Welch Allyn FN802FH Propaq 802 LTRN User Manual Users Manal part 5 of 10

3

49

Standalone Monitoring

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Preparing for a New Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

Continuing to Monitor a Patient on Power-Up . . . . . . . . . . . . . . . . . . . . . . . . . . .54

Monitoring ECG and Resp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55

Monitoring SpO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Monitoring Blood Pressure (NIBP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

To Discontinue Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75

Overview

The monitor is available as a standalone (model 802LT0N) or wireless model (model

802LTRN).

This chapter describes the operation of the standalone monitor, and of the wireless

monitor when it is not in communication with the Welch Allyn Flexnet® network and an

Acuity® Central Station.

About the Model 802LT0N (Standalone) Monitor

The model 802LT0N monitor operates in standalone mode. It measures and displays vital

signs, stores patient data, and locally indicates alarms and alert conditions.

• The configuration of the monitor is not affected by Acuity.

• The vital signs stored by the monitor are not sent to Acuity.

• Alarms and alerts generated by the monitor do not appear on Acuity.

• Alarms and alerts generated by Acuity do not appear on the monitor.

• Acuity does not update the monitor time and date settings.

About the Model 802LTRN (Wireless) Monitor

See “Monitoring in Communication with Acuity” on page 77.

50 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Preparing for a New Patient

To Begin Monitoring a New Patient

1. If the monitor is on, press to turn it off.

If prompted to save or delete existing data, highlight Delete and press . The monitor

deletes any saved data and temporary settings, and then shuts down.

2. Press to turn on the monitor.

• If the monitor holds stored data from the previously monitored patient, it displays

the “data saved” start-up screen (Figure 43, left):

Figure 43. Start-Up with Saved Data

• If the data from the previously monitored patient was deleted on shut-down, the

“no data saved” start-up screen appears (Figure 44):

Figure 44. Start-Up with No Saved Data

3. Highlight Start New Patient and press . The first configured data display appears

(Figure 45).

In place of a patient name, ID: is followed by a string that is generated by the monitor

when you select ‘Start New Patient’. This AutoID string, a combination of serial

number, time, and date, is unique to each new patient, and identifies the patient until

you supply the patient identification data.

Select ( ) to delete data

and start a new patient.

Portland Westside Hospital

Emergency Department

Note!

There is patient data stored for

Hall, Robert E. ID: 3456187

Start New Patient

Continue Patient

Info

Demo

Select ( ) to Start a New Patient.

No data saved.

Start New Patient

Info

Demo

Portland Westside Hospital

Emergency Department

Directions for Use Standalone Monitoring 51

Figure 45. Data Display with AutoID

4. In the primary data display, highlight ID: (upper left) and press .

The Patient Information Entry screen appears (Figure 46):

Figure 46. Patient Information Entry

5. Enter the ID and name of the new patient.

a. Press or to highlight (blue) a character in the character field (Figure 47).

b. Press to copy it to the green-highlighted location in the entry fields (Figure 46).

c. Repeat from step a until all characters are entered into the field.

d. Press until the insertion point in the entry field changes from green to blue.

e. Press or to move the insertion point to another entry field.

f. Press to return to the character field.

g. Repeat from step a until all fields are complete.

Figure 47. Patient Information Entry (continued)

Note To correct an error in an entry field: Place the cursor (step d and step e) to the

right of the error location, highlight and enter Backspace in the character field to

delete the erroneous character, and then enter the correct character.

ID: 0101819RO17Q

8:82:56

Adult

Rm

NIBP mmHg

Resp/min

HR/min

SpO2

%

S D M

Start-up AutoID

Last

Middle

First

ID#

Rm#

A B C D E F G H I J K L M N O P Q R S T U V

W X Y Z 1 2 3 4 5 6 7 8 9 0 -

Select ( ) to enter highlighted character

Confirm

Cancel

Backspace

Entry fields

Character field

Last

Middle

First

ID#

Rm#

A B C D E F G H I J K L M N O P Q R S T U V

W X Y Z 1 2 3 4 5 6 7 8 9 0 -

Select ( ) to enter highlighted character

Confirm

Cancel

HALL

HALL E

RO

Backspace

3456187

Next letter highlighted

52 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

6. Highlight Confirm and press .

\

7. Verify that the patient mode (adult, pediatric, or neonate) is set correctly for this

patient.

Neonatal Term birth through 28 days, or up to 44 gestational weeks.

Pediatric Between 29 days and 12 years.

Adult 13 years and older.

If the current patient mode setting is not correct:

a. Highlight the current patient mode (Adult, Pediatric, or Neonate) and press .

b. From the Patient Mode selection menu (Figure 48), highlight the appropriate

patient mode and press .

Figure 48. Changing Patient Mode

c. A confirmation screen appears:

Figure 49. Confirming a Change of Patient Mode

d. To confirm the change, highlight Confirm and press .

Note Name alone is not sufficient to confirm a patient ID; thus, you can confirm the

patient name only after you have entered the patient ID.

Note When you change the patient mode and confirm the change:

•All vital-signs data for the patient is lost.

•All monitor settings revert to the defaults for the new patient mode.

