Philips 4522_962_24371 MRx Monitor/Defibrillator With Q CPR And Intelli Vue Clinical Network Brochure Hospital (ENG)

User Manual: Philips MRx Monitor/Defibrillator تسريع رعاية ٠رضى احتشاء عضلة القلب الناج٠عن ارتفاع ٠قطع ST ‏(STEMI) ٠نذ اكتشاف الحالة ووصولاً إلى ٠رحلة العلاج

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HeartStart MRx
Monitor/De brillator
All-in-one monitoring, measurements, and proven therapies
Cardiac Resuscitation
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HeartStart MRx Monitor/Defi brillator2
Compact, lightweight and intuitive unit
combining a defi brillator, monitor and cardiograph
in one unit saves space and reduces weight on
hospital beds.
Industry-leading physiologic measurements
and Q-CPR real-time measurement and feedback.
Proven therapies including pacing and the SMART
Biphasic® waveform for effective de brillation and
synchronized cardioversion with less post-shock
trauma.
Clinical networking capability* on the IntelliVue
Clinical Network for monitoring and review at
the central station. The HeartStart MRx is the
only monitor/defi brillator with clinical networking
capability. During transport between clinical units,
maintain the level of care provided at the bedside with
remote surveillance and automatic updating of vitals.
Recent scientifi c evidence as well as American Heart
Association and European Resuscitation Council
guidelines demonstrate that quality CPR and effective
defi brillation are inextricably linked.
** To assist
caregivers in performing quality CPR, the Q-CPR
measurement and feedback tool offers objective
measurement and corrective feedback on compression
depth and rate as well as ventilation volume and rate.
The HeartStart MRx Monitor/Defi brillator unites Philips industry-leading
monitoring, superior diagnostic measurements, proven therapy capabilities,
and CPR measurement and feedback in a lightweight and intuitive package
designed to help caregivers save lives every day.
HeartStart MRx M
Leading-edge monitoring, r
AC or battery power, with
two bays for rechargeable lithium
ion batteries. Two fully charged
batteries provide a minimum of
10 hours of monitoring – more
than any other monitor/defi brillator.
Batteries charge to full capacity
in just three hours. Battery
conditioning is not required.
Powerful monitoring and
measurements, including:
Standard
• 3- and 5-lead ECG
• ST/AR Basic arrhythmia algorithm
• Vital signs trending
Optional
• FAST SpO2 (Fourier Artifact
Suppression Technology)
• Q-CPR measurement and
feedback
• Noninvasive Blood Pressure
(NBP)
• Microstream® Capnography
(EtCO2)
• 12-lead ECG
• 12-lead ECG transmission
• Invasive Blood Pressure, 2 lines
• Temperature
* Only available in the US.
** Cobb et al. (1999), JAMA, “Influence of Cardiopulmonary Resuscitation Prior
to Defibrillation in Patients with Out-of-Hospital Ventricular Fibrillation”
Weisfeldt et al. (2002), JAMA, “Resuscitation after Cardiac Arrest - A 3-phase
Time-Sensitive Model”
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HeartStart MRx Monitor/Defi brillator 3
Color display shows four waveforms
and numerics. It is the largest in its class
at 12.8 x 17.7 cm (8.4˝ diagonal), which
allows viewing of all 12 leads at once
with the 12-lead acquisition option.
Easily transported by hand or on
a hospital bed using the carrying
handle or bedrail hook. This
compact unit weighs only 6 kg (13.2 lbs.)
and measures 31.5 x 21.0 x 29.5 cm
(12.4˝ x 8.3˝ x 11.7˝).
Confi gure the intuitive user
interface based on preferences.
Monitoring ports are easily identifi ed
and color-coded to avoid confusion in
high-stress situations. Ports match Philips
patient monitors for easy patient handoffs.
Monitoring and therapy
controls sensibly organized.
Ready for use indicator ashes with
a black hourglass confi rming that the
unit is ready to go. Otherwise, it asks
for attention with a red “X” and an
audible chirp when the battery is low,
if the unit is not ready to pace or shock,
or if the ECG capability is compromised.
