Spacelabs Healthcare 76A90343 Medical Telemetry Device User Manual 8

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Application ID	3OQiefaX8SLRR61e+wwWVw==
Document Description	8
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Permanent Confidential	No
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Document Type	User Manual
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Filesize	66kB (824977 bits)
Date Submitted	1999-09-20 00:00:00
Date Available	1998-11-19 00:00:00
Creation Date	2001-06-06 02:58:43
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Document Lastmod	2001-06-06 02:58:45
Document Title	8

09/15‘28 15:01 FAX 425 682 3397 SH] E\G EB NORTH QUOZ
ULTRAVlEW DIGITAL TELEMETRY
Contents
Selling Up 5902 Monitoring
Ensuring Accurate Monitoring.
Selling or Adjusting Alarm le
Setting Sp02 Data Averaging Pant-id and
Acknowledging Signal Lem Sampling Interval. 19
Setting Battery Status Alarms .5 Viewing Pulse Hate
convening Palient- Initiated Recordings .8 Spoz Error Messages
Digital Telemetry Problem Solving . GSpOZ Toubleshooting
Setting Up EGG Monitoring... 9 NIBP Overview"
Display Detail 11 Setting Up NIBP Mgnrloring.
Monitoring Paeed ECG Pattern 12 Setting Up the ASP Monitor.
Restoring Deleuil Settings 12 Setting nrAdJueting Alarm l.i
changing the Display Fleeo uiron 13 Displaying Heart Rate Date.
Selecting Options tor Lead Display. 13 Displaying New or Previous Headings
ECG Tmubleshuotlngt... 14 90217 Event Codes”
5902 Overview (am: only; 16 NIBP Troubleshoofln
General Teiunetry Overview
Assigning a Telemetry Channel
Turning a Receiver tor a Bedside.
Entering Patient Inlorrnellen,
aswwxeese
General Telemetry Overview
The digital telemetry receiver module (Model 90478) when used“ In conjunction wtth
Spacetabs Medical telemetry transmitters. PCMS" or Ultraview'" monitor, and
modular receiver housing (Model 90479). provides oalllnunus monllorlng oi
electromrdingrephic signals in orderto detect abnormal cardiac rhythms. lneludlng ille-
threelenlng emrylhmiaa such as esyetoie. venuicular fibrillation, and ventricular
tachycardia. in addition, when used with the dgiiel telemetry mulflvarameler
transmitter (model 90343). monitoring of electrncerdiogrephic signals is augmented by
the eveilability at continuous or episadic 5902 measurements and episodic NlBP
measurements.
- The hanamitrersendreeeiversrefenedioimhis chaplarcomply
@ Mhpantiolmchcfluuqaereflonlssubiecrrome
NOTE Ioilowlng two conditions: (1) 17715 device may notaruse harmful
interference. and (2) this device must accept any Mariam-lee
received, Including Merle/emu that may cause undesired
memlioa.
- Change- or modifications not expressly approved by
summmdlulwill width-unfemthomymamte
W ”W
Transmitters
The tranemiller is e mil battery-paneled device carried by the patient tn monitm
ECG actrvtty and SpOg/NIBP (90343 only) date. and transmit this inlormalten to the
ieimtry receiver module.
- The 90343 and 90347 transmit tour leads oi EOG and use up to live lead wires.
However, only two leads may be displayed simultaneously.
- The 90341“; also capable oftransmiltlng numerical NiBP and Spa: date. This
data is displayed simultaneously with that at the ECG waveform data.
ULTRAWEW DIGITAL TELEMETRY~2
ULTRAVIEW DIGITAL TELEMETRY
Up to live standard disposable silver/silver chloride chest electrodes are
connected to the patient: the ECG lead wires are attached to these electrodes and
are connected to the transmitter. A patient-operated RECORD button initiates an
ECG strip at the system printer it this teature is enabled at the central or bedside.
- This device has a Ilmlted bandwidth from £5 to 30 Hz.
which may adversely affect the recording of high
trequency components In the ECG signal. especially when
the mo hol otthe ECG chan as re idl .
CAUTION rp (my 9 p y
- this devlce has a I ited dynamic range of i 5mV, which
may render the dewce vulnerable to saturation by ECG
signals with amplitudes higher than 5mV.
- To clean the transmitter use only the tollowing solutions
per the manufacturer's labeling: Isopropyl Alcohol (7036),
Hydrogen Peroxide, Cidex, Betadlne, and Clorox. Use of
cleaning solutions other than those listed wIII VOID the
warranty ol‘ the digllal telemetry transmitter cases.
Clean the transmitter alter each use. The transmitter does not require
@ any preventative maintenance other than cleaning.
NOTE
Transmltter Batteries
A s-Volt alkaline battery (PIN 146-0033-00) lS recommended tor standard use in
the digital telemetry transmitter. A 9-Volt lithium battery (PIN 1460054-00) may
also be used tor applications requiring more extended battery service lite.
Always observe the battery position and polarity as illustrated at the bottom ot the
battery compartment. Atter battery installation, close and latch the companment
cover. The transmitter begins transmitting as soon as the battery is in place,
- Whenever the transmitter is not in use, the battery should be
@ removed. Insert a battery only when the transmitter is actually
NOTE being used Wllh a patient.
- The LOW BA TTERYmessage appears and an alarm tone
sounds (it LO BAT is set to ON) when the transmitter battery
voltage falls below 7.0 volts. When this message appears. the
transmitter has up to 1 hour (depending on transmitter type and
selected options) of operating time left. depending on the type
of battery used. The low battery indicator will flash on the
enhanced digital telemetry transmitters when the transmitter
battery voltage falls below 7.0 Volts.
UL TRA VIEW DIGITAL TELEMETRV—3
PCMS
UL THA VIEW DIGITAL TELEMETRY-4
Digital Telemetry Receiver Module
The telemetry receiver module plugs into a bedside, central, or transport monitor,
or a digital lelemetry module housing. The receiver module receives patient vital
sign data from the transmitter. This data is reconstructed by the receiver module,
dtsplayed on the monitor and analyzed as described in the ECG. Arrhythmra, and
STAna/ysis chapters, and in the various $902 and NIBP sections oi this chapter.
interlerence than hardwired systems, which may Impact
~ Telemetry systems may be more susceptible to
fl patient safety.
WARNING - Operation of hand-held, wireless telephone equipth (for
example, cordless telephones, cellular telephones, etc.)
near telemetry systems may cause interference and should
be discouraged.
Do not Install a telemetry receiver module into a bedside
which is currently equipped with any other ECG module,
hardwired or telemetry, (or Spa? module or NIBP module i!
the 90343 is operating with that specific receiver module).
Doing so may result in inaccurate patient data displays at
remote monitors.
Digital Telemetry Module Housing
The telemetry module housing can hold up to eight separate telemetry receiver
modules. Except tor the ON/OFF swrtches, there are no operator controls on the
module housing, For normal operation with AC mains power applied. the AC
mains indicator light on the lront panel ol the housing must be illuminated.
Operation of the system without AC mains power is iirnited to ten minutes of
battery backup time
ULTRAVIEW DIGITAL TELEMETRY
Dlversl ».
