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GE CARESCAPE User Manual

Modular monitors
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Table of Contents

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GE Healthcare
CARESCAPE Modular Monitors
User's Manual
Software version 2
CARESCAPE Modular Monitors
English
2062978-001 DVD
2068394-008 paper
© 2012 General Electric Company.
All rights reserved.

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Summary of Contents for GE CARESCAPE

  • Page 1 GE Healthcare CARESCAPE Modular Monitors User's Manual Software version 2 CARESCAPE Modular Monitors English 2062978-001 DVD 2068394-008 paper © 2012 General Electric Company. All rights reserved.
  • Page 2 The information in this manual applies to the software version listed on the first page of the manual. Due to continuing product innovation, specifications in this manual are subject to change without notice. For technical documentation purposes, the abbreviation GE is used for the legal entity names, GE Medical Systems Information Technologies, Inc. and GE Healthcare Finland Oy.
  • Page 3 Site requirement warnings ................. 46 System caution safety messages ..............46 Loss of data ....................46 Electrical caution..................46 Site requirement cautions ................47 Notice safety messages ................47 Safety symbols ....................47 Indications for use..................48 2062971-001 CARESCAPE Modular Monitors...
  • Page 4 B450 monitor back panel ................65 Monitor battery ..................... 65 Inserting and removing the B650 monitor battery ........66 Inserting and removing the B450 monitor battery ........67 Checking the battery charge with monitor software........ 67 CARESCAPE Modular Monitors 2062971-001...
  • Page 5 Remote control and keypad ................. 78 Recorders and laser printers ................ 78 About the Unity Network Interface Device (ID)..........78 CIC Pro Clinical Information Center.............. 79 CARESCAPE Central Station ................79 iCentral ......................80 Remote alarm box (nurse call)..............80 iPanel software application ................81 Equipment symbols ..................
  • Page 6 Supply mains interruption ................106 Power failure alarm..................106 Setting up the monitor before use............107 Normal screen and other pages ..............107 Selecting the normal screen (main page) ..........107 Selecting pages ..................107 Adjusting sound volumes ................108 CARESCAPE Modular Monitors 2062971-001...
  • Page 7 Starting monitoring..................116 About the combination monitoring mode..........117 Entering patient data.................. 118 Entering patient data with the monitor ........... 118 Entering patient data with a barcode reader.......... 119 About the roving functionality..............119 Roving between units................120 2062971-001 CARESCAPE Modular Monitors...
  • Page 8 Roving between beds................120 Adding new units and beds (manual roving) ........... 120 Entering administrative information............121 Loading patient information from the CARESCAPE Network (ADT server) ......................121 Loading patient data and trend data from the S/5 Network ....121 About standby.....................
  • Page 9 ECG compatibility limitations..............147 ECG safety precautions ................147 ECG warnings .................... 147 ECG cautions ..................... 149 ECG measurement limitations..............149 ECG points to note ..................149 ECG measurement setup................150 ECG equipment to patient connection............. 150 2062971-001 CARESCAPE Modular Monitors...
  • Page 10 Showing a second HR value in the HR parameter window ....162 Showing ST in the HR parameter window ..........163 Showing PVC in the HR parameter window ..........163 Showing QT in the HR parameter window..........163 Displaying the ECG grid................163 CARESCAPE Modular Monitors 2062971-001...
  • Page 11 12 lead ECG analysis troubleshooting ............. 172 Pacemaker detection.................. 172 Pacemaker detection warnings ............... 172 Pacemaker detection points to note............173 Selecting the pacemaker detection ............173 Pacemaker detection troubleshooting ............ 174 Arrhythmia monitoring ................175 2062971-001 CARESCAPE Modular Monitors...
  • Page 12 Selecting the ST time scale ............... 186 ST trend display ..................186 Displaying QRS complexes and ST trends for other leads ...... 186 Reviewing ST trends .................. 187 Printing an ST trend report ............... 187 Ischemic burden..................187 CARESCAPE Modular Monitors 2062971-001...
  • Page 13 Apnea alarms’ deactivation with the pause audio key......198 Setting the apnea alarm delay ..............198 Enabling the respiration cardiac artifact alarm ........198 Respiration alarm priorities ..............198 Turning off the respiration measurement ..........198 Respiration measurement description ............199 2062971-001 CARESCAPE Modular Monitors...
  • Page 14 .................... 204 measurement limitations ..............204 points to note ..................204 SpO₂ measurement guidelines..............205 GE Ohmeda technology and sensor measurement guidelines....205 Masimo SET technology and sensor measurement guidelines....205 Nellcor OxiMax technology and sensor measurement guidelines....................206 SpO₂...
  • Page 15 Starting or stopping a single NIBP measurement from the NIBP Setup menu ......................223 Starting or stopping a single NIBP measurement with the PSM module key ....................223 Automatic NIBP measurements..............224 Automatic NIBP measurements and monitor clock synchronization ..................224 2062971-001 CARESCAPE Modular Monitors...
  • Page 16 Invasive pressure measurement setup ............. 236 Invasive pressure equipment to patient connection ......236 Invasive pressure module keys ..............236 Connecting the invasive pressure transducer and cable ....... 237 Checking the invasive pressure measurement ........237 CARESCAPE Modular Monitors 2062971-001...
  • Page 17 Systolic pressure variation and pulse pressure variation......245 Changing the SPV source ................. 245 Measuring SPV manually ................245 PA catheter insertion .................. 246 Selecting the PA catheter insertion mode ..........246 Pulmonary capillary wedge pressure (PCWP) measurement....246 2062971-001 CARESCAPE Modular Monitors...
  • Page 18 Displaying the delta value between two temperature channels ... 258 Setting temperature alarms ..............258 Stopping the temperature measurement..........259 Temperature practicalities ................. 259 Temperature troubleshooting ..............259 14 Cardiac output ...................261 C.O. safety precautions ................261 CARESCAPE Modular Monitors 2062971-001...
  • Page 19 Stopping the cardiac output measurement ..........269 C.O. practicalities..................269 Cardiac output washout curve..............269 How to improve the C.O. accuracy............269 C.O. troubleshooting..................270 15 Mixed venous oxygen saturation (SvO₂)..........275 compatibility limitations ..............275 SvO₂ safety precautions ................275 2062971-001 CARESCAPE Modular Monitors...
  • Page 20 Airway gases measurement limitations ............ 283 Airway gases points to note ............... 283 Airway gases measurement setup ............284 Airway gases equipment to patient connections with CARESCAPE respiratory modules .................. 284 Airway gases equipment to patient connections with compact airway modules, anesthesia setup ............285 Airway gases equipment to patient connections with compact airway modules, critical care setup ............

