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Philips IntelliVue MX800 Instructions For Use Manual

Patient monitoring
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In str uct ion s fo r Use
IntelliVue Patient Monitor
R e l e a s e H .0 w it h S o f tw a re R e v is i o n H . 0 x .x x
P a t ie n t M o n i t o r in g


Table of Contents

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  Summary of Contents for Philips IntelliVue MX800

  • Page 1 In str uct ion s fo r Use IntelliVue Patient Monitor MX800 R e l e a s e H .0 w it h S o f tw a re R e v is i o n H . 0 x .x x P a t ie n t M o n i t o r in g...
  • Page 2 Part Number 453564208131 Printed in Germany 07/10 *453564208131*...
  • Page 3: Table Of Contents

    Table of Contents 1 Introduction Introducing the Monitor Devices for Acquiring Measurements Operating and Navigating Operating Modes Understanding Screens Connecting Additional Displays to the Monitor Using the XDS Remote Display Using the Visitor Screen Understanding Profiles Understanding Settings Changing Wave Speeds Freezing Waves Entering Measurements Manually Changing Monitor Settings...
  • Page 4 Quick Admitting a Patient Editing Patient Information Discharging a Patient Transferring Patients Data Upload from an MMS Care Groups 5 ECG, Arrhythmia, ST and QT Monitoring Skin Preparation for Electrode Placement Connecting ECG Cables Selecting the Primary and Secondary ECG Leads Checking Paced Status Understanding the ECG Display Monitoring Paced Patients...
  • Page 5 6 Monitoring Pulse Rate Entering the Setup Pulse Menu System Pulse Source Switching Pulse On and Off Using Pulse Alarms 7 Monitoring Respiration Rate (Resp) Lead Placement for Monitoring Resp Understanding the Resp Display Changing Resp Detection Modes Changing the Size of the Respiration Wave Changing the Speed of the Respiration Wave Using Resp Alarms Changing the Apnea Alarm Delay...
  • Page 6 Calculating Temp Difference 11 Monitoring Invasive Pressure Setting up the Pressure Measurement Zeroing the Pressure Transducer Adjusting the Calibration Factor Displaying a Mean Pressure Value Only Changing the Pressure Wave Scale Optimizing the Waveform Using the Wave Cursor Non-Physiological Artifact Suppression Choosing the Pressure Alarm Source Calibrating Reusable Transducer CPJ840J6 Calculating Cerebral Perfusion...
  • Page 7 Setting up Spirometry 15 Monitoring tcGas Identifying tcGas Module Components Setting the tcGas Sensor Temperature Using the tcGas Site Timer Setting the tcGas Barometric Pressure Remembraning the tcGas Transducer Calibrating the tcGas Transducer Applying the tcGas Transducer Finishing tcGas Monitoring TcGas Corrections 16 Monitoring Intravascular Oxygen Saturation Selecting a Measurement Label...
  • Page 8 20 Trends Viewing Trends Setting Up Trends Documenting Trends Trends Databases Screen Trends 21 Calculations Viewing Calculations Reviewing Calculations Performing Calculations Entering Values for Calculations Documenting Calculations 22 High Resolution Trend Waves Changing the Hi-Res Trend Waves Displayed Hi-Res Trend Wave Scales Hi-Res Trend Waves and OxyCRG Printing Hi-Res Trend Wave Reports Hi-Res Trend Wave Recordings...
  • Page 9 26 Printing Patient Reports Starting Report Printouts Stopping Reports Printouts Setting Up Reports Setting Up Individual Print Jobs Checking Printer Settings Printing a Test Report Switching Printers On Or Off for Reports Dashed Lines on Reports Unavailable Printer: Re-routing Reports Checking Report Status and Printing Manually Printer Status Messages Sample Report Printouts...
  • Page 10 31 Respiratory Loops Viewing Loops Capturing and Deleting Loops Showing/Hiding Loops Changing Loops Display Size Using the Loops Cursor Changing Loops Type Setting Up Source Device Documenting Loops 32 Laboratory Data Viewing Received Data 33 Care and Cleaning General Points Cleaning the Monitor Disinfecting the Monitor Sterilizing the Monitor...
  • Page 11 SO2 Accessories for M1011A Recorder Accessories Battery Accessories 36 Specifications Intended Use Manufacturer's Information Symbols Installation Safety Information Monitor Mounting Precautions Altitude Setting Monitor Safety Specifications EMC And Radio Regulatory Compliance Physical Specifications Environmental Specifications Performance Specifications Interface Specifications Measurement Specifications Safety and Performance Tests 37 Default Settings Appendix Country-Specific Default Settings...
  • Page 13: Introduction

    Introduction These Instructions for Use are for clinical professionals using the IntelliVue MX800 patient monitor. This basic operation section gives you an overview of the monitor and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching a measurement on and off, setting up and adjusting wave speeds, working with profiles).
  • Page 14: Devices For Acquiring Measurements

    1 Introduction With the optional Integrated PC, you have computer functionality directly in the monitor. You can use standard applications (e.g. Web browsers), connect to the hospital network or intranet, and run a second independent display with content from the patient monitor. An IntelliVue X2 or MP5 can be connected to your monitor, where it acts as a multi-measurement module, acquiring measurements for the host monitor.
  • Page 15 1 Introduction Flexible Module Rack (M8048A) The flexible module rack (FMS) lets you use up to eight plug-in physiological measurement modules. The maximum number of specific module types that can be used simultaneously in an FMS is: five pressure modules, four temperature modules, four VueLink or IntelliBridge modules (any combination).
  • Page 16 1 Introduction The connector socket on the front of each module is the same color as the corresponding connector plug on the transducer or patient cable. Press the Setup key on the module's front to display the measurement's setup menu on the monitor screen.
  • Page 17 1 Introduction X1 Connectors and Symbols White ECG/Resp connector Blue SpO connector Red NBP connector Combined pressure (red) and temperature (brown) connector - connect either invasive pressure transducer or temperature probe. You might have a version of the MMS that does not have this connector.
  • Page 18 1 Introduction X2 Overview On/Standby switch Power and battery indicators (see “X2 Controls and Indicators” on page 18) 3.5-inch TFT LCD touchscreen QVGA display Alarm lamps (see “X2 Controls and Indicators” on page 18) Battery eject button Hard keys (see “X2 Controls and Indicators”...
  • Page 19 1 Introduction Main Screen key: closes all open menus/windows and returns to the main screen. SmartKeys key: brings up SmartKeys on the screen. Alarms key: turns alarms On/Off, or pauses them. Silence key Active alarm lamp. Red or yellow, depending on alarm level. Blinks until active alarm is acknowledged.
  • Page 20 1 Introduction MMS Extensions The MMS extensions connect to the X1 and X2 MMS and use the MMS settings and power. Trend data and measurement settings from the measurements in the extensions are stored in the MMS. WARNING • The MMS extensions can only function when they are connected to an MMS. If the MMS is removed during monitoring, the measurements from both the MMS and the extension are lost.
  • Page 21 1 Introduction The optional M3015A Microstream CO extension adds microstream capnography and optionally either pressure or temperature to the MMS. The optional M3015B Microstream CO extension adds microstream capnography, two pressures and a temperature to the MMS. M3015A M3015B Pressure connectors (red) - M3015A optional Temperature connector (brown) - M3015A optional Inlet Microstream connector CO...
  • Page 22: Operating And Navigating

    1 Introduction The cardiac output measurement in the M3014A is deactivated when the extension is used with an X2 MMS, even if the X2 is connected to an external power supply. The cardiac output measurement is only available when the X2 is connected to a host monitor. M3012A Hemodynamic MMS Extension Cardiac Output (orange;...
  • Page 23 1 Introduction Monitor information line Other screen elements network connection indicator alarm status area - shows active alarm messages (documented in Information Center Instructions for Use) bed label status line - shows information messages and prompting you for action patient identification close all open menus and windows and return to main screen enter Main Setup menu patient category...
  • Page 24 1 Introduction Using the Touchscreen Select screen elements by pressing them directly on the monitor's screen. Disabling Touchscreen Operation Main Screen To temporarily disable touchscreen operation of the monitor, press and hold the Main Screen permanent key. A padlock will appear on the permanent key.
  • Page 25 1 Introduction SmartKeys A SmartKey is a configurable graphical key, located at the bottom of the main screen. It gives you fast access to functions. The selection of SmartKeys available on your monitor depends on your monitor configuration and on the options purchased. If you have an integrated PC (iPC) you may also see Smartkeys generated by applications on the iPC.
  • Page 26 1 Introduction access patient reports zero invasive pressure transducer start a delayed recording access pop-up recording keys access Vital Signs recording access Select Waves recording function function set wide automatic alarm limits set narrow automatic alarm limits access wedge procedure window access the Loops window review vital signs trend review graph trend...
  • Page 27 1 Introduction display external device access timers information access ProtocolWatch set standard or EASI lead placement switch CO pump off new lead setup enter data manually start/stop car seat assessment record Histogram Unit Conversion open the window open window Hardkeys A hardkey is a physical key on a monitoring device, such as the zero pressure key on the MMS or a setup key on a module.
  • Page 28 1 Introduction Using the Remote Control The remote control provides you with direct access to five hard keys, a navigation knob and a numeric keypad: Hardkeys Silence - acknowledges all active alarms by switching off audible alarm indicators and lamps. Behavior follows the Silence permanent key configuration.
  • Page 29: Operating Modes

    1 Introduction Using the SmartKeys Key The SmartKeys hard key on the remote control displays a block of SmartKeys on the monitor screen. Nine SmartKeys appear in a 3 by 3 matrix which corresponds to the layout of the numeric pad on the remote control.
  • Page 30 1 Introduction • Monitoring Mode: This is the normal, every day working mode that you use for monitoring patients. You can change elements such as alarm limits, patient category and so forth. When you discharge the patient, these elements return to their default values. Changes can be stored permanently only in Configuration Mode.
  • Page 31: Understanding Screens

    1 Introduction Understanding Screens Your monitor comes with a set of pre-configured Screens, optimized for common monitoring scenarios such as OR adult, or ICU neonatal. A Screen defines the overall selection, size and position of waves, numerics and other elements on the monitor screen when you switch on. You can easily switch between different Screens during monitoring.
  • Page 32: Connecting Additional Displays To The Monitor

    1 Introduction If the monitor is switched off and then on again, modified Screens are erased from the monitor's memory and cannot be recalled. If a modified Screen was the last active Screen when the monitor was Automat. Default switched off, it is retained (unless is configured to Connecting Additional Displays to the Monitor You can connect a second display, showing the same Screen as the main display, to your monitor, for...
  • Page 33: Using The Visitor Screen

    1 Introduction For more details, including limitations and restrictions, refer to the Instructions for Use for the XDS Application. Using the Visitor Screen If a visitor Screen is configured for your monitor, you can use it to clear the screen of all waves and numerics but continue to monitor the patient with active alarms and trend storage at the bedside and Information Center.
  • Page 34: Understanding Settings

    1 Introduction WARNING If you switch to a different profile, the patient category and paced status normally change to the setting specified in the new profile. However some profiles may be set up to leave the patient category and paced status unchanged. Always check the patient category, paced status, and all alarms and settings, when you change profiles.
  • Page 35 1 Introduction Screen Settings, to define the selection and appearance of elements on each individual Screen Measurement settings, to define settings unique to each measurement, for example, high and low alarm limits Monitor settings, including settings that affect more than one measurement or Screen and define general aspects of how the monitor works, for example, alarm volume, reports and recordings, and display brightness.
  • Page 36: Changing Wave Speeds

    1 Introduction Adjusting a Measurement Wave To quickly adjust wave-related measurement settings (such as speed or size), select the measurement wave itself. This displays the measurement wave menu, which has only wave-related measurement settings. Changing Wave Speeds Lowering the wave speed compresses the wave and lets you view a longer time period. Increasing the speed expands the waveform, giving you a more detailed view.
  • Page 37 1 Introduction Freezing All Waves To freeze all waves on the screen, Freeze Waves Select the SmartKey. All realtime waves are replaced with frozen waves. Measuring Frozen Waves To measure a frozen wave, Select the frozen wave. If you are using touch, this automatically positions the vertical cursor. The cursor can be repositioned by touching the required point on the wave, or Using the SpeedPoint or another pointing device or touch: use the right/left arrow keys to move the vertical cursor.
  • Page 38 1 Introduction Label Select Choose a label from the list. The monitor automatically applies the scale, color, etc. settings stored in the Profile for the label you select. You can change scale settings in Monitoring Mode, but color can only be changed in the monitor's Configuration Mode.
  • Page 39 1 Introduction All the currently available measurement devices, for example MMSs, MMS extensions, measurement modules, Gas analyzers, devices connected to a host monitor and manually entered measurements Measurement Selection (marked ), are depicted in the window. De-activated devices are grayed-out (here the Temp measurement on the left) Any measurement labels causing a label conflict are shown in red.
  • Page 40: Entering Measurements Manually

    1 Introduction De- Activate – : to disable the conflicting device. It retains its label for future use but becomes invisible to the monitor, as though it had been unplugged. When the device has been deactivated the question marks under the measurement selection key will be replaced by XXX. Setup <Measurement Label>...
  • Page 41: Changing Monitor Settings

    1 Introduction ABPs ABPd ABPm Format For compound labels, for example , select the field to select whether all values are required or a single value. Save Select When a manually entered value has been configured to display as a numeric on the screen, you can also Enter MeasValues enter a new value for this measurement by selecting the numeric, then selecting Manually entered measurement values are marked with a * on the display, in trends, and so forth.
  • Page 42: Checking Your Monitor Revision

    1 Introduction Store Date, Time Select to change the date and time. If your monitor is connected to an Information Center, the date and time are automatically taken from this. Once it is set, the internal clock retains the setting even when you switch off the monitor. WARNING Changing the date or time will affect the storage of trends and events.
  • Page 43: Disconnecting From Power

    1 Introduction Power On/Power Off Behavior The general rules determining the behavior of the monitor when connected to, or disconnected from power are as follows: • A monitor that was switched on prior to a temporary power loss switches on again when power is restored.
  • Page 44: Networked Monitoring

    1 Introduction Networked Monitoring You can connect your monitor to an Information Center on a network, using one of the optional interfaces: • Standard wired LAN • Wireless LAN • IntelliVue Instrument Telemetry System (IIT). WARNING Do not connect patient monitors to the standard hospital network. Additionally, when an IntelliVue X2 or MP5 is equipped with IIT and declared at the Information Center as a telemetry device, it allows data continuity when paired to a host monitor.
  • Page 45 1 Introduction Main Setup Internal PC Select then Internal PC Switch PC On In the menu, select to start the iPC. Viewing the iPC Desktop on the Monitor Display If the Desktop is not displayed on the monitor display: Select the iPC icon, or Main Setup Internal PC Show PC Window...
  • Page 46: Using The X2 Or Mp5 With A Host Monitor

    1 Introduction • In some situations, shutting down the iPC can take a little time. The monitor will go into Standby mode until the shutdown is complete. By touching the touchscreen, you can bring the monitor back into operating mode. If you do this, the iPC will restart when the shutdown is complete. •...
  • Page 47: Alarms

    Alarms The alarm information here applies to all measurements. Measurement-specific alarm information is discussed in the sections on individual measurements. The monitor has two different types of alarm: patient alarms and INOPs. Patient Alarms Patient Alarms are red and yellow alarms. A red alarm indicates a high priority patient alarm such as a potentially life threatening situation (for example, asystole).
  • Page 48: Visual Alarm Indicators

    2 Alarms The monitor sounds an audible indicator for the highest priority alarm. If more than one alarm condition is active in the same measurement, the monitor announces the most severe. Your monitor may be configured to increase alarm indicator volume automatically during the time when the alarm is not acknowledged.
  • Page 49: Audible Alarm Indicators

    INOP tones • change the alarm sound to suit the different alarm standards valid in different countries. Traditional Audible Alarms (HP/Agilent/Philips/Carenet) • Red alarms and red INOPs: A high pitched sound is repeated once a second.
  • Page 50 2 Alarms • Standard INOPs: an INOP tone is repeated every two seconds. ISO/IEC Standard Audible Alarms • Red alarms and red INOPs: A high pitched tone is repeated five times, followed by a configurable pause. • Two-star yellow alarms and yellow INOPs: A lower pitched tone is repeated three times, followed by a configurable pause.
  • Page 51: Acknowledging Alarms

    2 Alarms The severe INOPs for which this applies are: CUFF NOT DEFLATED (configurable to yellow or red) NBP CUFF OVERPRESS (configurable to yellow or red) !!INSERT BATTERY - X2 (yellow) Power Loss Tone When power is lost - no power is available via the power cable - a buzzer will sound, if so configured. The tone can be silenced by pressing the On/Off power switch.
  • Page 52: Pausing Or Switching Off Alarms

    2 Alarms Alarm Reminder Alarm Reminder is configured on for your monitor, you will get an audible reminder of alarm conditions that remain active after you have acknowledged the alarm. This reminder may take the form of a repetition of the alarm tone for a limited time, or an unlimited repetition of the alarm tone (this is Alarm Reminder the same as a new alarm).
  • Page 53 2 Alarms To Switch Individual Measurement Alarms On or Off Select the measurement numeric to enter its setup menu. Alarms Select to switch between on and off. The alarms off symbol is shown beside the measurement numeric. While Alarms are Paused or Off •...
  • Page 54: Alarm Limits

    2 Alarms Extending the Alarm Pause Time If your monitor has extended alarm pause enabled, you can extend the alarm pause time. Use this to prevent alarms being indicated, for example, while you are washing a patient or carrying out a procedure.
  • Page 55 2 Alarms Measurement labels, with alarms off symbol where appropriate Current alarm limits Graphic view of current yellow and red alarm limits and currently monitored measurement value. indicates the measurement is switched off Show ST Limits • Select to expand the list of ST leads and view the currently set alarm limits. Hide ST Limits Selecting hides the list again.
  • Page 56 2 Alarms Parameter label High red alarm (view only) High yellow alarm field. Select to open a pop-up list of high alarm limits Alarms On/Off key - select to switch between alarms on or off Preview Alarm AutoLimits for a measurement before applying Select to apply wide AutoLimits Select to apply narrow AutoLimits Low yellow alarm field.
  • Page 57 2 Alarms About Automatic Alarm Limits The monitor can automatically set alarm limits suited to your individual patient, using the Automatic Alarm Limits function (AutoLimits). This tells the monitor to adapt the alarm limits of selected measurements to the measured vital signs within a defined safe limit. The monitor calculates safe AutoLimits for each patient based on the measured values from the last 12 seconds.
  • Page 58: Reviewing Alarms

