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

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Date Submitted	2001-10-16 00:00:00
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Vital Signs Monitor
Directions for Use
Models 242, 244, 246
Software Version 3.1X
Please 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 Service
8500 SW Creekside Place
Beaverton, Oregon 97008-7107 USA
Within USA, toll free:
Phone:
Phone Technical Services:
(800) 289-2500
(800) 289-2501
WorldWide: Phone:
Fax:
Fax Technical Services:
(503) 526-8500
(503) 526-4200
(503) 526-4910
Protocol Systems, Inc.: Asia/Pacific
P.O. Box 29020
Christchurch 5, New Zealand
Phone:
64 3 37 94 429
Fax:
64 3 37 92 374
Internet: http://www.protocol.com
Email Technical Services: solutions@protocol.com
Email Marketing Dept.: marketing@protocol.com
Protocol Medical Systems, Ltd.: NW Europe
Derby Service Centre
St. Georges House
Vernon Gate
Derby DE1 1UQ, United Kingdom
Phone:
44 1332 206208
Fax:
44 1332 206209
Email:
uk@protocol.com
Reorder No: 810-1097-01, Rev. A 5/00
Printed in USA
Table of
Contents
Contents
1 – General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Intended Use, Symbols, and Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Learn Propaq CS Operation with In-Service Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2 – Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Prepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Set Patient Alarms and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Change the Current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Change Powerup Patient Mode or Store Customized Settings . . . . . . . . . . . . . . . . . . 23
3 – Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Perform ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . . . . . . . . . . 32
Perform Invasive Blood Pressure (IBP) Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Take a Non-Invasive Blood Pressure (NIBP) Reading . . . . . . . . . . . . . . . . . . . . . . . . . 36
Perform Temperature Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Perform SpO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Perform Mainstream CO2 Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Perform Sidestream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Set Up the CO2 Display and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
4 – Alarms & Alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Respond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Customize Alarm Limits Based on Patient’s Current Vital Signs . . . . . . . . . . . . . . . . . 54
Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Connect Nurse Call Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Respond to An Equipment Alert. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Troubleshooting Equipment Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
5 – Printing & Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
Print Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Display or Print Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Set Printer Options and Automatic Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Propaq CS Directions for Use
6 – Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Connect the Monitor to the Acuity System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Disconnect the Monitor from the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
7 – Defibrillator Synchronization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . . . . . . . . . . . . . 79
Synchronous Cardioversion with LIFEPAK 6s Defibrillator . . . . . . . . . . . . . . . . . . . . . 82
8 – Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Connect the AC Power Adapter to Recharge the Battery . . . . . . . . . . . . . . . . . . . . . . 87
Replace Monitor Input Power Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Inspect and Clean the Monitor and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Service Interval Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
9 – Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Set the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Factory Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
10 – Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Protocol Systems, Inc.
1 – General Information
Intended Use, Symbols, and Safety Information . . . . . . . . . . . . . . . . . . . . .
Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Setup Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Learn Propaq CS Operation with In-Service Mode . . . . . . . . . . . . . . . . . . 16
General
Information
Controls and Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Touch-Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
System Control and Connectors (Right Side Panel) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Patient Connectors (Left Side Panel) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Option Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
6
Protocol Systems, Inc.
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 Temperature (TEMP) channel is intended to measure temperature using an attachable probe.
The Pulse Oximetry (SpO2) channel is intended to noninvasively measure oxygen saturation of arteriolar
hemoglobin at a peripheral measurement site.
The Capnography (CO2) channel is intended to noninvasively measure the following vital signs or events:
End-tidal CO2 (ETCO2), Inspired CO2 (INCO2), 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.
Symbols
Warning
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.
Propaq CS Directions for Use
General
Information
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 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 port
On
Input port
For continued fire protection, use only the
specified fuse
Output port
Direct current
Alternating current1
Direct current or alternating current
Separate batteries from other disposables for
recycling.
Caution: Refer to Directions For Use and
accompanying documentation
0123
Enclosure Protection Drip proof:
Classification IPX1 per IEC Publication 529
IPX1
Battery charging when green indicator
illuminated
Temperature sensor input
Patient connections are Type CF, isolated for
direct cardiac application, and protected
against defibrillation
Transformer meets requirements of a
short-circuit-proof safety-isolating power
transformer1
Patient connections are Type BF, and
protected against defibrillation
For 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 product1
The CE Mark and Notified Body Registration
Number signify the device has met all
essential requirements of European Medical
Device Directive 93/42/EEC
NRTL /C
Evaluated to CSA 601-1
and UL2601-1
Urgent alarm notification (output to Nurse
Call system)
US
The Canadian Standards Association has
evaluated this device according to CSA
601-1 and Underwriters Laboratory Standard
UL 2601-11.
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.
NIBP cuff sizes:
Thigh
Large adult
Adult
Small adult
Child
Infant
Single-use only (not reusable).
1. This symbol is on the Universal Power Adapter.
Protocol Systems, Inc.
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.
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 CO2 monitoring may not operate properly when used in conjunction with
high-frequency jet ventilation or high-frequency oscillatory ventilation.
Propaq CS Directions for Use
General
Information
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.
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 Connectors
Nurse Call
Option
Alarm Light
Alarm(s) Off Light
Suspend/
Resume
Alarm
Suspends alarm tone
for 90 seconds or
resumes alarm tone
(if active)
SpO2
Option
Start/
Stop
NIBP
Starts or stops NIBP
reading
Home
Mainstream
CO2 Option
Printer
Option
Returns the display to
the Main Menu
Printer Buttons
Sidestream
CO2 Option
10
Protocol Systems, Inc.
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.
General
Information
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)
On/Off Switch
MONITOR
DEFIB SYNCHRO
Defib Sync Connector
Real-time ECG Output Connector
Input Fuse
3A
2AG
EKG x 1000
Speaker
Connector for Acuity or Modem-Propaq
Power Input Connector
12-28V, 3A
Propaq CS Directions for Use
Battery Charging Light
11
Patient Connectors (Left Side Panel)
Model 242
Model 246
Model 244
ECG
NIBP
Temperature (two channels)*
ECG
Invasive Pressure (two channels)
NIBP
Temperature (two channels)*
ECG
Invasiv Pressure (one channel)
NIBP
Temperature (two channels)*
ECG / EKG RESP
INV. BP
ECG / EKG RESP
P1
INV. BP
P1
ECG / EKG RESP
NIBP
PSNI
NIBP
PSNI
T1
NIBP
PSNI
T1
T2
T2
T2
INV. BP
Propaq CS Model 242
Propaq CS Model 244
ECG / EKG RESP
INV. BP
T1
P2
Propaq CS Model 246
INV. BP
P1 ECG / EKG RESP
P1 ECG / EKG RESP
COMPATIBLE
HP
COMPATIBLE
HP
COMPATIBLE
HP
INV. BP
NIBP
NIBP
HP Model 242*
HP Model 244*
NIBP
P2
HP Model 246*
*The HP (Hewlett-Packard) side panels provide only one temperature connector.
Option Connectors
CO2
SpO2
CO2
NELLCOR
SENSORS/CAPTEURS
SpO2 Connector
12
Mainstream CO2 Connector
Sidestream CO2 Connector
Nurse Call Connector
Protocol Systems, Inc.
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.
Patient mode
NET OFF
to disconnect
from the Acuity
network.
Time of day
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
Status messages can appear here.
HR
PRINT FAULT
BPM
II
mV
1cm
Patient name
entered at
Acuity Central
Station.
P1
(M)
15) mmHg
mV
1cm
MON
NIBP
130
TEMP
85) mmHg
(M)
P 100
°F
70
30
MCO2
P 15
SpO2
mmHg
ALARMS
ACUITY
100.4
98.6
1.8
BR
38 12
Br/m
97
STATSCALE
T1
T2
∆T
Heart Rate in
beats per minute.
Bells indicate
alarm limit status
All numeric
values are
continuously
displayed and
updated.
General
Information
79
25
122
58
P2
STATSCALE
automatically adjusts
all waveform scales for
optimum viewing.
96) mmHg
(M)
MON
When
selected,
trends are
displayed
here.
11121
Heart Rate Source:
HR indicates ECG;
PR indicates blood
pressure or SpO2.
If the monitor
detects a vital
sign outside the
measurable
range, it displays
- - - (below the
range) or + + +
(above the
range).
MORE
TRENDS
While changing monitor settings, a status window may appear below the waveform:
ECG1
waveform
is always
displayed
if active.
Status
window
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
PRINT FAULT
HR
BPM
II
mV
1cm
P1
11121
(M)
79
25
122
58
( 96) mmHg
P2
MON
ECG/RESP
(M)
( 15) mmHg
: OFF
HR/PR TONE
PACER DISPLAY
: ON
ECG BANDWIDTH
: MONITOR (0.5-40Hz)
RESP LEAD
: Ld2 (RA-LL)
RESP MONITORING : ON
NIBP
(M)
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Propaq CS Directions for Use
CHANGE
ETCO2
concentration
Breath Rate
from CO2
Br/m
SpO2
NEXT
Systolic, diastolic,
and mean pressures
are uniquely labeled
and displayed.
97
Oxygen saturation is
a percentage value.
PREVIOUS
MENU
13
Menus
Menus for some patient vital signs are displayed only if the option is included in your Propaq CS
monitor.
Main Menu
MAIN MENU
NIBP
ECG/
RESP
INVASIVE
PRESSURE
SETUP
SpO2/
CO2
SpO2
CO2
PREVIOUS
MENU
CO2 MENU 1
RANGE
mm/s
MORE
PREVIOUS
MENU
CO2 MENU 2A (NO CO2 SENSORS)
GAS
COMP
RESPONSE
PREVIOUS
MENU
CO2 MENU 2B (MAINSTREAM CO2 ACTIVE)
GAS
COMP
RESPONSE
SOURCE
PREVIOUS
MENU
CO2 MENU 2C (SIDESTREAM CO2 ACTIVE)
GAS
COMP
RESPONSE
SOURCE
FLOW
RATE
PREVIOUS
MENU
SpO2 MENU 1
SIZE
MORE
PREVIOUS
MENU
SpO2 MENU 2
RESPONSE
C-LOCK
PREVIOUS
MENU
INVASIVE PRESSURE MENU 1
RANGE
RESCALE
ZERO P1
ZERO P2
CANCEL
CANCEL
MORE
INVASIVE PRESSURE MENU 2
LABEL
P1
FORMAT
P1
LABEL
P2
FORMAT
P2
RESP
SIZE
MORE
PREVIOUS
MENU
ECG/RESP MENU 1
ECG1
SIZE
ECG1
LEAD
ECG2
SIZE
ECG/RESP MENU 2
NEXT
CHANGE
PREVIOUS
MENU
NIBP MENU
START
AUTO/
MANUAL
INTERVAL
TURBOCUF
SMARTCUF
STOP
14
Protocol Systems, Inc.
Setup Menus
ECG/
RESP
INVASIVE
PRESSURE
SpO2/
CO2
SETUP
ALARMS
WAVE
WAVE SEL
SELECT
TRENDS
MORE
NIBP
SETUP MENU 1
STATSCALE
SETUP MENU 2
NEXT
ACUITY
CHANGE
WAVE
SELECT
PRINTER
MORE
TREND MENU
PRINT
NEXT
TREND
PRINT
OXYCRG
NET
OFF
SNAPSHOT
PREVIOUS
MENU
ALL
ALARMS
LIMITS
PREVIOUS
MENU
UP
DOWN
ON/
OFF
ACUITY MENU1
ALARMS MENU
SUSPEND
General
Information
STAT SET
RESUME
ALARM LIMITS MENU2
NEXT
PARAMETER
NEXT
SETTING
Acuity Menu is
displayed if the monitor
is connected to Acuity.
TIME/DAY MENU
NEXT
UP
DOWN
ENTER
SERVICE
SpO2
TEST
CO2
TEST
MORE
NET
TEST
PCMCIA
TEST
MORE
ON/OFF key is not
displayed for HR/PR
alarm limits if the
HR/PR ALARM
LIMITS setting is set
to CANNOT TURN
OFF.
SERVICE MENU 13
NIBP
TEST
IBP
TEST
SERVICE MENU 23
PIXEL
TEST
TEMP
TEST
SERVICE MENU 33
Service menu tests
are only for use by
authorized service
personnel and are
only available in the
Adult patient mode.
SETTINGS
SCREEN
CAL
SYSTEM
MORE
SETTINGS MENU
NEXT
CHANGE
PREVIOUS
MENU
PRINTER SETUP MENU
NEXT
CHANGE
CHANGE
PRINT
TREND
PREVIOUS
MENU
WAVE SELECT MENU
NEXT
ON/
OFF
PREVIOUS
MENU
NO
INSERVICE
Patient Mode menu
is accessed when
CHANGE is pressed
for PATIENT MODE.
