using the Patient MenuThe Patient menu allows you to see patient demographics information and to remove a patient from a device. Patient Demographic information is only displayed if the Cableless Measurement Device is assigned to a patient monitor or GuardianSoftware. Patient Category is the only item of patient data which can be changed at the Cableless Measurement Device, but only when the device is not assigned to a patient monitor or telemetry device.Displaying the Patient MenuTo display the Patient menu,• select the Patient SmartKey, or• select the Main Setup SmartKey followed by Patient.Stop Using a Device for a PatientTo remove a patient from the Cableless Measurement Device,•in the Patient menu select Free Device.All patient data is cleared, settings are reset to the defaults and the device is removed from the monitor or telemetry device.

3 IntelliVue CL NBP Pod50Connection with Host SystemsThe following sections describe how the IntelliVue Cableless Measurement Devices work together with host systems (Patient Monitors, Telemetry Devices / Information Center or GuardianSoftware).IntelliVue Cableless Measurements Use ModelsWith these patient-worn measurement devices you can measure and transmit a patient's vitals regularly or on an intermittent data collection basis. There are three typical use models:With a Patient MonitorThe IntelliVue Cableless Measurement Devices can be used together with an MP5/MP5SC/MP5T, MP2 or X2 patient monitor (with an SRR interface). They can communicate their measurement values via short range radio to the monitor. The monitor may be assigned to a patient sector at the IntelliVue Information Center (IIC). When assigned to the Information Center, certain actions can be performed at both the patient monitor and the Information Center. See the table “Controls Available with a Patient Monitor” on page 54.In situations where patients are becoming more mobile (for example, in step-down/intermediate care units) the lightweight Cableless Measurement Devices allow increased mobility within the short range radio range, without giving up vital signs monitoring.When assigned to a patient monitor, the Cableless Measurement Device can be selected for use in patient transport at the patient monitor (for details see the Patient Monitor Instructions for Use). In this case, the Cableless Measurement Device will perform local attended monitoring. The patient must be attended by a caregiver during transport, to ensure that alarms on the Cableless Measurement Device are recognized. In local attended monitoring mode, an alarm message text appears in the alarm status area at the top of the screen indicating the source of the alarm and an alarm tone is issued. See “Alarms” on page 28 for details.A telemetry device can be assigned to a patient monitor equipped with short range radio at the same time as any Cableless Measurement Devices are also assigned to this monitor.When assigned to a patient monitor, the admitted patient name is displayed on the NBP Pod.If the connection between the monitor and the Cableless Measurement Device is lost, an INOP will be displayed at the monitor: cl NBP Disconnect. A No Host Monitoring INOP will be displayed on the NBP Pod, and an INOP tone will sound. In this case, visual and audible alarms are still available at the NBP Pod, but it is not possible to change the alarm settings.With a Telemetry DeviceThe Cableless Measurement Devices can be assigned to a patient with the telemetry device TRx4841A/TRx4851A or an MX40 wearable patient monitor. They can communicate their measurement values via short range radio to the telemetry device which communicates them to an IntelliVue Information Center to provide a consolidated set of patient values.Some of the measurement tasks can be performed remotely from the Information Center. See the table “Controls Available with a Telemetry Device” on page 55.If the patient name is available at the Information Center, it will be also displayed on the NBP Pod.When a Cableless Measurement Device is assigned to a telemetry device, it is not possible for the telemetry device to be wirelessly assigned or directly connected to a patient monitor.