    2 Alarms WARNING Before using Smart Alarm Delays, make sure that you fully understand how the delay is applied and what the consequences are. Documenting Alarm Limits Alarm Limits The alarm limits pop-up keys appear with the and measurement alarm limits windows. Print Limits •...
  • Page 59: Latching Alarms

    2 Alarms When you select an item from the list, you can get additional information about that item. If you select Graphical Trends a high or low limit alarm in the list, the window will open to provide further data. If Event Episode you select an alarm resulting from an event alarm notification, the window for that...
  • Page 60: Testing Alarms

    2 Alarms Alarm Latching Behavior Red & Yellow Measurement Non-latching alarms Visual and audible Visual latching, Alarms latching audible non-latching Alarm has not Alarm condition Alarm tone on. Alarm Alarm tone on. Alarm Alarm tone on. Alarm been still present. lamp on.
  • Page 61: Alarm Recordings

    2 Alarms Alarm Recordings You can set up your monitor so that it automatically triggers alarm recordings at the Information Center, or if configured, to a printer as a realtime report. Main Setup Press the SmartKey. Alarms Main Setup Select from the menu.
  • Page 62 2 Alarms...
  • Page 63: Patient Alarms And Inops

    Patient Alarms and INOPs This chapter lists patient alarms alphabetically, and technical alarms (INOPs) arranged by the source of the INOP and then alphabetically, irrespective of their priority. All alarms and INOPs are listed here; the ones which can appear on your monitor will depend on the model and the individual options. For information on alarms and INOPs from the gas modules refer to your Gas Module Instructions for Use.
  • Page 64 3 Patient Alarms and INOPs Alarm Message From Condition Indication ** awRR LOW , Resp, AGM The airway respiration rate has dropped below numeric flashes and low limit is the low alarm limit. highlighted, yellow alarm lamp, alarm tone ** BIS HIGH The Bispectral Index value has exceeded the numeric flashes and high limit is high alarm limit.
  • Page 65 3 Patient Alarms and INOPs Alarm Message From Condition Indication *** EXTREME BRADY The bradycardia limit has been exceeded. numeric flashes and alarm limit is highlighted, red alarm lamp, alarm tone ** HR LOW The heart rate has fallen below the low alarm numeric flashes and low limit is limit.
  • Page 66 3 Patient Alarms and INOPs Alarm Message From Condition Indication *** <Press Label> LOW PRESS The measured pressure value is below the numeric flashes and low limit is extreme low alarm limit. highlighted, red alarm lamp, alarm s, d, or m after the label indicates whether the tone systolic, diastolic or mean pressure has crossed the limit.
  • Page 67 3 Patient Alarms and INOPs Alarm Message From Condition Indication ** ST-<n> LOW ECG/ST The ST depression in lead <n> is lower than numeric flashes and low alarm limit the limit. is highlighted, yellow alarm lamp, alarm tone * SVT ECG/Arrhythmia A run of supraventricular beats greater than the numeric flashes, yellow alarm lamp,...
  • Page 68: Technical Alarm Messages (Inops)

    3 Patient Alarms and INOPs Alarm Message From Condition Indication ***BRADY/P xxx<yyy Press, SpO The heart rate from the Pulse signal has fallen numeric flashes and alarm limit is ***BRADY xxx < yyy below the bradycardia limit. xxx denotes the highlighted, red alarm lamp, alarm lowest measured value;...
  • Page 69 3 Patient Alarms and INOPs INOP Message, Indication What to do Check Flex Texts Check the names of the monitor menus, for example the labels for screens, profiles, event or trend INOP tone group names, before you resume monitoring. If they are unexpected, there may be a problem with the monitor software.
  • Page 70 3 Patient Alarms and INOPs INOP Message, Indication What to do Meas. DEACTIVATED An X2 or MP5 has been connected to a host monitor (companion mode) and all derived measurements have been deactivated and/or measurements with a label conflict. The measurements can only be reactivated by disconnecting the measurement device from the host monitor.
  • Page 71 3 Patient Alarms and INOPs Battery INOPs INOP Message, Indication What to do Batt 1 MISSING The monitor requires two batteries but can detect only one battery. Insert the missing battery Batt 2 MISSING immediately. INOP tone During this INOP, alarms cannot be paused or switched off.
  • Page 72 3 Patient Alarms and INOPs INOP Message, Indication What to do CHECK BATT TEMP The temperature of one or both batteries is too high. Check that ventilation openings (if applicable) INOP tone are not blocked and monitor is not exposed to heat. Chk MSL Connection Check the MSL connection between X2/MP2 and the battery extension for damage or loose connections.
  • Page 73 3 Patient Alarms and INOPs INOP Message, Indication What to do MMS UNSUPPORTED The Multi-measurement Module is not supported by your monitor. Contact your service personnel. INOP tone MMSExt.Unsupported The MMS extensions not supported by your monitor. Contact your service personnel. INOP tone NO PPV FROM FMS The measurement device does not supply a beat-to-beat arterial pressure value.
  • Page 74 3 Patient Alarms and INOPs INOP Message, Indication What to do CANNOT ANALYZE ST The ST algorithm cannot generate a valid ST value. Possible causes are large variations in the measured ST values for consecutive beats, or ventricular paced beats. Review the ECG signal quality and the ST measurement points.
  • Page 75 3 Patient Alarms and INOPs Pulse INOPs INOP Message, Indication What to do PULSE NO ALARMING Pulse has no alarming because the system pulse is measured by an external device. Select another pulse Numeric is replaced by -?- source to enable pulse alarming. INOP tone Resp INOPs INOP Message, Indication...
  • Page 76 3 Patient Alarms and INOPs INOP Message, Indication What to do NBP DEACTIVATED The NBP measurement label in the measurement device has been deactivated by deactivating the label in the Measurement Selection window. The measurement automatically disappears from the INOP tone display.
  • Page 77 3 Patient Alarms and INOPs INOP Message, Indication What to do <Temp Label> A Temp measurement label has been deactivated, either by unplugging a module, or by deactivating UNPLUGGED the label in the Measurement Selection window. INOP tone The measurement automatically disappears from the display. To switch the measurement on again, either replug the module or reactivate the measurement label in the Measurement Selection window.
  • Page 78 3 Patient Alarms and INOPs INOP Message, Indication What to do <SpO₂ Label> NON- Check the perfusion at measurement site. If necessary, stimulate circulation or change measurement PULSAT. site. If the INOP is due to NBP measurement on the same limb, wait until the NBP measurement is Numeric is replaced by -?- finished.
  • Page 79 3 Patient Alarms and INOPs INOP Message, Indication What to do FAP INOPs See <Press Label> INOPs IC1 / IC2 INOPs See <Press Label> INOPs ICP INOPs See <Press Label> INOPs LAP INOPs See <Press Label> INOPs P / P1 / P2 / P3 / P4 INOPs See <Press Label>...
  • Page 80 3 Patient Alarms and INOPs INOP Message, Indication What to do <Press Label> Perform a zero and check the calibration of the transducer. ZERO+CHECK CAL Numeric is replaced by -?- RAP INOPs See <Press Label> INOPs UAP INOPs See <Press Label> INOPs UVP INOPs See <Press Label>...
  • Page 81 3 Patient Alarms and INOPs INOP Message, Indication What to do CO₂ NO TUBING Either the sample line is disconnected, or an incorrect line is attached. Check the connection. If Numeric is replaced by -?- necessary, connect another sample line (Use only the approved accessories). INOP tone If you silence this INOP, the measurement will be switched off.
  • Page 82 3 Patient Alarms and INOPs INOP Message, Indication What to do <SO₂ Label> EQUIP MALF The SO /SvO Module or Optical Module is faulty. Unplug and replug the Optical Module and SO Numeric is replaced by -?- module. Exchange the modules. If the INOP persists, contact your service personnel. INOP tone <SO₂...
  • Page 83 3 Patient Alarms and INOPs C.O. INOPs INOP Message, Indication What to do C.O. DEACTIVATED The Cardiac Output measurement label in the measurement device has been deactivated by deactivating the label in the Measurement Selection window. The measurement automatically INOP tone disappears from the display.
  • Page 84 3 Patient Alarms and INOPs INOP Message, Indication What to do CCO RECALIBRATE The most recent CCO or CCI calibration was made over 8 hours ago or the arterial pressure Numeric is replaced by -?- measurement used for CCO calculation has been zeroed after the CCO calibration was performed. You should recalibrate CCO or CCI with transpulmonary C.O.
  • Page 85 3 Patient Alarms and INOPs INOP Message, Indication What to do <tcGas Label> EQUIP There is a malfunction in the transducer or module. Connect another transducer. If this INOP persists, MALF contact your service personnel. Numeric is replaced by -?- INOP tone <tcGas Label>...
  • Page 86 The semi-reusable sensor cable connected is unknown or not supported by your software revision. INOP tone Replace it with a Philips-supported sensor cable. BIS CABLE USAGE The semi-reusable sensor cable has exceeded the maximum number of uses. Replace the cable.
  • Page 87 Unsupported sensor connected or sensor type unknown or not supported by your software revision. INOP tone Replace the sensor, using only Philips supported sensors. BIS SENSOR MALFUNC Malfunction in the sensor hardware, most often caused by liquids permeating into the connectors OR INOP tone patient interface cable (PIC) or DSC or BISx may be faulty.
  • Page 88 The VueLink module has not been configured during installation. The installation process should be CONFIG completed by either your biomedical engineering department or the Philips service engineer. INOP tone VueLink INOP abbreviations may differ slightly depending on the device category.
  • Page 89 3 Patient Alarms and INOPs IntelliBridge INOPs INOP Message, Indication What to do DEVICE CHECK CONF. Device identification completed, but communication could not be established due to error. INOP tone IntelliBridge INOP abbreviations may differ slightly depending on the device category. DEVICE CHECK SETUP Device identification completed, but communication could not be established due to timeout.
  • Page 90 3 Patient Alarms and INOPs INOP Message, Indication What to do INVALID LEADSET LEADSET UNPLUGGED The leadset has been unplugged from the telemetry device. NO ECG SOURCE A telemetry device is paired with the monitor but the Information Center is not detecting a valid ECG signal from either of them.
  • Page 91 3 Patient Alarms and INOPs Cableless Measurement Device INOPs INOP Message, Indication What to do cl NBP Batt Empty The remaining battery time of the NBP Pod is below 30 minutes. Change the battery. cl NBP Batt Incomp The battery in use with the NBP Pod is incompatible. Replace it with one approved for use with the NBP Pod.
  • Page 92 3 Patient Alarms and INOPs...
  • Page 93: Managing Patients

    Managing Patients Patient Demographics Use the window and its associated pop-up keys to admit, discharge, and transfer (ADT) patients. All patient demographic and ADT information is shared between the patient monitor and the Information Center, for example, patients admitted to the monitor are automatically admitted to a connected Information Center.
  • Page 94: Quick Admitting A Patient

    4 Managing Patients Middle Name – (if configured to appear): Enter the patient's middle name. Lifetime Id Encounter Id – : Whether these fields appear and how they are labeled can be configured for your hospital. One or both fields may be displayed and the labels may read: Case Id Visit Id , etc.
  • Page 95: Editing Patient Information

    4 Managing Patients Enter the required data (ID fields or last name depending on configuration) with the keyboard or a barcode scanner. Enter Select Confirm In the confirmation window, select to discharge the previous patient (if confirmation is configured). Check that patient category and paced status are correct for the new patient. If the monitor is connected to an Information Center and only the ID field is entered, the patient name is set to - - - at the Information Center.
  • Page 96: Transferring Patients

    4 Managing Patients End Case printed when you select . See the section on AutoReports for information on setting up end case reports. Dischrge Patient – - to discharge the patient without printing any reports. New Patient Check The monitor can be configured to ask you in certain situations: •...
  • Page 97 4 Managing Patients Patient Information Stored in Monitor Stored in MMS and extensions yes, for all MMS and extensions Measurement settings for all measurements measurements (alarm limits, measurement on/off, etc.) yes, for all MMS and extensions most recent 8 hours of Trend data measurements (up to a information, for all MMS and...
  • Page 98 4 Managing Patients Transferring a Centrally-Monitored Patient with X2 or MP5 WARNING Measurements from a MMS extension connected to an X2 are not available when the X2 is running on battery power. They are only available when the X2 is running on external power, either when connected to a host monitor or the external power supply (M8023A).
  • Page 99 4 Managing Patients – wait until the transfer has completed. Connect the X2/MP5 to the new host monitor. The monitor detects a patient mismatch and a Complete Transfer Of This Patient? window will open showing your patient's data and asking Select to complete the transfer.
  • Page 100: Data Upload From An Mms

    4 Managing Patients patient demographics, and, if configured, the measurement settings and trend data stored in the X2/MP5 to the monitor. Verify that the settings for patient category and paced mode are correct. Data Upload from an MMS The Multi-Measurement Module stores eight hours of patient trend data at one-minute resolution. It also stores patient demographic information and the measurement settings (including the ST baseline) and calibration data for the measurements carried out by the MMS and any connected extensions.
  • Page 101 4 Managing Patients the case of asystole. It is important that the patient category is set correctly so the ECG can be analyzed correctly and initial arrhythmia alarm limits set. In the case where an MP5 or X2 with an IntelliVue Instrument Telemetry interface is declared as a "telemetry device"...
  • Page 102 4 Managing Patients Patient demographics Patient category and paced status Same Patient - see “Patient Mismatch - If Both Patient Data Sets Are Correct” on page 102 below. New Patient - see “Patient Mismatch - If Neither Patient Data Set is Correct” on page 102 below. After you resolve the mismatch, the monitor displays a confirmation window that shows the patient that has been selected and where data will be erased, if applicable.
  • Page 103: Care Groups

    4 Managing Patients Patient Information This information is taken from... Patient Category the Multi-Measurement Module, if connected, otherwise the data is taken from the monitor. Date of Birth Height Weight Gender Paced Status Paced status is always set to where there is a mismatch in patient information.
  • Page 104 4 Managing Patients Understanding the Care Group Overview Bar The Care Group monitors' status is shown in symbol form in the Care Group overview bar. Flashing symbols indicate active alarms, symbols that are not flashing indicate alarms that have been acknowledged.
  • Page 105 4 Managing Patients Care Group Symbols (four alternative display possibilities depending on space available) The alarms at this monitor are suspended The monitor is in standby mode The monitor is in Demonstration mode The current monitor Care Group Symbols (used in the Care Group overview My Care Group bar and the window)
  • Page 106 4 Managing Patients My Care Group Use the pop-up keys to navigate through the Care Groups: My Unit lets you view a list of all the Information Centers in your Care Unit. Select an Information Center to see a list of the monitors connected to it. Select any monitor to see the Other Patient window for that bed.
  • Page 107 4 Managing Patients Note that a Screen with an embedded Other Bed screen element cannot be displayed on the D80 Intelligent Display. Changing the Screen may automatically change the bed shown in the other bed window. If you switch to a different Screen, you should check that the correct other bed is displayed. Other Bed Pop-Up Keys Other Patients Select the...
  • Page 108 4 Managing Patients Care Group Alarms Changes in the alarm status of beds in a Care Group are announced visually and audibly at all other beds in the same Care Group. The visual and audible indicators used depend on the monitor and Information Center configuration.
  • Page 109: Ecg, Arrhythmia, St And Qt Monitoring

    ECG, Arrhythmia, ST and QT Monitoring The electrocardiogram (ECG) measures the electrical activity of the heart and displays it on the monitor as a waveform and a numeric. This section also tells you about arrhythmia monitoring (see “About Arrhythmia Monitoring” on page 127), ST monitoring (see “About ST Monitoring” on page 137) and QT monitoring (see “About QT/QTc Interval Monitoring”...
  • Page 110: Selecting The Primary And Secondary Ecg Leads

    CAUTION To protect the monitor from damage during defibrillation, for accurate ECG information and to protect against noise and other interference, use only ECG electrodes and cables specified by Philips. Selecting the Primary and Secondary ECG Leads The monitor uses the primary and secondary lead to compute HR and to analyze and detect cardiac arrhythmias.
  • Page 111: Monitoring Paced Patients

    If the pacer spikes have been configured to have a fixed size, they will be displayed in the background as a dotted line. Pacer spikes configured to have a fixed size Defibrillator synchronization marks: If an HP/Agilent/Philips defibrillator is connected, or the 2nd ECG SyncPuls Sync Out channel is configured to and a sync cable is plugged in, the synchronization marks (vertical lines on the ECG wave) are shown on the ECG wave.
  • Page 112: Changing The Size Of The Ecg Wave

    5 ECG, Arrhythmia, ST and QT Monitoring • the normal QRS complex should be either completely above or below the baseline and it should not be biphasic. For paced patients, the QRS complexes should be at least twice the height of pace pulses.
  • Page 113: Changing The Volume Of The Qrs Tone

    5 ECG, Arrhythmia, ST and QT Monitoring Changing the adjustment factor only changes the visual appearance of the ECG wave on the screen. It does not affect the ECG signal analyzed by the monitor. Comparing the wave size to the 1 mV calibration bar on the ECG wave segment can help you to get an idea of the true ECG signal strength.
  • Page 114: Selecting Positions Of Va And Vb Chest Leads (For 6-Lead Placement)

    5 ECG, Arrhythmia, ST and QT Monitoring usually leads to a wandering or rough baseline. In the operating room, the Filter reduces artifacts and interference from electrosurgical units. Under normal measurement conditions, Filter selecting may suppress the QRS complexes too much and thus interfere with the clinical evaluation of the ECG displayed on the monitor.
  • Page 115: Ecg Lead Fallback