  • Page 21: Table Of Contents

    Selecting what to show with EtCO ............293 Selecting the FiO level................293 Selecting the N O level................293 Using the CARESCAPE respiratory modules and compact airway modules for O₂ measurement..............294 Selecting the O scale ................294 Selecting the O sweep speed ..............294 Setting O alarms ..................
  • Page 22 MAC values of different anesthetics in oxygen ........299 MAC values of different anesthetics in 65% N O ........300 ET balance gas, CARESCAPE respiratory modules and compact airway modules ....................... 300 Automatic agent identification with E-sCAiO, E-sCAiOV, E-CAiO, E-CAiOV and E-CAiOVX modules ..............301 Basics of CO₂...
  • Page 23 CO₂ measurement practicalities ..............319 Ventilation management ................319 Prevention of the breathing system contamination ....... 320 How to prevent effects of humidity............320 AquaKnot with the Dual CO2..............320 CAPNOSTAT Mainstream and Dual CO2 sensor placement....320 2062971-001 CARESCAPE Modular Monitors...
  • Page 24 Patient Spirometry measurement basics ..........328 Patient Spirometry measurement description ........328 D-lite(+)/Pedi-lite(+) flow sensor ..............329 Patient Spirometry parameters..............329 Patient Spirometry loops and waveforms ..........334 Patient Spirometry practicalities..............336 Patient Spirometry troubleshooting............337 CARESCAPE Modular Monitors 2062971-001...
  • Page 25 Entropy points to note ................351 Entropy measurement setup..............351 Entropy equipment to patient connection..........351 Entropy module keys................. 352 Preparing the patient for Entropy measurement........352 Checking the Entropy measurement ............352 Using the Entropy measurement ............... 353 2062971-001 CARESCAPE Modular Monitors...
  • Page 26 NMT safety precautions................361 NMT warnings.................... 361 NMT cautions..................... 362 NMT measurement limitations..............362 NMT points to note..................362 Checking the NMT measurement .............. 362 NMT measurement setup ................363 NMT equipment to patient connection ............ 363 CARESCAPE Modular Monitors 2062971-001...
  • Page 27 EEG indications for use ................374 EEG measurement limitations..............374 EEG points to note..................374 EEG measurement setup ................375 EEG equipment to patient connection ............. 375 EEG module keys ..................375 EEG electrode sites..................375 2062971-001 CARESCAPE Modular Monitors...
  • Page 28 EEG frequency bands................382 Compressed spectral array (CSA) ............. 383 How to interpret the EEG values............... 383 Normal EEG frequencies ................384 Abnormal EEG characteristics ..............384 EEG reactivity..................... 384 Examples of typical EEG patterns ............384 CARESCAPE Modular Monitors 2062971-001...
  • Page 29 BIS compatibility..................393 BIS safety precautions ................393 BIS warnings ....................393 BIS cautions ....................394 BIS indications for use ................395 BIS measurement limitations ..............395 BIS points to note ..................395 BIS measurement setup ................396 2062971-001 CARESCAPE Modular Monitors...
  • Page 30 Source data for calculations ..............405 Selecting source data for oxygenation calculations....... 406 Selecting source data for ventilation calculations ........406 Estimated values in oxygenation calculations .......... 406 Estimated values in hemodynamic calculations........406 Selecting the PCWP source............... 407 CARESCAPE Modular Monitors 2062971-001...
  • Page 31 Printing currently viewed graphic trends..........419 Printing all graphic trend data..............419 Graphic trend resolution and the high-resolution license ...... 419 Numeric trends.................... 419 Viewing numeric trends ................419 Changing the time interval of numeric trends ........420 2062971-001 CARESCAPE Modular Monitors...
  • Page 32 Snapshots and alarm history ..............428 Snapshot transfer to PDM ................428 ST snapshots ....................428 Creating ST snapshots manually.............. 428 Viewing ST snapshots ................429 Printing ST snapshots................429 Erasing ST-snapshots................429 Events ......................429 Description of events ................429 CARESCAPE Modular Monitors 2062971-001...
  • Page 33 Printing trends..................... 439 Configuration of numeric trends for printing .......... 439 Automatic printing of events and snapshots .......... 439 Printing trends manually................439 Printing reports ................... 439 Printing and patient discharge..............439 Configuring a trend report................ 439 2062971-001 CARESCAPE Modular Monitors...
  • Page 34 Interfacing warnings................. 447 Interfacing cautions .................. 447 Compatible peripheral devices ..............448 Unity Network Interface Device (ID) ............448 Software compatibility ................448 About the Unity Network Interface Device (ID)........448 Unity Network Interface Device (ID) interconnection......449 CARESCAPE Modular Monitors 2062971-001...
  • Page 35 D-fend(+), D-fend Pro(+), and Mini D-fend water trap care instructions ....................458 CAPNOSTAT sensor and adapter cleaning instructions ......458 How to store PDM and PSM................ 458 Monitor battery care ................... 459 Replacing the monitor battery ..............459 2062971-001 CARESCAPE Modular Monitors...
  • Page 36 Messages related to various situations ............. 505 34 Abbreviations .....................513 List of abbreviations..................513 Skills checklist ....................529 System introduction..................529 Starting and ending ..................530 Monitoring basics..................530 Alarms......................531 Trends ......................532 Snapshots and events ................532 CARESCAPE Modular Monitors 2062971-001...
  • Page 37 Airway gases ....................539 with CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 modules ....................... 540 Patient Spirometry ..................541 Gas exchange ..................... 541 Entropy......................542 Neuromuscular transmission ..............543 EEG and AEP ....................543 BIS ........................ 544 2062971-001 CARESCAPE Modular Monitors...
  • Page 38 CARESCAPE Modular Monitors 2062971-001...
  • Page 39 Using the device should never replace nor impede the human intervention and required patient care provided by clinical professionals. Training requirements No product-specific training is required for the use of the CARESCAPE modular monitors. Manual conventions This manual uses the following styles to emphasize text or indicate action.
  • Page 40 Monitor naming conventions In this manual, the CARESCAPE Monitor B850, CARESCAPE Monitor B650 and CARESCAPE Monitor B450 are referred to as “the monitor” when a function or a feature applies to all three. For describing monitor-specific issues, the monitors are referred to as B850, B650 and B450, respectively.
  • Page 41 CARESCAPE Central Station User’s Manual ● Ordering manuals A paper copy of this manual will be provided upon request. Contact your local GE representative and request the part number on the first page of the manual. 2062971-001 CARESCAPE Modular Monitors...
  • Page 42 Covidien is a trademark of Covidien AG. Masimo SET is a trademark of Masimo Corporation. Manufacturer responsibility GE is responsible for the effects on safety, reliability, and performance of the equipment only if: Assembly operations, extensions, readjustments, modifications, servicing, or ●...
  • Page 43 WARNING Use only approved accessories, including mounts, and defibrillator-proof cables and invasive pressure transducers. For a list of approved accessories, see the CARESCAPE Modular Monitors Supplemental Information Manual. Other cables, transducers and accessories may cause a safety hazard, damage the equipment or system, result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement.
  • Page 44 WARNING — INTERFACING OTHER EQUIPMENT — Connect only items that are specified as part of the system and as compatible. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. CARESCAPE Modular Monitors 2062971-001...
  • Page 45 ● metal. Equipment warnings WARNING — EXPLOSION — Do not use this equipment in the presence of flammable anesthetics, vapors or liquids. 2062971-001 CARESCAPE Modular Monitors...
  • Page 46 In U.S.A., if the installation of this equipment will use 240V rather than 120V, the source must be a center-tapped, 240V, single-phase circuit. This equipment is suitable for connection to public mains as defined in CISPR 11. CARESCAPE Modular Monitors 2062971-001...
  • Page 47 This symbol is identified by a yellow background, black triangular band, and a black symbol. Electrostatic sensitive device. Connections should not be made to this device unless ESD precautionary procedures are followed. Non-ionizing electromagnetic radiation. Interference may occur in the vicinity of this device. 2062971-001 CARESCAPE Modular Monitors...
  • Page 48 The CARESCAPE Monitor B850 is a multi-parameter high acuity patient monitor intended for use in multiple areas within a professional healthcare facility. The CARESCAPE Monitor B850 is intended for use on adult, pediatric, and neonatal patients and on one patient at a time.
  • Page 49 Safety The CARESCAPE Monitor B850 can be a stand-alone monitor or interfaced to other devices. It can also be connected to other monitors for remote viewing and to data management software devices via a network. The CARESCAPE Monitor B850 is intended for use under the direct supervision of a licensed healthcare practitioner, or by personnel trained in proper use of the equipment in a professional healthcare facility.
  • Page 50 The CARESCAPE Monitor B450 can be a stand-alone monitor or interfaced to other devices. It can also be connected to other monitors for remote viewing and to data management software devices via a network.
  • Page 51 WARNING Use only approved accessories, including mounts, and defibrillator-proof cables and invasive pressure transducers. For a list of approved accessories, see the CARESCAPE Modular Monitors Supplemental Information Manual. Other cables, transducers and accessories may cause a safety hazard, damage the equipment or system, result in increased emissions or decreased immunity of the equipment or system or interfere with the measurement.
  • Page 52 ESD sensitive equipment should be worn. See the documentation provided with the wrist straps for details of proper use. Floors should be covered by ESD dissipative carpets or similar. Non-synthetic clothing should be used when working with the component. CARESCAPE Modular Monitors 2062971-001...
  • Page 53 WARNING — PHYSICAL INJURY — Take care when mounting devices to an IV pole. If a device is mounted too high the IV pole may become unbalanced and tip over. 2062971-001 CARESCAPE Modular Monitors...
  • Page 54 WARNING — EXPLOSION OR FIRE — Using non-recommended batteries could result in injury/burns to the patients or users. Only use batteries recommended or manufactured by GE. The warranty can be voided if non-recommended batteries are used. WARNING Do not incinerate a battery or store at high temperatures.
  • Page 55 6. Laser printer: This device may be connected to the monitor, network, or to a central station on the network. The laser printer can print waveforms, alarm waveforms, numeric trends, and reports. If it is used within the patient 2062971-001 CARESCAPE Modular Monitors...
  • Page 56 (remote nurse call), or a Unity Network Interface Device (ID) to the monitor. B850 processing unit back view 1. Power on/off switch. 2. Power inlet connector. 3. Four USB ports: For connecting the touchscreen display, remote control, keyboard, mouse, and barcode reader. CARESCAPE Modular Monitors 2062971-001...
  • Page 57 4. Ethernet: For connecting the MC and IX networks. The MC Network establishes communication and allows patient data to be sent to an optional CIC Pro Clinical Information Center or CARESCAPE Central Station. The IX Network provides access for example to the MUSE server, Citrix server, and IX printers.
  • Page 58 Your system may not include all these components. Consult your local representative for the available components. 1. CARESCAPE Monitor B650 2. 19-inch display: Touchscreen display that provides abbreviated keypad and Trim Knob control. If a non-medical grade display is used as a secondary display...
  • Page 59 B650 monitor front panel 1. Alarm light 2. Trim Knob control 3. Abbreviated integrated keypad 4. Battery power/mains power indicators 5. On/standby 2062971-001 CARESCAPE Modular Monitors...
  • Page 60 * = optional 3. Release switch for the pivoting module frame 4. Defibrillator (ECG) and IABP synchronization (E-modules only) * = optional B650 monitor back panel 1. Pivoting module frame 2. Slide mount, connector for PDM CARESCAPE Modular Monitors 2062971-001...
  • Page 61 Do not touch the electrical connector located within the module housing or frame. 1. Press the pivoting module frame’s release switch and use the rail on top of the frame to help you in moving the frame. 2062971-001 CARESCAPE Modular Monitors...
  • Page 62 All components listed below can be used within the patient environment as long as an additional transformer providing at least basic isolation is used with non-medical grade secondary displays and printers. Your system may not include all these components. Consult your local representative for the available components. CARESCAPE Modular Monitors 2062971-001...
  • Page 63 System introduction 1. CARESCAPE Monitor B450 2. 19-inch display: Touchscreen display that provides abbreviated keypad and Trim Knob control. If a non-medical grade display is used as a secondary display within the patient environment it must always be powered from an additional transformer providing at least basic isolation.
  • Page 64 1. Module slot for one single-width 1. Receptacle for power cord module 2. Battery slot 2. Defibrillator (ECG) and IABP 3. Release latch for battery door synchronization (E-modules only) 3. Optional recorder 4. Release latch for recorder CARESCAPE Modular Monitors 2062971-001...
  • Page 65 3. Connector for MC Network. The MC Network establishes communication and allows patient data to be sent to an optional CIC Pro Clinical Information Center or CARESCAPE Central Station. 4. Connector for IX Network. The IX Network provides access for example to the MUSE server, Citrix server, and IX printers.
  • Page 66 WARNING — EXPLOSION OR FIRE — Using non-recommended batteries could result in injury/burns to the patients or users. Only use batteries recommended or manufactured by GE. The warranty can be voided if non-recommended batteries are used. WARNING Do not incinerate a battery or store at high temperatures.
  • Page 67 B650 and B450 only. You can check the monitor battery status using the monitor software: 1. Select the battery status area in the upper right corner of the screen, or select Monitor Setup > Battery Status. 2062971-001 CARESCAPE Modular Monitors...
  • Page 68 Four LEDs illuminated: 75% to 100% of full-charge capacity. ● Three LEDs illuminated: 50% to 74.9% of full-charge capacity. ● Two LEDs illuminated: 25% to 49.9% of full-charge capacity. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 69 B450: The monitor supports one secondary independent display. The monitor itself has a 12” integrated display. The GE 19-inch touchscreen display provides an integrated abbreviated keypad and a Trim Knob control. The displays integrate audible (B850 only) and visual alarms, and provide USB connectivity.
  • Page 70 You can use different types of acquisition modules with the monitor. They provide connection to the patient, process patient data signals, and send patient data signals to the monitor. For a complete list of compatible devices, see the CARESCAPE Modular Monitors Supplemental Information Manual.
  • Page 71 8. Dual function Power On and Zero All button 9. Defib/Sync 10. Tab for removing the module The PDM module requires additional time to power up when used without the PDM battery. Do not interrupt the startup sequence by unplugging the PDM module. 2062971-001 CARESCAPE Modular Monitors...
  • Page 72 WARNING — EXPLOSION OR FIRE — Using non-recommended batteries could result in injury/burns to the patients or users. Only use batteries recommended or manufactured by GE. The warranty can be voided if non-recommended batteries are used. TRAM module front view TRAM and Tram-Rac modules with the B850 only.
  • Page 73 System introduction 1. BP1 2. BP2 Modules and parameters Hemodynamic multiparameter modules The hemodynamic multi-parameter acquisition modules are compatible with the CARESCAPE Modular Monitors as follows: PSM: Monitors B850, B650, B450 ● PDM: Monitors B850, B650, B450 ● TRAM: Monitor B850 ●...
  • Page 74 E-modules, pressure E-modules, and Tram-Rac modules. E-modules offer a wide variety of parameter acquisition capability to the patient monitoring system. Hemodynamic modules are compatible with the CARESCAPE Modular Monitors as follows: E-COPS, E-COPSv: Monitors B850, B650, B450 ● E-PP, E-PT, E-P: Monitors B850, B650, B450 ●...
  • Page 75 Gas modules The gas acquisition modules provide measurements for gas parameters, anesthetic agents, Patient Spirometry, gas exchange, and metabolics. They are compatible with the CARESCAPE Modular Monitors as follows: E-sCO, E-sCOV, E-sCAiO, E-sCAiOV: Monitors B850, B650, B450 ● E-miniC: Monitors B850, B650, B450 ●...
  • Page 76 E-CAiOVX Tram-Rac gas parameters Parameter CAPNOSTAT Mainstream Dual CO2 CapnoFlex LF E-modules E-modules are the E-MASIMO and E-NSATX. They are compatible with all CARESCAPE modular monitors. E-MASIMO and E-NSATX parameters Parameter E-NSATX* E-MASIMO* Masimo Nellcor * Different SpO cables are required for each type of SpO processing.
  • Page 77 Mouse A standard mouse may be connected to the monitor or display via one of the USB connectors. The mouse allows you to select any on-screen items without a Trim Knob control or a touchscreen display. 2062971-001 CARESCAPE Modular Monitors...
  • Page 78 The monitor can print to a configured network laser printer, a PRN 50-M recorder (B850), an optional recorder (B650 and B450), or a remote recorder in the network. You need the IX Network or the S/5 Network for the network printer. About the Unity Network Interface Device (ID) CARESCAPE Modular Monitors 2062971-001...
  • Page 79 Device (ID) is used with the monitor to communicate with peripheral devices. It acquires digital data from eight individually isolated serial ports. The data is collected from up to eight peripheral devices (not necessarily manufactured by GE), and then the interface device transmits the formatted data to the monitor.
  • Page 80 System introduction The MC Network establishes communication and allows patient data to be sent to an optional CARESCAPE Central Station. See the CARESCAPE Central Station User’s Manual for operating instructions. iCentral The S/5 Network (Ethernet) establishes communication and allows patient data to be sent to an optional iCentral (central station).
  • Page 81 Citrix thin client on the monitor so no additional equipment is required at the bedside. See the CARESCAPE Modular Monitors Supplemental Information Manual for the iPanel application default settings. See the CARESCAPE Monitor B850 Technical Manual and the CARESCAPE Monitor B450 Technical Manual for configuring the size, location, and behavior of the iPanel application.
  • Page 82 Battery (monitor). Located on the battery slot cover. Battery (monitor): The battery slot cover is open/closed. Battery (monitor): Test button on the battery to check the battery charge level. Battery (PDM). Communication. Power indicator. On/standby button. Standby or power indicator. CARESCAPE Modular Monitors 2062971-001...
  • Page 83 The following symbols appear on one or more of the devices. Signal/power input. Signal/power output. Signal/power input/output (combined). ON. Power connection to the mains. Power supply connector. Power switch. Display brightness controls. Display speaker volume controls. USB connectors. Ethernet connectors. Serial interface. 2062971-001 CARESCAPE Modular Monitors...
  • Page 84 Degree of protection against harmful ingress of water: Components not marked with and IPX n code are rated as Ordinary (no protection against fluid ingress). All other IPXn rated components have the degree of protection per the ‘n’ rating. Latex-free. CARESCAPE Modular Monitors 2062971-001...
  • Page 85 (WLAN) Class 2 Identifier. Stacking limit by number. Date of manufacture. This symbol indicates the date of manufacture of this device. The first four digits identify the year and the last two digits identify the month. 2062971-001 CARESCAPE Modular Monitors...
  • Page 86 This symbol indicates that the waste of electrical and electronic equipment must not be disposed as unsorted municipal waste and must be collected separately. Please contact an authorized representative of the manufacturer for information concerning the decommissioning of your equipment. CARESCAPE Modular Monitors 2062971-001...
  • Page 87 Russia only. GOST-R mark. Brazil only. INMETRO certificate. The following symbols (required by China law only) are representative of what you may see on your equipment. The number in the symbol indicates the EFUP period in years, 2062971-001 CARESCAPE Modular Monitors...
  • Page 88 Equipment Type Approval. Australia only. The product complies with the applicable Australian standard and establishes a traceable link between the equipment and the manufacturer, importer or their agent responsible for compliance. Japan only. Approved under Japan TELEC requirements. CARESCAPE Modular Monitors 2062971-001...
  • Page 89 Audio alarms paused indicator with countdown timer - Indicates all audio alarms are paused and the amount of time remaining for the alarm pause period displays as a countdown timer. Displays in the upper left corner of the screen. 2062971-001 CARESCAPE Modular Monitors...
  • Page 90 Network connection indicator. Indicates the monitor is connected to the Wireless Local Area Network (WLAN). Network (WLAN) signal strength. The number of segments corresponds to the signal strength: four segments indicate strong signal, one segment weak signal. Monitor battery is full. CARESCAPE Modular Monitors 2062971-001...
  • Page 91 Beat volume icon. Adjust the volume of the QRS beep tone. Also the beat source indicator. Displays next to the selected beat source. Respiration indicator. Indicates a breath is detected by the impedance respiration algorithm. 2062971-001 CARESCAPE Modular Monitors...
  • Page 92 NMT Stimulus beep volume icon. Adjust the volume of the tone that sounds when a stimulus pulse is generated. Progress bar. Indicates the amount of time remaining until the next automatic measurement. CARESCAPE Modular Monitors 2062971-001...
  • Page 93 TRAM and Tram-Rac modules with the B850 only. CAPNOSTAT Mainstream, CapnoFlex LF and Dual CO2 modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Identical modules WARNING...
  • Page 94 1. With the module properly oriented (module release latch facing down), align the insertion guide slot in the module with the insertion guide in the frame. 2. Push the module into the frame until it clicks. CARESCAPE Modular Monitors 2062971-001...
  • Page 95 2. Press and hold the release levers found on each side of the front of the module. 3. Pull the module out about 15 cm (6 in). 4. Grasp the module firmly with both hands and remove it. Do not try to hold the module by the release levers. 2062971-001 CARESCAPE Modular Monitors...
  • Page 96 1. With the module properly oriented (module release latch facing down), align the insertion guide slot in the module with the insertion guide in the module frame. 2. Push the module into the module frame until it clicks. CARESCAPE Modular Monitors 2062971-001...
  • Page 97 2. Push the module into the docking station until it clicks and stops. NOTE The PDM module requires additional time to power up when used without the PDM battery. Do not interrupt the startup sequence by unplugging the PDM module. 2062971-001 CARESCAPE Modular Monitors...
  • Page 98 Remote control: optional for all Bx50 monitors ● M-port keypad: optional for B850 ● Trim Knob control: located on the remote control, used for selecting menus and ● menu options. The following table lists these keys and where they can be found. CARESCAPE Modular Monitors 2062971-001...
  • Page 99 Home. Close all Main menu ● menus/applications displayed USB remote control ● on the monitor. M-port keypad ● GE displays and monitor’s ● built-in display Main menu Pause audio alarm. Pause active ● audio alarms or pre-pause audio USB remote control ●...
  • Page 100 NIBP Auto Start or stop automatic USB remote control ● non-invasive blood pressure M-port keypad ● measurements at timed intervals. NIBP Start/Stop Start or stop a non-invasive blood USB remote control ● pressure measurement. M-port keypad ● CARESCAPE Modular Monitors 2062971-001...
  • Page 101 Bed name and care unit of the local monitor (if connected to the MC Network). ● Network symbol (if connected to the MC Network or S/5 Network). ● B650, B450: WLAN signal strength symbol (if connected to the wireless network). ● Telemetry transmitter used in combination monitoring ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 102 In this manual, the term select means using the mouse, Trim Knob control, or touchscreen display to select an item on the screen. NOTE With the B450 the Trim Knob is available only on the optional USB remote control. CARESCAPE Modular Monitors 2062971-001...