Operators have assurance that the
MRx is ready when needed when the
black hourglass is fl ashing.
Defi brillation as easy as 1-2-3
1 Select energy to choose an
appropriate dosage.
2 Charge button charges the
defi brillator in less than ve seconds.
3 Shock button to deliver therapy.
Quick Shock delivers a shock
typically in less than 10 seconds after
the user is prompted to pause chest
compressions for defi brillation.
Automated External Defi brillator
(AED) mode delivers a lifesaving
shock within seconds, guided by clear,
concise voice and on-screen prompts.
Integrated strip chart printer
documents ECG rhythm strips,
12-lead reports, clinical events, event
summary repor ts, vital signs
trending, operational checks,
con guration, status logs, and other
device information (50 mm standard
or 75 mm optional).
Monitor/De brillator
, r
esuscitation, and clinical networking*
Soft keys to customize the display,
set and respond to alarms, and select
additional monitoring parameters.
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HeartStart MRx Monitor/Defi brillator4
Diagnostic-quality measurements
and a variety of monitoring modes
There is no reason to compromise on
monitoring functionality in a monitor/
defibrillator. HeartStart MRx provides
easy-to-use, industry-leading measurements
common to all Philips patient monitors.
Arrhythmia using ST/AR
The ST/AR Basic arrhythmia algorithm analyzes the
ECG and calculates the heart rate, while continuously
monitoring for ventricular arrhythmias and generating
visible and audible alarms as needed. ST/AR detects
ten rhythm disturbances, including ve life-threatening
arrhythmias: asystole, ventricular fi brillation, ventricular
tachycardia, extreme bradycardia, and extreme tachycardia.
Pulse Oximetry with FAST SpO2
Patented Fourier Artifact Suppression Technology (FAST)
SpO2 with its low-noise hardware and quality indicators
enables MRx to provide accurate measurements, even in
the presence of low peripheral perfusion.
Noninvasive Blood Pressure (NBP)
ADVANTAGE® oscillometric NBP provides motion-
tolerant systolic and diastolic measurement capabilities.
It also calculates mean arterial pressure.
Invasive Blood Pressure (IBP)
The Invasive Blood Pressure (IBP) measurement
produces real-time waveforms and numeric values for
systolic, diastolic, and mean arterial blood pressure and
works with a range of catheters and blood pressure
transducers. Software algorithms fi lter typical artifacts
such as respiratory variation and pressure changes
caused by fl ushing the line or drawing blood samples.
Microstream® Capnography (EtCO2)
Microstream® CO2 technology for use with both
intubated and non-intubated patients is convenient
and fl exible, requiring no zeroing, heating, and no
external sensor to interfere with the patients airway.
Philips 12-lead ECG
Common to the Philips PageWriter Touch cardiograph
and IntelliVue bedside monitors, the 12-lead algorithm
delivers both ECG data and interpretation. It detects
ST-segment elevation acute myocardial infarction (STEMI)
and differentiates early acute coronary syndromes.
Continuous Temperature
Temperature measurement provides continuous body
temperature readings at a variety of sites including:
skin, rectal, nasal, esophogeal, arterial, and venous.
Temperatures from -1ºC to 45ºC can be tracked, and
the numeric display presented along with other key
parameters.
Vital Signs Trending
In Monitor Mode, the HeartStart MRx provides the
ability to view and print numeric vital signs trending
for the current patient event. The trend data is visible
at selected intervals for up to the most recent 12
hours of monitoring.
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HeartStart MRx Monitor/Defi brillator 5
Proven patient therapy
Philips HeartStart de brillators use sophisticated,
clinically-proven technology to provide effective
defi brillation, synchronized cardioversion and pacing.
Defi brillation and Synchronized Cardioversion
with SMART Biphasic Technology
Designed for maximum efficacy and minimized post-
event heart dysfunction, this patented waveform
technology measures chest impedance and delivers
a shock based on unique patient requirements.
Peer-reviewed evidence supports the effectiveness
of SMART Biphasic synchronized cardioversion
capabilities, which are activated with the push of a
button.* In Sync Mode, R-wave markers appear on or
above each detected R-wave.