3 IntelliVue CL NBP Pod52appears in the alarm status area at the top of the screen indicating the source of the alarm and an alarm tone is issued. See “Alarms” on page 28 for details.•When assigned to a telemetry device: Measurement values sent via the telemetry device to the IntelliVue Information Center can generate alarms at the Information Center when the values meet the criteria set there for alarms. The alarms will be announced in the same way as measurements from other sources. See the Instructions for Use of the Information Center for details.•When assigned to GuardianSoftware: Measurement values sent via transmitters or hotspots to IntelliVue GuardianSoftware will be visualized in GuardianSoftware. Since IntelliVue GuardianSoftware is a data management system, no alarms are announced. The IntelliVue Cableless Measurement Devices will also not generate physiological alarms when connected to IntelliVue GuardianSoftware. See the Instructions for Use of GuardianSoftware.Assigning an IntelliVue Cableless Measurement Device to a HostWhen an IntelliVue CL NBP Pod is used with a host system (patient monitor, telemetry device or GuardianSoftware), the Cableless Measurement Device must be assigned to that host system.The assignment can be done at the CL NBP Pod itself or at the host system (patient monitor or GuardianSoftware).WARNINGAlways make sure that the applied CL NBP Pod is assigned to the correct patient.WARNINGShort Range Radio connections are subject to interruption due to interference from other radio sources in the vicinity, including microwaves, bluetooth devices, WLAN devices (802.11b,g,n) and cordless phones. Depending on the strength and duration of the interference, the interruption may occur for an extended period. A loss of connection, due to moving out-of-range, interference, or for other reasons, is indicated with a No Host Monitoring INOP on the NBP Pod, or a cl NBP Disconnect INOP at the host monitor. Correct channel configuration is important, refer to the Configuration Guide for details.Assignment at the Measurement DeviceTo make an assignment, select:•the Add/Remove SmartKey , or• hold the ◄key pressed.This opens the Add To menu which lists the available patient monitors and telemetry devices within the SRR range. In order to save power, the list is only visible for a short time; the menu is automatically closed after 40 seconds.Telemetry device: A telemetry device must be put into assignment mode by pressing the  key on the telemetry device before it can appear in the list. Pressing the  key starts an SRR channel search to find the clearest channel available. During the search all 4 LEDs will blink once per

3 IntelliVue CL NBP Pod53second. The search will take approximately 20-25 seconds. Once a channel is identified, the first LED will light up and blink once per second to indicate that the telemetry device is ready for assignment.1Select a patient monitor or telemetry system using the ◄ and ► keys.If you select a patient monitor, the measurement selection key on that monitor will change to show the type of measurement device.2Activate the assignment by pressing the  key twice on the measurement device.The Cableless Measurement Device is assigned to the selected patient monitor or telemetry device. A telemetry device plays the assignment tone when the assignment is successful. A patient monitor issues an assignment prompt message.If the internal measurement in the patient monitor is active (the measurement selection key has a yellow frame), you will need to confirm that it should be deactivated in favor of the Cableless Measurement Device you want to assign. To do this:1Select the measurement selection key on the monitor.A prompt message appears with the Confirm and Cancel keys.2Select Confirm to deactivate the internal measurement.When the Cableless Measurement Device is assigned, the symbol appears on its display indicating that alarming capability has been transferred to the host (to the monitor or, for the telemetry device, to the Information Center). No patient alarms will be announced on the Cableless Measurement Device.To unassign the measurement device from the monitor or telemetry system, select the Add/Remove SmartKey, then select Remove From. After confirmation the SRR connection is disconnected.Assignment at the Patient MonitorPrepare the Pod for assignment by activating the Add/Remove SmartKey.At the patient monitor,1Select the Measurement Selection key.2Select the Add cl Msmt pop-up key.This opens the Add Cableless window, which shows the available Cableless Measurement Devices:Add ToMon 1Mon 2Tele 33Tele 44

3 IntelliVue CL NBP Pod543Select the device which you want to assign to the patient in the monitor.4The monitor displays the assignment prompt message.If the internal measurement in the patient monitor is active, you will need to confirm that it should be deactivated in favor of the Cableless Measurement Device you want to assign.When the Cableless Measurement Device is assigned, the symbol appears on its display indicating that alarms from the device will be sent to the patient monitor.An assigned Cableless Measurement Device can be removed in the Measurement Selection window. For more details see the Instructions for Use for your patient monitor.Assignment with GuardianSoftwareTo assign a Cableless Measurement Device to a patient in GuardianSoftware:1Select the patient on the Chalkboard.2Take the Cableless Measurement Device from the charger.3On the Equipment List tab, select the Cableless Measurement Device on the Available Equipment list, highlighted in green on top of the list. The device on top of the list is always the one with the most recent user interaction (taken off the charger, put on the charger, or key pressed).4Click Use for Patient to assign the device to the patient.Controls Available with a Patient MonitorThe controls available when the Cableless Measurement Device is assigned to a patient monitor are described in the table below.* except when SRR connection to host is lostWARNINGIf a patient being monitored by Cableless Measurement Devices moves out of range of the patient monitor, the measurements are not transmitted to the patient monitor or the Information Center. The measurements are available on the Cableless Measurement Device only. If this occurs, the No Host Action At the Cableless Measurement DeviceAt the Patient MonitorAt the IICStart/Stop/Stat NBP Yes Yes YesChange NBP Mode Yes Yes NoChange NBP Repetition Time Yes Yes NoChange Alarm Limits Yes* Yes NoAssign NBP Pod Yes Yes NoRemove NBP Pod Yes Yes NoPlace Device in Standby No Yes YesAlarm Silence No Yes YesAlarm Off/Pause No Yes Yes

