Welch Allyn 3021-100 Propaq G Series Wireless Option User Manual En Bk

Welch Allyn, Inc. Propaq G Series Wireless Option En Bk

Contents

User Manual for Host System

Vital Signs Monitor Directions for Use Models 242, 244, 246Software Version 3.1XPlease check for Updates in the back pocket of this manual.0123
Copyright © 2000 by Protocol Systems, Inc. Protocol ® , Propaq ® , Propaq ® CS, Acuity ® , Protocol Cordless ® , and Flexible Monitoring ® are registered trademarks and Smartcuf™ is a trademark of Protocol Systems, Inc. Protocol Systems, Inc. is protected under various patents and patents pending.NELLCOR ® , DURASENSOR ®, C-LOCK ® and OXISENSOR ® are registered trademarks of Mallinckrodt, Incorporated. LIFEPAK 5 ® and LIFEPAK 6s ® are registered trademarks of Physio-Control Corporation.The HP Component Monitoring System is a product of Agilent (formerly Hewlett-Packard Company). Copyright Notice: Software in this Product is Copyright © 2000 by Protocol Systems, Inc., or its vendors. All rights are reserved. The software is protected by United States of America Copyright laws, and international treaty provisions applicable all over the world. Under such laws, it may be used as intended in the operation of the product in which it is embedded, but it may not be copied, decompiled, reverse-engineered, disassembled, or otherwise reduced to human-perceivable form. Protocol Systems, Inc. will make available specifications necessary for interoperability of this software on request; however, users should be aware that use of Protocol Systems, Inc. hardware and software with devices or software not sold by Protocol or its authorized dealers and affiliates may lead to erroneous results and consequent danger in patient care, and may also void Protocol’s warranty. Disclaimers: Protocol Systems, Inc. cautions the reader of this manual:• This manual may be wholly or partially subject to change without notice.• All rights are reserved. No one is permitted to reproduce or duplicate, in any form, the whole or part of this manual without permission from Protocol Systems, Inc.• Protocol Systems, Inc. will not be responsible for any injury to the user or other person(s) that may result from accidents during operation of the Propaq CS monitor.• Protocol Systems, Inc. assumes no responsibility for usage not in accordance with this manual that results in illegal or improper use of the Propaq CS monitor. For information concerning this document or any Protocol Systems product, contact:Protocol Systems, Inc.Customer Service8500 SW Creekside PlaceBeaverton, Oregon 97008-7107 USA Within USA, toll free: Phone: (800) 289-2500Phone Technical Services: (800) 289-2501WorldWide: Phone: (503) 526-8500Fax: (503) 526-4200Fax Technical Services: (503) 526-4910Internet: http://www.protocol.comEmail Technical Services: solutions@protocol.comEmail Marketing Dept.: marketing@protocol.comProtocol Medical Systems, Ltd.: NW EuropeDerby Service CentreSt. Georges HouseVernon GateDerby DE1 1UQ, United KingdomPhone: 44 1332 206208Fax: 44 1332 206209Email: uk@protocol.comProtocol Systems, Inc.: Asia/PacificP.O. Box 29020Christchurch 5, New ZealandPhone: 64 3 37 94 429Fax: 64 3 37 92 374Reorder No: 810-1097-01, Rev. A 5/00Printed in USA
Table ofContents Propaq CS Directions for Use 3 Contents 1 – General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Intended Use, Symbols, and Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Learn Propaq CS Operation with In-Service Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2 – Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Prepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Set Patient Alarms and Alarm Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Change the Current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Change Powerup Patient Mode or Store Customized Settings . . . . . . . . . . . . . . . . . . 23 3 – Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 Perform ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . . . . . . . . . . 32Perform Invasive Blood Pressure (IBP) Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . 33Take a Non-Invasive Blood Pressure (NIBP) Reading. . . . . . . . . . . . . . . . . . . . . . . . . 36Perform Temperature Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Perform SpO 2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Perform Mainstream CO 2 Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44Perform Sidestream CO 2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46Set Up the CO 2 Display and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 4 – Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Respond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Customize Alarm Limits Based on Patient’s Current Vital Signs. . . . . . . . . . . . . . . . . 54Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Connect Nurse Call Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Respond to An Equipment Alert. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56Troubleshooting Equipment Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 5 – Printing & Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 Print Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Display or Print Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Set Printer Options and Automatic Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
4 Protocol Systems, Inc. 6 – Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Connect the Monitor to the Acuity System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75Disconnect the Monitor from the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 7 – Defibrillator Synchronization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . . . . . . . . . . . . . 79Synchronous Cardioversion with LIFEPAK 6s Defibrillator . . . . . . . . . . . . . . . . . . . . . 82 8 – Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Connect the AC Power Adapter to Recharge the Battery . . . . . . . . . . . . . . . . . . . . . . 87Replace Monitor Input Power Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90Inspect and Clean the Monitor and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91Service Interval Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 9 – Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Set the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96Factory Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 10 – Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
GeneralInformation 1 – General Information Intended Use, Symbols, and Safety Information . . . . . . . . . . . . . . . . . . . . . 7 Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7General Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Touch-Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11System Control and Connectors (Right Side Panel) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Patient Connectors (Left Side Panel) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Option Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Setup Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Learn Propaq CS Operation with In-Service Mode . . . . . . . . . . . . . . . . . . 16
6 Protocol Systems, Inc.
Propaq CS Directions for Use 7 GeneralInformation Intended Use, Symbols, and Safety Information Intended Use The Propaq CS monitor is intended to be used by skilled clinicians for multiparameter vital signs monitoring of neonatal, pediatric, and adult patients in health care facility bedside applications. It is also intended for intra-facility and ambulance transport. The ECG channel is intended for five-lead or three-lead ECG monitoring.The Respiration (RESP) channel is intended to detect the rate or absence of respiratory effort, deriving the signal by measuring the ac impedance between selected terminals of ECG electrodes.The Invasive Pressure (IBP) channel is intended for measuring arterial, venous, and intracranial pressures (and umbilical artery and vein pressures for neonates) using invasive transducers.The Noninvasive Blood Pressure (NIBP) channel is intended for indirectly measuring arterial pressures using an inflatable cuff. If ECG is also monitored, the Propaq CS Smartcuf™ software algorithm automatically synchronizes the NIBP measurement process to the occurrences of the R-wave, increasing accuracy in cases of extreme artifact and diminished pulses. The operator may disable or enable the Smartcuf algorithm in the NIBP Menu.The Temperature (TEMP) channel is intended to measure temperature using an attachable probe.The Pulse Oximetry (SpO 2 ) channel is intended to noninvasively measure oxygen saturation of arteriolar hemoglobin at a peripheral measurement site.The Capnography (CO 2 ) channel is intended to noninvasively measure the following vital signs or events: End-tidal CO 2 (ETCO 2 ), Inspired CO 2 (INCO 2 ), Breath Rate, and Apnea. This guide was written for clinicians. Although this guide may describe some monitoring techniques, Protocol Systems expects that you are a trained clinician who knows how to take and interpret a patient’s vital signs. This monitor has been designed as a quality monitor; however, inherent limitations require that good clinical judgment always prevails. SymbolsWarning WARNING statements in this manual identify conditions or practices that could result in personal injury.Caution CAUTION statements in this manual identify conditions or practices that could result in damage to the equipment or other property.Note NOTE statements provide additional important information.
8 Protocol Systems, Inc. The following symbols may appear on the Propaq CS monitor or accessories. They are defined by the International Electrotechnical Commission, IEC 878 and IEC 417A. Off (Standby) Two way communication portOn Input portFor continued fire protection, use only the specified fuseOutput portDirect current Alternating current 1 Direct current or alternating current Separate batteries from other disposables for recycling.Caution: Refer to Directions For Use and accompanying documentationEnclosure Protection Drip proof: Classification IPX1 per IEC Publication 529Battery charging when green indicator illuminatedTemperature sensor inputPatient connections are Type CF, isolated for direct cardiac application, and protected against defibrillationTransformer meets requirements of a short-circuit-proof safety-isolating power transformer 1 1. This symbol is on the Universal Power Adapter. Patient connections are Type BF, and protected against defibrillationFor indoor use only (on power adapter only)Patient connections are Type B Signifies the device has met all essential requirements of European Medical Device Directive 93/42/EEC for a Class 1 product 1 The CE Mark and Notified Body Registration Number signify the device has met all essential requirements of European Medical Device Directive 93/42/EECThe Canadian Standards Association has evaluated this device according to CSA 601-1 and Underwriters Laboratory Standard UL 2601-1 1 .Urgent alarm notification (output to Nurse Call system)This device has been tested and certified by the Canadian Standards Association International to comply with applicable U.S. and Canadian medical safety standards. Apply the NIBP cuff as shown.Single-use only (not reusable).IPX10123NRTL/CEvaluated to CSA 601-1and UL2601-1CUS2 NIBP cuff sizes:ThighLarge adultAdultSmall adultChildInfant
Propaq CS Directions for Use 9 GeneralInformation General Warnings and Cautions Familiarize yourself with all warnings and cautions before using the Propaq CS monitor. In addition to the following, other warnings and cautions appear throughout this manual.Warning Safe interconnection between the Propaq CS monitor and other devices must comply with applicable medical systems safety standards such as IEC 601-1-1.Within certain governmental jurisdictions, all interconnected accessory equipment must be labeled by an approved testing laboratory. After interconnection with accessory equipment, risk (leakage) current and grounding requirements must be maintained.Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.Always check the patient mode when monitoring a new patient. The patient mode determines default alarm limits, maximum cuff inflation pressure, and internal algorithm settings.The monitor may not meet its performance specifications if stored or used outside the specified temperature and humidity ranges.Place the Propaq CS monitor and accessories in locations where they cannot harm the patient if they fall from their shelf or mount.Do not connect more than one patient to a monitor. Do not connect more than one monitor to a patient.Inspect the power adapter cord periodically for fraying or other damage, and replace the adapter as needed. Do not operate the apparatus from ac power with a damaged power adapter cord or plug. Make frequent electrical and visual checks on cables, sensors, and electrode wires. All cables, sensors, and electrode wires must be inspected, properly maintained, and in proper working order to allow the equipment to function properly and protect patient safety.Avoid electrosurgery burns at monitoring sites by ensuring proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes and probes.During defibrillation, keep the discharge paddles away from ECG and other electrodes, as well as other conductive parts in contact with the patient. Avoid contact with any accessories connected to the monitor’s left side panel.To ensure patient safety, the conductive parts of the ECG electrodes (including associated connectors) and other patient-applied parts should not contact other conductive parts, including earth ground, at any time.Do not operate this product in the presence of flammable anesthetics; explosion can result.Electronic equipment that emits strong electromagnetic or radio frequency signals can cause electrical interference with ECG monitor operation. This interference may distort the displayed or recorded ECG signal, thereby preventing accurate rhythm analysis. Avoid operating this device near equipment of this type.To help protect against electrical shock due to leakage current, use only monitor ac power adapters recommended in the Protocol Systems Products and Accessories booklet (P/N 810-0409-XX).For best product performance and measurement accuracy, use only accessories supplied by Protocol Systems or recommended in the Protocol Systems Products and Accessories booklet. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use.If a product has been dropped or severely abused, send it to a qualified service person to confirm proper operation and acceptable risk (leakage) current values.Some or all NIBP safety functions are disabled in the NIBP TEST screen in the Service Menu. Do not attempt to conduct NIBP TEST when the cuff is attached to a patient.Do not use the Propaq CS monitor in a Magnetic Resonance Imaging (MRI) suite or a hyperbaric chamber. Such use can cause fire or explosion resulting in patient injury and monitor damage.Impedance pneumography and CO 2 monitoring may not operate properly when used in conjunction with high-frequency jet ventilation or high-frequency oscillatory ventilation.
10 Protocol Systems, Inc.Caution Do not autoclave the Propaq CS monitor. Autoclave accessories only if the manufacturer's instructions clearly approve it. Many accessories can be severely damaged by autoclaving.Federal USA law restricts this device to sale, distribution, or use by or on the order of a licensed medical practitioner. It is possible for the monitor to detect a problem that prevents the monitor from operating properly. If this occurs, the monitor displays an error message and error number. Report such errors to Protocol Systems.The Propaq CS monitor should be serviced only by a Protocol Systems service technician while under warranty. The Propaq CS Service Manual (P/N 810-1101-XX) is available from Protocol Systems to assist the biomedical engineer during post-warranty period service. Controls and ConnectorsMainstreamCO2 OptionNurse CallOptionPrinter ButtonsAlarm(s) Off LightAlarm LightSidestreamCO2 OptionPrinterOptionSpO2OptionStarts or stops NIBP readingSuspend/Resume AlarmReturns the display to the Main MenuSuspends alarm tone for 90 seconds or resumes alarm tone (if active)Start/Stop NIBPHome
Propaq CS Directions for Use 11 GeneralInformation Touch-Screen Controls The front panel touch-screen provides five softkeys along the bottom and three icon-labeled keys along the right side. An Acuity NET OFF key is displayed in the upper left corner if the monitor is connected to an Acuity system. These keys allow control of all monitoring and setup functions.Note Avoid pressing more than one touch-screen key at a time. Touching more than one key area at a time can cause the touch-screen to misinterpret the command and respond to the wrong key.Caution Do not touch the screen with a sharp object such as a pen or pencil. Sharp objects can damage the touch-screen. Use your finger to press the touch-screen keys. System Control and Connectors (Right Side Panel)DEFIB SYNCHROMONITOREKG x 1000!3A2AG!!!12-28V, 3AInput FuseOn/Off SwitchPower Input ConnectorDefib Sync ConnectorReal-time ECG Output ConnectorBattery Charging LightSpeakerConnector for Acuity or Modem-Propaq
12 Protocol Systems, Inc. Patient Connectors (Left Side Panel)Option ConnectorsNIBPPSNIECG / EKG RESPINV. BPT1T2P1!NIBPINV. BP P1COMPATIBLEHP!PSNIECG / EKG RESPNIBPPSNIECG / EKG RESPINV. BPT1T2INV. BP P2P1!NIBPECG / EKG RESPINV. BPINV. BP P2P1COMPATIBLEHP!PSNINIBPPSNIECG / EKG RESPT1T2!NIBPCOMPATIBLEHP!PSNIECG / EKG RESPPropaq CS Model 242HP Model 242*Propaq CS Model 246HP Model 246*Model 242ECGNIBPTemperature (two channels)*Model 246ECGInvasive Pressure (two channels)NIBPTemperature (two channels)*Model 244ECGInvasiv Pressure (one channel)NIBPTemperature (two channels)*Propaq CS Model 244HP Model 244**The HP (Hewlett-Packard) side panels provide only one temperature connector.NELLCORSENSORS/CAPTEURS!SpO2!CO2!CO2SpO2 Connector Mainstream CO2 Connector Sidestream CO2 Connector Nurse Call Connector
Propaq CS Directions for Use 13 GeneralInformation Display You can select up to four waveforms to be shown on the Propaq CS monitor. When only one waveform is selected, a trend window automatically appears beneath the waveform.While changing monitor settings, a status window may appear below the waveform:NET OFFHRMONVMON17:05:10 PRINT FAULT IIBRP1( 96)BPMmmHg(M)TEMP1301007030150P2P1100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/m12SDSTATSCALEALARMSACUITYTRENDSMOREADULTON NETWORKT1T2∆TmVcm1mVcm1112ALLEN KIMBells indicate alarm limit statusNET OFFto disconnectfrom the Acuitynetwork.Heart Rate in beats per minute.Heart Rate Source: HR indicates ECG;PR indicates blood pressure or SpO2.All numeric values are continuously displayed and updated.If the monitor detects a vital sign outside the measurable range, it displays - - - (below the range) or + + + (above the range).Whenselected,trends aredisplayedhere.Patient mode Status messages can appear here.Time of dayPatient nameentered atAcuity CentralStation.STATSCALEautomatically adjustsall waveform scales foroptimum viewing.12ADULTECG/RESPMON17:05:10 PRINT FAULT IIBRP1( 96) mmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTCHANGEPREVIOUSMENUNETOFF ON NETWORKT1T2∆TmVcm1112HRBPM: ON: MONITOR (0.5-40Hz): Ld2 (RA-LL): OFFHR/PR TONEPACER DISPLAYECG BANDWIDTHRESP LEADRESP MONITORING : ONALLEN KIMStatuswindowOxygen saturation is a percentage value.ETCO2 concentrationBreath Rate from CO2Systolic, diastolic, and mean pressures are uniquely labeled and displayed.ECG1waveformis alwaysdisplayedif active.
14 Protocol Systems, Inc.MenusMenus for some patient vital signs are displayed only if the option is included in your Propaq CS monitor.Main MenuSTART AUTO/MANUAL TURBOCUFSTOPINTERVALECG1SIZE ECG2SIZE RESPSIZE MORESIZE MOREPREVIOUSMENUmm/s MOREGASCOMP RESPONSECO2 MENU 2A (NO CO2 SENSORS)SpO2 MENU 1SpO2 MENU 2INVASIVE PRESSURE MENU 1INVASIVE PRESSURE MENU 2ECG/RESP MENU 1NIBP MENUCO2 MENU 1MAIN MENUPREVIOUSMENUSpO2 CO2ECG/RESP MENU 2RANGE RESCALE ZERO P1 MORECANCELZERO P2CANCELGASCOMP RESPONSE SOURCECO2 MENU 2B (MAINSTREAM CO2 ACTIVE)CO2 MENU 2C (SIDESTREAM CO2 ACTIVE)GASCOMP RESPONSE SOURCEFLOWRATEPREVIOUS MENUSETUPNIBP ECG/RESP INVASIVE PRESSURE SpO2/CO2PREVIOUSMENUPREVIOUS MENUPREVIOUS MENURESPONSE C-LOCK PREVIOUS MENULABELP1 FORMATP1 LABELP2 PREVIOUSMENUFORMATP2ECG1LEADNEXT PREVIOUS MENUCHANGERANGESMARTCUF
Propaq CS Directions for Use 15GeneralInformationSetup Menus4Patient Mode menu is accessed when CHANGE is pressed for PATIENT MODE.3Service menu tests are only for use by authorized service personnel and are only available in the Adult patient mode.2ON/OFF key is not displayed for HR/PR alarm limits if the HR/PR ALARM LIMITS setting is set to CANNOT TURN OFF.STAT SET SUSPEND ALLALARMS LIMITS PREVIOUSMENUSETUPNIBP ECG/RESPINVASIVE PRESSURE SpO2/CO2ALARMS MENU RESUMENEXTSETTING UP DOWNNEXTPARAMETER ON/OFFALARM LIMITS MENU2TREND MENU PRINT NEXT TREND PRINTOXYCRGSETUP MENU 1MOREALARMS TRENDSWAVE SELSTATSCALEON/OFFNEXT INSERVICE PREVIOUSMENUMORENIBPTEST IBPTESTSpO2TEST CO2 TESTMORENEXT CHANGE WAVE SELECT PRINTERWAVE SELECT MENU SERVICE MENU 13PREVIOUS MENUNEXT CHANGE PRINTTRENDPRINTER SETUP MENUTEMPTEST PIXELTEST PCMCIATESTSERVICE MENU 23MORESETTINGS SCREENCAL SYSTEMSERVICE MENU 33NETTESTNEXT UP DOWN ENTERTIME/DAY MENUPREVIOUSMENUNEXT CHANGESETTINGS MENUPREVIOUSMENUNEONATAL PEDIATRIC SETUPPATIENT MODE MENU4NEXT POWERUP* USENOW SAVEMODE SETUP MENU SETUP MENU 2MORESERVICEWAVE SELECT ACUITYACUITY MENU11Acuity Menu is displayed if the monitor is connected to Acuity.NETOFF SNAPSHOT PREVIOUSMENUNOINSERVICEADULTCHANGEPREVIOUSMENU
16 Protocol Systems, Inc.Learn Propaq CS Operation with In-Service ModeYou can practice using the Propaq CS monitor with the in-service mode of operation.The in-service mode cannot be activated while you are monitoring a patient. During in-service mode, the monitor display and all printouts include the message SIMULATING or SIMULATED DATA.To practice with your Propaq CS monitor:1. Disconnect all patient cables connected to the monitor. You can leave the NIBP cuff connected to the monitor so you can take NIBP measurements.2. If you have been monitoring a patient, turn off the monitor and turn it back on.If your monitor is programmed so that the NIBP Automatic Mode is selected at powerup, select one of the Factory Patient Modes as the powerup patient mode (see page 23). Then turn the monitor off and turn it back on. (The in-service mode is not available if the NIBP Automatic Mode has been selected.)3. From the Main Menu, press SETUP, WAVE SELECT, INSERVICE.The Propaq CS monitor has two sets of simulated patient information. To change between the sets, from the Main Menu press SETUP, WAVE SELECT, and INSERVICE again.While in the in-service mode, you can press any monitor keys (except the AUTO/MANUAL key in the NIBP Menu) to change a function setting. For example, you can change ECG and RESP waveform sizes, set alarm limits, or set custom settings.You can also apply the NIBP cuff to yourself and take NIBP measurements.4. To exit the in-service mode, turn off the monitor.If you changed the powerup patient mode in step 2, be sure to restore the appropriate powerup patient mode according to your local protocol.Note The in-service mode is not available if the monitor detects that a sensor has been connected (except for an NIBP cuff) or the NIBP Automatic Mode has been selected. If the monitor is in in-service mode and you connect a sensor (except for an NIBP cuff) or press the NIBP AUTO/MANUAL key, the monitor will turn off power to exit the in-service mode, and then turn on in the normal operating mode.The pacemaker signal indicators are not displayed in the in-service mode.