  • Page 103 Entering data with a keyboard 1. Select the desired data field. The selected field changes color into yellow, indicating that you can begin entering the text. 2. Type the desired text into the selected field with the keyboard. 2062971-001 CARESCAPE Modular Monitors...
  • Page 104 The monitor is designed to comply with the requirements of IEC 60601-1. ● Using the power cord supplied with the monitor, connect it to the power line. Use ● only the original cord. CARESCAPE Modular Monitors 2062971-001...
  • Page 105 Accessories are intact and properly connected. ● Monitor is displaying the monitoring screen. ● No messages display indicating the monitor or acquisition module is not ● functioning. Desired parameters are selected to view on the screen. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 106 This alarm remains active for as long as there is some residual power left, or until it is silenced with the pause audio alarm key, or until the power is reconnected. CARESCAPE Modular Monitors 2062971-001...
  • Page 107 There may be pages designed, for instance, for physicians, surgeons, or nurses. For more information on page configuration, see the CARESCAPE Modular Monitors Supplemental Information Manual. In addition to the normal screen, each profile can have up to five additional pages and some of these may be preconfigured.
  • Page 108 With the manual adjustment, you can set the display brightness level according to your needs. 1. Select Monitor Setup > Brightness. 2. Select the radio button for Manual adjustment. 3. Select Display % and adjust the display brightness in the range of 30% to 100%. CARESCAPE Modular Monitors 2062971-001...
  • Page 109 Each window can contain one or several parameters according to what you have chosen. The parameter windows can be of four different sizes according to the number of selected and active parameters on screen. The sizes can be described as big (full 2062971-001 CARESCAPE Modular Monitors...
  • Page 110 Selecting Double Height allows eight different parameter combinations in the selection lists in addition to the individual parameters, and selecting Single Height allows four combinations. Waveform field safety precautions WARNING Always make sure that the waveform size is sufficient for the care environment. CARESCAPE Modular Monitors 2062971-001...
  • Page 111 These settings are indicated with a lock symbol: The alarm and parameter settings that can be locked vary by acquisition module. They are set in the Care Unit Settings and they are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. 2062971-001...
  • Page 112 You can select display colors for the timer and all parameters according to your needs. However, note that these settings are not adjustable if the selection has been locked. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual.
  • Page 113 You can define the screen settings for several screens with the B850. For instance, you can select which applications they show, do they show menus and/or alarms etc. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Other setup changes All other setup changes, like care unit settings and profile settings, require a password.
  • Page 114 Setting up the monitor before use CARESCAPE Modular Monitors 2062971-001...
  • Page 115 Note that the currently stored labels may differ from defaults. The IP labels saved to PDM or TRAM are mapped according to this table: to PDM or TRAM From the monitor 2062971-001 CARESCAPE Modular Monitors...
  • Page 116 ECG, impedance respiration, Art, ABP, Fem, UAC, NIBP, SpO , EEG, BIS, or Entropy. Each vital sign has activation criteria that must be met before the vital sign is considered active. When a case is started/a patient is admitted CARESCAPE Modular Monitors 2062971-001...
  • Page 117 The combination monitoring mode can be enabled through Monitor Setup > Default Setup > Care Unit Settings > Telemetry > Monitor or Telemetry, and the setting is password protected. The monitor needs to be configured to the CARESCAPE Network. This option cannot be used in the NICU software package.
  • Page 118 Entering patient data Entering patient data with the monitor 1. Select the patient information area on the screen, or select Data & Pages > Admit/Discharge or Start / Reset Case. 2. Select the Patient tab. CARESCAPE Modular Monitors 2062971-001...
  • Page 119 When you move the monitor to a new location in the CARESCAPE Network, you can update the unit and/or bed names from drop-down lists, or add new names manually. Available selections depend on what has been allowed in configuration.
  • Page 120 4. Select the Care Unit Name or the Bed Name field and type the new name with the on-screen keyboard. The maximum number of characters for the Care Unit Name is seven, and for the Bed Name it is five. CARESCAPE Modular Monitors 2062971-001...
  • Page 121 Loading patient information from the CARESCAPE Network (ADT server) In the CARESCAPE Network, patient information can be loaded from the ADT server. You cannot merge data between the monitor and the ADT server. 1. Select the patient information area on the screen.
  • Page 122 6. Check that the NIBP Auto is turned off. The screen goes blank and the GE logo with a text like Patient temporarily in MRI (location according to your selection) appears. CARESCAPE Modular Monitors...
  • Page 123 No patient identification data available if there is no active case/admitted patient. Select one of the following to continue monitoring: Load PDM Data / Load Tram Data: This selection loads patient information and ● data from the module. 2062971-001 CARESCAPE Modular Monitors...
  • Page 124 If the Continue menu is open when a request for time adjustment is received, the adjustment will be delayed until the menu is closed and data has been loaded. CARESCAPE Modular Monitors 2062971-001...
  • Page 125 4. Select the Patient tab. 5. Select Reset Case or Discharge Patient. Monitor settings, including alarm limits, return to their default settings. All patient data and trend data is removed from both the monitor and a connected PDM or TRAM. 2062971-001 CARESCAPE Modular Monitors...
  • Page 126 Telemetry: The patient is discharged from the telemetry transmitter but not ● from the monitor. Monitor: The patient is discharged from the monitor but not from the telemetry ● transmitter. Both: The patient is discharged from the monitor and the telemetry transmitter. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 127 WARNING To avoid missed detection of critical alarms, always inform personnel dependent on the CARESCAPE monitor alarms of remote alarm silencing or pausing interactions. WARNING The peripheral device’s alarms must not be turned off or the...
  • Page 128 WARNING Only the most recent, highest priority alarm is sent to remote devices on the CARESCAPE Network. Therefore, less recent alarms of equal or lower priority may not be displayed or may not be indicated with their associated priority remotely.
  • Page 129 Examples of bedside alarm settings are: Parameter alarm limits ● Arrhythmia alarm priority settings ● Alarm conditions Physiological alarm conditions are triggered by a patient measurement being ● outside the parameter limits, by apnea, or by an arrhythmia condition. 2062971-001 CARESCAPE Modular Monitors...
  • Page 130 Certain technical alarms can be deactivated with the pause audio key. The ￭ Alarm Deactivation setting is configured in the Care Unit Settings and it is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Alarm priority levels Physiological and technical alarms are categorized by priority level: High priority alarms require an immediate response.
  • Page 131 See the central station user’s manual for details. Broadcast only alarms Alarms are sent to the CARESCAPE Network and displayed on the central station or remote monitor according to the following mapping. Feature...
  • Page 132 Alarms Feature Message on the bedside monitor Message sent to the CARESCAPE Network and displayed on the central station/remote monitor Patient Spirometry PEEPTOT HIGH PEEPtot high PEEPTOT LOW Patient Spirometry PEEPtot low PEEPE HIGH Patient Spirometry PEEPe high PEEPE LOW...
  • Page 133 Alarms Feature Message on the bedside monitor Message sent to the CARESCAPE Network and displayed on the central station/remote monitor Service MODULE V LOW Module voltage low SERVICE SGAS Service Service gas module - and specific error code Checking alarm function 1.
  • Page 134 The alarm and information messages stored in the clinical logs include: Time of occurrence ● Alarm or information message text ● Current value and the associated alarm limit if a limit alarm (local only) ● CARESCAPE Modular Monitors 2062971-001...
  • Page 135 Legacy or IEC. IEC tones are 60601-1-8 compliant. Legacy alarm tones match the tones used on some previous GE monitoring devices. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. AVOA alarm tones may differ from the local monitor alarm tones. Both the highest priority local alarm tone and the highest AVOA alarm tone will sound, but in a sequence containing one local alarm tone pattern and one AVOA alarm tone pattern.
  • Page 136 The AVOA audible alarm tone pattern may be configured to match the local monitor’s audible tone pattern, repeat a pattern of two beep tones, beep twice upon activation by an alarm condition, or be turned off. For configuring the AVOA audible alarm tone pattern, see the CARESCAPE Modular Monitors Supplemental Information Manual. Auditory information signals The monitor performs a self-diagnostic procedure at start-up and generates an auditory test signal.
  • Page 137 Alarms For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. When audible alarms are turned off: All audible alarms are turned off except for any high priority alarms configured ● to break through the audio off setting. The audio off bell icon displays in the upper left corner of the display screen.
  • Page 138 If necessary, you can activate all paused audible alarms before the 2 or 5 minute pause expires. 1. Select Alarm Setup from the monitor’s main menu. 2. Select the Audible & Visual tab. 3. Select Activate All Audible Alarms. CARESCAPE Modular Monitors 2062971-001...
  • Page 139 Certain technical alarms can be deactivated with the pause audio key. The Alarm Deactivation setting is configured in the Care Unit Settings and it is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Technical alarms for which the deactivation with the pause audio key can be allowed...
  • Page 140 The Latching Alarms setting is configured in the Care Unit Settings and it is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Setting parameter alarm limits Parameter alarm limits may be set in the Alarms Setup menu, or in the parameter menus’...
  • Page 141 Alarms indicator in the alarm adjustment dialog. Alarm guard limits are set in the Care Unit Settings and they are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Setting arrhythmia alarms You can set the arrhythmia alarms in the Alarms Setup menu, or in the ECG menu.
  • Page 142 When selected, the Auto Limits feature automatically sets new high limit and low limit values, based upon the current physiological value. The Auto Limits should only be used for patients whose currently measured values are considered safe. 1. Select Alarm Setup from the monitor’s main menu. CARESCAPE Modular Monitors 2062971-001...
  • Page 143 Tx-Ty-1.8°F Ppeak Ppeak+10 cmH Ppeak-10cmH PEEPtot PEEPtot+5cmH PEEPtot-5cmH PEEPe PEEPe+5cmH PEEPe-5cmH MVexp MVexp+2 MVexp-2 RR*1.25+2 RR*0.75-2 Returning the default alarm limits 1. Select Alarm Setup from the monitor’s main menu. 2. Select the Alarm Limits tab. 2062971-001 CARESCAPE Modular Monitors...
  • Page 144 Turning the remote monitor’s alarm light on or off. ● Selecting the remote alarm notification tone. ● For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Alarm settings after a power loss If the monitor loses power, the amount of time without power affects whether or not you need to reset the alarm settings.
  • Page 145 If the monitor goes through a power cycle or a loss of power, the stored alarm data is not affected. The alarm data remains stored in the Clinical log until the monitor automatically clears the oldest stored data to allow new data to be stored. 2062971-001 CARESCAPE Modular Monitors...
  • Page 146 Alarms CARESCAPE Modular Monitors 2062971-001...
  • Page 147 ECG compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. ECG safety precautions ECG warnings WARNING Make sure that the leadwire set clips or snaps do not touch any electrically conductive material including earth.
  • Page 148 The user may elect to turn the IntelliRate feature off for patients at risk of these events, otherwise patient treatment may be delayed. Such patients should always be kept under close observation. CARESCAPE Modular Monitors 2062971-001...
  • Page 149 Depending on the ECG module used, not all ECG measurements and settings are ● available to view or change. Select the Deactivate ECG Leads Off option to remove a Leads off message from ● the display when a cable is off. 2062971-001 CARESCAPE Modular Monitors...
  • Page 150 4. Dry the skin completely before applying the electrodes. Applying the electrodes to the patient 1. Place the electrodes on the prepared sites. 2. Stabilize the electrode and leadwire with a leadwire stress loop near the electrode. CARESCAPE Modular Monitors 2062971-001...
  • Page 151 Lower right edge of the rib cage. F (green) LL (red) Lower left edge of the rib cage. 6–lead ECG electrode placement NOTE PDM and PSM only. NOTE For 12RL monitoring, a 12RL 12 lead ECG license is required. 2062971-001 CARESCAPE Modular Monitors...
  • Page 152 Left anterior axillary line at C4/V4 level. N (black) RL (green) Lower right edge of the rib cage. F (green) LL (red) Lower left edge of the rib cage. 10–lead ECG electrode placement for cardiac monitoring CARESCAPE Modular Monitors 2062971-001...
  • Page 153 C4 (white/brown) V4 (brown/blue) intercostal space, mid-clavicular line. C5 (white/black) V5 (brown/orange) Left anterior axillary line at C4/V4 level. C6 (white/purple) V6 (brown/purple) Mid-axillary line at C4/V4 and C5/V5 levels. Standard resting 10–lead ECG electrode placement 2062971-001 CARESCAPE Modular Monitors...
  • Page 154 ECG synchronization pulse delay from the R-wave peak is <35 ms for the PDM and E-modules, with the exception of wide QRS (120 ms/0.5 mV). For more information and detailed specifications, refer to the supplemental information manual. CARESCAPE Modular Monitors 2062971-001...
  • Page 155 The combination monitoring mode can be enabled through Monitor Setup > Default Setup > Care Unit Settings > Telemetry > Monitor or Telemetry, and the setting is password protected. The monitor needs to be configured to the CARESCAPE Network. This option cannot be used in the NICU software package.
  • Page 156 This setting is available if the telemetry license is enabled and the combination monitoring mode Monitor or Telemetry has been enabled during configuration. The monitor needs to be in the CARESCAPE Network. 1. Select the HR parameter window. 2. Select a source from the ECG Source list.
  • Page 157 PDM and E-modules only. NOTE 12RL monitoring - The Vb lead is the second V-lead label used with a 6-leadwire ECG cable for 12RL monitoring and must be set to V5. This selection is not available with combination monitoring. 2062971-001 CARESCAPE Modular Monitors...
  • Page 158 Setting the beat volume 1. Select the HR parameter window. 2. Set the beat tone volume with the Beat Volume arrows. The range is 0 (volume off) to 10. The louder the volume, the more bars in the indicator. CARESCAPE Modular Monitors 2062971-001...
  • Page 159 If the setting is set to Only SpO2, other beep sounds are not affected by the changing SpO values. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Aspect ratio and different display sizes ECG aspect ratio is the ratio of the vertical sensitivity (ECG size) to the horizontal sensitivity (sweep speed).
  • Page 160 Telemetry transmitters: 0.05 Hz to 40 Hz. The waveform filter is ￭ automatically set to Monitoring and cannot be changed. Moderate: ● PDM, E-modules, TRAM: 0.05 Hz to 25 Hz. ￭ Maximum: ● PDM, E-modules, TRAM: 5 Hz to 25 Hz. ￭ CARESCAPE Modular Monitors 2062971-001...
  • Page 161 ECG pattern corrects false arrhythmia alarms and heart rate values, and restores the ST measurements. Relearning takes typically 30 seconds or less. The message Relearning... displays while the monitor relearns the QRS pattern. During this 2062971-001 CARESCAPE Modular Monitors...
  • Page 162 TRAM, the secondary HR source displayed in this order: UAC, Art, ABP, Fem, SpO2. UAC is available in the NICU software package only. If the primary HR source is anything else than mentioned above, the secondary HR ● source is always ECG. CARESCAPE Modular Monitors 2062971-001...
  • Page 163 It also allows you to set PVC and SVC alarm limits for ECG from the PVC/SVC Alarms tab. (The tab is called PVC Alarms with TRAM or telemetry transmitters). With the Multiple heart rate setting activated, turning off the SpO HR alarm limits does not turn off the primary HR alarm. 2062971-001 CARESCAPE Modular Monitors...
  • Page 164 If a feature is not active, the alarm limits are greyed out. 4. Select Alarm On to set the alarms. 5. Adjust the alarm limits with the arrows. Selecting the HR alarm range With the Single heart rate setting only. CARESCAPE Modular Monitors 2062971-001...
  • Page 165 TRAM, E-modules, and telemetry transmitters use the AUTO algorithm. AUTO selects the first available heart rate source based on a pre-defined parameter priority: 1. ECG 2. UAC (TRAM and NICU software package only) 3. Art 4. ABP 5. Fem 6. SpO 2062971-001 CARESCAPE Modular Monitors...
  • Page 166 Intended use of 12RL Interpolated 12 lead ECG analysis The GE 12RL program generates a 12 lead ECG report from a subset of the electrodes used to acquire a standard 12 lead ECG. Four of the precordial channels of the 12 lead ECG (V2, V3, V4, V6) are not acquired from the patient;...
  • Page 167 Like any computer-assisted ECG interpretation program, the GE Marquette ACI-TIPI evaluation and probability score is intended to supplement, not substitute for the physician’s decision process. It should be used in conjunction with knowledge of the patient’s history, the results of a physical examination, the...
  • Page 168 If roving between units is allowed and the 12SL ECG with ACI TIPI is enabled, you can enter the Location ID that will be used in the 12SL reports. 1. Select the patient information area on screen. 2. Select the Care Unit & Bed tab. CARESCAPE Modular Monitors 2062971-001...
  • Page 169 3. Select 12 Lead Now. All the waveforms in the 12 Lead Analysis view freeze during the analysis except for the ECG I waveform. Analysis takes less than one second to complete. At that time, the 2062971-001 CARESCAPE Modular Monitors...
  • Page 170 You can view and print 12 lead reports that are stored at the monitor (local), or if available, stored at a MUSE database. The newest reports are displayed first. To open a report that is stored at the MUSE database, a connection to the CARESCAPE Network is required.
  • Page 171 ECG data. This program generates a diagnostic textual report on patient’s cardiovascular condition. This report can be routed to the MUSE Cardiology Information System via the CARESCAPE Network. The following figure shows a typical 12 lead ECG report.
  • Page 172 Rate meters may continue to count the pacemaker rate during cardiac arrest and some arrhythmias. Therefore, do not rely entirely on rate meter alarms. See the CARESCAPE Modular Monitors Supplemental Information Manual for disclosure of the pacemaker pulse rejection capability of this device.
  • Page 173 However, this mode is also more sensitive to false pacemaker detections. PDM: ● On: Turns on pacemaker detection. ￭ Off: Turns off pacemaker detection. ￭ TRAM, combination monitoring: ● Off: Turns off pacemaker detection. ￭ 2062971-001 CARESCAPE Modular Monitors...
  • Page 174 PDM, TRAM, combination monitoring: The ● pacemaker detection program is turned off. Turn it on, reprep the skin and reposition the electrodes if necessary. Relearn ECG. The pacemaker signal is too weak for the monitor ● to detect. CARESCAPE Modular Monitors 2062971-001...
  • Page 175 QRS morphology. If an arrhythmia event is present and does not exhibit a significant change from the patient’s predominant morphology, it is possible for those events to remain undetected by the system. 2062971-001 CARESCAPE Modular Monitors...
  • Page 176 Monitoring devices rename the following arrhythmias when sending them to the network: Shown on the monitor Shown at remote devices like central stations SV Tachy Tachy Frequent SVCs Irregular CARESCAPE Modular Monitors 2062971-001...
  • Page 177 With TRAM or combination monitoring this setting is always 3 seconds and cannot be edited. You can set the time interval between the two adjacent beats before the pause alarm condition is annunciated. 1. Select the HR parameter window. 2. Select the Arrhythmia tab. 3. Select Atrial Alarms. 2062971-001 CARESCAPE Modular Monitors...
  • Page 178 According to priority Displayed 4/8-beat software package setting average ECG heart rate falls below the Full with all other user-selected common software packages HR low limit or ECG HR TRAM and combination low limit. monitoring only CARESCAPE Modular Monitors 2062971-001...
  • Page 179 According to priority A run of SVCs is detected setting with a run length of at E-modules and PDM only least the set SVT Length and the heart rate is at least the set HR for SVT /min. 2062971-001 CARESCAPE Modular Monitors...
  • Page 180 This phase is known as learning. Once learning is complete, the dominant QRS complex is stored as a reference template. Reference template is used as a normal morphology of that patient and it is compared with incoming beats to identify possible arrhythmias. CARESCAPE Modular Monitors 2062971-001...
  • Page 181 The invasive pressure pulse rate has been valid for ● the previous 60 seconds, and it has been 0/min during the previous 30 seconds. The mean arterial blood pressure of the invasive ● pressure pulse rate source is below the user- selected limit. 2062971-001 CARESCAPE Modular Monitors...
  • Page 182 J+ reference points to calculate the ST values. Once the learning is complete, the dominant QRS complex becomes the template for ST segment analysis. The algorithm uses continuous correlation and incremental template updating. Continuous correlation attempts to find the best match between each incoming complex and the CARESCAPE Modular Monitors 2062971-001...
  • Page 183 You can select the display order of the first, second, and third displayed ST lead. 1. Select the ST parameter window. 2. Select Setup. 3. Select a lead from the ST Leads list. Adjusting the ST point manually This selection is not available with combination monitoring. 2062971-001 CARESCAPE Modular Monitors...
  • Page 184 QRS complex. QRS complexes are updated every 40 seconds with PDM and every 10 seconds with E-modules. Current ST values in millimeters shall be displayed in each QRS window. Numeric values are updated every 10 seconds. CARESCAPE Modular Monitors 2062971-001...
  • Page 185 3. Select a saved reference from the Reference QRS list. Erasing a reference QRS This selection is not available with combination monitoring or TRAM. You cannot erase the initial reference QRS. 1. Select the ST parameter window. 2. Select Realtime View. 2062971-001 CARESCAPE Modular Monitors...
  • Page 186 ST trend window. The ST trends for the available leads are updated every 10 seconds. Displaying QRS complexes and ST trends for other leads This selection is not available with combination monitoring. 1. Select the ST parameter window. 2. Select Trend View. CARESCAPE Modular Monitors 2062971-001...
  • Page 187 The ST measurements are displayed as a numeric value: a negative (-) number indicates ST depression; a positive number indicates ST elevation. 2062971-001 CARESCAPE Modular Monitors...
  • Page 188 3. Select Alarm On for an ECG lead group: Anterior, Inferior, or Lateral. If the alarm is locked, there is a lock symbol beside the selection and the selection is not available. 4. Set upper and lower alarm limits with the arrows. CARESCAPE Modular Monitors 2062971-001...
  • Page 189 This selection is not available with combination monitoring or TRAM. 1. Select the HR parameter window. 2. Select the QT tab. 3. Select On from the QT Analysis list. Setting QT/QTc alarms This selection is not available with combination monitoring or TRAM. 2062971-001 CARESCAPE Modular Monitors...
  • Page 190 Selecting QT or QTc for analysis This selection is not available with combination monitoring or TRAM. 1. Select the HR parameter window. 2. Select the QT tab. 3. Select QT or QTc from the Show list. CARESCAPE Modular Monitors 2062971-001...
  • Page 191 Impedance respiration Impedance respiration compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Respiration safety precautions Respiration warnings WARNING Make sure that the leadwire set clips or snaps do not touch any electrically conductive material including earth.
  • Page 192 If these ventilator inspirations are substantially larger than the spontaneous breaths, the respiration calculation may mistakenly count only the inspirations and expirations produced by the ventilator. CARESCAPE Modular Monitors 2062971-001...
  • Page 193 4. Dry the skin completely before applying the electrodes. Respiration lead and breath detection Respiration leads identify the ECG leads used for respiration measurement. Each respiration lead is suited for specific breath detection conditions: 2062971-001 CARESCAPE Modular Monitors...
  • Page 194 ECG. Respiration lead I electrode placement ECG lead I for upper chest breather AAMI/AHA Electrode placement R (red) RA (white) Just below the right clavicle. L (yellow) LA (black) Just below the left clavicle. CARESCAPE Modular Monitors 2062971-001...