Patient Mode

Adult

Pediatric

Neonate

Patient Mode

Adult

Pediatric

Neonate

HALL, ROBERT E.

3456187

3:00:06P

Adult

Rm 239

NIBP mmHg

Resp/min

HR/min

SpO2

%

S D M

Note! You are changing the

patient mode from Adult to Pediatric.

This will change settings to default

Pediatric values and delete previous

If this is correct, highlight “Confirm”

then press Select ( ).

Cancel

Confirm

patient data.

Directions for Use Standalone Monitoring 53

8. Verify that the displayed time and date are correct.

• The monitor displays time in either the 12-hour (AM/PM) or 24-hour format, and

displays date in either the mm/dd/yy, dd.mm.yy, or yy/mm/dd format.

• The date does not appear on the primary display screens. It appears on the

snapshot list and on the snapshot display.

a. Highlight the time display (in the upper right corner of the screen) and press .

The Time/Date screen appears (Figure 50).

Figure 50. Time/Date Screen: 24-Hour Format

b. If the displayed time or date is not correct, press or to move the highlight

from one parameter to another, and press or to change the value of the

highlighted parameter. For example, to change the time display format from

24-hour to 12-hour, highlight Time Format and press either or once

(Figure 51).

Figure 51. Time/Date Screen: 12-Hour Format

c. When the time and date are correct and formatted appropriately, press to

accept the changes and return to the vital-signs display.

Note If you change the time or date settings and then decide not to accept the

changes, press to cancel the changes and return to the vital-signs display.

II 1mV/cm

Year

Date Format

HR/min

NIBP mmHg

Resp/min

SpO2

SpO2%

14:49:37

Adult

Time Format

Hour

Minute

Month

Day

HALL, ROBERT E.

3456187

Rm 239

12 Hour

24 Hour

14

45

3

17

2005

mm/dd/yy

dd.mm.yy

yy/mm/dd

Set

Cancel

24-hour format

II 1mV/cm

Year

Date Format

HR/min

NIBP mmHg

Resp/min

SpO2

SpO2%

14:49:54

Adult

Time Format

Hour

Minute

Month

Day

HALL, ROBERT E.

3456187

Rm 239

12 Hour

24 Hour

2P

45

3

17

2005

mm/dd/yy

dd.mm.yy

yy/mm/dd

Set

Cancel

12-hour format

54 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Continuing to Monitor a Patient on Power-Up

If a patient’s data was saved before the monitor was last turned off (see “To Turn Off the

Monitor” on page 45), you can resume monitoring that patient when the monitor is turned

on again. (When patient data is saved, the monitor settings are also saved.)

To resume monitoring the same patient:

1. Turn on the monitor. The “patient data stored” screen appears (Figure 52):

Figure 52. Start-Up with Saved Data

2. Verify that the displayed name and ID match that of the current patient.

3. Highlight Continue Patient (Figure 53) and press .

Figure 53. Start-Up with Saved Data

Select ( ) to delete data

and start a new patient.

Portland Westside Hospital

Emergency Department

Note!

There is patient data stored for

Hall, Robert E. ID: 3456187

Start New Patient

Continue Patient

Info

Demo

Select ( ) to continue

monitoring this patient.

Portland Westside Hospital

Emergency Department

Note!

There is patient data stored for

Hall, Robert E. ID: 3456187

Start New Patient

Continue Patient

Info

Demo

Directions for Use Standalone Monitoring 55

Monitoring ECG and Resp

Overview

You can monitor heart signs (ECG) and respiration rate (Resp) using either a 3-lead or a

5-lead ECG cable. Using a 3-lead cable, you can display one signal waveform for lead I, II,

or III. Using a 5-lead cable, you can display either one or two signal waveforms (I, II, III, V;

and if enabled in the configuration, aVR, aVL, or aVF). You can also display the SpO2 or

Resp waveform in place of an ECG waveform.

Safety

Note In this manual, lead refers to an ECG electrode or lead wire, and Lead refers to a

waveform source.

WARNING Always monitor and set alarms for SpO2 when using impedance

pneumography to monitor respiratory function.

WARNING When monitoring respiration via impedance pneumography, always

select the ECG Lead with the most prominent QRS complex. The monitor rejects

cardiovascular artifact, but this function depends upon accurate ECG R-wave

detection.

WARNING Do not place the monitor near another respiration monitor. Resp

measurement frequencies can cause mutual interference.

WARNING Do not perform impedance pneumography on paced patients.

Pacemaker pulses can sometimes be falsely counted as breaths.

WARNING Always keep patient motion to a minimum. Motion artifact can cause

incorrect breath rate or heart rate readings.

WARNING If a disconnected lead is too close to other electrical devices, it can

cause a false heart rate, a false respiration rate, or a failure to display a “Lead Fail”

message.

WARNING The monitor displays + + + for HR numerics between 301-350 beats

per minute. For heart rates above 350 beats per minute, it might display

incorrectly low heart readings, due to intermittent picking of R-waves.

56 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

WARNING The monitor does not provide internal arrhythmia analysis; therefore,

arrhythmias can cause the monitor to display inaccurate heart rates.

