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In stru ctio ns fo r Use
Avalon Fetal Monitor
FM20/30, FM40/50, Avalon CL
Rel ease L .3 wi t h So f t w a r e R e v i s i o n L .3 x .x x
Patient Monitori ng


Table of Contents

   Also See for Philips FM20

   Related Manuals for Philips FM20

   Summary of Contents for Philips FM20

  • Page 1 In stru ctio ns fo r Use Avalon Fetal Monitor FM20/30, FM40/50, Avalon CL Rel ease L .3 wi t h So f t w a r e R e v i s i o n L .3 x .x x...
  • Page 3: Table Of Contents

    What's New in Release J.3 3 Basic Operation Supported Measurements Avalon FM20 and FM30 Avalon FM40 and FM50 Getting to Know Your Avalon FM20/FM30 Getting to Know Your Avalon FM40/FM50 Connecting the Monitor to AC Mains Wired Transducers Operating and Navigating...
  • Page 4 Underwater Monitoring 5 FM20/30 Battery Option External Power Supply M8023A Using Batteries Optimizing Battery Performance Storing the Battery Cableless Monitoring with FM20/30 Battery Option Patient Transport Within the Hospital 6 Alarms Alarm Mode Nurse Call Systems Visual Alarm Indicators Audible Alarm Indicators...
  • Page 5 11 Cross-Channel Verification (CCV) Misidentification of Heart Rates Cross-Channel Verification Functionality Overview of Cross-Channel Comparisons Coincidence Examples Recommended Actions for Coincidence INOP 12 Monitoring FHR and FMP Using Ultrasound Technical Description Limitations of the Technology Misidentification of Maternal HR as FHR What You Need Cableless Monitoring - Important Considerations Preparing to Monitor...
  • Page 6 Monitoring DECG Suppressing Artifacts Troubleshooting Testing DECG Mode 17 Monitoring Uterine Activity Externally What You Need External Toco Monitoring Toco Sensitivity Troubleshooting 18 Monitoring Uterine Activity Internally What You Need Internal (IUP) Monitoring Troubleshooting 19 Monitoring aFHR, aHR, and aToco Fetal Heart Rate aFHR Uterine Activity aToco What You Need...
  • Page 7 23 Monitoring SpO2 Selecting an SpO2 Sensor Applying the Sensor Connecting SpO2 Cables Measuring SpO2 SpO2 Signal Quality Indicator (FAST SpO2 only) Assessing a Suspicious SpO2 Reading Understanding SpO2 Alarms Setting Up Tone Modulation Setting the QRS Volume 24 Monitoring Maternal Temperature Measuring Tympanic Temperature Entering Temperature Manually 25 Paper Save Mode for Maternal Measurements...
  • Page 8 Tympanic Temperature Accessories Recorder Paper Batteries 30 Specifications and Standards Compliance Environmental Specifications Physical Specifications Interface Specifications Performance Specifications Recorder Specifications External Displays: FM40/FM50 Only Manufacturer's Information Trademark Acknowledgment Regulatory and Standards Compliance Environment Monitoring After a Loss of Power ESU, MRI, and Defibrillation Cardiac Pacemakers and Electrical Stimulators Fast Transients/Bursts...
  • Page 9: Introduction

    Introduction Who this Book is For This book is for trained healthcare professionals using the Avalon FM20, FM30, FM40, and FM50 fetal/maternal monitors, and the Avalon CL Transducer System. It describes how to set up and use the monitor and transducers. Familiarize yourself with all instructions including warnings and cautions before starting to monitor patients.
  • Page 10: Confirm Fetal Life Before Using The Monitor

    1 Introduction • Monitor refers to the entire fetal/maternal monitor. Display refers to the physical display unit. Screen refers to everything you see on the monitor's display, such as measurements, alarms, patient data, and so forth. • Whenever a monitor’s identifier appears to the left of a heading or paragraph, it means that the FM30 information applies to that monitor only.
  • Page 11: Introducing The Avalon Family Of Fetal Monitors