  • Page 195 RL-LL vector for abdominal breather AAMI/AHA Electrode placement N (black) RL (green) Fifth intercostal space on the right. F (green) LL (red) Lower left edge of the rib cage. 2062971-001 CARESCAPE Modular Monitors...
  • Page 196 The greater the value, the larger the waveform size. Selecting the respiration waveform size automatically NOTE PDM and TRAM only. You can automatically size the waveform to fit the available space. 1. Select the impedance respiration parameter window. CARESCAPE Modular Monitors 2062971-001...
  • Page 197 If you select Alarm Off, you cannot adjust the alarm limits. Setting the respiration alarm limits 1. Select the impedance respiration parameter window. 2. Select the Alarms tab. 3. Set the Respiration Rate limits with the arrow selectors. 2062971-001 CARESCAPE Modular Monitors...
  • Page 198 Apnea alarms can be deactivated with the pause audio key if the Allow alarm deactivation with the Audio Pause key for: setting Apnea (CO2/Imped) is enabled in the Care Unit Settings. This setting is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Setting the apnea alarm delay NOTE PDM and TRAM only.
  • Page 199 Problem Solution What can I do if the respiration measurement fails? Check electrode quality and positioning. ● Adjust the breath detection sensitivity. During ● ventilator-supported breathing, the respiration calculation may count only ventilator-produced inspirations and expirations. 2062971-001 CARESCAPE Modular Monitors...
  • Page 200 The breath detection threshold is too low (1 = breath, breaths? 2 = artifact). The following is an example of incorrect detection. Increase the detection sensitivity percentage until ● the markers correctly identify each inspiration and expiration. The following is an example of correct detection. CARESCAPE Modular Monitors 2062971-001...
  • Page 201 Pulse oximetry compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. SpO₂ safety precautions warnings WARNING The operator is responsible for checking the compatibility of the pulse oximetry monitor, sensor, and patient cable prior to use.
  • Page 202 Low signal quality message. Procedures or devices previously applied in your facility for monitoring should be used in the event the SpO value from the monitor cannot be validated by the above criteria. CARESCAPE Modular Monitors 2062971-001...
  • Page 203 Sensor placement on the same extremity as a blood ￭ pressure cuff, arterial catheter or intravascular line; or arterial occlusion proximal to the sensor. Poor sensor fit. ￭ Do not allow tape to block the sensor light emitter and ￭ detector. 2062971-001 CARESCAPE Modular Monitors...
  • Page 204 To avoid erroneous measurements, do not use a blood pressure cuff on the same ● limb as the SpO sensor. points to note GE sensors are not made with natural rubber latex. ● Use dry and clean sensors only. ● Do not use damaged sensors.
  • Page 205 ￭ SpO₂ measurement guidelines GE Ohmeda technology and sensor measurement guidelines The following measurement guidelines apply to GE Ohmeda technology: The time period for acquiring a measurement average is adjustable. ● The SpO waveform corresponds to (but is not proportional to) the arterial pressure ●...
  • Page 206 Sensor that is not manufactured or licensed by Covidien. For patients with SpO levels in the 60% to 80% range, the LoSat accuracy feature is available. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. CARESCAPE Modular Monitors 2062971-001...
  • Page 207 Some models of commercially available bench-top functional testers and patient simulators can be used to verify proper functionality of pulse oximeter sensors, cables and monitors. While such devices may be useful for verifying that the pulse oximetry 2062971-001 CARESCAPE Modular Monitors...
  • Page 208 Changing the SpO waveform size NOTE All other modules except PSM. 1. Select the SpO parameter window. 2. Select the SpO2 or SpO2(2) tab. 3. Choose the size from the Size list: 1x, 2x, 4x, or 8x. CARESCAPE Modular Monitors 2062971-001...
  • Page 209 2. Select the SpO2 or SpO2(2) tab. 3. Select Show Pulse Rate. Adjusting the SpO pulse beep tone volume A variable pitch beep tone rises in pitch with increasing oxygen saturation or falls in pitch with decreasing oxygen saturation. 2062971-001 CARESCAPE Modular Monitors...
  • Page 210 If the setting is set to Only SpO2, other beep sounds are not affected by the changing SpO values. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Masimo SET data averaging and updating For Masimo SET technology, when using the default averaging time of 8 seconds, there is a maximum data-averaging signal processing time of 10 seconds from real time plus an additional delay of 2 seconds to update the displayed waveform.
  • Page 211 The number of percentage points that the SpO saturation falls outside the alarm limit is multiplied by the number of seconds that it remains outside the limit. This can be stated as the equation “points x seconds = 2062971-001 CARESCAPE Modular Monitors...
  • Page 212 Saturation Seconds pie chart empties in a counterclockwise direction. Showing the Saturation Seconds in the SpO parameter window NOTE PDM and TRAM with primary SpO measurement and the Nellcor option only. CARESCAPE Modular Monitors 2062971-001...
  • Page 213 You can select priorities for the SpO2 high, SpO2 low, and SpO2 probe off alarms through Alarm Setup > Alarm Priorities > Other Parameters. The choices are Low, Medium, High, and Escalating. Stopping the SpO measurement 1. Remove the SpO sensor from the patient. 2062971-001 CARESCAPE Modular Monitors...
  • Page 214 Signal strength is indicated with asterisks in the parameter window. For PSM with GE Ohmeda technology, the signal strength indicator is also displayed as the infrared modulation percentage in the waveform. Unity Network Interface Device (ID) does not display signal strength indicators. Signal strength may be determined by the amplitude of the SpO waveform.
  • Page 215 Pulse oximetry wavelengths and optical output power GE Ohmeda, Masimo SET and Nellcor OxiMax pulse oximetry are calibrated to display functional saturation. This information may be useful to clinicians such as those performing photodynamic therapy: Nellcor OxiMax pulse oximetry sensors contain LEDs that emit red light at a ●...
  • Page 216 Plugging the electrosurgery unit into a separate set of outlets from the monitor. ● For modules using Nellcor OxiMax and GE Marquette technologies, the main problem motion artifact can cause is erroneous SpO readings. Motion artifact occurs with excessive motion of the sensor, the cable leading to the sensor, or the cable/sensor junction.
  • Page 217 SpO Make sure there is only one secondary SpO module connected to the monitor. ● interface cable and sensor? Change the sensor. ● Change the cable. ● If the problem persists, contact authorized service personnel. 2062971-001 CARESCAPE Modular Monitors...
  • Page 218 Pulse oximetry CARESCAPE Modular Monitors 2062971-001...
  • Page 219 Non-invasive blood pressure NIBP compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. NIBP safety precautions NIBP warnings WARNING — PSM — Non-invasive blood pressure measurement is intended for patients weighing over 5 kg.
  • Page 220 NIBP Auto can be reset after connecting the Patient Data Module to the monitor. WARNING GE monitors are designed for use with dual-hose cuffs and tubing. The use of single-hose cuffs with dual hose tubing can result in unreliable and inaccurate NIBP data.
  • Page 221 ￭ The middle of the cuff is at the level of the right atrium of the patient’s heart. ￭ Also consider the following recommendations: ● Allow 5 minutes to pass before taking the first measurement. ￭ 2062971-001 CARESCAPE Modular Monitors...
  • Page 222 4. Make sure that the NIBP cuff tubes are not kinked, compressed, or stretched. 5. Verify or select the correct Init. Pressure or Cuff Size from the NIBP Setup menu. Checking the NIBP measurement 1. Check that the pressure values are displayed. CARESCAPE Modular Monitors 2062971-001...
  • Page 223 2. Start the measurement by selecting Start Manual NIBP. 3. Stop the measurement by selecting Cancel NIBP. Starting or stopping a single NIBP measurement with the PSM module key 1. Start the measurement by pressing the Start Cancel key. 2062971-001 CARESCAPE Modular Monitors...
  • Page 224 There will be at least a 30 second delay between two consecutive NIBP measurements during auto cycling. Starting or stopping the NIBP Auto from the NIBP Setup menu 1. Select the NIBP parameter window. 2. Select Start Cycling for NIBP Auto. CARESCAPE Modular Monitors 2062971-001...
  • Page 225 Pressure Duration Cuff Adult 80 ± 5 mmHg (10.7 ± 0.7 kPa) 2 minutes Child 60 ± 5 mmHg (8.0 ± 0.7 kPa) 2 minutes 1 minute Infant 40 ± 5 mmHg (5.3 ± 0.7 kPa) 2062971-001 CARESCAPE Modular Monitors...
  • Page 226 Selecting NIBP cuff size NOTE PDM and TRAM only. You must first select the NIBP cuff size before starting a NIBP measurement. 1. Select the NIBP parameter window. 2. Select Adult, Child, or Infant from the Cuff Size list. CARESCAPE Modular Monitors 2062971-001...
  • Page 227 1. Select the NIBP parameter window. 2. Select the Setup tab. 3. Select Infant, Child, or Adult from the Inflation Limits list. NIBP volume and display settings Adjusting the NIBP measurement completion tone volume 1. Select the NIBP parameter window. 2062971-001 CARESCAPE Modular Monitors...
  • Page 228 It is based on the principle that pulsatile blood flow through an artery creates oscillations of the arterial wall. Oscillometric devices use a blood pressure cuff to sense these oscillations that appear as tiny pulsations in cuff pressure. By measuring and analyzing at various cuff CARESCAPE Modular Monitors 2062971-001...
  • Page 229 Eventually, if the cuff is maintained at one pressure step for longer than one minute or the determination time exceeds two minutes, the monitor will time out and display an error. 2062971-001 CARESCAPE Modular Monitors...
  • Page 230 The algorithm examines pulses from the cuff and waits for two sequential pulses equal in both frequency and amplitude. It will not deflate the cuff until it has good data. Artifact and false pulses are rejected. CARESCAPE Modular Monitors 2062971-001...
  • Page 231 ECG. PSM modules’ NIBP technology PSM use a technology similar to DINAMAP Classic, with the exception of cuff deflation. In this algorithm the cuff pressure is deflated continuously (linear bleed), as opposed to step deflation. 2062971-001 CARESCAPE Modular Monitors...
  • Page 232 120 mmHg for infant. After the first measurement, the inflation pressure is adjusted according to measured systolic pressure. NIBP calibration NIBP calibration procedure is explained in the Module Frames and Modules Technical Manual. The calibration procedure is password protected. CARESCAPE Modular Monitors 2062971-001...
  • Page 233 For PSM, if cuff occlusion is detected during inflation the module might repeat the measurement. Perform a visual inspection of the equipment to ensure system integrity. 2062971-001 CARESCAPE Modular Monitors...
  • Page 234 Non-invasive blood pressure CARESCAPE Modular Monitors 2062971-001...
  • Page 235 Invasive pressures Invasive pressures compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Invasive pressure safety precautions Invasive pressure warnings WARNING All invasive procedures involve risks to the patient. Use aseptic technique.
  • Page 236 1. Module with invasive pressure measurement capability 2. Fluid bag with pressure infusor 3. Transducer setup 4. Invasive blood pressure adapter cable; single or dual cable (optional) Invasive pressure module keys There are invasive pressure keys on the following modules: CARESCAPE Modular Monitors 2062971-001...
  • Page 237 Right atrial pressure Intracranial pressure Right ventricular pressure Umibilical arterial pressure Umbilical venous pressure P1 to P8 Non-specific pressure channel labels NOTE UAC and UVC invasive pressure channels are only available in the NICU software package. 2062971-001 CARESCAPE Modular Monitors...
  • Page 238 Dual BP or BP Tram-Rac module in Tram-Rac slot 3, E-PP. Dual BP, BP/CO, or BP/Dual Temp Tram-Rac module in Tram-Rac slot 4, E-P, or E-PT. Dual BP or BP Tram-Rac module in Tram-Rac slot 4, E-COP, or E-COPSv. CARESCAPE Modular Monitors 2062971-001...
  • Page 239 P8 keys. You can zero all active transducers on the PDM module by pressing the zero all ● key. NOTE E-modules record a time stamp of the last successful zeroing for each invasive blood pressure channel. 2062971-001 CARESCAPE Modular Monitors...
  • Page 240 The algorithm uses the last four seconds of the waveform data to calculate the scale. If you notice a considerable change in the waveform during that time, wait for the waveform to stabilize and perform the operation again. CARESCAPE Modular Monitors 2062971-001...
  • Page 241 Sys/Dia /Mean: All values are shown in an equally big font. ● Selecting invasive pressure as the primary heart rate source The primary heart rate can be calculated from the ECG leads, SpO measurement, or invasive pressure waveform. 2062971-001 CARESCAPE Modular Monitors...
  • Page 242 SpO values. If the setting is set to Only SpO2, other beep sounds are not affected by the changing SpO values. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting the ventilation mode NOTE E-modules only.
  • Page 243 Some trigger modes on certain balloon pump devices may not be compatible with the GE analog output signal, and use may contribute to patient injury or sub-optimal pumping results.
  • Page 244 PR(x) Alarms (e.g., PR(Art) Alarms): Settings when the heart rate alarms are ● calculated from multiple sources. NOTE If a feature is not active, the alarm limits are greyed out. You can set them on by selecting Alarm On. CARESCAPE Modular Monitors 2062971-001...
  • Page 245 3. Adjust the cursors with the arrow selectors. NOTE You must always adjust the cursors in the NICU software package. The monitor does not suggest any cursor positions as there is no automatic SPV measurement in this software package. 2062971-001 CARESCAPE Modular Monitors...
  • Page 246 In either mode, the wedge algorithm then determines the PCWP value. You can confirm this value or adjust the measurement with the provided cursor. NOTE E-modules always use the automated wedge program to determine the PCWP value. CARESCAPE Modular Monitors 2062971-001...
  • Page 247 The PA wedge report contains 20 seconds of waveform data displayed at a waveform speed of 12.5 mm/s. Taking an automated PA wedge measurement 1. Select the PA invasive pressure parameter window. 2. Select the Setup tab. 3. Select Wedge. 4. Select Mode: Auto. 2062971-001 CARESCAPE Modular Monitors...
  • Page 248 3. Select the pressure site to test. 4. Increase or decrease the pressure to adjust the displayed pressure to a known calibration factor and select Confirm. 5. Repeat for each pressure site as needed. 6. Select Previous Menu > Close. CARESCAPE Modular Monitors 2062971-001...
  • Page 249 Not supported. catheter* diastolic, mean Mean Umbilical venous Not supported. catheter* * PDM and TRAM with NICU software package only. Intra-aortic balloon pump NOTE PDM, TRAM, and Tram-Rac only. Not available in the NICU software package. 2062971-001 CARESCAPE Modular Monitors...
  • Page 250 Invasive pressures GE recommends that the signal source used to trigger an IABP should be the intra-aortic balloon pump itself. This ensures that the trigger signal is compatible with all modes of the IABP. An extra set of ECG electrodes or an additional connection from the arterial line can be connected to the monitor to produce waveforms on the monitor’s display for consolidated viewing.
  • Page 251 Art 160/45 1:3 or more timing Diastolic numerics: The displayed diastole switches between the balloon end diastole and the patient end diastole. Systolic numerics: The displayed systolic numerics switch between the augmented diastole and patient systole. 2062971-001 CARESCAPE Modular Monitors...
  • Page 252 The channel standby is not selectable, or it is If the pressures remain between 10 mmHg and terminated without the user giving the activation 250 mmHg for 10 seconds or more, the selection is request. disabled or the standby is terminated. CARESCAPE Modular Monitors 2062971-001...
  • Page 253 These differences occur because direct methods measure pressure and indirect methods measure flow. In addition, differences occur because the measurement location is not the same (e.g., brachial artery for NIBP vs. radial artery for invasive arterial pressure monitoring). 2062971-001 CARESCAPE Modular Monitors...
  • Page 254 Why is there a flashing heart icon displayed next Art, ABP, Fem, or UAC has been selected as the to the PR value in the corresponding parameter Beat Source in the ECG or SpO2 menu. No action is window? required. CARESCAPE Modular Monitors 2062971-001...
  • Page 255 Temperature Temperature compatibility limitations TRAM and Tram-Rac modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Temperature safety precautions Temperature warnings WARNING When using an electrosurgery unit, note that the measurement cables do not incorporate means to protect against burns in case of a defective ESU return electrode.
  • Page 256 5. Reusable temperature probe 6. Disposable temperature probe Preparing the patient for temperature measurement 1. Follow the manufacturer's instructions for probe application and instructions. 2. Connect the single or dual temperature cable to the acquisition module connector. CARESCAPE Modular Monitors 2062971-001...
  • Page 257 No waveform is generated or displayed. NOTE A maximum of six user-defined measuring site label names can be configured. See the CARESCAPE Modular Monitors Supplemental Information Manual for details. The default temperature measuring site labels are as follows:...
  • Page 258 NOTE In addition to the default channel labels, you can configure up to six user-defined channel labels in the care unit settings. See the CARESCAPE Modular Monitors Supplemental Information Manual for details. Displaying the delta value between two temperature channels...
  • Page 259 Check that the acquisition module is properly ● connected to the monitor. Check the patient connection. ● Check that there are not two identical ● measurement modules in the system. Contact service if the problem continues. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 260 Temperature CARESCAPE Modular Monitors 2062971-001...
  • Page 261 C.O. measurement limitations E-modules used for this measurement are not suitable for use with neonatal ● patients. C.O. points to note Cardiac output measurements from the PDM and TRAM require a C.O. license. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 262 The C.O. connector cables are module-specific and can only be used with the ● appropriate C.O. module. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. The patient's height and weight values are required for determining Cardiac Index ●...
  • Page 263 There is one C.O. module key on the E-COP and E-COPSv modules: Start C.O. Starts and stops the cardiac output measurement. Preparing the C.O. measurement 1. Connect the C.O. cable to the acquisition module, thermistor, and injectate temperature port. 2062971-001 CARESCAPE Modular Monitors...
  • Page 264 Inject When Ready message. E-modules: When measuring C.O. using the automatic mode, new measurements can be taken when the Press Start C.O. Serial message displays. Holding the injectate syringe by the plunger, not the barrel, improves measurement accuracy. CARESCAPE Modular Monitors 2062971-001...
  • Page 265 With E-modules, you can also use the Start C.O. module key. 6. When the Inject now! message appears, inject the injectate solution smoothly within 4 to 5 seconds. 7. The message Measuring displays, followed by the message Please wait until the calculation is completed. 2062971-001 CARESCAPE Modular Monitors...
  • Page 266 E-modules: In addition to removing the previous measurement, you can also cancel an in-process measurement. C.O. catheter selections You can select a cardiac output catheter from a list of default catheters and preconfigured catheters, or enter a catheter for temporary use. Pre-configured CARESCAPE Modular Monitors 2062971-001...
  • Page 267 Care Unit Settings > Parameters > Catheters. These settings are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting a C.O. catheter from the list 1.
  • Page 268 When a C.O. measurement has been confirmed, you can access the calculations menu and adjust the hemodynamic, oxygenation, or ventilation calculation values as needed. 1. Select the cardiac output parameter window. 2. Select the Measurement tab. 3. Select Calculations. CARESCAPE Modular Monitors 2062971-001...
  • Page 269 Cardiac output varies with body size. To more accurately assess cardiac performance for individual patients, the cardiac index is often used. How to improve the C.O. accuracy The following influencing factors can influence the cardiac output accuracy: 2062971-001 CARESCAPE Modular Monitors...
  • Page 270 Decreasing the volume and increasing the temperature will give you a smaller differential change and should increase the chance of computing a cardiac output within the 20-second period. Decrease the volume injected. ● Increase the temperature of the injectate. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 271 It is recommended that you inject rapidly ￭ and smoothly into the proximal port of the pulmonary artery catheter, within 4 to 5 seconds. 2062971-001 CARESCAPE Modular Monitors...
  • Page 272 Maintain a constant rate, or if possible, stop the solution 30 seconds before the C.O. injection and then restart the infusion after the cardiac output is calculated. CARESCAPE Modular Monitors 2062971-001...
  • Page 273 Check for a significant amount of respiratory ● variation and for rapid IV solution infusion, either of which may influence the baseline temperature. It may be necessary to use the manual cardiac mode rather than the automatic mode. 2062971-001 CARESCAPE Modular Monitors...
  • Page 274 Cardiac output CARESCAPE Modular Monitors 2062971-001...
  • Page 275 (SvO₂) compatibility limitations All features of this measurement are available with all Bx50 monitors. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. SvO₂ safety precautions warnings WARNING All invasive procedures involve risks to the patient. Use aseptic technique.
  • Page 276 3. Calibrate in vivo and update the Hb value at least every 24 hours. measurement on screen Signal quality indicator from the catheter (only present when the SvO is measured from an external device): Indicator Explanation no asterisk No signal Poor signal Fair signal Good signal CARESCAPE Modular Monitors 2062971-001...
  • Page 277 Recalling a previous in vitro calibration After completing a successful initial calibration, you can recall the previous in vitro calibration measurement when: The optical module is connected and has not been calibrated since being ● connected. 2062971-001 CARESCAPE Modular Monitors...
  • Page 278 3. Set the alarm limits. Stopping the SvO measurement 1. Remove the catheter from the patient. 2. Disconnect the catheter from the optical module. 3. Disconnect the optical sensor from the SvO module. 4. Discard the catheter. CARESCAPE Modular Monitors 2062971-001...
  • Page 279 In vivo calibration fails Check the connections. ● Check that the optical cables have no sharp bends. ● If the in vivo calibration fails again, replace the catheter and/or the ● optical module, and repeat the procedure. 2062971-001 CARESCAPE Modular Monitors...
  • Page 280 Mixed venous oxygen saturation (SvO₂) CARESCAPE Modular Monitors 2062971-001...
  • Page 281 Airway gases Airway gases compatibility limitations Compact airway modules with the B850 and B650 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Airway gases safety precautions Airway gases warnings WARNING Always inspect the airway adapter for a tight connection and proper operation before attaching it to the patient.
  • Page 282 CARESCAPE respiratory module. WARNING When using the CARESCAPE respiratory modules with volume controlled ventilation at low tidal volumes, the specified gas withdrawal rate may significantly reduce the amount of gas delivered to the patient.
  • Page 283 E-miniC is not suitable for use with patients weighing less than 5 kg (11 lbs). ● Airway gases points to note If anesthetic agents are present, use GE Healthcare anesthesia sampling lines ● (PE/PVC). Otherwise, you can use GE Healthcare CO sampling line (PVC).
  • Page 284 Airway gases measurement setup Airway gases equipment to patient connections with CARESCAPE respiratory modules 1. CARESCAPE respiratory module 2. Gas sample, gas sampling line connector on the water trap 3. Gas sampling line 4. Gas sampling line connector on the airway adapter; place the connector upwards 5.
  • Page 285 4. Sampling line connector on the water trap 5. Sample gas outlet (gas exhaust) 6. Returning sample gas to patient circuit Airway gases equipment to patient connections with compact airway modules, critical care setup 1. Compact airway module 2. Gas sampling line 2062971-001 CARESCAPE Modular Monitors...
  • Page 286 To minimize the amount of dust drawn into the gas sampling system, always keep the water trap connected to the module. When gas measurement is not in use, you can disconnect the module from the monitor to eliminate the operating sound of the gas pump. CARESCAPE Modular Monitors 2062971-001...
  • Page 287 Airway gases CARESCAPE respiratory module connectors 1. Patient Spirometry keys 2. Water trap release/locking latch 3. Gas sample, sampling line connector on the water trap 4. Water trap container 5. Connectors for Patient Spirometry tubes 6. Gas exhaust, connector for the gas exhaust line Compact airway module connectors 1.