WARNING Motion artifact can cause the monitor to display inaccurate heart

rates. Minimize patient motion whenever possible.

WARNING (1) During a surgical procedure, do not use small ECG electrodes.

(2) Select ECG electrode attachment points remote from the surgical site and

remote from the electrosurgical return electrode. (3) Use electrosurgical return

electrodes with the largest practical contact area. (4) Assure proper application of

the electrosurgical return electrode to the patient.

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 and can lead to

measurement errors.

WARNING Make sure the patient mode is correct. Incorrect patient mode can

result in inaccurate heart rate readings and inappropriate alarm settings.

WARNING Always use the provided garment clips to route ECG cables away

from the patient’s head.

WARNING Use only accessories listed in the Welch Allyn Products and

Accessories guide (810-0409-XX).

WARNING Never use ECG cables with loose or faulty detachable lead wires.

These can cause erratic behavior of the ECG and respiration waveforms due to

intermittent ECG lead wire connections.

WARNING Resp is derived from the same leads as the ECG channel, so the

monitor determines which signals are cardiovascular artifact and which signals are

a result of respiratory effort. If the breath rate is within five per cent of the heart

rate or is a multiple or submultiple of the heart rate, the monitor might ignore

breaths and trigger a respiration alarm.

Caution Never use an ECG cable longer than 10 feet (3 meters) including

extensions. If you use an ECG extension cable with an ECG cable longer than

4 feet, the monitor acts as though no ECG cable is connected.

Caution To protect the monitor from damage during defibrillation or

electrosurgery, for accurate ECG information, and for protection against noise

and other interference, use only ECG electrodes and cables specified or supplied

by Welch Allyn (these cables have the required current-limiting resistors). Follow

recommended application procedures.

Directions for Use Standalone Monitoring 57

Monitoring ECG

Procedure

1. Inspect the ECG cable. Replace it if it shows any signs of wear, breakage, or fraying.

2. Plug the cable into the monitor.

3. Select electrode sites on the patient (Figure 54), choosing flat areas and avoiding fatty

or bony areas and major muscles.

Figure 54. ECG Leads - Actual Placement

Note The monitor contains type CF fully isolated patient-connected circuitry, but it is

not intended for direct application on a patient’s heart.

Severe artifact and interference (such as defibrillation interference) can cause the

waveform to move off of the display for a few seconds before it is restored.

Impedance pneumography (Resp) is not recommended for use with

high-frequency ventilation.

The monitor counts as breaths any respiratory efforts larger than twice the

background cardiovascular artifact.

Use only silver/silver chloride electrodes. Other electrodes, such as stainless

steel electrodes, squeeze-bulb electrodes, or electrodes with dissimilar metals,

are subject to large offset potentials due to polarization. Other electrodes can also

have slower recovery time after the application of defibrillator pulses.

3-lead, adult and pediatric 3-lead, neonatal

5-lead, adult and pediatric

RA

LL

LA

RA

LL

LA

RA

LL

LA

V1 V6

RL

Six possible V lead electrode

placement sites for the C lead.

58 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

4. Shave or clip the hair from the electrode sites.

5. Thoroughly clean the skin, using soap and water, isopropyl alcohol, or skin preparation

pads, and lightly rub it dry.

6. If you are using gelled electrodes, verify that the electrode expiration date has not

passed and that the gel is intact and not dried out.

If you are not using gelled electrodes, apply a mound of gel (1/4-inch to 1/2-inch, or

0.6-cm to 1.3-cm) to each electrode contact area.

7. Attach lead wires to the electrodes before applying them to the patient.

8. Apply the electrodes to the patient in the proper locations (Figure 54).

Figure 55. ECG Leads - Placement Displays, 5-Lead and 3-Lead

The locations of the circles displayed on the monitor (Figure 55) for each lead are

fixed, and do not indicate the exact placement of the electrodes on the patient.

If the monitor detects that some lead wires are not connected, it displays an “ECG

Fault” equipment alert and a chest diagram (Figure 56) indicating the location of the

disconnected lead or leads. If the disconnected lead(s) invalidate the Lead used for

HR determination, then the monitor reassigns, if possible, the Lead used for HR. If

the reassignment succeeds, the monitor then displays another equipment alert with

the message “ECG Lead changed”.

Caution To protect the patient from allergic reactions to electrodes, refer to the

electrode manufacturer’s directions for use.

Note At least three appropriate electrode connections are required for ECG/Resp

monitoring.

Directions for Use Standalone Monitoring 59

Figure 56. ECG Leads - Disconnected Leads

9. When all leads are properly connected, confirm that the monitor displays the ECG

waveform, heart rate, and other patient data.

Figure 57. All Vital Signs Being Displayed

To Change the Waveform Selection

1. Highlight the current waveform source selection (Lead II, for example) and press .

Figure 58. Waveform Source: II

2. Highlight your waveform source choice and press or .

X

Disconnected leads

140/78

80

12

97

97 %

HALL, ROBERT E.