Noninvasive Pacing
Users can perform transcutaneous pacing, which offers
a constant 40-msec pulse width, and an adjustable rate
and output (mA). MRx offers both demand mode and
xed mode.
* Page et al. (2002),JACC, “Biphasic Versus Monophasic Shock Waveform for
Conversion of Atrial Fibrillation”
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HeartStart MRx Monitor/Defi brillator6
Networked
*
for work ow
convenient d
Wired
IntelliVue
Monitors
Hospital LAN
IntelliVue
Information
Center
Database
Server
IntelliVue
Application
Server
Common Wireless
Access Points
Sync Unit
Power
Over
Ethernet Switch
Access
Point
Controller Router
32’
Switch
Patient
IntelliVue Telemetry System
Instrument
Telemetry
HeartStart MRx
(wired and 1.4GHz
Smart-hopping
connectivity in
the US only)
Reference Data
Physiologic Data
Access Point
HeartStart MRx and the
IntelliVue Clinical Network
Wired and wireless networking capability* connects
the HeartStart MRx to the IntelliVue Clinical
Network. This means that waveforms, vitals, and
alarms from HeartStart MRx stream in real-time to
the IntelliVue Information Center and can be reviewed
using a range of Clinical Review Applications on the
IntelliVue Information Center. Clinicians can monitor
and silence alarms from the IntelliVue Information
Center. Patients monitored by a HeartStart MRx in a
chest pain room, in the emergency department, or
at the cardiac cath lab, for example, have the added
safety of surveillance at the central station.
The IntelliVue Clinical Network centralizes patient
information, streamlining documentation and reporting.
For regulatory reporting such as the Joint Commission’s
mandate for sentinel events, HeartStart MRxs
networking capability ensures continuous streaming
of patient data to the IntelliVue Information Center
for inclusion in the patient chart.
Bi-directional information flow means that patient
data can be entered at either the bedside or
central station. The HeartStart MRx can admit,
discharge, and transfer patients so that the data
moves with the patient. The network is also able
to adjust the HeartStart MRx time clock to ensure
synchronization with the clinical network.
Because the HeartStart MRx shares the same algorithms,
parameters, and medical consumables as other Philips
patient monitors, patients do not require re-cabling at
handoffs, which means smoother and faster transitions
for care givers and less discomfort for patients.
The HeartStart
MRx connects to
the IntelliVue Clinical
Network via a LAN
cable or wireless medical
transmission service
(WMTS) radio.
Hospital Infrastructure
* Only available in the US.
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HeartStart MRx Monitor/Defi brillator 7
w effi ciency,
t documentation, and patient safety
Automated self tests and operational checks
The HeartStart MRx automatically performs hourly,
daily, and weekly self tests without user involvement. In
addition, users can run operational checks periodically.
Saving HeartStart MRx information
for review and documentation
To simplify Joint Commission and other reporting
requirements, HeartStart MRx’s internal memory
automatically stores up to twelve hours of continuous
ECG waveform and event data (including drug and
therapy markers) and up to 55 Event Summaries. The
data can also be copied to a removable CompactFlash®
data card for transfer to a laptop or personal computer.
Review results on screen or print results using the
strip chart printer. Transfer results to a PC running
HeartStart Event Review Pro data management
software to compile, edit, share, and archive patient
care information for quality control and reporting.
Plug and play with Philips monitor/defi brillators
and patient monitors
HeartStart accessories are interchangeable with
Philips patient monitors to allow “plug and play
handoff between the bedside and the monitor/
de brillator for easy transports.
An ADT interface allows patients to be admitted, discharged, or
transferred at the bedside through HeartStart MRx. Patient data
from the IntelliVue Information Centerincluding patient name,
category, pacing status, and locationare displayed on the monitor.
Bed/equipment label
Network status icon
Patient name
Patient category
Paced status (internal)
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HeartStart MRx Monitor/Defi brillator8
HeartStart Defi brillator Pads and Paddles
Optimized for Philips de brillators, HeartStart multifunction
defi brillator pads come in adult, pediatric, and specialty choices
to fi t the needs of a variety of departments, caregivers, patients
and treatments – from emergency use to ECG monitoring and
radiological procedures. When connected to
HeartStart
MRx,
they can provide ECG monitoring, synchronized cardioversion,
and noninvasive pacing, in addition to external de brillation.