    159. Introducing the Avalon Family of Fetal Monitors The Avalon family of fetal monitors consists of the Avalon FM20, FM30, FM40, and FM50. While the FM20/FM30 and the FM40/FM50 have different form factors, the method of operation is very similar for all monitors. The Avalon fetal monitors also share transducers, accessories, software, and are compatible with the Avalon CL, and Avalon CTS Fetal Transducer Systems.
  • Page 12 1 Introduction WARNING The fetal/maternal monitors are not intended for: • use during defibrillation, electro-surgery, or magnetic resonance imaging (MRI). • Electrocardiography (ECG) measurements on patients connected to electrical stimulator or with cardiac pacemakers. • use of the invasive measurements IUP and fetal DECG, use of the patient module (M2738A) and use of the Avalon CL system in domestic establishments, and those connected directly to the public low-voltage supply network that supplies buildings used for domestic purposes.
  • Page 13 1 Introduction Indications for Use Avalon Fetal/Maternal Monitor FM20 Indicated for use by trained health care professionals whenever there is a need for monitoring the physiological parameters uterine activity, heart rate, oxygen saturation, noninvasive blood pressure, pulse rate, and temperature of pregnant women, and the fetal heart rates of single fetuses, twins, and triplets in labor and delivery rooms, in antepartum testing areas, in private households and during transports in healthcare facilities.
  • Page 14 Do not use AC mains extension cords or multiple portable socket-outlets. • FM20/FM30 only: The protective earth conductor is required for EMC purposes. It has no protective function against electric shock. Double and/or reinforced insulation protects this device against electric shock.
  • Page 15 Use of the devices in such an environment may present an explosion hazard. • Use only Philips batteries part number M4605A with the FM20 or FM30 with battery option. Use of a different battery may present a risk of fire or explosion. Environmental Specifications: •...
  • Page 16 Accessories WARNING Philips' approval: Use only Philips-approved accessories. Using non-Philips-approved accessories may compromise device functionality and system performance, and cause a potential hazard. Reuse: Never reuse disposable transducers, sensors, accessories, and so forth, that are intended for single use, or single patient use only.
  • Page 17 1 Introduction Security Information Protecting Personal Information Protecting personal health information is a primary component of a security strategy. Each facility using the monitors must provide the protective means necessary to safeguard personal information consistent with country laws and regulations, and consistent with the facility’s policies for managing this information.
  • Page 18 24 October 1995). In addition, your facility should also take into account any additional, more stringent standards put forward by any individual EU countries; that is, Germany, France, and so on. Philips Product Security Policy Statement Additional security and privacy information can be found on the Philips product security web site at: index.wpd Manufacturer Disclosure Statement for Medical Device Security –...
  • Page 19 1 Introduction Avalon FM20/FM30 and FM40/ Avalon CL Base Station CL Pods FM50 Avalon CL Transducers Wired Transducers US transducer (wired) Avalon CL US Transducer Avalon CL Fetal & Maternal Pod (cableless) 866488 M2736A 866076 Toco/ Toco MP transducer Avalon CL Toco+ MP Transducer...
  • Page 20 1 Introduction Avalon FM20/FM30 and FM40/ Avalon CL Base Station CL Pods FM50 Avalon CL Transducers Wired Transducers Toco+ transducer with ECG/IUP Avalon CL ECG/IUP Transducer IntelliVue CL NBP Pod capability (wired) (cableless) (cableless) 865216 M2735A 866077 Patient Module for ECG/IUP...
  • Page 21: What's New

    What's New This section lists the most important new features and improvements to the fetal monitors and their user interface introduced with Release L.3. You may not have all of these features, depending on the fetal monitor configuration purchased. What's New in Release L.3 Avalon CL Fetal &...
  • Page 22 129. Using CL Pods with FM20/30 #E25 The CL Pods can now also be used with a battery operated FM20 or FM30 (option #E25). The CL Pods can be assigned and activated. The CL F&M Pod can also be charged.
  • Page 23 What's New in Release J.3 Avalon CL Transducer System The Avalon CL Transducer System provides cableless monitoring with the Avalon FM20/FM30 and FM40/FM50 with the same functionality and performance as the wired measurement devices (e.g. twin and triplets monitoring). The Avalon CL Transducer System has a straight-forward handling and operating concept.
  • Page 24 2 What's New Manually Entered Maternal Temperature Measurements Manually measured temperatures can be entered at the fetal monitor. They are displayed as a numeric on screen, and are printed out on the recorder trace (“Monitoring Maternal Temperature” on page 249). SpO2 Recordings and Transmissions annotation on local recorder You can now configure the interval for printing the SpO...
  • Page 25 USB Interface An optional USB interface allows the use of bar code readers and input devices such as a keyboard, or mouse (see “Getting to Know Your Avalon FM20/FM30”/“Bottom” on page 32 “Getting to Know Your Avalon FM40/FM50”/“Rear” on page 33).
  • Page 26 2 What's New Alarm Reminder In Configuration Mode, you can set now an Alarm Reminder . The Alarm Reminder emits an audible reminder of alarm conditions that remain active after the alarm is acknowledged. 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 the same as a new alarm).
  • Page 27: Basic Operation