3456187

3:00:06P

Adult

Rm 239

HR/min

NIBP mmHg (102)

@2:47P Manual

Resp/min

SpO2

2x

II 1mV/cm

%

STEWART, ANN

7762940

15:14:28

Adult

Rm 263

HR/min

NIBP mmHg

Resp/min

SpO2

II 1mV/cm

80

12

97

Waveform Source

Lead I

Lead II 6 sec

Lead III

aVR

aVL

aVF

V

Resp

SpO2

Add 2nd Wave

60 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Figure 59. Waveform Source: Resp

To Change the Waveform Size

1. Highlight the current waveform scale (1mV/cm, for example) and press .

Figure 60. Waveform Size Popup Menu

2. Highlight the desired scaling factor and press . (Waveform size does not affect

QRS-detector sensitivity.)

About Pacemakers and ECG Monitoring

If the patient being monitored has a pacemaker, the monitor detects and can indicate the

occurrence of pacemaker signals. If the Pacer Indicator setting is ON, the monitor displays

and prints vertical dashed lines to indicate detected pacemaker signals. If Pacer Indicator

is OFF, the monitor continues to detect the pacemaker signals but does not display or

print the pacer markers.

Note If you scroll to the bottom selection of the Waveform Source menu—either Add

2nd Wave or Remove 2nd wave—the selection takes effect immediately and the

monitor returns to the primary data display.

Note In the Waveform Source menu, either the source Lead or the waveform period

can be highlighted. If the waveform period is highlighted, a second trace of the

same source will be cascaded to double the period obtained from a single trace.

%

STEWART, ANN

7762940

15:14:28

Adult

Rm 263

HR/min

Resp/min

SpO2

Resp 4x

60

20

97

130/74

NIBP mmHg (88)

@7:05P Manual

Waveform Source

Lead I

Lead II

Lead III

aVR

aVL

aVF

V

Resp 24 sec

SpO2

Add 2nd Wave

%

HR/min

NIBP mmHg

Resp/min

SpO2

II 1mV/cm

I 4mV/cm

STEWART, ANN

7762940

12:41:32

Adult

Rm 263

80

12

97

Waveform Size

0.2 mV/cm

0.5 mV/cm

1 mV/cm

2 mV/cm

4 mV/cm

8 mV/cm

Directions for Use Standalone Monitoring 61

Safety

Procedure

To enable or disable the display of pacer indicators, follow these steps:

1. Access the Setup menu. (See “To Access the Setup Menus” on page 38.)

2. Highlight ECG (Figure 61).

Figure 61. Turning the Pacer Indicator Off in the ECG Setup Menu

3. Highlight Pacer indicator and press or to highlight Off or On.

4. To exit the Setup menu, press or , or highlight Exit and press .

WARNING Signals differ between pacemakers. 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.”

WARNING Use of respiration monitoring by impedance pneumography can

affect the operation of some pacemakers. If pacemaker operation is affected, turn

off respiration pneumography. (See Figure 61 on page 61.)

WARNING Always use fresh ECG electrodes and make sure the ECG cable lead

wires make good connections. The presence of pacer-like noise can cause the

displayed heart rate to be erratic even though the ECG trace might look

undistorted with the pacer indicator off.

Note If the pacemaker signal is strong enough, the monitor displays it as a waveform

spike. This is true with Pacer indicator ON or OFF.

In accordance with the Pacer Pulse Rejection specification (“Pacer pulse

rejection” on page 165.), pacemaker pulses are not counted as heartbeats

whether Pacer Indicator is On or Off.

Noise on the ECG signal might be detected as pacer signals, causing the pacer

indicator to appear on the display. If you do not need to indicate pacemaker

signals, turn off the pacemaker indicator for a better ECG waveform display.

II 1mV/cm

Exit

Trends

Snapshots

Setup

60Hz

50Hz

80

HR/min

140/78

NIBP mmHg (102)

Resp/min

SpO2

Off

On

Power source filter

Resp Monitoring

Setup

12

97

%

HALL, ROBERT E.

3456187

3:00:06P

Adult

Rm 239

Alarms

ECG

NIBP

Timings

Off

Service

ECG Bandwidth

Pacer indicator

Monitor

Off

On

Extended

Pacer indicator Off

62 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Improving the Waveform Display

If the power source filter is off, noise from the power source can cause an unclear or

noisy waveform.

To Change the Power Source Filter to Reduce Noise

1. Access the Setup menu. (See “To Access the Setup Menus” on page 38.)

2. Highlight ECG.

Verify that the setting for Power source filter (Figure 62) is correct for the power

source in your facility. If you do not know what this setting should be, consult a

qualified service person.

3. Highlight Power source filter and press or as needed to select 60 Hz, 50 Hz,

or Off.

Figure 62. Turning On the 60 Hz Power Source Filter in the ECG Setup Menu

4. Exit the Setup menu by pressing or .

Monitoring Respiration

Resp is based on impedance pneumography, where respirations are sensed from the

ECG electrodes.

Resp is part of ECG monitoring. The Resp numeric is displayed (in purple) in the lower

right corner. To view the Resp waveform:

Change the waveform source to Resp (Figure 63). (See “To Change the Waveform

Selection” on page 59.)