    5 ECG, Arrhythmia, ST and QT Monitoring ECG Leads Monitored If you are using these leads are available: Resp is measured between electrodes: a 3-electrode set I, II, III RA and LL a 5-electrode set I, II, III, aVR, aVL, aVF, V and MCL RA and LL a 6-electrode set I, II, III, aVR, aVL, aVF, Va, Vb...
  • Page 116 5 ECG, Arrhythmia, ST and QT Monitoring Electrode labels Electrode colors AAMI EASI AAMI Brown/Yellow White/Yellow Brown/Green White/Green Brown/Blue White/Brown Brown/Orange White/Black Brown/Violet White/Violet Standard 3-Lead Placement RA placement: directly below the clavicle and near the right shoulder LA placement: directly below the clavicle and near the left shoulder LL placement: on the left lower abdomen...
  • Page 117 5 ECG, Arrhythmia, ST and QT Monitoring Standard 5-Lead Placement RA placement: directly below the clavicle and near the right shoulder LA placement: directly below the clavicle and near the left shoulder RL placement: on the right lower abdomen LL placement: on the left lower abdomen V placement: on the chest, the position depends on your required lead selection 6-Lead Placement...
  • Page 118 5 ECG, Arrhythmia, ST and QT Monitoring Chest Electrode Placement V1 on the fourth intercostal space at the right sternal border V2 on the fourth intercostal space at the left sternal border V3 midway between the V2 and V4 electrode positions V4 on the fifth intercostal space at the left midclavicular line...
  • Page 119 5 ECG, Arrhythmia, ST and QT Monitoring Conventional 12-Lead ECG V1 - V6 In conventional 12-Lead ECG using 10 electrodes, an electrode is placed on the right arm, left arm, right leg, and left leg. Six V- electrodes are placed on the chest. The right leg electrode is the reference electrode.
  • Page 120 5 ECG, Arrhythmia, ST and QT Monitoring Modified 12-Lead ECG V1-V6 Angle of Lewis If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System), place the four limb electrodes close to the shoulders and lower abdomen. The six V electrodes are placed on the chest in the same position as the conventional 12-lead placement.
  • Page 121: Capture 12-Lead

    5 ECG, Arrhythmia, ST and QT Monitoring Capture 12-Lead You can view a 12-Lead ECG on the screen, capture a 12-Lead ECG episode, preview the captured ECG data and then store it and send it to a connected Information Center for analysis. You can also print a 12-Lead report.
  • Page 122 5 ECG, Arrhythmia, ST and QT Monitoring Setting Up the 12-Lead ECG Preview Setup 12 Lead In the window, select the pop-up key to choose settings for filter, gain, etc., if changes are needed. All changes apply to both the display and the printed 12-Lead report. Filter Applies a filter to the waveforms.
  • Page 123: Easi Ecg Lead Placement

    5 ECG, Arrhythmia, ST and QT Monitoring Capture 12-Lead Pop-up Keys Here is a summary of all the pop-up keys available during 12-Lead ECG procedure: Pop-up Keys Selecting this pop-up key lets you Admit Patient Patient Demographics enter the age and gender for the patient in the window, to allow analysis of the 12-Lead ECG.
  • Page 124: Ecg And Arrhythmia Alarm Overview

    5 ECG, Arrhythmia, ST and QT Monitoring EASI Electrode Placement E (V) - on the lower sternum at the level of the fifth intercostal space A (LL) - on the left midaxillary line at the same level as the E electrode S (LA) - on the upper sternum I (RA) - on the right midaxillary line at the same level as the E electrode...
  • Page 125: Using Ecg Alarms

    5 ECG, Arrhythmia, ST and QT Monitoring Cardiotach Alarms Additional Alarms with Basic Additional Alarms with Arrhythmia Option Enhanced Arrhythmia Option ***Asystole ***Ventricular Tachycardia **Afib ***Ventricular Fibrillation/ **Pacer Not Capture **Supraventricular Tach Tachycardia **Pacer Not Pacing **Missed Beat ***Extreme Bradycardia **PVCs/min HIGH (PVC >...
  • Page 126: Ecg Safety Information

    5 ECG, Arrhythmia, ST and QT Monitoring ECG Alarms Off Disabled Alarms Off Be aware that your hospital department may have decided to disable the setting for ECG in the monitor's Configuration Mode. In this case, HR alarms cannot be switched off in Monitoring To activate enter Config and Mode.
  • Page 127: About Arrhythmia Monitoring

    5 ECG, Arrhythmia, ST and QT Monitoring During surgery: Use the appropriate orange electrode ECG safety cable, or lead cable with an orange connector, for measuring ECG in the operating room. These cables have extra circuitry to protect the patient from burns during cautery, and they decrease electrical interference.
  • Page 128: Switching Arrhythmia Analysis On And Off

    5 ECG, Arrhythmia, ST and QT Monitoring • optimizes ECG signal quality. This is important for arrhythmia analysis. The monitor continuously filters the ECG signal to remove baseline wander, muscle artifact, and signal irregularities. Also, if the Patient Paced status is set to Yes, pace pulses are filtered out to avoid processing them as QRS beats.
  • Page 129 5 ECG, Arrhythmia, ST and QT Monitoring To prevent detection of P-waves or baseline noises as QRS complexes, the minimum detection level for QRS complexes is set at 0.15 mV, according to AAMI-EC 13 specifications. Adjusting the ECG wave size on the monitor display (gain adjustment) does not affect the ECG signal which is used for arrhythmia analysis.
  • Page 130: Understanding The Arrhythmia Display

    5 ECG, Arrhythmia, ST and QT Monitoring Understanding the Arrhythmia Display Your monitor screen may look slightly different from the illustration. Beat label Pace pulse marks Rhythm status message PVC Numeric HR Numeric Ectopic status message Delayed arrhythmia wave Viewing Arrhythmia Waves Setup Arrhythmia Annotate Arrhy To review arrhythmia beat labels, in the...
  • Page 131 5 ECG, Arrhythmia, ST and QT Monitoring • Rhythm Status Messages -- to indicate the patient's rhythm. • Ectopic Status Messages -- to indicate the presence of ectopic beats. These status messages are shown on the right hand side of the primary ECG wave. They are updated every second, with the exception of the Sinus and Supraventricular (SV) rhythm messages.
  • Page 132: Arrhythmia Relearning

    5 ECG, Arrhythmia, ST and QT Monitoring Ectopic Status Message Explanation B or E (No message displayed) No ectopic activity within the last minute Run PVCs More than 2 consecutive PVCs within the last minute Pair PVCs Pair PVCs within the last minute Pacer Not Capt Pause with pace pulse (paced patient only) within the last B, E...
  • Page 133: Arrhythmia Alarms

    5 ECG, Arrhythmia, ST and QT Monitoring Automatic Arrhythmia Relearn Arrhythmia relearning is initiated automatically whenever: • ECG monitoring is switched on • The ECG Lead or Lead Label of the primary/secondary lead is changed manually, or when fallback occurs •...
  • Page 134 5 ECG, Arrhythmia, ST and QT Monitoring Yellow Arrhythmia Alarms Yellow arrhythmia alarms are short yellow alarms specific to arrhythmia-related patient conditions. Depending on your monitor and Information Center configuration, they may be shown with one or two stars. The heart rate alarms (High HR and Low HR) can be configured as short yellow or standard yellow alarms.
  • Page 135 5 ECG, Arrhythmia, ST and QT Monitoring • if a more serious alarm condition is active in the same chain • if a timeout period is in effect for a particular alarm • if a timeout period is in effect for a higher alarm in that chain. See “Arrhythmia Alarm Chaining”...
  • Page 136 5 ECG, Arrhythmia, ST and QT Monitoring Arrhythmia Alarm Chaining When arrhythmia analysis is switched on, multiple alarm conditions may be present. Announcing all of the detected alarm conditions would be confusing, and might hide a more serious condition. For this reason, arrhythmia alarms are prioritized in three alarm "chains": PVC Alarms;...
  • Page 137: About St Monitoring

    5 ECG, Arrhythmia, ST and QT Monitoring – If there is an active Vent Bigeminy alarm, a PVCs > xx/min will not be triggered because it is lower on the same chain. However, a high HR alarm will become active because it is on a different chain.
  • Page 138: Switching St On And Off

    5 ECG, Arrhythmia, ST and QT Monitoring WARNING Some clinical conditions may make it difficult to achieve reliable ST monitoring, for example: • if you are unable to get a lead that is not noisy • if arrhythmias such as atrial fib/flutter are present, which may cause an irregular baseline •...
  • Page 139: Understanding The St Display

    5 ECG, Arrhythmia, ST and QT Monitoring Understanding the ST Display Your monitor screen may be configured to look slightly different from the illustrations. ST numerics Current HR alarm limits Current heart rate ST Numerics Up to 12 ST numerics plus the ST index can be displayed on the monitor screen. They can be configured to show beside the measurement numerics, beside the ECG wave, or beside the ST snippet.
  • Page 140: Updating St Baseline Snippets

    5 ECG, Arrhythmia, ST and QT Monitoring ST label and numeric Baseline ST numeric Difference between current values and baseline values 1 mV calibration bar Current snippet ST baseline Timestamp of most recently stored baseline snippet Updating ST Baseline Snippets ST analysis requires valid samples to measure and store a snippet.
  • Page 141: About The St Measurement Points

    5 ECG, Arrhythmia, ST and QT Monitoring About the ST Measurement Points The ST value for each beat complex is the vertical difference between the ISO point and the ST point, as shown in the diagram below. The isoelectric (ISO) point provides the baseline, the ST point is at the midpoint of the ST segment.
  • Page 142 5 ECG, Arrhythmia, ST and QT Monitoring Select Point Use the pop-up key to scroll through the points and activate the point you need to adjust, then use the left and right arrow keys to move the measurement point. Each point is highlighted while active.
  • Page 143: St Alarms

    5 ECG, Arrhythmia, ST and QT Monitoring To position the ST-point (3) relative to the J-point: J+60 J+80 J Point select either . Select and use the arrow keys to move the J-Point and position the ST-point at the midpoint of the ST segment. To position the ST-point directly: ST Point select...
  • Page 144: Viewing St Maps

    5 ECG, Arrhythmia, ST and QT Monitoring Viewing ST Maps The monitor can derive a multi-axis portrait (map) from the ST analysis to help you detect changes in ST values. It displays two planes obtained from a multilead ECG in a multi-axis diagram, where each axis represents a lead.
  • Page 145 5 ECG, Arrhythmia, ST and QT Monitoring If a lead is in INOP (the value is being measured but is invalid or unavailable because, for example, the corresponding ECG electrode is off), the area formed by the remaining ST leads is left open. If there is insufficient information (for example, there are less than three chest leads) for a second ST map to be displayed, the currently available ST values are displayed in place of the second ST map.
  • Page 146 5 ECG, Arrhythmia, ST and QT Monitoring In this diagram, V4 was either temporarily switched off, or in INOP, for around 30 seconds. No data was recorded. Consequently, the affected maps are not closed. Viewing an ST Map To display an ST map, Main Setup ST Map •...
  • Page 147: About Qt/Qtc Interval Monitoring

    5 ECG, Arrhythmia, ST and QT Monitoring Changing the Trending Interval To determine how frequently the monitor displays a trended sample, Select Interval In Trend view, select Select the required interval from the menu. The interval ranges between 12 seconds to 30 minutes. Printing an ST Map Report To print the most recently viewed (current or trend) window, Main Setup...
  • Page 148 5 ECG, Arrhythmia, ST and QT Monitoring Because of the different algorithm approaches, a QT/QTc measurement from a diagnostic 12-lead program may differ from the realtime measurement on the monitor. Where Can I Find More Information? See the Application Note on QT/QTc Interval Monitoring and the QT Interval Monitoring Quick Guide supplied on your documentation DVD for detailed information on the QT algorithm and performance.
  • Page 149 5 ECG, Arrhythmia, ST and QT Monitoring • Single-Lead mode - a single lead selected from all available leads (except the augmented leads) will be used for QT measurement. QT measurement will stop if the selected lead becomes unavailable. To select the mode, Setup QT Analysis Select the QT numeric to enter the window.
  • Page 150: Qt Alarms

    5 ECG, Arrhythmia, ST and QT Monitoring To set the baseline, Set Baseline • Select and set the value. If no baseline has been set for this patient, the first five minute value after the start of monitoring is automatically set as baseline. If you set a new baseline the previous baseline is discarded. As the ΔQTc alarm is based on the difference between the baseline and the current value, setting an inappropriate new baseline may prevent a ΔQTc alarm from being generated.
  • Page 151: Switching Qt Monitoring On And Off

    5 ECG, Arrhythmia, ST and QT Monitoring Additional Message Cause of Invalid QT Measurement End of T not Detected End of the T-Wave cannot be accurately detected QT out of Range QT measurement is outside the specified range of valid QT values (200-800 msec) QTc out of Range QTc measurement is outside the specified range of valid QTc values...
  • Page 152 5 ECG, Arrhythmia, ST and QT Monitoring...
  • Page 153: Monitoring Pulse Rate

    Monitoring Pulse Rate The pulse numeric counts the arterial pulsations that result from the mechanical activity of the heart in beats per minute (bpm). You can display a pulse from any measured SpO signal (pleth wave), or any arterial pressure (P, ABP, ART, Ao, PAP, UAP, FAP, BAP: see the pressure section for an explanation of the pressure labels).
  • Page 154: Switching Pulse On And Off

    6 Monitoring Pulse Rate Switching Pulse On and Off Setup Pulse To switch a particular pulse numeric on or off, enter the menu via the measurement setup menu or wave menu of the pulse source. For example, to switch an SpO pulse numeric on or off, Setup Pulse Pulse...
  • Page 155 6 Monitoring Pulse Rate WARNING Selecting Pulse as the active alarm source for HR/Pulse switches off the arrhythmia alarms listed in the section “ECG and Arrhythmia Alarm Overview” on page 124, including Asystole, Vfib and Vtach ECG/ARRH ALARM OFF alarms, and the heart rate alarms. This is indicated by the message (unless this has been configured off for your monitor), and the crossed-out alarm symbol beside the ECG heart ECG/ARRH ALARM OFF...
  • Page 156 6 Monitoring Pulse Rate...
  • Page 157: Monitoring Respiration Rate (Resp)

    Monitoring Respiration Rate (Resp) For the respiratory measurement (Resp), the monitor measures the thoracic impedance between two ECG electrodes on the patient's chest. Changes in the impedance due to thoracic movement produce the Resp waveform on the monitor screen. The monitor counts the waveform cycles to calculate the respiration rate (RR).
  • Page 158: Understanding The Resp Display

    7 Monitoring Respiration Rate (Resp) Lateral Chest Expansion Some patients, especially neonates, expand their chests laterally. In these cases it is best to place the two respiratory electrodes in the right midaxillary and left lateral chest areas at the patient's maximum point of breathing movement to optimize the respiratory wave.
  • Page 159: Changing The Size Of The Respiration Wave

    7 Monitoring Respiration Rate (Resp) • the detection level (a dotted line) is not displayed on the waveform, • the algorithm expects a heart rate and therefore needs at least 3 electrodes attached to the patient. If you are monitoring respiration with only two electrodes, the detection algorithm becomes less sensitive which may result in reduced breath detection performance.
  • Page 160: Changing The Speed Of The Respiration Wave

    7 Monitoring Respiration Rate (Resp) Changing the Speed of the Respiration Wave Resp waveforms are usually viewed at a slower speed than other waveforms. For this reason, the Resp measurement has its own speed control and is not affected by the wave speed settings of the other measurements.
  • Page 161 7 Monitoring Respiration Rate (Resp) To monitor respiration, use only the non-OR ECG accessories listed in the Resp section of the accessories chapter. You cannot measure respiration if you are using an orange OR ECG cable set. This is because of the higher internal impedance of the OR cable set, required for use if electrosurgery is being performed.
  • Page 162 7 Monitoring Respiration Rate (Resp)
  • Page 163: Monitoring Spo2

    Monitoring SpO2 Philips pulse oximetry uses a motion-tolerant signal processing algorithm, based on Fourier artifact suppression technology (FAST). It provides four measurements: • Oxygen saturation of arterial blood (SpO ) - percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin (functional arterial oxygen saturation).
  • Page 164: Connecting Spo2 Cables

    Connecting SpO2 Cables Connect the sensor cable to the color-coded socket on the measurement device (MMS or module). You can connect some Philips sensors directly to the measurement device. For other sensors, use the corresponding adapter cable. CAUTION Extension cables: Do not use more than one extension cable (M1941A).
  • Page 165: Measuring Spo2

    8 Monitoring SpO2 Measuring SpO2 Select the correct patient category setting (adult/pediatric and neonatal), as this is used to optimize the calculation of the SpO and pulse numerics. During measurement, ensure that the application site: – has a pulsatile flow, ideally with a perfusion indicator value above 1.0. –...
  • Page 166: Assessing A Suspicious Spo2 Reading

    8 Monitoring SpO2 Assessing a Suspicious SpO2 Reading Traditionally, pulse rate from SpO was compared with heart rate from ECG to confirm the validity of the SpO reading. With newer algorithms, such as FAST-SpO , this is no longer a valid criteria because the correct calculation of SpO is not directly linked to the correct detection of each pulse.
  • Page 167 8 Monitoring SpO2 CAUTION If you measure SpO on a limb that has an inflated noninvasive blood pressure cuff, a non-pulsatile INOP can occur. If the monitor is configured to suppress this alarm there may be a delay of up to 60 seconds in indicating a critical status, such as sudden pulse loss or hypoxia.
  • Page 168 8 Monitoring SpO2 Examples In the examples, the SpO low alarm limit is set to 90%, and the Smart Alarm Delay is configured on. The measured SpO signal is represented by the dotted curve. The vertical axis (V) shows the change in the SpO value and the horizontal axis (T) shows the time.
  • Page 169: Pleth Wave

    8 Monitoring SpO2 Adjusting the Alarm Limits Setup SpO₂ In the menu: High Limit • Select then choose the high alarm limit. Low Limit • Select then choose the low alarm limit. WARNING High oxygen levels may predispose a premature infant to retrolental fibroplasia. If this is a consideration do NOT set the high alarm limit to 100%, which is equivalent to switching the alarm off.
  • Page 170: Setting Spo2/Pleth As Pulse Source

    8 Monitoring SpO2 When a reference value has been set, the perfusion change indicator is displayed next to the perfusion numeric. Setting SpO2/Pleth as Pulse Source Setup SpO₂ Pulse (SpO₂) Setup Pulse In the menu, select to enter the menu. Setup Pulse System Pulse In the...
  • Page 171: Monitoring Nbp

    Monitoring NBP This monitor uses the oscillometric method for measuring NBP. In adult and pediatric mode, the blood pressure measurements determined with this device comply with the American National Standard for Electronic or Automated Sphygmomanometers (ANSI/AAMI SP10-1992) in relation to mean error and standard deviation, when compared to intra-arterial or auscultatory measurements (depending on the configuration) in a representative patient population.
  • Page 172: Measurement Modes