Anlmn? (a
System ,, ,
NOTE. The UCW bedside CONPEUS to
"‘° ”CW "“’““‘° "°““"9- 3“ m" PC Scam or Ullraviewloso
ucw cemral connects In the mgnal (e—
lemelry module housing.
UCW Badsldo or Central
or Ullravlew 1500
SDLC
9047s
Receiver Modulz
Ullravlew 1700
SDLC
a o o 0
El ‘ ‘ H
—l a o o o
n o o o o H
o o o o 7
Fl ' ' H
o o 0 o 7
H o o o o 11
90479
Dlglml Telsmatry Module Housing
90347 90343
Dlgllul Telemetry ECG Transmitm Diglial Telamalry MullI-paumsler Tunsmlner
Figure Telemetry-1: Ullrawew Dig/“la! Telemerry System
UL TEA VIEW DIGITAL TELEMETFIV~5
PCMS
To set up the central lor ECG (
bed name not remembered):
1 Touch key label that matches
transmitter‘s lrequency
2 Select bed/room number lor
transmitter channel
To set up the can re or ECG
(P01 only):
Touch MONITOR SETUP
Touch SCREEN FORMAT
Select zone desired
Select bed/mom number
Select ECG ON
mauve—-
To tune a receiver module at
bedside:
Touch ECG
Touch SETUP
Touch TM SETUP
Touch SET TM CHANNEL
Select the digit to change. Use
the T Jr keys to select the value
lor that digit.
5 Repeat for all digits as
necessary
7 Touch STORE
album-A
memamv
To admit a patlent:
1 Touch MONITOR SETUP
2 Touch ADMIT/DISCH
3 Select bed/room number tor
channel
Touch ADMlT
Select YES
Select ID, NAME. HEIGHT,
WElGHT. or BSA
mun:
7 Enterdata using pop~up keypad
or keyboard
Touch ENTER
win
has been entered
UL TEA VIEW DIGITAL TELEMETHY-E
.utm
Repeat steps 6 ~ 8 until all data
Assigning a Telemetry Channel
Telemetry transmitters are preassigned with channel frequencies. This channel
number is identified on the back at the case and cannot be changed. To receive
this telemetry channel. one at the receivers in the telemetry receiver housing must
be tuned to its assigned lrequency.
HIE“
NOTE
Tuning telemetry receiver modules to transmitter channels at
the central must be done by a quail/led service person.
- Your central can be configured to remember beds that are
assigned to individual telemetry channels using the Module
Configuration Manager feature. These beds are permanently
assigned until you deasslgn or reassrgn them.
Tuning a Receiver for a Bedside
The central must be tuned by a qualilled service person. but the bedside may be
tuned using the ECG TM Setup menu. Vou may use this menu to tune the
receiver module to the prerassigned channel lrequencies on the telemetry
transmitter.
The module default is set lor North America v UHF band operation.
H? II operating in another country you must select the appropriate fre—
NOTE ouency hand using the Module Configuration Manager feature.
Entering Patient Information
The ADMlT/DISCHARGE menu enables you to enter a patient identification (lD)
number, name. height, weight. and body surlace area (BSA).
Admitting a newpetient purges data trorn the previous patient on that
E telemetry channel.
NOTE
Acknowledging Signal Loss
When a telemetry signal is lost because ine transmitter lS out at range or lhe
battery is removed. the receiver initiates a squelch condition. This condition is
indicated when a triangular waveform replaces the normal ECG waveiorrn. The
notation SQUELCH is included in the edge print for any strip chart recording. The
ECG trace automatically begins again it the lost signal returns,
may
To control low battery alarm
Touch ECG
Touch SETUP
Touch TM SETUP
Select LO BAT ON or OFF
Aura;
~ .~ a“,
4 .
To control transmitters Patient
Record function:
Touch ECG
Touch SETUP
Touch TM SETUP
Select F’T RECORD YES or NO
aura;
ULTRAVIEW DIGITAL TELEMETRY
Alter eight seconds OI loss, the is SIGNAL LOSS PERMANENT? message
appears, Selecting NO suspends alarm tonest Selecting YES displays the
message DISCHARGE THE PATIENT? Selecting YES again. provides you with
the message PURGES DATA-ARE YOU SURE? Selecting YES a third ume,
discharges the patient Irom the system and purges all data for that patient,
Selecting NO at any point in this sequence returns you to the preyious option.
Setting Battery Status Alarms
The telemetry battery alarm tone alerts you to a low battery condition in the
transmitter, A LOW BATTERY message also appears in the ECG zone involved.
You may select to disable the low battery alarm tone, it your bedside or central is
configured to do so.
The lactory delauit setting tor low battery alarm is ON.
Controlling Patient-Initiated Recordings
it the Patient Record iunction is activated (PT RECORD is YES) in the ECG TM
SETUP menu, the patient may initiate a recording by pressing the RECORD
button on the front at the transmitter.
Digital Telemetry Problem Solving
INTERMITTENT SIGNAL LOSS
This message indicates that the patient may be out of antenna range. or that the
battery depleted.
. Return the patient into antenna range
- Check that the battery 45 iunctioning properly.
LOW BATTERY
The battery is weak. Afterthis message appears, the battery has trom a law hours
to 24 hours at charge left (depending on the type of battery used).lnstall new
battery.
SIGNAL INTERFERENCE
This message indicates, via the displayed triangle squelch waveform, that a
stronger. interterring, signal has been detected.
PERMANENT SIGNAL LOSS
This message indicates that no RF signal is being detected,
LIL TFIA VIEW DIGITAL TELEMETHY— 7
PCMS
P .
To initiate ECG monttorlng
Select a transmitter
Note its channel number
Attach lead wires to transmitter
Attach lead wires to electrodes
Install a transmitter battery
Apply electrodes to patient
Close the transmitter case
MmuthuN—n
UL THA VIEW DIGITAL TELEMETHY»8
Setting Up ECG Monitoring
Each lead wire must be plugged into the transmitter. connected to an electrode,
and then attached to the patient. Match the lead wire color to the colorrcoded
connectors on the top oi the transmitter case. Reier to the ECG chapter in this
manual tor details regarding electrode application. Telemetry patients are
commonly ambulatory and require optimal skin preparation and lead application
to minimize motion artifact. After the electrodes and lead wires have been
attached, it is important to tape a loop 01 lead wire close to the electrode to
minimize stress or pulling on the electrode itsell - a process called stress-looping.
ECG monitoring begins when the telemetry receiver module detects a signal sent
by a telemetry transmitter. The telemetry transmitter sends a signal as soon as its
battery is installed.
ECG telemetry reception requires the iollowing minimum conditions:
- The telemetry receiver module must be connected to a POMS or Ultraview
‘ monitor. either directly or through a module housing. with the power ON and
a Spacelabs Medical diversity antenna connected.
~ ECG electrodes must be properly attached to the patient. and lead wires to
the transmitter.
‘- The transmitter battery must be lunctional.
- The telemetry receiver module must be tuned to the telemetry transmitters
Irequency (channel number}.
- All system connections must be made by Spacelabs Medical
$1 personnel only.
NOTE Leakage currents are not aflected by the high level output. The
patient is electrically isolated from the patient monitor by the HF
link.
- Operation of television receivers or other CRT dlsplays
near the lransmltter {withln 2 to 3 feet), or operation of
some pacemaker programmers may suppress the ECG
waveform, preventing OHS detect/on and rate counting. An
erroneous Asyslole alarm may result.