II 1mV/cm

Exit

Trends

Snapshots

Setup

60Hz

50Hz

80

HR/min

140/78

NIBP mmHg (102)

Resp/min

SpO2

Off

On

Power source filter

Resp Monitoring

Setup

12

97

%

HALL, ROBERT E.

3456187

3:00:06P

Adult

Rm 239

Alarms

ECG

NIBP

Timings

Off

Service

ECG Bandwidth

Pacer indicator

Monitor

Off

On

Extended

Power source filter 60 Hz

Note All ECG cables listed for the Propaq LT monitor in Products and Accessories

(810-0409-XX) permit respiration monitoring and electrosurgical interference

suppression.

Note To measure Resp with Lead II selected, the LL lead must be attached to the

patient.

WARNING Use of respiration monitoring by impedance pneumography can

affect the operation of some pacemakers. If pacemaker operation is affected, turn

off respiration pneumography. (See Figure 61 on page 61.)

Directions for Use Standalone Monitoring 63

Figure 63. Resp Waveform, Default Size (2x)

For more detail, change the waveform size to 8x (Figure 64). (See “To Change the

Waveform Size” on page 60.)

Figure 64. Resp Waveform Enlarged for Detail (8x)

Note Waveform size does not affect breath-detector sensitivity.

%

HALL, ROBERT E.

3456187

3:08:16

Adult

Rm 239

HR/min

Resp/min

SpO2

Resp

2x

80

12

97

NIBP mmHg

%

HALL, ROBERT E.

3456187

3:08:16

Adult

Rm 239

HR/min

Resp/min

SpO2

Resp

8x

80

12

97

NIBP mmHg

64 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Monitoring SpO2

Safety

WARNING Accurate measurements of oxygen saturation, when derived from

pulse oximetry, depend to a great extent on patient condition and proper sensor

placement. Patient conditions such as shivering and smoke inhalation can result in

erroneous readings. If you believe a measurement might be inaccurate, verify it

using another clinically accepted measurement method, such as arterial blood gas

measurements using a co-oximeter.

WARNING Use only Nellcor accessories listed in the Welch Allyn Products and

Accessories guide (810-0409-XX). Inspect sensors and cables, and discard any

that are damaged. Do not use a sensor with exposed optical components.

WARNING If you need to increase the length of the sensor cable, use only one

extension. Use of multiple extensions can adversely affect performance. Do not

attach any cable that is intended for computer use to the SpO2 connector at the

monitor.

WARNING Tissue damage and erroneous measurements can be caused by

incorrect application or use of a sensor. (Examples of bad practices: 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

manufacturer’s directions for specific instructions on application and use, and for

description, warnings, cautions, and specifications.

WARNING Do not modify the sensor.

WARNING Do not wet the sensor or immerse it in fluid. Do not attempt to

sterilize a sensor.

WARNING Sensors exposed to ambient light while not applied to a patient can

exhibit seminormal saturation readings. Be sure the sensor is securely placed on

the patient and check its application often to ensure accurate readings.

WARNING Inaccurate measurements might be caused by venous pulsations.

WARNING The pulse oximeter can be used during defibrillation, but the

readings might be inaccurate for a short time.

WARNING Do not use the pulse oximeter as an apnea monitor.

WARNING When using the motion-tolerant pulse oximetry channel, a very

sudden and substantial change in pulse rate can result in erroneous pulse rate

readings. Always validate the patient data and patient condition before effecting

an intervention or a change in patient care.

Directions for Use Standalone Monitoring 65

Procedure

1. Inspect the SpO2 cable. Replace it if it shows any signs of wear, breakage, or fraying.

2. Plug the cable into the sensor and the monitor.

Each SpO2 sensor is intended for application to a specific site and site size on the

patient. To obtain optimal performance, use the right sensor and apply it as instructed

by the sensor manufacturer.

3. Clean the application site. Remove anything, such as nail polish, that could interfere

with the operation of the sensor.

4. Attach the SpO2 sensor to the patient according to the manufacturer’s directions for

use, observing all warnings and cautions.

5. Confirm that the monitor displays SpO2 data within a few seconds of being

connected to the patient.

• If ambient light is too bright, shield the sensor site with opaque material. Failure

to do so can result in inaccurate measurements. Light sources that can affect

performance include the following:

-surgical lights (especially those with a xenon light source)

-bilirubin lamps

-fluorescent lights

-infrared heating lamps

- direct sunlight.

• When NIBP and SpO2 are monitored simultaneously, place the NIBP cuff on a

different limb than the SpO2 sensor to help reduce unnecessary SpO2 alarms.

• Do not attach the SpO2 sensor on the same limb as an arterial catheter or

intravascular line.

WARNING Interfering substances: Carboxyhemoglobin can erroneously

increase readings; the level of increase is approximately equal to the amount of

carboxyhemoglobin present. Methemoglobin and other dysfunctional

hemoglobins can also cause erroneous readings. Further assessment beyond

pulse oximetry is recommended. Intravascular dyes, or any substances

containing dyes, that change usual arterial pigmentation can cause erroneous

readings. Darkly pigmented skin can adversely affect SpO2 readings.