  • Page 288: E-Minic Indications For Use

    With E-sCAiOV, E-sCOV, E-CAiOV, E-CAiOVX, E-COV, and E-COVX modules, use ● the D-lite(+)/Pedi-lite(+) sensor and a gas sampling line with Patient Spirometry tubing. When monitoring pediatric patients, remember to select the sensor type accordingly from the monitor menu. CARESCAPE Modular Monitors 2062971-001...

  • Page 289: Checking The Airway Gases Measurement

    3. Airway adapter 4. Sample line Infant ventilation 1. Endotracheal tube 2. Pediatric airway adapter 3. Fresh gas inlet 4. Sample line Checking the airway gases measurement 1. Check that the water trap container is empty. 2062971-001 CARESCAPE Modular Monitors...

  • Page 290: Airway Gases Parameters

    2. Occlude the sampling line and check that the Sample line blocked message appears within 30 seconds and gas waveforms are showing zero at the same time. Airway gases parameters Airway gases parameters, CARESCAPE respiratory modules The CARESCAPE respiratory modules measure the following airway gas parameters: Parameter E-sCO E-sCOV...
  • Page 291 MACage Balance gas Gas exchange Patient Spirometry Respiration rate Sampling method Sidestream Mainstream automatic compensation. NOTE The measured N O value is not displayed. E-miniC requires manual selection from the monitor menu to compensate for N 2062971-001 CARESCAPE Modular Monitors...

  • Page 292: Using The E-Modules For Co₂ Measurement

    3. Select Deactivate Apnea Alarm. NOTE When the alarm is deactivated, there will be no audible or visual Apnea alarm indications. The alarm is automatically reactivated if CO vitals signs are detected and alarm condition is met again. CARESCAPE Modular Monitors 2062971-001...

  • Page 293: Apnea Alarms' Deactivation With The Pause Audio Key

    Apnea alarms can be deactivated with the pause audio key if the Allow alarm deactivation with the Audio Pause key for: setting Apnea (CO2/Imped) is enabled in the Care Unit Settings. This setting is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting what to show with EtCO...

  • Page 294: Using The Carescape Respiratory Modules And Compact Airway

    Every anesthetic agent has its own default scale that the monitor uses when detecting the agent. You can change the scale of an agent if the amount used is higher than the default scale. Default scales are given in the CARESCAPE Modular Monitors Supplemental Information Manual.

  • Page 295: Setting Agent Limit Alarms

    2. Connect the exhaust line only to an open scavenging system where gas is removed at room pressure. NOTE Do not connect the module directly to a strong vacuum scavenging system. NOTE If the E-miniC is used, do not return sample gas to the patient circuit. 2062971-001 CARESCAPE Modular Monitors...

  • Page 296: Stopping The Airway Gases Measurement

    Ensure that the calibration gas and regulator are functioning properly before calibration. Perform annual maintenance of the regulator as required. NOTE Make sure that you are using a correct GE Healthcare calibration gas, see the CARESCAPE Modular Monitors Supplemental Information Manual. Do not use any other calibration gases.