    9 Monitoring NBP Unattended measurement: Use clinical judgement to decide whether to perform frequent unattended blood pressure measurements in cases of severe blood clotting disorders because of the risk of hematoma in the limb fitted with the cuff. CAUTION If you spill liquid onto the equipment or accessories, particularly if there is a chance that it can get inside the tubing or the measurement device, contact your service personnel.
  • Page 173: Preparing To Measure Nbp

    Plug the air tubing into the red NBP connector. Avoid compression or restriction of pressure tubes. Air must pass unrestricted through the tubing. Make sure that you are using a Philips-approved correct sized cuff and that the bladder inside the cover is not folded or twisted.
  • Page 174: Starting And Stopping Measurements

    9 Monitoring NBP Understanding the NBP Numerics Alarm source Measurement Mode Timestamp/Timer Mean pressure Diastolic Systolic Alarm limits Depending on the NBP numeric size, not all elements may be visible. Your monitor may be configured to display only the systolic and diastolic values. The measured NBP value, together with the corresponding pulse rate if this is switched on, will be displayed for one hour.
  • Page 175 9 Monitoring NBP Action to be performed NBP Setup menu SmartKeys MMS hardkey Start/Stop Start/Stop Start manual measurement Start Auto series Start/ Stop Start NBP NBP STAT STAT (for MMS Start STAT measurement without Pressure/ Temp measurement) NBP STAT Start STAT Start/Stop Start/Stop Stop Manual measurements...
  • Page 176: Enabling Automatic Mode And Setting Repetition Time

    9 Monitoring NBP CAUTION Use clinical judgment to decide whether to perform repeated series of STAT measurements because of the risk of purpura, ischemia and neuropathy in the limb with the cuff. Enabling Automatic Mode and Setting Repetition Time Setup NBP Mode Auto In the...
  • Page 177: Switching Pulse From Nbp On/Off

    9 Monitoring NBP Menu option Pressure value monitored Sys. systolic Dia. diastolic Mean mean Sys & Dia systolic and diastolic in parallel Dia & Mean diastolic and mean in parallel Sys & Mean systolic and mean in parallel Sys&Dia&Mean all three pressures in parallel Mean Sys.
  • Page 178 9 Monitoring NBP...
  • Page 179: Monitoring Temperature

    Monitoring Temperature WARNING Measurements from an MMS extension connected to an X2 are not available when the X2 is running on its own battery power. They are only available when the X2 is powered by external power: when connected to a host monitor, to the external power supply (M8023A) or to the Battery Extension (865297).
  • Page 180: Calculating Temp Difference

    10 Monitoring Temperature Select the appropriate label from the list. Temp Trect non-specific temperature label rectal temperature Tart Tskin arterial temperature skin temperature Tcore Tven core temperature venous temperature Tesoph Tnaso esophageal temperature nasopharyngeal temperature Extended Temperature Label Set Label Set Full The following additional labels are available if is set to...
  • Page 181: Monitoring Invasive Pressure

    Monitoring Invasive Pressure WARNING Measurements from an MMS extension connected to an X2 are not available when the X2 is running on its own battery power. They are only available when the X2 is powered by external power: when connected to a host monitor, to the external power supply (M8023A) or to the Battery Extension (865297).
  • Page 182 11 Monitoring Invasive Pressure Position the transducer so that it is level with the heart, approximately at the level of the midaxillary line. WARNING If measuring intracranial pressure (ICP, IC1 or IC2) with a sitting patient, level the transducer with the top of the patient's ear.
  • Page 183: Zeroing The Pressure Transducer

    11 Monitoring Invasive Pressure Zeroing the Pressure Transducer To avoid inaccurate pressure readings, the monitor requires a valid zero. Zero the transducer in accordance with your hospital policy. You must perform a zero: • when you use a new transducer or tubing •...
  • Page 184 11 Monitoring Invasive Pressure <Press Label> zero done at <date and time> When you see the message on the status line, close the stopcock to atmospheric pressure, and open the stopcock to the patient. CAUTION When using high frequency ventilation, ensure that the tubing from the ventilator does not touch the arterial line, or connect with it indirectly, while zeroing the pressure.
  • Page 185: Adjusting The Calibration Factor

    11 Monitoring Invasive Pressure Message Corrective Action unable to zero - no Make sure that the transducer is connected and try again. If this fails, transducer exchange the adapter cable and try again. If this fails, exchange the transducer. unable to zero - Make sure that the transducer is vented to air, not to the patient, and try pulsatile pressure again.
  • Page 186: Using The Wave Cursor

    11 Monitoring Invasive Pressure Using the Wave Cursor When the pressure wave is selected, you can display a cursor in the wave. It appears as a white horizontal line in the wave. Using the pop-up keys you can move the cursor up or down to the required position and store the corresponding value.
  • Page 187: Calibrating Reusable Transducer Cpj840J6

    11 Monitoring Invasive Pressure Menu option Pressure value monitored Sys & Dia systolic and diastolic in parallel Dia & Mean diastolic and mean in parallel Sys & Mean systolic and mean in parallel Sys&Dia&Mean all three pressures in parallel High Limit Low Limit Select and set the for the pressure(s) you have selected.
  • Page 188 11 Monitoring Invasive Pressure • approximately 25cm of tubing. Making the Pressure Calibration WARNING Never perform the invasive pressure calibration while a patient is being monitored. Zero the transducer. Connect the syringe and manometer. a. Attach the tubing to the manometer. b.
  • Page 189: Calculating Cerebral Perfusion

    11 Monitoring Invasive Pressure Reconnect the patient and start measuring again. Troubleshooting the Pressure Calibration The status line lists the probable cause of an unsuccessful calibration. Message Corrective Action unable to calibrate - equipment Contact your service department. The pressure hardware is malfunction faulty.
  • Page 190: Measuring Pulmonary Artery Wedge Pressure

    11 Monitoring Invasive Pressure – during ventilation with tidal volumes lower than 8 ml/kg – for patients with acute right ventricular dysfunction ("cor pulmonale"). • The PPV measurement has been validated only for adult patients To select an arterial pressure as PPV source: Main Setup Measurements In the...
  • Page 191: Editing The Wedge

    11 Monitoring Invasive Pressure Refernce Wave 1 Refernce Wave 2 Use the pop-up keys to select any ECG or respiratory wave as reference waves. Change Speed Select if you want to change the speed of the displayed wave. The speed can also be changed in the screen for editing the wedge.
  • Page 192: Identifying The Pressure Analog Output Connector

    11 Monitoring Invasive Pressure Identifying the Pressure Analog Output Connector Analog output (module M1006B, option C01 only)
  • Page 193: Monitoring Cardiac Output

    Monitoring Cardiac Output The Cardiac Output (C.O.) measurement invasively measures cardiac output and other hemodynamic parameters using a technique called thermodilution. This can be used to determine the flow rate of a system by introducing a cold solution into the system and measuring the resulting drop in temperature at a downstream site.
  • Page 194: Using The C.o.procedure Window

    12 Monitoring Cardiac Output PiCCO Method Right Heart Thermodilution (Transpulmonary Measured and Calculated Hemodynamic Thermodilution) Parameters and Indexes Main HemoCalc Main HemoCalc Continuous? Continuous? Screen Window Screen Window Blood Temperature (Tblood) C.O./C.I.: Cardiac Output CCO/CCI: Continuous Cardiac Output Y (in the Not available C.O.
  • Page 195: Accessing The Setup C.o. And Setup Cco Menus

    12 Monitoring Cardiac Output Average - column of averaged values Unit column Continuously measured numeric Prompt message field Thermodilution curve of current trial Curve alert message field Current trial number Setup information Trial numbers for the trial curves 10 Trial curves 11 Results table of current trial 12 Trial curve scale •...
  • Page 196: Entering The Hemocalc Window

    12 Monitoring Cardiac Output Setup CCO CCO/CCI settings can be changed in the menu. To access this menu, • select any of the continuously measured hemodynamic numerics (CCO, CCI.) on the screen. Entering the HemoCalc Window Hemo Calc Hemo Calculations From the procedure window, select the pop-up key to open the window.
  • Page 197 12 Monitoring Cardiac Output Pulse Pressure Variation (PPV) is calculated from beat-to-beat arterial pressure values. Pulse pressure is the difference between the systolic and the diastolic pressure values for a single beat. Pulse pressure variation is defined as the maximal pressure less the minimum pressure divided by the average of these two pressures.
  • Page 198 12 Monitoring Cardiac Output Setting Up the PiCCO C.O. Measurement C.O. Module C.O. Interface Cable PULSION Pressure Transducer Press Module Pressure Adapter Cable Thermistor Connection Cable Thermistor Connection PULSION Arterial Catheter CVP Line 10 Injectate Temperature Probe Housing 11 Injectate Syringe 12 Injectate Temperature Probe 13 Remote Switch Set up the arterial line using the arterial catheter (transpulmonary catheter) and the transducer kit...
  • Page 199 12 Monitoring Cardiac Output If you are measuring CCO, set up the pressure measurement now. The CCO measurement requires a minimally dampened invasive pressure setup. You must ensure that there are no air bubbles in the pressure line or dome and use only specified accessories. Check that the correct measurement method is selected.
  • Page 200 12 Monitoring Cardiac Output Editing PiCCO C.O. Measurements It is important to identify and reject erroneous trials, as the monitor uses all the measurement trial values you do not reject to calculate the averaged cardiac output. Review the trials. Irregular trials or trials marked with a "?" should be reviewed carefully. Consider the similarity of the values and the shape of the C.O.
  • Page 201: Measuring C.o. Using The Right Heart Thermodilution Method

    12 Monitoring Cardiac Output For a trial to be eligible for calibration, the pressure signal must be continuously available and undisturbed starting 30 seconds before the first C.O. measurement of the series. Do not zero the pressure measurement, change the pressure label, or disturb the pressure signal in any other way during this time.
  • Page 202 12 Monitoring Cardiac Output Setting up RH C.O. Measurements C.O. Module C.O. Interface Cable Remote Start Switch Thermistor Connector Thermistor Connection Cable PA Catheter Injectate Temperature Probe Housing Injectate Syringe Injectate Temperature Probe Set up the PA line using a PA catheter. Attach the injectate temperature probe housing to the PA line.
  • Page 203 12 Monitoring Cardiac Output Ice-Bath Setup for RH Thermodilution C.O. Measurements If you are using the flow-through method illustrated above, the injectate temperature is measured at the time of injection by the temperature probe in the injectate temperature probe housing. If you are using the ice-bath setup, the injectate temperature probe and the injectate are both placed in an ice-bath and the probe measures the temperature of the contents of the ice bucket.
  • Page 204: Documenting C.o. Measurements

    12 Monitoring Cardiac Output Documenting C.O. Measurements You can document C.O. measurements on the default printer or recorder. Print/ Record. In the procedure window, select the pop-up key From the pop-up list, choose: Print Results – to print the contents of the procedure window Record Results –...
  • Page 205: C.o./Cco Curve Alert Messages

    12 Monitoring Cardiac Output Cold Injectate Room Temperature Injectate Patient Weight ETVI < 10 ETVI ≥ 10 ETVI < 10 ETVI ≥ 10 < 3 kg 2 ml 2 ml 3 ml Use cold injectate < 10 kg 2 ml 3 ml 3 ml <...
  • Page 206 12 Monitoring Cardiac Output C.O./CCO Curve Alert Possible Causes Messages Tinj off scale The Tinjectate is out of the range -1°C and 30°C. Cool down or heat up the injectate or change the injectate solution and repeat the measurement. Noisy baseline A blood temperature baseline drift that could not be compensated was detected during the C.O.
  • Page 207: C.o./Cco Prompt Messages

    12 Monitoring Cardiac Output C.O./CCO Curve Alert Possible Causes Messages Check Injectate Temperature The recorded Tinj signal is uncharacteristic for the M1646 Probe Type injectate temperature probe. An incorrect probe type may have been used. Unsteady baseline There is a noisy baseline, and thermal baseline drift. Multiple peaks Caused by faulty injection technique.
  • Page 208: C.o./Cco Safety Information

    12 Monitoring Cardiac Output C.O./CCO Warning Messages Possible Causes Next measurement erases older Six curves are stored, this is the maximum possible. If curve another measurement is stored, the oldest thermodilution curve will be erased. Previous C.O. setup data replaced A C.O.
  • Page 209 12 Monitoring Cardiac Output CAUTION During the cardiac output measurement procedure the blood temperature alarms are inactive. This is indicated by a crossed-out alarm symbol next to the temperature numeric. Making alarms inactive during this procedure prevents false alarms. The alarms are automatically reactivated when you have completed the measurement procedure.
  • Page 210 12 Monitoring Cardiac Output...
  • Page 211: Monitoring Carbon Dioxide

    Sidestream measurement takes a sample of the respiratory gas with a constant sample flow from the patient's airway and analyzes it with a remote CO sensor built into the measurement system. Philips offers the sidestream CO measurement in the M3014A Capnography Extension or the X2 with the optional CO...
  • Page 212: Measurement Principles

    13 Monitoring Carbon Dioxide Low etCO2 values: Leakages in the breathing system or sampling system may cause the displayed etCO values to be significantly too low. Always connect all components securely and check for leaks according to standard clinical procedures. Displacement of the nasal or combined nasal oral cannulas can cause lower than actual etCO readings.
  • Page 213 5% for every 1000m difference. CAUTION Use the CO measurement with Philips approved accessories only. Refer to the instructions for use provided with the accessory. Preparing to Measure Mainstream CO2 You must perform a zero as described in this procedure each time you use a new airway adapter.
  • Page 214 13 Monitoring Carbon Dioxide CO₂ calibration done at <date and time> – When you see the message on the status line, the zero calibration is finished and you can begin monitoring. Install the airway adapter at the proximal end of the circuit between the elbow and the ventilator Y- section.
  • Page 215 13 Monitoring Carbon Dioxide – expose the sensor to room air and keep it away from all sources of CO including the ventilator, the patient's breath and your own. Start Zero Cal – in the setup menu for the CO , select zero done at <date and time>...
  • Page 216: Measuring Mainstream Co2 Using M3016A

    13 Monitoring Carbon Dioxide CAUTION Always disconnect the cannula, airway adapter or sample line from the sensor when not in use. Using the Sidestream Sensor Holder The holder delivered with the sensor can be used to clamp the sensor onto an IV pole or a shelf. Push the sensor into the holder until it clicks into position.
  • Page 217 13 Monitoring Carbon Dioxide Preparing to Measure Mainstream CO2 Attach the transducer connector to the CO connector on the M3016A extension. Wait 20 minutes, allowing the transducer to reach its operating temperature and a stable thermal condition. Perform an accuracy check and then, if necessary, calibrate the transducer. Checking Transducer Accuracy WARNING Check transducer accuracy at least once a week or if you doubt the CO...
  • Page 218: Measuring Microstream Co2 Using M3015A/B

    13 Monitoring Carbon Dioxide CO₂ SENS.WARMUP message until the transducer reaches operating temperature. Wait until this disappears before starting the measurement. To remove the transducer from the airway adapter, open the latch and pull out the airway adapter. WARNING To prevent stress on the endotracheal tube, support the transducer and airway adapter. To avoid infection, use only sterilized airway adapters.
  • Page 219 13 Monitoring Carbon Dioxide Preparing to Measure Microstream CO2 Use appropriate accessories for: • the patient type (adult, pediatric or neonatal), • the ventilation situation (including humidification) • the duration - short term use, up to 24 hours (typically OR), or long term use (typically ICU). All accessories are for single patient use only.
  • Page 220: Setting Up All Co2 Measurements

    13 Monitoring Carbon Dioxide Removing Exhaust Gases from the System WARNING Anesthetics: When using the Microstream CO measurement on patients who are receiving or have recently received anesthetics, connect the outlet to a scavenging system, or to the anesthesia machine/ ventilator, to avoid exposing medical staff to anesthetics.
  • Page 221 13 Monitoring Carbon Dioxide Correction Altitude Altitude is set during installation. The monitor automatically applies an (M3014A only) appropriate correction. Setup CO₂ Oxy. Corr In the menu, select and select a value between 20% and (M3014A only) 100%, the default value is 20%. If you are not measuring the expired O estimate it by subtracting 5% from the inspired O then select the nearest value from the list.
  • Page 222 13 Monitoring Carbon Dioxide Setup awRR Apnea Time menu, select Choose the apnea alarm delay time. WARNING Safety and effectiveness of the respiration measurement method in the detection of apnea, particularly the apnea of prematurity and apnea of infancy, has not been established. Prolonged delay: The selected apnea alarm delay may be prolonged by up to 17 seconds, if an apnea occurs during the automatic zero process.
  • Page 223: Monitoring Airway Flow, Volume And Pressure

    Monitoring Airway Flow, Volume and Pressure The M1014A Spirometry Module is designed to be used in combination with Philips-branded airway flow sensors and combined CO /airway flow sensors. It produces a real time wave for flow, volume and pressure of respiratory gases together with numerics for analysis of ventilatory mechanics.
  • Page 224: Attaching The Flow Sensor

    Attaching the Flow Sensor CAUTION Use the M1014A Spirometry Module with Philips approved accessories only. Refer to the instructions for use provided with the accessory. Select the appropriate flow sensor. Make sure that you are using the correct sensor for the respective patient category.
  • Page 225 14 Monitoring Airway Flow, Volume and Pressure If you are using a combined CO /Flow sensor, connect it to the CO sensor head first. The airway adapter clicks into place when seated correctly. Click the connector into place in the flow sensor receptacle on the monitor before connecting to the breathing circuit.
  • Page 226: Zero Calibration

    14 Monitoring Airway Flow, Volume and Pressure • Periodically check the flow sensor and tubing for excessive moisture or secretion build up. Perform a purge cycle if droplets are visible within the sensor or tubing. Repeat if necessary. If purging does not remove the droplets, replace the sensor. •...
  • Page 227: Automatic Purging

    14 Monitoring Airway Flow, Volume and Pressure Automatic Purging A double lumen connecting line (tubing) connects the flow sensors to the patient monitor. The M1014A Spirometry Module includes an automatic and manual purge feature which provides a flush of room air to keep the sensor tubing free from water condensation and patient secretions. This feature is available for the adult, pediatric, and neonatal modes.
  • Page 228: Setting Up Spirometry