Setup2 – SetupPrepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . 19Set Patient Alarms and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Change the Current Patient Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Change Powerup Patient Mode or Store Customized Settings . . . . . . . . 23Change the Powerup Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Customize Patient Mode Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
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Propaq CS Directions for Use 19SetupPrepare the Propaq CS Monitor for a New PatientWarning Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.1. Press the gray recessed MONITOR button on the right side of the monitor to turn the monitor off (if it is on). Press it again to turn the monitor on. The monitor displays the powerup screen for about 10 seconds, then displays the Main Menu. The monitor is in the powerup patient mode with the associated settings.2. Confirm that the monitor emits a tone. If the monitor has SpO2, listen for two tones and confirm both speakers are working.Note Check the battery voltage level on the powerup screen (or check it on the Time/Day window: Home, SETUP, MORE, MORE). If the battery voltage is 7.4V or less or a low battery message is displayed, connect the monitor to an ac power adapter to recharge the battery (see page 24). Connecting the adapter does not interrupt patient monitoring.3. Confirm the monitor is in the correct patient mode according to the patient’s age. If the patient mode is not correct, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window:4. Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 23 for information about preset Factory patient modes or programmable Custom patient modes.Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits.Home PATIENT MODE NEONATALPEDIATRICADULTSETUPSELECT PATIENT MODE BASED ON AGE:PED : > 44 WEEKS GEST. AGE,ADULT:NEO : < 44 WEEKS GEST. AGE< 9 YEARS > 9 YEARSBATTERY: 8.2 VOLTSPREVIOUSMENU
20 Protocol Systems, Inc.5. To select which vital sign waveforms will display, from the Main Menu press SETUP, MORE, WAVE SELECT. Use NEXT and ON/OFF to turn on the desired waveforms in the Wave Select window..You can turn on all waveforms, but only the first four waveforms selected as ON in the Wave Select window are displayed. You cannot turn off the ECG1 waveform.6. To set the HR/PR source, display sweep speed, tone volumes, and display brightness, from the Main Menu press SETUP, MORE to access Setup Menu 2. Use NEXT and CHANGE to select settings.CURRENT SOURCE When the selected HR/PR source is no longer available, the current source is the active source with highest priority. The RR/BR source cannot be manually selected. It is always CO2 if CO2 is active. Otherwise, it is ECG/RESP.SELECTED SOURCE The user-selected HR/PR source is displayed along with the HR/PR source currently used by the monitor.SWEEP (mm/s) Selectable sweep speeds for HR/PR: 12.5, 25, 50 mm/sec.Selectable sweep speeds for RR/BR: 3.13, 6.25, 12.5 mm/sec.ALARM TONE Sets the Alarm Tone volume to HIGH, MEDIUM, or LOW.HR/PR TONE Sets the Heart Tone volume to HIGH, MEDIUM, LOW, or OFF.BRIGHTNESS Sets the display brightness to NORMAL or LOW.Warning At the highest volume alarm level, the sound pressure level does not exceed safe limits (OSHA HSM 73-1101, 1972). However, additional precautions may be required in patients under treatment with ototoxic medications.SETUPECG1 : ONWAVE SELECT CO2 : ON RESP : ON SpO2 : ON NIBP : ONECG2 : ONNEXTON/OFFINSERVICE PREVIOUSMENUPA : ONP2: ONSETUPCURRENT SOURCE : ???SELECTED SOURCE : ECGSWEEP (mm/s)ALARM TONEHR/PR TONEPATIENT MODEBRIGHTNESSHR/PR RR/BRNEXTCHANGEWAVESELECT MORE???---:25.0 6.25::::LOWOFFADULTNORMALPRINTERThe ? ? ? is displayed until a source is active.
Propaq CS Directions for Use 21SetupSet Patient Alarms and Alarm Limits1. From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu:2. Press LIMITS to display the Alarms Limits window:3. Press NEXT PARAMETER to highlight the parameter you want to change, then press NEXT SETTING to highlight the limit you want to change.4. Press UP, DOWN, or ON/OFF to change the limits.The apnea alarm cannot be turned off at any time.5. After setting the desired limits, press Home to return to the Main Menu.ALARM STATUSBRTEMP 100.498.61.897P2( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDSTAT SETSUSPENDALLALARMS PREVIOUSMENUT1T2∆TLIMITSAPNEA :HR/PR :P1 :P2 :CO2 :RR/BR : SpO2 :NIBP :TEMP : 12All alarm limits are on.At least one alarm limit is off.(No bell) All alarm limits are off or the vital sign is not being monitored.Bells also appear in numerics windows.ALARM LIMITSBRTEMP 99.898.61.297( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTPARAMETERT1T2∆TON/OFFRR/BRAPNEA DELAYSpO2ETCO2INCO2NIBP SNIBP DNIBP (M) T1T2∆TmmHgmmHgmmHgmmHgmmHgNEXTSETTING UPBr/Msec%°F°F°FHR/PR BPM 120 50UPPER LOWER 30 20100220110120100.0100.0 5.0590OFF75355095.095.0 0.0DOWN*OFFOFF12An asterisk indicates this alarm limit was violated during monitoring. Red asterisk = alarm is occurring now.Yellow asterisk = alarm has occurred since the last time this window was entered.The asterisk is removed when you exit this menu. The asterisk reappears if the limit is violated again.HomeArrow indicatesthere are moreparameters thatare not displayed.Press NEXTPARAMETER toscroll down. Afterthe selectionreaches the lastparameter, itreturns to the top(HR/PR).
22 Protocol Systems, Inc.Change the Current Patient Mode1. To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to access the Patient Mode window:2. Based on the patient’s age, press NEONATAL, PEDIATRIC, or ADULT. When the confirmation window appears, press YES to confirm your selection.Whenever you change the patient mode, the alarm limit settings, maximum NIBP cuff inflation pressures, and internal computations are automatically changed to the defaults for that patient mode. See page 23 for information about preset Factory patient modes or programmable Custom patient modes.Note If you change the patient mode, the CO2 alarm limits in the new mode might vary slightly from the originally-programmed CO2 alarm limits for the new mode. Check the CO2 alarm limits. PATIENT MODE NEONATALPEDIATRICADULTSETUPSELECT PATIENT MODE BASED ON AGE:PED : > 44 WEEKS GEST. AGE,ADULT:NEO : < 44 WEEKS GEST. AGE< 9 YEARS > 9 YEARSBATTERY: 8.2 VOLTSPREVIOUSMENU
Propaq CS Directions for Use 23SetupChange Powerup Patient Mode or Store Customized SettingsThe Propaq CS monitor has standard, preset, default powerup settings and alarm limits for each patient mode: Adult, Pediatric, and Neonatal. These are “Factory Patient Mode” settings (listed on page 97).You can also choose to customize and store programmable powerup settings and alarm limits for each patient mode. These are “Custom Patient Mode” settings.The instructions below describe how to change the powerup patient mode and how to select and store new Custom Patient Mode settings.Note When you change patient modes, you also change the alarm limits associated with the new patient mode.Change the Powerup Patient Mode1. From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.2. Press NEXT to highlight the desired Factory or Custom powerup mode, then press POWERUP* and YES. The new powerup selection is marked by the asterisk.Changing the powerup mode does not affect the patient mode currently used.MODE SETUPBRTEMP 100.498.61.897P2( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTT1T2∆TPREVIOUSMENUPOWERUP* USENOWFACTORY:SAVEBATTERY: 9.2 VOLTS*ADULT PEDCUSTOM* = PATIENT MODE ON POWERUPADULT PEDNEONEO:12Asteriskindicates whichpatient mode iscurrentlyselected forpowerup.
24 Protocol Systems, Inc.Customize Patient Mode Settings1. From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.2. The patient mode you want to reprogram (ADULT, PED, or NEO) must be currently selected. To make sure it is currently selected, press NEXT as needed to highlight the desired mode, then press USE NOW and YES.3. Press Home to exit the Mode Setup window, then use other menus and keys to set the monitor settings and alarm limits as desired.A convenient way to access settings and alarm limits for all functions without connecting cables is to select the in-service mode (disconnect all patient cables, turn the monitor power off and then on, then press SETUP, WAVE SELECT, INSERVICE from the Main Menu).Warning If any alarms are set to OFF and you select SAVE to store settings for a Custom patient mode, those alarms will be OFF when the monitor powers up in that Custom patient mode or that Custom patient mode is selected. Consider carefully before setting Custom patient mode powerup alarms to OFF.4. Re-enter the Mode Setup window, press NEXT as needed to highlight the desired Custom mode, then press SAVE and YES.If the in-service mode is used, turn off the monitor to exit the in-service mode.Home
Monitoring3 – MonitoringPerform ECG/RESP Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Prepare for ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Use the ECG Filter to Display a Better Waveform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . 32Perform Invasive Blood Pressure (IBP) Monitoring . . . . . . . . . . . . . . . . . 33Take a Non-Invasive Blood Pressure (NIBP) Reading. . . . . . . . . . . . . . . . 36Improve NIBP Accuracy with Smartcuf™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Take the NIPB Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Perform Temperature Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Perform SpO2 Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Perform SpO2 “Spot-Check” Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43Perform Mainstream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44Perform Sidestream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46Set Up the CO2 Display and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . 48
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Propaq CS Directions for Use 27MonitoringECG/RESPPerform ECG/RESP MonitoringWarning Impedance pneumography detects respiratory effort via changes in chest volume; therefore, impedance pneumography can be used to detect central apnea. However, apnea episodes with continued respiratory effort, such as obstructive apnea and mixed apnea, may go undetected. Also, artifact due to patient motion, apnea mattress shaking, or electrocautery use may cause apnea episodes to go undetected. Always monitor and set alarms for SpO2 when using impedance pneumography to monitor respiratory function.The Propaq CS monitor automatically rejects cardiovascular artifact. This function is dependent upon accurate ECG R-wave detection. Therefore, always select the ECG lead with the most prominent QRS complex when monitoring respiration via impedance pneumography.Don’t place the Propaq CS monitor with RESP in close proximity to another respiration monitor because the RESP measurement frequencies may interfere with one another.Because pacemaker pulses in some instances may be falsely counted as breaths, impedance pneumography is not recommended for use on paced patients.Motion artifact can cause incorrect breath rate or heart rate readings. Minimize patient motion whenever possible.If a disconnected lead is in too close proximity to other electrical devices, it may cause false heart rate, a failure to detect apnea, or a failure to display a Lead Fail message.The Propaq CS monitor does not provide arrhythmia analysis. Therefore, arrhythmias are not analyzed and may cause the monitor to display inaccurate heart rates.The Propaq CS monitor will show + + + for HR numerics between 301-350 beats per minute. Above 350 beats per minute, it may display incorrectly low heart rates, due to intermittent picking of R-waves.High-intensity radio frequency (RF) energy from external sources, such as an improperly connected electrosurgical unit, can induce heat into electrodes and cables which can cause burns on the patient. Reading errors and damage to equipment may also result. This hazard can be reduced by (1) avoiding the use of small ECG electrodes, (2) selecting ECG electrode attachment points remote from the surgical site and from the electrosurgical return electrode, (3) using electrosurgical return electrodes with the largest practical contact area, and (4) assuring proper application of the electrosurgical return electrode to the patient. Verify patient mode. Incorrect patient mode may result in inaccurate heart rates and inappropriate alarm settings.To help prevent injury, use the provided garment clips to route the ECG cables away from the patient’s head.Use of ECG cables with loose or faulty detachable lead wires may cause erratic behavior of the ECG waveform, SpO2 (C-LOCK), and NIBP (Smartcuf) due to intermittent ECG lead wire connections.Use only ECG safety cables that are designed so that they cannot accidently be plugged into an ac mains outlet or make contact with other hazardous electrical potentials including earth ground. To prevent damage during defibrillation, don’t use ECG cables without 1 kΩ series resistors.Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values and alarm limit settings. ECG/RESP
28 Protocol Systems, Inc.Caution To protect the Propaq CS monitor from damage during defibrillation, for accurate ECG information, and for protection against noise and other interference, use only ECG electrodes and cables specified or supplied by Protocol Systems (these cables have the required current-limiting resistors). Follow recommended application procedures.• Impedance pneumography (RESP) is not recommended for use with high frequency ventilation.• Since RESP is derived from the same leads as the ECG channel, the Propaq CS monitor determines which signals are cardiovascular artifact and which signals are a result of respiratory effort. If the breath rate is within five percent of the heart rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths and trigger an apnea alarm.• When monitoring RESP it is highly recommended that you use SpO2 monitoring as a backup monitoring method.• The Propaq CS monitor counts as “breaths” respiratory efforts that are larger than two times background cardiovascular artifact.• Even though the Propaq CS monitor contains fully isolated patient-connected circuitry, it has not been specially designed for direct application on a patient’s heart.• Use only with accessories provided or recommended in the Protocol Systems Products and Accessories booklet. • Severe artifact and interference (such as defibrillation interference) can cause the waveform to move off the display for a few seconds before it is restored.Prepare for ECG/RESP Monitoring1. Inspect the ECG cable and replace it if it shows signs of wear, breakage, or fraying.2. Select the appropriate patient mode. To change patient modes, from the Main Menu press SETUP, MORE, CHANGE, then the desired patient mode (NEONATAL, PEDIATRIC, or ADULT) and then YES.3. Select electrode sites on the patient.Choose flat areas; avoid fatty areas and major muscles.4. Shave or clip hair from electrode sites, thoroughly clean skin, and lightly rub dry.You may use soap and water, isopropyl alcohol or special skin preparation pads. To avoid allergic reactions to electrodes, refer to the electrode manufacturer’s directions.5. If you are using pre-gelled electrodes, make sure the electrode date is not expired and the gel is intact and not dried out. For best results, use only silver/silver chloride electrode.If you are using non-gelled electrodes, apply a 1/4 to 1/2 inch mound of gel over the electrode contact area. For best product performance and measurement accuracy, do not use stainless steel needle electrodes, squeeze bulb electrodes, or electrodes with dissimilar metals. Do not use electrodes from more than one manufacturer on the same patient.
Propaq CS Directions for Use 29MonitoringECG/RESP6. Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes to the patient as shown.7. Plug the ECG cable into the ECG connector on the monitor's left side panel.8. Support the ECG cable so it does not stress the electrode wires, ECG cable connectors, or electrodes.9. If an electrosurgical unit will be used, place the ECG cable and electrode wires as far as possible from the surgical site and from the electrosurgical return electrode and its cables. This minimizes interference.Although the ECG channel contains electrosurgical interference suppression (ESIS) circuitry, noise artifact may be displayed on the ECG trace while an electrosurgical device is in use. Choose electrode placement to minimize interference.10. Look for an ECG waveform and heart rate on the monitor. Depending on how your monitor is programmed, a beep tone may occur with each detected QRS.If there is no waveform, check the electrodes, wires, cable, and the monitor for a possible misconnection or lead fault.G+RA LA LL If using MCL1, select LEAD II on the monitor, and use all three electrodes.Standard 3-leadConfiguration (G)=LA (-)=RA (+)=LLMarriott Configuration MCL 1 One of six V lead electrode placement sites for the C lead.LL LARA RL5-lead Configuration V6V1Neonate 3-lead ConfigurationRA LALL
30 Protocol Systems, Inc.11. To set up the ECG/RESP display, from the Main Menu press ECG/RESP to display the first ECG/RESP menu:12. Press buttons as desired to adjust the display:ECG1 SIZE Selects the ECG1 waveform size: 4, 2, 1, 0.5, or 0.2 mV/cm.ECG1 LEAD Selects the ECG1 lead: I, II, III, aVR, aVL, aVF, or V.Selections aVR, aVL, aVF, and V are only available with a 5-lead ECG cable.The ECG2 lead is always V, except when the ECG1 lead is V (in that case the ECG2 lead is II).ECG2 SIZE Selects the ECG2 waveform size: 4, 2, 1, 0.5, or 0.2 mV/cm.RESP SIZE Selects the RESP waveform size: 1x, 2x, 4x, 8x, or 16x.The QRS detector sensitivity threshold is not affected by changing the ECG display size. Likewise, the RESP breath detector threshold is not affected by changing the RESP display size.13. Press MORE to display the second ECG/RESP menu and status window:NET OFFHRMONMON17:05:10 PRINT FAULT IIBRP1( 96)BPMmmHg(M)TEMPLd2100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/m12SDECG1SIZEECG1LEADECG2SIZERESPSIZEMOREADULTON NETWORKT1T2∆TmVcm1112RESP2XmVcm1VALLEN KIMECG1 leadselectedECG1 sizeselectedRESP waveformis displayed (withRESP option)RESP leadselectedRESP sizeselectedBR indicates respiration rate is derived from active CO2 channel. RR indicates CO2 is not monitored and respiration rate is derived from ECG/RESP.ECG2 leadThe ECG2 leadis always V,except when theECG1 lead is V(in that case theECG2 lead is II).12ECG/RESPMONBR( 96) mmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTCHANGEPREVIOUSMENUT1T2∆TmVcm1: ON: MONITOR (0.5-40Hz): Ld2 (RA-LL): OFFHR/PR TONEPACER DISPLAYECG BANDWIDTHRESP LEADRESP MONITORING : ONECG bandwidth selected:MON = MonitorEXT = Extended
Propaq CS Directions for Use 31MonitoringECG/RESP14. Press NEXT and CHANGE as desired to adjust the display.HR/PR TONE Sets heart tone loudness to LOW, MEDIUM, HIGH, or OFF.If SpO2 is monitored, tone pitch varies with the SpO2 value.PACER DISPLAY Turns on and off the pacer indicator in the ECG waveform.If the patient has a pacemaker, you may want to turn on the pacer indicator (see page 32).ECG BANDWIDTH Selects the bandwidth for displayed and printed data.MONITOR is 0.5-40 Hz (Adult mode) or 0.5-120 Hz (Pediatric and Neonatal mode).Monitor Mode filters out extraneous noise and artifact to provide a more stable display.EXTENDED is 0.05-40 Hz (Adult mode) or 0.05-120 Hz (Pediatric and Neonatal mode).Extended Mode is a higher-resolution setting that allow more detailed analysis.Always use Extended Mode when observing ST segment morphology on the display or printer. Although Monitor Mode is useful to minimize baseline wander due to artifact, ST segments can be distorted in Monitor Mode. This can potentially cause underestimation of ST elevation and overestimation of ST depression. Although the monitor does not have automated ST segment monitoring, ST segments may be accurately displayed and printed in Extended Mode.RESP LEAD Selects the RESP lead: Ld1 (RA-LA) or Ld2 (RA-LL). RESP lead selection is independent of ECG lead selection.Choose the RESP lead that gives you the best signal. If neither signal is adequate, experiment with nonstandard electrode placement such as placing the RA and LA electrodes on the respective mid-axillary lines just above the level of the nipples.RESP MONITORING Turns RESP on or off.15. Set alarms according to your facility’s standards.Use the ECG Filter to Display a Better WaveformIf the ECG waveform appears unclear or distorted, make sure the monitor ECG filter is properly set to reduce interference from your facility’s ac power frequency. To check the filter:1. Press SETUP, MORE, MORE, SERVICE, YES to access the Service Menu.2. Press MORE, MORE, SETTINGS to display the Settings Menu.3. If the FILTER setting does not match your ac power frequency (60 or 50 Hz), press NEXT to highlight FILTER, then press CHANGE to change settings.Contact a qualified service person if you have questions.
32 Protocol Systems, Inc.Use the Propaq CS Monitor With Pacemaker PatientsWarning Pacemaker signals can differ from one pacemaker to the next. The Association for Advancement of Medical Instrumentation (AAMI) cautions that “in some devices, rate meters may continue to count the pacemaker rate during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate meter alarms. All pacemaker patients should be kept under close or constant observation.”The presence of much pacer-like noise can cause the displayed heart rate to be erratic even though the ECG trace may look undistorted with the pacer indicator off. To help avoid this noise problem, use fresh ECG electrodes and make sure the ECG cable lead wires make good connections.If the patient being monitored has a pacemaker, the Propaq CS monitor detects and can indicate the occurrence of pacemaker signals. 1. To access the monitor pacer indicator, from the Main Menu press ECG/RESP, MORE, and then NEXT to select the PACER DISPLAY.2. Press CHANGE to set the PACER DISPLAY either ON or OFF.When ON, the monitor displays (and prints on printouts) vertical dashed lines to indicate each time a pacemaker signal is detected. (If the pacemaker signal is strong enough, the monitor also displays it as a waveform “spike.”)When OFF, the vertical lines are not displayed (or printed), but the pacemaker signal waveform spike is still displayed if strong enough.Note Pacemaker pulses are not counted as heartbeats as defined by the Pacer Pulse Rejection specifications (see page 100).Noise on the ECG signal may be detected as pacer signals, causing the pacer indicator to appear on the display. If you don't need to indicate pacemaker signals, turn off the pacemaker indicator for a better ECG waveform display.NET OFFHRVMON17:05:10 PRINT FAULT II P1( 96)BPMmmHg(M) 121 79SDP2(M) 259SDADULTON NETWORKmVcm1 80ALLEN KIMPacemaker signal indicators
Propaq CS Directions for Use 33MonitoringINV PRSPerform Invasive Blood Pressure (IBP) MonitoringWarning If electrocautery is used, always avoid using any transducer with a conductive (metal) case that is electrically connected to its cable shield. Using a conductive transducer case with such a shield connection risks high-frequency burns at the ECG electrodes if the transducer case becomes earth grounded.Although complete disconnections of invasive pressure transducers will be detected by the normal alarm functions, partial disconnection will not be detected, nor will the use of some incompatible transducers. The user must exercise reasonable measures to ensure that approved transducers are used and that pressure transducers are connected properly.Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s trend values and alarm limit settings.For best product performance and measurement accuracy, use only accessories supplied by Protocol Systems or recommended in the Protocol Systems Products and Accessories booklet. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use. Do not use light-sensitive disposable transducers.1. Inspect the transducer cable and transducer dome for wear, breakage, or fraying. Replace any worn or broken accessory.2. Set up the transducer according to your hospital's procedures. Always refer to the transducer manufacturer’s Directions for Use. If the transducer is a disposable unit with separate cable, connect the transducer to the transducer cable.3. Plug the transducer (or transducer cable) into an invasive pressure connector on the monitor left side panel.4. To zero the transducer, open the transducer's stopcock to atmospheric air. Wait a few seconds for the transducer to settle. Before zeroing, make sure the transducer cable is properly connected to the monitor and the transducer is open to atmospheric air and positioned at the same level as the patient’s heart. The monitor will not zero the transducer if the pressure waveform is pulsatile, there is too much signal noise, or the transducer’s offset is too great.MONVMON IIBRP1BPMTEMPP1100.498.61.897NOTZEROEDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/m12SDRANGERESCALEZERO P1ZERO P2MORET1T2∆TmVcm1mVcm1112The message NOT ZEROED immediately appears in the IBP numerics window for the invasive pressure channel being used.INVPRS
34 Protocol Systems, Inc.5. If the ZERO menu is not displayed, from the Main Menu press INVASIVE PRESSURE, then ZERO P1 (or ZERO P2). The word ZEROING appears in the numerics window during zeroing.If you want to cancel the zeroing process, press CANCEL.6. Wait for a brief tone to sound and the word ZEROED to appear in the blood pressure numerics window.7. Close the transducer's stopcock. The monitor displays the pressure scale and numerics.8. If the transducer will not zero, the monitor displays the words ZERO REJECTED in the numerics window. Press CANCEL and try zeroing again beginning at step 4. The monitor does not display numerics or scales until an acceptable zero reference is established.You can rezero an IBP transducer at any time after you again open the transducer stopcock to atmospheric air. If the transducer has already produced pressure readings, rezeroing provides a new zero reference for the monitor.If the zero value is not accepted, the monitor continues to use the previous zero reference and displays numerics and waveforms based on that value.If the transducer still does not zero, try another transducer or another cable.Warning If you press ZERO after an invasive pressure channel has been successfully zeroed and the channel is currently monitoring a pressure waveform, the message ZERO REJECTED will display in the IBP numerics window. This message continues to display in place of the valid invasive pressure numerics until you press Home, INVASIVE PRESSURE, and then CANCEL in the IBP menu. If an IBP alarm occurs while ZERO REJECTED is displayed in place of IBP numerics, the IBP numerics will not flash to indicate invasive pressure is in alarm.9. To set up the IBP display, from the Main Menu press INVASIVE PRESSSURE to display the first IBP menu:MONVBRTEMP1301007030150P2P1100.498.61.897( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/m12SDRANGERESCALEZERO P1ZERO P2MORET1T2∆TmVcm1LABELP1FORMATP1PREVIOUSMENUFORMATP2LABELP2First IBP menuSecond IBP menuIBP labels areuser-selectable.