If paddles are preferred, the MRx is optionally equipped with
a set of external paddles. These anterior/anterior paddles
(water resistant available) quickly and easily convert from adult
to pediatric by removing the outer surfaces. The paddles also
have Philips’ patented Patient Contact Indicator (PCI) to assess
paddle-to-patient contact and indicate contact quality on the
sternum paddle’s handle.
For open-heart and other intrathoracic procedures, HeartStart
MRx can be used with Philips internal defi brillation paddles,
which come in a range of sizes.
Measurement Supplies
ECG cables, NBP cuffs, SpO2 sensors, and CO2 fi l t e r
lines are interchangeable with HeartStart MRx and other
Philips patient monitors. This contributes to ef ciency
during transfer since there’s no need for re-cabling.
It also simplifi es purchasing, stocking, and managing
inventory for cables and other supplies throughout the
hospital. All supplies are backed by a one-year warranty.
A range of medical consumables
to suit clinician preference
Carrying case
A durable, semi-rigid structure covered in easy-to-clean vinyl,
the case adds a layer of protection to the HeartStart MRx and
enables easy transport of well-organized accessories. Modular
pouches can be removed if desired.
Interactive Multimedia
Use the self-paced, interactive, web-based
training program to explore device features,
simulate hands-on procedures, and test your
understanding. Continuing education credits
are available upon course completion. Philips
also provides video-based training (optional).
Instructor-based Training and Toolkit
An Instructor Guide, User Training Workbook,
and Skills Checklist combine to help you
deliver MRx education in an effective and
ef cient manner. On-site instructor-based
training delivered by clinical educators is
also available, customized to your needs and
presented in realistic critical care context.
Application Notes
Application notes explain the theory behind
our therapeutic and monitoring technologies,
as well as provide support for their clinical
ef cacy and intended interpretation.
Education
Solutions
Philips has created a variety of education
and training solutions, all developed using
sound instructional design principles, to
further enhance your experience with
the HeartStart MRx. Some of these
solutions include:
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HeartStart MRx Monitor/Defi brillator 9
Defi brillation and CPR are inextricably linked
Based on much peer-reviewed research, internationally
recognized organizations such as the American
Heart Association and the European Resuscitation
Council have published guidelines that emphasize
not only the importance of both early de brillation
and quality CPR, but also the way in which these
therapies work together. Q-CPR technology by
Laerdal in the MRx is the worlds fi rst and only real-
time measurement and feedback tool to provide
personalized feedback on both components of CPR:
ventilation and compressions.
Objective feedback on the
quality of your CPR with Q-CPR
Q-CPR measures and provides feedback on
these important aspects of CPR:
• Chest compression rate (too high, too low)
Chest compression depth (too shallow, too deep)
• Chest compression complete release/recoil
• Chest Compression “hands-off” time
• Ventilation rate (too high, too low)
• Ventilation volume
• Ventilation inactivity
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HeartStart MRx Monitor/Defi brillator10
Physical
Dimensions Without external paddles: 12.4 in. (W) x 8.3 in. (D)
x 11.7 in. (H) (313 mm x 210 mm x 295 mm)
With external paddles: 13.4 in. (W) x 8.3 in. (D)
x 13.6 in. (H) (340 mm x 210 mm x 345 mm)
Weight
13.2 lbs. (6 kg): base unit with 1 battery, pads and
pads cable. Carrying case adds 4.1 lbs. (1.86 kg).
Paddle tray and external standard paddles add less
than 2.5 lbs. (1.1 kg).
Environmental and Physical Requirements
Water Resistance Meets IEC 60601-2-4
Solids Resistance IP2X
Temperature Operating: 32º - 113º F (0º - 45º C)
Storage: -4º - 158º F (-20º - 70º C)
Humidity Operating: 0% to 95% relative
Safety Meets EN 60601-1, UL 2601-1, CSA C22.2
No. 601-1-M90 CSA, EN 60601-2-4
Display
Dimensions 8.4’’ diagonal (128 mm x 171 mm)
Type TFT color LCD
Resolution 640 x 480 pixels (VGA)
Wave Viewing Time
5 seconds (ECG)
Defi brillator
Defi brillator Model HeartStart MRx (M3535A)
Waveform Truncated Exponential Biphasic. Waveform parameters
adjusted as a function of patient impedance.