    Basic Operation This chapter 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 on a measurement, changing some monitor settings, and setting up the recorder). The alarms section gives an overview of alarms. The remaining sections tell you how to perform individual measurements, and how to care for and maintain the equipment.
  • Page 28: Supported Measurements

    Different measurements for the same physiological parameter may have a different appearance on the trace, due to: variability (HR), averaging, delay, amplitude, or artifacts. Before interpreting the trace, regard the fetal monitor setup and transducers used. The following Fetal measurements are supported: Measurements FM20 FM30 FM40 FM50 Standard...
  • Page 29: Avalon Fm20 And Fm30

    The Avalon FM30 fetal/maternal monitor offers a solution for both external and internal fetal monitoring applications, and optional noninvasive maternal vital signs. The Avalon FM30 shares all the features and capabilities of the Avalon FM20. In addition, you can monitor one FHR internally with a direct fetal electrocardiogram (DECG), uterine activity internally using an intrauterine pressure (IUP) catheter together with a Toco transducer or patient module.
  • Page 30: Avalon Fm40 And Fm50

    3 Basic Operation The battery option for the FM20/30 provides support for the in-transport monitoring of all FM20/30 with measurements when disconnected from a power supply. Existing data storage is automatically Battery Option #E25 uploaded to OB TraceVue or IntelliSpace Perinatal after reconnecting it to the system. Trace printing Only during transport is also possible.
  • Page 31: Getting To Know Your Avalon Fm20/fm30

    (IUP) catheter together with a Toco transducer or patient module. The Avalon FM50 carries the IP label, indicating that it is capable of intrapartum monitoring. Getting to Know Your Avalon FM20/FM30 Overview Touchscreen display (tilt and fold) Power LED...
  • Page 32 Each of the fetal sensor sockets accepts any fetal transducer, one Avalon CL or one Avalon CTS Cableless Fetal Transducer System base station, or an event marker. Bottom There are five optional interfaces available for the Avalon FM20/30 monitor: • LAN/RS232 system interface •...
  • Page 33 3 Basic Operation You can use two of the five optional interfaces at the same time. LAN/RS232 system interface Dual PS/2 system interface Optional Interfaces Description Flexible nurse call interface card Quad. USB ports Dual MIB/RS232 Rear Display release Carrying handle Built-in stand...
  • Page 34: Getting To Know Your Avalon Fm40/fm50

    3 Basic Operation Getting to Know Your Avalon FM40/FM50 Front Touchscreen color display Transparent paper guide with tear-off edge Paper eject button Power LED On/Standby button Recorder paper table Fetal sensor sockets Noninvasive blood pressure socket (optional) socket (optional) Connect any fetal sensor or patient module at the fetal sensor sockets, including an Avalon CL or an Avalon CTS via interface cable (with red connector).
  • Page 35 3 Basic Operation Rear Reserved for future use: protective earth intended for use in system installations Equipotential grounding point Power cord connector Loudspeaker Slot 01 for optional LAN/RS232 system interface (for connection to an obstetrical information and surveillance system) Slot 03 reserved for future use Video output (VGA) Telemetry interface Slot 02 for optional interfaces: Either...
  • Page 36: Connecting The Monitor To Ac Mains

    Check that the line frequency is correctly configured in the Global Settings menu. • FM20/FM30 only: The protective earth conductor is required for EMC purposes. It has no protective function against electric shock. Double and/or reinforced insulation protects this device against electric shock. •...
  • Page 37 3 Basic Operation Cable - connects to any of the four fetal sensor sockets on the monitor The M2736AA US transducer is identical to the M2736A US transducer, including all specifications Ultrasound Transducer (M2736A) Connector - for connecting ECG/IUP adapter cables (M2735A Toco transducer only) Toco...
  • Page 38: Operating And Navigating