INSERVICE
PATIENT MODE MENU4
NEONATAL
PEDIATRIC
ADULT
SETUP
PREVIOUS
MENU
USE
NOW
SAVE
PREVIOUS
MENU
MODE SETUP MENU
NEXT
Propaq CS Directions for Use
POWERUP*
15
Learn Propaq CS Operation with In-Service Mode
You 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.
16
Protocol Systems, Inc.
2 – Setup
Prepare the Propaq CS Monitor for a New Patient . . . . . . . . . . . . . . . . . . 19
Set Patient Alarms and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Change the Current Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Change Powerup Patient Mode or Store Customized Settings . . . . . . . . 23
Change the Powerup Patient Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Customize Patient Mode Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Setup
18
Protocol Systems, Inc.
Prepare the Propaq CS Monitor for a New Patient
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 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.
Home
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:
PATIENT MODE
BATTERY: 8.2 VOLTS
SELECT PATIENT MODE BASED ON AGE:
NEO : < 44 WEEKS GEST. AGE
PED : > 44 WEEKS GEST. AGE,
< 9 YEARS
Setup
ADULT: > 9 YEARS
NEONATAL
4.
PEDIATRIC
ADULT
SETUP
PREVIOUS
MENU
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.
Propaq CS Directions for Use
19
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.
WAVE SELECT
SETUP
ECG1 : ON
CO2 : ON
ECG2 : ON
RESP : ON
PA
: ON
SpO2 : ON
P2
: ON
NIBP : ON
NEXT
PREVIOUS
MENU
INSERVICE
ON/
OFF
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.
SETUP
CURRENT SOURCE :
SELECTED SOURCE :
SWEEP (mm/s)
HR/PR
RR/BR
???
ECG
25.0
???
--6.25
ALARM TONE
HR/PR TONE
: LOW
: OFF
PATIENT MODE
BRIGHTNESS
: NORMAL
NEXT
CHANGE
The ? ? ? is
displayed until
a source is
active.
ADULT
WAVE
SELECT
PRINTER
MORE
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.
20
Protocol Systems, Inc.
Set Patient Alarms and Alarm Limits
1.
From the Main Menu, press SETUP, ALARMS to access the Alarms Status Menu:
P2
ALARM STATUS
NIBP
RR/BR :
APNEA :
HR/PR :
SpO2 :
P1
NIBP :
P2
TEMP :
CO2
(M)
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
SUSPEND
ALL
ALARMS
Bells also
appear in
numerics
windows.
97
STAT SET
25
122
58
15) mmHg
(M)
LIMITS
PREVIOUS
MENU
All alarm limits are on.
At least one alarm limit is off.
(No bell)
2.
All alarm limits are off or the vital
sign is not being monitored.
Press LIMITS to display the Alarms Limits window:
ALARM LIMITS
Press NEXT
PARAMETER to
scroll down. After
the selection
reaches the last
parameter, it
returns to the top
(HR/PR).
NEXT
PARAMETER
BPM
Br/M
sec
mmHg
mmHg
mmHg
mmHg
mmHg
°F
°F
°F
NEXT
SETTING
UP
LOWER
50
(M)
25
122
58
( 15) mmHg
NIBP
(M)
( 85) mmHg
90
OFF
TEMP
75
35
50
95.0
95.0
0.0
MCO2
°F
DOWN
mmHg
T1
T2
∆T
99.8
98.6
1.2
BR
38 12
Setup
Arrow indicates
there are more
parameters that
are not displayed.
HR/PR
RR/BR
APNEA DELAY
SpO2
ETCO2
INCO2
NIBP S
NIBP D
NIBP (M)
T1
T2
∆T
UPPER
120
30
20
100
OFF
OFF
220
110
120
* 100.0
100.0
5.0
Br/m
SpO2
97
ON/
OFF
An 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.
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.
Home
Propaq CS Directions for Use
21
Change the Current Patient Mode
1.
To change the current patient mode, from the Main Menu press SETUP, MORE, CHANGE to access
the Patient Mode window:
PATIENT MODE
BATTERY: 8.2 VOLTS
SELECT PATIENT MODE BASED ON AGE:
NEO : < 44 WEEKS GEST. AGE
PED : > 44 WEEKS GEST. AGE,
< 9 YEARS
ADULT: > 9 YEARS
NEONATAL
2.
PEDIATRIC
ADULT
SETUP
PREVIOUS
MENU
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.
22
Protocol Systems, Inc.
Change Powerup Patient Mode or Store Customized Settings
The 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 Mode
1.
From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.
P2
MODE SETUP
FACTORY:
BATTERY: 9.2 VOLTS
*ADULT
PED
(M)
NIBP
NEO
85) mmHg
(M)
Asterisk
indicates which
patient mode is
currently
selected for
powerup.
CUSTOM :
ADULT
PED
NEO
TEMP
°F
* = PATIENT MODE ON POWERUP
25
122
58
( 15) mmHg
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
USE
NOW
SAVE
97
PREVIOUS
MENU
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.
Propaq CS Directions for Use
23
Setup
2.
POWERUP*
Customize Patient Mode Settings
1.
2.
3.
From the Main Menu, press SETUP, MORE, CHANGE, SETUP to access the Mode Setup window.
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.
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).
Home
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.
24
Protocol Systems, Inc.
3 – Monitoring
Perform ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Prepare for ECG/RESP Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Use the ECG Filter to Display a Better Waveform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Use the Propaq CS Monitor With Pacemaker Patients . . . . . . . . . . . . . . . 32
Perform Invasive Blood Pressure (IBP) Monitoring . . . . . . . . . . . . . . . . . 33
Take a Non-Invasive Blood Pressure (NIBP) Reading. . . . . . . . . . . . . . . . 36
Improve NIBP Accuracy with Smartcuf™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Take the NIPB Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Perform Temperature Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Perform SpO2 Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Perform SpO2 “Spot-Check” Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Perform Mainstream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Perform Sidestream CO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Set Up the CO2 Display and Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . 48
Monitoring
26
Protocol Systems, Inc.
Perform ECG/RESP Monitoring
ECG/R
ESP
Warning
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.
Monitoring
Propaq CS Directions for Use
27
ECG/
RESP
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 Monitoring
1.
2.
Inspect the ECG cable and replace it if it shows signs of wear, breakage, or fraying.
3.
Select electrode sites on the patient.
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.
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.
28
Protocol Systems, Inc.
6.
Attach lead wires to the electrodes before applying them to the patient. Apply the electrodes
to the patient as shown.
LA
RA
Standard 3-lead
Configuration
If using MCL1,
select LEAD II
on the monitor,
and use all three
electrodes.
LL
Marriott
Configuration
MCL 1
(G)=LA (-)=RA (+)=LL
RA
LA
LA
RA
V1
V6
One of six V lead
electrode placement
sites for the C lead.
RL
5-lead Configuration
LL
LL
Neonate 3-lead Configuration
7.
8.
Plug the ECG cable into the ECG connector on the monitor's left side panel.
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.
Support the ECG cable so it does not stress the electrode wires, ECG cable connectors, or
electrodes.
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.
Monitoring
Propaq CS Directions for Use
29
ECG/
RESP
11.
To set up the ECG/RESP display, from the Main Menu press ECG/RESP to display the first
ECG/RESP menu:
ECG1 lead
selected
ECG1 size
selected
ECG2 lead
The ECG2 lead
is always V,
except when the
ECG1 lead is V
(in that case the
ECG2 lead is II).
RESP waveform
is displayed (with
RESP option)
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
PRINT FAULT
BPM
II
mV
1cm
P1
12.
11121
(M)
79
25
122
58
( 96) mmHg
P2
MON
(M)
( 15) mmHg
mV
1cm
MON
Ld2
2X
NIBP
85) mmHg
(M)
TEMP
T1
T2
∆T
°F
RESP
MCO2
mmHg
RESP lead
selected
RESP size
selected
HR
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
97
ECG1
SIZE
ECG2
SIZE
ECG1
LEAD
BR indicates
respiration rate is
derived from
active CO2
channel.
RR indicates CO2
is not monitored
and respiration
rate is derived
from ECG/RESP.
MORE
RESP
SIZE
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:
ECG bandwidth selected:
MON = Monitor
EXT = Extended
mV
1cm
MON
(M)
121
79
25
122
58
( 96) mmHg
P2
ECG/RESP
(M)
( 15) mmHg
: OFF
HR/PR TONE
PACER DISPLAY
: ON
ECG BANDWIDTH
: MONITOR (0.5-40Hz)
RESP LEAD
: Ld2 (RA-LL)
RESP MONITORING : ON
NIBP
(M)
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
30
CHANGE
97
PREVIOUS
MENU
Protocol Systems, Inc.
14.
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
15.
Turns RESP on or off.
Set alarms according to your facility’s standards.
Use the ECG Filter to Display a Better Waveform
If 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.
2.
3.
Press SETUP, MORE, MORE, SERVICE, YES to access the Service Menu.
Press MORE, MORE, SETTINGS to display the Settings Menu.
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.
Monitoring
Contact a qualified service person if you have questions.
Propaq CS Directions for Use
31
ECG/
RESP
Use the Propaq CS Monitor With Pacemaker Patients
Warning
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.”)
Pacemaker signal indicators
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
II
mV
1cm
MON
PRINT FAULT
HR
BPM
P1
(M)
8121
( 96) mmHg
P2
(M)
79
25
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.
32
Protocol Systems, Inc.
Perform Invasive Blood Pressure (IBP) Monitoring
INV
PRS
Warning
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.
BPM
II
mV
1cm
P1
112
NOT
ZEROED
MON
mV
1cm
MON
NIBP
(M)
122
58
The message
NOT ZEROED
immediately
appears in the IBP
numerics window
for the invasive
pressure channel
being used.
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
RANGE
4.
RESCALE
ZERO P1
ZERO P2
97
MORE
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.
Propaq CS Directions for Use
Monitoring
To zero the transducer, open the transducer's stopcock to atmospheric air. Wait a few seconds
for the transducer to settle.
33
INV
PRS
5.
If the ZERO menu is not displayed, from the Main Menu press INVASIVE PRESSURE, then ZERO
(or ZERO P2). The word ZEROING appears in the numerics window during zeroing.
P1
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.
8.
Close the transducer's stopcock. The monitor displays the pressure scale and numerics.
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:
(M)
mV
1cm
MON
NIBP
130
TEMP
(M)
°F
70
30
MCO2
P 15
SpO2
mmHg
34
( 85) mmHg
P 100
IBP labels are
user-selectable.
25
122
58
( 15) mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
97
RANGE
RESCALE
ZERO P1
ZERO P2
MORE
LABEL
P1
FORMAT
P1
LABEL
P2
FORMAT
P2
PREVIOUS
MENU
First IBP
menu
Second IBP
menu
Protocol Systems, Inc.
10.
To display all invasive pressure waveforms on one
scale (when two IBP channels are active), press
RANGE to select the Range Mode.
180
90
Press RANGE again to select another scale. Five scales
are available:
300/150/0
180/90/0
120/60/0
60/30/0
30/15/0
RANGE
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.
ZERO P1
Range Mode displays both
waveforms on one scale.
Choose the scale carefully to make sure both
waveforms are displayed (if monitored).
11.
RESCALE
130
P 100
70
30
P 15
RANGE
RESCALE
ZERO P1
Rescale Mode displays each
waveform on its own scale.
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 label
P2
(yellow)
default label
ART (red)
arterial
PA
(yellow)
pulmonary artery
CVP (blue)
central venous pressure
ICP
(white)
intracranial pressure
UA
(red)
umbilical artery (NEO mode only)
UV
(blue)
umbilical vein (NEO mode only)
130
A 100
T 70
30
P 15
LABEL
P1
FORMAT
P1
LABEL
P2
LABEL selects alternate labels.
13.
To change the format of the IBP numerics, from the
second IBP menu press FORMAT.
To restore the first format, press FORMAT again.
P1
P1
( 96)
(M)
S / D
121
14.
121
79
(M)
First format
( 96) mmHg
Second format
79 mmHg
Set alarms according to your facility’s standards.
Monitoring
Propaq CS Directions for Use
35
INV
PRS
Take a Non-Invasive Blood Pressure (NIBP) Reading
NIBP
Warning
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.
36
Protocol Systems, Inc.