Propaq CS Directions for Use 35MonitoringINV PRS10. To display all invasive pressure waveforms on one scale (when two IBP channels are active), press RANGE to select the Range Mode.Press RANGE again to select another scale. Five scales are available:300/150/0180/90/0120/60/060/30/030/15/0Choose the scale carefully to make sure both waveforms are displayed (if monitored).11. To display each invasive waveform on its own scale, press RESCALE to select the Rescale Mode.Whenever you press RESCALE, the monitor automatically adjusts the scale for the best appearance based on the highest and lowest pressure levels.12. To change the displayed waveform label, press MORE to access the second IBP menu, then press LABEL P1 (or LABEL P2).Selectable labels (and display colors) are:P1 (red) default labelP2 (yellow) default labelART (red) arterialPA (yellow) pulmonary arteryCVP (blue) central venous pressureICP (white) intracranial pressureUA (red) umbilical artery (NEO mode only)UV (blue) umbilical vein (NEO mode only)13. To change the format of the IBP numerics, from the second IBP menu press FORMAT.To restore the first format, press FORMAT again.14. Set alarms according to your facility’s standards.Range Mode displays both waveforms on one scale.1800PRSINVRANGERESCALEZERO P1901301007030150P2P1RANGERESCALEZERO P1Rescale Mode displays each waveform on its own scale.1301007030150PAARTLABELP1FORMATP1LABELP2LABEL selects alternate labels.P1( 96) mmHg(M) 121 79SDFirst formatP1121 mmHg(M)( 96)S / D79Second format
36 Protocol Systems, Inc.Take a Non-Invasive Blood Pressure (NIBP) ReadingWarning Periodically observe the patient’s limb to make sure that the circulation is not impaired for a prolonged period of time. Also make sure the cuff is properly placed according to the following instructions. Prolonged impairment of circulation or improper cuff placement can cause bruising.The Propaq CS monitor should never be used to monitor NIBP on one patient while simultaneously monitoring ECG on another patient.If a noninvasive blood pressure measurement is suspect, repeat the measurement. If you are still uncertain about the reading, use another method.Do not attempt to take NIBP pressures on patients during cardiopulmonary bypass.When monitoring NIBP, match the monitor patient mode to the NIBP cuff. For neonates, set the monitor to Neonatal Mode unless the circumference of the limb is too large for the cuff. In that case, use the Pediatric Mode. Be aware, however, that the maximum cuff inflation limits are based on the patient mode, not the cuff; the maximum cuff inflation limits for Pediatric Mode are greater than for Neonate Mode (see page 104 for values).Warning Before you use a Propaq CS monitor on a new patient, always turn it off for a few seconds, then turn it on again. This clears the prior patient’s NIBP cuff inflation target, trend values, and alarm limit settings.At powerup, the Propaq CS monitor has an NIBP default inflation pressure (cuff inflation target) based on the patient mode (see page 104 for the values). After each NIBP measurement, the monitor adjusts the target inflation pressure to optimize the next NIBP measurement. To avoid possible patient discomfort, turn the monitor off and then on between different patients to reset the cuff inflation target to the default value.NIBP measurements can be adversely affected by poorly fitting cuffs or improper cuff placement. Be sure to select the appropriate cuff and apply the cuff properly according to the directions in this manual.Note NIBP measurements are affected by normal physiological pressure variations from reading to reading.Improve NIBP Accuracy with Smartcuf™NIBP measurements can be adversely affected by many factors such as cardiac arrhythmias, sudden changes in blood pressure, body motions such as convulsions or shivering, bumping the cuff, vibration, vehicle motion, or weak pulses.The patented Smartcuf software filtering technology greatly increases NIBP measurement accuracy in the presence of motion artifact or diminished pulses. Smartcuf synchronizes the NIBP reading with the R-wave of the patient’s ECG to eliminate noise created by external stimuli such as patient motion or vibration. The monitor must perform ECG monitoring while using Smartcuf.To enable the Smartcuf filter:• Connect the ECG leads to the patient and perform ECG monitoring during NIBP.• From the Main Menu, press NIBP to display the NIBP Menu (shown on page 38) and set Smartcuf to ON.NIBP
Propaq CS Directions for Use 37MonitoringNIBPIf artifact is so severe while Smartcuf is enabled that it affects the accuracy of an NIBP measurement, that measurement is marked with a special symbol on the display and on printouts:There may be some situations where it is desirable to disable Smartcuf. This may include situations with very extreme motion artifact, certain types of arrhythmias, or other situations where it is not possible to obtain a good ECG signal. NIBP measurements can still be performed when Smartcuf is disabled.To disable Smartcuf, from the Main Menu press NIBP to display the NIBP Menu and set Smartcuf to OFF.Take the NIPB Reading1. Select a cuff and hose appropriate for the patient. Select cuff size based on limb circumference. Use only hoses and cuffs listed in the Protocol Systems Products and Accessories booklet.Note Be sure the patient mode selected is appropriate for the cuff you are using. For instructions about changing the patient mode, see page 22. Be aware that changing patient modes will cancel an NIBP reading in progress.2. Squeeze as much air from the cuff as you can before placing it on the patient.Neonate Mode Pediatric Mode Adult ModeTypical Hoses Neonate/Infant Neonate/Infant, Adult AdultTypical Cuffs Neonate #1 to #5 (disposable); newborn, infant (reusable)Neonate #4, neonate #5, infant, child, small adult Child, small adult, adult, large adult, thighRecommended Limb Circumferenceup to 15 cm 10 to 25 cm greater than 15 cmNIBP TRENDTIMEMONPRINT10:01 9:46 9:31 9:20 9:08 8:52 8:47 8:41 8:35 8:30HH:MMHR/PR SpO2S D (M) RR/BRBPM % mmHg Br/M8080808080808080808097979797979797979797122 58 ( 85)126 62 ( 86)127 62 ( 86)134 66 ( 89)124 57 ( 86)127 58 ( 88)124 56 ( 85)126 57 ( 84)127 58 ( 85)132 61 ( 89)12121212121212121212NEXT TRENDThis symbol indicates the NIBP reading was taken in the presence of high artifact while monitoring ECG with Smartcuf enabled. Artifact can affect accuracy. To help reduce artifact, see step 6 on page 39.Trend DisplayPrintout112 58 ( 85)NIBP18:45SD(M)mmHgNumeric Display
38 Protocol Systems, Inc.3. Place the cuff on the limb.If possible, place it at the same level as the heart. If above the heart, add 1.9 mmHg to the NIBP measurement for every inch above the heart. If below the heart, subtract 1.9 mmHg for every inch.The cuff should be snug, but not uncomfortable. The hose must not be kinked or pinched. Make sure the cuff tubing is centered over the brachial artery.If SpO2 will also be monitored, place the NIBP cuff on a different limb than the SpO2 sensor to help reduce unnecessary SpO2 alarms.4. Screw the hose connector onto the NIBP connector on the monitor's left side.5. From the Main Menu, press NIBP to display the NIBP Menu:START/STOP Starts and stops NIBP measurements. During the measurement, you can press STOP (or the Start/Stop NIBP key at the right side of the screen) to stop the measurement and vent the cuff.If the Propaq CS monitor does not recognize a valid NIBP reading, it automatically attempts another measurement while displaying a retry message. The monitor attempts up to two retries (depending on patient mode and settings).AUTO/MANUAL Switches between Automatic and Manual Mode. In Automatic Mode, the monitor automatically takes measurements at the selected interval.Cuff applied evenly and snugly with bottom edge of cuff one inch above antecubital fossaPossible cuff placements for neonates112 58 ( 85)NIBP18:45SD(M)mmHgADULTNIBP ADULTMODE : TURBOCUFTIME : 4:21SMARTCUF : ONMON17:05:10 PRINT FAULT IIBRP1( 96) mmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDSTOPAUTO/MANUALINTERVAL SMARTCUFNETOFF ON NETWORKT1T2∆TmVcm1112HRBPMmmHgTURBOCUF( 85)75 50 100 150 20017:05:01TIME OFREADING: (M) 122 58SD12ALLEN KIMManometer Bar:Systolic, diastolic,and mean valuesare indicated assmall triangles.The last measurementMeasurement modeAfter 16 minutes, the NIBP display changes as shown below for 44 minutes.Time remaining inTurbocuf Mode orAuto Mode intervalSTART is displayedwhen nomeasurement isoccurring.This symbol indicates the NIBP reading was taken in the presence of high artifact while monitoring ECG with Smartcuf enabled. Artifact can affect accuracy. To help reduce artifact, see step 6 on page 39.Smartcuf statusStart/Stop NIBP
Propaq CS Directions for Use 39MonitoringNIBPINTERVAL Selects the measurement interval for Automatic Mode NIBP measurements: 1, 2, 3, 5, 10, 15, 30, or 60 minutes.For intervals 5, 10, 15, 30, or 60, measurements occur at corresponding intervals past the hour. For example, if 5 is selected at 10:47:20, the measurements occur at 10:50, 10:55, 11:00, etc.For intervals 1, 2, or 3 minutes, measurements begin 1, 2, or 3 minutes after the interval is set. For example, if 1 is selected at 10:47:20, the next measurement starts at 10:48:20.TURBOCUF Automatically starts NIBP measurements and takes as many as possible within five minutes. To stop the Turbocuf Mode, press STOP or the Start/Stop NIBP key.After you stop the Turbocuf Mode or the monitor completes the five-minute Turbocuf cycle, the monitor returns to the previous NIBP mode (Automatic or Manual).SMARTCUF Enables or disables the Smartcuf motion artifact filter. NIBP measurements can still be taken when Smartcuf is off. Artifact may interfere with the accuracy of NIBP measurements with Smartcuf off.6. If motion artifact such as shivering, coughing, or other motion interferes with NIBP readings, do the following:Position the patient’s limb away from the body so the applied cuff is not in contact with the patient’s body or any other object such as a bed rail. Try to keep the cuff at the same level as the heart.Make sure the Smartcuf filter is ON. Make sure ECG leads are properly connected to the patient and perform ECG monitoring during NIBP. (ECG monitoring is required for Smartcuf.)7. Set alarm limits according to your facility’s standards.
40 Protocol Systems, Inc.Perform Temperature Monitoring1. Place the temperature probe on the patient.Warning Application and use of metal-jacketed temperature probes that come in contact with conductive objects or clinical personnel during electrocautery may cause burns at the patient-probe/electrode contact points. Do not touch conductive temperature sensors during defibrillation or cautery.Use only temperature probes listed in the Protocol Systems Products and Accessories booklet. Other probes may produce incorrect temperature readings.2. Plug the probe cable into one of the temperature connectors on the monitor side panel. Within a few seconds, the monitor displays the temperature:If you connect a second temperature probe, the monitor displays the temperature for T1, T2, and ∆T.3. To set alarm limits, from the Main Menu press SETUP, ALARMS, LIMITS to access the Alarms Limits Menu. Press NEXT PARAMETER as needed to highlight the desired temperature parameter. Use NEXT SETTING, UP, DOWN, and ON/OFF to set the alarm limits according to your facility's standards.4. To change the temperature units (°C or °F), from the Main Menu press SETUP, MORE, MORE, SERVICE, YES (to access the Service Menu), MORE, MORE, SETTINGS. Use NEXT and CHANGE to change the temperature units.Changing units does not clear temperature trends.T198.8°FTEMP
Propaq CS Directions for Use 41MonitoringSpO2Perform SpO2 MonitoringWarning Oxygen saturation measurements using pulse oximetry are highly dependent on proper placement of the sensor and patient conditions. Patient conditions such as shivering and smoke inhalation may result in erroneous oxygen saturation readings. If pulse oximetry measurements are suspect, verify the reading using another clinically accepted measurement method, such as arterial blood gas measurements.Tissue damage can be caused by incorrect application or use of a sensor (e.g., wrapping the sensor too tightly, applying supplemental tape, failing to periodically inspect the sensor site, leaving a sensor on too long in one place). Refer to the Directions for Use provided with each sensor for specific instructions on application and use, and for description, warnings, cautions, and specifications.Sensors exposed to ambient light while not applied to a patient can exhibit semi-normal saturation readings. Be sure the sensor is securely placed on the patient and check its application often to ensure accurate readings.Before you use a Propaq CS monitor on a new patient, always turn off the monitor for a few seconds, then turn it on again. This clears the prior patient’s trend values, alarm limit settings, and NIBP cuff inflation target.Note During SpO2 monitoring, the monitor performs an SpO2 self-calibration procedure every 15 minutes to help make sure the SpO2 channel is functioning properly. During the self-calibration, the SpO2 waveform is displayed as a flat line for a few seconds. After calibration, the SpO2 monitoring resumes.1. Attach the sensor to the patient according to the sensor manufacturer's instructions, observing all warnings and cautions.Use only NELLCOR accessories and sensors with the Propaq CS monitor SpO2 option as listed in the Protocol Systems Products and Accessories booklet. Each sensor is designed for application to a specific site on a patient within a certain size range. To ensure optimal performance, use an appropriate sensor and apply it as described in the sensor's Directions for Use. Always observe all warnings and cautions. Consider using other types of listed sensors for different applications if you have problems obtaining good measurements.If excessive ambient light is present, cover the sensor site with opaque material to block the light. Failure to do so may result in inaccurate measurements. Light sources that can affect performance include surgical lights (especially those with a xenon light source), bilirubin lamps, fluorescent lights, infrared heating lamps, and direct sunlight.If NIBP will be monitored while using SpO2, place the NIBP cuff on a different limb than the SpO2 sensor to help reduce unnecessary SpO2 alarms.2. Plug the sensor into the SpO2 sensor extension cable and plug the cable into the monitor, or plug the sensor directly into the monitor.3. Lock the connector in place by turning the locking ring clockwise until it stops. The monitor displays STANDBY in the SpO2 numeric window until it measures and displays the SpO2 value.The monitor self-calibrates the SpO2 channel whenever the monitor is first turned on, at least every 15 minutes thereafter, and whenever a sensor is connected to the SpO2 channel. During calibration, the SpO2 waveform is momentarily flat.As oxygen saturation increases and decreases, the pitch of the heart tone rises and falls.SpO2
42 Protocol Systems, Inc.4. From the Main Menu, press SpO2 (or SpO2/CO2, then SpO2) to display the first SpO2 menu:5. Press SIZE to adjust the waveform size for best viewing (1x, 2x, 4x, or 8x).6. Adjust the placement of the sensor until a good SpO2 waveform is displayed. A waveform with artifact may cause erroneous oxygen saturation readings.7. Press MORE to display the second SpO2 menu:8. Press RESPONSE to select the appropriate time required to measure SpO2:9. If the C-LOCK function is desired, press C-LOCK to set it to ON.C-LOCK synchronizes the pulse oximeter's systole determination to the R-wave to reduce the effects artifact may have on SpO2 measurements. Under some conditions you may find more stable SpO2 readings with C-LOCK set to ON. SYNC appears next to the waveform when synchronization to the ECG has been obtained. Synchronization takes a few seconds to establish the first time. If C-LOCK is on and the HR source is SpO2, the heart rate source is automatically changed to ECG. An ECG signal must be present or C-LOCK does not activate.If you get false SpO2 alarms with patients with low perfusion states or multiple arrhythmias, try turning off C-LOCK.10. Set alarm limits according to your hospital’s standards.Response Time Indications for UseNORMAL 5-7 seconds Use for relatively stable patients.FAST 2-3 seconds Use when patient movement or other artifact is not present.SLOW 10-15 seconds Use when patients exhibiting movement are preventing accurate measurement at NORMAL setting.BR70SpO2197%MCO2SpO2mmHg 38 Br/m12SIZEMOREPREVIOUSMENU2XPulse amplitude indicatorOxygen saturation percentageRESPONSEC-LOCKPREVIOUSMENU
Propaq CS Directions for Use 43MonitoringSpO211. If patient movement interferes with measurements, consider the following possible solutions:• be sure the sensor is secure and properly applied• use a new sensor with fresh adhesive backing• select a different type of sensor• move the sensor to a less active site• set the RESPONSE mode to SLOW• consider using C-LOCK; see step 9.Perform SpO2 “Spot-Check” MonitoringThe SpO2 Standby Mode allows you to remove the SpO2 sensor from a patient without having to disable all alarms or disconnect the SpO2 sensor cable from the Propaq CS monitor. You can therefore perform intermittent or “spot-check” SpO2 monitoring.1. While monitoring SpO2, remove the SpO2 sensor from the patient, but leave it connected to the monitor. When the monitor detects the lack of a pulsatile waveform, it sounds a patient alarm and displays this menu:2. Press STANDBY to place SpO2 into the Standby Mode.The monitor suspends the SpO2 alarm tone indefinitely and displays STANDBY in place of SpO2 numerics. SpO2 remains in the Standby Mode until the SpO2 sensor is reapplied to a patient. Other vital sign monitoring is not restricted. By contrast, if you press SUSPEND instead of STANDBY, the monitor temporarily suspends all alarm tones; however, the alarm tone resumes after 90 seconds if the SpO2 sensor is still disconnected from the patient—see page 53.3. To resume SpO2 monitoring, reapply the SpO2 sensor to a patient.The monitor exits the Standby Mode and resumes SpO2 monitoringNote The message STBY on the SpO2 trend display and trend printouts indicates the monitor was in the SpO2 Standby Mode.SUSPENDSTANDBY
44 Protocol Systems, Inc.Perform Mainstream CO2 MonitoringThe capnography (CO2) option measures End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea. Patients using Mainstream CO2 must either be intubated or breathing through a tight-fitting face mask connected to a breathing system such as an anesthesia circle system. The Mainstream CO2 option requires the SpO2 option.Warning Avoid exposing older Mainstream CO2 sensors to non-patient sources of CO2 such as vehicle engine exhaust or smoke. Exposure to these CO2 sources can temporarily trap CO2 within the monitor or Mainstream CO2 sensor housing, even when monitor power is off. This can temporarily cause an erroneous elevated CO2 measurement baseline until the trapped CO2 leaks out and the baseline returns to zero (which can require as long as 3-24 hours).Do not attempt to verify operation of the CO2 sensor by blowing through it directly. Always blow through an attached airway adapter. Otherwise, a small amount of CO2 from your breath may enter the CO2 sensor housing and cause a small shift in the measured CO2 values. It may take 3-24 hours for the sensor to return to proper calibration.Do not clean and/or reuse a single-patient-use airway adapter. When a single-patient-use airway adapter becomes occluded, replace it.For best product performance and measurement accuracy, use only accessories supplied by Protocol Systems or recommended in the Protocol Systems Products and Accessories booklet. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use for instructions about operation, cleaning, and replacement. Only sensors recommended by Protocol Systems provide calibrated waveforms and numerics.Note The Mainstream CO2 operating temperature range is 10° to 40°C. This is different than the range of 0° to 40°C for other Propaq CS monitor functions. CO2 monitoring outside the specified range can cause inaccurate CO2 measurements.1. Select the appropriate airway adapter.2. Connect the adapter, ventilator circuit, and CO2 sensor according to the manufacturer’s instructions.Low dead space airway adapterAdult airway adapterWindow WindowCO2
Propaq CS Directions for Use 45MonitoringCO2Warning Before using an airway adapter, always look through the window lumen and inspect the adapter for inadvertently lodged obstructions and for window integrity.If the sensor does not easily slide onto the adapter, do not attempt to force these components together. They fit together in only one way. Take care not to damage the glass window.After attaching the sensor to the adapter, check for proper placement. Check the sensor and adapter periodically during monitoring to make sure they are properly connected and the adapter is not clogged by obstructions or debris.When attaching the airway adapter, position the adapter so the sensor is on top to avoid fluid collection in the sensor airway slot. Any concentration of fluids here can cause inaccurate CO2 readings.When connecting the adapter and sensor to the ventilator circuit, do not use the adapter and sensor as a wrench to twist the adapter into the ventilator circuit. Such action could damage the adapter and sensor.Always check to make sure there are no leaks in the breathing circuit. Check all of the connections.3. Plug in the CO2 sensor cable to the Mainstream CO2 connector on the monitor left side panel. Warning When disconnecting the CO2 sensor from the tracheal or endotracheal tube, check the sensor to determine how hot it is. If it is too hot for patient comfort, do not allow it to come into contact with the patient.4. See page 48 and set up the CO2 display and alarm limits.Note When disconnecting the airway adapter from the ventilator circuit, always detach the CO2 sensor from the airway adapter before removing the airway adapter from the ventilator circuit.
46 Protocol Systems, Inc.Perform Sidestream CO2 MonitoringThe capnography (CO2) option measures End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), Breath Rate, and Apnea. Patients using Sidestream CO2 can either be intubated or non-intubated using a CO2 Sampling cannula or a combination CO2 Sampling/Oxygen Delivery nasal cannula. The Sidestream CO2 option requires the SpO2 option.Warning Do not use Sidestream CO2 if flammable anesthetic gases are in use.If the Sidestream CO2 option is connected to a ventilatory circuit, be sure to adjust appropriate ventilator or anesthesia system settings to compensate for the sampling flow volume (90 or 175 ml/min) that is aspirated from the ventilatory circuit by the Sidestream CO2 option.Avoid exposing a Propaq CS monitor with the Sidestream CO2 option to non-patient sources of CO2 such as vehicle engine exhaust or smoke. When such exposure is possible, avoid opening the printer door. Exposure to these CO2 sources can temporarily trap CO2 within the monitor, even when monitor power is off. This can temporarily cause an erroneous elevated CO2 measurement baseline until the trapped CO2 leaks out and the baseline returns to zero (which can require as long as 3-24 hours).For best product performance and measurement accuracy, use only accessories supplied by Protocol Systems or recommended in the Protocol Systems Products and Accessories booklet. Use accessories according to your facility’s standards and the manufacturer’s recommendations. Always refer to the manufacturer’s Directions for Use for instructions about operation, cleaning, and replacement.Note The Sidestream CO2 operating temperature range is 5° to 40°C. This is different than the range of 0° to 40°C for other Propaq CS monitor functions. CO2 monitoring outside the specified range can cause inaccurate CO2 measurements.• When monitoring a small child with a rapid respiratory rate, Mainstream CO2 can provide a more accurate representation of the expired CO2 waveform than Sidestream CO2.• Breath rates greater than 50 breaths/minute may reduce the reported ETCO2 values. Select the 175 ml/min flow rate to minimize errors at higher breath rates.• The 175 ml/min flow rate is recommended for intubated adult patients.1. Firmly insert the Sidestream CO2 watertrap into the Sidestream CO2 connector on the monitor left side panel.Warning The watertrap is disposable and should only be used for a single patient. Do not reuse the watertrap for another patient.2. See page 48 and set up the CO2 display and alarm limits, then continue this procedure with step 3.Sidestream CO2 ConnectorWatertrapExhaust Port. WARNING - Do not connect sample line or patient input to exhaust port.