    3 Basic Operation Operating and Navigating Your monitor has a touchscreen. Everything you need to operate the monitor, except the on and off switch, is contained on its screen. Most screen elements are interactive. Screen elements include measurement numerics, screen keys, information fields, status indicators, alarms fields, and menus. Operator Position The typical operator's position is in front of the monitor.
  • Page 39 Perinatal, via a LAN cable or not. Patient identification Date and time Bed label (when connected to a Philips OB TraceVue/IntelliSpace Perinatal system) Fetal heart sound volume adjust/indicator Alarm volume adjust/indicator INOP and alarm status area - shows active alarm messages...
  • Page 40 3 Basic Operation Measurement Area Antenna symbol (indicates a cableless measurement from a connected Avalon CL or Avalon CTS system) Configurable alarm limits NST test Audio source symbol Measurement numeric Alarms off symbol Fetal trace recorder - status indicator Avalon CL or Avalon CTS system - status indicator Battery status indicator Status line - shows status and prompt messages Signal quality indicator: good, acceptable, poor...
  • Page 41 3 Basic Operation Screen Details Icon Description The antenna symbol indicates a cableless measurement (Avalon CL or Avalon CTS). Indicates a short range radio measurement (CL Pods). Signal quality indicator: Good Acceptable Poor Fetal trace recorder - status indicator Fetal recorder is on Fetal recorder is off (when is off) Paper Save Mode...
  • Page 42 3 Basic Operation Keys The monitor has three different types of keys. Permanent Keys A permanent key is a graphical key that remains permanently on the screen, giving you fast access to functions. Name Function Acknowledges all active alarms by switching off audible Silence alarm indicators.
  • Page 43 3 Basic Operation SmartKey Name Function Pages the patient. Only enabled if at least one Call Patient CL transducer is currently active Calls up the window cl F&M Status cl F&M Electrode Status Pause Alarms Pauses alarm indicators. Pause duration depends on monitor configuration.
  • Page 44: Operating Modes

    3 Basic Operation Pop-Up Keys Pop-up keys are context-sensitive graphical keys that appear automatically on the monitor screen when required. For example, the pop-up key appears when you need to confirm a change. Confirm Using the Touchscreen Select screen elements by pressing them directly on the monitor's screen. Disabling Touchscreen Operation To temporarily disable the touchscreen operation of the monitor, press and hold the Main Screen...
  • Page 45: Automatic Screen Layouts

    3 Basic Operation Mode Description Password Protected Configuration Mode The Configuration Mode is for personnel trained in configuration tasks. You can change and store the default values and patient profiles permanently in the Configuration Mode. These tasks are described in the Configuration Guide.
  • Page 46 3 Basic Operation User Default User Defaults are a complete configuration stored in the monitor's long-term memory. You can store the active settings, modified to your preference, in the (in Configuration Mode). User Defaults In Monitoring Mode, you can load the settings to return to your preferred settings: User Defaults Select the...
  • Page 47 Store Date, Time WARNING Do not change the date and time setting, if the fetal monitor is connected to a Philips OB TraceVue/ IntelliSpace Perinatal system. The monitor uses the OB TraceVue/IntelliSpace Perinatal system date and time, including daylight saving time changes. As long as the fetal monitor is connected to the OB...
  • Page 48: Preparing To Monitor