  • Page 297: Basics Of Airway Gases Measurement

    Airway gases measurement description, CARESCAPE respiratory modules and compact airway modules With CARESCAPE respiratory modules and compact airway modules, you can measure and monitor gases being delivered to the patient and exhaled by the patient through the breathing circuit. The modules consist of an infrared sensor for measuring CO...
  • Page 298 Total sample size volume during one respiratory cycle depends on the respiration rate. Minimum Alveolar Concentration (MAC) NOTE CARESCAPE respiratory modules and compact airway modules only. The use of either traditional MAC or MACage is selected during monitor configuration. The MACage provides age and temperature compensated measurement. To enable MACage calculations, enter patient’s age to the monitor and attach a temperature...
  • Page 299 1 MAC (3 yrs) 0.75% 0.63% 0.97% Halothane 1.70% 1.43% 2.2% Enflurane 1.15% 0.97% 1.5% Isoflurane 2.05% 1.73% 2.65% Sevoflurane 6.00% 5.05% 7.80% Desflurane 100% The following illustration shows the Agent% corresponding to 1 MAC as function of age: 2062971-001 CARESCAPE Modular Monitors...
  • Page 300 1.1% 4.1% Desflurane ET balance gas, CARESCAPE respiratory modules and compact airway modules You can obtain a calculated value for balance gas, EtBal. End-tidal balance gas is the percentage of gas concentration not measured by the gas sensors. It is displayed in a parameter window with the MAC value.
  • Page 301 ) concentration is measured at the end of this plateau. D: When the next inspiration starts the capnogram rapidly falls towards the ● baseline. The minimum level of CO measured during the inspiratory phase is called the inspired CO concentration (normally 0.0%). 2062971-001 CARESCAPE Modular Monitors...
  • Page 302 CO rich gas is sampled. This causes variations in sampled CO concentrations. In the illustration below, CO waveform is the one on top, and flow is the lower waveform. 1. Expiration 2. Cardiogenic oscillations CARESCAPE Modular Monitors 2062971-001...
  • Page 303 Oxygen measurement interpretation, CARESCAPE respiratory modules and compact airway modules The CARESCAPE respiratory modules and compact airway modules oxygen measurement provides: Inspired oxygen level, the actual inspired oxygen concentration ● End-tidal oxygen level, the expired oxygen concentration ●...
  • Page 304 ● ventilator’s inspiratory and expiratory breathing tubings. They are also useful for condensed water collection during long-lasting anesthesia. Oxygen delivery, CARESCAPE respiratory modules and compact airway modules Oxygen uptake and consumption Oxygen consumption is the difference between the amount of oxygen delivered to the tissues by the arterial circulation and the amount of oxygen returned to the heart by the venous system.
  • Page 305 The dips seen in the capnogram during expiration ● expiration? are related to the sidestream gas sampling, the continuous gas flow to the Y-piece, and patient’s cardiac contractions, which cause intra-thoracic pressure changes and therefore flow variations. 2062971-001 CARESCAPE Modular Monitors...
  • Page 306 Also check the following technical issues: integrity ● of the breathing circuit; blood-gas analysis corrected to a lower temperature in case of hypothermia. CARESCAPE Modular Monitors 2062971-001...
  • Page 307 CapnoFlex LF, and Dual CO2 modules compatibility limitations CAPNOSTAT Mainstream, CapnoFlex LF and Dual CO2 modules with the B850 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. CO₂ safety precautions warnings WARNING Always inspect the airway adapter for a tight connection and proper operation before attaching it to the patient.
  • Page 308 CO2 with CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 modules WARNING Do not use a CO module at the same time as a compact airway module or a CARESCAPE respiratory module. WARNING Do not wash, disinfect or open the water trap cartridge. WARNING To avoid the risk of patient cross-infection, do not return the sampled gas to the breathing system.
  • Page 309 CO₂ measurement setup Equipment connection with CAPNOSTAT Mainstream module WARNING Do not plug the CAPNOSTAT Mainstream EtCO sensor into the Solar CapnoFlex Adapter. Plug the sensor directly into the Mainstream EtCO module or the Dual CO2 module. 2062971-001 CARESCAPE Modular Monitors...
  • Page 310 1. Place the sensor away from all sources of CO , including the patient’s exhaled breath, your exhaled breath, and ventilator exhaust valves. 2. With the cable connected to the module, select a gas related parameter window. 3. Select the Calibration tab. CARESCAPE Modular Monitors 2062971-001...
  • Page 311 Calibration error appears instead. In this case, perform a new calibration. Equipment connection with CapnoFlex LF module For intubated and non-intubated patients. 1. CAPNOSTAT Mainstream or Dual CO2 module 2. Adapter cable 2062971-001 CARESCAPE Modular Monitors...
  • Page 312 4. Select Start Calibrating. The message Calibrated appears on the screen after a successful calibration. If the calibration fails, the message Calibration error appears instead. In this case, perform a new calibration. Equipment connection with Dual CO2 module CARESCAPE Modular Monitors 2062971-001...
  • Page 313 6. Snap the sidestream adapter with its tubing into the sensor. 7. Connect the sensor cable to the module. The message Warming up appears on the monitor screen. Wait until it disappears. 8. Turn on the pump. 2062971-001 CARESCAPE Modular Monitors...
  • Page 314 3. Select the Calibration tab. 4. Select Start Calibrating. The message Calibrated appears on the screen after a successful calibration. If the calibration fails, the message Calibration error appears instead. In this case, perform a new calibration. CARESCAPE Modular Monitors 2062971-001...
  • Page 315 3. Select Deactivate Apnea Alarm. NOTE When the alarm is deactivated, there will be no audible or visual Apnea alarm indications. The alarm is automatically reactivated if CO vitals signs are detected and alarm condition is met again. 2062971-001 CARESCAPE Modular Monitors...
  • Page 316 Apnea alarms can be deactivated with the pause audio key if the Allow alarm deactivation with the Audio Pause key for: setting Apnea (CO2/Imped) is enabled in the Care Unit Settings. This setting is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting CO...
  • Page 317 The capnogram of a healthy patient under controlled ventilation has a normal shape. Changes in the CO waveform may indicate compromised patient respiratory and/or circulatory function or improper mechanical ventilator functionality. 2062971-001 CARESCAPE Modular Monitors...
  • Page 318 CO free fresh gas and exhaled CO rich gas is sampled. This causes variations in sampled CO concentrations. In the illustration below, CO waveform is the one on top, and flow is the lower waveform. CARESCAPE Modular Monitors 2062971-001...
  • Page 319 > 6.0% / 45 mmHg) indicates hypoventilation or ineffective alveolar ventilation, which will lead to hypercapnia and respiratory acidosis. Increased inspiratory CO (FiCO ) concentrations may also be caused by: Exhausted CO absorber. ● Malfunction of the breathing system valves. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 320 Check the sensor. ● Make sure the patient is not breathing CO . Check ● that the amount of fresh gas is sufficient for the patient, and check that the CO absorber is in good condition. CARESCAPE Modular Monitors 2062971-001...
  • Page 321 Also check the integrity of the breathing ● circuit; blood-gas analysis corrected to a lower temperature in case of hypothermia. 2062971-001 CARESCAPE Modular Monitors...
  • Page 322 CO2 with CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 modules CARESCAPE Modular Monitors 2062971-001...
  • Page 323 Patient Spirometry Patient Spirometry compatibility Compact airway modules with the B850 and B650 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Patient Spirometry safety precautions Patient Spirometry warnings WARNING The presence of Helium or Xenon in the breathing circuit causes incorrect measurement values.
  • Page 324 5. Gas sampling line 6. Heat and moisture exchanger with filter (HMEF) (optional) Patient Spirometry module keys There are two keys on the CARESCAPE respiratory modules E-sCAiOV and E-sCOV: Save Loop Saves the currently active loop with corresponding numeric data.
  • Page 325 Pedi-lite/Pedi-lite+ sensor. For other patients, use the D-lite/D-lite+ sensor. Select the sensor type accordingly. 1. Select the Patient Spirometry parameter window. 2. Select Setup. 3. Select the sensor type (Pediatric or Adult) from the Sensor Type list. 2062971-001 CARESCAPE Modular Monitors...
  • Page 326 The smaller the value, the slower the sweep speed. Selecting the displayed Patient Spirometry volume type This setting determines which numeric data (tidal volumes TVinsp and TVexp, or minute volumes MVinsp and MVexp) will appear in the Flow parameter window. CARESCAPE Modular Monitors 2062971-001...
  • Page 327 1. Select the Patient Spirometry parameter window. 2. Select Loops. 3. Erase the loop by selecting Erase Selected. Printing a Patient Spirometry loop You can print the currently displayed loop. 1. Select the Patient Spirometry parameter window. 2062971-001 CARESCAPE Modular Monitors...
  • Page 328 Patient Spirometry measurement basics Patient Spirometry measurement description The CARESCAPE respiratory modules E-sCOV and E-sCAiOV, and the compact airway modules E-COV, E-COVX, E-CAiOV, and E-CAiOVX measure airway pressures, flow, volumes, compliance and airway resistance breath by breath at the patient's airway.
  • Page 329 Extrinsic positive end expiratory pressure (PEEPe) and intrinsic positive end ● expiratory pressure (PEEPi) (not in OR and PACU software packages). Compliance (Compl): calculated for each breath, indicates the pressure difference ● required to deliver a certain volume of gas into the patient. 2062971-001 CARESCAPE Modular Monitors...
  • Page 330 3. Pmean 4. PEEPe 5. PEEPtot 6. (PEEPi = PEEPtot — PEEPe) NOTE PEEPe and PEEPi not available in OR and PACU software packages. PEEPtot NOTE The following loop illustrates how PEEPtot (=PEEPe + PEEPi) is displayed. CARESCAPE Modular Monitors 2062971-001...
  • Page 331 ● Barotraumas ￭ Muscle fatigue ￭ Decreased compliance ￭ Reduced oxygen delivery ￭ Increased ventilatory dead space ￭ Hemodynamic side effects: ● Impeded venous return ￭ Increased pulmonary vascular resistance ￭ Reduced left ventricular compliance ￭ 2062971-001 CARESCAPE Modular Monitors...
  • Page 332 = V ● 1. Inspiration 2. Expiration If respiration rate is 10 breaths/min (respiration cycle 6 seconds) and I:E is 1:3, then the inspiration time is 1.5 seconds and the expiration time is 4.5 seconds: CARESCAPE Modular Monitors 2062971-001...
  • Page 333 NOTE An endotracheal tube greatly contributes to Raw. The resistance of the tube is normally higher than that of the remaining internal airways. 2062971-001 CARESCAPE Modular Monitors...
  • Page 334 Normal Paw-Vol loop The shape of the Paw-Vol loop depends on the patient’s respiratory status and the ventilation mode used. The “normal” Paw-Vol loop appears if only a small pressure is required before volume starts entering the lungs. CARESCAPE Modular Monitors 2062971-001...
  • Page 335 Flow-Vol loop illustrates the relationship between flow and volume. Inspiratory flow shows the type of flow pattern used by the ventilator, and expiratory flow indicates the resistance during expiration. All flow-restrictive incidents (airway obstruction, intrinsic PEEP) are visible in the Flow-Vol loop. 2062971-001 CARESCAPE Modular Monitors...
  • Page 336 Humidity condensing in the Patient Spirometry ports of the D-lite(+)/Pedi-lite(+) ● sensor may increase the measured volumes during longer low flow anesthesia. Position the sensor in such a way that gravity can remove the condensed water from the Patient Spirometry tubes. CARESCAPE Modular Monitors 2062971-001...
  • Page 337 The monitor measures directly at the endotracheal different compliance value? tube and reflects more accurate compliance of the lung. Hoses and other equipment between the patient and the ventilator influence the values measured in the ventilator. 2062971-001 CARESCAPE Modular Monitors...
  • Page 338 Patient Spirometry CARESCAPE Modular Monitors 2062971-001...
  • Page 339 Gas exchange compatibility limitations This measurement is available with the B850 and B650 only. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Gas exchange safety precautions Gas exchange warnings Before using the gas exchange measurement, familiarize yourself with safety precautions related to airway gases and Patient Spirometry measurements.
  • Page 340 To ensure measurement accuracy, check the accuracy of airway gas measurement ● once a month: feed calibration gas mixture to the monitor in the normal operation mode (without entering the calibration menu) and check that the readings on the CARESCAPE Modular Monitors 2062971-001...
  • Page 341 T-adapter) between the Y-piece and D-lite(+)/Pedi-lite(+). The by-pass flow effect may exist even in an adult setting, but it is more emphasized when monitoring pediatric patients and using the Pedi-lite(+). Gas exchange patient connections with flexible tube 2062971-001 CARESCAPE Modular Monitors...
  • Page 342 (VCO2/kg or VCO2/m2), you must enter the patient’s height and weight. For VO2/kg and VCO2/kg, measured values are divided by the patient’s weight, and for VO2/m2 and VCO2/m2, measured values are divided by the patient’s BSA. CARESCAPE Modular Monitors 2062971-001...
  • Page 343 Pulmonary gas exchange measurement means monitoring of oxygen consumption ) and carbon dioxide production (VCO ). Based on these measurements, it is possible to calculate the respiratory quotient, RQ, which is the ratio between CO 2062971-001 CARESCAPE Modular Monitors...
  • Page 344 Under these circumstances, enough time should be allowed for the body CO pool to stabilize if the measured VCO should reflect the metabolic production of CO . Continuous measurement of gas exchange facilitates the verification of a steady state. CARESCAPE Modular Monitors 2062971-001...
  • Page 345 VO Hemodynamic catastrophes, like circulatory collapse, may acutely reduce both VO and VCO , and a compensatory increase can be observed once adequate tissue perfusion has been restored. Various factors contribute to energy expenditure: 2062971-001 CARESCAPE Modular Monitors...
  • Page 346 Use a correct sampling line length. Sampling lines require specific lengths and ￭ diameters for accurate reporting of gas and flow. GE recommends using only a 2-m (7-ft) sampling line. Free tubing with no obstructions.
  • Page 347 > 85%. This is also indicated on screen by the replacement of numbers by ---. Please also note that full measurement accuracy is obtained when FiO is less than 65%. Between 65% and 85% , the accuracy is reduced to +/-15% 2062971-001 CARESCAPE Modular Monitors...
  • Page 348 Why are the EE and RQ values shown in gray? EE and RQ are gray when there is not enough (> 1/5 of the selected averaging time) valid data available for reliable calculations. CARESCAPE Modular Monitors 2062971-001...
  • Page 349 Entropy Entropy compatibility All features of this measurement are available with all Bx50 monitors. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. Entropy safety precautions Entropy warnings WARNING Make sure that the electrodes, sensor and connectors do not touch any electrically conductive material, including earth.
  • Page 350 Entropy indications for use The GE Healthcare Entropy module, E-ENTROPY, and accessories are indicated for adult and pediatric patients older than 2 years within a hospital for monitoring the state of the brain by data acquisition of electroencephalograph (EEG) and frontal electromyograph (FEMG) signals.
  • Page 351 ● review important situations and limitations that can influence the Entropy number. GE recommends that clinicians review the following practice advisory that includes a section on brain function monitoring: The American Society of Anesthesiologists, Practice Advisory for Intraoperative Awareness and Brain Function Monitoring (Anesthesiology 2006;...
  • Page 352 Entropy 1. Module with Entropy measurement capability 2. GE Entropy sensor cable 3. GE Entropy sensor 4. Entropy EasyFit sensor Entropy module keys There are two keys on the module. Depending on the module version either the text only or symbol only appear on the keys, and the table below covers both versions: Opens or closes the Entropy menu on the screen.
  • Page 353 Showing Entropy microtrend You can select an Entropy microtrend to the screen together with numeric values. 1. Press the module key, or select the Entropy parameter window. 2. Select Setup. 3. Select Show Entropy Microtrend. 2062971-001 CARESCAPE Modular Monitors...
  • Page 354 Setting Entropy alarm limits You can set the limit alarms on or off and adjust their activation limits according to your needs. 1. Press the module key, or select the Entropy parameter window. 2. Select Setup. CARESCAPE Modular Monitors 2062971-001...
  • Page 355 Entropy measurement is based on processing of raw EEG and FEMG signals by using the Entropy algorithm, a GE application of Spectral Entropy. The algorithm is published: Viertiö-Oja H et al. Description of the Entropy algorithm as applied in the Datex-Ohmeda S/5 Entropy Module.
  • Page 356 Graphical display: ● Entropy values: Low Entropy values ● EEG: Regular EEG ● Patient Status: Moderate anesthesia ● Graphical display: ● Entropy values: Low Entropy values ● EEG: Regular EEG ● Patient Status: Very deep anesthesia ● CARESCAPE Modular Monitors 2062971-001...
  • Page 357 Raw EEG on the screen may also enable the clinician to view the EEG for recognizable and clinically relevant patterns of EEG activity. Do not use other sensors than Entropy sensors by GE. ● 2062971-001...
  • Page 358 Change in infusion pump settings for intravenous ● anesthetics. Change in vaporizer settings, or fresh-gas flow ● rate. Volume loading with infused fluids. ● Fault in the operation of anesthetic delivery ● systems. Impedance check. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 359 In this study using sevoflurane, propofol and thiopental, the authors found that SE and RE distinguished excellently between conscious and unconscious states. The authors conclude that RE indicates emergence from anesthesia earlier than SE or BIS. 2062971-001 CARESCAPE Modular Monitors...
  • Page 360 Entropy Module and BIS in children. Choi SR, Lim YH, Lee JH & Chung CJ: Spectral entropy monitoring allowed lower ● sevoflurane concentration and faster recovery in children. Acta Anaesthesiologica Scandinavica 54 (7): 850—862; Aug 10 2010. CARESCAPE Modular Monitors 2062971-001...
  • Page 361 Neuromuscular transmission NMT compatibility All features of this measurement are available with all Bx50 monitors. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. NMT safety precautions NMT warnings WARNING Make sure that the lead set clips or snaps do not touch any electrically conductive material including earth.
  • Page 362 Moving or touching the patient during measurement may cause incorrect results. ● For safe extubation, the TOF% should be higher than 90. Also assess other clinical ● signs. Checking the NMT measurement 1. Always check the electrode quality. CARESCAPE Modular Monitors 2062971-001...
  • Page 363 2. Clean the skin at the NMT application area. 3. When applying the electrodes, make sure that the entire electrode surfaces make an optimal contact to the skin. 4. Always connect the white NMT stimulation lead to the proximal electrode. 2062971-001 CARESCAPE Modular Monitors...
  • Page 364 (stimulated behind the head of fibula). Place the electrodes for red and green lead connection site on the m. flexor hallucis brevis, and the electrode for black lead connection (ground) as indicated in the figure. CARESCAPE Modular Monitors 2062971-001...
  • Page 365 2. Select Stimulus Mode > TOF, DBS or ST. 3. Select Start with > New patient. 4. Select Start-up. Changing the NMT stimulus current 1. Select the NMT parameter window > Setup. 2. Select a value from the Current list. 2062971-001 CARESCAPE Modular Monitors...
  • Page 366 1. Select the NMT parameter window > Setup. 2. Select Start Tetanic/PTC. Continuing the NMT measurement To continue interrupted NMT measurement with the same patient and monitor, press the Stop Continue module key, or: 1. Select the NMT parameter window > Setup. CARESCAPE Modular Monitors 2062971-001...
  • Page 367 The NMT module delivers single stimulation pulses at a selected rate until it is manually stopped. Muscle contractions from the stimulated innervating motoric nerve(s) may be observed. Note that you need specific accessories for this measurement. 2062971-001 CARESCAPE Modular Monitors...
  • Page 368 NMT parameter window > Regional Block > Stop. NMT measurement basics NMT measurement description The GE NMT measurement devices are used for monitoring the relaxation of the patient and regional block stimulation for nerve location. Neuromuscular transmission is the transfer of a motor nerve impulse over the neuromuscular junction.
  • Page 369 DBS consists of two separate bursts. Each burst consists of three consecutive pulses at a 50 Hz frequency. The response ratio of the second to the first burst is calculated, resulting in DBS% (equivalent to TOF%). 2062971-001 CARESCAPE Modular Monitors...
  • Page 370 Check the quality of the stimulation electrodes. ● Use GE approved NMT electrodes for stimulation. They are tested with the ￭ module and provide low impedance, which is crucial for accurate measurement. Do not use the electrodes after their expiration date.