Output Energy Manual (selected): 1-10, 15, 20, 30, 50, 70, 100, 120,
150, 170, 200 Joules maximum energy, limited to 50
Joules for internal defi brillation.
AED Mode (single energy output): 150 Joules into a
50 ohm load.
Charge Time Less than 5 seconds to 200 Joules with a new, fully
charged lithium ion battery at 25º C
Shock Delivery Via multifunction de b electrode pads or paddles
Quick Shock Less than 10 seconds from cessation of CPR to shock
delivery
Patient Impedance
Range
Minimum: 15 Ohm (internal de brillation); 25 Ohm
(external defi brillation)
Maximum: 180 Ohm
AED Mode Shock advisory sensitivity and speci city meet AAMI
DF-39 guidelines
Strip Chart Printer
Printer Standard: 50 mm (paper width) thermal array printer
Optional: 75 mm (paper width) thermal array printer
Continuous ECG
Strip
Prints primary ECG lead with event annotations and
measurements in real-time or with 10-second delay
Auto Printing Printer can be confi gured to print marked events,
charge, shock and alarms
Reports
Event Summary, 12-lead, Vital Signs Trending, Operational
Check, Confi guration, Status Log, and Device Information
Paper Size 1.97 in. (50 mm) W by 100 ft. (30 m) L
2.95 in. (75 mm) W by 100 ft. (30 m) L
Product Specifi cations
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HeartStart MRx Monitor/Defi brillator 11
Battery
Type 6.0 Ah, 14.8 V, rechargeable lithium ion
Dimensions
6.5” (H) x 3.8” (W) x 1.6” (D) (165 mm x 95 mm x 42 mm)
Weight 1.6 lb. (0.73 kg)
Charge Time Approximately 3 hours to 100%, 2 hours to 80%
Capacity At least 5 hours of monitoring with ECG, SpO2, CO2,
temperature and two invasive pressures monitored
continuously, NBP measured every 15 minutes, and
20 200J discharges (with a new, fully charged battery,
operating at room temperature, 25º C).
At least 3.5 hours of monitoring with ECG, SpO2,
CO2, temperature and two invasive pressures
monitored continuously, NBP measured every 15
minutes, and pacing at 180ppm at 160mA.
Battery
Indicators
Battery gauge on battery, capacity indicator on
display; fl ashing RFU indicator, chirp, and ‘Low
Battery’ message appears on display for low battery
condition, when 10 minutes of monitoring time and
6 maximum energy discharges remain (with a new
battery at room temperature, 25º C)
Data Storage
Internal 12 hours of continuous ECG waveforms and events,
maximum capacity of 55 Event Summaries
Data Card
60 event summary reports or 240 megabytes of patient data
ECG and Arrhythmia Monitoring
Input Up to 4 ECG waves displayed and up to 2 ECG waves
print simultaneously
Lead I, II, or III obtained through 3-lead ECG cable and
separate monitoring electrodes. With 5-lead cable,
obtain leads aVR, aVL, aVF, or V. Pads ECG obtained
through 2 multifunction de brillation electrode pads.