- Signals resulting from devices such as Automatlc
Implantable Cardlac Dellbrlllators {Ach} may momentarily
blank the ECG trace rather than display an aut-of-range
signal. In such cases. It may not be apparent that the A100
has fired and the condition of the patient should be
checked. In all Instances ol AICD flrlng, the bedside or
central will redlsplay the ECG waveform within 5 seconds.
WARNING
ECG monitoring in telemetry is identical to hardwired ECG monitoring. Refer to
the ECG, Arrhythmia. and ST Analysis chapters ol the POMS Operations Manual
(P/N 070-1 oat-xx) for detailed descriptions of configurations, displays, and
controls. A brief overview oi ECG monitoring Iollows.
Electrodes
Use silver/silver-chloride electrodes or their equivalent. Always connect all
electrodes required tor a particular lead. Missing electrodes may result in the loss
at ECG tracing. Reter to the ECG chapter lor inlormatron on placing the
electrodes.
EEF
NOTE
L1”)
CAUTION
ULTRAVIEW DIGITAL TELEMETRY
Use only Space/abs Medical recommended electrodes. Some elec-
trodes may be subject to large offset potentials due to polarization,
Recovery time after application of defibrillator pulses may be espe-
cially compromised, Squeeze bulb electrodes commonly used for di-
agnoslic ECG recording may be particularly vulnerable to this effect.
Vlsually Inspect each lead wire for obvious damage and
replace as needed.
Only use patlent cables and lead wires specllled by
Spacelabs Medical. Other cables and lead wires may
degrade performance and may damage the monitor during
deflbrlllation or high lrequency electrosurgery. Non-
Spaoelabs Medical cables and lead wires may also change
the required input Impedance and 0.0. offset voltage,
affecting monitor performance.
Do not use stainless steel electrodes.
Do not allow conductive parts of electrodes and
connectors, including the reference electrode, to contact
other conductlve parts, including the ground.
Poor cable dress or improper electrode preparation may
cause line isolatlon monltur translents to resemble actual
cardiac waveforms and thus inhibit heart rate alarms. Refer
to the ECG chapter in this manual for details on proper
electrode preparation and appllcatlon.
UL THA VIEW DIGITAL TELEMETRY-9
PCMS
Display Detail
Signal detection is indicated on your monitor when an ECG signal appears next to
the ECG parameter Key in the zone assigned to receive the transmitted telemetry
channel. The transmitters channel number is always identified above the
waveiarm. to the left ol the ECG key.
it °\‘\‘if’f@
cum Hm ll Mon "can
(3 's'r=o. no AM "7 9"
G A-a m“ \ flD'
)1NlEP=120/63(90) 10:20 Sp02= sass 70 \1zo\®
BED 01 DANlELs R '
ll E g
E Vl
AA/xAA/VM 8 W C srm\
G (D
BED 01 DANlEL$,R ‘
Split Screen Central
<5"
Full Screen Central/Bedside \@
0 ECG trace tor first lead
0 telemetry channel number
9 ECG key tor first lead
0 QRS indicator (flashes once per detected beat)
0 ECG lead designator
0 display resolution (monitor or extended)
0 paced operation indication (pacemaker detection is enabled)
0 abnormals per minute alarm Iimir '
0 ST segment level lor first lead "
CID abnormals in a row alarm limit '
0 ECG rate alarm limits; split screen centrals display a bell symbol when alarms
are enabled: bedsides display the rate alarm limits (120/40)
G abnormals per minute counter '
@ current heart rate
w ECG lead designator lor second lead
® ST segment level lor second lead"
@ ECG key (or second lead
0 NlBP measurements: systoliddiastolic(mean) @ hourszminutes; SpOZ
measurement (90343 only)
' Only appears with the Multhiew l or ll option in the adult mode with Arrhythmia
detection enabled.
“ Only appears in adult mode with the ST segment analysis option.
ULTRA VIEW DIGITAL TELEMETRV— 10
ULTRAVIEW DIGITAL TELEMETRY
Monitoring Paced ECG Patients
When monitoring pacemaker patients, use the paced ieature to automatically
enhance pacemaker spikes for display and eliminate them imrn the heart rate
To monitor paced patiem
1 Touch ECG Th I . . .
2 Touch SETUP counter. e ast setting you select is retained as the detault.
3 Select PACED YES
It the interval between the pacemaker pulse and the QRS complex is greater than
150 milliseconds, the beat is considered to have originated in the atria and is not
classified as a paced beat.
To prevent pacemaker pulses imm being counted as actual beats. specialized
circuitry removes the pacemaker pulses irom the ECG signal and replaces them
with pacemaker flags.
The optimal leads for monrtoring paced patients may vary. in telem~
Ll? etry monitoring, pacemaker spikes are detected on lead ll. prace-
NOTE maker spikes are not detected, change electrode position.
- ECG detection circuitry may continue to count the
pacemaker rate during occurrences of cardiac arrest or
some arrhythmias. Do not rely entirely upon ECG rate
alarms. Keep pacemaker patients under close surveillance.
WARNING
- The system may insert pacemaker flags into the ECG
signal In response to signals that are not pacemaker
pulses. Therefore, if you use a Spacelabs Medical monitor
to observe pacemaker performance, you must take Into
account all possible sources of pacemaker flags.
- Use the pacemaker manuiacturer’s performance analyzer
as the primary means of evaluating pacemaker operation.
Restoring Default Settings
With the Module Configuration Manager feature, you can restore all default
settings. User-configurable options are listed in the Module Configuratron
1 Touch ECG M n h r i h' m n i.
2 Touch SETUP a agerc apie o t is a ua
3 TONS" RESTORE SETHNGS RESTORE SETTINGS changes the user-configurable options lorali
4 Select YES parameters in the module.
NOTE
, ULTRAVlEW DlGlTAL TELEMETRY—fl
PCMS
Changing the Display Resolution
Towchange the display resolution: The MONITOR/EXTENDED key determines the display resolution of the two ECG
traces, whether or not both traces are currently displayed on the monitor
1 Touch ECG
2 Touch SETUP
3 Select MONITOR or Key Display Resolution
EXTENDED
Monitor (0.5 - 30 Hz)
Extended (0.05 > 30 HZ)
Changing the display resolution does not change the waveform
@ bandwidth used to analyze the ECG signals lor arrhythmia and ST
NOTE segment ls vel.
The factory default setting lor display resolution is monitor mode.
To select ECG lead Selecting Options for Lead Display
1 Touch ECG
2 Touch LEAD SELECT One operational mode is available with the 90343 and 90347 multi-Iead
3 Touch 151- or 2ND LEAD transmitters, When all electrodes are connected to the patient, leads I. lit III. AVR,
4 Select the desired lead AVL, AVE and Vx, where x = 1 to St are available. When no chest lead is applied,
leads I, ll. Ill, AVR, AVL, and AVF are available using the remaining connected
electrodes.