  • Page 371 1. adductor pollicis 2. abductor digiti minimi (hypothenar) 3. flexor pollicis brevis (thenar) 4. ulnar medial 5. epicondyle Also, supramaximal current may not be found if ● the patient has anatomical and/or physiological anomalies. 2062971-001 CARESCAPE Modular Monitors...
  • Page 372 Neuromuscular transmission CARESCAPE Modular Monitors 2062971-001...
  • Page 373 EEG and auditory evoked potentials EEG compatibility All features of this measurement are available with all Bx50 monitors. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. EEG safety precautions EEG warnings WARNING —...
  • Page 374 ￭ factors that influence EEG (like blood flow, neurological pathologies, underlying ￭ illnesses, and temperature). A cloth bandage over cup electrodes and around the patient's head may enhance ● good contact. CARESCAPE Modular Monitors 2062971-001...
  • Page 375 Follow the electrode manufacturer’s instructions for the frequency of changing ● the electrodes. Only use electrodes that are intended for EEG measurement. ● Use one type of electrodes in the whole montage. ● International 10–20 system The international 10–20 system’s standardized electrode locations: 2062971-001 CARESCAPE Modular Monitors...
  • Page 376 Preferably use adhesive electrodes if all montage placements are within skin area. 1. Clean the skin with alcohol. 2. Remove the electrode from its package and attach it to the desired location. 3. Press the electrode gently for several seconds to attach it. CARESCAPE Modular Monitors 2062971-001...
  • Page 377 If you change them, always update the montage settings according to the instructions. BASIC montage 1. Ground Montage Settings Electrodes 1. A1 -Fp1 Two channels, bipolar Five adhesive electrodes 2. A2 - Fp Ground 2062971-001 CARESCAPE Modular Monitors...
  • Page 378 3. Red horizontal line represents the parameter selected for Numeric 1 (e.g., SEF measured in Hz. 4. Black line ends touching the red and blue lines represent the channel-specific parameters for Numeric 1 and Numeric 2 (for instance, SEF and amplitude). CARESCAPE Modular Monitors 2062971-001...
  • Page 379 Selecting EEG numeric parameters EEG numeric trends are available in the ED, ICU, and NICU software packages. 1. Select the EEG parameter window. 2. Select EEG tab > Setup. 3. Select a parameter from the Numeric 1 list. 2062971-001 CARESCAPE Modular Monitors...
  • Page 380 NOTE Changing the scale will erase the previous CSA content. Selecting the EEG numerical view You can choose to view a numeric list of all EEG parameters on all channels. 1. Select the EEG parameter window. CARESCAPE Modular Monitors 2062971-001...
  • Page 381 You can print the currently displayed EEG view. 1. Select the EEG parameter window. 2. Select EEG tab > View. 3. Select Numerical or CSA. 4. Select Print Page. Stopping the EEG measurement 1. Disconnect the electrodes. 2062971-001 CARESCAPE Modular Monitors...
  • Page 382 For example, Delta% = power in delta band / Total power. The spectrum is displayed graphically as a single, continuously updating curve, or compressed spectral array (CSA), where spectra are stacked one on top of the other to form a trend display. CARESCAPE Modular Monitors 2062971-001...
  • Page 383 EEG findings are usually non-specific, and consequently they indicate a malfunction but do not reveal the reason for it. Distinguishable characteristics to look for are: Frequency and amplitude ● Rhythm location and specific waveforms ● Artifact ● Reactivity ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 384 Existing reactivity in the EEG is a sign of healthy brain activity. Accordingly, reduced reactivity may indicate a disorder in the brain activity, which requires action. Examples of typical EEG patterns Pathologically slowed rhythms: ● Seizure activity: ● CARESCAPE Modular Monitors 2062971-001...
  • Page 385 Typical EEG recordings with electrical interference Electrical currents (AC): These are a ● common source of interference. Try using different low-pass or notch filters to eliminate them. Eye movements: Patient eye movements ● cause typical patterns in the EEG waveform. 2062971-001 CARESCAPE Modular Monitors...
  • Page 386 Why are all EEG waveforms not drawn even if The number of channels in the montage is smaller electrodes and cables are OK? than the number of channels connected to the patient. CARESCAPE Modular Monitors 2062971-001...
  • Page 387 (for example, when the patient is lying on one side). NOTE Use only GE Healthcare supplied headphones/earphones. In other headphones/earphones the sensitivity may vary causing too high an intensity, which may damage the ear, or too low an intensity, which may cause a poor response.
  • Page 388 1. Select the EEG parameter window. 2. Select the AEP tab > Setup. 3. Select the number of responses from the Responses list. Selecting the AEP stimulus frequency You can select how often the stimulus is given. CARESCAPE Modular Monitors 2062971-001...
  • Page 389 2. Select the AEP tab > View. 3. Select a value from the Cycle list. Selecting the AEP size 1. Select the EEG parameter window. 2. Select the AEP tab > View. 3. Select a value from the EP Size list. 2062971-001 CARESCAPE Modular Monitors...
  • Page 390 2. Select Reports > Individual Reports > AEP. Stopping the AEP measurement Press the EP Start/Stop key on the headbox or module, or: 1. Select the EEG parameter window. 2. Select the AEP tab > View. 3. Select Stop AEP. CARESCAPE Modular Monitors 2062971-001...
  • Page 391 100 ms to 1000 ms ￭ frontal cortex ￭ NOTE LLAEP display is not supported in the monitor. Examples of typical AEP patterns AEP 1 ms to 1000 ms with anatomical sites and labeling: 2062971-001 CARESCAPE Modular Monitors...
  • Page 392 EEG waveform because of filtering. Check that the electrode impedances are below ● 5 kOhm, and that the impedances of a same channel are close to each other. If this does not help, try to remove sources of noise. CARESCAPE Modular Monitors 2062971-001...
  • Page 393 Bispectral index BIS compatibility All features of this measurement are available with all Bx50 monitors. For detailed information regarding module, monitor, and accessory compatibility, see the CARESCAPE Modular Monitors Supplemental Information Manual. BIS safety precautions BIS warnings WARNING — DEFIBRILLATOR PRECAUTIONS — Patient signal inputs...
  • Page 394 Covidien (www.covidien.com) or contact that company itself if they have clinical-based BIS questions relating to this module portion of the GE monitor. Failure to do so could potentially result in incorrect administration of anesthetic agents and/or other potential complications of anesthesia or sedation. We...
  • Page 395 BIS sensors are disposable, for single patient use only, and not made with natural ● rubber latex. Check the sensor expiration date on the sensor package. ● Do not use a sensor for more than 24 hours. ● Use only Covidien BIS sensors. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 396 7. Observe the results of the automatic sensor check in the parameter window. 8. The measurement starts automatically after the sensor has passed the check. Checking the BIS measurement 1. Check that the sensor/electrode passes the sensor/electrode check when you are starting to monitor a new patient. CARESCAPE Modular Monitors 2062971-001...
  • Page 397 3. Select a value from the Smoothing Rate list. The bigger the value, the “smoother” the trend. Setting BIS filters With BIS filters you can filter out disturbances from the EEG signal and improve the signal quality. 1. Press the module key or select the BIS parameter window. 2062971-001 CARESCAPE Modular Monitors...
  • Page 398 After the test is completed, the result shown is PASS or FAIL. Stopping the BIS measurement 1. Remove the BIS sensor from the patient. 2. Disconnect the sensor from the patient interface cable. 3. Discard the sensor. CARESCAPE Modular Monitors 2062971-001...
  • Page 399 Check the digital signal processing unit. ● BIS signal is poor Check the sensor’s contact with skin. ● Check the sensor. ● Ensure that the digital signal processing unit is not close to any ● electrical radiating equipment. 2062971-001 CARESCAPE Modular Monitors...
  • Page 400 Poor sensor connection. ￭ Defective patient interface cable or sensor. ￭ To correct the situation: Recheck the sensor. ● Reapply the sensor according to instructions. ● Check sensor connection. ● Replace patient interface cable or sensor. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 401 They are changed through Monitor Setup > Default Setup > Care Unit Settings > Units > Laboratory Values and the settings are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Viewing laboratory data You can view the most recently saved laboratory data.
  • Page 402 View tab shows either the corrected or uncorrected values depending on the Temperature Correction selection. Formulas used to calculate the values when temperature correction is enabled are given in the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting the type of temperature correction 1. Select Data & Pages.
  • Page 403 If you do not select Save, new data is lost when you exit the menu. Printing laboratory values You can print the most recently saved laboratory data. 1. Select Data & Pages. 2. Select Laboratory Data. 3. Select the View tab. 4. Select Print. 2062971-001 CARESCAPE Modular Monitors...
  • Page 404 Laboratory data CARESCAPE Modular Monitors 2062971-001...
  • Page 405 Viewing calculation values Ventilation calculations with the B850 and B650 only. A list of displayed input and calculated parameters is given in the CARESCAPE Modular Monitors Supplemental Information Manual. 1. Select Data & Pages.
  • Page 406 You can select different sources for the PCWP. If you select LAP mean or PA, the PCWP value in Hemo > Trend will be marked as an estimated value with the letter e. Instead, the Hemo > Edit Input and Hemo > View show the actual selected label. CARESCAPE Modular Monitors 2062971-001...
  • Page 407 5. Enter or edit the parameter values with the arrows of the Value column. 6. To perform the actual calculation and save the values, select the View tab > Save. If you select Previous Menu before saving the values, they are lost. 2062971-001 CARESCAPE Modular Monitors...
  • Page 408 Ventilation calculations with the B850 and B650 only. You must save the calculations before you can print them. If they have not been saved, the Print selection is disabled. 1. Select Data & Pages. 2. Select Calculations. CARESCAPE Modular Monitors 2062971-001...
  • Page 409 Ventilation calculations with the B850 and B650 only. You can print all calculation trends at once. 1. Select Data & Pages. 2. Select Calculations. 3. Select Hemo, Oxy, or Vent tab. 4. Select Trend. 5. Select Print. 2062971-001 CARESCAPE Modular Monitors...
  • Page 410 Calculations CARESCAPE Modular Monitors 2062971-001...
  • Page 411 The titration table displays drug dosage information that can be used to help the clinician determine the dosing effects of intravenous pump setting and infusion rate changes. 2062971-001 CARESCAPE Modular Monitors...
  • Page 412 6. Patient's Weight: Allows you to enter the patient’s weight if the selected Dose Unit requires it. 7. Selections for entering drug specification information from the drug order. Concentration is automatically calculated. 8. Selections for entering drug dose administration information. CARESCAPE Modular Monitors 2062971-001...
  • Page 413 5. Enter the drug name with the on-screen keyboard. The name can contain a maximum of 20 characters and it is case-sensitive (for example, Insulin and insulin would be two different drug names). 6. Select Add. 2062971-001 CARESCAPE Modular Monitors...
  • Page 414 Infusion Rate (ml/h) column. Printing the titration table 1. Select Data & Pages. 2. Select Drug Calculations. 3. Select the Titration Table tab. 4. Select the Print. 5. You can stop printing by selecting Stop Printing or Cancel Printing. CARESCAPE Modular Monitors 2062971-001...
  • Page 415 You can print a list of resuscitation medications and their concentration level, delivery method, and dose value. 1. Select Data & Pages. 2. Select Drug Calculations. 3. Select the Resuscitation Medications tab. 4. Select Print. 5. You can stop printing by selecting Stop Printing or Stop Printing. 2062971-001 CARESCAPE Modular Monitors...
  • Page 416 Drug calculations CARESCAPE Modular Monitors 2062971-001...
  • Page 417 Trend views can be configured through Monitor Setup > Default Setup > Profile Settings > Trends & Snapshot. These selections are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. When entering the trends menu after ending a case/discharging the patient or when the monitor has been powered down for longer than 15 minutes, the displayed menu and trend view are the configured graphic or numeric ones.
  • Page 418 10 h, 12 h, and 24 h. The 72 h license provides the basic settings and additionally 36 h, 48 h, and ● 72 h selections. The high-resolution license provides basic settings and additionally 2 minute ● and 4 minute selections. CARESCAPE Modular Monitors 2062971-001...
  • Page 419 The lowest row, Mark, shows snapshot event numbers. If more than one snapshot has been created in a one-minute period, only the last snapshot event number is shown. You cannot configure the layout of the Numeric trend view. 1. Select Trends. 2062971-001 CARESCAPE Modular Monitors...
  • Page 420 This configuration is done through Monitor Setup > Default Setup > Care Unit Settings > Printer > Numeric Trends Printing and it is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual.
  • Page 421 CO and respiration. Minitrends follow graphic trend scale settings. Use the same scale for waveforms and trends. IP minitrends are an exception: they follow the IP waveform scales and not the IP trend scales. 2062971-001 CARESCAPE Modular Monitors...
  • Page 422 You can also have minitrends on other pages than the normal screen. This setting is configured through Monitor Setup > Default Setup > Profile Settings > Pages and it is password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Selecting the minitrend to screen 1.
  • Page 423 Time adjustment is allowed during a patient case if the monitor is configured to the CARESCAPE Network. When the time is adjusted, the monitor shifts the timestamps of continuous trend data and of discrete data, except NIBP and wedge measurements.
  • Page 424 Trends CARESCAPE Modular Monitors 2062971-001...
  • Page 425 Snapshot configuration Snapshots are configured through Profile Settings > Trends & Snapshot > Snapshot and these settings are password protected. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. Manually created snapshots You can create a snapshot manually by selecting Freeze/Snapshot. The monitor saves the image of preconfigured waveforms or trends at that moment in time.
  • Page 426 The snapshot cursor’s time is set to the time of that snapshot. Changing the snapshot time scale 1. Select Trends. 2. Select Snapshot from the Trend list. 3. Select a time value from the Time Scale list. CARESCAPE Modular Monitors 2062971-001...
  • Page 427 When the memory is too full, the message Snapshot memory full. Oldest snapshot erased. is displayed in the message field for five seconds. If the contents of the snapshot have been changed, a new snapshot may 2062971-001 CARESCAPE Modular Monitors...
  • Page 428 ECG waveforms and/or arterial invasive pressure channel. Otherwise, no waveform data is displayed. A snapshot is sent to the CARESCAPE Network if it contains one of the following waveforms: ECG lead I, II, III, or Va, or any arterial invasive pressure.
  • Page 429 ● Manually created snapshots or ST snapshots. ● An event is also created automatically when alarm history is transferred from PDM, TRAM, or telemetry transmitter to the monitor and corresponding snapshots are created at the monitor. 2062971-001 CARESCAPE Modular Monitors...
  • Page 430 2. Select Event from the View list. 3. Select the desired event from the Event trend view. 4. Select Annotate Event. 5. Type the text in the Annotation field with the on-screen keyboard. The maximum number of characters is 50. CARESCAPE Modular Monitors 2062971-001...
  • Page 431 You can print alarms and user event in event history reports. Depending on the number of saved events, one or more pages are printed. 1. Select Trends. 2. Select Event from the View list. 3. Select Print Page. 4. You can stop printing by selecting Cancel Printing. 2062971-001 CARESCAPE Modular Monitors...
  • Page 432 Snapshots and events CARESCAPE Modular Monitors 2062971-001...
  • Page 433 Printing to a remote recorder connected to another networked bedside monitor ● (except a B650 or a B450) or a central station in the CARESCAPE Network. Printing to a bedside printer connected via the IX network interface. In this case the ●...
  • Page 434 You can connect a recorder directly to the monitor (B850) or use the built-in recorder option locally (B650, B450). You can also use a recorder over the network connected to a central station or connected to a remote monitor (other than B650 and B450). PRN 50–M recorder (B850 only) CARESCAPE Modular Monitors 2062971-001...
  • Page 435 B650 B450 1. Built-in recorder option NOTE Remote recording is only possible from the B650 or B450 to a GE monitor or a central station; remote recording is not possible to the B650 and B450. Printing device selections Changing printer 1.
  • Page 436 Telemetry Waveforms if the PRN 50-M recorder is connected. Remote Remote recorder or printer (a recorder in another monitor in the CARESCAPE network, or a recorder or a printer connected to a central station in the network). Network printer (a printer in the IX Network Network or connected to an iCentral).
  • Page 437 An arrhythmia alarm waveform continues to print up to 20 seconds after the arrhythmia resolves or a new arrhythmia has been identified. The length of the event shall determine the length of the printout. 1. Select Monitor Setup > Printing. 2. Select the Waveforms tab. 2062971-001 CARESCAPE Modular Monitors...
  • Page 438 Stopping a waveform printout from the main display 1. Select Stop Printing. Stopping a waveform printout from the waveforms window 1. Select Monitor Setup > Printing. 2. Select Waveforms tab. 3. Select Stop Printing or Cancel Printing. CARESCAPE Modular Monitors 2062971-001...
  • Page 439 (Data on Screen) or all numeric trend data (All Data) relating to the currently viewed page. NOTE For details, see the CARESCAPE Modular Monitors Supplemental Information Manual. Automatic printing of events and snapshots Event, snapshot and ST snapshot printouts can be printed automatically by an alarm.
  • Page 440 3. Select the report type you wish to print: QRS/ST, Loops, AEP, Calculation Trends, and Patient Information. Care report printouts NOTE For details, see the CARESCAPE Modular Monitors Supplemental Information Manual. NOTE Care reports are predefined in the default setup.
  • Page 441 1. Select Data & Pages. 2. Select Laboratory Data. 3. Select View > Print. Parameter printouts You can print parameter printouts from the parameters' own menus. You can get printouts of: ECG waveforms ● 12SL ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 442 Notes field for manually written notes ● Recorder print header Patient name ● Second ID ● Medical record number ● Bed number ● Unit name ● Date and time of the printout ● Printout title ● CARESCAPE Modular Monitors 2062971-001...
  • Page 443 Settings > Alarms > Remote Alarms, and they are password protected: Enabling or disabling audio pausing remotely for another monitor (Allow Audio ● Pause: For Remote Bed). Choices are Yes and No. CARESCAPE Network only. Selecting which remote locations are allowed to pause audio alarms on this ●...
  • Page 444 Selecting the notifying alarm priority level 1. Select Data & Pages. 2. Select Other Patients. 3. Select the Receive Alarms tab. 4. Select a care unit from the Unit list. 5. Select a patient bed from the displayed list. CARESCAPE Modular Monitors 2062971-001...
  • Page 445 1. Select Data & Pages. 2. Select Other Patients. 3. Select the View Patients tab. 4. Select a care unit from the Unit list. A list of remote patient beds is displayed for the selected care unit. 2062971-001 CARESCAPE Modular Monitors...
  • Page 446 Audio pause for a remote patient bed alarms NOTE This feature is available with the CARESCAPE Network only. You can pause active alarms for the remote bed viewed by selecting Remote from the bed-to-bed window. If the selection is not selectable, this option has not been enabled during configuration.
  • Page 447 WARNING — INTERFACING OTHER EQUIPMENT — Connect only items that are specified as part of the system and as compatible. For more information, see the CARESCAPE Modular Monitors Supplemental Information Manual. WARNING If a ventilator and a gas acquisition module are connected...
  • Page 448 Device (ID) is used with the monitor to communicate with peripheral devices. It acquires digital data from eight individually isolated serial ports. The data is collected from up to eight peripheral devices (not necessarily manufactured by GE), and then the interface device transmits the formatted data to the monitor.
  • Page 449 Unity Network Interface Device (ID) serial port indicator lights Each serial port on the connectivity device has an indicator light located directly above it. The light indicates the status of the serial port. 2062971-001 CARESCAPE Modular Monitors...
  • Page 450 The chart below gives some general information as to what data is available to the monitoring system and how it is handled (trending, alarm broadcast, etc.). See the Unity Network Interface Device (ID) operator and service manuals for more detailed information regarding waveforms and alarms. CARESCAPE Modular Monitors 2062971-001...