    14 Monitoring Airway Flow, Volume and Pressure NOTE If you unintentionally switch the gas compensation to the incorrect setting, the accuracy of the measured flow and volume values may be significantly reduced. The tables below show examples of incorrect gas compensation settings and the resulting inaccuracies: Agent Difference between measured and actual...
  • Page 229 NOTE • Gas concentrations from the gas analyzer are only available for Philips gas analyzers, not for devices connected via a Vuelink/IntelliBridge module. • If gas concentrations from the gas analyzer are selected but not all data is available, the missing data is taken from manually entered values.
  • Page 230 14 Monitoring Airway Flow, Volume and Pressure Changing the Concentration of Inspired O2 and the Inspired Agents Setup Spirometry Gas Compensation In the menu, select Inspired O₂ Select to change the concentration of inspired O Inspired Agent Select to change the concentration of the inspired agent(s). Select the appropriate setting.
  • Page 231: Monitoring Tcgas

    Monitoring tcGas The tcGas module measures the partial pressure of the oxygen and carbon dioxide that diffuses through the skin, thereby providing a measure of these gases in the capillary blood. The monitor's settings for altitude and barometric pressure influence the measurement. The tcpO tcpCO measurement is valid for an infant patient not under gas anesthesia.
  • Page 232: Using The Tcgas Site Timer

    15 Monitoring tcGas Choose a temperature value appropriate for your patient's age, weight and physical condition in accordance with your hospital policy. Usually, a higher transducer temperature gives a better correlation and a quicker response time. However, higher temperatures also increase the risk of skin burns. Most physicians prefer a temperature between 42°C (107°F) and 44°C (111°F), and a site time of four hours or less.
  • Page 233: Setting The Tcgas Barometric Pressure

    Calibrating the tcGas Transducer You can use either a Philips (15210B) or a Radiometer TCC3 calibration unit and a gas cylinder whose pressure indicator is above the 'out-of-gas' zone (black on 15210B, red on TCC3). To maintain accuracy, it is recommended to calibrate the transducer every four hours, even if the monitor does not prompt you to do so.
  • Page 234 15 Monitoring tcGas Connect the calibration unit to the inlet on the side of the module's calibration chamber using the recommended gas tubing. Different tubing will cause inaccurate measurements. Plug the transducer cable into the module. Swing the calibration chamber cover open and insert the transducer into the chamber.
  • Page 235: Applying The Tcgas Transducer

    15 Monitoring tcGas Troubleshooting tcGas Calibration Perform each of the following steps, in order, until calibration is successful. Check the calibration unit, then recalibrate, remembering to turn on the gas supply on the calibration unit. If the pressure indicator reading is in the out of gas zone, there is insufficient gas in the cylinder.
  • Page 236: Finishing Tcgas Monitoring

    15 Monitoring tcGas WARNING You must either remove the transducer before defibrillating, or remembrane and calibrate the transducer after defibrillating. CAUTION To avoid transducer damage, remove it from the patient during high frequency surgical procedures. Selecting the tcGas HeatPowerDisplay Mode The heat power display gives an indication of the skin's perfusion below the transducer and of the transducer's contact with the skin.
  • Page 237 15 Monitoring tcGas Metabolism Correction for tcpCO2 production in the epidermis increases the CO value. Your monitor may be configured to CO₂ Correction automatically deduct a metabolism factor (only applies when is on). Setup tcGas MetabolismFactor In the menu, look at the value shown for the menu item .
  • Page 238 15 Monitoring tcGas...
  • Page 239: Monitoring Intravascular Oxygen Saturation

    Monitoring Intravascular Oxygen Saturation Depending on the probe or catheter used and the measurement location, the two modules, M1011A and M1021A, measure the central venous oxygen saturation or mixed venous oxygen saturation continuously and invasively. The two modules can be differentiated by their size and their labeling. The M1011A is a single-width module (narrow) and is labeled SO .
  • Page 240: Selecting A Measurement Label

    Protocol Watch is in use, to ensure that the correct limits are used for the criteria applied. CAUTION Use the modules with Philips approved accessories only. Refer to the instructions for use provided with the accessory. Selecting a Measurement Label Always select a measurement label before inserting a catheter/probe.
  • Page 241 16 Monitoring Intravascular Oxygen Saturation Optical module Balloon inflation stopcock Hospira fiber optic catheter Optical reference Enter setup/calibration Connect the optical module (Hospira 50131) to the measurement module. Allow the optical module to warm up before you perform a calibration. Although the warm up message disappears from the screen after one minute, Hospira recommends letting the optical module warm up for 15 minutes for best accuracy.
  • Page 242 16 Monitoring Intravascular Oxygen Saturation Inserting the Catheter Remove the inner cover of the catheter tray. Remove the catheter tip from the optical reference. Check the catheter's proper operation (for example: the balloon tip). Prepare and insert the catheter in accordance with standard hospital practice. The SvO catheter is thin and flexible, treat it carefully.
  • Page 243 16 Monitoring Intravascular Oxygen Saturation Making the In-Vivo Calibration Be prepared to draw a blood sample from the patient. Setup <SO₂ Label> Start In-VivoCal In the menu, select To clear the distal lumen, draw off and discard at least 2 ml of blood before taking the sample. Draw a blood sample from the distal port of the catheter and flush the line according to standard hospital practice.
  • Page 244: Preparing To Monitor With The M1011A Narrow Module

    Preparing to Monitor with the M1011A Narrow Module In addition to the module, you need a Philips SO Optical Module and a compatible fiber optic probe or catheter. Use only the accessories listed as applicable for the intended measurement location in the Accessories section.
  • Page 245: Further Information For Both Modules

    16 Monitoring Intravascular Oxygen Saturation The probe/catheter should be replaced after it has been in place for 72 hours. CAUTION Do not apply excessive tension to any sensor cable or part of the catheter. Performing In-Vivo Calibration Perform an in-vivo calibration: •...
  • Page 246 16 Monitoring Intravascular Oxygen Saturation...
  • Page 247: Monitoring Eeg

    Monitoring EEG The Electroencephalograph (EEG) module monitors the patient's cerebral function by measuring the electrical activity of the brain. It provides the monitor with two channels of realtime EEG waves, EEG trend information in the form of Compressed Spectral Arrays (CSA), and up to eight of the following numerics: Spectral Edge Frequency - The SEF is the frequency below which a defined percentage of the Total Power lies.
  • Page 248: Using The Eeg Impedance/Montage Window

    17 Monitoring EEG EEG Impedance / Montage Check the electrode-to-skin impedance in the window. For good signal quality, keep all lead wires together and away from other electric devices and metallic bodies. Using the EEG Impedance/Montage Window Setup EEG Show Montage EEG Montage To open the window, in the menu, select...
  • Page 249 17 Monitoring EEG Changing the Impedance Limit Setup EEG The impedance limit can be set for all electrodes simultaneously in the menu, or in the Impedance / Montage window using the pop-up keys. If the limit is exceeded during monitoring, an INOP will appear and the graphic impedance indicator will change.
  • Page 250: About Compressed Spectral Arrays (Csa)

    17 Monitoring EEG Impedance Indicators Electrode/Skin Symbol Color Displayed Action Impedance Impedance Value Electrode not connected no value connect electrode Noisy signal gray 60 kΩ (fixed) check electrode-to-skin connections Electrode connected, yellow measured value check limit, check impedance above limit (e.g.
  • Page 251: Changing Eeg Settings

    17 Monitoring EEG The CSA contains the following information Lead label for example, Fp1-T3, Fp2-T4 CSA label CSA1 or CSA2 according to EEG channel Montage label for example, Montage A Status line Filter settings for example, 1-30 Hz Buffer label and time the buffer and interval between spectral lines on the CSA Current SEF Threshold can only be changed in Configuration Mode...
  • Page 252: Eeg Reports

    17 Monitoring EEG Setup EEG Wave Scale In the menu, select to call up a list of wave scales. Select the required scale from this list. Scaling information is displayed with each EEG wave. Show Gridlines • is set to in Configuration Mode, gridlines and the current wave scale values are shown with the EEG wave.
  • Page 253: Eeg Safety Information

    17 Monitoring EEG EEG Safety Information WARNING Do not touch the patient, or table, or instruments during defibrillation. When connecting electrodes and/or patient cables, ensure that the EEG leads and connectors do not come into contact with other conductive parts or earth. High-frequency Surgery - To reduce the hazard of burns in the high-frequency surgical neutral electrode connection, the EEG electrodes should not be located between the surgical site and the electrosurgical unit return electrode.
  • Page 254 17 Monitoring EEG...
  • Page 255: Monitoring Bis

    Monitoring BIS Bispectral Index monitoring helps to monitor the level of consciousness of a patient under general anesthesia or sedation in the OR and ICU. The BIS sensor is placed on the patient's forehead to capture electroencephalographic (EEG) signals from which several numerics are derived, including a single BIS value representing the level of consciousness.
  • Page 256 18 Monitoring BIS Monitoring BIS Using the DSC and BIS Engine BIS Engine Cable BIS Module Aspect BIS Engine 185-0111 Aspect Digital Signal Converter 185-0124 Aspect Patient Interface Cable 186-0131 Aspect BIS Sensor If you are monitoring BIS with the DSC and BIS engine, a.
  • Page 257 18 Monitoring BIS Monitoring BIS using the BISx BIS Module Aspect BISx 185-0145-PH Aspect Patient Interface Cable 186- 0131 Aspect BIS Sensor If you are monitoring BIS using the BISx, a. Connect the BISx device to the BIS module b. Use the clip on the rear of the BISx device to affix it in a position convenient for your patient, not above the patient's head.
  • Page 258: Bis Continuous Impedance Check

    18 Monitoring BIS BIS Continuous Impedance Check This checks: • the combined impedance of the signal electrodes plus the reference electrode. This is done continuously and does not affect the EEG wave. As long as the impedances are within the valid range, there is no notification of this check or its results. •...
  • Page 259: Bis Window

    18 Monitoring BIS BIS Window Setup BIS Show Sensor To open the BIS window, in the menu, select The window may look slightly different on your monitor. The graphic in the BIS Window automatically adapts to show the type of sensor you are using, showing three or four electrodes as required.
  • Page 260: Changing The Bis Smoothing Rate

    18 Monitoring BIS In addition to the symbols, the impedance value in kOhm is also displayed. Changing the BIS Smoothing Rate The smoothing rate defines how the monitor averages the BIS value. Setup BIS Smoothing Rate To change the smoothing rate, in the menu, select then choose either: 15 sec...
  • Page 261: Bis Safety Information

    18 Monitoring BIS BIS Safety Information For information on the use of BIS in specific monitoring situations and on pharmacological responses to the anesthetic agents Nitrous Oxide (when used as the sole anesthetic agent), Ketamine, and Etomidate, please contact Aspect Medical Systems to request a copy of their publication "A Clinician's Guide to the Bispectral Index®".
  • Page 262 18 Monitoring BIS...
  • Page 263: Assigning A Telemetry Device And A Monitor To One Patient

    "pairing" and when a telemetry device and a monitor are paired, the measurement data from the telemetry device will be displayed on the monitor screen. A telemetry device can be: • any Philips telemetry device (only for indirect connections, see below). • a TRx/TRx+ Intellivue Telemetry system transceiver. •...
  • Page 264 19 Assigning a Telemetry Device and a Monitor to One Patient Main Setup Measurements Select then Telemetry Select Setup Telemetry Paired Equipment menu will appear with only one entry Enter here the equipment label of the telemetry device to be paired. Pairing at the monitor is only possible when the monitor already has a connection to the Information Center and the Information Center software version allows pairing at the monitor.
  • Page 265: Functions Available When The Telemetry Data Window Is Displayed

    19 Assigning a Telemetry Device and a Monitor to One Patient • When a telemetry device is connected to the monitor, arrhythmia relearning is initiated, and again when the telemetry device is disconnected. • Controls on the Telemetry Device (e.g. nurse call) will be inactive when the device is directly connected to the monitor except in the case when the monitor has no network connection and data are transferred via the telemetry device.
  • Page 266: General Telemetry-Related Functions

    19 Assigning a Telemetry Device and a Monitor to One Patient If configured, alarms generated from a paired telemetry device can be silenced at the bedside. Either Silence the monitor key is configured to silence both monitor and telemetry alarms (must be Silence Bed configured at the Information Center) or the pop-up key will be available:...
  • Page 267 19 Assigning a Telemetry Device and a Monitor to One Patient !!CHECK ECG SOURCE In case of ambiguity, a yellow INOP message indicates that more than one valid ECG source is active. Synchronized Settings If ECG is measured at the monitor, and then the patient is connected to a telemetry device for monitoring, the Information Center will use the monitor settings for the telemetry device.
  • Page 268: Use Models With Telemetry

    19 Assigning a Telemetry Device and a Monitor to One Patient Use Models With Telemetry The standard use model combining a monitor and a telemetry device involves pairing the two devices so that the data measured by the telemetry device appears on the monitor screen - and at the Information Center in the same patient sector as the monitor data.
  • Page 269: Trends

    Trends Trends are patient data collected over time and displayed in graphic, tabular or histogram form to give you a picture of how your patient's condition is developing. Trend information is stored in the trends database for continuously-monitored measurements, such as ECG, as well as for aperiodically- measured parameters, such as Cardiac Output.
  • Page 270 20 Trends Trends Pop-Up Keys When you open the graphic or tabular trends window, a selection of pop-up keys appears to let you navigate through the stored trend data and carry out trends-related tasks. Pop-Up Keys Selecting this pop-up key lets you..Select Group see a pop-up list of trend groups and select a group for viewing.
  • Page 271 20 Trends To use the trend cursor to navigate in time through the trends database, Select the graphical trend or the arrow pop-up keys to activate the cursor. Use the arrow pop-up keys to move the trend cursor backwards and forwards in time, or Place the cursor at a specific time by touching the graph.
  • Page 272: Setting Up Trends

    20 Trends Viewing Histogram Trends The title line of the window shows the label of the trended measurement and the resolution of the data; in the RR histogram above, 1 minute trend samples. The horizontal axis shows the range and unit of the displayed measurement. The vertical axis shows the percentage of time.
  • Page 273 20 Trends Expanded View Graphical Trends To expand the segment to fill the window, Segment Expand • in the menu, select to have that segment enlarged to fill the window. In the expanded view, you can also highlight a measurement to make it more easily visible (for example when multiple ST trends are in one segment).
  • Page 274 20 Trends Change Group To change the selection of measurements in a trend group, either use the setting in the Segment menu or: Main Setup Trends Trend Groups Select , then Change Delete Select the Trend Group you want to change and use the pop-up keys to , or the selection of measurements trended.
  • Page 275 20 Trends Graphical Trend Presentation Graphical trends and screen trends for measurements with compound values (for example ABP or ) can be viewed in line or band form. To change the presentation style, Main Setup Trends Select then select Global Style Select and choose Line...
  • Page 276: Documenting Trends

    20 Trends Documenting Trends To print a Vital Signs or Graphical Trends report, Vital Signs Graph Trends Print • in the window, select the pop-up key to print a report for the trend group currently on the monitor screen. Reports include the most recent information in the trends database and extend backwards in time according to the selected trend interval and your monitor's configuration.
  • Page 277: Screen Trends

    20 Trends Trending Multiple-Value Measurements Some measurements generate multiple values, for example invasive pressure measurements can provide systolic, diastolic, and mean values. These values are trended as separate measurements. Screen Trends Trends configured to display permanently on special monitor Screens are called screen trends. The selection and number of measurement waves in the Screen Trend segment depends on your monitor configuration.
  • Page 278 20 Trends Select the screen trend. Activate Cursor Select You can now use the arrow keys to move the cursor across the time line. The values measured at the cursor time are shown next to the cursor. To de-activate the cursor, Main Screen •...
  • Page 279 20 Trends • a horizon, drawn in white, as a reference point or baseline to help you visualize changes in your patient's condition. The horizon can be set to represent your patient's current condition, or a target condition and can be a single value or a range. •...
  • Page 280 20 Trends...
  • Page 281: Calculations

    Calculations Calculations are patient data that is not directly measured but calculated by the monitor when you provide it with the appropriate information. Your monitor can perform the following hemodynamic, oxygenation, and ventilation calculations. Hemodynamic Oxygenation Ventilation Cardiac Index (C.I.) Arterial Oxygen Content (CaO Minute Volume (MINVOL) Stroke Volume (SV)
  • Page 282: Viewing Calculations

    21 Calculations Viewing Calculations Calcs Calculations • Select the SmartKey to open the window. Calc Type • Select the field and select the required calculation type for display. Calculations Windows Hemodynamic Calculations This example calculations window shows the window. The ventilation and oxygenation windows are similar.
  • Page 283: Reviewing Calculations

    21 Calculations Pop-Up Keys Selecting this pop-up key lets you..Resample Vitals use the most recent monitored values. Resampling sets the calculation time to the current time, and displays the corresponding values for the previous second. Perform Calc perform the displayed calculation using the currently-input values and store the calculation in the calculations database Print/Record print or record the displayed calculation.
  • Page 284: Entering Values For Calculations

    21 Calculations Enter any values that must be entered or edited manually. Select the value field and then use the Enter pop-up keypad to enter the required values. Select to confirm each entered value. Manually- entered values are marked with an asterisk (*). Entering Values for Calculations The monitor automatically enters any available values for calculations.
  • Page 285: Documenting Calculations

    21 Calculations Patient Demographics • To check the current setting, select the patient name to enter the menu. BSA(B) BSA(D) indicates that the Boyd formula is used; indicates that the Dubois formula is used. Comparing Dynamic Compliance Values If you compare the dynamic compliance value (COMP) from the ventilation calculations with the value from the Spirometry measurement you may see a difference.
  • Page 286 21 Calculations...
  • Page 287: High Resolution Trend Waves

    High Resolution Trend Waves High resolution (hi-res) trend waves provide information for fast-changing parameters at a glance. They can help you to recognize trend patterns and to find interrelationships between measurements, by comparing changes in your patient's condition across different hi-res trend waves.This can aid in the early detection of cardiorespiratory and hemodynamic problems.
  • Page 288: Printing Hi-Res Trend Wave Reports

    22 High Resolution Trend Waves Printing Hi-Res Trend Wave Reports To print hi-res trend waves on reports, you can choose to print either VisibleWaves • - prints all waves and hi-res trend waves currently displayed All Waves • - prints realtime waves and hi-res trend waves for all currently-monitored measurements HiRes Waves •...
  • Page 289: Event Surveillance

    Event Surveillance Events are electronic records of episodes in your patient's condition. You can trigger them manually, or set them to trigger automatically during pre-defined clinical situations. Depending on the level of event surveillance available on your monitor, the information stored for each event episode can include: •...
  • Page 290: Event Groups