Connected Electrodes
(x) 90343/90347
Valid Lead Vectors
harge a patie RL 0 LL LA RA
1 Disconnect the transmitter lrom X X X X X Vl-G, I. II. III. AVFl. AVL, AVF
the patient )( x x X l
2 Remove battery '——I—
3 Select YES to confirm signal X X X X H
loss permanent Li X X ”l
4 Select YES to discharge X X I, ll, Ill, AVR, AV
5 Select YES to purge data T_ X X |
X X X H
X X X ”I
X X X X I, IL I”, AVR. AVLv AVF
X X X I
X X X II
X X X Ill
X X X II
All combinations of leads not shown above result ”7 no valid lead
[IF vectors In geneml, for at least one valid vector, either BL or C and
NOTE two limb leads must be connected.
UL TFtA VIEW DIGITAL TELEMETHY- 12
—_——_—___
ULTRAVIEW DIGITAL TELEMETRY
ECG Troubleshooting
Heier to the ECG Problem Solving section in the ECG chapter of this manual for
additional conditions and solutions.
ASYSTOLE
An ASYSTOLE message means it has been 5 seconds or more since a OHS
complex has been detected. Check the patient. It the patient is all right, try the
following.
~ Check that the lead wires are inserted into the proper receptacle.
- Using the continuity tester, check that there is no damage to the lead wires.
' It the amplitude is poor. check the appropriate lead with a 12-lead ECG.
- Check that the transmitter is not too near (within 3 leet] a televtsion receiver
or other CRT displays.
ECG VOLTAGE TOO LOW
The ECG amplitude may have dropped below the Fl-wave detector threshold
level. Reposition the electrodes to obtain a QRS amplitude 01 at least 0.20 mV
(adult) and 0.15 mV (neonate).
NOISY SIGNAL
The patent may be moving excessively. Secure the lead wires to the patient.
~ Check the electrodes for good skin adhesion.
- Check lead Wires at the transmitter tor good contact.
UL TRA VIEW DIGITAL TELEMETR Y-13
ECG Troubleshooting Guide
Clinical Situation Possible Cause Solution
Not I ECG frequency response set to I Select monitor mode
extended mode
I Electrodes dry or poor skin I Repeat skin preparation and apply
adhesion new‘ moist electrodes
asclinc wa ndeis I Patient movrng excessively I Secure lead wires by stresslooping
to the patient
I Respiration artifact I Flo-position electrodes
I Electrodes dry or poor skin I Repeat skin preparation and apply
adhesion new, moist electrodes
Low amplitude ECG I Skin improperly prepared I Abrade skin and reapply electrodes
I Lead selected not providing OHS I Select another lead lor monitoring
complex with greatest amplitude
I Electrodes could be positioned over I Reposition electrodes
bone or muscle mass
ECG won‘t learn I ECG signal too noisy I Check lead wires and electrodes
then relearn patient rhythm
I ECG voltage not within threshold, I Select a diflerent lead or adjust
ECG VOLTAGE TOO LOW electrode location
message may be displayed
ElCeSSIVe alarms I Electrodes dry or poor skin I Repeat skin preparation and apply
adhesion new, moist electrodes
I I I I
I Alarm limits set too close to patient's I Readjust alarm limit
normal heart rate
I Excessive patient movement or I Reposition electrodes and secure
muscle tremor electrodes wtlh tape it necessary
Reler to the Problem Solving sections in this chapter and in the ECG chapter tor further monitoring tips.
To set up SPO:
mutt-u
' file's .
monito g.
Connect the adapter cable to
the transmitter
Attach the sensor to the patient
and connect the sensor cable to
the adapter cable
Initiate ECG monitoring
Select ECG
Select CHANNEL FORMAT
Set Sp02 ON
ULTRAVIEW DIGITAL TELEMETRY
SpOQ Overview (90343 only)
Pulse oximetry enables you to noninvasively monitor a patients hemoglobin
oxygen saturation. This may be accomplished in either a continuous or episodic
manner, The oximetry sensor contains two light emitting diodes (LEDs) that
transmit specific wavelengths (660 and 940 nanometers) ol light Which are
received by a photodetector.
Oxygen saturated blood absorbs light dinerently as compared to unsaturated
blood. Thus the amount oi light absorbed by the blood can be used to calculate
the ratio of oxygenated hemoglobin to total hemoglobin in arterial blood. The
monitor displays this ratio as percent SpOQ. Normal values range from 95 to
100%.
A pulse aximeter should NOTbe used as an apnea monitor.
& - A pulse oxlmercr should be considered an early warning
device. If a trend towards patient deoxygenation is
WARNING indicated, blood samples should be analyzed by a
laboratory co-oxlmeter to completely understand the
patient's condition.
ll your module is equipped with the Module Configuration Manager
E feature, you can define your own default settings tar such
NOTE characteristics as alarm limits and display configuration See the
Module Configuration Manager chapter in this manual for further
details.
Setting Up Sp02 Monitoring
The model 901MB digital telemetry mum-parameter transmitter uses Soacelabs
Medical sensors as well as those lrom other manufacturers. Fleter to the Sensors
section at the end oi this chapter lor iniormation oonoeming specific sensors and
their operation,
It you use sensors other than those specified, it may
degrade periormance and could damage the transmitter
during detibrillation.
- Check the sensor site frequently. Do not allow the sensor
to remain on one site for a prolonged time period.
especially when monitoring neonates. Rater to sensor
manutaeturer‘s instructions.
- Never attach an SpO, sensor on a limb being monitored
with a blood pressure cuff or a limb with restricted blood
llow.
- A poorly applied sensor may glve incorrect saturation
values.
g ' Use only patient sensors specified by Spacelabs Medical.
CAUTION
- Choose a site with sufficient pertuslon to ensure accurate
oxlmetry values.
UL TFlA VIEW DIGITAL TELEMETH y. 15
PCMS
All sensors require an adapter cable between the sensor and the transmittert Do
not discard the adapter cable when you have finished using a disposable oximetry
sensor. Disconnect the sensor cable lrom the adapter cable belore discardan the
sensor.
To connect the adapter cable to the transmitter. align the cable with the notch on
the (rent at the transmitter connector and push the cable straight down into the
transmitter, When you remove the cable, press the latch release (use a blunt
device) on the bottom oi the cable and pull the cable straight out. Never twist the
cable.
Figure Telemetry/2: Spoé Adapter Cable to Transmitter
Ta enable Sp02 monitoring in the model 90343 digital telemetry mum-parameter
transmitter. enable the Sp02 setting lar DIP switch 5 beneath the battery
compartment. (The lactory default at this switch is ON)
CHAN “121 E xx VVV FAA/xi:
‘ ECG WA VEFDR ZONE CHECK XX g A:XX ROW 5
‘ Sp02=98% 13“
‘ BED NAME PATIENT NAME 78 W
Figure Telemetry-3: Display Zone — Full Screen
0 0
HR=XXX A=XX LEAD
CHECK xx
ECG WAVEFDRMZONE
5 024896
F CHAN xxxx
(Dom
47-2 Jane Doe
Figure Telem airy-4 : Display Zone — Split Screen
0 Current Spoz value (percent)
0 The bell indicates that alarms are enabled (on split screen central only)
UL TEA VIEW DIGITAL TEL EMETFl Y— 16
“
auto—4
or
set or equal alarms
4»,
Touch ECG
Touch ALARM LlMITS
Select SpOZ ALARMS ON
Select HIZ, L0=, ALM DELAY.
and MSG ALARM DELAY
Use arrow keys to adjust
ULTRAVIEW DIGITAL TELEMETRY
Ensuring Accurate Monitoring
While each sensor requires site specific application procedures, the following
general points will aid in ensuring oximetry monitoring success.