WARNING For a premature infant, high oxygen levels might predispose the

infant to develop retinopathy. Therefore, the upper alarm limit for oxygen

saturation must be carefully selected in accord with accepted clinical standards

and considering the accuracy range of the monitor.

Caution If liquid gets into the SpO2 connector cavity, discontinue SpO2

monitoring until the liquid is removed and the cavity is dry.

66 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

• The pulse signal can disappear if any of the following conditions exists:

-the sensor is too tight

-ambient light is too bright

-an NIBP cuff is inflated on the same limb as the sensor

-arterial occlusion occurs near the sensor

-the patient is in cardiac arrest or shock

- the patient has hypotension, severe vasoconstriction, severe anemia, or

hypothermia.

• If poor perfusion affects performance for an adult, consider using the adult nasal

sensor.

• If a sensor is connected and the sensor light does not come on within 3 seconds:

-Verify that SpO2 is turned on (Figure 65)

- Replace the sensor

•The SpO

2 system is tolerant of normal patient motion. If excessive or prolonged

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

6. Periodically verify that the sensor remains properly positioned on the patient.

About SpO2 Spot Check

When SpO2 is turned on, the monitor generates an alarm condition whenever SpO2

readings are interrupted, such as when the sensor is disconnected from the patient after

the monitor begins taking SpO2 readings.

Using the SpO2 Spot Check feature, however, you can take any number of spot SpO2

readings at random intervals, attaching and detaching the sensor repeatedly without

generating alarms.

To Prepare to Take a Spot Check Reading

1. Highlight SpO2 and press .

Note The Spot Check feature is available only if it is enabled in the monitor

configuration. Refer to “Configuring the Monitor” on page 126.‘

Directions for Use Standalone Monitoring 67

2. Highlight SpO2 Monitoring (Figure 65), press to highlight Off, and press to

return to the main screen.

Figure 65. SpO2 Monitoring Turned Off

‘SpO2’ has changed to ‘SpO2 @ (time)’ (Figure 66). Spot checks are now enabled.

Figure 66. SpO2 Monitoring Turned Off

To Ta ke a n S p O 2 Spot Check Reading

1. Enable spot checks. (See “To Prepare to Take a Spot Check Reading” on page 66.)

2. Attach the sensor to the monitor and the patient.

3. Highlight SpO2 @ XX:XX and press . The SpO2 drop-down menu appears

(Figure 67).

Figure 67. SpO2 Drop-Down Menu

4. Press to highlight Spot Check.

• The drop-down menu disappears. SEARCH appears above SpO2 Spot Check

(Figure 68) (with pulse rate if SpO2 is the source of pulse rate).

Note The SpO2 drop-down menu can be accessed only when SpO2 is set to Off.

SpO2 Monitoring

Upper Alarm

Upper Limit

Lower Alarm

Lower Limit

HP/PR Tone

SpO2

Off

On

Low

Med

High

100

90

Standby

Press to move the

highlight to Off.

80

HALL, ROBERT E.

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NIBP mmHg

Resp/min

HR/min

SpO2 @ 3:03P

%

S D M

SpO2 Monitoring is Off

SpO2

On

Off

Spot Check

Enable continuous automatic SpO2 function

Disable automatic SpO2 function (enable Spot Checks)

Take a Spot Check reading

68 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Figure 68. SpO2 Spot Check: Waiting for an SpO2 Signal

• After a few seconds, the SpO2 heart-beat indicator starts showing heart beats.

• After about 30 seconds, SEARCH disappears and the pulse oximetry reading

appears (Figure 69).

Figure 69. SpO2 Spot Check: Pulse Rate Reading

• The spot check ends, and SpO2 monitoring is again turned off.

•The SpO

2 text on the display screen now includes the time of the most recent

SpO2 measurement. For example: SpO2@ 3:05P.

5. Detach the sensor from the patient.

6. To take another spot check later, repeat from step 2.

To Return to Continuous SpO2 Measurements

1. Highlight SpO2 @ XX:XX and press .

2. Press to turn automatic SpO2 On. The pop-up menu disappears.

To Adjust the SpO2 and ECG Pulse Tone Volume

1. Highlight SpO2 and press .

2. Highlight HR/PR Tone.

3. Highlight the desired volume level (Off, Low, Med, or High) and press .

Note Spot checks are included in trends displays.

HALL, ROBERT E.

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Resp/min

PR/min

SpO2 Spot Check

%

NIBP mmHg

SEARCH

S D M

SEARCH indicates that the monitor

is waiting for pulse oximetry data.

78

98

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%

NIBP mmHg

NIBP mmHg S D M

Pulse rate

Directions for Use Standalone Monitoring 69

Monitoring Blood Pressure (NIBP)

Safety

Procedure

When the monitor is powered on, the default cuff inflation pressure is based on the

patient mode. (See “Default inflation pressure” on page 169.) After an NIBP

measurement occurs, the monitor adjusts the inflation pressure to optimize subsequent

NIBP measurements.

1. Select cuff size based on limb circumference. Use only hoses and cuffs listed in the

Welch Allyn Products and Accessories guide.