If 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:
MON
NIBP TREND
RR/BR
TIME HR/PR SpO2 S D (M)
Br/M
HH:MM BPM
mmHg
80
97 122 58 ( 85)
12
10:01
80
97 126 62 ( 86)
12
9:46
80
97 127 62 ( 86)
12
9:31
80
97 134 66 ( 89)
12
9:20
80
97 124 57 ( 86)
12
9:08
80
97 127 58 ( 88)
12
8:52
80
97 124 56 ( 85)
12
8:47
80
97 126 57 ( 84)
12
8:41
80
97 127 58 ( 85)
12
8:35
80
97 132 61 ( 89)
12
8:30
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.
NIBP
112
58
(M)( 85)
PRINT
18:45
mmHg
Numeric Display
Printout
NEXT
TREND
Trend Display
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 Reading
1.
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.
Neonate Mode
Pediatric Mode
Adult Mode
Typical Hoses
Neonate/Infant
Neonate/Infant, Adult
Adult
Typical Cuffs
Neonate #1 to #5
(disposable); newborn,
infant (reusable)
Neonate #4, neonate #5,
infant, child, small adult
Child, small adult, adult,
large adult, thigh
Recommended Limb
Circumference
up to 15 cm
10 to 25 cm
greater than 15 cm
Note
2.
Squeeze as much air from the cuff as you can before placing it on the patient.
Propaq CS Directions for Use
Monitoring
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.
37
NIBP
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.
Cuff applied
evenly and
snugly with
bottom edge
of cuff one
inch above
antecubital
fossa
The cuff should be snug, but not
uncomfortable. The hose must not
be kinked or pinched.
Possible cuff
placements for
neonates
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:
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
PRINT FAULT
BPM
II
mV
1cm
P1
Time remaining in
Turbocuf Mode or
Auto Mode interval
Smartcuf status
(M)
NIBP ADULT
(M)
TIME OF
READING:
MODE : TURBOCUF
TIME : 4:21
SMARTCUF : ON
Manometer Bar:
Systolic, diastolic,
and mean values
are indicated as
small triangles.
START is displayed
when no
measurement is
occurring.
START/STOP
11121
122
58
NIBP
( 85)
(M)
17:05:01
mmHg
100
150
200
85) mmHg
TEMP
°F
50
79
25
122
58
( 15) mmHg
(M) D
MCO2
75
( 96) mmHg
P2
MON
Measurement mode
HR
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
STOP
AUTO/
MANUAL
INTERVAL
TURBOCUF
97
SMARTCUF
The last
measurement
After 16 minutes,
the NIBP display
changes as
shown below for
44 minutes.
NIBP
112
58
(M)( 85)
18:45
mmHg
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.
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
38
Start/
Stop
NIBP
Switches between Automatic and Manual Mode. In Automatic Mode, the
monitor automatically takes measurements at the selected interval.
Protocol Systems, Inc.
INTERVAL
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
6.
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.
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.
Monitoring
Propaq CS Directions for Use
39
NIBP
Perform Temperature Monitoring
1.
TEMP
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:
T1
°F
98.8
If you connect a second temperature probe, the monitor displays the temperature for T1, T2, and ∆T.
3.
4.
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.
To change the temperature units (°C or °F), from the Main Menu press SETUP, MORE, MORE,
(to access the Service Menu), MORE, MORE, SETTINGS. Use NEXT and CHANGE to
change the temperature units.
SERVICE, YES
Changing units does not clear temperature trends.
40
Protocol Systems, Inc.
Perform SpO2 Monitoring
SpO2
Warning
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 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.
Propaq CS Directions for Use
Monitoring
The monitor displays STANDBY in the SpO2 numeric window until it measures and displays the
SpO2 value.
41
SpO2
4.
From the Main Menu, press SpO2 (or SpO2/CO2, then SpO2) to display the first SpO2 menu:
MCO2
70
mmHg
BR
38 12
Br/m
Oxygen
saturation
percentage
SpO2
97
SIZE
PREVIOUS
MENU
MORE
Pulse amplitude indicator
5.
6.
Press SIZE to adjust the waveform size for best viewing (1x, 2x, 4x, or 8x).
7.
Press MORE to display the second SpO2 menu:
Adjust the placement of the sensor until a good SpO2 waveform is displayed. A waveform
with artifact may cause erroneous oxygen saturation readings.
RESPONSE
8.
PREVIOUS
MENU
Press RESPONSE to select the appropriate time required to measure SpO2:
Response
9.
C-LOCK
Time
Indications for Use
NORMAL
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.
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.
42
Set alarm limits according to your hospital’s standards.
Protocol Systems, Inc.
11.
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” Monitoring
The 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:
SUSPEND
2.
STANDBY
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 monitoring
Note
Mode.
The message STBY on the SpO2 trend display and trend printouts indicates the monitor was in the SpO2 Standby
Monitoring
Propaq CS Directions for Use
43
SpO2
Perform Mainstream CO2 Monitoring
CO2
The 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.
2.
Select the appropriate airway adapter.
Connect the adapter, ventilator circuit, and CO2 sensor according to the manufacturer’s
instructions.
Adult airway adapter
Window
44
Low dead space airway adapter
Window
Protocol Systems, Inc.
Warning
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.
Monitoring
Propaq CS Directions for Use
45
CO2
Perform Sidestream CO2 Monitoring
The 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.
Sidestream CO2
Connector
Watertrap
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.
Exhaust Port.
WARNING - Do not connect sample
line or patient input to exhaust port.
46
Protocol Systems, Inc.
3.
For a non-intubated patient, position the
cannula on the patient according to the
manufacturer’s instructions.
3. For an intubated patient, connect the
gas sampling elbow and elbow
connector into the patient’s breathing
circuit according to the
manufacturer’s instructions.
Warning
Watertrap
The cannula is disposable and should only be used for a
single patient. Do not reuse the cannula for another patient.
Sample line
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.
Exhaust Port
WARNING - Do not connect sample
line or patient input to exhaust port
Watertrap
Sample line
Exhaust Port
Elbow
connector
To cannula
WARNING - Do not connect sample
line or patient input to exhaust port
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).
Propaq CS Directions for Use
Monitoring
Sidestream CO2 accuracy decreases if additional tubing is connected to the sample line. Avoid
connecting additional tubing to the standard sample line.
47
CO2
Set Up the CO2 Display and Alarm Limits
Note
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:
Measured CO2
levels are normally
displayed as a
waveform and an
ETCO2 numeric
value
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
1.
P1
P2
60
30
79
25
122
58
(M)
ETCO2
MCO2
(M)
15) mmHg
NIBP
8121
96) mmHg
(M)
MON
mmHg
35
10
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
INCO2 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%).
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NIBP
ECG/
RESP
INVASIVE
PRESSURE
SpO2/
CO2
97
Breath Rate is
determined from
the CO2 sensor.
SETUP
To adjust the display, from the Main Menu press SpO2/CO2, CO2 to access the first CO2 menu:
RANGE
2.
HR
BPM
II
mV
1cm
MCO2 indicates
Mainstream CO2 is
active.
SCO2 is displayed
when Sidestream
CO2 is active.
CO2 is displayed if a
Mainstream sensor
or Sidestream
watertrap is installed
but not active.
PRINT FAULT
mm/s
MORE
PREVIOUS
MENU
Press RANGE to select the CO2 waveform scale or range.
mmHg:
kPa:
%:
0-100
0-14
0-14
0-60 (default)
0-8
0-8
0-30
0-4
0-4
To 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.
48
Protocol Systems, Inc.
4.
Press MORE to access the second CO2 menu and status window:
CO2
NIBP
GAS COMPENSATION: OFF
RESPONSE
: NORMAL
CO2 SOURCE
: SIDESTREAM
SWEEP SPEED
: 6.25 mm/s
BAROMETER
FLOW RATE
(M)
5.
( 85) mmHg
TEMP
°F
SCO2
: 756.8 mmHg
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
: 175 ml/min
GAS
COMP
25
122
58
15) mmHg
(M)
RESPONSE
SOURCE
FLOW
RATE
FLOW RATE is only
displayed for
Sidestream CO2
(not Mainstream CO2).
97
PREVIOUS
MENU
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
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.
Propaq CS Directions for Use
Monitoring
For patient safety, it is recommended that the Breath Rate alarm limits always be turned on and set
appropriately.
49
CO2
50
Protocol Systems, Inc.
Respond to Patient Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Customize Alarm Limits Based on Patient’s Current Vital Signs . . . . . . .54
Alarm Holdoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Connect Nurse Call Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Respond to An Equipment Alert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Troubleshooting Equipment Alert Messages . . . . . . . . . . . . . . . . . . . . . . .57
ECG Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
RESP Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
IBP Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
NIBP Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Temperature Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
SpO2 Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Mainstream CO2 Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Sidestream CO2 Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Network Alert Message with Acuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Program Alert Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Printer Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Defibrillator Alert Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Very Low Battery Alert Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Alarms &
Alerts
4 – Alarms & Alerts
52
Protocol Systems, Inc.
Alarms &
Alerts
Respond to Patient Alarms
When an apnea alarm or patient alarm occurs, the monitor produces an audible tone and visual
indicators and displays the following:
Alarm lights
(see table on
page 109)
Press to suspend
the tone for 90
seconds.
Flashing numerics
indicate that limits
have been
violated.
Press LIMITS to
adjust alarm limits
(if LIMITS is
available).
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.
Suspend/
Resume
Alarms
Warning
Suspending an alarm suspends ALL alarm tones for 90 seconds or until RESUME is pressed.
2.
3.
Check the patient and provide appropriate care.
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.
Home
• 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.
Propaq CS Directions for Use
53
Customize Alarm Limits Based on Patient’s Current Vital Signs
1.
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.
STAT SET Limit Calculations1
Vital Sign
If the Patient’s Vital Sign
Value is
Then Calculated New
Lower Limit is
Then Calculated New Upper
Limit is
Heart Rate
HR ≤ 99
100 - 250
HR ≥ 251
HR x 0.8
HR - 20
Unchanged
HR x 1.2
HR + 20
250
Pulse Rate
PR ≤ 99
PR ≥ 100
PR x 0.8
PR - 20
PR x 1.2
PR + 20
Invasive Pressure
Inv Prs ≤ 25
26 - 99
Inv Prs ≥ 100
Inv. Pressure - 5
Inv. Pressure x 0.8
Inv. Pressure - 20
Inv. Pressure + 5
Inv. Pressure x 1.2
Inv. Pressure + 20
NIBP
NIBP ≤ 25
26 - 99
NIBP ≥ 100
NIBP - 5
NIBP x 0.8
NIBP - 20
NIBP + 5
NIBP x 1.2
NIBP + 20
Respiration
Rate/Breath Rate
RR/BR ≤ 25
26 - 99
RR/BR ≥ 100
RR/BR - 5
RR/BR x 0.8
RR/BR - 20
RR/BR + 5
RR/BR x 1.2
RR/BR + 20
Temperature
Temp ≥ 0˚C
Temp - 0.5
Temp + 0.5
SpO2
SpO2 ≥ 0%
SpO2 - 5
(min. limit 50%)
100% (adult and pediatric mode)
SpO2 + 5 (neonate mode)
ETCO2
ETCO2 ≥ 0 mmHg
ETCO2 + 10 mmHg
ETCO2 ≥ 2.0 (% or kPa)
ETCO2 - 5 mmHg
(min. 15 mmHg)
ETCO2 - 0.7 (% or kPa)
(min 2.0% or 2.0 kPa)
INCO2
INCO2 ≥ 0 mmHg
INCO2 ≥ 0 (% or kPa)
Not affected by STAT SET
INCO2 + 5 mmHg
INCO2 + 0.7 (% or kPa)
Apnea Delay
Not affected by STAT SET
ETCO2 + 1.4 (% or kPa)
1. 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.
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 LIMIT
Overrange
+++
Maximum
Unchanged
Underrange
--Unchanged
Minimum
Indeterminate
???
Unchanged
Unchanged
54
Protocol Systems, Inc.
To 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.
Vital Sign
Alarm Holdoff Time Period
HR/PR
3 seconds (except NIBP PR)
SpO2
10 seconds
RR/BR
5 seconds
Connect Nurse Call Option
The 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.
Nurse Call Connector
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.
Propaq CS Directions for Use
55
Alarms &
Alerts
Alarm Holdoffs
Respond to An Equipment Alert
When 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:
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
PRINT FAULT
BPM
II
mV
1cm
P1
11121
(M)
( 96) mmHg
P2
MON
General
equipment alert
message
HR
(M)
EQUIPMENT ALERT
( 15) mmHg
79
25
Specific problem
NIBP FAULT
TEMP
CUFF NOT DETECTED
MCO2
PRESS ANY KEY BELOW TO ACKNOWLEDGE
Press any key to
silence the alert tone.