- Choose a site that provides proper alignment of the LEDs and receiVing
photodetector.
' Reduce light interlerence when monitoring a neonate under bright light by
using a diaper or other light block over the sensor.
- Select a site that has unrestricted blood llow and can remain as immobile as
possible to reduce or eliminate movement artifact.
- Do not restrict blood flow when securing a sensor with tape.
- Do not select a site near potential electrical interierence (electrical cords, for
example),
Setting or Adjusting Alarm Limits
Pulse oximetry alarm limits and delays are based either on lactory delault limits or
user-delined limits The factory delault settings for alarm limits are 100% tor high
and 85% for low. For alarm delays, the factory delault settlngs are 15 seconds for
alarm limit delay and 20 seconds lor message alarm delay. Plead the Alarms
chapter in this manual lor details concerning POMS alarm operation.
Reier to the Module Configuration Mahagerchapter in this manual icr $902
parameter tables that list available user settings and factory defaults for this
parameter.
ALM DELAY Key
This key sets the number of seconds delay the system will wait before it reports
that an alarm limit has been violated. When this lsature rs ofl. the key label will
read “ALM DELAY OFF". When it is on, the label will read ”ALM DELAY xx" where
“xx" is the value. in seconds. of the delay.
The caregiver can set the delay time by taking the icllowing steps:
1. Touch ALM DELAV xx (or ALM DELAY OFF),
2. Touch the up and down arrow keys until the value is set as desired. Possible
settings are OFF, 5, 10. 15, 20. 25. and 30 seconds.
- II the caregiver presses the down arrow key after the lowest
[@ Value has been reached, the following message will appear on
NOTE the prompt line:
Minimum alarm delay time has been reached,
- If the caregiver presses the up arrow key alter the highest value
has been reached, the following message will appear on the
prompt line:
Maximum alarm delay time has been reached
MSG ALM DELAY Key
This key sets the number of seconds delay the system will wait beiore it issues an
alarm tone lollowmg any 01 the iollowing messages:
' Sp02 MONlTOR FAILURE
- SpOZ FAULTY SENSOR
UL TRA VIEW DIGITAL TELEMETH Y— 1 7
PCMS
Sp02 SENSOR OFF PATIENT
' SDOZ INSUFFICIENT SIGNAL
- AMBIENT LIGHT INTERFERENCE
- Sp02 INSUFFICIENT SIGNAL
' SpOZ NOISY SIGNAL
when this leature is oft, the key label will read “MSG ALM DELAV OFF" When it
is on. the label will read "MSG ALM DELAY xx“ where “xx" is the value, in
seconds, 01 the delay,
The caregiver can set the message delay lime by taking the lollowing steps:
1. Touch MSG ALM DELAY xx (Dr MSG ALM DELAY OFF).
2. Touch the up and down arrow keys until the value is set as desired. Possible
settings are OFF, 10, 20. 30. 40, 50, and 60 seconds.
~ If the caregiver presses the down arrow key after the lowest
[IF value has been reached, the following message will appear on
NOTE the prompt line:
Minimum message alarm delay lime has been reached.
- If the caregiver presses the up arrow key after the highest value
has been reached, the lollawing message will appear on the
prompt line:
Maximum message alarm delay time has been reached.
Setting SpOg Data Averaging Period and
Sampling Interval
The Spoz data averaging selection is used to smooth the oximetry saturation
value for averaging the patient input values ever 4, 8, or 16 seconds This
selection IS made by setting the DIP switches 1 and 2 beneath the battery
compartment in the Model 90343 digital telemetry mum-parameter transmitter,
The default value is 8 seconds. Reler to Figure Telemetry-5: DlP Switch Setting in
Battery Compartment
DIP Switch 1 DIP Switch 2 I Eflecl
FOFF OFF 4 seconds averaging enabled
OFF ON 8 seconds averaging enabled (default)
ON OFF I 16 seconds averaging enabled
ULTRA VIEW DIGITAL TELEMETFIY» 18
To display heart rate from Spoz
sensor:
1 Touch ECG
2 Touch CHANNEL FORMAT
3 Head heart rate m the area to
the left ol the SpOZ ON/OFF
key
ULTRAVIEW DIGITAL TELEMEI' RY
Figure Telemetry-5: DIP Switch Setting in Battery Compartment
The sampling interval selection permits the caregiver to determine how often an
SpOg measurement will be taken, Less frequent SpOz readings can extend the
usable life 01 the the battery. (Reier to the Ultraview Dlgltal Telemetry Products
Data Sheet 7 PIN OGt—OSOt—xxftor more inlormation on battery service life.)
This selection is made by setting DIP swttches 3 and 4 beneath the battery
compartment in the model 90343 digital telemetry mum-parameter transmittert
The default setting is 1 minute intervals.
DIP Switch 3 DIP Swltch 4 Effect
OFF OFF Continuous sampling
OFF ON 1 minute sampling interval (detault)
ON OFF 2 minute sampling interval
I. ON ON 5 minute sampling interval
Viewing Pulse Rate
In normal operations the heart rate for display will be obtained directly trim the
acquired ECG leads or an alternate rate source. Sp02 can be used as the
alternate source, it it is set for continuous measurement. When it is set tor
episodic measurement, SpOg cannot be used as an alternate rate source.
Sp02 Error Messages
Error messages indicate a problem or condition which may affect accurate
monitoring values. Do not ignore these messages. Correct any fault before
continuing.
When the lollowing messages are displayed. the saturation value is immediately
changed to 777 and an alarm is triggered, it your module has been configured
with an alarm tor that message. {Pieter to the Module Configuration Manager
chapter).
UL TRA VIEW DIGITAL TELEMETR Y— 19
PCMS
Sp02 SENSOR DISCONNECTED
' The transmitter does not detect an adaptor cable connected or a sensor
connected to an adaptor cable. ll the message persists and the adaptor cable
is secure. replace the adapter cable.
- The alarm will stop after approximalely 10 seconds.
~ On remote view, there may be no audible alarm on the remote mainframe
belore the local alarm stops.
Sp02 MONITOR FAILURE
. The LED and/or photodiode have failed. Replace the sensor and/or Sp02
adapter cable.
When the lollowing messages appear, the monitor displays the saturation value
alternately with the message ??? every two seconds. An alarm will begin alter the
message alarm delay time has elapsed (Reier to the Module Configuration
Manager chapter)
Sp02 AMBIENT LIGHT INTERFERENCE
- The sensor is receiving external light interlerence train a bright light source
near the sensor. Shield the sensor from the external light source. lithe
condition persists lor more than 30 seconds, 777 will replace the data
display. >
- The sensor photodiooe and LEDs are misaligned on flexible sensors thereby
allowmg light to enter. Realign the sensor photodiode With LEDs.
- It a message appears with linger clip. replace sensor.
$902 INSUFFICIENT SIGNAL
- Insufficient signal tor proper operation.
- Poor sensor application or site. Correctly re-apply or reposition to a better
pertused site, massage site, or apply new sensor.
Sp02 NOlSY SIGNAL
- The sensor signal is disturbed by motion or other interlerence. Eliminate
sensor movement. The message disappears when a value is obtained.