Lead Fault Lead Off’ message and dashed line displayed, if an
electrode or lead wire becomes disconnected
Pads Fault Dashed line displayed if a pad becomes disconnected
Heart Rate Display Digital readout on display 15 to 300 bpm, accuracy ±10%
Heart Rate/
Arrhythmia Alarms
HR, Asystole, VFIB/VTACH, VTACH, extreme
tachycardia, extreme bradycardia, PVC rate, Pacer
not capture, Pacer not pacing
ECG Size 2.5, 5, 10, 20, 40 mm/mV, autogain
Noninvasive Pacing
Waveform Monophasic Truncated Exponential
Current Pulse
Amplitude
10 mA to 175 mA (5 mA resolution); accuracy
10% or 5 mA whichever is greater
Pulse Width 40 ms with ± 10% accuracy
Rate
30 ppm to 180 ppm (10 ppm increments); accuracy ± 1.5%
Modes Demand or Fixed Rate
Refractory Period 340 msec (30 to 80 ppm); 240 msec (90 to 180 ppm)
SpO2 Pulse Oximetry
Measurement
Range
0 to 100%
Resolution 1%
Alarm Range Low Limit: 50 to 99% (Adult/Pediatric)
High Limit: 51 to 100% (Adult/Pediatric)
Desat Alarm Signal
Generation Delay
20 seconds
Noninvasive Blood Pressure
Pressure Range Systolic: 40 to 260 mmHg
Diastolic: 20 to 200 mmHg
Initial Pressure Adult: 160 mmHg
Pediatric: 120 mmHg
Maximum Pressure 280 mmHg
Alarm Range Systolic high limit: 30 - 270 (Adult), 35 - 180 (Pediatric)
Systolic low limit: 30 - 265 (Adult), 30 - 175 (Pediatric)
Diastolic high limit: 15 - 245 (Adult), 15 - 150 (Pediatric)
Diastolic low limit: 10 - 240 (Adult), 10 - 145 (Pediatric)
End-Tidal CO2
Measurement
Range
0 to 99 mmHg
Resolution 1 mmHg (0.1 kPa)
Sample Size 50 ml per minute
Alarm Range Low Limit: 10 to 94 mmHg (Adult/Pediatric)
High Limit: 20 to 95 mmHg (Adult/Pediatric)
Invasive Blood Pressure
Channels 2
Transducer
Sensitivity
5uV/V mmHg (37.5uV/V/kPa)
Measurement
Range
-40 to 361 mmHg (-5.3 to 48.1kPa)
Measurement
Resolution
1 mmHg (0.1kPa)
Pulse Rate Range 25 - 350 bpm
Temperature
Measurement
Range
0º - 45º C (32º - 113º F)
Measurement
Resolution
0.1º C (0.2º F)
CPR Measurement and Feedback
Compression
Depth Target
-1.50 to -2.00 in. (-38 to -51 mm)
Compression Rate
Target
90 to 120 cpm
Ventilation Volume
Graphic indicator
Empty, 1/3-full, 2/3-full, full
Ventilation Rate 4 to 16 ventilations per minute or 9-16 vpm after
performing rescue breathing following 60 seconds
without compressions
12-Lead ECG
Input 12-lead cable: leads I, II, III, aVR, aVL, aVF, V/C1-V/C6
Display View All 12-lead ECG waves display simultaneously
Strip Record All 12-leads print on the strip chart printer in 3x4 format
Transmission CompactFlash data card; cellular dial-up Internet
connection
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Philips Medical Systems is part of
Royal Philips Electronics
Interested?
Would you like to know more about our imaginative
products? Please do not hesitate to contact us. We
would be glad to hear from you.
On the web
www.medical.philips.com
Via email
medical@philips.com
By fax
+31 40 27 64 887
By mail
Philips Medical Systems
Global Information Center
P.O. Box 1168
5602 BD Eindhoven
The Netherlands
By phone
Asia
Tel: +852 2821 5888
Europe, Middle East, Africa
Tel: +49 7031 463 2254
Latin America
Tel: +55 11 2125 0764
North America
Tel: +1 800 299 6417
© 2007 Koninklijke Philips Electronics N.V.
All rights are reserved. Reproduction in whole or in part is prohibited without the prior written consent of the copyright holder.
Philips Medical Systems Nederland B.V. reserves the right to make changes in specifi cations and/or to discontinue any product at any time without
notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Printed in The Netherlands.
4522 962 24371/861 * JUN 2007
Microstream and FilterLine are registered
trademarks of Oridion Medical Ltd.
ADVANTAGE is a registered trademark of
SunTech Medical Instruments. CompactFlash is
a registered trademark of SanDisk Corporation.
Q-CPR is a trademark of Laerdal Medical. SMART
Biphasic is a registered trademark of Philips.
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