    There is no special emergency access for the Avalon Fetal monitors. For all clinical use cases according the Intended Use, the monitors are taken into operation by connecting them to AC mains and by switching them on. Switching On: FM20/FM30 Connect the monitor to AC mains and switch the monitor on. –...
  • Page 49 Adjusting the Display Angle (FM20/FM30) You can tilt the display on the FM20 and FM30 to one of five different positions, or you can fold it completely down. The tilt/fold mechanism works on a one-way ratchet system. You hear a click as each of the five positions is reached.
  • Page 50 3 Basic Operation To fold the display, pull the display forwards as far as it will go. Then push the display all the way back until it clicks shut. If your monitor is wall-mounted, the display should be folded flat. Fastening Belts and Transducers You can use more than one belt if, for example, you are monitoring uterine activity and FHR simultaneously.
  • Page 51 3 Basic Operation Using Belts with Button Fixings Place the transducer belt across the bed, so that the fixing button will face away from the mother when it is fastened. Lie the patient on the bed and arrange the belt around her until it is tight but still comfortable. Fasten the belt by pushing the fixing button through the overlapping section of the belt.
  • Page 52 3 Basic Operation Alternatively, attach the butterfly belt clip to the transducer belt button and use this to attach the transducer to the belt. The clip allows you to slide the transducer for easy repositioning. Using Belt with Velcro Fixings Insert one end of the belt between the belt guides on one side of the butterfly belt clip, and secure with the velcro fixing.
  • Page 53 3 Basic Operation Repositioning Transducers A patient possibly wears transducers for long periods without interruption. In rare cases, skin irritations may occur if a transducer is attached to one location for a longer period. To ensure there are no adverse effects on the patient's skin, inspect the transducer application site at least every three hours.
  • Page 54 3 Basic Operation For the FM20 and FM30, you can connect an Avalon CL or Avalon CTS Cableless Fetal Transducer system interface cable (red connector) to one of the fetal sensor sockets at the left side of the monitor. For the FM40 and FM50, you can connect an Avalon CL or Avalon CTS Cableless Fetal Transducer System interface cable (black connector) to one of the two dedicated black sockets marked "Tele"...
  • Page 55 3 Basic Operation The blue finder LED on a wired fetal transducer lights up when you touch the measurement on the screen, allowing you to identify the corresponding transducer. finder LED The white finder LED on a cableless fetal transducer lights up when you touch the measurement on the screen, allowing you to identify the corresponding transducer.
  • Page 56 3 Basic Operation Paper Guide FM40/FM50 The recorder in the FM40 and FM50 features a transparent paper guide which: • facilitates correct alignment of the paper, both during loading and while the recorder is running. “Loading Paper FM40/FM50” on page •...
  • Page 57 3 Basic Operation Fetal heart rate label Uterine activity label The current monitoring modes (if any transducers are connected to the monitor) are printed. Whenever a transducer's mode is changed, the following are printed: • the time • the date •...
  • Page 58 3 Basic Operation Time stamp printed every ten minutes The trace records maternal parameters also. When measuring noninvasive blood pressure, the annotation is made at the end of the measurement. If the noninvasive blood pressure measurement repetition time is short, the noninvasive blood pressure numeric may not always be printed. The recording of notes (see “Entering Notes”...
  • Page 59 3 Basic Operation Recording Elements A variety of information can appear on the recorder trace. Here is a sample trace with some of the most common elements and their meaning. Each trace header contains the last name and first name, the patient ID, patient date of birth, the current date and time, patient's bed label, and the gestational age of the pregnancy.
  • Page 60 3 Basic Operation Caution The trace contains sensitive personal data. For information how to protect personal information, see “Protecting Personal Information” on page Choosing Recorder Speed You can choose a recorder speed of 1, 2, or 3 centimeters per minute (cm/min). The default setting is 3 cm/min.
  • Page 61 3 Basic Operation A small arrow is printed on the heart rate scale on the trace paper. This reflects exactly when the marker button was first pressed; keeping the button pressed has no influence on the annotation. Tearing Off the Paper CAUTION Never pull on the paper to advance it, as this can cause misalignment of the paper.
  • Page 62 SmartKey, wait for the paper to stop, then tear it off. The FM20/FM30 does not have a paper guide. The procedure is the same as described for the FM40/ FM20/FM30 FM50 with the exception that you should advance the paper to a perforation.
  • Page 63 3 Basic Operation To load a pack of paper: FM20/FM30 If the recorder is on, press the recorder Start/ Stop SmartKey or the Stop Recordng SmartKey to turn it off before loading a new pack of paper. Press the paper table release to unlock the paper drawer and then pull the table forward to open it fully.
  • Page 64 3 Basic Operation Unfold the top page of the pack and position the uterine activity scale on the right. Slide the pack into the tray.
  • Page 65 Loading Paper FM40/FM50 CAUTION Using recorder paper that is not approved by Philips can result in accelerated paper fading and can damage the thermal line printhead. This type of damage is not covered by warranty. To load a pack of paper:...
  • Page 66 3 Basic Operation Lift out any remaining paper from the tray. Press and hold the paper eject button to partially eject the paper, thus making it easier to remove. Hinge the transparent paper guide forward. It is held in the closed position by a small protrusion on each side of the holder.
  • Page 67 3 Basic Operation Prepare to place the new pack of paper in the tray with the bottom side down. The bottom side is indicated by the word STOP printed on the final page of the new pack. Unfold the top page of the pack and position the uterine activity scale on the right. Slide the pack into the tray.
  • Page 68 3 Basic Operation Close the paper drawer. Now close the paper guide. Press the recorder SmartKey or the SmartKey to switch on the recorder. Start/ Stop Start Recordng Annotations of trace information are printed on the trace paper (see “Switching the Recorder On and Off”...
  • Page 69 3 Basic Operation Entering Notes Your monitor has a set of 15 factory pre-configured notes (see below). It is possible to edit these notes in Configuration Mode (see the Configuration Guide). The maximum length of one single note is 30 characters. To enter a note: Select the SmartKey to open the...
  • Page 70: After Monitoring