°F
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
97
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.
56
Protocol Systems, Inc.
Alarms &
Alerts
Troubleshooting Equipment Alert Messages
ECG Messages
If 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 Messages
LEAD 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 Messages
TRANSDUCER 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 Messages
If 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.
Propaq CS Directions for Use
57
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).
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Protocol Systems, Inc.
Alarms &
Alerts
The 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 Messages
PROBE 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 Messages
SpO2 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.
Propaq CS Directions for Use
59
Mainstream CO2 Messages
Messages 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.
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Protocol Systems, Inc.
ALTIMETER 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.
Propaq CS Directions for Use
61
Alarms &
Alerts
Sidestream CO2 Messages
Network Alert Message with Acuity
NETWORK 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 Message
PROGRAM 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.
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Protocol Systems, Inc.
Alarms &
Alerts
Printer Alert Messages
CHECK 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 Message
DEFIB FAULT, CHECK INTERFACE CABLE. The monitor detects a problem with the interface
cable. Check the cable and defibrillator.
Very Low Battery Alert Message
VERY 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.
Propaq CS Directions for Use
63
64
Protocol Systems, Inc.
5 – Printing & Trends
Print Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Print the Displayed Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Set Printer Options and Automatic Printing. . . . . . . . . . . . . . . . . . . . . . . . 70
Print OxyCRG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Printing &
Trends
Display or Print Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Display or Print a Single Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Print Multiple Trends Manually or Automatically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Delete All Patient Trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
66
Protocol Systems, Inc.
Print Patient Data
Print the Displayed Waveforms
1.
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.
SNAP
SHOT
Printing &
Trends
START
STOP
Manually starts and stops a printout of patient
information as it is monitored (continuous or
real time).
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.
PRINT
TRENDS
Prints all trends that are enabled in the Printer
Setup Page (see page 69).
Printer Buttons
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.
Propaq CS Directions for Use
67
Display or Print Trends
Display or Print a Single Trend
1.
To display a patient data trend, press SETUP, TRENDS from the Main Menu. The monitor
displays the Trend Menu:
The monitor stores
trends every 2 minutes
(except for NIBP) for up
to 5 hours. After 5
hours, newly recorded
trends replace the
oldest trends.
NIBP trends are stored
when measured. Up to
128 NIBP trends can be
stored (up to 8 hours).
The TIME, HR/PR, and
SpO2 are stored for all
trends.
OFF indicates the vital
sign was not being
monitored.
ERR#x in an NIBP
TREND display or
printout indicates an
NIBP equipment alert
occurred. See page 57
for NIBP alert error
numbers and
definitions.
BPM
II
mV
1cm
P1
(M)
79
25
122
58
( 96) mmHg
P2
MON
RESP TREND
TIME HR/PR SpO2 RR/BR ETCO2
Br/M mmHg
HH:MM BPM
38
97
12
10:00 101
38
98
97
12
9:58
38
98 SRCH 12
9:56
38
97
9:54
OFF 12
38
98
12
9:52
98
38
21
9:50 112
94
38
99
12
9:48
97
38
98
12
9:46
97
38
98
12
9:44
98
38
98
12
9:42
98
(M)
( 15) mmHg
INCO2
mmHg
PRINT
Press to print the
displayed trend.
11121
NIBP
85) mmHg
(M)
TEMP
T1
T2
∆T
°F
MCO2
mmHg
BR
38 12
Br/m
SpO2
97
NEXT
TREND
Press to scroll through
the recorded trends.
100.4
98.6
1.8
PRINT
OXYCRG
Press to scroll to the next vital sign
trend (IBP, TEMP, and NIBP).
Numerics
that have
alarmed are
highlighted.
Press to print OxyCRG
(see page 71).
Trends are also displayed on the Main Menu if all waveforms except ECG1 are turned off in the Wave
Select Window.
2.
3.
Press NEXT TREND as needed to display the desired trend.
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.
P2
NIBP TREND
RR/BR
TIME HR/PR SpO2 S D (M)
Br/M
HH:MM BPM
mmHg
80
97 122 58 ( 85)
12
10:01
80
97 126 62 ( 86)
12
9:46
80
97 127 62 ( 86)
12
9:31
80
97 134 66 ( 89)
12
9:20
80
97 124 57 ( 86)
12
9:08
80
97 127 58 ( 88)
12
8:52
80
97 124 56 ( 85)
12
8:47
80
97 126 57 ( 84)
12
8:41
80
97 127 58 ( 85)
12
8:35
80
97 132 61 ( 89)
12
8:30
PRINT
68
25
122
58
15) mmHg
(M)
NIBP
(M)
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
TREND
97
PRINT
OXYCRG
Protocol Systems, Inc.
Print Multiple Trends Manually or Automatically
1.
Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page:
P2
PRINTER
SETUP PAGE
CONTINUOUS
AUTO PRINT
ALARM PRINT
NIBP TICKET
APNEA TICKET
OXYCRG ON ALARM
AUTO TREND
NIBP :
RESP :
P1
Select ON to include in trend printing.
25.0 mm/s
OFF
OFF
OFF
ON
OFF
: 01 05 09 13 17 21
ON
: OFF
P2
TEMP : OFF
OFF
ON
NIBP
(M)
Press to scroll to
the next selection.
CHANGE
Press to change
the displayed
value.
PRINT
TREND
( 85) mmHg
TEMP
°F
MCO2
mmHg
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
25
122
58
Printing &
Trends
Specifies what time the trends
automatically print. Trends are printed
every 4 hours beginning at either
01, 02, 03, or 04 hours.
(OFF=no printing.)
(M)
( 15) mmHg
97
PREVIOUS
MENU
Press to print all
selected trends.
2.
Press NEXT as needed to scroll down to the parameters listed below AUTO TREND (NIBP,
RESP, etc.).
3.
4.
Press NEXT and CHANGE to set desired trends to ON.
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 Trends
1.
To delete all trends recorded for a patient, turn off the monitor.
Propaq CS Directions for Use
69
Set Printer Options and Automatic Printing
1.
Press SETUP, MORE, PRINTER from the Main Menu to display the Printer Setup Page:
PRINTER
SETUP PAGE
CONTINUOUS
AUTO PRINT
ALARM PRINT
NIBP TICKET
APNEA TICKET
OXYCRG ON ALARM
AUTO TREND
NIBP :
RESP :
P1
: OFF
ON
OFF
ON
25.0 mm/s
OFF
OFF
OFF
ON
OFF
(M)
NIBP
(M)
TEMP
°F
mmHg
Press to scroll to
the next selection.
2.
CHANGE
Press to change the
displayed value.
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
( 85) mmHg
MCO2
: OFF
P2
TEMP : OFF
25
122
58
( 15) mmHg
PRINT
TREND
97
PREVIOUS
MENU
Press to print all
selected trends.
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
70
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.
Protocol Systems, Inc.
Print OxyCRG
The 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.
Printing &
Trends
Propaq CS Directions for Use
71
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Protocol Systems, Inc.
6 – Acuity
Connect the Monitor to the Acuity System . . . . . . . . . . . . . . . . . . . . . . . . 75
Print at Acuity from the Propaq CS Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Disconnect the Monitor from the Acuity System. . . . . . . . . . . . . . . . . . . . . 76
Acuity
74
Protocol Systems, Inc.
Connect the Monitor to the Acuity System
Warning
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.
Acuity
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.
Propaq CS Directions for Use
75
3.
4.
5.
6.
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.
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.
Confirm the patient identification at the bedside or enter the
patient information at the Acuity Central Station using the Patient
ID Setup Window.
If alarm limits have not been set, do so at the monitor or at the
Acuity Central Station using the Alarms Setup Window.
MONITOR
DEFIB SYNCHRO
3A
2AG
EKG x 1000
12-28V, 3A
Acuity Connector
Battery charging light
Power input connector
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 Monitor
1.
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 System
Press to disconnect
from Acuity
17:05:10
NET ADULT
OFF ON NETWORK ALLEN KIM
PRINT FAULT
II
mV
1cm
MON
1.
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.
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Protocol Systems, Inc.
7 – Defibrillator Synchronization
Synchronous Cardioversion with LIFEPAK 5 Defibrillator . . . . . . . . . . . . 79
Install the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Perform Synchronous Cardioversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Remove the Interface Cable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Synchronous Cardioversion with LIFEPAK 6s Defibrillator . . . . . . . . . . . 82
Defibrillator
Synchronization
78
Protocol Systems, Inc.
Synchronous Cardioversion with LIFEPAK 5 Defibrillator
Warning
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 Cable
1.
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
Defibrillator
Synchronization
Propaq CS Directions for Use
79
Perform Synchronous Cardioversion
1.
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.
SYNC
ONLY
WITH
LP5
3 LEAD
OR SYNC
MODEL
CARDIOSCOPES
SYNC
button
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.
(PUSH)
SYNC
Synchronization markers
17:05:10
T ADULT
F ON NETWORK ALLEN KIM
mV
1cm
PRINT FAULT
HR
BPM
P1
11121
96) mmHg
(M)
P2
(M)
79
25
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.
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Protocol Systems, Inc.
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 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.
6.
Follow hospital procedures and LIFEPAK 5 Defibrillator instructions for cardioversion.
If subsequent cardioversion must be performed, repeat steps 3 through 5.
Remove the Interface Cable
1.
2.
Disconnect the Interface Cable from the monitor.
3.
Store the Interface Cable in its static-protected
plastic bag.
Press the lever on the side of the LIFEPAK 5
Defibrillator and slide the Interface forward until
it is detached.
Defibrillator
Synchronization
Propaq CS Directions for Use
81
Synchronous Cardioversion with LIFEPAK 6s Defibrillator
Warning
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.
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Protocol Systems, Inc.
4.
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 panel
The SYNC button lights when activated.
6.
INTRNL
PADDLE
DISCHG
SYNC
SYNC
ENERGY SELECT
DELIVERED ENERGY –– JOULES
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.
100
150
50
POWER
200
30
20
CHARGE
300
10
360
CAUTION
HAZARDOUS ELECTRICAL OUTPUT. THIS EQUIPMENT
IS FOR USE ONLY BY QUALIFIED MEDICAL PERSONNEL.
PHYSIO-CONTROL
LIFEPAK66 s
LIFEPAK
DEFIBRILLATOR
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.
Follow hospital procedures and LIFEPAK 6s Defibrillator instructions for cardioversion.
8.
If subsequent cardioversion must be performed, repeat steps 5 through 7.
Propaq CS Directions for Use
Defibrillator
Synchronization
7.
83
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Protocol Systems, Inc.
8 – Maintenance
Connect the AC Power Adapter to Recharge the Battery . . . . . . . . . . . . . 87
Replace Power Adapter Fuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Replace Monitor Input Power Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Install Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Inspect and Clean the Monitor and Accessories . . . . . . . . . . . . . . . . . . . . 91
Service Interval Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Monitor Recycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Battery Recycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Extended Storage Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Maintenance
86
Protocol Systems, Inc.
Connect the AC Power Adapter to Recharge the Battery
Warning
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).
Power
setting
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.
MONITOR
DEFIB SYNCHRO
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.
3A
2AG
EKG x 1000
Power
input
connector
12-28V, 3A
Right Side Panel
87
Maintenance
Propaq CS Directions for Use
Green
battery
charging
light
Replace Power Adapter Fuses
If 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.
2.
3.
Unplug the removable power
cord from the ac power source
and adapter.
Using a small, flat-blade
screwdriver, carefully pry the
fuse module away from the
adapter.
Power
Switch
Fuse
Fuse Module
Remove and replace both fuses
with the correct type specified
on the adapter. The fuse module
can contain spare fuses.
Voltage
Selector and
Indicator
Power
Adapter
Spare Fuse
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.
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Protocol Systems, Inc.
Replace Monitor Input Power Fuse
If 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.
MONITOR
DEFIB SYNCHRO
Power
input fuse
holder
3A
2AG
EKG x 1000
Green
battery
charging
light
12-28V, 3A
Right Side Panel
89
Maintenance
Propaq CS Directions for Use
Install Printer Paper
Caution
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.
2.
3.
4.
Lay the monitor on its back to gain access to the bottom of the printer.
5.
6.
7.
Slide the end of the paper into the printer slot until it extends out the side.
Squeeze the locks on the paper door and pull out to open it.
Lift the paper roll from the holder and pull out any paper remaining in the printer.
Place the new paper roll onto the spindle on the door as shown, and pull out several inches of
paper.
Close the paper door and turn the monitor upright.
Simultaneously press the START/STOP and PRINT
button. Confirm the monitor prints a test
print similar to the following:
TRENDS
90
Protocol Systems, Inc.