2. Squeeze all the air from the cuff before placing the cuff on the patient.

3. Place the cuff on the limb, as near heart level as possible (Figure 70 on page 70).

WARNING Always use a properly fitting cuff, placing it carefully on the patient

according to the instructions presented below. Failure to fit and locate the cuff

correctly can lead to inaccurate pressure readings.

WARNING During monitoring, periodically observe the patient’s limb to make

sure that the circulation is not impaired for a prolonged period. Prolonged

impairment of circulation or improper cuff placement can cause bruising.

WARNING Do not use the monitor to simultaneously measure NIBP on one

patient and monitor ECG on another patient.

WARNING If an NIBP measurement is suspect, repeat the measurement. If you

are still uncertain about the reading, verify it using another method.

WARNING Do not take NIBP measurements on patients during

cardiopulmonary bypass.

WARNING 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 “NIBP” on page 168 for values.)

Caution Pulse-rate measurements generated through the blood pressure cuff

or through SpO2 are subject to artifact and might not be as accurate as heart-rate

measurements generated through ECG or through manual observation.

Note Always cycle the monitor power before you begin to monitor another patient.

Normal physiological pressure variations affect NIBP measurements from reading

to reading.

If the monitor is in Adult mode and a neonate cuff is connected to the monitor,

the monitor generates an equipment alert.

70 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

• The cuff must fit snugly without being uncomfortably tight.

• The hose must be free of kinks and not pinched.

4. Align the point where the tubing connects to the cuff over the brachial or other

appropriate artery.

Figure 70. Cuff Placement

5. Screw the hose connector onto the NIBP air connector on the top of the monitor (see

Figure 4 on page 9).

6. Press to start a reading.

• If you need to stop the reading and vent the cuff at any time during the

measurement, press .

• If the monitor cannot get a valid NIBP reading, it displays the message

‘NIBP retry in progress’ in the upper left corner of the screen and attempts

another measurement. Depending on settings and patient mode, the monitor

attempts one or two retries.

7. If motion artifact, such as shivering or coughing, interferes with NIBP readings, do the

following:

• Position the patient’s limb away from the body so that the applied cuff is not in

contact with the patient’s body or any other object (such as a bed rail). Keep the

cuff as close to heart level as possible.

Note For every inch the cuff is placed above the heart, add 1.9 mmHg (0.253 kPa) to the

displayed NIBP reading. For every inch below the heart, subtract 1.9 mmHg

(0.253 kPa).

Note If you are simultaneously monitoring blood pressure and SpO2, you can reduce or

eliminate unnecessary SpO2 alarms by placing the cuff and the SpO2 sensor on

different limbs.

Note If the battery charge is low and the monitor is not in the cradle, the battery icon

indicates low battery and NIBP monitoring is disabled.

Cuff applied evenly and snugly. The

center of the cuff is at heart level,

and the bottom edge is one inch (2.5

cm) above the antecubital fossa. Possible cuff placements for neonates

Directions for Use Standalone Monitoring 71

• Verify that the Smartcuf filter is ON. (See “Improving NIBP Accuracy with

Smartcuf” on page 71.)

• Verify that the ECG leads are properly connected to the patient and monitor ECG

during NIBP. (ECG monitoring is required for Smartcuf.)

Improving NIBP Accuracy with Smartcuf

Many factors can adversely affect an NIBP measurement: cardiac arrhythmias, sudden

changes in blood pressure, patient motion such as convulsions or shivering, sudden cuff

movement, vibration, vehicle motion, or a weak pulse. The Smartcuf feature increases

NIBP measurement accuracy in the presence of moderate motion artifact or diminished

pulses.

To Enable Smartcuf

1. Simultaneously monitor ECG and NIBP.

2. Access the Setup menu. (See “To Access the Setup Menus” on page 38.)

3. Highlight NIBP, highlight Smartcuf, and enable the Smartcuf filter.

If Smartcuf is enabled and motion artifact is so severe that it still affects measurement

accuracy, the measurement is marked with the symbol on the display and on printouts.

During certain types of arrhythmias and other situations where a good ECG signal cannot

be obtained, consider disabling Smartcuf, as follows:

To Disable Smartcuf

1. Access the Setup menu. (See “To Access the Setup Menus” on page 38.)

2. Highlight NIBP, highlight Smartcuf, and disable the Smartcuf filter.

Note The message ???/???/(???) in an NIBP TREND display or printout indicates that

the monitor could not complete an NIBP measurement during that period.

Note On-demand NIBP readings (manual or turbo) are delayed by 8 seconds if they are

started while the monitor is in a power-saving mode such as display time-out.

Note Smartcuf will be available in 2006.

Note

s

Smartcuf can function only when ECG is being monitored.

72 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Taking Automatic NIBP Readings

In the Auto NIBP mode, for intervals shorter than 5 minutes, the monitor immediately

begins taking NIBP readings at the specified interval. For intervals of 5 minutes or longer,

the readings begin when the time of day is a multiple of the interval. (If the interval is 15

minutes, for example, then the readings begin at 00, 15, 30, or 45 minutes after the hour.)

To Start Automatic NIBP Readings

1. Select and apply the appropriate NIBP cuff and hose. (“Monitoring Blood Pressure

(NIBP)” on page 69.)