Propaq CS Directions for Use 47MonitoringCO23. For a non-intubated patient, position the cannula on the patient according to the manufacturer’s instructions.Warning The cannula is disposable and should only be used for a single patient. Do not reuse the cannula for another patient.If oxygen is being delivered while using Sidestream CO2, be sure to use a CO2 Sampling and O2 Delivery Cannula. Using a different type of cannula could obstruct oxygen delivery.4. Connect the sample line to the cannula (for a non-intubated patient) or the elbow connector (for an intubated patient) and the watertrap. Make sure that the sample line is firmly connected.Warning The exhaust port for Sidestream CO2 is an output for the expired gases from the patient and any connected breathing apparatus. The exhaust port is intended only for connection to gas collection equipment such as gas scavenger devices (the device should comply with ISO 8835-3:1997 E). Do not allow any other connection to the exhaust port.If the Sidestream CO2 option is connected to a ventilatory circuit, be sure to adjust appropriate ventilator or anesthesia system settings to compensate for the sampling flow volume (90 or 175 ml/min) that is aspirated from the ventilatory circuit by the Sidestream CO2 option.If you use a gas scavenging system with Sidestream CO2, be sure to install it according to the manufacturer’s instructions. The scavenging system should comply with ISO 8835-3:1997 (E).Sidestream CO2 accuracy decreases if additional tubing is connected to the sample line. Avoid connecting additional tubing to the standard sample line.Sample lineWatertrapExhaust Port WARNING - Do not connect sample line or patient input to exhaust portElbow connector3. For an intubated patient, connect the gas sampling elbow and elbow connector into the patient’s breathing circuit according to the manufacturer’s instructions.Exhaust Port WARNING - Do not connect sample line or patient input to exhaust portSample lineTo cannulaWatertrap
48 Protocol Systems, Inc.Set Up the CO2 Display and Alarm LimitsNote After you connect a Mainstream CO2 sensor or Sidestream CO2 watertrap, the Propaq CS monitor displays the waveform briefly without a scale. It displays WARM UP (for Mainstream) or START UP (for Sidestream) in the CO2 numerics window. After about 30 seconds, the monitor displays the CO2 measurement and waveform range.CO2 monitoring is typically displayed as shown:1. To adjust the display, from the Main Menu press SpO2/CO2, CO2 to access the first CO2 menu:2. Press RANGE to select the CO2 waveform scale or range.mmHg: 0-100 0-60 (default) 0-30kPa: 0-14 0-8 0-4%: 0-14 0-8 0-4To change CO2 units (mmHg, kPa, or %) see page 96.Note If an inspired value is displayed indicating patient rebreathing (non-zero INCO2), check the patient breathing circuit for proper function. For Mainstream CO2, also remove the sensor from the patient’s airway, hold it away from any source of breath, and confirm INCO2 begins to go down to the baseline value. If the Propaq CS monitor continues to display inspired values, return the Mainstream CO2 sensor to Protocol Systems for service.3. Press mm/s to set the display sweep speed for CO2 and RESP (3.13, 6.25, or 12.5 mm/sec). The default is 6.25.To view the sweep speed setting, press MORE to access the CO2 status window.NET OFFHRMON17:05:10 PRINT FAULT IIBRP1( 96)BPMmmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/m12SDNIBPECG/RESPINVASIVEPRESSURESpO2/CO2SETUPADULTON NETWORKT1T2∆TmVcm160300MCO2 80ALLEN KIMMCO2mmHg3510MCO2 indicatesMainstream CO2 isactive.SCO2 is displayedwhen SidestreamCO2 is active.CO2 is displayed if aMainstream sensoror Sidestreamwatertrap is installedbut not active.ETCO2INCO2 appears here when displayed. The INCO2 numeric value is only displayed if it is in alarm or if it is ≥ 7.5 mmHg (or 1kPa or 1%).Breath Rate is determined from the CO2 sensor.Measured CO2levels are normallydisplayed as awaveform and anETCO2 numericvalueRANGEmm/sPREVIOUSMENUMORE
Propaq CS Directions for Use 49MonitoringCO24. Press MORE to access the second CO2 menu and status window:5. If O2 or N2O is being administered to the patient, press GAS COMP to set the proper gas compensation (for specifications, see page 106). If no gas is being administered, choose OFF (the default).Note If ETCO2 is displayed as + + +, have a biomedical technician check the CO2 calibration against a known reference gas. If the sensor calibration is not accurate, return it to Protocol Systems for service.6. Press RESPONSE to set CO2 measurement response time (NORMAL, FAST, or SLOW).FAST is recommended where a sudden step change in ETCO2 is of concern, such as that induced by an air embolus in certain neurosurgical procedures. SLOW is recommended to help reduce ETCO2 false alarms when breath morphology varies considerably from one breath to the next. The default is NORMAL.7. Press SOURCE to change between Mainstream CO2 and Sidestream CO2 monitoring (if both options are installed), or to disable CO2 monitoring.Choosing OFF allows you to disable CO2 monitoring without removing the watertrap or sensor. When CO2 is off, OFF is displayed for CO2 numerics.8. For Sidestream CO2, press FLOW RATE to set the sampling flow rate (90 or 175 ml/min).You can change the flow rate while Sidestream CO2 is active.9. To set alarm limits, from the Main Menu press SETUP, ALARMS, LIMITS. Then set alarm limits for RR/BR, ETCO2 and INCO2.INCO2 has an upper alarm limit setting but no lower alarm limit setting.Warning For patient safety, it is recommended that the Breath Rate alarm limits always be turned on and set appropriately.10. Set the Apnea Delay limit (the maximum time allowed between two consecutive breaths before an Apnea alarm occurs) in the Alarm Limits window.After the first breath has been detected, the Apnea Delay limit setting is automatically turned on for as long as the CO2 channel is active. CO2BRTEMP 100.498.61.897( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58SCO2SpO2mmHg 38 Br/mSDGASCOMPRESPONSESOURCE PREVIOUSMENUT1T2∆TFLOWRATEGAS COMPENSATION: OFFCO2 SOURCESWEEP SPEED:NORMAL::BAROMETERRESPONSESIDESTREAM6.25 mm/s:756.8 mmHgFLOW RATE :175 ml/min12 FLOW RATE is only displayed forSidestream CO2(not Mainstream CO2).
50 Protocol Systems, Inc.
Alarms &Alerts4 – Alarms & AlertsRespond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53Customize Alarm Limits Based on Patient’s Current Vital Signs . . . . . . .54Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55Connect Nurse Call Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Respond to An Equipment Alert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56Troubleshooting Equipment Alert Messages . . . . . . . . . . . . . . . . . . . . . . .57ECG Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57RESP Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57IBP Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57NIBP Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Temperature Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59SpO2 Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59Mainstream CO2 Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60Sidestream CO2 Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61Network Alert Message with Acuity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Program Alert Message. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Printer Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Defibrillator Alert Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Very Low Battery Alert Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
52 Protocol Systems, Inc.
Propaq CS Directions for Use 53Alarms &AlertsRespond to Patient AlarmsWhen an apnea alarm or patient alarm occurs, the monitor produces an audible tone and visual indicators and displays the following:1. Press the Suspend/Resume Alarms key in the upper right corner of the screen or SUSPEND in the Patient Alarm Menu. The tone is suspended for 90 seconds. During that period, visual alarm indications continue.To “unsuspend” the alarm before 90 seconds has elapsed, press the Suspend/Resume key or RESUME. If an alarm condition still exists, the tone will again sound. For NIBP, pressing Suspend/Resume or RESUME will not resume the NIBP alarm because NIBP is not continuously measured.Warning Suspending an alarm suspends ALL alarm tones for 90 seconds or until RESUME is pressed.2. Check the patient and provide appropriate care.3. To adjust alarm limits, press Home, SETUP, ALARMS, LIMITS to display the Alarm Limits Window. Use NEXT PARAMETER and NEXT SETTING as needed to highlight the limit you want to change.• Press UP or DOWN to change the limits.• Press ON/OFF to turn an alarm off or on. (The ON/OFF button is not available for HR/PR alarm limits if HR/PR ALARM LIMITS in the Settings window is set to CANNOT TURN OFF.)4. If you want to quickly turn off all alarm limits, from the Main Menu press SETUP, ALARMS, ALL ALARMS. You cannot turn off the Apnea alarm.5. After caring for the patient, turn on the appropriate alarm limits.Flashing numerics indicate that limits have been violated.Alarm lights (see table on page 109)Press LIMITS to adjust alarm limits (if LIMITS is available).Press to suspend the tone for 90 seconds.Suspend/Resume AlarmsHome
54 Protocol Systems, Inc.Customize Alarm Limits Based on Patient’s Current Vital Signs1. To quickly set all alarm limits, from the Main Menu press SETUP, ALARMS, STAT SET. The monitor turns on all alarms and calculates new alarm limits based on the patient’s current vital sign values. Make sure that the new limits are appropriate for the patient.Warning If a patient’s vital sign value falls outside of the upper or lower alarm range limit, STAT SET turns off the alarm and the alarm limit except for the following:1. The lower alarm limits for SpO2 and ETCO2 are not turned off by STAT SET.2. If HR/PR ALARM LIMITS in the Settings window is set to CANNOT TURN OFF, STAT SET affects HR/PR alarm limits as follows: HR/PR PATIENT VALUE DISPLAY UPPER LIMIT LOWER LIMITOverrange +++ Maximum UnchangedUnderrange - - - Unchanged MinimumIndeterminate ??? Unchanged Unchanged STAT SET Limit Calculations11. New alarm limits calculated by STAT SET cannot be outside the allowable alarm limit range. If a new limit is calculated to be above or below the allowable alarm limit range, it defaults to the maximum or minimum alarm limit allowed for that vital sign.Vital Sign If the Patient’s Vital Sign Value is Then Calculated New Lower Limit is Then Calculated New Upper Limit isHeart Rate HR ≤ 99100 - 250HR ≥ 251HR x 0.8HR - 20UnchangedHR x 1.2HR + 20250Pulse Rate PR ≤ 99PR ≥ 100 PR x 0.8PR - 20 PR x 1.2PR + 20Invasive Pressure Inv Prs ≤ 2526 - 99Inv Prs ≥ 100Inv. Pressure - 5Inv. Pressure x 0.8Inv. Pressure - 20Inv. Pressure + 5Inv. Pressure x 1.2Inv. Pressure + 20NIBP NIBP ≤ 2526 - 99NIBP ≥ 100NIBP - 5NIBP x 0.8NIBP - 20NIBP + 5NIBP x 1.2NIBP + 20Respiration Rate/Breath Rate RR/BR ≤ 2526 - 99RR/BR ≥ 100RR/BR - 5RR/BR x 0.8RR/BR - 20RR/BR + 5RR/BR x 1.2RR/BR + 20Temperature Temp ≥ 0˚C Temp - 0.5 Temp + 0.5SpO2 SpO2 ≥ 0% SpO2 - 5(min. limit 50%) 100% (adult and pediatric mode)SpO2 + 5 (neonate mode)ETCO2ETCO2 ≥ 0 mmHgETCO2 ≥ 2.0 (% or kPa)ETCO2 - 5 mmHg(min. 15 mmHg)ETCO2 - 0.7 (% or kPa)(min 2.0% or 2.0 kPa)ETCO2 + 10 mmHgETCO2 + 1.4 (% or kPa)INCO2INCO2 ≥ 0 mmHgINCO2 ≥ 0 (% or kPa) Not affected by STAT SET INCO2 + 5 mmHgINCO2 + 0.7 (% or kPa)Apnea Delay Not affected by STAT SET
Propaq CS Directions for Use 55Alarms &AlertsAlarm HoldoffsTo help minimize false alarms, the monitor briefly delays or “holds off” triggering alarms for limit violations for HR/PR, SpO2, and RR/BR. After the alarm holdoff period begins, if the monitor detects that the patient’s vital sign has returned to acceptable limits, the monitor cancels the alarm holdoff. The next time a vital sign limit is violated, the monitor starts a new holdoff period.Connect Nurse Call OptionThe Propaq CS monitor can be connected to a Nurse Call system through a customized cable that connects to the left-side Nurse Call connector. When connected, the monitor immediately notifies the Nurse Call system whenever a patient alarm occurs.To connect the monitor to the Nurse Call system, you need a cable (Protocol Part Number 008-0634-XX) that has been customized for your Nurse Call system. If you do not have this cable, contact your biomedical engineering department for assistance. For specifications, see page 110.Note When an apnea alarm or patient alarm occurs, pressing the Suspend/Resume Alarm key or SUSPEND suspends the alarm tone and Nurse Call alarm for 90 seconds. However, the visual indicators on the monitor are not suspended during this time.Even though the Nurse Call option allows remote alarm indication, it does not replace appropriate bedside surveillance by trained clinicians.Vital Sign Alarm Holdoff Time PeriodHR/PR 3 seconds (except NIBP PR)SpO210 secondsRR/BR 5 secondsNurse Call Connector
56 Protocol Systems, Inc.Respond to An Equipment AlertWhen the monitor detects an equipment problem, it produces an audible alert tone every five seconds. It also displays an equipment alert message similar to the following:1. Press any key at the bottom of the screen to silence the alert tone (or press the Suspend/Resume Alarms key in the upper right corner to silence the alert tone for 90 seconds).2. Determine what caused the problem and correct it. For descriptions of equipment alert messages and suggested responses, see page 57.Sometimes an equipment alert also causes one or more patient alarms. Patient alarms have a higher priority than equipment alerts and are displayed first. Respond to the patient alarm or alarms (see page 53), then respond to the equipment alert.If you turn off any alarm limits while responding to a patient alarm, be sure to restore the appropriate alarm limits before resuming patient monitoring.NET OFFHRMON17:05:10 PRINT FAULT IIBRP1( 96)BPMmmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SD%°FMCO2SpO2mmHg 38 Br/m12ADULTON NETWORKT1T2∆TmVcm1112EQUIPMENT ALERTNIBP FAULTCUFF NOT DETECTEDPRESS ANY KEY BELOW TO ACKNOWLEDGEALLEN KIMGeneralequipment alertmessageSpecific problemPress any key tosilence the alert tone.
Propaq CS Directions for Use 57Alarms &AlertsTroubleshooting Equipment Alert MessagesECG MessagesIf a lead fault occurs, the ECG equipment alert typically shows which lead failed. If multiple leads fail, the monitor displays MULTIPLE.ECG LEAD CHANGED. The Propaq CS monitor has automatically changed an ECG lead due to a lead wire or electrode problem. LEAD FAIL: REPLACE ELECTRODES. The cable may not be properly connected to the electrodes or the electrodes may have failed. Check for proper connection; replace electrodes if needed.RESP MessagesLEAD FAIL. One or more electrodes are making very poor or no contact. Check for proper connection; replace electrodes if needed.INAPPROPRIATE ECG CABLE. ECG cable appears not to contain 1 kΩ current limiting resistors. These resistors are required for RESP operation and to protect the monitor from damage during defibrillation. Replace cable with proper type.NOISY SIGNAL, CHECK ELECTRODES. Electrodes are making poor contact and may be dried out. Replace electrodes.IBP MessagesTRANSDUCER NOT DETECTED. The transducer connection is broken.TRANSDUCER SHORT CIRCUIT. This message appears when the Propaq CS monitor senses a short in the transducer. The transducer should be replaced.INCOMPATIBLE TRANSDUCER. Check the compatible transducers listed in the Protocol Systems Products and Accessories booklet to confirm you are using a compatible transducer.NIBP MessagesIf an error number (ERR# x) is listed in an NIBP trend printout or display, it indicates that the corresponding NIBP equipment alert occurred.AIR LEAK, CHECK HOSE (ERR# 1). The Propaq CS monitor could not properly inflate cuff. Check the hose and cuff for obvious leaks, such as the O-rings in the hose connections.CUFF NOT DETECTED (ERR# 2). During cuff inflation the detected pressure did not sufficiently rise. Check that the cuff connection is tight and take the measurement again.KINKED HOSE, CHECK HOSE (ERR# 3). The Propaq CS monitor could not properly inflate cuff. Check for a kinked hose between the monitor and the patient.
58 Protocol Systems, Inc.OVERPRESSURE CONDITION (ERR# 4). The pressure in the cuff exceeded the acceptable limits for patient mode. Check the hose and try taking another measurement.WEAK PULSES, CAN'T FIND SYS/DIA (ERR# 5). There are not enough pulses to determine the systolic or diastolic pressures, but a mean pressure is available. Try reapplying the cuff after squeezing as much air from it as you can.ARTIFACT, CAN’T FIND SYS/DIA (ERR# 6). The systolic or diastolic pressures are unreliable due to artifact, but a mean pressure is available. May be caused by patient motion.NO PULSES DETECTED (ERR# 7). The cuff may not be properly applied to the patient, or the patient may not have detectable pulses due to shock or arrhythmias.Warning The Propaq CS monitor cannot differentiate between physiologic and cuff application causes of the NO PULSES DETECTED message. Always evaluate the patient for presence of life threatening conditions whenever this message occurs.CONNECT ECG TO REDUCE NIBP ARTIFACT (ERR# 8). NIBP artifact prevents a valid reading. Connect ECG electrodes to improve NIBP measurements.NO VALID BLOOD PRESSURE FOUND (ERR# 9). This message can occur due to motion artifact, the Propaq CS monitor being set in the wrong patient mode, or the wrong hose or cuff being used in relation to the patient mode.CALIBRATING, PLEASE WAIT (ERR# 10). The Propaq CS monitor periodically recalibrates the NIBP channel to ensure it can properly make NIBP determinations. Normal monitor operation continues while the NIBP channel is calibrating. If the NIBP channel has not updated its calibration in 15 minutes, the channel will briefly deactivate until a new calibration has occurred.LOW BATTERY, NIBP DISABLED (ERR# 11). The battery lacks sufficient voltage to be able to operate the NIBP channel. Connect the Propaq CS monitor to the ac power adapter.SERVICE REQUIRED, NIBP DISABLED (ERR# 12). Have the monitor serviced.CUFF TOO LARGE FOR PATIENT MODE (ERR# 13). The monitor detects a cuff too large for the current patient mode. First, verify the patient mode. If the patient mode is correct, confirm the cuff size is correct and make sure the cuff fits snugly. If this alert occurs in Neonatal Mode, change the patient mode to Pediatric Mode and check the alarm limits. If the alert occurs in Pediatric Mode, change to Adult Mode and check the alarm limits. Note that different pressures and retries are used for each mode as stated in “NIBP Specifications” on page 104.KINKED OR NEONATE HOSE (ERR# 14). This message occurs when a hose is kinked or when a neonate hose is detected in the adult patient mode. Check the hose or the patient mode selection.ARTIFACT PRESENT, MINIMIZE ARTIFACT (ERR# 15). The monitor has detected too much artifact to allow accurate readings. Take steps to reduce artifact. Position the patient’s limb away from the body so the applied cuff is not in contact with the patient’s body or any other object such as a bed rail. If the Smartcuf motion artifact filter is on, make sure that the ECG leads are properly connected to perform ECG monitoring during NIBP. If the Smartcuf motion artifact filter is off, consider turning it on (and connect ECG if not already connected).
Propaq CS Directions for Use 59Alarms &AlertsThe following messages can appear in the NIBP status window.CALIBRATING. The NIBP channel is running an internal calibration.DISABLED, LOW BATT. See LOW BATTERY, NIBP DISABLED above.NIBP DISABLED, SERVICE REQUIRED. See SERVICE REQUIRED, NIBP DISABLED above.RETRY. Since the Propaq CS monitor did not receive a valid NIBP reading, it will automatically attempt to take another reading.The following NIBP status message looks similar to an equipment alert, although it does not indicate a malfunction and does not cause an alert tone.NIBP IN PROGRESS, PLEASE WAIT, FILTERING ARTIFACT. Noise or artifact such as vehicle motion is causing a delay while measuring NIBP. To remove the message, press any key below the screen. To cancel the NIBP measurement, press the Start/Stop NIBP key at the right of the screen.Temperature MessagesPROBE NOT DETECTED. This message occurs when the Propaq CS monitor has successfully measured temperature and a probe is then disconnected. Reconnect the probe or acknowledge the equipment alert by pressing any menu key.PROBE SHORT. Verify that the probe is properly inserted in the left side panel. If so, replace probe.CALIBRATION ERROR, TEMP DISABLED. This message appears when the Propaq CS monitor has detected that it cannot accurately measure the temperature. The monitor should be serviced.Malfunction of the temperature probes may result in inaccurate readings. Confirm suspect readings.SpO2 MessagesSpO2 messages can appear in the equipment alert window or in the SpO2 numeric window.NO SENSOR DETECTED. Indicates an SpO2 sensor has been disconnected from the monitor after being plugged in for more than a few seconds.SEARCH: During this search time, the SpO2 channel tries to detect blood pulsing through the measurement site. After the measurement has been established, the oxygen saturation value is displayed in the numeric window.STANDBY is displayed in the numeric window when the SpO2 sensor is disconnected from the patient, an alarm occurs, and you press the STANDBY key. STANDBY is also displayed if you first plug the SpO2 sensor cable into the monitor connector before attaching the SpO2 sensor to the patient.