    Switch off the monitor. NOTE If an Avalon CL base station is connected to your FM20/30 monitor, do not turn off the monitor if you need to recharge the batteries of the CL transducers. They can only be recharged if the FM20/30 monitor is on.
  • Page 71: Switching The Monitor To The Standby Screen

    • A fetal monitor that was switched off prior to a temporary power loss, remains off when power is restored. • When AC mains power is lost, a battery powered monitor (FM20/30) continues to run without interruption on battery power.
  • Page 72: Monitoring After A Power Failure

    Use recommended paper Dirty printhead Clean printhead, see “Cleaning the Print Head” on page 273 FM20/30 only: Paper misaligned due Shut the drawer fully, pushing evenly to drawer not being correctly shut with both hands End of paper noted when pack not...
  • Page 73: Cableless Monitoring

    Avalon CL Transducer System, you can monitor a single fetus, twins, and triplets. The Avalon fetal monitor (FM20-FM50) connected to the CL base station displays and records the parameters. All the CL transducers and the CL F&M Pod are watertight. The IntelliVue CL Pods should not be immersed in water.
  • Page 74: Basics Of Cableless Systems

    4 Cableless Monitoring Basics of Cableless Systems Avalon CL Transducer System Avalon CTS Transducer System Assigning Cableless Devices The cableless devices of the Avalon CL are assigned by simply docking them at the base station connected to the patient’s fetal monitor. See the Avalon CTS Instructions for Use for the assignment of the CTS transducers.
  • Page 75: Twins And Triplets Support

    The configuration should be carried out by authorized and qualified service personnel, either by the hospital's biomedical department, or by Philips Support. For a detailed description of the configuration see the Avalon CL Service Guide and the Fetal Monitor Configuration Guide.
  • Page 76: Getting To Know Your Avalon Cl

    4 Cableless Monitoring Getting to Know Your Avalon CL Front Transducer docking slots On/Standby button with LED Device label LED for optional cableless Pods Docking slot for cableless Pods WARNING • To avoid magnetic interference affecting the mode of the pacemaker, ensure that the Avalon CL base station does not come into close contact with implanted pacemakers.
  • Page 77 4 Cableless Monitoring Docking Slots for Cableless Transducers The Avalon CL base station has three docking slots to hold the CL transducers. The transducers are charged while docked. The base station has a built-in radio interface with an integrated antenna to communicate with the transducers.
  • Page 78 The base station issues a permanent beeping tone if it is disconnected from a fetal monitor, or if the FM20 or FM30 monitor is switched off, and the base station has transducers or a Pod currently docked that need to be recharged.
  • Page 79 4 Cableless Monitoring Rear and Bottom Name plate Manufacturer label Cable reel...
  • Page 80 CTS Transducer Systems. Regard the following points for cableless monitoring: • You can connect one Avalon CL base station with a red connector to an FM20/FM30 or an FM40/FM50 (fetal socket), or one Avalon CL base station with a black connector to an FM40/ FM50 (telemetry socket).
  • Page 81 You cannot connect two Avalon CL base stations to an FM40/FM50, if one Avalon CL base station has a red connector, and the other Avalon CL base station has a black connector. • You can connect one Avalon CTS system to an FM20/FM30 or FM40/FM50 at a time (either fetal or telemetry socket).
  • Page 82 4 Cableless Monitoring • You cannot connect an Avalon CTS and an Avalon CL at the same time to the same fetal monitor. • Monitoring a multiple pregnancy using cableless transducers is supported by the Avalon CL system only. • Using a mixture of wired and cableless fetal transducers is not supported.
  • Page 83 4 Cableless Monitoring Connecting Two CL Base Stations to an FM40/50 Monitor Two base stations can be connected to an FM 40/50 fetal monitor at the rear black telemetry ports. At both base stations CL transducers and CL Pods can be assigned, activated, and redocked for charging. The base stations work as one extended system together.
  • Page 84: Cableless Transducers