- The sensor is placed adjacent to power cords or other electrically noisy
devices. Movethe noisy devtce or move the sensor to another site.
Sp02 SENSOR OFF PATIENT
» The transmitter is unable to detect a valid sensor input signal. Check the
patient lor proper sensor placement.
- Tissue between the LED and photodiode is too transmissive. ll sensor
placement seems correct and the message persists, try a sensor site with a
thicker tissue bed
Adaptor cables and sensors are ordered separately through the
[IF Spacelabs Medical Supplies Products.
NOTE
UL TEA VIEW DIGITAL TEL EMETFIY—ZU
ULTRAVIEW DIGITAL TELEMETRY
NelJcor adaptor came (P/N 012-0587-00) Nellcor
sensor
90343 digital 1e\emetry mu\li»parameter transmitter
Figure Telemetry-5: Neflcor and Sensors and Adaptor Cab/es
UL TBA VIEW DIGITAL TELEMETRY»21
Sp02 Troubleshooting Guide
Clinical Situation Possible Cause
Solution
l Spo2 IS not enabled at the 90343
No SpOg label is
displayed
I Be sure transmitter DIP when 5
setting is ON
I Be sure DlP switch 3 IS OFF
Sensor not connected to patient
SpOL value displays 0
I Adapter cable not connected to
module properly
I Sensor not connected to adapter
cable
I Excessive patient motion
I Transmitter is in the initialization
phase (the tlrst 15 seconds atter
sensor application)
Low Signal stren gth I Sensor placement riot optimum
pressure cufi
Intermittent or complete I Transmitter error
[allure to operate
I Sensor placed below blood
I Depleted battery
Factors which cause I Presence ol dysfunctional
hemoglobins (COHb, MetHb)
significant variances in
sensor accuracy
I Presence of intrevascular dyes
(lndocyamine green. methylene
blue) depending on their
concentration in the blood stream
I High ambient light level
I Electrosurgical interierence
I Patient is significantly anemic (Hb
less than ng/dl) or patient has
received large amounts of IV
solutions
I Reattach sensor
I Correctly connect the adapter cable
I Correctly connect the sensor
I Urge patient to remain still while
reading is in progress
I Wait until initialization is complete
I Move sensor to a site which has
better pertusion
I Align LED with sensor photodetector
I Move sensor to an altemate limb
I Call qualified service person
I Replace battery
I Follow hospital procedure for
determining oxygenation in these
patients
I Follow hospital procedure tor
determining oxygenation in these
patients
I Reduce light levels near patient
I Follow hospital procedure for
determining oxygenation iri these
patients during the procedure
I Follow hospital procedure tor
determining oxygenation in these
patients
04mm
90217 ABP Monltui‘
Attach appropriate butt and
90217 ABP monitor to patient
Attach adapter cable between
902i 7 and 90343
Initialize 90217 with 90239A lo-
cal report generator
Configure 90343 DIP switch 6 to
enable NlBP operations
Initiate ECG monitoring
Select ECG
Select CHANNEL FORMAT
Set NIBP ON
ULTRAVIEW DIGITAL TELEMETRY
NIBP Overview
The model 90343 digital telemetry mum-parameter transmitter can send the non-
invasive blood pressure (NlBP) patient data acquired by the Model 90217
ambulatory blood pressure (ABP) monitor. to the Model 90478 digital telemetry
receiver. The Model 90478 can display the patient's episodic NIBP data and
trigger alarms based on thresholds set at the Central Station monitor by the
clinician.
The Model 90217 ABP monitor is a small, lightweight: battery-powered unit
designed to take blood pressure and heart rate measurements for 24 or 48 hours
or ior longer periods of time. Please refer to the 917217 Operations Manual (070
0137-xx) for more detailed information on this specific product: its initialization via
a Local Report Generator (Model 90239A) or direct PC interiace (Model 90121);
Patient Preperation: Data Transfer and Reports: and Event Codes.
Noninvasive blood pressure (NIBP) uses oscillometric monitoring to measure
systolic (S). diastolic (D), and mean (M) arterial blood pressures. The POMS
monitor displays these readings and the time the measurement was acquired.
You can also display heart rate. The ABP monitor can display up to ten readings
at one time and store up to i20 readings.
The Model 9027 7ABP Monitor is intended for use with adult patients
@ only.
NOTE
Setting Up NIBP Monitoring
Proper cuff selection and application is a critical issue in ensuring the accuracy of
NIl-ZiFl readings, To ensure proper cul‘l selection, first measure the circumference
oi the limb at its midpoint. Match the limb measurement to the range of
appropriate circumferences (in centimeters) specified on each cuff. lithe cult
bladder is too wide tor the patient. the reading will be talsely lowered; if too
narrow, the reading will be falsely elevated. Undersizing the cuff results in the
greatest chance of error, so a variety oi cuii sizes should be available to
accommodate your lull patient population.
The suit should be snugly applied. When the cuff is properly applied to an adult,
you should be able to insert one linger between the coil and the arm. If you can
insert two fingers, the cult is too loose which may result in falsely elevated
readings. Make sure the hose is not kinked when the coil is applied.
During blood pressure measurement. the inflated cuff reduces blood flow to the
limb to which it is applied. Do not apply a cuff to a limb that has restricted blood
flow. Check the patient periodically.
- Do not apply a blood pressure cuff to a limb being monitored
[$1 with a pulse oximetry sensor because $002 will be affected
NOTE during NIBP readings. Avoid applying a cuff to a limb that has
an intravenous line in place. Do not apply a cuff to a limb that
has restricted blood flow.
~ Never use extensions or adaplers with the neonatal hose. Use
only single hose cults to ensure proper operation. Space/abs
Medical's hoses are non-conductive with respect to defibrillator
discharge effects.
UL TEA VIEW DIGITAL TELEMETHY—23
PCMS
Patient Factors Affecting Readings
Excess patient movement. speech, or muscle contractions as a result oi severe
pain or shivering can interfere with automated NlBP readings. Ensure that the
patient is quiet and not moving during NlBP readings just as you would manual
readings. Avoid applying external pressure to the cult during readings. Institute
measures to minimize shivering and alleviate pain.
Some arrhythmias may cause beat-to-beat pressure fluctuations that can make
obtaining NIEP readings more ditlicult, increased variability ol readings can result
irorn these pressure variations. ll it becomes ditlicull to obtain readings in the
presence oi arrhythmia. pressure should be temporarily veriiied using another
method. Pressure also varies cyclically with normal respiration. With deep
respirations or in certain patients this etiect may be enhanced. increasing reading
variability.
For patients in shock. indirect methods of measunng pressure (auscultatory,
oscillometric. Doppler) may not be reliable because 01 peripheral vascular
changes. These changes include peripheral vasoconstriction and diminished
peripheral circulation resulting from shunting of blood to central organs In some
cases peripheral pulses or Korotkotf sounds may be diminished or disappear in
spite oi adequate blood pressure. In such cases, measuring a cult pressure may
be impossible or give misleading results. Direct blood pressure measurements
(Invasive) should be considered in patients with signs oi shock or any patient who
rapidly becomes unstable lor unknown reasons.
Setting Up the ABP Monitor
After the monitor has been initialized. prepare the patient ior monitoring as
follows.