60 Protocol Systems, Inc.Mainstream CO2 MessagesMessages for the Mainstream CO2 option can appear in the equipment alert window and in numeric zones. If a sensor is damaged, contact Protocol Systems’ Technical Services Department for information on sensor service options.ALTIMETER FAILURE - RANGE. The Propaq CS monitor is operating at an altitude outside the Mainstream CO2 option’s operating altitude range of -2,000 to 15,000 feet. Returning the monitor to within this range automatically cancels this message and restores operation.ALTIMETER FAILURE - RATE. The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg/minute. When the rate of change is back within the 100 mmHg/minute range, disconnect and reconnect the CO2 sensor to the Propaq CS monitor.DEGRADED WAVEFORM - CHECK ADAPTER (UNCAL appears in the numerics area). The Mainstream CO2 adapter is obstructed or the CO2 sensor has failed. The CO2 waveform is displayed without range values. Replace the adapter or replace the sensor. LACK OF WAVE - CHECK ADAPTER, SENSOR. Either the airway adapter is obstructed or the CO2 sensor has failed. Replace the airway adapter if it is obstructed. The sensor must be unplugged and plugged in again.LOW BATTERY - HEATER DISABLED (UNCAL appears in the numerics area). The monitor’s battery voltage is too low. The CO2 waveform is displayed without range values. To continue operation, supply ac power to the monitor.NO MAINSTREAM SENSOR DETECTED (SRCH appears in the numerics area). The Mainstream CO2 sensor has been disconnected from the Propaq CS monitor after providing CO2 values. Disconnect and reconnect the sensor to the monitor if necessary.NON-PROTOCOL SENSOR (UNCAL appears in the numerics area). A CO2 sensor has been connected that does not match Protocol’s specifications. The CO2 waveform is displayed without range values. Replace the sensor with a Protocol Systems CO2 sensor.SENSOR FAILURE - CALIBRATION ERROR. A sensor is defective or out of calibration and disabled. Replace the sensor.SENSOR FAILURE - EEPROM. The sensor has failed. Replace the sensor.SENSOR FAILURE - HEATER. The sensor’s temperature control circuit or the monitor’s CO2 circuitry has failed. Try replacing the sensor. If the message reappears, have the monitor serviced.SENSOR FAILURE - MOTOR DRIVE. The sensor’s motor drive (in the sensor head) has failed. Replace the sensor.SENSOR TEMPERATURE TOO HIGH. The sensor’s temperature is too high. The sensor’s ambient operating range is 10° to 46° C. When the ambient temperature returns to this range, this message is automatically removed and operation is restored.The following messages can appear in the numerics display area.OFF. No CO2 source is selected.SRCH. The sensor is preparing for a measurement.UNCAL. The monitor has detected a problem such as a lack of calibration, an obstruction, or a low battery.WARM UP. The sensor heater is warming up. Wait 20 to 30 seconds for the sensor to heat. Values should appear in the numerics area when the sensor is sufficiently warm.
Propaq CS Directions for Use 61Alarms &AlertsSidestream CO2 MessagesALTIMETER FAILURE - RANGE. The Propaq CS monitor is operating at an altitude outside the Sidestream CO2 option’s operating altitude range of -2,000 to 15,000 feet. Returning the monitor to within this range automatically cancels this message and restores operation.ALTIMETER FAILURE - RATE. The altimeter has detected that the ambient pressure is changing at a rate greater than 100 mmHg/minute. When the rate of change is back within the 100 mmHg/minute range, disconnect and reconnect the CO2 sensor to the monitor.ALTIMETER NOT CALIBRATED - EEPROM - The Sidestream CO2 option has not been calibrated. Refer the Propaq CS monitor to a biomedical engineer for calibration.AMBIENT TEMPERATURE TOO HIGH. The sensor temperature is too high. The Sidestream CO2 option is disabed until the ambient temperature is within the operating range specifications.AMBIENT TEMPERATURE TOO LOW. The sensor temperature is too low. The Sidestream CO2 option is disabed until the ambient temperature is within the operating range specifications.CALIBRATION ERROR - SERVICE REQUIRED. Send the Propaq CS monitor to a biomedical engineer for service.DEGRADED WAVEFORM - SERVICE REQUIRED. Send the Propaq CS monitor to a biomedical engineer for service.LACK OF WAVEFORM - SERVICE REQUIRED. Send the Propaq CS monitor to a biomedical engineer for service.MOTOR FAILURE - SERVICE REQUIRED. The sensor hardware has failed. Send the Propaq CS monitor to a biomedical engineer for service.NO WATERTRAP DETECTED. There is no Sidestream CO2 watertrap installed. Install a watertrap.OCCLUSION - CHECK EXHAUST PORT/TUBING. Blockage has been detected on the pneumatic exhaust port. Check the exhaust port and related tubing for occlusions. Make sure that the sampling line and any inputs to the patient breathing apparatus are not connected to the exhaust port.OCCLUSION - CHECK WATERTRAP/TUBING. Blockage has been detected on the Sidestream CO2 input. Check the watertrap, sample line, and any connected tubing for occlusion.PUMP FAILURE, SERVICE REQUIRED. The pump is not able to maintain the target flow rate. Send the Propaq CS monitor to a biomedical engineer for service.SIDESTREAM STICK EEPROM FAILURE. Send the Propaq CS monitor to a biomedical engineer for service.SSP BOARD EEPROM FAILURE. Send the Propaq CS monitor to a biomedical engineer for service.The following messages can appear in the numerics display area.OFF. No CO2 source is selected.SRCH. The sensor is preparing for a measurement.START UP. Sidestream CO2 has been activated and is preparing for operation. This typically requires 30 seconds at room temperature.UNCAL. The monitor has detected a problem such as a lack of calibration, an obstruction, or a low battery.
62 Protocol Systems, Inc.Network Alert Message with AcuityNETWORK FAULT, CHECK ACUITY/DATA COMM CONNECTION. The Propaq CS monitor detects a problem in communication with Acuity. Check the Acuity network cable to be sure it is plugged in to the side panel and to the bedside jack. If the cable is damaged, replace the cable. If the cable appears undamaged and the Acuity system is operating normally, ask your service personnel to check the network and the Propaq CS monitor Acuity connector.Program Alert MessagePROGRAM FAULT, SETTINGS LOST, TIME/DAY RESET. At powerup, the monitor cannot recall the programmed Custom patient mode settings and current time and date. This can occur if the battery is drained or after new software has been installed.If this occurs, the monitor provides a special sequence of display windows to help you regain use of your monitor as quickly as possible. Do the following:1. Connect an ac power adapter to recharge the battery (if the battery is drained).2. Press any key below the equipment alert screen to acknowledge the alert. The monitor displays the Mode Setup window (shown on page 23).3. Press these keys to select one of the Factory patient modes for use:• Factory Adult mode: POWERUP*, YES.• Factory Pediatric mode: NEXT, POWERUP*, YES.• Factory Neonatal mode: NEXT, NEXT, POWERUP*, YES.After you press YES, the monitor displays the Time/Day window.4. Press NEXT, UP, and DOWN as needed to set the time and date. Then press ENTER to store the new time and date.5. Turn off the monitor, then turn it on again so the settings will take effect.The monitor is ready for use. To store customized patient mode settings, refer to page 24.If you follow these steps and the equipment alert reappears at powerup, the monitor may need to be serviced and the battery replaced. Contact a qualified service person.Note These display screens are only displayed in this order if the PROGRAM FAULT equipment alert occurs.
Propaq CS Directions for Use 63Alarms &AlertsPrinter Alert MessagesCHECK DOOR. The door on the bottom of the printer is open. Close the door to remove this message.LOW BATTERY, PRINTER DISABLED. The monitor’s battery voltage is too low to support printing. Connect the ac power adapter to recharge the battery (see page 87).OVERHEATING. The printer is overheating. Service may be required.PAPER OUT. To add printer paper, see page 90.Defibrillator Alert MessageDEFIB FAULT, CHECK INTERFACE CABLE. The monitor detects a problem with the interface cable. Check the cable and defibrillator.Very Low Battery Alert MessageVERY LOW BATTERY, PLUG IN EXTERNAL POWER ADAPTER. The monitor battery needs to be recharged. Connect the ac power adapter to recharge the battery (see page 87).If the battery is not recharged, the monitor will begin to disable monitor functions and eventually turn off completely.
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Printing &Trends5 – Printing & TrendsPrint Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Print the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Display or Print Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Display or Print a Single Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68Print Multiple Trends Manually or Automatically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69Delete All Patient Trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69Set Printer Options and Automatic Printing. . . . . . . . . . . . . . . . . . . . . . . . 70Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
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Propaq CS Directions for Use 67Printing &TrendsPrint Patient DataPrint the Displayed Waveforms1. Press SNAPSHOT or START/STOP. The Propaq CS monitor prints up to three of the displayed waveforms.When four waveforms are displayed, the monitor prints the top three displayed waveforms (except for the ECG2 waveform which is never printed).If you pressed START/STOP, the monitor continues to print until you press START/STOP again.Note This symbol indicates the NIBP reading was taken in the presence of high artifact while monitoring ECG with the Smartcuf motion artifact filter on. Artifact can affect accuracy. To help reduce artifact, see page 39, step 6.STARTSTOPSNAPSHOTPRINTTRENDSManually starts and stops a printout of patient information as it is monitored (continuous or real time).Prints all trends that are enabled in the Printer Setup Page (see page 69).Prints the last 8 seconds of data for nonrespiration waveforms and 32 seconds of compressed waveform history for respiration waveforms.The numerics across the top of the printout apply to the moment you press SNAPSHOT.Printer Buttons
68 Protocol Systems, Inc.Display or Print TrendsDisplay or Print a Single Trend1. To display a patient data trend, press SETUP, TRENDS from the Main Menu. The monitor displays the Trend Menu:Trends are also displayed on the Main Menu if all waveforms except ECG1 are turned off in the Wave Select Window.2. Press NEXT TREND as needed to display the desired trend.3. Press PRINT to print the displayed trend.Note This symbol indicates the NIBP reading was taken in the presence of high artifact while monitoring ECG with the Smartcuf motion artifact filter on. Artifact can affect accuracy. To help reduce artifact, see page 39, step 6.RESP TRENDTIMEMON IIBRP1( 96) mmHg(M)TEMP 100.498.61.897121 79SDP2( 15) mmHg(M) 259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDPRINT PRINTOXYCRGT1T2∆TmVcm1112BPM10:00 9:58 9:56 9:54 9:52 9:50 9:48 9:46 9:44 9:42HH:MMHR/PR SpO2RR/BRBPM % Br/M9898979899989898 97 9712121212122112121212SRCH OFF 98 94 97 97 98 98ETCO2INCO2mmHg38383838383838383838mmHg333333333311210112NEXTTRENDPress to scroll through the recorded trends.Press to print the displayed trend.The monitor storestrends every 2 minutes(except for NIBP) for upto 5 hours. After 5hours, newly recordedtrends replace theoldest trends.NIBP trends are storedwhen measured. Up to128 NIBP trends can bestored (up to 8 hours).The TIME, HR/PR, andSpO2 are stored for alltrends.OFF indicates the vitalsign was not beingmonitored.ERR#x in an NIBPTREND display orprintout indicates anNIBP equipment alertoccurred. See page 57for NIBP alert errornumbers anddefinitions. Press to scroll to the next vital sign trend (IBP, TEMP, and NIBP). Press to print OxyCRG (see page 71).Numerics that have alarmed are highlighted.NIBP TRENDTIMEBRTEMP 100.498.61.897P2( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDPRINTT1T2∆T10:01 9:46 9:31 9:20 9:08 8:52 8:47 8:41 8:35 8:30HH:MMHR/PR SpO2S D (M) RR/BRBPM % mmHg Br/M8080808080808080808097979797979797979797122 58 ( 85)126 62 ( 86)127 62 ( 86)134 66 ( 89)124 57 ( 86)127 58 ( 88)124 56 ( 85)126 57 ( 84)127 58 ( 85)132 61 ( 89)12121212121212121212PRINTOXYCRGNEXT TREND12
Propaq CS Directions for Use 69Printing &TrendsPrint Multiple Trends Manually or Automatically1. Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page:2. Press NEXT as needed to scroll down to the parameters listed below AUTO TREND (NIBP, RESP, etc.).3. Press NEXT and CHANGE to set desired trends to ON.4. To manually print all selected trends, press PRINT TREND on this page or press PRINT TRENDS on the bottom front panel of the monitor.You can print all selected trends at any time by pressing this PRINT TRENDS button.5. To program the monitor to automatically print selected trends every four hours, press NEXT as needed to highlight AUTO TREND, then press CHANGE to select the hours for printing.For example, if you select 01 05 09 13 17 21 at 4:27, the printer will automatically print selected trends first at 5:00, then 9:00, etc.Delete All Patient Trends1. To delete all trends recorded for a patient, turn off the monitor.PRINTERBRTEMP 100.498.61.897P2( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTT1T2∆TPREVIOUSMENUSETUP PAGEAUTO TREND : 01 05 09 13 17 21CONTINUOUSAUTO PRINTALARM PRINTNIBP TICKET APNEA TICKET OXYCRG ON ALARM NIBP : ON RESP : OFF P1 : ON: 25.0 mm/s: OFF: OFF: OFF: ON: OFF P2 : OFFCHANGE PRINTTRENDTEMP : OFF12Press to print all selected trends.Press to scroll to the next selection. Press to change the displayed value.Specifies what time the trendsautomatically print. Trends are printedevery 4 hours beginning at either01, 02, 03, or 04 hours.(OFF=no printing.)Select ON to include in trend printing.
70 Protocol Systems, Inc.Set Printer Options and Automatic Printing1. Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page:2. Press NEXT and CHANGE as desired to set printer options.CONTINUOUS Set the speed for continuous printing: 6.25, 12.5, or 25.0 mm/s.AUTO PRINT Automatically print a waveform snapshot at the specified interval: 15 or 30 minutes, or 1, 2, or 4 hours (or OFF).ALARM PRINT If ON, automatically prints patient data whenever a patient alarm occurs, beginning with 12 seconds of patient data history stored before the alarm occurred.Printing continues for 20 seconds after you suspend the alarm. To immediately stop printing, press START/STOP.Note Because the Alarm Print begins with the 12 seconds of patient data stored before the alarm occurred, the monitor stores and prints all Alarm Print data 12 seconds after the patient data appears on the display. The time annotated on the Alarm Print indicates the time the data was recorded.NIBP TICKET If ON, automatically prints an NIBP TICKET with NIBP data whenever NIBP is measured.APNEA TICKET If ON, automatically prints an APNEA TICKET with apnea data after the patient resumes breathing and/or every minute the apnea alarm continues.OXYCRG ON ALARM If ON, automatically prints an OxyCRG whenever an SpO2, HR/PR, RR/BR, or apnea patient alarm occurs (see page 71).If an SpO2 or HR/PR alarm occurs, the OxyCRG prints 60 seconds later. If an Apnea or RR/BR alarm occurs, the OxyCRG prints 75 seconds later. Highlighted labels in the printout indicate which alarms occurred.AUTO TREND Automatically print trends at the selected hours. Only the parameters set to ON (for NIBP, RESP, P1, P2, or TEMP) are included in trend printouts.PRINTERBRTEMP 100.498.61.897( 15)mmHg(M)259SDNIBP( 85)mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTT1T2∆TPREVIOUSMENUSETUP PAGEAUTO TREND : OFFCONTINUOUSAUTO PRINTALARM PRINTNIBP TICKET APNEA TICKET OXYCRG ON ALARM NIBP : ON RESP : OFF P1 : ON: 25.0 mm/s: OFF: OFF: OFF: ON: OFF P2 : OFFCHANGE PRINTTRENDTEMP : OFF12Press to print all selected trends.Press to scroll to the next selection. Press to change the displayed value.
Propaq CS Directions for Use 71Printing &TrendsPrint OxyCRGThe OxyCRG is a printout of two minutes of continuous HR/PR and SpO2 numerics, and a compressed respiratory waveform.1. To print OxyCRG, from the Main Menu press SETUP, TRENDS, PRINT OXYCRG. If any of the parameters have been completely inactive for the two minutes prior to the printout, the associated band is empty.
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Acuity6 – AcuityConnect the Monitor to the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . 75Print at Acuity from the Propaq CS Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76Disconnect the Monitor from the Acuity System. . . . . . . . . . . . . . . . . . . . .76
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Propaq CS Directions for Use 75AcuityConnect the Monitor to the Acuity SystemWarning Connect the Propaq CS monitor to an Acuity system only. Connecting to other networks could damage the monitor or injure the patient. If in doubt about the network jacks or devices, consult your facility’s Biomedical Engineering Department.Make sure the Acuity network cable is not damaged. The Acuity network cable is the sole link between the Propaq CS monitor and the Acuity Central Station.If you don’t set alarm limits, the Acuity system uses preset settings (for arrhythmia test limits), and the powerup default settings for the Propaq CS monitor.Use the Acuity System in compliance with the instructions in this Propaq CS Directions for Use, the Acuity System Reference Guide, and accepted hospital and clinical protocols.1. If the Propaq CS monitor has already been connected to the patient, save the patient’s Trends and Alarm Limit settings by keeping the monitor turned on.The monitor transmits up to five hours of trend information when you connect it to the Acuity network.If the monitor has not been connected to the patient, clear any prior patient’s trends and alarm limit settings by turning off the monitor, then turning it on after a few seconds.2. If the monitor is not already connected to the patient, attach leads and sensors to the patient as described in this reference guide.For neonatal patients, use all Acuity features except the Protocol Cordless Acuity and the ST and arrhythmia detection options.Caution Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards (e.g., EN 60950 for data processing equipment and EN 60601-1 for medical equipment). Furthermore, all configurations shall comply with the system standard IEC 601-1-1. Anyone connecting additional equipment to the signal input or output connectors is configuring a medical system, and is therefore responsible that the system complies with the requirements of the system standard IEC 601-1-1. If in doubt, consult your Biomedical Engineering Department.
76 Protocol Systems, Inc.3. Plug in the Acuity network cable to the Acuity network jack on the monitor side panel as shown. Plug in the other end of the cable to the bedside Acuity network jack.4. Connect the ac power adapter to the monitor and the wall outlet to charge the battery (see page 87 for instructions). Check to see that the green battery charging light on the monitor’s right side panel is on.5. Confirm the patient identification at the bedside or enter the patient information at the Acuity Central Station using the Patient ID Setup Window.6. If alarm limits have not been set, do so at the monitor or at the Acuity Central Station using the Alarms Setup Window.Note When a Propaq CS monitor in Adult or Pediatric Mode is connected to an Acuity System, the audible alarms at the bedside Propaq CS monitor can be delayed up to 4 minutes and 15 seconds. The delay time is selected in Acuity software at the time of Acuity installation. Visual alarm indications are not delayed.Print at Acuity from the Propaq CS Monitor1. To print a waveform displayed on the bedside Propaq CS monitor screen at the Acuity printer, press SETUP, ACUITY, SNAPSHOT.Disconnect the Monitor from the Acuity System1. To permanently disconnect the Propaq CS monitor from the Acuity network, press the NET OFF key on the upper left corner of the monitor display (or from the Main Menu press SETUP, ACUITY, NET OFF).2. Within 15 seconds, disconnect the Acuity network cable from either the Propaq CS monitor side panel or the bedside jack. If the patient will no longer be monitored with this monitor, turn off the monitor to erase trend information.If you want to temporarily disconnect the Propaq CS monitor from the Acuity network and reconnect the same patient to the Acuity network later, see the Acuity System Reference Guide.DEFIB SYNCHROMONITOREKG x 1000!3A2AG!!!12-28V, 3AAcuity ConnectorBattery charging lightPower input connectorADULTMON17:05:10 PRINT FAULT IINETOFF ON NETWORKmVcm1ALLEN KIMPress to disconnect from Acuity
DefibrillatorSynchronization7 – Defibrillator SynchronizationSynchronous Cardioversion with LIFEPAK 5 Defibrillator. . . . . . . . . . . . 79Install the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Perform Synchronous Cardioversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80Remove the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Synchronous Cardioversion with LIFEPAK 6s Defibrillator. . . . . . . . . . . 82
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Propaq CS Directions for Use 79DefibrillatorSynchronizationSynchronous Cardioversion with LIFEPAK 5 DefibrillatorWarning Use only the correct Protocol Systems cable with the LIFEPAK 5 Defibrillator as listed in the Protocol Systems Products and Accessories guide when performing synchronous cardioversion. (This cable contains circuitry in addition to wiring.) The use of any other cable will result in incorrect operation.The Defibrillator Synchronization option is designed to operate only with the LIFEPAK 5 or LIFEPAK 6s defibrillator. These instructions are not intended to replace existing hospital procedures for cardiac electrical therapy and operation of the Physio-Control LIFEPAK 5 defibrillator. Follow all safety standards and clinical protocols as defined by your institution.Install the Interface Cable1. Before installing the LIFEPAK 5 Defibrillator Synchronization Interface Cable (P/N 008-0136-XX) on the defibrillator, examine the contacts on the left side of the LIFEPAK 5 defibrillator. Make sure the contacts are clean in order to allow good signal transmission to the Propaq CS monitor. 2. Slide the Interface Cable onto the left side of the defibrillator as shown until it snaps in place.3. Connect the other end of the Interface Cable to the DEFIB SYNCHRO connector on the monitor right side panel.Contact points
80 Protocol Systems, Inc.Perform Synchronous Cardioversion1. Set up the LIFEPAK 5 Defibrillator and any other instrumentation according to institutional procedures and manufacturer’s operating instructions.2. Confirm the monitor displays an ECG waveform with tall, distinct R-waves and minimal artifact. Warning The R-wave amplitude must be at least 0.5 mV (5 mm tall when the Propaq CS monitor ECG SIZE is set to 1 mV/cm) to guarantee that the defibrillator sync pulse will occur no later than 35 milliseconds after the peak of an R-wave.1 Reposition the patient electrodes or change the Propaq CS monitor lead selection as necessary to ensure sufficient ECG waveform amplitude. However, make sure the R-wave amplitude is not so high that it obscures the displayed sync markers.3. With the defibrillator turned on, press the defibrillator SYNC button. Confirm the SYNC button light turns on.4. Check the monitor display for synchronization markers as shown. The markers should be nearly simultaneous with the R-waves. Confirm the SYNC button also flashes with each R-wave.1. As a visual gauge for estimating R-wave amplitude, the ‘V’ of the mV/cm label to the left of the ECG waveform is about 4 mm in height. With the Propaq CS monitor ECG sensitivity set to 1 mV/cm, compare the letter ‘V’ with the height of the R-wave, which should be at least 5 mm tall.SYNCONLYWITHLP53 LEADOR SYNCMODELCARDIO-SCOPESSYNC(PUSH)SYNC buttonT FHRN17:05:10 PRINT FAULTIP1( 96)BPMmmHg(M) 121 79SDP2(M)25SADULTON NETWORKmVcm1112ALLEN KIMSynchronization markers
Propaq CS Directions for Use 81DefibrillatorSynchronizationWarning If the R-wave synchronization markers do not appear to be nearly simultaneous with the R-waves on the Propaq CS monitor display or are not present, do not proceed with synchronized cardioversion. You must press the LIFEPAK 5 Defibrillator SYNC button and check for appropriate synchronization markers on the Propaq CS monitor before each attempt at cardioversion. Protocol Systems cannot guarantee the delay from the sync marker to the defibrillator discharge.Note A problem with the Interface Cable connecting the defibrillator and monitor, such as a cable fault or unplugging the cable, will prevent display of synchronization markers and may prevent the defibrillator from entering the synchronized mode.5. Follow hospital procedures and LIFEPAK 5 Defibrillator instructions for cardioversion.6. If subsequent cardioversion must be performed, repeat steps 3 through 5.Remove the Interface Cable1. Disconnect the Interface Cable from the monitor.2. Press the lever on the side of the LIFEPAK 5 Defibrillator and slide the Interface forward until it is detached.3. Store the Interface Cable in its static-protected plastic bag.