2. Highlight NIBP and press .

3. Highlight NIBP Mode and select Auto.

4. Highlight Auto Interval (min) and select an interval.

To Stop Automatic NIBP Readings

1. Highlight NIBP and press .

2. Highlight NIBP Mode and select Manual.

Taking NIBP Readings Using Turbo Mode

In Turbo mode, the monitor starts an NIBP reading and then takes as many more readings

as possible within five minutes.

To Use the Turbo Mode

1. Select and apply the NIBP cuff and hose. (“Monitoring Blood Pressure (NIBP)” on

page 69.)

2. Highlight NIBP and press .

3. Highlight NIBP Mode and select Tu r b o .

To End the Turbo Mode

Press or select NIBP Mode Manual. The monitor returns to manual NIBP

measurement mode.

Note After you invoke an automatic NIBP, expect a delay before the monitor starts the

first measurement. The delay can be as long as the interval selected.

Note If you cycle the monitor power, NIBP returns to manual mode.

Directions for Use Standalone Monitoring 73

Taking NIBP Readings Using the Digital Manometer

To Use the Digital Manometer

1. Attach the appropriate cuff to the patient. (See Step 1 on page 69.)

2. In the NIBP control menu (see “Using Control Menus” on page 34), highlight

Manometer. The manometer menu appears (Figure 71).

Figure 71. NIBP: Manometer Initial View

3. Press to start the NIBP measurement cycle. When the cuff is inflated, the

manometer bar dynamically displays the pressure reading (Figure 72).

Figure 72. NIBP: Manometer Reading in Progress

When the cycle completes, measurement numerics appear below the waveform grid

and the systolic, diastolic, and MAP values are displayed as markers along the

manometer scale (Figure 73).

NIBP Mode:

II 1mV/cm

Exit

Trends

Snapshots

Setup

HR/min

NIBP mmHg

Resp/min

SpO2

NIBP

Systolic

Diastolic

Mean

%

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Manometer

Manual

0

50

100

150

200

250

300

NIBP Mode:

II 1mV/cm

Exit

Trends

Snapshots

Setup

HR/min

NIBP mmHg

Resp/min

SpO2

NIBP

Systolic

Diastolic

Mean

%

STEWART, ANN

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Manometer

Manual

NIBP in progress.

145

50

100

150

200

250

300

Manometer pressure indicator bar

74 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Figure 73. NIBP: Manometer Reading Complete

NIBP Measurements in Power-Saving Mode

When a manual or turbo NIBP activity awakens the monitor from power-saving mode

(“Power Saving” on page 45), cuff inflation pressure is reset to default levels and cuff

inflation is delayed for up to 8 seconds.

NIBP Disabled When the Battery is Low

If the battery is low and the monitor is operating on battery power, NIBP functions are

disabled and the monitor displays the message “NIBP off. Low battery.”

If you attempt to start an NIBP measurement during a low-battery condition, the monitor

displays an equipment alert with the message “Low battery. NIBP disabled.”

NIBP Mode:

II 1mV/cm

Exit

Trends

Snapshots

Setup

PR/min

NIBP mmHg

Resp/min

SpO2

NIBP

Systolic

Diastolic

Mean

%

STEWART, ANN

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Manometer

Manual

2

50

100

150

200

250

300

(98)

79

132/83

Systolic, diastolic, and MAP

(numeric)

Systolic, diastolic, and MAP

(graphical)

Note Inserting a monitor into a powered cradle during a low-battery condition

immediately enables NIBP monitoring.

Directions for Use Standalone Monitoring 75

To Discontinue Monitoring

1. Press . The Power Off screen appears (Figure 74 on page 75).

Figure 74. Power Off

• If you intend to continue monitoring the same patient when the monitor is turned

on again, and if you want to save the stored vital-signs data and monitor settings

(to print them at a PC), highlight Save & Shut Down and then press . The

monitor saves the patient data and the monitor settings, and then turns off.

• If you do not intend to continue monitoring the same patient when the monitor is

turned on again, highlight Delete & Shut Down and then press . The monitor

turns off without saving the data and the settings.

2. Disconnect the leads and sensors from the patient.

If you press and then decide that instead of turning off the monitor you want to resume

monitoring the same patient, do one of the following:

• Highlight Cancel and press .

• Wait for 30 seconds.

• Press .

Note When you power down from Demo mode, you cannot save settings and patient

data. In this case, the following screen appears:

Select ( ) to delete patient data

You have pressed the Power Off button.

Delete & Shut Down

Cancel

Setu

pSetup

and shut down.

15:01:24

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There is patient data stored for

Hall, Robert E. ID: 3456187

Save & Shut Down

HALL, ROBERT E.

3456187

Delete & Shut Down

Cancel

Setup

ID: SET_DEMMATJP

12:41:32

Adult

Rm

Select ( ) to delete patient data

and shut down.

You have pressed the Power Off button.

SIMULATION

76 Standalone Monitoring Welch Allyn Propaq LT Vital Signs Monitor

Welch Allyn FN802FH Propaq 802 LTRN User Manual Users Manal part 5 of 10

Welch Allyn, Inc. Propaq 802 LTRN Users Manal part 5 of 10

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