Inspect and Clean the Monitor and Accessories
Before 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.
Equipment
Cleaning Instructions
Approved Cleaning Solutions1
Coverage®
Fantastik®
Formula 409®
Windex®
Hydrogen peroxide solution
Propaq CS Monitor2
• 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.3
Warm water
Liquid soap
Wex-cide®4
T.B.Q.®4
Cidex®
Ovation®
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 sensor5
• Wipe gently with cloth dampened
Mild detergent solution; also consult
with cleaning solution. Do not immerse manufacturer’s instructions.
the CO2 sensor in liquid.
Nellcor cables, Durasensor
oxygen transducers
• Wipe gently with cloth dampened
with isopropyl alcohol.
Isopropyl alcohol
Other accessories
• Consult manufacturer’s instructions.
Consult manufacturer’s instructions.
1. 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.
2. 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.)
3. 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.
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.
5. 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.
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.
91
Maintenance
Propaq CS Directions for Use
Service Interval Recommendations
At 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).
Recommended Interval1
Service Action
Six 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 50µA2
Minimum every three years
• Check battery capacity
1. More frequent service may be needed in extreme environments (heat, cold, dust, etc.).
2. 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.
Monitor Recycling
You can return a Propaq CS monitor to Protocol Systems for recycling when the monitor reaches the
end of its life.
Battery Recycling
When 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 Precautions
Caution
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.
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Protocol Systems, Inc.
Set the Time and Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Time/Day Settings and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Change the Date Format, ECG Filter, and Units . . . . . . . . . . . . . . . . . . . . 96
Factory Default Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
ECG Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Real-Time ECG Analog/Defib Sync Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Impedance Pneumography (RESP) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Invasive Pressure Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
NIBP Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Temperature Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Pulse Oximetry (SpO2) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Capnography (CO2) Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Alarms Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Nurse Call Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Nurse Call Cable Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Trends Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Display Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Monitor (Environmental) Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Monitor (Physical) Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Printer Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Power Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Power Adapter Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Reference
9 – Reference
94
Protocol Systems, Inc.
Reference
Set the Time and Date
1.
From the Main Menu press SETUP, MORE, MORE to display the Time/Day window:
(M)
TIME
( 85) mmHg
DAY
TEMP
H:MIN:S
MO/DA/YR
15:55:10
10/21/99
°F
MCO2
mmHg
T1
T2
∆T
58
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
2.
UP
DOWN
ENTER
97
SERVICE
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 Trends
Warning
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.
Propaq CS Directions for Use
95
Change the Date Format, ECG Filter, and Units
1.
2.
Make sure you are in the Adult patient mode (from the Main Menu press SETUP, MORE,
CHANGE, ADULT, YES).
From the Main Menu press SETUP, MORE, MORE, SERVICE, YES (to access the Service Menu),
The monitor displays the Settings window:
MORE, MORE, SETTINGS.
P2
BATTERY: 9.3 VOLTS
SETTINGS
DATE
FILTER
: MO/DA/YR
: 60 Hz
(M)
NIBP
(M)
TEMP
°F
DECIMAL : .
MCO2
CO2 UNITS: mmHg
mmHg
3.
CHANGE
T1
T2
∆T
100.4
98.6
1.8
BR
38 12
Br/m
SpO2
NEXT
( 85) mmHg
TEMP F/C : °C
HR/PR ALARM LIMITS: CAN TURN OFF
25
122
58
( 15) mmHg
97
PREVIOUS
MENU
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.
96
Protocol Systems, Inc.
The 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
Date1
Decimal1
HR/PR Sweep
RR/BR Sweep
Alarm Tone
HR/PR TONE
HR/PR SOURCE
RR/BR Source
Patient Mode
Display Brightness
ECG Bandwidth
ECG Size
ECG1 Lead
ECG2 Lead
ECG Filter1
ECG Pacer
RESP size
RESP lead
RESP sweep
RESP monitoring
RESP window
IBP Range
IBP Rescale
IBP Mode
Invasive Pressure Formats
NIBP Mode
NIBP Auto Time
NIBP Smartcuf
SpO2 SIZE
SpO2 C-LOCK
SpO2 Response
TEMP F/C1
CO2 Range
CO2 Sweep
CO2 Response
CO2 Units1
CO2 Gas Compensation
Sidestream CO2 Flow Rate
Display Wave Select
Propaq CS Directions for Use
Factory Default
MO/DA/YR. This setting is automatically updated whenever it is
changed during use (continuously programmed).
. (Period) This setting is automatically updated whenever it is
changed during use (continuously programmed).
25 mm/s
6.25 mm/s
MEDIUM
LOW
ECG
CO2 if available or ECG (not programmable)
Adult
Normal
Monitor
1 mV/cm
II
60 Hz. This setting is automatically updated whenever it is changed
during use.
ON
2X
Ld2
6.25 mm/s
ON
ON
0 to 180 mmHg
0 to 140 mmHg (not programmable)
RESCALE
Label dependent
MANUAL
15 min
ON
2x
OFF
NORMAL
Celsius
0 to 60 mmHg
6.25 mm/s
NORMAL
mmHg
OFF
Adult: 90 ml/minute
Ped: 90 ml/minute
Neonate: 90 ml/minute
(The flow rate cannot be programmed to a different value in a
Custom Patient Mode, see page 23.)
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).
97
Reference
Factory Default Settings
Factory Default Settings (Continued)
Setting
Factory Default
Trend Group
NIBP
Alarm Limits
HR/PR Alarm Limits1
HR Limits
All are ON except P2
CAN TURN OFF
Adult: 50, 120 beats per minute
Ped: 50, 150 beats per minute
Neonate: 100, 200 beats per minute
Adult: 75, 220 mmHg
Ped: 75, 145 mmHg
Neonate: 50, 100 mmHg
Adult: 35, 110 mmHg
Ped: 35, 100 mmHg
Neonate: 30, 70 mmHg
Adult: 50, 120 mmHg
Ped: 50, 110 mmHg
Neonate: 35, 80 mmHg
Adult: 75, 220 mmHg
Ped: 75, 145 mmHg
Neonate: 50, 100 mmHg
Adult: 35, 110 mmHg
Ped: 35, 100 mmHg
Neonate: 30, 70 mmHg
Adult: 50, 120 mmHg
Ped: 50, 110 mmHg
Neonate: 35, 80 mmHg
Adult: 90%, 100%
Ped: 90%, 100%
Neonate: 85%, 98%
Adult: 5, 30 Br/M
Ped: 10, 45 Br/M
Neonate: 10, 75 Br/M
35.0°, 37.8° C
0.0°, 2.8° C
25, 60 mmHg (3.0 and 8.0 for % and kPa)
N/A, 5 mmHg (0.7 for % and kPa)
Adult/Ped: 20 seconds
Neonate: 15 seconds
NIBP Limits - Systolic
NIBP Limits - Diastolic
NIBP Limits - Mean
P1, P2 Limits - Systolic
P1, P2 Limits - Diastolic
P1, P2 Limits - Mean
SpO2 Limits
RR/BR
TEMP Limits
∆T Limits
ETCO2 Limits
INCO2 Limits
Apnea Delay
Printer Settings
Printer Alarm Print
Printer Auto Print
Printer NIBP Ticket
Printer Apnea Ticket
Printer Print Speed
Printer Auto Trend
Printer Trend Selections
Printer OxyCRG on Alarm
OFF
OFF
OFF
ON
25 mm/s
OFF
NIBP and P1 = ON; all others = OFF
OFF
1. 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.
98
Protocol Systems, Inc.
Reference
Specifications
ECG Specifications
The 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
Connector
Selectable Leads
Lead Fault Indicator
ECG Size (sensitivity) in mV/cm
Display Sweep Speeds
QRS Tone Volume
QRS Tone Frequency
Bandwidth:
MONITOR
EXTENDED
Sample Rate
Input Protection
Lead Fail Sense Current
Tall T-wave Rejection
Common Mode Rejection
Input Impedance
Input Range (ac)
Input Range (dc)
System Noise
QRS Detector
Heart Rate Range
Heart Rate Meter Response Time
Propaq CS Directions for Use
Specification
AAMI 6 pin or Hewlett-Packard compatible 12-pin style connector
(optional). See illustration on page 100.
I, II, III, aVR, aVL, aVF, V
LA, LL, RA, RL, C, multiple
4, 2, 1, 0.5, 0.2
12.5, 25, and 50 mm/s
High, Low, Medium, Off
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 monitored
Adult Mode:
0.5 to 40 Hz
Pediatric Mode:
0.5 to 120 Hz
Neonatal Mode:
0.5 to 120 Hz
Adult Mode:
Pediatric Mode:
Neonatal Mode:
0.05 to 40 Hz
0.05 to 120 Hz
0.05 to 120 Hz
(see Real-Time ECG Analog/Defib Sync specification)
364 Hz
Electrosurgery and defibrillator protected when used with specified
ECG cables. All models also include electrosurgery interference
suppression.
50 nA dc for active leads
100-200 nA dc for driven lead, depending on number of electrodes
attached
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.
<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 ON
>2.5 MΩ differential @ 60 Hz
10 mV peak to peak
Up to ±300 mV
≤30 µV peak-to-peak, RTI, with all inputs = 47K in parallel with 0.047
µF.
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 ms
Adult Width Range (Duration): 70 to 120 ms
25 to 350 beats per minute (measurement)
25 to 300 beats per minute (display)
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.
99
ECG Specifications (Continued)
Characteristic
HR Accuracy
Heart Rate Averaging Method
Drift Tolerance (AAMI Specification
EC13-1992, 3.2.6.3)
Pacer Display
Pacer Pulse Rejection
Specification
±3 beats per minute or 3%, whichever is greater
NOTE: 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 = 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.
80 beats per minute indicated for 80 beats per minute ECG plus drift
waveform
Pacer indicator shown on screen if PACER function turned on; pacer
spike always shown if of sufficient amplitude.
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 3.1.4.2
Response to Irregular Rhythm (AAMI specification EC13-1992, 3.1.2.1. Part e.)
Ventricular Bigeminy (VB)
Slow Alternating VB
Rapid Alternating VB
Bidirectional Systole
1mV Ventricular Tachycardia
2mV Ventricular Tachycardia
78 to 81 bpm (80 bpm expected)
57 to 65 bpm (60 bpm expected)
118 to 123 bpm (120 bpm expected)
88 to 93 bpm (90 bpm expected)
197 to 198 bpm (206 bpm expected)
193 to 197 bpm (206 bpm expected)
LA
RA
SHIELD
LL
LA
RL
RL
LL
AAMI 6-pin ECG connector side
panel view
100
SHIELD
RA
HP 12-pin ECG connector side
panel view
Protocol Systems, Inc.
Special 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
Specification
Sync Output
0 to 5 V pulse, 100 ±5 ms wide, starts within 35 ms after peak of
R-wave. 15 mA short circuit current.
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.
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.
Common terminal for other signals
Real-time ECG Output
Marker Input (Defib Sync only)
Shield
SHIELD
N/C
ECG
SHIELD
GROUND
N/C
Real-time ECG Output connector side panel view
Propaq CS Directions for Use
SYNC
OUT
GROUND
N/C
MARKER IN
N/C
N/C
Defib Sync connector side panel view
101
Reference
Real-Time ECG Analog/Defib Sync Specifications
Impedance Pneumography (RESP) Specifications
Characteristic
Sweep speed
Amplitude range
Excitation signal characteristics
Sensing electrodes
Base impedance (in addition to 1kΩ
resistors in ECG cables)
Impedance dynamic range
Signal bandwidth after detection
Breath detection threshold
Respiration rate range
Respiration rate accuracy
Respiration rate source (RR)
Apnea alarm delay accuracy
Resolution
Apnea alarm delay settings
Cardiovascular artifact rejection
(CVA)
Motion artifact rejection
Obstructive apnea
102
Specification
3.13, 6.25, 12.5 mm/s; user-selectable
1x, 2x, 4x, 8x, 16x
65 µA RMS ±5% at 63.0 kHz pseudo sine wave
User selectable RA-LA or RA-LL
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.
20 ohms
0.06 Hz (single pole) to 3.2 Hz (2 pole)
140 milliohms or 2x CVA, whichever is greater
Adult/Ped: 0 (apnea), 2 to 150 breaths/min
Neonate: 0 (apnea), 3 to 150 breaths/min
±2 breaths/min or ±2%, whichever is greater
When CO2 is active, CO2 is the BR source. Otherwise, RESP from
ECG is the RR source.