1, Turn on the monitor (wait for the monitorto periorm seIi-tests). When the LCD
displays the current time. the monitor is ready ior operation.
2, Strap the monitor to the patient on the hip opposite the side on which the cuil
is worn. Secure the monitor using the patient‘s own bett or the ABP pouch
strapped over the opposite shoulder. When using the shoulder strap. use the
belt supplied with the monitor or the patient's belt to provide additional
secu my.
3. To select the proper cuti. iirst measure the circumlerence oi the limb at the
point where the cuii is to be applied. Match the limb measurement to the range
oi appropriate circumlerences (in centimeters) specilied on each cull (reler to
the table below).
Cu" Size Limb Circumierence
Pediatric 13 to 20 cm
Small Adult 17 to 26 cm
Average Adult 24 to 32 cm
Large Adult 32 to 42 cm
Extra-large Adult 38 to 50 cm
4. Position the cuii so that the center ol the inilatable bladder IS directly overthe
brachial anery. The center oi the bladder location is marked on the outside oi
the cult. Once the proper position is determined. the cult must be tightened to
UL TFiA VIEW DIGITAL TELEMETRY»24
ULTRAVIEW DIGITAL TELEMETRY
ensure that it is equally snug at the top and bottom edges and that it is not
kinkedt This is especiain important on larger arms. Insert a finger between the
cult and the limb to ensure it is not too light. It may be necessary to wrap the
cult with its tail at an angle to achieve unitorrn tightness. ll the out! is not
equally snug at the top and bottom edges, the number of readings available
will be limited and the monitor may indicate that the cull is improperly applied.
manulaclurer‘s cuffs may result in inaccurate readings even it
w - Use only Space/abs Medical cuffs With this monitor. Using other
NOTE the manufacturer’s recommended size is observed.
- ‘ ll the cult is too small, pressure readings may be falsely high; a
cuff that is too large produces a falsely low reading. The bladder
can be positioned in the cull for either the left or right arm.
- Avoid compression or restrlctlon of pressure in the NIBP
patient connector tubes. Check that operatlon of the
equlpment does not result in prolonged impairment of
CAUTION clrculation.
- Do not apply cult to areas of branched or Inlured skin.
‘ Cull hose connectlons use luer fittings. Be careful not to
connect the ABP monltor Into an Intravenous lluid line
when working close to them.
- Thls product contains natural latex rubber components to
which some people may be allerglc. These components
Include the bladder and the first tour inches of tubing
extending from the butt
5. Once cull is applied. the arm should be relaxed at the patient‘s side, To avoid
reading errors due to hydrostatic pressure difierences, the level 0! the cult on
the arm should be near the level of the heart.
6. Lead the nose up the arm with the cull and place it across the back of the
patient. Drape the hose so i! does not cause the patient discomlort and is not
pinched shut by too tight a radius. Figure Telemetry-7: Common Cull Hose
Positions shows the most common positions for the cuff hose.
ALTERNATIVE 431
Figure Telemetryr7: Common Cull Hose Positions
UL TFIA VIEW DIGITAL TELEMETR Y-25
PCMS
7. Connect the hose to the monitor
BA To verify proper monitor operation. take one or more blood pressure readings.
Push the START/STOP key to begin a measurement.
9. interconnect the adapter cable between the communications port on the
90217 and the NIBP port on the 90343 as shown in Figure Telemetry-5:
Transmmer and ABP Mon/(or Connections.
Sp02
Adapter Cable
NIBF' CUFF
Sp02 Sensor
NIBP Adapter Cable
90217 & 90343 mtlum In
poms to patients belt,
Figure Telemetry~8: Transminer and ABP Monitor Connections
—-——_—_—_—_
UL TBA VIEW DIGITAL TELEMETHY—zs
“
Touch ECG
Touch ALARM LIMITS
Select NiBP/ALM ON
Select SVS. DlA, or MEAN
Select HI= or L!)
Use arrow keys to adiust
ULTRAVIEW DIGITAL TELEMETHY
Figure Telemetry-9: Display Zone - Full Screen and Figure Telemetry-1D:
Display Zone— Split Screen illustrate typical NiBP displays. You can view NIBP
readings from any F'CMS bedSide or central monitor on a network. NlBP displays
on a split screen central monitor appear in a lorrnat slightly diflerent train that of
bedside or lull screen central menitors.
CHAN xxxx E ' xx W" 2:53
l ECG WA VEFDHMZDNE CHECK xx 8 A-xx now 5
7in NlBPsI n l 4) n : m Sp02=93% ‘35
EED NAMEP n n N g 78 W
06960
Figure Telemetin: Display Zone — Full Screen
HR-xxx Atxx LEAD ‘
ZONE CHECK xx
O2=93%
Sp CHAN xxxx
Figure Telemeliy- 10: Display Zane — Split Screen
0 Last systolic reading
a Last diastolic reading
e Last mean reading
0 Hnur of day oi last reading
9 Minutes after the hour 01 last reading
Setting or Adjusting Alarm Limits
You can define pressure alarm limits lor systolic, diastolic and mean values. The
deiault setting lor alarms is OFF. Read the Alamvs chapter in this manual lur
PCMS system alarm lunetmns. The alarm limits defaults are listed in Table 1:
Alarm Limits
Table 1: Alarm Limits
I HI Low
systolic 150 mmHg (20.0 kPa) 100 mmHg (13.5 kPa)
diastolic 100 mmHg (13.5 kPa) 60 mmHg (8.0 kPa)
mean 110 mmHg (14.5 kPa) 90 mmHg (12.0 kPa)
Reler to the Module Configuration Manager chapter in this manual lor NiBP
parameter tables that list available user settings and iactory delaults lur this
parameter.
UL TFIA VIEW DIGITAL TELEMETRY~27
Displaying Heart Rate Data
in normal operalion, the heart rale Ior display wiil be obtained diremly 1mm the
ABP moniior: acquired ECG leads or an alternate source (Spozi The ABP heart rate is net
1 Touch ECG availabie as an ailemale hean rate source due to the episodic nature oi the NSF
2 Touch CHANNEL FORMAT measurement-
3 Read heart rate in the area to
zheiemnheuusPON/OFery Displaying New or Previous Readings
—_—_—_—.——_
UL TM VIEW DIGITAL TEL EMETFIVVZG
—-—__
ULTRAVIEW DIGITAL TELEMEI'HY
90217 Event Codes
The ambulatory blood pressure monitor will drsplay an event code whenever an
event prevents the unit lrom suocesstully completing a blood pressure
measurement. The two numerical digits of the event code indicate the reason the
measurement was aborted. The table below lists event codes that are displayed
on the monitor, as well as event codes that appear on the Event Code Report.
Monltor Report Condition
ECOO
E010 Excess movement artifact, Frequent EC10 messages may indicate an air leak.
E020 A) A very large number of movement artilacts
B) Heart rate arrhythmia
L.—
ECSO A) Movement arrilact at mean arterial pressure
B) Heart rate arrhythmia
EC40 A) Movement artifact at asystole
B) Heart rate arrhythmia
EC50 A) Movement artifact at diastole
B) Heart rate arrhythmia
E060 A) Movement artiiact
B) Heart rate arrhythmia
E070 Systole was iound to be above the highest cuff pressure. However. this result appears to be
an error caused by matron artifact. Therelore. the suit will not be inflated to a higher pressure
on the next measurement attempt.