    23 Event Surveillance Basic Event Neonatal Event Review Advanced Event Surveillance Event Functionality Surveillance (NER) Option C07 Option C06 Option C04 6 (one group can be configured Event groups to NER) 3 (plus 1 for episode Measurements per group recording) Triggers per measurement 1 Simple ("at least one") Combined ("at least two")
  • Page 291: Event Episodes

    23 Event Surveillance Event Episodes When an event occurs, information for a predefined duration is stored. This is the event episode. It includes information from a defined period before the trigger, called the event pre-time. The episode time after the event is called the event post-time. If a further event occurs during the event post-time it changes a single event to a combined event (combi-event).
  • Page 292: Events Pop-Up Keys

    23 Event Surveillance Events Pop-Up Keys Depending on the events view you choose, a selection of the events pop-up keys let you navigate through the stored events and carry out events-related tasks. Pop-Up Keys Selecting this pop-up key lets you..Event Setup Event Setup open the...
  • Page 293 23 Event Surveillance If more than one trigger is available for the measurements in the active event group, the trigger At Least One Param. At Least Two Param. At Least Three Par. All Four condition may be , or Parameter At Least One Param.
  • Page 294 23 Event Surveillance If You Set Use-defined Deviation Triggers You can define event triggers that are independent of specific limits and based instead on deviations from the current values. You must set a deviation and a period of time in which the deviation occurs. ANY Deviation UP Deviation There are three types of deviation available:...
  • Page 295 23 Event Surveillance Set the event trigger for each measurement. Select each trigger name and select, if available, either an alarm trigger, or a user-defined trigger from the pop-up trigger list. If you select a user-defined trigger, set the required threshold level and delay time. Activated Deactivated Set the trigger status to...
  • Page 296: The Events Database

    23 Event Surveillance Running a Car Seat Assessment Record In the NER group you can run a Car Seat Assessment Record (CAR). This is a special period of event surveillance using the current setup of the NER group. To start a CAR period: Start CAR Select the pop-up key or SmartKey.
  • Page 297 23 Event Surveillance Event Summary and Event Counter Event Summary Vertical bars mark events in the window. The timeline shows the position of the stored events in the event database. Selecting this view activates a cursor that lets you navigate across Show Episode Event the timeline.
  • Page 298 23 Event Surveillance symbol meaning group activated, notification set to *alarm group activated, notification set to screen prompt group is activated, notification is switched off no symbol group not activated Event Summary Selecting the window calls up the events pop-up keys. Event Summary Parts of the window can also be embedded in Screens so that they are always visible,...
  • Page 299: Annotating Events

    23 Event Surveillance Event Episode Depending on the event group settings, the window shows either 20 minutes of average trend event information, four minutes of high-resolution event information, or 15 seconds of realtime wave information. Follow-on event values Trigger event values, highlighted Timeline, showing episode Pre/Post-time...
  • Page 300 23 Event Surveillance Record Graphic For a graphic Event Review recording, select the pop-up key. Record Tabular For a tabular Event Review recording, select the pop-up key. Print CAR For a CAR review report, select the pop-up key Print Review To print an Event Report, select the pop-up key.
  • Page 301 23 Event Surveillance Patient information and medical record no. In graphic event review recordings, events are represented by bars, and each event group is printed on a separate channel. The timeline reflects the period stored in the database, either 24 hours (divided into 4 hour sections) or 8 hours (divided into one-hour sections).
  • Page 302 23 Event Surveillance The second section (2 below) shows the waveforms recorded during the episode. The trigger moment is marked with a triangle and divides the episode into the pre/post time. Any calibration marks and grid marks on the screen are automatically printed on the recording. If there are four measurements in the event group being recorded, two waveforms will be recorded in two separate waveforms segments.
  • Page 303 23 Event Surveillance Event Episode Reports The event episode report documents the patient information from the currently-selected event. See the section on event recordings for an explanation of the report elements.
  • Page 304 23 Event Surveillance Event Summary Reports (Advanced Event Surveillance only). The event summary report shows a graphical view and a tabular view of all events in the database for all groups.
  • Page 305 23 Event Surveillance...
  • Page 306 23 Event Surveillance...
  • Page 307: Protocolwatch

    It is a computerized implementation of the January 2008 Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock. Philips does not make any claims about their effectiveness to reduce the morbidity or mortality associated with severe sepsis.
  • Page 308 24 ProtocolWatch Depending on the option your monitor has, it may be that only the Severe Sepsis Screening phase is implemented. If, at the end of this phase sepsis has been confirmed, and the patient is transferred for treatment in the resuscitation and management phases, you can transfer the current state, the settings and the log from the SSC Sepsis Protocol in the MMS to another monitor with the full version of the SSC Sepsis Protocol.
  • Page 309 24 ProtocolWatch CAUTION It is not possible to transfer SSC Sepsis Protocol data from a monitor with release F.0 software to another monitor with release G.0 software or above, and vice versa. Suspending the Protocol for 24 Hours To suspend the protocol for 24 hours: Main Setup ProtocolWatch Suspend for 24 hours...
  • Page 310 24 ProtocolWatch Confirm Select when the check boxes reflect the current patient status. Remind 15 min Select if you want to delay filling out this screen. (When you enter the screen manually Cancel this key will be a key, as no action is required in this case.) Changing Conditions The window reappears if: •...
  • Page 311 24 ProtocolWatch If you select , the window for the Lactate measurement will reappear. If you select , screening continues - comparing heart rate, temperature and respiration rate values against the screening criteria. Authorized Clinician Review Protocol Log To review the protocol, select .
  • Page 312 24 ProtocolWatch Enter Lact Select the key to enter a lactate value. When you have entered a value, or if a lactate value had previously been entered, the box is checked. Take Blood Cultures Check the box when you have taken blood cultures. Administer Intravenous Antibiotics Check the box when you have started broad-spectrum antibiotic...
  • Page 313 24 ProtocolWatch ProtocolWatch When the Sepsis Management Bundle phase begins, the Screen is automatically updated (if configured and available on the monitor). In the lower area of the Screen, the list of recommendations for the Sepsis Management Bundle replaces the list for the Sepsis Resuscitation Bundle.
  • Page 314 24 ProtocolWatch After completion of the Sepsis Management Bundle a sepsis standby phase begins which allows time for further patient stabilization and recovery. During this phase Severe Sepsis Screening is suspended. The standby phase is by default 7 days but the length can be adjusted in Configuration Mode. Viewing And Printing The Protocol Log The Protocol Log stores all user interactions, alarms and phase transitions while the SSC Sepsis Protocol is running.
  • Page 315: Recording

    Recording The M1116B plug-in recorder records numerics for all active measurements and up to three waveforms. You can use it for local recording mounted in the monitor's FMS. M1116B Plug-in Recorder Continue LED - flashes if a continuous recording is ongoing RUN/CONT key - starts a delayed recording or makes the current recording continuous...
  • Page 316 25 Recording The selection of pop-up keys available depends on the monitor you are using. Delayed Recordng Vital Signs RT A Recordng Alarm Limits RT B Recordng ST Segments RT C Recordng ECG QT Select Waves Setup Recordng HiRes Recordng Stop All Recordng All ECG Waves Quickstarting Recordings...
  • Page 317: Overview Of Recording Types

    25 Recording Recor- dings Select Waves Either: Select the SmartKey then select the pop-up key Record Waves Or: Select the SmartKey Use the pop-up keys to choose up to three measurement waves to be printed on the recording. If you want fewer than three waves on the recording, select the waves you want then select the Continue pop-up key.
  • Page 318: All Ecg Waves Recordings

    25 Recording All ECG Waves Recordings All ECG Waves recording shows a 4 second recording of each lead with a calibration bar preceding each ECG lead. All available leads are recorded sequentially in the standardized lead order. The recording is realtime, that is, the information recorded is not simultaneous. Creating and Changing Recordings Templates To save you defining recording settings each time you start a recording, you can create templates for Setup Recording...
  • Page 319: Changing Ecg Wave Gain

    25 Recording Central Config General : if available in the menu, select this setting to use the recording settings made for the centrally-connected recorder. Changing ECG Wave Gain ECG Gain General Recording Setup setting in the window defines how every recorded ECG wave, irrespective of template or recording type, will appear on the recorder strip.
  • Page 320 25 Recording Code Meaning Recording type Realtime Delayed Alarm Context (Procedures) Operating mode Monitoring Demo Configuration Service Application area NICU Patient category Adult Pediatric Neonatal Recorded Waveforms A selection of up to three waveforms is recorded, marked with wave labels and wave scale information. Wave scale information can be in the form of a calibration bar, like the 1 mV calibration bar for ECG, or calibration steps before the waveform starts.
  • Page 321: Reloading Paper

    25 Recording Reloading Paper M1116B Use the latch on the right side of the recorder door to pull the door open. Remove the empty core. Insert a new roll so that it fits snugly into its housing and the paper end is feeding from the top.
  • Page 322 25 Recording...
  • Page 323: Printing Patient Reports

    Printout Location Depending on availability, reports can be printed on locally connected printers, printers connected to the Information Center or the Application server, an external PC-based print server with Philips server software or into the print database. Print jobs stored in the database are automatically printed when a print device with a matching paper size becomes available.
  • Page 324: Stopping Reports Printouts

    26 Printing Patient Reports Starting the Different Types of Report Report types Report contents How to start printing reports In the Vital Signs window, select Print/ Record, then select Vital Signs Report depends on selected trend group, data Print. resolution, and period. In the Graphical Trends window, select Print.
  • Page 325: Setting Up Reports

    26 Printing Patient Reports Delete Report – to stop the current print job Delete All Repts – to cancel all queued report printouts Scheduled Rep. – to select and switch off scheduled reports. Setting Up Reports As the content of context-linked reports, such as Cardiac Output, Calculations, and Wedge, is defined by the content of the procedure window these reports do not need to be set up, however a target Setup Reports printer can be configured in the...
  • Page 326: Setting Up Individual Print Jobs

    26 Printing Patient Reports Setting Up Auto Reports Auto Reports print automatically when a specified trigger occurs. There are two types of Auto Reports: Scheduled Reports, which print at predefined intervals, and End Case Reports, which print when a patient is discharged using the End Case function. An Auto Report can be both a Scheduled Report and an End Case report.
  • Page 327: Checking Printer Settings

    26 Printing Patient Reports Report Type Select and then select the reports template you want the report selected in Step 2 to use. The selection of templates listed depends on the report type selected. Each template includes patient demographic data, and each Realtime Report also includes alarm and INOP information.
  • Page 328: Switching Printers On Or Off For Reports

    26 Printing Patient Reports Switching Printers On Or Off for Reports You can enable or disable printer status to switch individual printers on or off for report printouts. Setup Printers Printer In the menu, select and then select the name of the device you want to switch on or off for Reports printing from the pop-up list.
  • Page 329: Checking Report Status And Printing Manually

    26 Printing Patient Reports Checking Report Status and Printing Manually Reports Job List A list of all print requests which are waiting, printing or stored can be viewed in the Reports Reports Job List To view the list, in the menu, select The following information is displayed for each print request: •...
  • Page 330: Printer Status Messages

    26 Printing Patient Reports Printer Status Messages Printer Status Message Possible causes and suggested action Print job queued for <Printer The report has been placed in the queue for the named printer. Name> Print job could not be queued The printer queue is full and the monitor cannot accept another report request. (insufficient resources) Wait until some more reports have been printed, then try again, OR Print job could not be queued...
  • Page 331: Sample Report Printouts

    26 Printing Patient Reports Sample Report Printouts Each report header contains the patient's bed label, last name and first name, middle name (if there is enough space) the patient ID, the date and time, and the name of the report. The report footer contains the hospital label and page number, and the last page contains a note to mark the report end.
  • Page 332 26 Printing Patient Reports Alarm Limits Report Measurement labels, with alarms off symbol where alarms are switched off Graphic view of current alarm limits in relation to currently monitored measurement value...
  • Page 333 26 Printing Patient Reports Realtime Report Patient demographic information, time stamp Active Alarms and INOPs, followed by vital signs Measurement waves section...
  • Page 334 26 Printing Patient Reports Cardiac Output Report ECG Reports Patient information Numeric block Wave area Below the header on ECG Reports, the numeric block shows the current HR, PVC, and ST values. The wave area shows the printed waves for all available ECG leads. A 1 mV calibration bar is printed at the beginning of each wave.
  • Page 335 26 Printing Patient Reports Other Reports See the sections on Trends and Calculations and the chapter on Event Surveillance for other example reports.
  • Page 336 26 Printing Patient Reports...
  • Page 337: Using The Drug Calculator

    Using the Drug Calculator Drug mixtures for intravenous (IV) drug infusions combine information on drug dose, rate, amount, volume, concentration, and standardized rate. The Drug Calculator helps you to manage infusions by calculating one of these values at a time. Term Definition Units...
  • Page 338: Accessing The Drug Calculator

    27 Using the Drug Calculator Accessing the Drug Calculator Main Setup Calculations Drug Calculator To access the Drug Calculator, select then followed by , or Drug Calc select the SmartKey, if configured. Performing Drug Calculations Using the service Support Tool, a list of drugs can be configured for the monitor containing pre- defined dosage recommendations and unit settings.
  • Page 339 27 Using the Drug Calculator Performing Calculations for a Non-Specific Drug If a list of drugs has not been configured for your monitor, you can use the Drug Calculator to ANY DRUG calculate drug doses for a single, generic drug called .
  • Page 340: Charting Infusion Progress

    27 Using the Drug Calculator Select the correct patient category for your patient. Rule Of 6 If you have a neonatal or pediatric patient, the choice may be available. Select if required. Enter the patient weight, if necessary. Patient Demographics If available, the patient weight from the window is entered automatically in Drug Calculator...
  • Page 341: Using The Titration Table

    27 Using the Drug Calculator Using the Titration Table Titration Table Use the to see at a glance what dose your patient would receive of a drug at different Dose increments infusion rates. By clicking on the title row of the table you can switch between the Rate increments view.
  • Page 342 27 Using the Drug Calculator...
  • Page 343: Intellibridge Ec10 Module

    IntelliBridge EC10 Module An IntelliBridge EC10 module transmits information from a connected external device to your monitor. The IntelliBridge EC5 ID module is used to provide identification information from the external device. Data imported from the external device, for example waveforms, measurement numerics, settings and alarms, can be displayed on the monitor, passed on to an Information Center and included in trends as appropriate.
  • Page 344: Changing Waves And Numerics Displayed

    28 IntelliBridge EC10 Module Changing Waves and Numerics Displayed To change the waves and numerics from the IntelliBridge module displayed on the Screen, Main Setup Measurements <External Device> Select , then to enter the setup menu for the connected device. Setup Driver Select Setup Waves...
  • Page 345: Alarms/Inops From External Devices

    28 IntelliBridge EC10 Module Alarms/INOPs from External Devices The IntelliBridge module itself generates INOPs, but does not generate alarms. If the external device's alarms are on, the module transmits these to the monitor. A message in the External Device Data Device Alarms Ignored Device Alarms Accepted No Alarms Available...
  • Page 346 28 IntelliBridge EC10 Module...
  • Page 347: Vuelink Modules

    VueLink Modules A VueLink module transmits information from a connected external device to your monitor. Each module can be connected to one of up to three preselected external devices, and supports alarms from the external device. Data from VueLink modules cannot be included in monitor trends when the label is a free-text label.
  • Page 348: Connecting An External Device

    29 VueLink Modules The device labels (2) on the module indicate for which external devices the module is configured. The selection LED (3) shows which device is currently active. The device label text may differ slightly from the labels on the external devices. See the documentation supplied with the VueLink module for a list of supported devices and accessories, and for configuration information.
  • Page 349: Viewing The Vuelink Device Data Window

    29 VueLink Modules Viewing the VueLink Device Data Window To view the VueLink device data window, either External Devices • select the setup hardkey on the VueLink module or the SmartKey, and then select the pop-up key for the device, or Setup <External Device>...
  • Page 350: Language Conflict With External Device Drivers

    29 VueLink Modules Alarms from external devices are: • transmitted to the monitor. For all numerics configured in the setup menu, an alarm condition is announced at the monitor. For one or more measurements not configured in the setup menu, an alarm is announced as a text message for the highest priority alarm.
  • Page 351: Using Timers

    Using Timers With the Timers function you can set timers to notify you when a specific time period has expired. CAUTION Do not use the timers to schedule critical patient-related tasks. Viewing Timers Timers You can view currently active timers in the window or directly on the Main Screen (if a timer has been substituted for a numeric).
  • Page 352: Timer Setup Pop-Up Keys

    30 Using Timers Timer Setup Pop-up Keys Timers When you open the window and select a timer, then select the setup key, the setup window opens and a selection of pop-up keys appear to let you activate and control the timers. Pop-Up Keys Selecting this pop-up key lets you..
  • Page 353: Displaying A Timer On The Main Screen

    30 Using Timers Timer Counting Direction No Limit Timers can count up or down, showing elapsed time or remaining time. timers automatically count up. Timers To change the direction, in the window: Setup Select the required timer and display the window.
  • Page 354: Displaying A Clock On The Main Screen

    30 Using Timers To display a timer on the Main Screen: Select the numeric you want to substitute. Change Numeric Select Any Timer Select Main Screen Timer Pop-up Keys When you select a timer displayed on the Main Screen, additional pop-up keys become available: Pop-Up Keys Selecting this pop-up key lets you..
  • Page 355: Respiratory Loops

    Respiratory Loops Using a Spirometry module or a VueLink/IntelliBridge module connected to a ventilator, you can measure and store graphic representations of realtime respiratory loops. Respiratory loops can help you recognize changes in your patient's lung function, and they can also indicate a fault in the airway tubing (for example, if the respiratory loop does not close).
  • Page 356: Capturing And Deleting Loops

    31 Respiratory Loops Loops To open the window, and its associated pop-up keys, Main Setup Loops Loops • select then , or select the SmartKey, if configured. Loops In the window, in addition to the stored loops, two realtime airway waves and up to nine available numerics from the source device can be shown.
  • Page 357: Changing Loops Type

    31 Respiratory Loops Changing Loops Type Loops Loop Type To change the loop type, in the window, select the pop-up key (only available if the source device delivers three waves), then select Press/Volume • to display Pressure/Volume loops Flow/Volume • to display Volume/Flow loops Press/Flow •...
  • Page 358 31 Respiratory Loops...
  • Page 359: Laboratory Data