+1 second
5 seconds
Central apnea only - alarm delay is set by the user
Adult/Ped = 6, 10, 15, 20, 25, 30 seconds
Neonate = 6, 10, 15, 20 seconds
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.
not rejected
not detected
Protocol Systems, Inc.
Reference
Invasive Pressure Specifications
Characteristic
Transducer Type
Transducer Excitation Impedance
Range
Transducer sensitivity
Excitation Voltage
Connector
Bandwidth
Zero Drift
Zero Adjustment
Numeric Accuracy
Pressure range
Pulse range
Leakage Current
Electrosurgery interference
suppression
Specification
Strain-gauge resistive bridge, or HP quartz (with HP Option). 1
200 to 2000 Ω
5 µV/V/mmHg
4.85 V Pulsed dc @ 181 Hz 2
ITT-Cannon plug MS3106F-14S-6P Std.
Hewlett-Packard compatible 12-pin connector (optional).
Digital filtered, dc to 20 Hz
±1 mmHg without transducer drift
±200 mmHg including transducer offset
±2 mmHg or 2% of reading, whichever is greater, plus transducer
error
-30 to 300 mmHg
25 to 250 beats per minute
Meets ANSI/AAMI risk (leakage) requirements
Included in all models
1. Transducers with 40 µV/V/mmHg sensitivity are not compatible.
2. Duty factor depends on transducer impedance. For 200 to ~900 Ω, duty factor is ≈ 11%. Above ~900 Ω, the duty
factor increases to ≈ 91%.
- SIGNAL
+ SIGNAL
+ EXC
- SIGNAL
+ EXC
- EXC
+ SIGNAL
- EXC
SHIELD
Standard 6-pin IBP connector side panel view
Propaq CS Directions for Use
SHIELD
HP 12-pin IBP connector side panel view
103
NIBP Specifications
Characteristic
Method
Control
Auto Intervals
Turbocuf
Displayed Pressures
Systolic Range
Diastolic Range
Mean Range
Static Manometer Accuracy
Minimum Inflation Pressure
Maximum Allowable Pressure
Default Inflation Pressure
Normal Overpressure Limit (results in up
to 2 retries)
Single Fault Overpressure Limit
Leak Rate
Pulse Rate Range
Maximum Determination Time (with
retries)
Maximum Determination Time (no retries)
Typical Determination Time without
Artifact
Minimum Time between automatic
measurements
Artifact Filtering
Electrosurgery Interference Suppression
NIBP Performance
NIBP Safety
104
Specification
Oscillometric
Automatic and manual measurement control
1, 2, 3, 5, 10, 15, 30, and 60 minutes
Maximum measurements allowable in a 5-minute period
Systolic, Diastolic, and Mean plus on-screen manometer
Adult: 30 to 260 mmHg
Ped: 30 to 160 mmHg
Neonate: 25 to 120 mmHg
Adult: 20 to 235 mmHg
Ped: 15 to 130 mmHg
Neonate: 10 to 105 mmHg
Adult: 20 to 255 mmHg
Ped: 15 to 140 mmHg
Neonate: 10 to 110 mmHg
±3 mmHg
Adult: 100 mmHg
Ped: 80 mmHg
Neonate: 50 mmHg
Adult: 270 mmHg
Ped: 170 mmHg
Neonate: 132 mmHg
Adult: 160 mmHg
Ped: 120 mmHg
Neonate: 90 mmHg
Adult: 280 mmHg
Ped: 200 mmHg
Neonate: 141 mmHg
Adult: 308 mmHg
Ped: 220 mmHg
Neonate: 154 mmHg
After a 1 minute settling period, leak rate is ≤4 mm/Hg over a
3-minute period at 270 mm/Hg.
30 to 220 beats per minute
Adult: 4.5 minutes
Ped: 4 minutes
Neonate: 3 minutes
Adult: 3 minutes
Ped: 2 minutes
Neonate: 1.5 minutes
30 to 45 seconds
30 seconds (Auto Mode)
2 seconds (Turbo Mode)
Smartcuf software algorithm (may be be enabled or disabled;
requires ECG monitoring). NIBP measurements can still be
taken if Smartcuf is disabled.
Included in all models.
Per EN 1060-1, EN 1060-3 and ANSI/AAMI SP10-1992
Per EN 60601-2-30
Protocol Systems, Inc.
Reference
Temperature Specifications
Characteristic
Range
Displays
Probes
Units
Channel Accuracy
Resolution
Electrosurgery interference
suppression
Specification
0° to +50°C; 32° to +122°F
T1, T2, and ∆T
Compatible with YSI Series 400 and 700 probes. HP side panel only
compatible with YSI 400 and has HP connector.
°C and °F selectable
Temperature Range
Tolerance
0° 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°F
0.1°C or °F
Included in all models.
Pulse Oximetry (SpO2) Specifications
Characteristic
Range
Probe Accuracy
(specified at 28° to 42° C)
Specification
0% to 100%
Adults:
70% to 100% ±2 digits
50% to 69% ±3 digits
0% to 49% unspecified
Pediatrics:
70% to 100% ±3 digits
Pulse Rate Range
Pulse Rate Accuracy
Sensor Compatibility
Electrosurgery interference
suppression
Alarm Hold-Off Time Period
Propaq CS Directions for Use
Neonates:
70% to 95% ±3 digits
25 to 250 beats per minute
±3 beats per minute or 3%, whichever is greater
Compatible only with NELLCOR sensors listed in the Protocol
Systems Products and Accessories booklet.
Included in all models.
10 seconds; reset if the sensor reports levels within limits before 10
seconds elapses.
105
Capnography (CO2) Specifications
General CO2 Specifications (Mainstream CO2 and Sidestream CO2)
Characteristic
Specification
CO2 Display
Screen Display
Numeric Display Ranges
Waveform Scale (Maximum)
Units
Sweep Speed
Response Modes
Gas Compensation
Alarm Limit Ranges
Resolution
Accuracy
CO2 waveform and ETCO2 and INCO2 (when in alarm) numerics
ETCO2: 0-99 mmHg, 0-13.2 kPa, 0-23.1%
INCO2: 81-25 mmHg, 1.11-5 kPa, 1.11-5%
0-100 mmHg, 0-14 kPa, 0-14%
mmHg, kPa,%; user-selectable
3.13, 6.25, 12.5 mm/s; user-selectable
Fast: 15 s sampling time period
Normal: 30 s sampling time period
Slow: 45 s sampling time period
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 0.952
ETCO2: 0-99 mmHg, 0-13.2 kPa, 0-13.2%
INCO2: 2-25 mmHg, 0.2-5 kPa, % (no lower limit)
1 mmHg
Mainstream2:
0-30 mmHg, ±3 mmHg
31-99 mmHg, ± 10% of value
0-30 mmHg, ±3 mmHg
31-99 mmHg, ± 10% of value
±0.4%/1,000 ft (304.8 m)
Sidestream3:
Altitude Error
Breath Rate Display
Screen Display
Breath rate (BR) source
Units
Range
Resolution
Accuracy
Alarm Limits Range
Numeric
When CO2 is active, CO2 is BR source. Otherwise, RESP from ECG is RR source.
Breaths/Minute
Adult/Ped: 0 (apnea), 2 to 150 breaths/min
Neonate: 0 (apnea), 3 to 150 breaths/min
±1 breaths/min
±1 breaths/min or ±5%, whichever is greater4
Adult/Ped: 2 to 150 breaths/min
Neonate: 3 to 150 breaths/min
Apnea Alarms and Tickets
Apnea Ticket
Apnea Alarm Accuracy
Set to auto print after apnea event and after 1 minute continued apnea
±2s
Apnea delay setting
Adult/Ped = 6, 10, 15, 20, 25, 30 seconds
Neonate = 6, 10, 15, 20 seconds
Barometric Pressure
Pressure Compensation
Operating Range
Screen Display
Units
Accuracy
Automatic
-2,000 to 15,000 ft (-610 to 4572 m) 817 to 429 mmHg
Numeric (CO2 Status Window)
mmHg, kPa, or %
±3 mmHg or 2.5% of difference from calibration pressure, whichever is greater
Specification
Per ISO 9918:1993 (E) / EN 864:1996
CO2 Performance
1. Lower if in alarm.
2. 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.
4. For Sidestream CO2, this applies only for BR≤50.
106
Protocol Systems, Inc.
Reference
Mainstream CO2 Specifications
Characteristic
Specification
Mainstream CO2 Sensor
Sensor Type
Principle of Operation
Warm-up time (CO2 sensor and
monitor)
Response Time
Waveform Rise Time
Calibration
Sensor Housing Temperature
Mainstream
Non-dispersive, infrared, single-beam, single path/wavelength,
ratiometric
45 s typical, 3 min maximum
30 ms typical, 60 ms maximum
<120 ms to 90% after step change
Verify semi-annually, calibrate only as required
42°C nominal
Mainstream CO2 Sensor and Cable Dimensions and Weight
Sensor Height 1
Sensor Width 1
Sensor Depth 1
Sensor Weight 1
Cable Length
1.003 in (2.548 cm)
1.036 in (2.631 cm)
0.78 in (1.981 cm)
< 0.53 oz (15.03 g)
10 ft (3.05 m) nominal
Mainstream CO2 Airway Adapter
Type
Size
Material
Per ISO 3040, single-use
15 mm ID, (meets ISO specifications)
clear polycarbonate, with sapphire windows
Added Deadspace
< 6cc (0.37 cubic inches) for adult model, <0.6 cc (0.037 cubic
inches) for low deadspace model
Mainstream CO2 Sensor Environmental Specifications
Operating Ambient Temperature
10° to 40°C
Storage Temperature
Operating Altitude
Storage Altitude
Operating and Storage Humidity
Shock
Vibration
-20° to 60°C
-2,000 to 15,000 ft (-610 to 4,572 m), 817 to 429 mmHg
-2,000 to 40,000 ft (-610 to 12,192 m), 817 to 141 mmHg
0% to 95%, noncondensing
100 g for 4 ms
5-35 Hz, 0.015 in (0.038 cm) peak-to-peak,
35-100 Hz, 1 g acceleration
36 inches free fall to floor (tile over concrete, one drop each face,
one drop each edge/corner)
Drop
1. Not including cable
Propaq CS Directions for Use
107
Sidestream CO2 Specifications
Characteristic
Sensor Type
Principle of Operation
Operating Ambient Temperature
Startup Time
Rise Time
Delay Time
Total System Response Time
Calibration
Sampling Chamber
Pneumatic and Exhaust System
Barometric Pressure Compensation
BTPS, ATPS, STPD2
Sampling Line
Watertrap
Flow Rate
Specification
Sidestream, internal
Non-dispersive, infrared, single-beam, single path/wavelength,
ratiometric
5° to 40°C
30 seconds typical, 3 minutes maximum
240 ms (10% to 90%) at 175 ml/min
1.12 seconds maximum1
1.36 seconds maximum (Rise Time and Delay Time)
Verify semi-annually, calibrate only as required
Internal (replaceable by service technician)
Integral
Automatic
CO2 value = calculated CO2 value x 0.977
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)
Disposable single-use
90 or 175 ml/min, user-selectable
1. 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).
2. BTPS (Body Temperature and Pressure, Saturated), ATPS (Ambient Temperature and Pressure, Saturated), STPD
(Standard Temperature and Pressure, Dry).
108
Protocol Systems, Inc.
Reference
Alarms Specifications
Characteristic
Indicators (see table below)
Tone Frequency
Selectable Tone Volume
Limits
Control
Alarm Priority
Alarm on Tachycardias
Apnea delay setting
Alarm Holdoff Time Period1
Audio Alarm Holdoff with
Acuity
Specification
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.
900 Hertz
Tone is steady for a patient alarm and sounds for 1 second every 4 seconds for
an equipment alert.
Low, Medium, High
Settable on all parameters
Automatic preset or manual settings
Highest priority: Apnea, then patient alarms
Lowest priority: Equipment alerts
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.”
Adult/Ped = 6, 10, 15, 20, 25, 30 seconds
Neonate = 6, 10, 15, 20 seconds
HR/PR = 3 seconds (except NIBP PR)
SpO2 = 10 seconds
RR/BR = 5 seconds
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.
1. 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.
Propaq CS Monitor Alarm Indications
Red
Yellow
Patient and Alarm Limit Status
Alarm
Alarm(s)
Off
Nurse
Call
Tone
Patient in alarm condition, and all alarm limits on
Patient in alarm condition, and at least one alarm limit is off
Patient alarms suspended (whether in alarm condition or not)
and at least one alarm limit is off
Patient alarms suspended (whether in alarm condition or not)
and all alarm limits are on
Patient not in alarm condition, and at least one alarm limit is off.