ECBO A) Movement artifact
3) Heart rate arrhythmia
ECSO A) Movement artifact
B) Heart rate arrhythmia
EC01
E011 Did not pump above the mean arterial level
L—
ECZ1 Did not pump above systolic pressure
E091 Systole appears higherthan the selec1ed maximum cuff pressure limit
5002
l_
E012 Did not reach initial curt pressure. The curl may have been improperly applied or there may
be an air leak,
mm
5022 Overpressure
E032 Overpressure
E042 No curt attached
_J.
E052 Kinked has
8 __r
EC62 Cufl applied too loosely
EC72 Kinked hose
UL TFiA VIEW DIGITAL TELEMETH Y-29
PCMS
Monitor Report T Condition
E082 Kmked hose.
_l__
E003
t—
ECOS Patient canceled reading by pressing STOP key, No retry attempt is made following an E003
code.
E013 The Office Check Mode has been reinstated. No retry attempt is made lollowrng an E013
J code. ‘
J—
E004
E004 Blood pressure measurement not completed in the maximum time allowed. Occasional
E004 messages may result trom excessive patient movement. Frequent ECO4 messages
would indicate an improperly applied cufl or a monitor maltunotion which requires service.
ECn4 Twhere n = 1 to 9) Indicates that one or more oi the blood pressure results have been
corrupted and subsequently recovered. Frequent occurrence of this message would indicate
a malfunction which requires servtce.
E005 The individual blood pressure result has been corrupted and cannot be recovered.
E015 Equipment malfunction. Return to Spaeelabs Medical lor service.
E025 Unit failed to initialize Please initialize,
E035 T The monitor needs to be reinitialized.
E005
1“E005 & E045 Invalid bleed srze. The monitor automatically has changed the bleed size to 8 mmHg, 1
E045
E005 8. E055 An unexpected loss at power possibly caused by a) removal of the batteries during a blood
E055 pressure measurement. b) hardware overpressure, or c) a hardware time-out. Frequent
E055 messages would indicate a mallunction which requires service.
E005 & E065 Extremely large artilact.
E065
l _. . . .
E005 & E075 Equipment mallunction. Return to Spacelabs Medical tor servtce.
E075
E005 8. E055 Equipment malfunction. Return to Spacelabs Medical tor sen/ice.
ECBS _]
E005 6. E095 Cuff pressure baseline out ol bounds. The monitor should correct the baseline automatically
E095 within 10 minutes: or it can be set by initialization of the monitor. If initialization does not
correct the condition the monitor must be returned to Spacelabs Medical tor calibration.
u—
5007 _|
EC78 Clogged luer tilter
—-l 1
£008
E018 Too lew data entries to accurately determine blood pressure. The message may lndicate that
the cuff is not being worn by the patient (taken oh but left connected to the monitor). The
message may also indicate that motion artitacts cause the majority ol the incomplete data.
ECZE Diastole above 200 mmHg
.__.
—————____—___
UL TEA VIEW DIGITAL TELEMETH Y—30
“
ULTRAVIEW DIGITAL TELEMETRY
Monitor Report Condition
E038 Pulse pressure less than 16 mmHg
'l_ . .
E043 A) Movement artiiact at mean arterial pressure
B) Heart rate arrhythmia
5055 A) Movement artiiact at diastole
B) Heart rate arrhythmia
ECSB Division by zero ‘
E009
J—
E019 Contradictory instructions sent to hardware (e.g.. “pump on and valve open")
5029 Diastolic pressure mlue cannot be obtained from the data available.
E039 Algorithm could not process input data quickly enough resulting in an input queue overflow.
E049 This monitor must be initialized.
E059 Heart rate value cannot be obtained from the data available.
EGGS LHeart rate value cannot be obtained irom the data available.
EC79 Bleed steps were too small. This may be caused by a partially obstructed air hose All blood
pressure attempts iollowing this message are inhibited, Attempts can be enabled by turning
the power switch oft then on.
E099 Unexpected or contradictory data (such as a negative cufl pressure).
LLL
E016 Low battery detected prior to start at measurement.
E026 Low battery detected after measurement started. Usually caused by the pump drawing 7
enough current to lower the battery voltage.
Lbb The report does not print an event code lor this condition. which is a low backup battery
Contact Spacelabs Medical ior replacement of the battery.
_t
. UL TRA VIEW DIGITAL TELEMETFi‘V-af
Clinical Situation
N0 NlBP displays
int em or coil Ie
L we to operate
Apparent incorrect value
Variable readings occui
Nu NIBP readlngs or
questionable vaiues in the
presence of Shodx
NIBP Troubleshooting Guide
Possible Cause
Solution
IAdapier cable not inserted correctly
.NiBF not enabled on 90343 or 90478
IABP monitor not properly initialized
.Hemove and re-insert adapter cable
.Enat)|e NIEP function by setting transmitter
DIP switch 6 ON and setting DIP swttch 8 OFF
IReinitiaIize ABP Monitor
lincorrect or inoperative cuff in use
ICuff tubing is attached to adult outlet, but
monitor is configured in the neonatal
mode (or vice versa)
.Tubing is kinked
.Some arrhythmias (eg. atrial fibrillation
and frequent ventricular ectopyt may
cause a single or repeated failure to
obtain a reading (may be due to true
beatnto-beai variations in pressure)
.Excessive patient motion or muscle
contractions associated wrih shivering or
severe pain
.B|ood pressure outside of measurement
range
IAEP monitor error
lFtepiaoe with cuff known to be operative
IConnect tubing to correct outlet Correlate
monitor mode, cuff and patient type.
lLocate kink and straighten tubing
.Document arrhythmia if present, verity
pressure With another method, then follow
hospital procedure for care of this type of
patient
-Ensure that patient is quiet with minimal
movement during NIBP readings. Minimize
patients shivering
IVenfy extremely high or low pressure With
another method
.Hemove AEP monitor from service: record
event code; and call qualified service person
IWrong size cuff for patient
loufr is damaged
lExcessive patient motion, shivering or
severe pain
lFalse high readings may be the result of
venous congestion caused by frequent
readings
lCuft too loose or positioned incorrectly
-Some arrhythmias may cause beat-tor
beat pressure and NIBP readings
.Larger than normal influence ot
respiratory phases on blood pressure
(inspiratory fall in blood pressure;
expiratory rise)
.Fenpnerai vascular changes experienced
during shock may reduce the reliability of
blood pressure readings obtained with
any indirect method Peripheral pulses
may be diminished or absent.
lMeasure patients limbs at the midpoint.
Match limb measurement to range specified
on cuff (undersizing the cuff results in the
greatest degree of error).
IReplace with good cuff
IEnsure patient is quiet with minimal
movement during NIBP readings. Minimize
patients shivering,
.Reduce frequency of readings
.Tighten cuff or reposition appropriately
.Docurnent arrhythmia if present. verity
pressure using another method. then follow
hospital procedure for care of this type of
patient
INiEP software usually compensates for
normal variation
-Consider invasive pressure measurements in
patiems with symptoms of shock or in any
patient who rapidly becomes unstable for
unknown reasons

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