    Laboratory Data Laboratory data can be entered manually at the Information Center or at the monitor. For details on manual entry at the monitor, see “Entering Measurements Manually” on page 40. Selected laboratory data can be integrated on the monitor - values are then stored in the database and included in trends and reports and can be displayed as a numeric on the main screen.
  • Page 360 32 Laboratory Data...
  • Page 361: Care And Cleaning

    Warranty does not cover damage caused by using unapproved substances or methods. Philips makes no claims regarding the efficacy of the listed chemicals or methods as a means for controlling infection. Consult your hospital's Infection Control Officer or Epidemiologist. For comprehensive details on cleaning agents and their efficacy refer to "Guidelines for Prevention of...
  • Page 362: Cleaning The Monitor

    33 Care and Cleaning Cleaning the Monitor Clean with a lint-free cloth, moistened with warm water (40°C/104°F maximum) and soap, a diluted non-caustic detergent, tenside, ammonia- or alcohol-based cleaning agent. Do not use strong solvents such as acetone or trichloroethylene. Take extra care when cleaning the screen of the monitor because it is more sensitive to rough cleaning methods than the housing.
  • Page 363: Sterilizing The Monitor

    33 Care and Cleaning Product Name Product Type Ingredients TM/MC Carpe Diem spray 0.5% accelerated hydrogen peroxide Ready-to-Use General Virucide, Bactericide, Tuberculocide, Fungicide, Sanitizer TM/MC Carpe Diem Tb Wipes wipes 0.5% accelerated hydrogen peroxide Super Sani-Cloth wipes isopropanol 55% quaternary ammonium chlorides 0.5% Germicidal Disposable Wipes SANI-CLOTH®...
  • Page 364 33 Care and Cleaning Thread the cloth cleaning strip instead of paper around the rubber roller until approximately two inches of the strip come out from the top of the roller. Close the recorder door, aligning both ends of the strip over the top of the door. Holding the top end of the cleaning strip between your thumb and forefinger, pull the strip through and out of the recorder.
  • Page 365: Maintenance And Troubleshooting

    Contact: If you discover a problem with any of the equipment, contact your service personnel, Philips, or your authorized supplier. Inspecting the Equipment and Accessories You should perform a visual inspection before every use, and in accordance with your hospital's policy.
  • Page 366: Inspecting The Cables And Cords

    Examine all system cables, the power plug and cord for damage. Make sure that the prongs of the plug do not move in the casing. If damaged, replace it with an appropriate Philips power cord. Inspect the Measurement Link cable and ensure that it makes good connection with the MMS and the FMS.
  • Page 367: Troubleshooting

    You can disassemble the monitor, MMS, FMS and modules as described in the Service Guide. You will find detailed disposal information on the following web page: The Recycling Passports located there contain information on the material content of the equipment, including potentially dangerous materials which must be removed before recycling (for example, batteries and parts containing mercury or magnesium).
  • Page 368 34 Maintenance and Troubleshooting WARNING Ensure that the cylinder is completely empty before trying to remove the valve stem or drill a hole in the cylinder.
  • Page 369: Accessories

    Accessories You can order parts and accessories from Philips supplies at or consult your local Philips representative for details. WARNING Reuse: Never reuse disposable transducers, sensors, accessories and so forth that are intended for single use, or single patient use only. Reuse may compromise device functionality and system performance and cause a potential hazard.
  • Page 370 35 Accessories 3-Electrode Cable Sets Description Length AAMI Part No. IEC Part No. OR Grabber shielded 1.0 m M1675A M1678A ICU Grabber shielded 1.0 m M1671A M1672A ICU snap shielded 1.0 m M1673A M1674A ICU Clip non-shielded 0.45 m M1622A ICU Clip non-shielded 0.7 m M1624A...
  • Page 371 35 Accessories 10-Electrode (6+4)Cable Sets Description Length AAMI Part No. IEC Part No. ICU Grabber, chest, shielded 1.0 m M1532A M1533A ICU Snap, chest, shielded 1.0 m M1537A M1538A OR Grabber, chest, shielded 1.0 m M1557A M1558A For Limb Leads see 6-electrode cable sets One-piece Cables Description Length...
  • Page 372 35 Accessories Supported Cables Trunk Cables 3-Electrode Cable Set 5-Electrode Cable Set Length AAMI Part No. IEC Part No. AAMI Part No. IEC Part No. 0.9 m M1540C M1550C M1560C M1570C 2.7 m M1500A M1510A M1520A M1530A 3-Electrode Cable Sets Description Length AAMI Part No.
  • Page 373: Nbp Accessories

    35 Accessories 5-Electrode One Piece Cables AAMI 5-electrode One Length AAMI Part No. IEC 5-electrode One IEC Part No. Piece Cables Piece Cables OR Grabber 2.5 m M1975A OR Grabber M1985A ICU Snap 2.5 m M1977A ICU Grabber M1986A Set Combiners and Organizers Set combiners and organizers Part No.
  • Page 374 35 Accessories Reusable Cuff Kits Cuff Kits Part No. Infant, pediatric, small adult, adult M1577A Small adult, adult, large adult, thigh M1578A Infant, pediatric, small adult, adult, large adult, thigh M1579A Adult/Pediatric Antimicrobial Coated Reusable cuffs Patient Category (color) Limb Bladder Part No.
  • Page 375: Invasive Pressure Accessories

    35 Accessories Neonatal/Infant Cuffs (Disposable, non-sterile) Cuffs Limb Bladder Part No. Tubing Circumference Width Size 1 3.1 to 5.7 cm 2.2 cm M1866A M1596B (1.5 m) or Size 2 4.3 to 8.0 cm 2.8 cm M1868A M1597B Size 3 5.8 to 10.9 cm 3.9 cm M1870A (3 m)
  • Page 376: Spo2 Accessories

    Some Nellcor sensors contain natural rubber latex which may cause allergic reactions. See the Instructions for Use supplied with the sensors for more information. M1901B, M1902B, M1903B and M1904B disposable sensors are not available in USA from Philips. Purchase Nellcor sensors and adapter cables directly from Tyco Healthcare.
  • Page 377 1 kg and 4 kg. Hand or foot. M1196T Adult clip sensor (0.9 m cable) for patients over 40 kg. Any finger except thumb. Philips disposable sensors. Not available in the USA. M1904B Identical to OxiMax MAX-A Option A01: Use...
  • Page 378 Oxiband OXI- Pediatric / infant sensor Durasensor Adult finger clip sensor DS100A Dura-Y D-YS Y-sensor Extension / Adapter Cables for Philips and Nellcor Sensors M1941A Extension cable (2 m) For use with Philips reusable sensors and M1943A adapter cable.
  • Page 379 OC-3 Adapter Cable for OxiCliq sensors Available from Nellcor only. Product Description Compatible with Philips Part Number Number Opt. A01 Opt. A02 MASIMO LNOP® reusable sensors. LNOP DCI Adult Finger Sensor (> 30 kg) LNOP DCIP Pediatric Finger Sensor (10 - 50 kg) LNOP YI Multi-Site Sensor (>...
  • Page 380: Temperature Accessories

    LNCS MP Series Patient Cable (3.0 m) Adapter 989803148221 Cable for Masimo LNCS Sensors The Philips M3001A/M3002A option A01 and the M1020B option A01 SpO Module use Masimo certified pulse oximetry for reduced noise and low perfusion performance with Masimo Sensors under the Masimo NR&LP protocol available from Masimo.
  • Page 381: Cardiac Output (C.o.) Accessories

    35 Accessories Temperature Probes Part No. Minimum measurement time for accurate readings Foley Catheter Probe (12 French) M2255A 180 sec Foley Catheter Probe (16 French) 21096A 180 sec Foley Catheter Probe (18 French) 21097A 180 sec Adapter cable 1.5m 21082B Adapter cable 3.0m 21082A Cardiac Output (C.O.) Accessories...
  • Page 382: Mainstream Co2 Accessories

    35 Accessories Mainstream CO2 Accessories Description Part No. Sensor M2501A Adult/Pediatric Airway Adapter (reusable) M2513A Infant Airway Adapter (reusable) M2516A Adult Airway Adapter (single-patient use) M2533A Infant Airway Adapter (single-patient use) M2536A Sidestream CO2 Accessories Description Part No. Sensor M2741A Nasal and Oral-Nasal Cannulas Nasal Cannula, Adult M2744A...
  • Page 383: Mainstream Co2 Accessories (For M3016A)

    35 Accessories Mainstream CO2 Accessories (for M3016A) Description Part No. Sensor M1460A Standard Airway Adapter (reusable) M1465A Small Airway Adapter (reusable) 14363A Microstream CO2 Accessories • "FilterLine Set" is a combination of a FilterLine with an Airway Adapter. • "H" in the accessory name indicates suitability for humidified ventilation and longer usage due to the active removal of humidity from the sample line.
  • Page 384: Spirometry Accessories

    Sedation, Critical Lab, Long-term Sedation, Critical Care, EMS, ED Pain Management Care, EMS, ED Philips part numbers (A = Adult, P= Pediatric, I = Infant, N = Neonate) FilterLine Set: FilterLine H Set: Smart CapnoLine CapnoLine HO CapnoLine H: Smart CapnoLine:...
  • Page 385: Tcgas Accessories

    35 Accessories tcGas Accessories This symbol indicates that the specified transducer (but not its membranes) is designed to have special protection against electric shocks (particularly regarding allowable leakage currents), and is defibrillator proof. Description Part No. tcpO2/CO2 transducer M1918A Accessory Kit for M1918A (O-ring remover, absorbent paper, electrolyte solution, 12 15209-60010 replacement membranes) Application Kit for M1918A (4x25 disposable fixation rings, contact fluid)
  • Page 386: Bis Accessories

    BIS Sensor Pediatric (4 electrode) 989803143581 186-0200 BIS Sensor Extend 186-0160 Other BIS Accessories Order the following parts from your nearest Philips sales office and quote the Philips ordering number Description Philips Ordering Number PIC PLUS Cable M1034-61630 SO2 Accessories for M1021A Contact your local Hospira representative for information on accessories.
  • Page 387: So2 Accessories For M1011A

    Philips SO Optical Module 989803151591 Pulsion: CeVOX Fiberoptic Probe family (ScvO Contact PULSION for part numbers of compatible probes Edwards: Philips-compatible versions of the PreSep Contact Edwards for part numbers of compatible Catheter (ScvO ) or Swan-Ganz Oximetry Catheter catheters (SvO...
  • Page 388 35 Accessories...
  • Page 389: Specifications

    The monitor is indicated for use by health care professionals whenever there is a need for monitoring the physiological parameters of patients. WARNING The monitor is not intended for use in an MRI environment or in an oxygen-enriched environment (for example, hyperbaric chambers). Manufacturer's Information You can write to Philips at this address...
  • Page 390 71034 Boeblingen Germany Visit our website at: © Copyright 2010. Koninklijke Philips Electronics N.V. All Rights Reserved. BIS Manufacturer's Information BISx, the BIS engine, the DSC, the Patient Interface Cable and the BIS Sensor are manufactured by Aspect Medical Systems:...
  • Page 391: Symbols

    36 Specifications Symbols These symbols can appear on the monitor and its associated equipment. Symbols Refer to accompanying Protective earth Equipotential grounding documents Standby FMS power-on indicator Error LED Alternating current Connection direction Connection direction indicator indicator Electrical input indicator Electrical output indicator Connector has special (In some cases gas output...
  • Page 392: Installation Safety Information

    36 Specifications Symbols Masimo SET technology Nellcor OxiMax Uses FAST SpO compatible algorithm Silence Alarms Alarms On/Off Alarms Switched Off Main Screen SmartKeys Back key ECG Sync Output/ Analog ECG Output Installation Safety Information WARNING If multiple instruments are connected to a patient, the sum of the leakage currents may exceed the limits given in IEC/EN60601-1, IEC60601-1-1, UL60601-1.
  • Page 393 36 Specifications Rear of the Monitor Serial/MIB (RS232) connectors, type RJ45 AC power input Protective earth screw hole Equipotential ground connector Main measurement links (MSL) USB rear connectors (for remote control, keyboard, pointing devices, printer) Serial RS232 connector Nurse Call Wired network connector Video out connector (digital/analog) The following connectors are only present with the iPC...
  • Page 394 36 Specifications Left side of the Monitor ECG Sync Output/Analog ECG output connector Right side of the Monitor USB side connector (only present with the iPC)
  • Page 395: Monitor Mounting Precautions

    Quick Mount release button when lifting or moving items located under the monitor, such as pole mounts, etc. If in doubt, use the Philips Fix Mount solution to avoid such situations. Refer to the respective IntelliVue Monitor Service Manual, Installation Instructions chapter, for more details.
  • Page 396 (2) this device must accept any interference received, including interference that may cause undesired operation. Any changes or modifications to this equipment not expressly approved by Philips Medical Systems may cause harmful radio frequency interference and void your authority to operate this equipment.
  • Page 397: Physical Specifications

    (2) this device must accept any interference received, including interference that may cause undesired operation. Any changes or modifications to this equipment not expressly approved by Philips Medical Systems may cause harmful radio frequency interference and void your authority to operate this equipment.
  • Page 398 36 Specifications Product W x H x D Comments Weight M1029A 215 g (7.6 oz) 36 x 99.6 x 97.5 mm, Temperature Module 1.4 x 3.9 x 3.8 in M1012A 225 g (7.9 oz.) 36 x 99.6 x 97.5 mm Cardiac Output Module 1.4 x 3.9 x 3.8 in M1014A...
  • Page 399: Environmental Specifications

    36 Specifications Environmental Specifications The monitor may not meet the performance specifications given here if stored or used outside the specified temperature and humidity ranges. When the monitor and related products have differing environmental specifications, the effective range for the combined products is that range which is common to the specifications for all products. MX800 Monitor Item Condition...
  • Page 400 36 Specifications Multi-measurement Module M3001A, MMS Extensions M3016A M3015A, M3014A, M3012A, Measurement Modules, and Flexible Module Rack M8048A Item Condition Range Temperature Range Operating 0 to 45°C (32 to 113°F) Non-operating -40 to 70°C (-40 to 158°F) Humidity Range Operating 95% Relative Humidity (RH) max.
  • Page 401: Performance Specifications

    36 Specifications Performance Specifications MX800 Performance Specifications Power Specifications Power Consumption <200 W average Line Voltage 100 to 240 V Current 1.9 to 0.9 A Frequency 50/60 Hz Indicators Alarms Off red (crossed out alarms symbol) LED Alarms red/yellow/light blue (cyan) LED On/Standby/Error green/red LED integrated in power switch External Power...
  • Page 402 36 Specifications MX800 Performance Specifications Real Time Clock Range from: January 1, 1997, 00:00 to: December 31, 2080, 23:59 Accuracy better than 4 seconds per day Hold Time infinite if powered by AC; otherwise at least 48 hours (typical: >72 hours) Buffered Memory Hold Time if powered by AC: infinite...
  • Page 403 36 Specifications X2 (M3002A) Performance Specifications Real Time Clock Range from: January 1, 1997, 00:00 to: December 31, 2080, 23:59 Accuracy <4 seconds per day (typically) Hold Time infinite if powered by host monitor or external power supply; otherwise at least 48 hours Buffered Memory Hold Time if powered by host monitor or external power supply: infinite...
  • Page 404: Interface Specifications

    Delay <[Configured Latency +0.5] sec IntelliVue Instrument Type Internal WMTS Adapter Telemetry Wireless Technology compatible with Philips IntelliVue Telemetry System (ITS), Network (USA only) cellular infrastructure Frequency Band WMTS, 1395-1400 MHz and 1427-1432 MHz IntelliVue Instrument Type Internal ISM Adapter...
  • Page 405 36 Specifications MX800 Interface Specifications Short Range Radio Type Internal SRR interface Interface Technology IEEE 802.15.4 Frequency band 2.4 GHz ISM (2.400 - 2.483 GHz) Modulation DSSS (O -QPSK) technique Effective radiated max. 0 dBm (1 mW) power Measurement Link Connectors ODU out (Proprietary) (MSL)
  • Page 406 36 Specifications MX800 Interface Specifications Analog ECG Output Full scale on display signal gain x measured ECG voltage (ring, tip) Gain error <15 % Baseline offset <100 mV Bandwidth 1 to 100 Hz Output voltage swing ±4 V (min) Signal delay <22 ms Signal delay with <30 ms...
  • Page 407 36 Specifications X2 (M3002A) Interface Specifications ECG Sync Pulse Cable detection Output (rectangular Marker In pulse) Wave Output Connector Binder Series 709/719 Output levels Output low <0.8 V @ I = -4 mA Output high >2.4 V @ I = 4 mA Isolation None Pulse Width...
  • Page 408: Measurement Specifications