82 Protocol Systems, Inc.Synchronous Cardioversion with LIFEPAK 6s DefibrillatorWarning Use only the correct Protocol Systems cable with the LIFEPAK 6s Defibrillator as listed in the Protocol Systems Products and Accessories guide when performing synchronous cardioversion. (This cable contains circuitry in addition to wiring.) The use of any other cable will result in incorrect operation.Note The Physio-Control LP6s Defibrillator Sync Connector/Cover (Physio-Control P/N 801297-00) must be installed before you can connect it to the Propaq CS monitor.The Defibrillator Synchronization option is designed to operate only with the LIFEPAK 5 or LIFEPAK 6s defibrillator. These instructions are not intended to replace existing hospital procedures for cardiac electrical therapy and operation of the Physio-Control LIFEPAK 6s defibrillator. Follow all safety standards and clinical protocols as defined by your institution.1. Set up the LIFEPAK 6s Defibrillator and any other instrumentation according to institutional procedures or manufacturer’s operating instructions.2. Confirm the monitor displays an ECG waveform with tall, distinct R-waves and minimal artifact. Warning The R-wave amplitude must be at least 0.5 mV (5 mm tall when the Propaq CS monitor ECG SIZE is set to 1 mV/cm) to guarantee that the defibrillator sync pulse will occur no later than 35 milliseconds after the peak of an R-wave.1 Reposition the patient electrodes or change the Propaq CS monitor lead selection as necessary to ensure sufficient ECG waveform amplitude. However, make sure the R-wave amplitude is not so high that it obscures the displayed sync markers.3. Connect the monitor end of the LIFEPAK 6s Defibrillator Synchronization Cable (P/N 008-0154-XX) to the DEFIB SYNCHRO connector on the Propaq CS monitor right side panel.1. As a visual gauge for estimating R-wave amplitude, the ‘V’ of the mV/cm label to the left of the ECG waveform is about 4 mm in height. With the Propaq CS monitor ECG sensitivity set to 1 mV/cm, compare the letter ‘V’ with the height of the R-wave, which should be at least 5 mm tall.
Propaq CS Directions for Use 83DefibrillatorSynchronization4. Connect the other end of the cable to the SYNC connector at the top rear of the LIFEPAK 6s Defibrillator. 5. With the LIFEPAK 6s turned on, press the SYNC button on the front control panelThe SYNC button lights when activated.6. Check the Propaq display for synchronization markers as shown on page 80. The markers should be nearly simultaneous with the R-waves. Confirm that the LIFEPAK 6s SYNC button flashes with each R-wave.Warning If the R-wave synchronization markers do not appear to be nearly simultaneous with the R-waves on the Propaq CS monitor display or are not present, do not proceed with synchronized cardioversion. You must press the LIFEPAK 6s Defibrillator SYNC button and check for appropriate synchronization markers on the Propaq CS monitor before each attempt at cardioversion. Protocol Systems cannot guarantee the delay from the sync marker to the defibrillator discharge.Note A problem with the Interface Cable connecting the defibrillator and monitor, such as a cable fault or unplugging the cable, will prevent display of synchronization markers and may prevent the defibrillator from entering the synchronized mode.7. Follow hospital procedures and LIFEPAK 6s Defibrillator instructions for cardioversion.8. If subsequent cardioversion must be performed, repeat steps 5 through 7.123SYNCINTRNLPADDLEDISCHGPOWER CHARGE100 15020030036050302010 5ENERGY SELECTDELIVERED ENERGY –– JOULESHAZARDOUS ELECTRICAL OUTPUT. THIS EQUIPMENTIS FOR USE ONLY BY QUALIFIED MEDICAL PERSONNEL.CAUTIONPHYSIO-CONTROLPHYSIO-CONTROLLIFEPAKLIFEPAK66ssDEFIBRILLATORSYNC
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Maintenance8 – MaintenanceConnect the AC Power Adapter to Recharge the Battery. . . . . . . . . . . . . 87Replace Power Adapter Fuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88Replace Monitor Input Power Fuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90Inspect and Clean the Monitor and Accessories. . . . . . . . . . . . . . . . . . . . 91Service Interval Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92Monitor Recycling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92Battery Recycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92Extended Storage Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
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Propaq CS Directions for Use 87MaintenanceConnect the AC Power Adapter to Recharge the BatteryWarning Use only the Protocol Systems ac power adapter and power cord appropriate for your location and ac power source as listed in the Protocol Systems Products and Accessories booklet. Use of other power adapters or power cords could cause a current leakage hazard or damage the Propaq CS monitor.Place the power adapter where it cannot fall and harm someone.Caution Leaving the monitor's lead-acid batteries in a completely discharged state may result in permanent battery damage. The batteries should be kept fully charged. When the Propaq CS monitor battery voltage is low, the monitor displays the message LOW BATTERY at the top of the screen or the equipment alert message VERY LOW BATTERY, PLUG IN EXTERNAL POWER ADAPTER. You should connect an ac power adapter as soon as possible to recharge the battery.If the battery is not recharged, the monitor will begin to disable monitor functions and eventually turn off completely.1. Before connecting the ac power adapter, check the adapter power setting in the small window next to the power cord connector. Make sure the setting matches your ac power source (either 100V-120V or 200V-240V).If it does not match, send it to your service department.2. Plug the ac adapter power cord into the ac power adapter and the ac power source outlet.3. Plug the ac adapter cord into the power input connector on the right side of the monitor.4. Confirm that the green battery charging light is on. The ac power adapter charges the battery even when monitor power is off. If monitor power is off, the battery charges to full capacity within 8 hours.If the green light is not on, check all connections and make sure the ac power source is on.If the green light is still not on, fuses may need replacement in the ac power adapter or the monitor. Contact your service department.Power settingDEFIB SYNCHROMONITOREKG x 1000!3A2AG!!!12-28V, 3APowerinputconnectorGreenbatterycharginglightRight Side Panel
88 Protocol Systems, Inc.Replace Power Adapter FusesIf the green battery charging light is off and the ac power adapter does not provide power to the monitor even when all connections are intact, the adapter fuses may need to be replaced. This procedure must be performed by a qualified service person. To change fuses:1. Unplug the removable power cord from the ac power source and adapter.2. Using a small, flat-blade screwdriver, carefully pry the fuse module away from the adapter.3. Remove and replace both fuses with the correct type specified on the adapter. The fuse module can contain spare fuses.Note Replace both fuses at the same time, even if only one fuse has opened due to an overcurrent situation. The unopened fuse may be damaged and unreliable.Caution Spare fuses are contained in housings next to the fuses in the fuse module as shown in the illustration. Between the fuses is a small printed-circuit board (PCB) that sets the power adapter to the desired ac mains voltage. When handling the fuse module, the PCB may slide out.Make sure the voltage selector indicates the proper ac input voltage. If you change the adapter voltage setting, you must replace all fuses to match the appropriate type specified on the bottom of the power adapter. The only fuses contained in the power adapter when shipped from the factory are fuses specified for the original adapter input voltage setting.Replace each fuse only with the specified type (see page 114).If the small PCB between the fuses has slipped out of place, slide it back into place in the fuse module, and verify that the voltage setting indicated in the window on the fuse module is correct. If the voltage setting is incorrect, simply slide the PCB out of the fuse module, rotate it 180° and slide it back into place.FusePowerSwitchVoltageSelector andIndicatorSpare FuseFuse ModulePower Adapter
Propaq CS Directions for Use 89MaintenanceReplace Monitor Input Power FuseIf the green battery charging light is off and the ac power adapter does not provide power to the monitor even when all connections are intact, the monitor’s input power fuse may need to be replaced. This procedure must be performed by a qualified service person. To change fuses:1. Disconnect the monitor from the patient and turn off the monitor.2. Disconnect the ac power adapter from the monitor.3. Using a small, flat-blade screwdriver, turn the fuse carrier counterclockwise to release it.4. Remove the fuse carrier and replace the fuse with the type 3A/250V, 2AG.DEFIB SYNCHROMONITOREKG x 1000!3A2AG!!!12-28V, 3APowerinput fuseholderGreenbatterycharginglightRight Side Panel
90 Protocol Systems, Inc.Install Printer PaperCaution Use only low-debris printer paper listed in the Protocol Systems Products and Accessories booklet. Use of other paper can cause unclear printing of patient data, printhead damage, and eventual printer failure. Store all paper (including a monitor loaded with paper) in compliance with paper storage specifications (see page 113).1. Lay the monitor on its back to gain access to the bottom of the printer.2. Squeeze the locks on the paper door and pull out to open it.3. Lift the paper roll from the holder and pull out any paper remaining in the printer.4. Place the new paper roll onto the spindle on the door as shown, and pull out several inches of paper.5. Slide the end of the paper into the printer slot until it extends out the side.6. Close the paper door and turn the monitor upright.7. Simultaneously press the START/STOP and PRINT TRENDS button. Confirm the monitor prints a test print similar to the following:
Propaq CS Directions for Use 91MaintenanceInspect and Clean the Monitor and AccessoriesBefore cleaning, thoroughly inspect the monitor and all accessories for any signs of damage, cracks, or improper mechanical function of keypads, switches, connectors, and printer paper door. While gently bending and flexing cables and tubing, inspect for damage, cracks, cuts, abrasions, extreme wear, exposed wires or bent connectors. Confirm connectors securely engage. Report damage or improper function to your service department.Caution Do not autoclave the Propaq CS monitor or its accessories. Do not immerse the monitor in liquid when cleaning. Do not immerse accessories in liquid when cleaning unless the accessory manufacturer’s cleaning instructions explicitly instruct you to do so.Equipment Cleaning Instructions Approved Cleaning Solutions11. Do not use these cleaning solutions (they may damage the monitor): Butyl alcohol, Denatured ethanol, Freon™, Mild chlorine bleach solution, Isopropyl alcohol, Trichloroethane, Trichloroethylene, Acetone, Vesphene II, Enviroquat®, Staphene®, Misty®, Glutaraldehyde.Propaq CS Monitor22. The monitor may be disinfected to comply with OSHA requirements for cleaning and decontaminating spills of blood and other body fluids. (Federal OSHA Standard on bloodborne pathogens: 29 CFR 1910.1030, 12/6/91.)• Wipe with a nearly-dry cloth moistened with cleaning solution. • Thoroughly wipe off any excess cleaning solution. Do not let water or cleaning solution run into connector openings or crevices.33. If liquid gets into the right side panel connectors, it will drain out. If moisture gets into a left side panel connector, dry the connector with warm air, then check the monitoring functions for proper operation.Warm water Coverage®Liquid soap Fantastik®Wex-cide®4Formula 409®T.B.Q.®4Windex®Cidex®Hydrogen peroxide solutionOvation®4. Wex-cide (Wexford Labs, Inc., Kirkwood, MO) and T.B.Q. (Calgon Vestal Lab., Calgon Corp., St. Louis, MO) are disinfectants that meet OSHA requirements, are EPA approved, and will not harm the outside of the monitor. Wipe away disinfectants with a water-dampened cloth after the manufacturer’s recommended period of time.NIBP cuff • Wipe gently with cloth dampened with cleaning solution.• Thoroughly wipe off excess cleaning solution. To avoid harming cuff function, do not let water or cleaning solution enter cuff tubing.Common hospital disinfectants, including Cidex, Clorox® liquid bleach (1:10 solution of Clorox/water), isopropyl alcohol, Lysol® solution, Phisohex®, Quatricide®, Virex® and Vesphene®Cables, tubing, CO2 sensor55. The Mainstream CO2 sensor may also be disinfected with Wex-cide. Follow the disinfectant manufacturer’s instructions. Do not leave Wex-cide on sensor longer than 30 minutes. Thoroughly clean off residue with water-dampened cloth. Prolonged exposure of the sensor to Wex-cide will damage the sensor.• Wipe gently with cloth dampened with cleaning solution. Do not immerse the CO2 sensor in liquid.Mild detergent solution; also consult manufacturer’s instructions.Nellcor cables, Durasensor oxygen transducers• Wipe gently with cloth dampened with isopropyl alcohol.Isopropyl alcoholOther accessories • Consult manufacturer’s instructions. Consult manufacturer’s instructions.
92 Protocol Systems, Inc.Service Interval RecommendationsAt the intervals recommended below, qualified biomedical service personnel should service the Propaq CS monitor. Service information is described in the Propaq CS Service Manual (P/N 810-1101-XX).Monitor RecyclingYou can return a Propaq CS monitor to Protocol Systems for recycling when the monitor reaches the end of its life.Battery RecyclingWhen the monitor’s internal lead-acid battery reaches the end of its life, recycle the battery locally according to national, state, and local regulations. You can also return the battery to Protocol Systems for recycling.Extended Storage PrecautionsCaution If a Propaq CS monitor has a battery installed or ac power connected and is stored for an extended period of time without use, the printer paper can cause damage to the printhead. Before storing a Propaq CS monitor for more than two months without use, remove the roll of printer paper.Storing the Propaq CS monitor for extended periods (more than three months) without being connected to the ac power adapter can cause damage to the battery. Even when the monitor is turned off, a very small amount of current is drawn from the battery. For long-term storage, remove the battery from the monitor. Battery removal is described in the Propaq CS Service Manual.Removing the battery will erase all stored Custom patient mode settings. See page 24 to reprogram Custom patient mode settings.Recommended Interval11. More frequent service may be needed in extreme environments (heat, cold, dust, etc.).Service ActionSix months to two years • Complete functional verification; see Propaq CS Service Manual • Inspect the monitor for mechanical and functional damage • Inspect safety labels for legibility • Inspect the side panel fuse for compliance to specified rating• Verify that visual and acoustic alarms are functioning properly • Test patient leakage current according to IEC 601-1/1988 • Test patient leakage current with mains voltage on patient-applied parts according to IEC 601-1/1988: limit 50µA22. The leakage current should never exceed the 50µA limit. The data should be recorded in an equipment log. If the device is not functioning properly or fails any of the above tests, do not attempt to repair the device. Please return the device to the manufacturer or to your distributor for any required repairs.Minimum every three years • Check battery capacity
Reference9 – ReferenceSet the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95Time/Day Settings and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . 96Factory Default Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99ECG Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Real-Time ECG Analog/Defib Sync Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101Impedance Pneumography (RESP) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102Invasive Pressure Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103NIBP Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104Temperature Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105Pulse Oximetry (SpO2) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105Capnography (CO2) Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106Alarms Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109Nurse Call Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110Nurse Call Cable Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110Trends Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Display Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Monitor (Environmental) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Monitor (Physical) Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Printer Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Power Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113Power Adapter Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
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Propaq CS Directions for Use 95ReferenceSet the Time and Date1. From the Main Menu press SETUP, MORE, MORE to display the Time/Day window:2. Press NEXT, UP, and DOWN as needed to set the time and date. Then press ENTER to store the new time and date.Time/Day Settings and TrendsWarning Changing the hour/minute/second setting for the monitor in the Time/Day window can cause the monitor to erase previously stored patient trend data.When you change the hour/minute/second setting for the monitor in the Time/Day window, the monitor deletes any patient trend data that is older than five hours for non-NIBP trends or older than eight hours for NIBP trends according to the new clock setting.However, if the monitor has not yet stored the full capacity of trends and you change the hour/minute/second setting to a time that is within the stored trend period, previously stored trends are not erased.Changing the day, month, or year setting does not affect the stored patient trends.BRTEMP 100.498.61.897( 85) mmHg(M)%°F 58MCO2SpO2mmHg 38 Br/mDNEXTT1T2∆TSERVICETIME DAYUP DOWN ENTERH:MIN:S15:55:10MO/DA/YR10/21/9912
96 Protocol Systems, Inc.Change the Date Format, ECG Filter, and Units1. Make sure you are in the Adult patient mode (from the Main Menu press SETUP, MORE, CHANGE, ADULT, YES).2. From the Main Menu press SETUP, MORE, MORE, SERVICE, YES (to access the Service Menu), MORE, MORE, SETTINGS. The monitor displays the Settings window:3. Press NEXT and CHANGE to select the desired settings.DATE Sets the date format: Month/Day/Year, Day.Month.Year, or Year/Month/Day.FILTER Sets the ECG filter frequency: 60 Hz, 50 Hz, or OFF. Make sure it is set to your ac mains frequency.TEMP F/C Sets the temperature display units: Fahrenheit or Celsius. Changing units does not erase the TEMP trends.DECIMAL Sets the decimal character as either a period (.) or a comma (,).HR/PR ALARM LIMITS Allows or prohibits turning off the HR/PR alarm limits. If CANNOT TURN OFF is selected, the ON/OFF key is not displayed for HR/PR in the Alarm Limits Menu.CO2 UNITS Sets the CO2 display units as mmHg, kPa, or percent (%).Changing units erases the CO2 trends and changes CO2 alarm limit settings to the factory default settings for the currently-used patient mode.Note Any time you change the Date, Filter, Temp F/C, Decimal, HR/PR Alarm Limits (CAN or CANNOT TURN OFF), or CO2 Units setting, the new setting also becomes the powerup default setting.SETTINGSBRTEMP 100.498.61.897P2( 15) mmHg(M)259SDNIBP( 85) mmHg(M)%°F122 58MCO2SpO2mmHg 38 Br/mSDNEXTT1T2∆TPREVIOUSMENUBATTERY: 9.3 VOLTSDATECHANGEFILTERTEMP F/C :DECIMAL : .HR/PR ALARM LIMITS: CAN TURN OFF::MO/DA/YR60 Hz°CCO2 UNITS: mmHg12
Propaq CS Directions for Use 97ReferenceFactory Default SettingsThe monitor is shipped from the factory with these preset default settings. For information about how to customize your monitor settings, see page 23.Factory Default Settings Setting Factory DefaultDate1MO/DA/YR. This setting is automatically updated whenever it is changed during use (continuously programmed).Decimal1 . (Period) This setting is automatically updated whenever it is changed during use (continuously programmed).HR/PR Sweep 25 mm/sRR/BR Sweep 6.25 mm/sAlarm Tone MEDIUMHR/PR TONE LOWHR/PR SOURCE ECGRR/BR Source CO2 if available or ECG (not programmable)Patient Mode AdultDisplay Brightness NormalECG Bandwidth MonitorECG Size 1 mV/cmECG1 Lead IIECG2 Lead VECG Filter1 60 Hz. This setting is automatically updated whenever it is changed during use.ECG Pacer ONRESP size 2XRESP lead Ld2RESP sweep 6.25 mm/sRESP monitoring ONRESP window ONIBP Range 0 to 180 mmHgIBP Rescale 0 to 140 mmHg (not programmable)IBP Mode RESCALEInvasive Pressure Formats Label dependentNIBP Mode MANUALNIBP Auto Time 15 minNIBP Smartcuf ONSpO2 SIZE 2xSpO2 C-LOCK OFFSpO2 Response NORMALTEMP F/C1 CelsiusCO2 Range 0 to 60 mmHgCO2 Sweep 6.25 mm/sCO2 Response NORMALCO2 Units1 mmHgCO2 Gas Compensation OFF Sidestream CO2 Flow Rate Adult: 90 ml/minutePed: 90 ml/minuteNeonate: 90 ml/minute(The flow rate cannot be programmed to a different value in a Custom Patient Mode, see page 23.)Display Wave Select Adult and Pediatric Patient Mode: ECG1, ECG2, P1, P2, and CO2 = ON, and large NIBP numerics are displayed (in order of priority); SpO2 and RESP = OFF.Neonatal Mode: all waveforms are ON and large NIBP numerics are displayed (in order of priority).
98 Protocol Systems, Inc.Trend Group NIBPAlarm Limits All are ON except P2HR/PR Alarm Limits1 CAN TURN OFFHR Limits Adult: 50, 120 beats per minutePed: 50, 150 beats per minuteNeonate: 100, 200 beats per minuteNIBP Limits - Systolic Adult: 75, 220 mmHgPed: 75, 145 mmHgNeonate: 50, 100 mmHgNIBP Limits - Diastolic Adult: 35, 110 mmHgPed: 35, 100 mmHgNeonate: 30, 70 mmHgNIBP Limits - Mean Adult: 50, 120 mmHgPed: 50, 110 mmHgNeonate: 35, 80 mmHgP1, P2 Limits - Systolic Adult: 75, 220 mmHgPed: 75, 145 mmHgNeonate: 50, 100 mmHgP1, P2 Limits - Diastolic Adult: 35, 110 mmHgPed: 35, 100 mmHgNeonate: 30, 70 mmHgP1, P2 Limits - Mean Adult: 50, 120 mmHgPed: 50, 110 mmHgNeonate: 35, 80 mmHgSpO2 Limits Adult: 90%, 100%Ped: 90%, 100%Neonate: 85%, 98%RR/BR Adult: 5, 30 Br/MPed: 10, 45 Br/MNeonate: 10, 75 Br/MTEMP Limits 35.0°, 37.8° C∆T Limits 0.0°, 2.8° CETCO2 Limits 25, 60 mmHg (3.0 and 8.0 for % and kPa)INCO2 Limits N/A, 5 mmHg (0.7 for % and kPa)Apnea Delay Adult/Ped: 20 secondsNeonate: 15 secondsPrinter SettingsPrinter Alarm Print OFFPrinter Auto Print OFFPrinter NIBP Ticket OFFPrinter Apnea Ticket ONPrinter Print Speed 25 mm/sPrinter Auto Trend OFFPrinter Trend Selections NIBP and P1 = ON; all others = OFFPrinter OxyCRG on Alarm OFF1. Any time you change the Date, Filter, Temp F/C, Decimal, HR/PR Alarm Limits (Can or Cannot Turn Off) or CO2 Units setting, the new setting also becomes the powerup default setting.Factory Default Settings (Continued)Setting Factory Default
Propaq CS Directions for Use 99ReferenceSpecificationsECG SpecificationsThe ECG channel meets all the requirements for Cardiac Monitors Heart Rate Meters and Alarms specified ANSI/AAMI EC13-1992, except for Standardizing Voltage (section 3.2.9.9). The channel also meets the American National Standard, Safe Current Limits for Electromedical Apparatus (ANSI/AAMI ES1-1993). ECG Specifications Characteristic SpecificationConnector AAMI 6 pin or Hewlett-Packard compatible 12-pin style connector (optional). See illustration on page 100.Selectable Leads I, II, III, aVR, aVL, aVF, VLead Fault Indicator LA, LL, RA, RL, C, multipleECG Size (sensitivity) in mV/cm 4, 2, 1, 0.5, 0.2Display Sweep Speeds 12.5, 25, and 50 mm/sQRS Tone Volume High, Low, Medium, OffQRS Tone Frequency 900 Hz for Propaq CS monitor without Expansion Module, 665 Hertz when equipped with SpO2 but SpO2 not being monitored; variable pitch with SpO2 option and SpO2 being monitoredBandwidth: MONITOREXTENDEDAdult Mode: 0.5 to 40 HzPediatric Mode: 0.5 to 120 HzNeonatal Mode: 0.5 to 120 HzAdult Mode: 0.05 to 40 HzPediatric Mode: 0.05 to 120 HzNeonatal Mode: 0.05 to 120 Hz(see Real-Time ECG Analog/Defib Sync specification)Sample Rate 364 HzInput Protection Electrosurgery and defibrillator protected when used with specified ECG cables. All models also include electrosurgery interference suppression.Lead Fail Sense Current 50 nA dc for active leads100-200 nA dc for driven lead, depending on number of electrodes attachedTall T-wave Rejection Meets AAMI (USA) EC13-1992, section 3.1.2.1.c, for 1.2 mV T-wave and 1 mV QRS using AAMI test waveform.Common Mode Rejection <1 mV p-p RTI for 10V rms, 50/60 Hz input, 200 pF source impedance, input unbalanced, FILTER function OFF<0.1 mV p-p RTI for 10V rms, 50/60 Hz input, 200 pF source impedance, input unbalanced, FILTER function ONInput Impedance >2.5 MΩ differential @ 60 HzInput Range (ac) 10 mV peak to peakInput Range (dc) Up to ±300 mVSystem Noise ≤30 µV peak-to-peak, RTI, with all inputs = 47K in parallel with 0.047 µF.QRS Detector Adult or Pediatric Amplitude Range: 0.22 to 5.0 mV (RTI)Neonatal Amplitude Range: 0.1 to 5.0 mV (RTI)Neonatal and Pediatric Width Range (Duration): 40 to 120 msAdult Width Range (Duration): 70 to 120 msHeart Rate Range 25 to 350 beats per minute (measurement)25 to 300 beats per minute (display)Heart Rate Meter Response Time Responds to change in heart rate within 5 to 9 seconds depending on physiological waveform. (As measured per AAMI standard EC 13-1992 clause 4.1.2.1 (f), including 3.1.2.1 parts f. and g. waveforms.) Includes 1 second readout update interval.