3 IntelliVue CL NBP Pod55Monitoring message is displayed on the measurement device. The measurement device will also sound the INOP tone.Controls Available with a Telemetry DeviceThe controls available when the Cableless Measurement Device is assigned to a TRx4841/TRx4851A Transceiver or MX40 wearable patient monitor with a short range radio adapter (SRRA) are described in the table below.NOTEWhen you unplug the ECG cable from the telemetry device and plug it into the monitor associated with the same patient, the ECG source will automatically be from the monitor. The NBP measurement devices assigned to the telemetry device will continue to source data to the telemetry device and the Information Center. You may need to change screens on the patient monitor to see the measurements.Controls Available with GuardianSoftwareThe controls available when the Cableless Measurement Device is assigned to GuardianSoftware are described in the table below.Action At the Cableless Measurement DeviceAt the IICStart/Stop/Stat NBP Yes NoChange NBP Mode Yes NoChange NBP Repetition Time Yes NoChange Alarm Limits No YesAssign NBP Pod Yes NoRemove NBP Pod Yes YesPlace Device in Standby No NoAlarm Silence No YesAlarm Off/Pause No YesAction At the Cableless Measurement DeviceAt GuardianSoftwareStart/Stop/Stat NBP Yes YesChange NBP Mode Yes YesChange NBP Repetition Time Yes YesAssign NBP Pod Yes YesRemove NBP Pod Yes YesPlace Device in Standby No NoAlarm Silence No YesAlarm Off/Pause No No

$3 IntelliVue CL NBP Pod56TrendingThe IntelliVue Cableless Measurement Devices provide data for trending of parameters. The trended data are only available via a host system. For details on trends see the Instructions for Use of your host system.When the connection to the host is lost during measurement, the IntelliVue Cableless Measurement Devices are able to collect data in a local memory. These data can be uploaded to GuardianSoftware, but not to other host systems, when a connection is established at a later stage.Monitoring NBPThe IntelliVue CL NBP Pod uses the oscillometric method for measuring NBP. The blood pressure measurements determined with this device were clinically validated according to ANSI/AAMI SP10 and ISO 81060-2 in relation to mean error and standard deviation, when compared to auscultatory measurements (depending on the configuration) in a representative patient population. The fifth Korotkoff sound was used to determine the diastolic pressure for adult/adolescent subjects and the 4th for pediatric subjects.The accuracy of the mean arterial pressure (MAP) was validated using the approximation MAPref = (SYSref + 2*DIAref) / 3 with SYSref and DIAref being the blood pressure measured by the auscultatory method.The NBP measurement is suitable for use in the presence of electrosurgery and during the discharge of a cardiac defibrillator according to IEC 60601-2-30:1999/EN 60601-2-30:2000.Introducing the Oscillometric NBP MeasurementOscillometric devices measure the amplitude of pressure changes (oscillations) in the occluding cuff as the cuff deflates from above systolic pressure. The amplitude suddenly increases as the pulse breaks through the occlusion in the artery. As the cuff pressure decreases further, the pulsations increase in amplitude, reach a maximum (which approximates to the mean pressure), and then diminish.Studies show that, especially in critical cases (arrhythmia, vasoconstriction, hypertension, shock), oscillometric devices are more accurate and consistent than devices using other noninvasive measuring techniques.WARNINGPatient Category: Do not use the IntelliVue CL NBP Pod on neonatal patients. The initial inflation pressure and overpressure safety limits are too high for neonatal patients and could cause fractures and bruises.Intravenous infusion: Do not use the NBP cuff on a limb with an intravenous infusion or arterial catheter in place. This could cause tissue damage around the catheter when the infusion is slowed or blocked during cuff inflation.Skin Damage: Do not measure NBP in cases of sickle-cell disease or any condition where skin damage has occurred or is expected.Unattended measurement: Use clinical judgement to decide whether to perform frequent unattended blood pressure measurements in cases of severe blood clotting disorders because of the risk of hematoma in the limb fitted with the cuff.$