  • Page 451 Unity Network Interface Device (ID) supports only digital waveforms. CIC Pro version 4.0.7 and subsequent. CARESCAPE Central Station software version 1.0 and subsequent. POC blood gas monitor data is displayed in Data & Pages > Laboratory Data. Peripheral device data presentation and menus The data displayed in the parameter window may vary with each device.
  • Page 452 Ventilator/anesthesia machine settings and technical alarms ● The settings are displayed in numeric trends. ￭ Technical alarms and settings are displayed and trended even when there is a ￭ gas module connected to the monitor. CARESCAPE Modular Monitors 2062971-001...
  • Page 453 Cleanup and disposal of broken display monitors must be in compliance with the safety and waste control guidelines regulating this product. WARNING Never immerse any part of the device, cables, or leadwires in liquids or allow liquid to enter the interior of the device. 2062971-001 CARESCAPE Modular Monitors...
  • Page 454 If you have any questions concerning disposal of a product, please contact GE or its representatives. CAUTION —...
  • Page 455 A calibration check of temperature, NIBP and invasive blood pressures should ￭ be performed at least once a year to ensure that the measurement accuracy remains within specifications. For calibration instructions, see the Module Frames and Modules Technical Manual. 2062971-001 CARESCAPE Modular Monitors...
  • Page 456 1. Turn off the power to the equipment. 2. Disconnect the equipment from the power supply. 3. Remove all cables and batteries (if applicable) and close battery door(s). 4. Dampen a soft lint-free cloth with one of the permitted detergents or disinfectants. CARESCAPE Modular Monitors 2062971-001...
  • Page 457 1. Remove cables and leadwires from the handheld device or system before cleaning. 2. Use care in cleaning leadwires to prevent pulling the long wires from the connector ends. Metal connections can be pulled away from the connectors. 2062971-001 CARESCAPE Modular Monitors...
  • Page 458 Before reusing the adapter, make sure the adapter windows are clean and dry. How to store PDM and PSM Remove PDM batteries when the device is not in use, even for short periods of time. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 459 WARNING — EXPLOSION OR FIRE — Using non-recommended batteries could result in injury/burns to the patients or users. Only use batteries recommended or manufactured by GE. The warranty can be voided if non-recommended batteries are used. WARNING — PHYSICAL INJURY — Make sure the battery is completely inserted and the battery door is completely closed.
  • Page 460 WARNING — EXPLOSION OR FIRE — Using non-recommended batteries could result in injury/burns to the patients or users. Only use batteries recommended or manufactured by GE. The warranty can be voided if non-recommended batteries are used. WARNING — PHYSICAL INJURY — Do not install the PDM above a patient.
  • Page 461 Cleaning and care If the lithium battery charge becomes low during normal operation, the message Service Monitor Error Code 0xHOST1100 appears near the middle of the screen. If this happens, contact authorized service personnel. 2062971-001 CARESCAPE Modular Monitors...
  • Page 462 Cleaning and care CARESCAPE Modular Monitors 2062971-001...
  • Page 463 Messages Messages related to ECG measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear. The message location is indicated with the following abbreviations: al.
  • Page 464 HR(ECG) high / al. area Measurement values are equal Check the patient status. ● ● ● to or outside the alarm limits. HR(ECG) low Adjust alarm limits if ● necessary. CARESCAPE Modular Monitors 2062971-001...
  • Page 465 Make sure the transmitter is ● ● ● with the telemetry transmitter. not out of range. Check the telemetry ● transmitter’s battery. Wait to see if the problem ● resolves. If the problem persists, contact authorized service personnel. 2062971-001 CARESCAPE Modular Monitors...
  • Page 466 ST XXX high / ST XXX al. area Measurement values are equal Check the patient status. ● ● ● to or outside the alarm limits. Adjust alarm limits if ● where XXX = ECG lead necessary. label CARESCAPE Modular Monitors 2062971-001...
  • Page 467 V4/C4 lead off ● V5/C5 lead off ● V6/C6 lead off ● V/C lead off ● Va/Ca lead off ● Vb/Cb lead off ● VT>2 al. area, Physiological alarm. Check the patient status. ● ● ● wavef. 2062971-001 CARESCAPE Modular Monitors...
  • Page 468 Messages Messages related to impedance respiration measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 469 ● Messages related to SpO measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear. The message location is indicated with the following abbreviations: al.
  • Page 470 ● Incompatible probe The sensor is not compatible. Replace the sensor. See the ● ● CARESCAPE Modular Monitors Supplemental Information Manual. If the problem persists, ● contact authorized service personnel. Incompatible SpO2 al. area The sensor is not compatible.
  • Page 471 The finger or earlobe may be Check the patient status. ● ● ● /SpO2(2) probe off too thin or the sensor is off the Reposition the SpO sensor. ● patient. Replace the SpO sensor. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 472 MasimoSet cable to the PDM Nellcor. Messages related to NIBP measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 473 85 s for infant TRAM: <3 min for adult/ child, ● 90 s for infant al. area Loose cuff or cuff hose. Check the cuff and cuff hose. NIBP air leakage / ● ● ● NIBP manual 2062971-001 CARESCAPE Modular Monitors...
  • Page 474 Repeat the measurement. ● If the problem persists, ● contact authorized service personnel. param. ● Weak pulsation Weak or unstable oscillation Check the patient status. ● ● signal. Reposition the cuff. ● Repeat the measurement. ● CARESCAPE Modular Monitors 2062971-001...
  • Page 475 ● Messages related to invasive pressures measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 476 Check the connections and ● ● recalibrate. al. area Measurement values are equal Check the patient status. CPP high / CPP low ● ● ● to or outside the alarm limits. Adjust alarm limits if ● necessary. CARESCAPE Modular Monitors 2062971-001...
  • Page 477 Identical IP8 modules ● Identical IP RAC al. area There are two or more IP RAC Remove all but one IP RAC ● ● ● modules modules in identical slots in the module. system. 2062971-001 CARESCAPE Modular Monitors...
  • Page 478 If the problem persists, ● contact authorized service personnel. param. ● P1 standby to P8 The IP channel has been set to Reactivate the channel by ● ● standby standby. selecting Activate P1 to Activate P8. CARESCAPE Modular Monitors 2062971-001...
  • Page 479 RAP sys high / ● ● ● to or outside the alarm limits. RAP sys low Adjust alarm limits if ● necessary. RAP mean high / ● RAP mean low RAP dia high / RAP dia ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 480 ● Replace the transducer. ● Replace the module. ● If the problem persists, ● contact authorized service personnel. param. ● Zeroed Zeroing was successful. No action required. ● ● Message is automatically removed after 10 seconds. CARESCAPE Modular Monitors 2062971-001...
  • Page 481 ICP channel setup menu. Messages related to temperature measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 482 Messages related to cardiac output measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 483 Identical C.O. al. area There are two or more identical Remove all but one C.O. ● ● ● modules C.O. modules in the system. module. Also when there are more than one active C.O. sources. 2062971-001 CARESCAPE Modular Monitors...
  • Page 484 Start C.O. With E-modules, you can also use the Start C.O. module key. C.O. Press Start C.O. Serial ● Prompt text during the Proceed with the ● ● menu Automatic measurement measurement by selecting mode. Start C.O. Serial. CARESCAPE Modular Monitors 2062971-001...
  • Page 485 Messages related to SvO measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear. The message location is indicated with the following abbreviations: al.
  • Page 486 ● ● catheter. Change optical module and ● recalibrate. If the problem persists, ● contact authorized service personnel. param. ● In vivo calibrating In vivo calibration is in process. Wait until the message ● ● disappears. CARESCAPE Modular Monitors 2062971-001...
  • Page 487 Re-connect the cable to the ● ● ● the module. module. SvO2 faulty cable al. area, The optical module has failed. Check the optical module and ● ● ● param. connections. Replace the optical module. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 488 Messages related to gases measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 489 Change module if needed. ● Check sample line al. area, The sample line is disconnected, Reconnect the disconnected ● ● ● param. or of a different type than the sample line. last one used. Calibrate the sample line. ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 490 An unknown agent or three or Flush the breathing circuit ● ● more agents detected. Vaporizer with O flush (O +, 100% O may contain a mixture of agents. Empty the vaporizer and refill ● from an unopened container. CARESCAPE Modular Monitors 2062971-001...
  • Page 491 Incompatible gas al. area The module is not compatible. Replace with compatible ● ● ● module gas module. See the CARESCAPE Modular Monitors Supplemental Information Manual. If the problem persists, ● contact authorized service personnel. param. ● Incompatible sensor The sensor is of wrong type.
  • Page 492 The sensor is warming up. Wait until the message ● ● disappears. param. Zero error ● ● Zeroing has failed. Repeat the zeroing. ● param. Zeroing ● Zeroing is in progress. Wait until the zeroing is ● ● completed. CARESCAPE Modular Monitors 2062971-001...
  • Page 493 Messages Messages related to spirometry measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear. The message location is indicated with the following abbreviations: al.
  • Page 494 Interfaced device needs to be Check the patient status. ● ● ● checked. Check the ventilator tubing ● and patient connection. Check the interfaced device. ● If the problem persists, ● contact authorized service personnel. CARESCAPE Modular Monitors 2062971-001...
  • Page 495 Messages related to gas exchange measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 496 - and specific error indication Messages related to Entropy measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 497 Check that the sensor is an ● Entropy sensor. Identical Entropy al. area There are two or more Entropy Remove all but one Entropy ● ● ● modules modules in the system. module. 2062971-001 CARESCAPE Modular Monitors...
  • Page 498 Entropy values appear automatically. Messages related to NMT measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 499 ● Supramax search Supramaximal stimulus current Wait until the search is ● ● search is in progress. completed. param. TETANIC ● ● Tetanic stimulation is in progress. Wait until the stimulation is ● completed. 2062971-001 CARESCAPE Modular Monitors...
  • Page 500 Messages Messages related to EEG and AEP measurements For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 501 Check the impedance. ● Messages related to BIS measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 502 No sensor ● param., ● unit BISx. and sensor and PIC (patient wavef. interface cable). param., ● Poor signal The BIS cannot be calculated Check electrode connections. ● ● wavef. because the SQI is below 50. CARESCAPE Modular Monitors 2062971-001...
  • Page 503 Messages related to TC measurement For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 504 Messages related to trends, snapshots, and laboratory data For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 505 Messages related to various situations For information regarding alarm priorities and escalation times, see the CARESCAPE Modular Monitors Supplemental Information Manual. Make sure you are familiar with the generic layout of the screen. This will help you identify where on screen the following messages appear.
  • Page 506 Battery A or B is faulty. Replace the battery if ● ● ● necessary. Battery B failure ● Battery failure al. area The monitor battery is faulty. Replace the battery if ● ● ● necessary. CARESCAPE Modular Monitors 2062971-001...
  • Page 507 Countdown timer al. area User set countdown timer has Reset the timer if required. ● ● ● expired expired. Entering standby al.area Activate standby has been No action required. ● ● ● selected. 2062971-001 CARESCAPE Modular Monitors...
  • Page 508 Incompatible Module al. area The module is not compatible. Replace with compatible ● ● ● module. See the CARESCAPE Modular Monitors Supplemental Information Manual. If the problem persists, ● contact authorized service personnel. Incompatible al.
  • Page 509 Connection to an iCentral is No action required. ● ● ● name> established. Network down al. area CARESCAPE Network connection Try to re-establish the ● ● ● has failed. connection. B650, B450: If the monitor Contact authorized service ●...
  • Page 510 Recorder: An alarm has Wait for the printing to finish. ● ● ● triggered printing. Printing ready al. area Your printing request has been No action required. ● ● ● forwarded to the printer. CARESCAPE Modular Monitors 2062971-001...
  • Page 511 Setting activation al. area There is a pending setting If necessary, cancel the ● ● ● after next case end activation that will take place activation. after you end the case. 2062971-001 CARESCAPE Modular Monitors...
  • Page 512 Connect the module if ● ● ● removed removed. you want to restart the measurements. Unable to read al. area The system cannot use the Contact authorized service ● ● ● licenses correct license file. personnel. CARESCAPE Modular Monitors 2062971-001...
  • Page 513 Accel. Ventric. accelerated ventricular rhythm ACI - TIPI acute cardiac ischemia - time insensitive predictive instrument access control list acute coronary syndrome activated clotting time A/C TCPL assist control time-cycle pressure-limited auditory evoked potential 2062971-001 CARESCAPE Modular Monitors...
  • Page 514 Beta beta frequency band beta frequency band percentage BIPAP biphasic positive airway pressure bispectral index BISx digital signal processing unit Blad bladder temperature B-type natriuretic peptide beats per minute Brady bradycardia body surface area CARESCAPE Modular Monitors 2062971-001...
  • Page 515 COcalc cardiac output calculated by Fick equation COHb carboxyhemoglobin Compl; C compliance Complstat static compliance Contin Flow continuos flow Contrl; Controlled controlled ventilation core temperature Core Count count of responses CPAP continuous positive airway pressure 2062971-001 CARESCAPE Modular Monitors...
  • Page 516 Dia; DIA diastolic pressure DIDCA Device IDentification Cable Adapter DIFF difference oxygen delivery DO2I oxygen delivery index dead space ventilation digital signal converter estimated electrocardiogram emergency department end-diastolic volume EDVI end-diastolic volume index energy expenditure (kcal/24h) CARESCAPE Modular Monitors 2062971-001...
  • Page 517 (describing location) frontal F(I-E)O inspiratory mixed expiratory oxygen fraction difference FECO mixed expired carbon dioxide concentration femoral FEMG frontal electromyogram FemV femoral venous mixed expired oxygen concentration fast Fourier transform FI; Fi fraction of inspired gas 2062971-001 CARESCAPE Modular Monitors...
  • Page 518 Hemo hemodynamic Hemo Calcs hemodynamic calculations high frequency ventilation hospital information system heat and moisture exchanger HMEF heat and moisture exchanger with filter hectopascal heart rate HRdif heart rate difference hardware hertz lead I CARESCAPE Modular Monitors 2062971-001...
  • Page 519 PDM internet protocol invasive blood pressure IPPV intermittent positive pressure ventilation IPPV/ASSIST intermittent positive pressure ventilation & assisted IrMod% infrared modulation percentage isoflurane International Standards Organization intravenous idioventricular rhythm joule potassium kbps kilobits per second 2062971-001 CARESCAPE Modular Monitors...
  • Page 520 MAC compensated with patient age, patient temperature, and atmospheric pressure manual Man/Spont manual/spontaneous mean arterial pressure Max. maximum megabyte mbar millibar module bus controller mcg/l microgram per liter mcmol/l micromole per liter Mean; M mean blood pressure milliequivalent mEq/l milliequivalent per liter CARESCAPE Modular Monitors 2062971-001...
  • Page 521 BTPS conditions MVexp (STPD) expired minute volume in STPD conditions MVinsp inspired minute volume (l/min) MVspont spontaneous minute volume myocardiac temperature neutral not applicable nitrogen nitrous oxide sodium Naso nasopharyngeal temperature neonate 2062971-001 CARESCAPE Modular Monitors...
  • Page 522 Paw-Vol Loop pressure volume loop Pbaro barometric pressure personal computer pCO2; PCO2 carbon dioxide partial pressure pieces pressure controlled ventilation PCV-A/C pressure controlled ventilation & assisted control CARESCAPE Modular Monitors 2062971-001...
  • Page 523 (relative) Pleth plethysmographic pulse waveform mean pressure Pmean Pmin minimum pressure part number pO2; PO2 oxygen partial pressure Ppeak peak pressure Pplat plateau (pause) pressure Pplatstat static plateau pressure pulse pressure variation pulse rate 2062971-001 CARESCAPE Modular Monitors...
  • Page 524 (total) (measured) radio frequency reduced hemoglobin reduced leadset average (root mean square) power read only memory room temperature Room respiratory quotient respiration rate residual volume RVEDV right ventricular end-diastolic volume RVEDVI right ventricular end-diastolic volume index CARESCAPE Modular Monitors 2062971-001...
  • Page 525 Spiro Patient Spirometry SpO2 oxygen saturation Spont spontaneous samples per second systolic pressure variation subcutaneous signal quality index suppression ratio SRAM static random access memory SSEP somatosensory evoked potentials single twitch ST segment 2062971-001 CARESCAPE Modular Monitors...
  • Page 526 PCO , PO TCP/IP transmission control protocol / internet protocol temperature Temp Texp expiratory time Theta theta frequency band Theta% theta frequency band percentage Tinj injectate temperature Tinsp inspiratory time CARESCAPE Modular Monitors 2062971-001...
  • Page 527 WLAN wireless local area network oxygen consumption VO2calc calculated oxygen consumption VO2Icalc calculated oxygen consumption index oxygen consumption index Vol; V volume Vol Assist volume assisted VT > 2 ventricular tachycardia with more than two beats 2062971-001 CARESCAPE Modular Monitors...
  • Page 528 Abbreviations year years CARESCAPE Modular Monitors 2062971-001...
  • Page 529 MONITOR BATTERY Monitor battery (65) ● ALARM LIGHT Alarm light (69) ● DISPLAYS Displays (69) ● ACQUISITION MODULES Acquisition modules (70) ● EQUIPMENT SYMBOLS Equipment symbols (81) ● USER INTERFACE SYMBOLS User interface symbols (89) ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 530 Roving between beds (120) ● Adding new units and beds (manual roving) (120) ● LOADING PATIENT INFORMATION Loading patient information from the CARESCAPE Network ● (ADT server) (121) Loading patient data and trend data from the S/5 Network (121) ●...
  • Page 531 ● Audible and visual alarm signals (136) ● Turning off all local alarm indicators (sleep mode) (144) ● Physiological alarms’ activation criteria (130) ● ALARM DEACTIVATION Technical alarms’ deactivation with the pause audio key (139) ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 532 To familiarize yourself with these functions and features, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table. CARESCAPE Modular Monitors 2062971-001...
  • Page 533 Deleting events (431) ● To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 534 QT/QTc measurement limitations (189) ● Starting the QT/QTc measurement (189) ● Impedance respiration To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. CARESCAPE Modular Monitors 2062971-001...
  • Page 535 ● Pulse oximetry (SpO To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 536 ● Non-invasive blood pressure To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 537 ● Invasive pressures To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 538 Skills checklist Temperature To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 539 ● Mixed venous oxygen saturation (SvO To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 540 CAPNOSTAT Mainstream, CapnoFlex LF, and Dual CO2 modules To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 541 ● Patient Spirometry To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 542 ● Entropy To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 543 Skills checklist Neuromuscular transmission To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 544 Starting the AEP measurement (388) ● To familiarize yourself with this parameter and its use with the CARESCAPE modular monitors, study the topics listed as the recommended reading of this User’s Manual. The numbers in brackets refer to the page numbers in the manual. As you proceed, mark your completed tasks in the table.
  • Page 545 Selecting the BIS smoothing rate (397) ● Using the automatic BIS sensor check (398) ● Using the manual BIS sensor check (398) ● HOW TO INTERPRET THE VALUES How to interpret the BIS values (399) ● 2062971-001 CARESCAPE Modular Monitors...
  • Page 546 Skills checklist CARESCAPE Modular Monitors 2062971-001...
  • Page 547 content...
  • Page 548 Asia Headquarters GE Healthcare Finland Oy GE Medical Systems GE Medical Systems Kuortaneenkatu 2 Information Technologies, Inc. Information Technologies Asia; GE (China) Co., Ltd. FI-00510 Helsinki 8200 West Tower Avenue No1 Huatuo Road, Finland Milwaukee, WI 53223 USA Zhangjiang Hi-tech Park Pudong...

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