Equipment alert, patient not in alarm condition
FLASH
FLASH
ON
OFF
ON
ON
ON
ON
OFF
ON
ON
OFF
ON
OFF
OFF
OFF
OFF
OFF
ON
FLASH
OFF
OFF
Equipment alert, patient alarms suspended
ON
FLASH
OFF
OFF
ON 1 s,
OFF 4 s
OFF
Propaq CS Directions for Use
109
Propaq CS Monitor Audible Alarm Indications
Alarm Condition
Tone
Patient alarm
Apnea alarm
Equipment alert
Continuous ON
ON for 1 second, OFF for 1 second
ON for 1 second, OFF for 4 seconds
Nurse Call Specifications
Characteristic
Specification
Maximum switch current
Maximum switch voltage
Isolation
Alarm relay
Customized cable2 (Protocol Systems Part Number
008-0634-XX); see below.
1A
30 V ac/dc
1500 Vrms
Energized during apnea alarm or patient alarm1
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.
1. Pressing the Suspend/Resume Alarm key or SUSPEND suspends the Nurse Call alarm for 90 seconds.
2. Refer to the Protocol Systems Products and Accessories booklet to order the cable.
1 Normally Open
4 Not Connected
3 Normally Closed
2 Common (Arm)
Nurse Call Connector
on Monitor
Nurse Call Cable Specifications
This cable (Part Number 008-0634-XX) must be customized by a biomedical technician to connect to
the local Nurse Call system.
Pin 4
Pin 1
Pin 3
Pin 2
30V
at 1A MAX
Normally Open (Black)
Arm (Red)
Normally Closed (Green)
Not Connected
EXTERNAL VIEW
Nurse Call Cable (Part Number 008-0634-00)
110
Protocol Systems, Inc.
Reference
Trends Specifications
Specification 1
Characteristic
Model 242 Parameters
Model 244 Parameters
Model 246 Parameters
Duration
Resolution
NIBP, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal CO2,
Inspired CO2, Breath Rate/Resp Rate
NIBP, P1, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2,
End-tidal CO2, Inspired CO2, Breath Rate/Resp Rate
NIBP, P1, P2, T1, T2, ∆T, HR (heart rate/pulse rate), SpO2, End-tidal
CO2, Inspired CO2, Breath Rate/Resp Rate
5 hours for non-NIBP trends (up to 150 readings)
A maximum of 128 readings (up to 8 hours) for NIBP trends
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.
1. Assumes SpO2 and CO2 functions are present.
Display Specifications
Characteristic
Type
Resolution
Active Viewing Area
Pixel Pitch
Viewing Angle
Contrast Ratio
Display Color
Luminance
Response Time
Specification
Color active matrix; TFT (Thin Film Transistor) LCD module
640 x 480 pixels; 1 pixel = R + G + B dots
6.73 x 5.10 inches (170.9 x 129.6 mm)
0.0105 inches (0.267 mm)
U/D 40°, R/L 60° (typical), ≥ 10:1 contrast ratio
150:1 (typical); measured in dark room at center of screen
18-bit (6 bits per primary color)
200 cd/m2 (typical); measured at saturation point
40 ms (maximum); “white to black”
Monitor (Environmental) Specifications
Characteristic
Operating Temperature
Shipping and Storage Temperature
Operating Altitude
Shipping and Storage Altitude
Operating Relative Humidity
Shipping and Storage Relative
Humidity
Shock
Vibration, Random
Electromagnetic Compatibility (EMC)
Specification
0° to 40° C
-20° to 60° C
-2,000 to 15,000 ft (-610 to 4,572 m)
-2,000 to 40,000 ft (-610 to 12,192 m)
15% to 95%, noncondensing per MIL STD 810E, Procedure
1-natural
15% to 95%, noncondensing per MIL STD 810E, Procedure
1-natural
50 g
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.
EN 60601-1-2: 1993
Caution
The monitor may not meet performance specifications if it is not used or stored within these environmental
specifications.
Propaq CS Directions for Use
111
Monitor (Physical) Specifications
Characteristic
Specification
Protection Classifications, all Configurations 1
Type of Protection against Electric
Shock—Power Adapter
Type of Protection against Electric
Shock—Monitor (connected to power
adapter or internal battery)
Degree of Protection Against Electric
Shock, for Parts Applied to Patients
Method of Disinfection
Flammable Anesthetics
Power adapter class 1
Height
Width
Depth
Weight
8.2 in (20.8 cm) with handle
9.6 in (24.4 cm)
5.6 in (14.1 cm)
7.6 lb (3.4 kg)
Protective earth not available in monitor. Monitor designed and
tested to meet Double Insulation Requirement.
See monitor labels
Not suitable for autoclaving (see cleaning instructions, page 91)
Not suitable for use with flammable anesthetics
Monitor Only
Monitor with SpO2 Module
Height
Width
Depth
Weight
8.2 in (20.8 cm) with handle
9.6 in (24.4 cm)
7.7 in (19.7 cm)
10.8 lb (4.9 kg)
Monitor with Expansion Module
(Printer / SpO2 / MCO2)
Height
Width
Depth
Weight with Printer, SpO2, and MCO2
11.4 in (28.8 cm)
9.6 in (24.4 cm)
7.7 in (19.7 cm) with back feet
14.4 lb (6.5 kg)
1. Per EN 60601-1 unless otherwise stated.
Printer Specifications
Characteristic
Specification
Operation
Operating Modes
Auto Print Intervals
Auto Trend Shifts
Number of Waveforms
Grid
Annotation
Printing Speeds
112
Continuous, Snapshot, Auto Print, Auto Trend, Tabular Trend, Alarm
Print, NIBP Ticket, Apnea Ticket, OxyCRG, OxyCRG on Alarm
15 min, 30 min, 1 hour, 2 hours, 4 hours
Once every 4 hours
Up to three: ECG1, P1, P2, SpO2, CO2, RESP
5 mm and 1 mm gradations
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.
6.25, 12.5, 25.0 mm/s,
simulated 6.25 mm/s for CO2 and RESP in Snapshot mode
Protocol Systems, Inc.
Reference
Characteristic
Specification
Printer Mechanism
Printing Method
Dot structure
Printing width
Horizontal Dot Pitch
Vertical Dot Pitch
Paper Feed Method
Paper Feed Precision
Paper Width
Thermally sensitive dot method
320 dots per line
53 mm
0.165 mm, 6 dots/mm
0.165 mm
Friction Feed
±2% @ 25° C and 60% Relative Humidity
60 mm
Reliability
30 million pulses/dot
Environmental
Monitor/Expansion Module
Operating Temperature
Shipping and Storage Temperature
Operating Relative Humidity
Shipping, Storage Relative Humidity
Operating Altitude
Shipping and Storage Altitude
Shock
Vibration, Random
Electromagnetic Compatibility (EMC)
+5° to 40° C
-20° to 60° C
35% to 85% noncondensing
15% to 90% noncondensing
-2,000 to 15,000 ft (-610 to 4,572 m)
-2,000 to 40,000 ft (-610 to 12,192 m)
30 g
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.
Per IEC/EN 60601-1-2, which is a collateral standard of IEC/EN
60601-1, for electromagnetic compatibility.
Paper Storage
Short-term Storage Environment
(up to 7 days)
Long-term Storage Environment
(up to 5 years)
-20 to 40°C; 5% to 80% noncondensing
25°C (optimal), 65% noncondensing
Power Specifications
Characteristic
Mode of Operation
Battery Pack Type
Battery Pack Capacity
Battery Recharger Circuitry
DC Input Power Required
Input Fuse Rating
Operating Times on Battery
Battery Recharge Time with
instrument on
Battery Recharge Time with
instrument off
Recharge time until monitor is
usable, starting with discharged
but non-faulty battery
Propaq CS Directions for Use
Specification
Continuous
Sealed, gel-type lead acid
Monitor only: 8 V, 2.7 Ampere-Hours; Monitor with Expansion Modules: 8
V, 5.4 Ampere-Hours
Internal, powered by external power adapter
12 to 28 V, 25 Watts
3A/250V, Type 2AG (0.57x 0.177 in)
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.
Range of 8 hours to 12 hours typical, depending upon product
configuration
Range of 6 hours to 8 hours depending upon product configuration
≤ 2 minutes typically (longer time required before NIBP, printer, and CO2
are available)
113
Characteristic
Specification
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.
Power Adapter Specifications
Characteristic
Specification
Protection Classifications, all Adapters 1 2
Type of Protection Against Electric Shock
Degree of Protection Against Harmful
Ingress of Water
Method of Disinfection
Flammable Anesthetics
Class I, (Protectively Earthed)
For ordinary, indoor locations only.
Not suitable for autoclaving
Not suitable for use with flammable anesthetics
Environmental Specifications, All Adapters
Operating Temperature
Shipping and Storage Temperature
Operating Altitude
Shipping and Storage Altitude
Operating Relative Humidity
Shipping, Storage Relative Humidity
Shock
Vibration
0° to 50° C
-20° to 60° C
-2,000 to 15,000 feet (-610 to 4,572 m)
-2,000 to 40,000 feet (-610 to 12,192 m)
15% to 95%, noncondensing
15% to 95%, noncondensing
50 g
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 Specifications
Length
Width
Height
Weight
5.0 in (12.7 cm)
3.6 in (9.1 cm)
3.1 in (7.9 cm)
3.1 lb (1.4 kg)
Universal Power Adapter, Part No. 503-0054-00
Rated Input
Rated Fuses
Rated Output (Continuous)
Additional Features
100-120 V ac, 500 mA, 50/60 Hz
T800 mA/250 V, Time-Delay, 5x20mm
16-24 V dc, 25 VA
Detachable power cord, pilot light
Universal Power Adapter, Part No. 503-0054-01
Rated Input
Rated Fuses
Rated Output (Continuous)
Additional Features
200-240 V ac, 250 mA, 50/60 Hz
T400 mA/250 V, Time-Delay, 5 x 20mm
16-24 V dc, 25 VA
Detachable power cord, pilot light
1. Per EN 60601-1 unless otherwise stated.
2. See the Protocol Systems Products and Accessories booklet for model numbers.
Negative (-)
Positive (+)
114
Power Adapter
connector
Protocol Systems, Inc.