    36 Specifications Display Specifications 19" WSXGA Type 482 mm active matrix color LCD (TFT) Resolution 1680 x 1050 (WSXGA+) Refresh frequency 58 Hz Useful screen 409,5 mm x 255.9 mm Pixel size 0.244 mm x 0.244 mm Measurement Specifications See the Appendix on Default Settings for a list of the settings the monitor is initially shipped with. ECG/Arrhythmia/ST/QT Complies with IEC 60601-2-25:1993 + A1:1999 /EN60601-2-25:1995 + A1:1999, IEC 60601-2- 27:2005/EN60601-2-27:2006, IEC 60601-2-51:2003 /EN 60601-2-51:2003 and AAMI EC11/...
  • Page 409 36 Specifications ECG/Arrhythmia/ST Performance Specifications Sinus and SV Rhythm Ranges Brady Adult: 15 to 59 bpm Pedi: 15 to 79 bpm Neo: 15 to 89 bpm Normal Adult: 60 to 100 bpm Pedi: 80 to 160 bpm Neo: 90 to 180 bpm Tachy Adult: >100 bpm Pedi: >160 bpm...
  • Page 410 36 Specifications ECG/Arrhythmia/ST/QT Range Adjustment Alarm Specifications Vent Rhythm Run 3 to 99 PVCs/minute 1 PVC SVT HR 120 to 300 bpm 5 bpm SVT Run 3 to 99 SV beats 1 SV beat ST High -19.8 to +20 mm 0.2 mm ST Low -20 to +19.8 mm...
  • Page 411 Unless otherwise specified, this information is valid for SpO measured using the M3001A and M3002A Multi-measurement modules and the M1020B measurement module. The SpO Performance Specifications in this section apply to devices with Philips SpO technology. For SpO Performance Specifications valid for other SpO technologies, refer to the instructions for use provided with these devices.
  • Page 412 M1193T (Neonate) = 4 % (70 % to 100 %) values Philips Disposable Sensors with M1943A(L): M1132A, M1133A (adult/infant), M1134A (adult/infant) = 2 % M1901B, M1902B, M1903B, M1904B, M1131A, M1133A (neonate), M1134A (neonate) = 3 % (70 % to 100 %) NellcorPB®...
  • Page 413 36 Specifications Performance Specifications Pulse Range 30 to 300 bpm Accuracy ±2% or 1 bpm, whichever is greater Resolution 1 bpm Sensors Wavelength range: 500 to 1000 nm Emitted Light Energy: ≤15 mW Information about the wavelength range can be especially useful to clinicians (for instance, when photodynamic therapy is performed) Pulse Oximeter 70% to 100%...
  • Page 414 36 Specifications Smart Alarm Delay Specifications The Smart Alarm Delay functionality is currently not available in the U.S.A. or in clinical environments under FDA control. Deviation from violated Resulting alarm delay alarm limit Short Medium Long 10 sec 10 sec 14 sec 10 sec 10 sec...
  • Page 415 36 Specifications NBP Performance Specifications Auto Mode Repetition Times 1, 2, 2.5, 3, 5, 10, 15, 20, 30, 45, 60 or 120 minutes STAT Mode Cycle Time 5 minutes Venipuncture Mode Inflation Inflation Pressure Adult 20 to 120 mmHg (3 to 16 kPa) Pediatric 20 to 80 mmHg (3 to 11 kPa) Neonatal...
  • Page 416 36 Specifications Invasive Pressure Performance Specifications Measurement Range -40 to 360 mmHg Pulse Rate Range 25 to 350 bpm Accuracy ±1% Full Range Resolution 1 bpm Input Sensitivity Sensitivity: 5 µV/V/mmHg (37.5 µV/V/kPa) Adjustment range: ±10% Load Impedance: 200 to 2000 Ω (resistive) Transducer Output Impedance: ≤3000 Ω...
  • Page 417 36 Specifications Invasive Pressure Alarm Specifications Invasive Pressure Alarm Range Adjustment Delay Specifications Pressure -40 to 360 mmHg -40 to 50 mmHg max. (-5.0 to 48 kPa) 2 mmHg (0.5 kPa) 12 seconds >50 mmHg 5 mmHg (1 kPa) Extreme High Difference to high limit 0 to 5 mmHg steps (0.5 kPa) 25 mmHg...
  • Page 418 36 Specifications M3015A Microstream CO Performance Specifications Range 0 to 150 mmHg (0 to 20 kPa), or 20% CO , whichever is lower Accuracy Up to 5 minutes during warmup: ±4 mmHg or 12%, whichever is greater After 5 minutes warmup: 0 to 40 mmHg (0 to 5.3 kPa):±2.2 mmHg (±0.3 kPa) Above 40 mmHg (5.3 kPa):±(5.5% + (0.08%/mmHg above 40 mmHg)) of reading...
  • Page 419 36 Specifications M3014A Mainstream CO Performance Specifications Range 0 to 150 mmHg (0 to 20.0 kPa) Accuracy after 2 minutes warmup: For values between 0 and 40 mmHg: ±2.0 mmHg (±0.29 kPa) For values from 41 to 70 mmHg: ±5% of reading For values from 71 to 100 mmHg: ±8% of reading The specifications are valid for standard gas mixtures, balance air, fully hydrated at 35°C, P...
  • Page 420 36 Specifications Either BTPS or ATPD can be selected as the humidity correction factor for the CO readings. The formula for the correction calculation is: where: = partial pressure at body temperature and pressure, BTPS saturated = partial pressure at ambient temperature and pressure, ATPD Pabs = absolute pressure = 42 mmHg @35°C and 100% RH...
  • Page 421 36 Specifications Alarm Range Adjustment Delay Specifications etCO High 20 to 95 mmHg (2 to 13 kPa) 1 mmHg (0.1 kPa) M3002A/M3014A/M3016A: less than 14 seconds etCO 10 to 90 mmHg (1 to 12 kPa) M3015A: less than 21 seconds. imCO High 2 to 20 mmHg...
  • Page 422 36 Specifications Spirometry The following specifications apply for 760 mmHg ambient pressure and patient gas: room air at 35°C, unless otherwise noted Spirometry Performance Specifications Flow Wave (AWF) Range ±25 l/min (neonatal) ±100 l/min (pediatric) ±180 l/min (adult) Accuracy ±3% or 0.125 l/min (neonatal) 0.25 l/min (pediatric) 0.5 l/min (adult)
  • Page 423 36 Specifications Spirometry Performance Specifications Inspired Volume Range 5 to 100 ml (neonatal) numeric (TVin) 30 to 400 ml (pediatric) 200 to 3000 ml (adult) Resolution 1 ml (neonatal/pediatric) 10 ml (adult) Expired Volume Range 5 to 100 ml (neonatal) numeric (TVexp) 30 to 400 ml (pediatric) 200 to 3000 ml (adult)
  • Page 424 36 Specifications Cardiac Output / Continuous Cardiac Output C.O./CCO Performance Specifications Range 0.1 to 20.0 l/min C.O. (right heart) Accuracy Instrument Specification (electrical): ±3% or 0.1 l/min System Specification: ±5%.or 0.2 l/min Repeatability Instrument Specification (electrical): ±2% or 0.1 l/min System Specification: ±3%.or 0.1 l/min Range 0.1 to 25.0 l/min...
  • Page 425 ±2% (i.e. ±2 units), 1 standard deviation over 40% to 100% range. Resolution Stability (system) Drift <2% over 24 hours Response Time (10 % to 90 %) 5 seconds The accuracy specification for Edwards Lifesciences’ Philips-compatible catheters has been verified in the saturation range 40%-95%.
  • Page 426 36 Specifications Alarm Specifications Range Adjustment Delay SO2, SvO2, ScvO2 10% to 100% max. 15 +4 seconds after value exceeds the set limit range Complies with IEC 60601-2-26:1994/EN60601-2-26:1994. EEG Performance Specifications Leakage Current <=10 mA @ 110 Vac Input Signal Range 1 mVp-p Differential Input Impedance >15 MΩ...
  • Page 427: Safety And Performance Tests

    36 Specifications BIS Performance Specifications BIS, BISx M1034A Bandwidth 0.25 - 100 Hz (-3 dB) High Pass Filters 0.25 Hz, 1 Hz, 2 Hz (-3 dB) Low Pass Filters 30 Hz, 50 Hz, 70 Hz, 100 Hz (-3 dB) Notch Filters (for line frequency) 50 Hz, 60 Hz Impedance Measurement Range 0 to 999 kΩ...
  • Page 428 1 Vrms for conducted disturbances induced by RF fields. Electromagnetic fields with field strengths above 1 V/m and conducted disturbances above 1 Vrms may cause erroneous measurements. Therefore Philips recommends that you avoid using electrically radiating equipment in the close proximity of these measurements.
  • Page 429 36 Specifications IEC 60601-1-2 Electromagnetic environment Immunity test Compliance level test level guidance Voltage dips, <5% U (>95% dip in U <5% U (>95% dip in U Mains power quality should be that short for 0.5 cycles for 0.5 cycles of a typical commercial and/or interruptions hospital environment.
  • Page 430 36 Specifications IEC 60601-1-2 Immunity test Compliance level Electromagnetic environment guidance test level Conducted RF 3 VRMS 3 VRMS Recommended separation distance: IEC 61000-4-6 150 kHz to 80 MHz d = 1.2√P (1 VRMS for respiration and BIS) for respiration and BIS: d = 3.5√P Radiated RF 3 V/m...
  • Page 431 36 Specifications Frequency of 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2,5 GHz transmitter d = 1.2√P d = 1.2√P d = 2.3√P Equation for respiration and BIS: for respiration and BIS: for respiration and BIS: d = 3.5√P d = 3.5√P d = 7.0√P...
  • Page 432 36 Specifications...
  • Page 433: Default Settings Appendix

    Default Settings Appendix This appendix documents the most important default settings of your monitor as it is delivered from the factory. For a comprehensive list and explanation of default settings, see the Configuration Guide supplied with your monitor. The monitor's default settings can be permanently changed in Configuration Mode.
  • Page 434 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Bahamas, The AAMI Bahrain AAMI Bangladesh AAMI Barbados AAMI Belarus Belgium Belize AAMI Benin AAMI Bermuda AAMI Bhutan AAMI Bolivia AAMI Bosnia and Herzegovina Botswana Bouvet Island AAMI Brazil AAMI...
  • Page 435 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Cook Islands AAMI Costa Rica AAMI Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark AAMI Djibouti Dominica AAMI Dominican Republic AAMI Ecuador AAMI Egypt El Salvador AAMI Equatorial Guinea Eritrea...
  • Page 436 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Guatemala AAMI Guernsey Guinea AAMI Guinea-Bissau AAMI Guyana AAMI Haiti AAMI Heard Island and McDonald AAMI Islands Holy See, Vatican City State AAMI Honduras AAMI Hong Kong Hungary Iceland India...
  • Page 437 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Liberia Libyan Arab Jamahiriya AAMI Liechtenstein AAMI Lithuania Luxembourg Macao AAMI Macedonia, The former Yugoslavian Republic of Madagascar Malawi Malaysia Maldives AAMI Mali Malta Marshall Islands AAMI Martinique Mauritania...
  • Page 438 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Niger Nigeria Niue AAMI Norfolk Islands AAMI Northern Mariana Islands AAMI Norway Oman AAMI Pakistan Palau AAMI Palestinian Territory AAMI Panama AAMI Papua New Guinea AAMI Paraguay AAMI Peru...
  • Page 439 37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color Sierra Leone Singapore Slovakia Slovenia Solomon Islands AAMI Somalia South Africa AAMI South Georgia and the South AAMI Sandwich Islands Spain Sri Lanka AAMI Sudan Suriname AAMI Svalbard and Jan Mayen AAMI...
  • Page 440: Alarm And Measurement Default Settings

    37 Default Settings Appendix Country-Description Line Units Units ECG Cable Frequency Weight Height Color United States Minor Outlying AAMI Islands Uruguay AAMI Uzbekistan AAMI Vanuatu AAMI Venezuela AAMI Viet Nam Virgin Islands (British) AAMI Virgin Islands (US) AAMI Wallis and Futuna Islands AAMI Western Sahara Yemen...
  • Page 441: Ecg, Arrhythmia, St And Qt Default Settings

    37 Default Settings Appendix H30 (deviations from H10/ Alarm Settings Factory Default H10/H20/H40 H20/H40) Yel.Al. Interval 20 sec Alarm Low Red Alarm Volume AlarmVol. +2 Yell.AlarmVolume AlarmVol. +0 Inop Volume AlarmVol. +0 AutoIncrease Vol 2 Steps IncreaseVolDelay 20 sec Keep Blinking Relay1 Sensitiv.
  • Page 442: Pulse Default Settings

    37 Default Settings Appendix Factory defaults H10/H20/H40 H30 (deviations from H10/H20/H40) ECG Settings Adult Pedi Adult Pedi Δ ExtrBrady 20 bpm 20 bpm 20 bpm Brady Clamp 40 bpm 40 bpm 50 bpm 40 bpm 60 bpm 80 bpm ECG AL. OFF Inop Cyan Cyan Cyan...
  • Page 443: Respiration Default Settings

    37 Default Settings Appendix Respiration Default Settings Factory defaults H10/H20/H40 H30 (deviations from H10/H20/H40) Respiration Settings Adult Pedi Adult Pedi High Limit 30 rpm 30 rpm 100 rpm Low Limit 8 rpm 8 rpm 30 rpm Apnea Time 20 sec 20 sec 20 sec Alarms...
  • Page 444: Nbp Default Settings

    37 Default Settings Appendix Alarm Default Settings Adult Pedi Setting High Alarm Delay 10 sec 10 sec 10 sec Low Alarm Delay 10 sec 10 sec 10 sec SmartAlarmDelay (SAD) High Alarm Delay (SAD) Short Short Short Low Alarm Delay (SAD) Short Short Short...
  • Page 445: Temperature Default Settings

    37 Default Settings Appendix Temperature Default Settings Factory defaults H10/H20/H40 H30 (deviations from H10/H20/H40) Temp Settings Adult Pedi Adult Pedi Low Limit High Limit Alarms Unit °C °C °C Range 35...43 35...43 35...43 Color Green Green Green Light Light Light Green Green Green...
  • Page 446 37 Default Settings Appendix Factory defaults H10/H20/H40 H30 (deviations from H10/H20/H40) CVP, RAP, LAP, UVP Settings Adult Pedi Adult Pedi Alarms from Mean Mean Mean High Limit 14/6 (10) 10/2 (4) 10/2 (4) Low Limit 6/-4 (0) 2/-4 (0) 2/-4 (0) Alarms Extreme Alarms Enabled...
  • Page 447: Cardiac Output Default Settings

    37 Default Settings Appendix Factory Defaults ICP, IC1, IC2 Settings Adult Pedi Alarms from Mean Mean Mean High Limit 14/6 (10) 10/2 (4) 10/2 (4) Low Limit 6/-4 (0) 2/-4 (0) 2/-4 (0) Alarms Extreme Alarms Enabled Enabled Enabled Δ Extreme High Δ...
  • Page 448: Co2 Default Settings

    37 Default Settings Appendix CCO High Limit 8.5 l/min 3.7 l/min 1.3 l/min CCO Low Limit 4.0 l/min 2.6 l/min 0.3 l/min Alarms CCI High Limit 4.3 l/min/m2 4.3 l/min/m2 5.2 l/min/m2 CCI Low Limit 2.0 l/min/m2 2.6 l/min/m2 1.2 l/min/m2 CO2 Default Settings Factory defaults H10/H20/H40 H30 (deviations from H10/H20/H40)
  • Page 449: Spirometry Default Settings

    37 Default Settings Appendix Spirometry Default Settings Factory Adult Factory Pedi Factory Neo Spirometry Settings Apnea Time MVexp Low 4.0 l/min 2.5 l/min 0.4 l/min MVexp High 8.0 l/min 4.0 l/min 0.8 l/min PIP High PEEP Low PEEP High High Limit (RRspir) Low Limit (RRspir) Scale (AWF) ±150 l/min...
  • Page 450: So2 Default Settings

    37 Default Settings Appendix SO2 Default Settings Factory Adult Factory Neo Factory Pedi Settings Low Limit HR High Limit Alarms Light Intensity Color Yellow Yellow Yellow Hb/Hct Entry Hct [%] Factor Entry Disabled SvO2 Default Settings Factory Adult Factory Pedi Factory Neo Settings Low Limit...
  • Page 451: Eeg Default Settings

    37 Default Settings Appendix EEG Default Settings Factory Adult Factory Pedi Factory Neo EEG Settings TP, SEF MDF, PPF, Delta, Theta, Alpha, Beta SEF Threshold Numeric Average 8 sec 8 sec 8 sec Wave Scale 100µV (or +/- 50µV if Show Gridlines is configured to Yes) Show Gridlines Low Filter 0.5 Hz...
  • Page 452: Vuelink Default Settings

    37 Default Settings Appendix VueLink Default Settings Device Alarms Ignored Color Green...
  • Page 453: Index

    Index Adjusting the Screen Brightness Arrhythmia Relearning Admitting a Centrally-Monitored Arrhythmia Status Messages 10-Electrode (5+5)Cable Sets Patient Assessing a Suspicious SpO2 Reading 10-Electrode (6+4)Cable Sets Admitting a Patient Assigning a Telemetry Device and a 10-Lead Placement Adult Mode Monitor to One Patient 3-Electrode Cable Sets Adult/Pediatric Antimicrobial Coated Assisting Venous Puncture...
  • Page 454 C.O./CCO Curve Alert Messages Pressure) Manually C.O./CCO Prompt Messages Changing Measurement Settings Checking Suspicious Values C.O./CCO Safety Information Changing Monitor Settings Checking The Sepsis Resuscitation Bundle Window C.O./CCO Warning Messages Changing QTc Alarm Limits Checking Transducer Accuracy Cableless Measurement Device INOPs Changing Resp Detection Modes Checking Your Monitor Revision Calculated Values INOPs...
  • Page 455 Centers ECG, Arrhythmia, ST and QT Default Event Review Reports Settings Data Upload from an MMS Event Review Window ECG, Arrhythmia, ST and QT Default Profile Event Summary and Event Counter Monitoring Default Settings Appendix Event Summary Reports ECG/Arrhythmia/ST/QT Defining the Column Interval Using the Event Summary Window ECG/Resp Accessories NBP Measurement...
  • Page 456 How Can You Combine Devices? Invasive Pressure and Pulse Thermodilution Method HR Alarms When Arrhythmia Analysis is Invasive Pressure Default Settings Measuring CO2 using M3014A or X2 Switched Off ISO/IEC Standard Audible Alarms Measuring Continuous Cardiac Hypotension Evaluation Output Measuring Frozen Waves Measuring Mainstream CO2 using Label Compatibility M3016A...
  • Page 457 Performing Calculations for a Specific Realtime Report Drug Rear of the Monitor Performing Drug Calculations Recommended Cables NBP Accessories Performing In-Vivo Calibration Recommended Separation Distance NBP Default Settings Performing PiCCO C.O. Recommended separation distances from NBP INOPs Measurements portable and mobile RF communication NBP Timestamp Performing RH C.O.
  • Page 458 Measurements Setting Up the 12-Lead ECG Starting the iPC Screen Trends Setting Up the In-Vivo Calibration Sterilizing the Monitor ScvO2 Default Settings Stopping a Cyclic Impedance Check Setting up the Modules Selecting a Measurement Label Stopping Recordings Setting Up the PiCCO C.O. Selecting a Pressure for Monitoring Stopping Reports Printouts Measurement...
  • Page 459 Understanding the Resp Display Viewing Calculations Trademark Acknowledgement Understanding the ST Display Viewing Events Traditional Audible Alarms (HP/Agilent/ Updating an ST Map Reference Philips/Carenet) Viewing Graphic Trends Baseline Transferring a Centrally-Monitored Viewing Histogram Trends Updating ST Baseline Snippets Patient Viewing Individual Alarm Limits...
  • Page 460 Weight What is a Timeout Period? Where Can I Find More Information? While Alarms are Paused or Off Working in the ST Map Task Window X1 Connectors and Symbols X1 Multi-Measurement Module (M3001A) X2 Controls and Indicators X2 Left Side X2 Multi-Measurement Module (M3002A) X2 Overview...