100 Protocol Systems, Inc.HR Accuracy ±3 beats per minute or 3%, whichever is greaterNOTE: AAMI Test 4.1.4 part f: Accuracy is affected (i.e., rate drops) when QRS and pacer spikes are nearly simultaneous as occasionally is the case during this AAMI test.Heart Rate Averaging Method Heart rate = 60 / latest average interval in seconds.For higher heart rates, latest average interval = 7/8 of previous average interval + 1/8 of latest interval.For lower heart rates, latest average interval = 3/4 (previous average interval) + 1/4 latest interval.Transition rates for choice of formula include hysteresis and are 70 and 80 beats per minute.Drift Tolerance (AAMI Specification EC13-1992, 3.2.6.3) 80 beats per minute indicated for 80 beats per minute ECG plus drift waveformPacer Display Pacer indicator shown on screen if PACER function turned on; pacer spike always shown if of sufficient amplitude.Pacer Pulse Rejection Pacer detection range (i.e., will show the dashed vertical marker) for 0.1 ms pulses is ±3 mV to ±700 mV, and drops linearly to ±2 mV to ±700 mV for 0.2 to 2 ms pulses.Will not count as heartbeats approximately 95% of pacemaker pulses within pacer detection range, with or without AAMI (EC13 1992) tails of 4, 25, 50, 75, or 100 ms decay time constant, whose tail amplitudes are 2.5% or 25%, 2mV maximum, whether ventricular only, or A-V sequential pulses, all per AAMI tests 3.1.4.1 and 3.1.4.2Response to Irregular Rhythm (AAMI specification EC13-1992, 3.1.2.1. Part e.)Ventricular Bigeminy (VB) 78 to 81 bpm (80 bpm expected)Slow Alternating VB 57 to 65 bpm (60 bpm expected)Rapid Alternating VB 118 to 123 bpm (120 bpm expected)Bidirectional Systole 88 to 93 bpm (90 bpm expected)1mV Ventricular Tachycardia 197 to 198 bpm (206 bpm expected)2mV Ventricular Tachycardia 193 to 197 bpm (206 bpm expected) ECG Specifications (Continued)Characteristic SpecificationAAMI 6-pin ECG connector side panel view HP 12-pin ECG connector side panel viewLALLRASHIELDCRLRALLLASHIELDRLC
Propaq CS Directions for Use 101ReferenceReal-Time ECG Analog/Defib Sync SpecificationsSpecial cables are required to interface the defib sync connector to a Physio-Control LIFEPAK 5 or LIFEPAK 6s defibrillator. The sync and real-time ECG outputs do not operate during in-service mode.Signal SpecificationSync Output 0 to 5 V pulse, 100 ±5 ms wide, starts within 35 ms after peak of R-wave. 15 mA short circuit current.Real-time ECG Output Range = ±6 V minimum, centered about 0 V, Gain = 1000X, noninverting for lead II, inverting for all other leads, delay <3 ms, 0.05-100 Hz, going to -5.9 V ±5% during ECG lead fail. V lead has no Real-Time analog output.Marker Input (Defib Sync only) Normally 0 V in, a pulse either ±3 to ±15 V for 10-70 ms puts a marker in ECG trace. ~ 5 kΩ input resistance.Shield Common terminal for other signalsN/CN/CGROUNDMARKER INSYNCOUTN/CReal-time ECG Output connector side panel view Defib Sync connector side panel viewECGN/C GROUNDSHIELDN/CSHIELD
102 Protocol Systems, Inc.Impedance Pneumography (RESP) SpecificationsCharacteristic SpecificationSweep speed 3.13, 6.25, 12.5 mm/s; user-selectableAmplitude range 1x, 2x, 4x, 8x, 16xExcitation signal characteristics 65 µA RMS ±5% at 63.0 kHz pseudo sine waveSensing electrodes User selectable RA-LA or RA-LLBase impedance (in addition to 1kΩ resistors in ECG cables) 100 to 1200 ohms is normal monitoring range, approx. 1200-1500 ohms range produces a “NOISY SIGNAL, CHECK ELECTRODES” equipment alert. Above approx. 1500 ohms produces a “RESP FAULT, LEAD FAIL” equipment alert. Thresholds are dependent on ECG cable type.Impedance dynamic range 20 ohmsSignal bandwidth after detection 0.06 Hz (single pole) to 3.2 Hz (2 pole)Breath detection threshold 140 milliohms or 2x CVA, whichever is greaterRespiration rate range Adult/Ped: 0 (apnea), 2 to 150 breaths/minNeonate: 0 (apnea), 3 to 150 breaths/minRespiration rate accuracy ±2 breaths/min or ±2%, whichever is greaterRespiration rate source (RR) When CO2 is active, CO2 is the BR source. Otherwise, RESP from ECG is the RR source.Apnea alarm delay accuracy +1 secondResolution 5 secondsApnea alarm delay settings Central apnea only - alarm delay is set by the userAdult/Ped = 6, 10, 15, 20, 25, 30 secondsNeonate = 6, 10, 15, 20 secondsCardiovascular artifact rejection (CVA) Presence of CVA is detected automatically. Breaths will be picked in the presence of CVA unless the Breath Rate is within 5% of the Heart Rate or a sub-multiple of the heart rate.Motion artifact rejection not rejectedObstructive apnea not detected
Propaq CS Directions for Use 103ReferenceInvasive Pressure SpecificationsCharacteristic SpecificationTransducer Type Strain-gauge resistive bridge, or HP quartz (with HP Option). 11. Transducers with 40 µV/V/mmHg sensitivity are not compatible.Transducer Excitation Impedance Range 200 to 2000 ΩTransducer sensitivity 5 µV/V/mmHgExcitation Voltage 4.85 V Pulsed dc @ 181 Hz 22. Duty factor depends on transducer impedance. For 200 to ~900 Ω, duty factor is ≈ 11%. Above ~900 Ω, the duty factor increases to ≈ 91%.Connector ITT-Cannon plug MS3106F-14S-6P Std.Hewlett-Packard compatible 12-pin connector (optional). Bandwidth Digital filtered, dc to 20 HzZero Drift ±1 mmHg without transducer driftZero Adjustment ±200 mmHg including transducer offsetNumeric Accuracy ±2 mmHg or 2% of reading, whichever is greater, plus transducer errorPressure range -30 to 300 mmHgPulse range 25 to 250 beats per minuteLeakage Current Meets ANSI/AAMI risk (leakage) requirementsElectrosurgery interference suppression Included in all modelsHP 12-pin IBP connector side panel view+ EXC+ EXC- EXC - EXC+ SIGNAL- SIGNAL+ SIGNAL- SIGNALSHIELD SHIELDStandard 6-pin IBP connector side panel view
104 Protocol Systems, Inc.NIBP SpecificationsCharacteristic SpecificationMethod OscillometricControl Automatic and manual measurement controlAuto Intervals 1, 2, 3, 5, 10, 15, 30, and 60 minutesTurbocuf Maximum measurements allowable in a 5-minute periodDisplayed Pressures Systolic, Diastolic, and Mean plus on-screen manometerSystolic Range Adult: 30 to 260 mmHgPed: 30 to 160 mmHgNeonate: 25 to 120 mmHgDiastolic Range Adult: 20 to 235 mmHgPed: 15 to 130 mmHgNeonate: 10 to 105 mmHgMean Range Adult: 20 to 255 mmHgPed: 15 to 140 mmHgNeonate: 10 to 110 mmHgStatic Manometer Accuracy ±3 mmHgMinimum Inflation Pressure Adult: 100 mmHgPed: 80 mmHgNeonate: 50 mmHgMaximum Allowable Pressure Adult: 270 mmHgPed: 170 mmHgNeonate: 132 mmHgDefault Inflation Pressure Adult: 160 mmHgPed: 120 mmHg Neonate: 90 mmHgNormal Overpressure Limit (results in up to 2 retries) Adult: 280 mmHgPed: 200 mmHgNeonate: 141 mmHgSingle Fault Overpressure Limit Adult: 308 mmHgPed: 220 mmHgNeonate: 154 mmHgLeak Rate After a 1 minute settling period, leak rate is ≤4 mm/Hg over a 3-minute period at 270 mm/Hg.Pulse Rate Range 30 to 220 beats per minuteMaximum Determination Time (with retries) Adult: 4.5 minutesPed: 4 minutesNeonate: 3 minutesMaximum Determination Time (no retries) Adult: 3 minutesPed: 2 minutesNeonate: 1.5 minutesTypical Determination Time without Artifact 30 to 45 secondsMinimum Time between automatic measurements 30 seconds (Auto Mode)2 seconds (Turbo Mode)Artifact Filtering Smartcuf software algorithm (may be be enabled or disabled; requires ECG monitoring). NIBP measurements can still be taken if Smartcuf is disabled.Electrosurgery Interference Suppression Included in all models.NIBP Performance Per EN 1060-1, EN 1060-3 and ANSI/AAMI SP10-1992NIBP Safety Per EN 60601-2-30
Propaq CS Directions for Use 105ReferenceTemperature SpecificationsPulse Oximetry (SpO2) SpecificationsCharacteristic SpecificationRange 0° to +50°C; 32° to +122°FDisplays T1, T2, and ∆TProbes Compatible with YSI Series 400 and 700 probes. HP side panel only compatible with YSI 400 and has HP connector.Units °C and °F selectable Channel Accuracy Temperature Range Tolerance0° to +10°C ±0.2°C>10° to +50°C ±0.1°C+32° to +50°F ±0.4°F>50° to +122°F ±0.2°FResolution 0.1°C or °FElectrosurgery interferencesuppression Included in all models.Characteristic SpecificationRange 0% to 100%Probe Accuracy (specified at 28° to 42° C) Adults:70% to 100% ±2 digits50% to 69% ±3 digits0% to 49% unspecifiedPediatrics:70% to 100% ±3 digitsNeonates:70% to 95% ±3 digitsPulse Rate Range 25 to 250 beats per minutePulse Rate Accuracy ±3 beats per minute or 3%, whichever is greaterSensor Compatibility Compatible only with NELLCOR sensors listed in the Protocol Systems Products and Accessories booklet.Electrosurgery interferencesuppression Included in all models.Alarm Hold-Off Time Period 10 seconds; reset if the sensor reports levels within limits before 10 seconds elapses.
106 Protocol Systems, Inc.Capnography (CO2) Specifications General CO2 Specifications (Mainstream CO2 and Sidestream CO2)Characteristic SpecificationCO2 DisplayScreen Display CO2 waveform and ETCO2 and INCO2 (when in alarm) numericsNumeric Display Ranges ETCO2: 0-99 mmHg, 0-13.2 kPa, 0-23.1%INCO2: 81-25 mmHg, 1.11-5 kPa, 1.11-5%1. Lower if in alarm.Waveform Scale (Maximum) 0-100 mmHg, 0-14 kPa, 0-14%Units mmHg, kPa,%; user-selectableSweep Speed 3.13, 6.25, 12.5 mm/s; user-selectableResponse Modes Fast: 15 s sampling time periodNormal: 30 s sampling time periodSlow: 45 s sampling time periodGas Compensation OFF: CO2 value = calculated CO2 value;O2 > 50%, No N2O: CO2 value = calculated CO2 value x 1.03;N2O > 50%: CO2 value = calculated CO2 value x 0.952Alarm Limit Ranges ETCO2: 0-99 mmHg, 0-13.2 kPa, 0-13.2%INCO2: 2-25 mmHg, 0.2-5 kPa, % (no lower limit)Resolution 1 mmHgAccuracy Mainstream2:0-30 mmHg, ±3 mmHg31-99 mmHg, ± 10% of valueSidestream3: 0-30 mmHg, ±3 mmHg31-99 mmHg, ± 10% of value2. Based on these airway conditions: sensor temperature = 42°C, airway adapter temperature = 33°C, water vapor pressure = 38 mmHg; standard gas mixture = CO2 in balance air, fully hydrated at 33°C; barometric pressure = 760 mmHg and flow = 60 ml/min.3. Based on the following additional airway conditions: Sample line = 7 ft, 0.055 in ID (2.13 m, 1.4 mm ID); Sample flow rate = 175 ml/min; Protocol watertrap (new/unused); Respiratory rate ≤50 bpm, stable to ±3 breaths/min; Inspired/Expired time ratio = 1:2; Barometric pressure = 760 mmHg.Altitude Error ±0.4%/1,000 ft (304.8 m)Breath Rate DisplayScreen Display NumericBreath rate (BR) source When CO2 is active, CO2 is BR source. Otherwise, RESP from ECG is RR source.Units Breaths/MinuteRange Adult/Ped: 0 (apnea), 2 to 150 breaths/minNeonate: 0 (apnea), 3 to 150 breaths/minResolution ±1 breaths/minAccuracy ±1 breaths/min or ±5%, whichever is greater44. For Sidestream CO2, this applies only for BR≤50.Alarm Limits Range Adult/Ped: 2 to 150 breaths/minNeonate: 3 to 150 breaths/minApnea Alarms and TicketsApnea Ticket Set to auto print after apnea event and after 1 minute continued apneaApnea Alarm Accuracy ± 2 sApnea delay setting Adult/Ped = 6, 10, 15, 20, 25, 30 secondsNeonate = 6, 10, 15, 20 secondsBarometric PressurePressure Compensation AutomaticOperating Range -2,000 to 15,000 ft (-610 to 4572 m) 817 to 429 mmHgScreen Display Numeric (CO2 Status Window)Units mmHg, kPa, or %Accuracy ±3 mmHg or 2.5% of difference from calibration pressure, whichever is greaterCO2 PerformanceSpecification Per ISO 9918:1993 (E) / EN 864:1996
Propaq CS Directions for Use 107Reference Mainstream CO2 SpecificationsCharacteristic SpecificationMainstream CO2 SensorSensor Type MainstreamPrinciple of Operation Non-dispersive, infrared, single-beam, single path/wavelength, ratiometricWarm-up time (CO2 sensor and monitor) 45 s typical, 3 min maximumResponse Time 30 ms typical, 60 ms maximumWaveform Rise Time <120 ms to 90% after step changeCalibration Verify semi-annually, calibrate only as requiredSensor Housing Temperature 42°C nominalMainstream CO2 Sensor and Cable Dimensions and WeightSensor Height 11. Not including cable1.003 in (2.548 cm)Sensor Width 11.036 in (2.631 cm)Sensor Depth 10.78 in (1.981 cm)Sensor Weight 1< 0.53 oz (15.03 g)Cable Length 10 ft (3.05 m) nominalMainstream CO2 Airway AdapterType Per ISO 3040, single-useSize 15 mm ID, (meets ISO specifications)Material clear polycarbonate, with sapphire windowsAdded Deadspace < 6cc (0.37 cubic inches) for adult model, <0.6 cc (0.037 cubic inches) for low deadspace modelMainstream CO2 Sensor Environmental SpecificationsOperating Ambient Temperature 10° to 40°CStorage Temperature -20° to 60°COperating Altitude -2,000 to 15,000 ft (-610 to 4,572 m), 817 to 429 mmHgStorage Altitude -2,000 to 40,000 ft (-610 to 12,192 m), 817 to 141 mmHgOperating and Storage Humidity 0% to 95%, noncondensingShock 100 g for 4 ms Vibration 5-35 Hz, 0.015 in (0.038 cm) peak-to-peak, 35-100 Hz, 1 g accelerationDrop 36 inches free fall to floor (tile over concrete, one drop each face, one drop each edge/corner)
108 Protocol Systems, Inc. Sidestream CO2 SpecificationsCharacteristic SpecificationSensor Type Sidestream, internalPrinciple of Operation Non-dispersive, infrared, single-beam, single path/wavelength, ratiometricOperating Ambient Temperature 5° to 40°CStartup Time 30 seconds typical, 3 minutes maximumRise Time 240 ms (10% to 90%) at 175 ml/minDelay Time 1.12 seconds maximum11. Based on the following additional airway conditions: Sample line = 7 ft, 0.055 in ID (2.13 m, 1.4 mm ID); Sample flow rate = 175 ml/min; Protocol watertrap (new/unused).Total System Response Time 1.36 seconds maximum (Rise Time and Delay Time)Calibration Verify semi-annually, calibrate only as requiredSampling Chamber Internal (replaceable by service technician)Pneumatic and Exhaust System IntegralBarometric Pressure Compensation AutomaticBTPS, ATPS, STPD22. BTPS (Body Temperature and Pressure, Saturated), ATPS (Ambient Temperature and Pressure, Saturated), STPD (Standard Temperature and Pressure, Dry).CO2 value = calculated CO2 value x 0.977Sampling Line 7-foot sampling line, ID 0.055 in (1.4 mm), for use with disposable single-use cannula (CO2 only or CO2 sampling/O2 delivery)Watertrap Disposable single-useFlow Rate 90 or 175 ml/min, user-selectable
Propaq CS Directions for Use 109ReferenceAlarms SpecificationsCharacteristic SpecificationIndicators (see table below) Red indicator light: flashing light indicates patient alarm; continuously on indicates patient alarms are suspended.Yellow indicator light: continuously on indicates one or more alarm limits have been disabled; flashing light indicates an equipment alert.Tone Frequency 900 HertzTone is steady for a patient alarm and sounds for 1 second every 4 seconds for an equipment alert.Selectable Tone Volume Low, Medium, HighLimits Settable on all parametersControl Automatic preset or manual settingsAlarm Priority Highest priority: Apnea, then patient alarmsLowest priority: Equipment alertsAlarm on Tachycardias Most tachycardias will alarm in less than 8 seconds. These include AAMI 3.1.2.1 part f. waveforms. Certain multifocal tachycardias may initially alarm as “low rate.”Apnea delay setting Adult/Ped = 6, 10, 15, 20, 25, 30 secondsNeonate = 6, 10, 15, 20 secondsAlarm Holdoff Time Period11. To help minimize false alarms, the monitor briefly delays or “holds off” triggering alarms for limit violations for these vital signs. After the alarm holdoff period begins, if the monitor detects that the patient’s vital sign has returned to acceptable limits, the monitor cancels the alarm holdoff. The next time a vital sign limit is violated, the monitor starts a new holdoff period.HR/PR = 3 seconds (except NIBP PR)SpO2 = 10 secondsRR/BR = 5 secondsAudio Alarm Holdoff with Acuity When a Propaq CS monitor in Adult or Pediatric Mode is connected to an Acuity System, the audio alarms at the bedside monitor can be delayed up to 4 minutes and 15 seconds. The delay time is selected in Acuity software at the time of Acuity installation. Visual alarm indications and Nurse Call alarm are not delayed. Propaq CS Monitor Alarm IndicationsPatient and Alarm Limit StatusRedAlarmYellow Alarm(s) OffNurse Call TonePatient in alarm condition, and all alarm limits on FLASH OFF ON ONPatient in alarm condition, and at least one alarm limit is off FLASH ON ON ONPatient alarms suspended (whether in alarm condition or not) and at least one alarm limit is off ON ON OFF OFFPatient alarms suspended (whether in alarm condition or not) and all alarm limits are on ON OFF OFF OFFPatient not in alarm condition, and at least one alarm limit is off. OFF ON OFF OFFEquipment alert, patient not in alarm condition OFF FLASH OFF ON 1 s, OFF 4 sEquipment alert, patient alarms suspended ON FLASH OFF OFF
110 Protocol Systems, Inc.Nurse Call SpecificationsNurse Call Cable SpecificationsThis cable (Part Number 008-0634-XX) must be customized by a biomedical technician to connect to the local Nurse Call system. Propaq CS Monitor Audible Alarm IndicationsAlarm Condition TonePatient alarm Continuous ONApnea alarm ON for 1 second, OFF for 1 secondEquipment alert ON for 1 second, OFF for 4 secondsCharacteristic SpecificationMaximum switch current 1 AMaximum switch voltage 30 V ac/dcIsolation 1500 VrmsAlarm relay Energized during apnea alarm or patient alarm11. Pressing the Suspend/Resume Alarm key or SUSPEND suspends the Nurse Call alarm for 90 seconds.Customized cable2 (Protocol Systems Part Number 008-0634-XX); see below.2. Refer to the Protocol Systems Products and Accessories booklet to order the cable.One end is a 4-pin plug compatible with the monitor Nurse Call connector; the other end must be customized to connect to the local Nurse Call system.Nurse Call Connectoron Monitor1 Normally Open4 Not Connected3 Normally Closed2 Common (Arm) 30V at 1A MAXPin 4Pin 3Pin 1Pin 2EXTERNAL VIEW1234Normally Open (Black)Arm (Red)Normally Closed (Green)Not ConnectedNurse Call Cable (Part Number 008-0634-00)
Propaq CS Directions for Use 111ReferenceTrends SpecificationsDisplay SpecificationsMonitor (Environmental) SpecificationsCaution The monitor may not meet performance specifications if it is not used or stored within these environmental specifications.Characteristic Specification 11. Assumes SpO2 and CO2 functions are present.Model 242 Parameters NIBP, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp RateModel 244 Parameters NIBP, P1, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp RateModel 246 Parameters NIBP, P1, P2, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2, Inspired CO2, Breath Rate/Resp RateDuration 5 hours for non-NIBP trends (up to 150 readings)A maximum of 128 readings (up to 8 hours) for NIBP trendsResolution All channels except NIBP sample data at 2-minute intervals.For NIBP trends, a new entry is placed in the table each time an NIBP determination is made.Characteristic SpecificationType Color active matrix; TFT (Thin Film Transistor) LCD moduleResolution 640 x 480 pixels; 1 pixel = R + G + B dotsActive Viewing Area 6.73 x 5.10 inches (170.9 x 129.6 mm)Pixel Pitch 0.0105 inches (0.267 mm)Viewing Angle U/D 40°, R/L 60° (typical), ≥ 10:1 contrast ratioContrast Ratio 150:1 (typical); measured in dark room at center of screenDisplay Color 18-bit (6 bits per primary color)Luminance 200 cd/m2 (typical); measured at saturation pointResponse Time 40 ms (maximum); “white to black”Characteristic SpecificationOperating Temperature 0° to 40° CShipping and Storage Temperature -20° to 60° COperating Altitude -2,000 to 15,000 ft (-610 to 4,572 m)Shipping and Storage Altitude -2,000 to 40,000 ft (-610 to 12,192 m)Operating Relative Humidity 15% to 95%, noncondensing per MIL STD 810E, Procedure 1-naturalShipping and Storage Relative Humidity 15% to 95%, noncondensing per MIL STD 810E, Procedure 1-naturalShock 50 g Vibration, Random 0.02 g2/Hz from 10 to 500 Hz, ramping down to 0.002 g2/Hz at 2000 Hz. Operating 1 hour per axis, 3 hours per test. Designed to meet RTCA DO-160D, Category C.Electromagnetic Compatibility (EMC) EN 60601-1-2: 1993