Index
Bandwidth selection, ECG 31
Battery
Long-term storage precautions 92
Low battery message 63, 87
Recharging 87
Recycling 92
Beeper loudness 20
Brightness display control 20
Propaq CS Directions for Use
Cannula for Sidestream CO2 47
Capnography(see Mainstream CO2 and Sidestream CO2)
Caution statements, general 9
Centigrade temperature units 40
Change alarm limits 21
Charge battery 87
Cleaning instructions 91
Clock setting 95
C-LOCK, SpO2 measurement 42
CO2
Alarm limits 49
Equipment alert messages 60, 61
Flowrate, Sidestream CO2 49
Gas compensation 49
Mainstream CO2 44
Response time 49
Select measurement units 96
Set up CO2 display 48
Sidestream CO2 46
Source selection 49
Specifications, general 106
Sweep speed selection 48
Connector locations 10
Connectors, patient 12
Continuous printing 70
Controls 10
Cuff inflation target (NIBP) 36
Cuff selection (NIBP) 37
Current patient mode 22
Custom patient modes 23
Customize alarm limits 54
Data communication equipment alert message 62
Date and time setting 95
Date format setting 96
Decimal character setting 96
Default inflation pressure (NIBP) 36
Default settings 97
DEFIB FAULT message 63
Defib Sync (see Defibrillator Synchronization)
Defibrillator Synchronization
Connector 11
Equipment alert messages 63
Install LIFEPAK 5 Interface Cable 79
LIFEPAK 5 defibrillator 79
LIFEPAK 6s defibrillator 82
Remove LIFEPAK 5 Interface Cable 81
Specifications 101
Sync marker display 80
Warning with LIFEPAK 5 79
Warning with LIFEPAK 6s 82
Delete all patient trends 69
Disconnect monitor from Acuity 76
Disinfection instructions 91
Display
Artifact interference 28
Brightness control 20
CO2 48
115
Index
AC Power Adapter
Change fuses 88
Change voltage selection 88
Connect to monitor 87
AC power adapter, specifications 114
AC power filter for ECG 31
Acuity
Connect the monitor to Acuity 75
Connector 11
Disconnect the monitor 76
Print at Acuity printer from monitor 76
Warnings 75
Acuity network equipment alert message 62
Airway adapter, Mainstream CO2 44
Alarm Holdoffs 109
Alarm indicators, specifications 109
Alarm Limits
Adjust after alarm 53
CO2 49
Customize alarm limits (STAT SET) 54
Setup 21
Alarm Limits Menu 21
Alarm Tone volume 20
Alarms
Adjust alarm limits 53
Automatic printing on alarm 70
Nurse Call Alarm 55
Patient Alarm Menu 53
Respond to patient alarms 53
Resume alarms 53
Setup alarm limits 21
Setup alarms 21
Specifications 109
Suspend or cancel alarms 53
Alarms Status Menu 21
Alert, equipment problem 56
Apnea
Automatic printing on apnea alarm 70
Apnea alarm 21, 53
Apnea measurement 44, 46
Apnea ticket (printout) 70
Artifact interference and waveform display 28
Artifact marker on display, prints (NIBP) 37
Artifact reduction with C-LOCK (SpO2) 42
Artifact reduction with SMARTCUF (NIBP) 36
Artifact with NIBP 7, 38, 39, 67, 68
Audible alarms 110
Automatic intervals (NIBP) 39
Automatic NIBP measurements 39
Defib sync markers 80
ECG/RESP 30
Equipment alert messages 57
Equipment alerts 56
General description 13
IBP waveforms 34
NIBP 38
Pacemaker indicators 32
Specifications 111
SpO2 42
Sweep speed selection 20
Sweep speed selection, CO2 and RESP
48
Temperature 40
Trends 68
Waveform selection 20
ECG
Bandwidth selection 31
Display 30
Electrode selection and placement 28
Electrosurgery and interference 29
Equipment alert messages 57
Filter to reduce interference 31
Lead selection 30
Pacemaker display indicators 32
Specifications 99
Waveform size adjustment 30
ECG filter setting 96
ECG LEAD 30
ECG SIZE 30
ECG/RESP menu 1 30
ECG/RESP menu 2 30
Electrocautery and IBP monitoring 33
Electrodes and ECG (see ECG)
Electrosurgery and ECG interference 29
Environmental specifications 111
Equipment Alert
Acuity Network Message 62
Defibrillator Messages 63
ECG Messages 57
Example display 56
IBP Messages 57
Low battery messages 63
Mainstream CO2 Messages 60
Messages 57
NIBP Messages 57
Printer Messages 63
PROGRAM FAULT Message 62
RESP Messages 57
Respond to equipment alert 56
Sidestream CO2 Messages 61
SpO2 Messages 59
Temperature Messages 59
ERR message for NIBP 68
ETCO2 (End-Tidal CO2) 44, 46
Exhaust port, Sidestream CO2 47
Extended Mode ECG bandwidth 31
Extended storage precautions 92
116
Factory default settings 97
Factory patient modes
Setup 23
Fahrenheit temperature units 40
False alarms with SpO2 43
Filter to reduce ECG interference 31, 96
Flowrate, Sidestream CO2 49
Format adjustment for IBP numerics 35
Fuse replacement
AC power adapter 88
Monitor input power 89
Gas compensation, CO2 49
Gas exhaust port, Sidestream CO2 47
Gas scavenging system, Sidestream CO2 47
Hazards 9
Heart Tone volume 20
Hewlett-Packard patient connectors 12
High frequency ventilation and RESP 28
HP (Hewlett-Packard) patient connectors 12
HR/PR Alarm Limits, on/off enable 96
HR/PR source 20
HR/PR tone volume adjustment 20, 31
IBP
Adjust waveform scale 35
Automatic display adjustment 35
Change waveform display labels 35
Display 34
Electrocautery warning 33
Equipment alert messages 57
Monitoring 33
Numeric format adjustment 35
Range Mode 35
Rescale Mode 35
Specifications 103
Transducer 33
Zero a transducer 33
Impedance Pneumography (see RESP)
INCO2 (Inspired CO2) 44, 46
Input power fuse replacement 89
INSERV 16
In-Service mode 16
Inspect the monitor 91
Interference filter for ECG 31
Interference with electrosurgery, ECG 29
Intubated patient and Sidestream CO2 47
Invasive Blood Pressure (see IBP)
Label selection for IBP 35
Lead selection, RESP 31
Learn to use Encore 16
LIFEPAK 5 defibrillator 79
LIFEPAK 6s defibrillator 82
Line power adapter 87
Protocol Systems, Inc.
Loudness adjustment, HR/PR tone 31
Loudness selection 20
Low battery message 63, 87
NET OFF, disconnect from Acuity 76
Network fault equipment alert message 62
New patient setup 19
NIBP
Artifact 7, 38, 39, 67, 68
Propaq CS Directions for Use
Index
Main Menu, General description 14
Mainstream CO2
Airway adapter 44
Alarm limits 49
Display 48
Equipment alert messages 60
Gas compensation 49
Menus 48
Monitoring 44
Response time 49
Specifications 107
SpO2 option and CO2 44
Switch to Sidestream CO2 49
Turn on/off 49
Warnings 44
Maintenance instructions 92
Manometer bar (NIBP display) 38
Marriot Configuration for ECG 29
MCO2(see Mainstream CO2)
Menus
Alarm Limits 21
Alarms Status 21
CO2 48
ECG/RESP Menu 1 30
ECG/RESP Menu 2 30
General description 14
IBP 34
Main Menu 14
NIBP 38
Patient Alarm 53
Printer Setup Page 70
Setup Menus 15
SpO2 42
Messages, equipment alerts 57
Mode Setup window 23
Model numbers 12
Modem-Propaq connector 11
Monitor Mode ECG bandwidth 31
Monitor recycling 92
Monitoring
ECG/RESP 27
IBP 33
Mainstream CO2 44
NIBP 36
Sidestream CO2 46
SpO2 41
Temperature 40
Motion artifact and NIBP 7, 38, 39, 67, 68
Artifact filtering message 59
Automatic intervals 39
Automatic Mode 38
Automatic printing on NIBP 70
Cuff and hose selection 37
Cuff placement 38
Default inflation pressure 36
Display information 38
Equipment alert messages 57
Interval for automatic measurements 39
Manual Mode 38
Monitoring 36
Motion artifact 7, 38, 39, 67, 68
NIBP IN PROGRESS message 59
NIBP Menu 38
Printout symbol with artifact 67
Retries 38
SMARTCUF artifact filter 36
Specifications 104
Start/stop measurement 38
Symbol in display 38, 68
Symbol in printout 67
TURBOCUF repeated measurements
39
Warnings 36
NIBP IN PROGRESS message 59
NIBP ticket (printout) 70
NIBP Trend 68
Non-intubated patient and Sidestream CO2 47
Non-Invasive Blood Pressure (see NIBP)
Nurse Call Alarm
Description 55
Specifications 110
Options 12
OxyCRG
Automatic printing on alarm 70
Description 71
How to print 71
Oxygen saturation display 42
Oxygen saturation measurement(see SpO2)
Pacemaker display indicators 32
Pacemaker patients and monitoring 32
Pacer indicator 31
Paper replacement, printer 90
Patient Alarm Menu 53
Patient Alarms
Cancel alarms 53
Respond 53
Suspend alarms 53
Patient mode
Change current patient mode 22
Change powerup patient mode 23
Check at powerup 19
Custom 23
Factory 23
Patient Mode window 19
117
Periodic maintenance 92
Physical inspection 91
Physical specifications 112
Power
Specifications 113
Power Adapter
Specifications 114
Power adapter 87
Power fuse replacement 89
Powerup patient mode 23
Powerup procedure 19
Practice using Encore 16
Print
Automatic alarm printing 70
Automatic apnea ticket printing 70
Automatic NIBP ticket printing 70
Automatic OxyCRG printing 70
Automatic printing 70
Automatic trend printing 69
Continuous printing 70
Displayed trend 68
Displayed waveforms 67
Multiple trends 69
OxyCRG 71
Print at Acuity printer from monitor 76
Set printer options 70
Printer
Equipment alert messages 63
Generate a test print 90
Long-term storage precautions 92
Paper replacement 90
Set options 70
Specifications 112
Printer Setup Page 70
Printing
Artifact symbol with NIBP 67
PROGRAM FAULT equipment alert message 62
Programmable patient modes 23
Propaq CS
Models and options 12
Physical inspection 91
Pulse Oximetry(see SpO2)
Rebreathing, INCO2 48
Recharge battery 87
Recycling
Battery 92
Monitor 92
Replace fuses
AC power adapter 88
Monitor input power 89
Replace printer paper 90
Reset clock 95
RESP
Display 30
Equipment alert messages 57
High frequency ventilation 28
Lead selection 31
Specifications 102
118
SpO2 monitoring as backup method 28
Turn on or off 31
Waveform size adjustment 30
RESPONSE time (SpO2) 42
Response time, CO2 49
Resume alarms 53
Retries (NIBP) 38
Right side panel 11
Scavenging system for gas, Sidestream CO2 47
SCO2(see Sidestream CO2)
Service
Recommendations 10
Service Manual 10
Service interval recommendations 92
Service Menus 15
Set time and date 95
Settings, factory default 97
Setup
Alarm limits 21
Alarms 21
Custom patient modes 23
New patient 19
Patient modes 23
Powerup patient mode 23
Setup Menus 15
Side panel
Left side panel 12
Right side panel 11
Sidestream CO2
Alarm limits 49
Cannulas 47
Display 48
Equipment alert messages 61
Exhaust port 47
Flow rate 49
Gas compensation 49
Gas scavenging system 47
Intubated patient 47
Menus 48
Monitoring 46
Non-intubated patient 47
Rapid breath rate and ETCO2 values 46
Rapid respiratory rate for children 46
Response time 49
Specifications 108
SpO2 option and CO2 46
Switch to Mainstream CO2 49
Turn on/off 49
Warnings 46
Watertrap insertion 46
Skin preparation for ECG 28
SMARTCUF NIBP artifact filter 36
SMARTCUF symbol on display, prints 37
Snapshot printing 67
Sound volume selection 20
Source selection, CO2 49
Specifications
AC power adapter 114
Protocol Systems, Inc.
T
Temperature
Display 40
Equipment alert messages 59
Monitoring 40
Select measurement units 96
Specifications 105
Warnings 40
Propaq CS Directions for Use
Temperature units, change 40
Time and date setting 95
Tone volumes 20
Transducer for IBP 33
Trends
Automatic printing 69
Delete all trends 69
Display 68
NIBP and symbol 68
Print all selected trends 69
Select trends for printing 69
Specifications 111
TURBOCUF (automatic NIBP) 39
Turn on waveform display 20
Units of measure, CO2 96
Units of measure, temperature 40, 96
Index
Alarm indicators 109
Alarms, audible 110
CO2, general 106
Display 111
ECG 99
Environmental 111
IBP 103
Mainstream CO2 107
Monitor, physical 112
NIBP 104
Nurse Call Alarm 110
Power 113
Printer 112
Real-Time ECG Analog/Defib Sync 101
RESP 102
Sidestream CO2 108
SpO2 105
Temperature 105
Trends 111
SpO2
Adjust waveform size 42
C-LOCK 42
Display 42
Equipment alert messages 59
Monitoring 41
NIBP and SpO2 41
Reducing false alarms 43
Response time selection 42
Self-calibration 41
Sensor selection 41
Specifications 105
SpO2 Menus 42
Spot-Check monitoring 43
STANDBY message 41
Standby Mode 43
Warnings 41
Spot-Check SpO2 monitoring 43
STANDBY and SpO2 43
STANDBY message, SpO2 41
Standby Mode, SpO2 43
STARTUP message, Sidestream CO2 48
STAT SET, customize alarm limits 54
STATSCALE 13
STBY message, SpO2 STANDBY 43
Storage precautions 92
Sweep speed selection 20
Sweep speed selection, CO2 and RESP 48
Symbol
In NIBP display 38, 68
In NIBP printout 67
Synchronizing R-waves, C-LOCK 42
Ventilation, high frequency and RESP 28
VERY LOW BATTERY message 63
Vital sign waveform display 20
Volume adjustment, HR/PR tone 31
Volume tone selection 20
WARMUP message, Mainstream CO2 48
Warnings
Acuity 75
Defib Sync and LIFEPAK 5 79
Defib Sync and LIFEPAK 6s 82
ECG/RESP 27
General 9
IBP 33
Mainstream CO2 44
NIBP 36
Pacemaker patients 32
Sidestream CO2 46
SpO2 41
Temperature 40
Warranty period service 10
Watertrap for Sidestream CO2 46
Wave Select window 20
Waveform
CO2 48
ECG size adjustment 30
IBP 35
RESP size adjustment 30
SpO2 42
Waveform display 13
Waveform display selection 20
Windows, general description 13
Zero a transducer 33
119
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Protocol Systems, Inc.

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