112 Protocol Systems, Inc.Monitor (Physical) SpecificationsPrinter SpecificationsCharacteristic SpecificationProtection Classifications, all Configurations 11. Per EN 60601-1 unless otherwise stated.Type of Protection against Electric Shock—Power Adapter Power adapter class 1Type of Protection against Electric Shock—Monitor (connected to power adapter or internal battery)Protective earth not available in monitor. Monitor designed and tested to meet Double Insulation Requirement.Degree of Protection Against Electric Shock, for Parts Applied to Patients See monitor labelsMethod of Disinfection Not suitable for autoclaving (see cleaning instructions, page 91)Flammable Anesthetics Not suitable for use with flammable anestheticsMonitor OnlyHeight 8.2 in (20.8 cm) with handleWidth 9.6 in (24.4 cm)Depth 5.6 in (14.1 cm)Weight 7.6 lb (3.4 kg)Monitor with SpO2 ModuleHeight 8.2 in (20.8 cm) with handleWidth 9.6 in (24.4 cm)Depth 7.7 in (19.7 cm)Weight 10.8 lb (4.9 kg)Monitor with Expansion Module(Printer / SpO2 / MCO2)Height 11.4 in (28.8 cm)Width 9.6 in (24.4 cm)Depth 7.7 in (19.7 cm) with back feetWeight with Printer, SpO2, and MCO2 14.4 lb (6.5 kg)Characteristic SpecificationOperationOperating Modes Continuous, Snapshot, Auto Print, Auto Trend, Tabular Trend, Alarm Print, NIBP Ticket, Apnea Ticket, OxyCRG, OxyCRG on AlarmAuto Print Intervals 15 min, 30 min, 1 hour, 2 hours, 4 hoursAuto Trend Shifts Once every 4 hoursNumber of Waveforms Up to three: ECG1, P1, P2, SpO2, CO2, RESPGrid 5 mm and 1 mm gradationsAnnotation Date, Time, Print Mode, Speed, Heart Rate, Systolic, Diastolic, Mean, SpO2, Breath Rate, ETCO2, INCO2, Temperature, ∆T, Pacer Status, Company Logo, ECG Bandwidth, Patient Mode, scale factors for all traces and, if Acuity is connected, patient name and identification.Printing Speeds 6.25, 12.5, 25.0 mm/s, simulated 6.25 mm/s for CO2 and RESP in Snapshot mode
Propaq CS Directions for Use 113ReferencePower SpecificationsPrinter Mechanism Printing Method Thermally sensitive dot methodDot structure 320 dots per linePrinting width 53 mmHorizontal Dot Pitch 0.165 mm, 6 dots/mmVertical Dot Pitch 0.165 mmPaper Feed Method Friction FeedPaper Feed Precision ±2% @ 25° C and 60% Relative HumidityPaper Width 60 mmReliability 30 million pulses/dotEnvironmentalMonitor/Expansion Module Operating Temperature +5° to 40° CShipping and Storage Temperature -20° to 60° COperating Relative Humidity 35% to 85% noncondensingShipping, Storage Relative Humidity 15% to 90% noncondensingOperating Altitude -2,000 to 15,000 ft (-610 to 4,572 m)Shipping and Storage Altitude -2,000 to 40,000 ft (-610 to 12,192 m)Shock 30 gVibration, Random 0.02 g2/Hz from 10 to 500 Hz, ramping down to 0.002 g2/Hz at 2000 Hz. Operating 1 hour per axis, 3 hours per test.Electromagnetic Compatibility (EMC) Per IEC/EN 60601-1-2, which is a collateral standard of IEC/EN 60601-1, for electromagnetic compatibility.Paper StorageShort-term Storage Environment (up to 7 days) -20 to 40°C; 5% to 80% noncondensingLong-term Storage Environment (up to 5 years) 25°C (optimal), 65% noncondensingCharacteristic SpecificationMode of Operation ContinuousBattery Pack Type Sealed, gel-type lead acidBattery Pack Capacity Monitor only: 8 V, 2.7 Ampere-Hours; Monitor with Expansion Modules: 8 V, 5.4 Ampere-HoursBattery Recharger Circuitry Internal, powered by external power adapterDC Input Power Required 12 to 28 V, 25 Watts Input Fuse Rating 3A/250V, Type 2AG (0.57x 0.177 in)Operating Times on Battery Typically 2 hours for monitor without Expansion Module, about 3 hours for monitor with Expansion Module with printer, SpO2 and CO2 options, and about 4 hours for monitor without Expansion Module but with the SpO2 option.Battery Recharge Time with instrument on Range of 8 hours to 12 hours typical, depending upon product configurationBattery Recharge Time with instrument off Range of 6 hours to 8 hours depending upon product configurationRecharge time until monitor is usable, starting with discharged but non-faulty battery≤ 2 minutes typically (longer time required before NIBP, printer, and CO2 are available)Characteristic Specification
114 Protocol Systems, Inc.Power Adapter Specifications Low Battery Voltage and Operation < 7.8 V: Caution message LOW BATTERY.< 7.6 V: Caution messages LOW BATTERY, PRINTER DISABLED and LOW BATTERY, NIBP DISABLED.< 7.4 V: Equipment alert VERY LOW BATTERY< 7.3 V: Equipment alert LOW BATTERY, HEATER DISABLED (MCO2)< 7.0 V: Monitor automatically turns off.Characteristic SpecificationProtection Classifications, all Adapters 1 21. Per EN 60601-1 unless otherwise stated.2. See the Protocol Systems Products and Accessories booklet for model numbers.Type of Protection Against Electric Shock Class I, (Protectively Earthed)Degree of Protection Against Harmful Ingress of Water For ordinary, indoor locations only.Method of Disinfection Not suitable for autoclavingFlammable Anesthetics Not suitable for use with flammable anestheticsEnvironmental Specifications, All AdaptersOperating Temperature 0° to 50° CShipping and Storage Temperature -20° to 60° COperating Altitude -2,000 to 15,000 feet (-610 to 4,572 m)Shipping and Storage Altitude -2,000 to 40,000 feet (-610 to 12,192 m)Operating Relative Humidity 15% to 95%, noncondensingShipping, Storage Relative Humidity 15% to 95%, noncondensingShock 50 gVibration Random Vibration, 0.02 g2/Hz from 10 to 300 Hz, ramping down to 0.002 g2/Hz at 500 Hz. Operating 1 hour per axis, 3 hours/ test.Physical SpecificationsLength 5.0 in (12.7 cm)Width 3.6 in (9.1 cm)Height 3.1 in (7.9 cm)Weight 3.1 lb (1.4 kg)Universal Power Adapter, Part No. 503-0054-00Rated Input 100-120 V ac, 500 mA, 50/60 HzRated Fuses T800 mA/250 V, Time-Delay, 5x20mmRated Output (Continuous) 16-24 V dc, 25 VAAdditional Features Detachable power cord, pilot lightUniversal Power Adapter, Part No. 503-0054-01Rated Input 200-240 V ac, 250 mA, 50/60 HzRated Fuses T400 mA/250 V, Time-Delay, 5 x 20mmRated Output (Continuous) 16-24 V dc, 25 VAAdditional Features Detachable power cord, pilot lightCharacteristic SpecificationPower Adapter connectorPositive (+)Negative (-)
Propaq CS Directions for Use 115IndexIndexAAC Power AdapterChange fuses 88Change voltage selection 88Connect to monitor 87AC power adapter, specifications 114AC power filter for ECG 31AcuityConnect the monitor to Acuity 75Connector 11Disconnect the monitor 76Print at Acuity printer from monitor 76Warnings 75Acuity network equipment alert message 62Airway adapter, Mainstream CO2 44Alarm Holdoffs 109Alarm indicators, specifications 109Alarm LimitsAdjust after alarm 53CO2 49Customize alarm limits (STAT SET) 54Setup 21Alarm Limits Menu 21Alarm Tone volume 20AlarmsAdjust alarm limits 53Automatic printing on alarm 70Nurse Call Alarm 55Patient Alarm Menu 53Respond to patient alarms 53Resume alarms 53Setup alarm limits 21Setup alarms 21Specifications 109Suspend or cancel alarms 53Alarms Status Menu 21Alert, equipment problem 56ApneaAutomatic printing on apnea alarm 70Apnea alarm 21, 53Apnea measurement 44, 46Apnea ticket (printout) 70Artifact interference and waveform display 28Artifact marker on display, prints (NIBP) 37Artifact reduction with C-LOCK (SpO2) 42Artifact reduction with SMARTCUF (NIBP) 36Artifact with NIBP 7, 38, 39, 67, 68Audible alarms 110Automatic intervals (NIBP) 39Automatic NIBP measurements 39BBandwidth selection, ECG 31BatteryLong-term storage precautions 92Low battery message 63, 87Recharging 87Recycling 92Beeper loudness 20Brightness display control 20CCannula for Sidestream CO2 47Capnography(see Mainstream CO2 and Sidestream CO2)Caution statements, general 9Centigrade temperature units 40Change alarm limits 21Charge battery 87Cleaning instructions 91Clock setting 95C-LOCK, SpO2 measurement 42CO2Alarm limits 49Equipment alert messages 60, 61Flowrate, Sidestream CO2 49Gas compensation 49Mainstream CO2 44Response time 49Select measurement units 96Set up CO2 display 48Sidestream CO2 46Source selection 49Specifications, general 106Sweep speed selection 48Connector locations 10Connectors, patient 12Continuous printing 70Controls 10Cuff inflation target (NIBP) 36Cuff selection (NIBP) 37Current patient mode 22Custom patient modes 23Customize alarm limits 54DData communication equipment alert message 62Date and time setting 95Date format setting 96Decimal character setting 96Default inflation pressure (NIBP) 36Default settings 97DEFIB FAULT message 63Defib Sync (see Defibrillator Synchronization)Defibrillator SynchronizationConnector 11Equipment alert messages 63Install LIFEPAK 5 Interface Cable 79LIFEPAK 5 defibrillator 79LIFEPAK 6s defibrillator 82Remove LIFEPAK 5 Interface Cable 81Specifications 101Sync marker display 80Warning with LIFEPAK 5 79Warning with LIFEPAK 6s 82Delete all patient trends 69Disconnect monitor from Acuity 76Disinfection instructions 91DisplayArtifact interference 28Brightness control 20CO2 48
116 Protocol Systems, Inc.Defib sync markers 80ECG/RESP 30Equipment alert messages 57Equipment alerts 56General description 13IBP waveforms 34NIBP 38Pacemaker indicators 32Specifications 111SpO2 42Sweep speed selection 20Sweep speed selection, CO2 and RESP 48Temperature 40Trends 68Waveform selection 20EECGBandwidth selection 31Display 30Electrode selection and placement 28Electrosurgery and interference 29Equipment alert messages 57Filter to reduce interference 31Lead selection 30Pacemaker display indicators 32Specifications 99Waveform size adjustment 30ECG filter setting 96ECG LEAD 30ECG SIZE 30ECG/RESP menu 1 30ECG/RESP menu 2 30Electrocautery and IBP monitoring 33Electrodes and ECG (see ECG)Electrosurgery and ECG interference 29Environmental specifications 111Equipment AlertAcuity Network Message 62Defibrillator Messages 63ECG Messages 57Example display 56IBP Messages 57Low battery messages 63Mainstream CO2 Messages 60Messages 57NIBP Messages 57Printer Messages 63PROGRAM FAULT Message 62RESP Messages 57Respond to equipment alert 56Sidestream CO2 Messages 61SpO2 Messages 59Temperature Messages 59ERR message for NIBP 68ETCO2 (End-Tidal CO2) 44, 46Exhaust port, Sidestream CO2 47Extended Mode ECG bandwidth 31Extended storage precautions 92FFactory default settings 97Factory patient modesSetup 23Fahrenheit temperature units 40False alarms with SpO2 43Filter to reduce ECG interference 31, 96Flowrate, Sidestream CO2 49Format adjustment for IBP numerics 35Fuse replacementAC power adapter 88Monitor input power 89GGas compensation, CO2 49Gas exhaust port, Sidestream CO2 47Gas scavenging system, Sidestream CO2 47HHazards 9Heart Tone volume 20Hewlett-Packard patient connectors 12High frequency ventilation and RESP 28HP (Hewlett-Packard) patient connectors 12HR/PR Alarm Limits, on/off enable 96HR/PR source 20HR/PR tone volume adjustment 20, 31IIBPAdjust waveform scale 35Automatic display adjustment 35Change waveform display labels 35Display 34Electrocautery warning 33Equipment alert messages 57Monitoring 33Numeric format adjustment 35Range Mode 35Rescale Mode 35Specifications 103Transducer 33Zero a transducer 33Impedance Pneumography (see RESP)INCO2 (Inspired CO2) 44, 46Input power fuse replacement 89INSERV 16In-Service mode 16Inspect the monitor 91Interference filter for ECG 31Interference with electrosurgery, ECG 29Intubated patient and Sidestream CO2 47Invasive Blood Pressure (see IBP)LLabel selection for IBP 35Lead selection, RESP 31Learn to use Encore 16LIFEPAK 5 defibrillator 79LIFEPAK 6s defibrillator 82Line power adapter 87
Propaq CS Directions for Use 117IndexLoudness adjustment, HR/PR tone 31Loudness selection 20Low battery message 63, 87MMain Menu, General description 14Mainstream CO2Airway adapter 44Alarm limits 49Display 48Equipment alert messages 60Gas compensation 49Menus 48Monitoring 44Response time 49Specifications 107SpO2 option and CO2 44Switch to Sidestream CO2 49Turn on/off 49Warnings 44Maintenance instructions 92Manometer bar (NIBP display) 38Marriot Configuration for ECG 29MCO2(see Mainstream CO2)MenusAlarm Limits 21Alarms Status 21CO2 48ECG/RESP Menu 1 30ECG/RESP Menu 2 30General description 14IBP 34Main Menu 14NIBP 38Patient Alarm 53Printer Setup Page 70Setup Menus 15SpO2 42Messages, equipment alerts 57Mode Setup window 23Model numbers 12Modem-Propaq connector 11Monitor Mode ECG bandwidth 31Monitor recycling 92MonitoringECG/RESP 27IBP 33Mainstream CO2 44NIBP 36Sidestream CO2 46SpO2 41Temperature 40Motion artifact and NIBP 7, 38, 39, 67, 68NNET OFF, disconnect from Acuity 76Network fault equipment alert message 62New patient setup 19NIBPArtifact 7, 38, 39, 67, 68Artifact filtering message 59Automatic intervals 39Automatic Mode 38Automatic printing on NIBP 70Cuff and hose selection 37Cuff placement 38Default inflation pressure 36Display information 38Equipment alert messages 57Interval for automatic measurements 39Manual Mode 38Monitoring 36Motion artifact 7, 38, 39, 67, 68NIBP IN PROGRESS message 59NIBP Menu 38Printout symbol with artifact 67Retries 38SMARTCUF artifact filter 36Specifications 104Start/stop measurement 38Symbol in display 38, 68Symbol in printout 67TURBOCUF repeated measurements 39Warnings 36NIBP IN PROGRESS message 59NIBP ticket (printout) 70NIBP Trend 68Non-intubated patient and Sidestream CO2 47Non-Invasive Blood Pressure (see NIBP)Nurse Call AlarmDescription 55Specifications 110OOptions 12OxyCRGAutomatic printing on alarm 70Description 71How to print 71Oxygen saturation display 42Oxygen saturation measurement(see SpO2)PPacemaker display indicators 32Pacemaker patients and monitoring 32Pacer indicator 31Paper replacement, printer 90Patient Alarm Menu 53Patient AlarmsCancel alarms 53Respond 53Suspend alarms 53Patient modeChange current patient mode 22Change powerup patient mode 23Check at powerup 19Custom 23Factory 23Patient Mode window 19
118 Protocol Systems, Inc.Periodic maintenance 92Physical inspection 91Physical specifications 112PowerSpecifications 113Power AdapterSpecifications 114Power adapter 87Power fuse replacement 89Powerup patient mode 23Powerup procedure 19Practice using Encore 16PrintAutomatic alarm printing 70Automatic apnea ticket printing 70Automatic NIBP ticket printing 70Automatic OxyCRG printing 70Automatic printing 70Automatic trend printing 69Continuous printing 70Displayed trend 68Displayed waveforms 67Multiple trends 69OxyCRG 71Print at Acuity printer from monitor 76Set printer options 70PrinterEquipment alert messages 63Generate a test print 90Long-term storage precautions 92Paper replacement 90Set options 70Specifications 112Printer Setup Page 70PrintingArtifact symbol with NIBP 67PROGRAM FAULT equipment alert message 62Programmable patient modes 23Propaq CSModels and options 12Physical inspection 91Pulse Oximetry(see SpO2)RRebreathing, INCO2 48Recharge battery 87RecyclingBattery 92Monitor 92Replace fusesAC power adapter 88Monitor input power 89Replace printer paper 90Reset clock 95RESPDisplay 30Equipment alert messages 57High frequency ventilation 28Lead selection 31Specifications 102SpO2 monitoring as backup method 28Turn on or off 31Waveform size adjustment 30RESPONSE time (SpO2) 42Response time, CO2 49Resume alarms 53Retries (NIBP) 38Right side panel 11SScavenging system for gas, Sidestream CO2 47SCO2(see Sidestream CO2)ServiceRecommendations 10Service Manual 10Service interval recommendations 92Service Menus 15Set time and date 95Settings, factory default 97SetupAlarm limits 21Alarms 21Custom patient modes 23New patient 19Patient modes 23Powerup patient mode 23Setup Menus 15Side panelLeft side panel 12Right side panel 11Sidestream CO2Alarm limits 49Cannulas 47Display 48Equipment alert messages 61Exhaust port 47Flow rate 49Gas compensation 49Gas scavenging system 47Intubated patient 47Menus 48Monitoring 46Non-intubated patient 47Rapid breath rate and ETCO2 values 46Rapid respiratory rate for children 46Response time 49Specifications 108SpO2 option and CO2 46Switch to Mainstream CO2 49Turn on/off 49Warnings 46Watertrap insertion 46Skin preparation for ECG 28SMARTCUF NIBP artifact filter 36SMARTCUF symbol on display, prints 37Snapshot printing 67Sound volume selection 20Source selection, CO2 49SpecificationsAC power adapter 114
Propaq CS Directions for Use 119IndexAlarm indicators 109Alarms, audible 110CO2, general 106Display 111ECG 99Environmental 111IBP 103Mainstream CO2 107Monitor, physical 112NIBP 104Nurse Call Alarm 110Power 113Printer 112Real-Time ECG Analog/Defib Sync 101RESP 102Sidestream CO2 108SpO2 105Temperature 105Trends 111SpO2Adjust waveform size 42C-LOCK 42Display 42Equipment alert messages 59Monitoring 41NIBP and SpO2 41Reducing false alarms 43Response time selection 42Self-calibration 41Sensor selection 41Specifications 105SpO2 Menus 42Spot-Check monitoring 43STANDBY message 41Standby Mode 43Warnings 41Spot-Check SpO2 monitoring 43STANDBY and SpO2 43STANDBY message, SpO2 41Standby Mode, SpO2 43STARTUP message, Sidestream CO2 48STAT SET, customize alarm limits 54STATSCALE 13STBY message, SpO2 STANDBY 43Storage precautions 92Sweep speed selection 20Sweep speed selection, CO2 and RESP 48SymbolIn NIBP display 38, 68In NIBP printout 67Synchronizing R-waves, C-LOCK 42TTemperatureDisplay 40Equipment alert messages 59Monitoring 40Select measurement units 96Specifications 105Warnings 40Temperature units, change 40Time and date setting 95Tone volumes 20Transducer for IBP 33TrendsAutomatic printing 69Delete all trends 69Display 68NIBP and symbol 68Print all selected trends 69Select trends for printing 69Specifications 111TURBOCUF (automatic NIBP) 39Turn on waveform display 20UUnits of measure, CO2 96Units of measure, temperature 40, 96VVentilation, high frequency and RESP 28VERY LOW BATTERY message 63Vital sign waveform display 20Volume adjustment, HR/PR tone 31Volume tone selection 20WWARMUP message, Mainstream CO2 48WarningsAcuity 75Defib Sync and LIFEPAK 5 79Defib Sync and LIFEPAK 6s 82ECG/RESP 27General 9IBP 33Mainstream CO2 44NIBP 36Pacemaker patients 32Sidestream CO2 46SpO2 41Temperature 40Warranty period service 10Watertrap for Sidestream CO2 46Wave Select window 20WaveformCO2 48ECG size adjustment 30IBP 35RESP size adjustment 30SpO2 42Waveform display 13Waveform display selection 20Windows, general description 13ZZero a transducer 33
120 Protocol Systems, Inc.

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