    4 Cableless Monitoring Cableless Transducers The cableless Avalon CL transducers have a built-in radio interface with an on-board, integrated antenna. The fetal monitor connected to the Avalon CL base station can control the transducer using radio communication. The CL transducer transmits measured values, alarms, and status information to the fetal monitor.
  • Page 85 4 Cableless Monitoring CL ECG/IUP transducer Connector Cap for the CL Toco+ MP Transducer The CL Toco MP transducer is delivered with a connector cap covering the MECG/DECG/IUP connector. The connector cap is designed to cover the connector, not to protect it from water. (The connector itself is water-proof and may be immersed in water).
  • Page 86 Cableless Transducer LED Indication The cableless transducers have a multi-color LED that indicates the status of the transducer with specific colors. This LED remains visible when the transducer is correctly attached to the transducer belt (Philips standard belt). LED Status Meaning...
  • Page 87 4 Cableless Monitoring Audio Signal CL Transducers The Avalon CL transducers have three audio signals: • If an ascending tone sequence is played three times, the transducer was triggered by the fetal monitor to page the patient wearing it, or to locate a not docked transducer. •...
  • Page 88 4 Cableless Monitoring Using CL Transducers with a Belt Clip The Avalon CL transducers can also be used with an optional belt clip to be ordered separately (989803184851). Avalon CL belt clip...
  • Page 89: Cl Pods

    4 Cableless Monitoring CL Pods CL Fetal & Maternal Pod The CL F&M Pod provides measurement values for FHR, Toco, and HR. It communicates them to the fetal monitor using short range radio (SRR). It is controlled via SRR from the Avalon CL base station and the connected fetal monitor.
  • Page 90 4 Cableless Monitoring CL Fetal & Maternal Pod LED Indication The CL F&M Pod has a multi-color LED that indicates the status of the CL F&M Pod with specific colors. LED Status Meaning White The LED lights up to identify the CL Pod, and to easily verify the correct assignment (finder).
  • Page 91 4 Cableless Monitoring CL Fetal & Maternal Electrode Patch The single-use disposable adhesive electrode patch holds the CL F&M Pod at the intended application site on the abdomen of the patient. The electrode patch has five adhesive electrodes. The CL F&M Pod is held in place during monitoring with magnetic contacts, and a connector.
  • Page 92 4 Cableless Monitoring IntelliVue CL Pods The two IntelliVue CL Pods provide measurement values for SpO and NBP on the built-in display, and communicate them to the fetal monitor using short range radio (SRR). They are controlled with SRR from the Avalon CL base station and the connected fetal monitor. The maternal measurement pods are assigned by docking them at the Avalon CL base station.
  • Page 93: Calling Patients

    4 Cableless Monitoring Battery Status LED for CL Pods The CL Pods do not have their own battery status LED, but a small battery gauge on their display. On the Avalon CL base station, the battery status LED for the CL Pods is located directly under the docking slot.
  • Page 94: Telemetry

    4 Cableless Monitoring Telemetry Tele Info Window window of the fetal monitors allows you to manage the Avalon CL or CTS system. Tele Info Below is an exemplary view of the Tele Info window. Your window may differ depending on the status of the connected system.
  • Page 95 4 Cableless Monitoring Cableless Status Indication When the monitor recognizes a connected Avalon CL or Avalon CTS interface cable (red or black connector), it confirms the recognition with the following status indicators displayed in the lower right-hand corner of the screen: Avalon CTS Indicator Description...
  • Page 96 4 Cableless Monitoring Indicator Avalon CL A base station is connected to the monitor, it is on, and minimum one assigned cableless transducer or cableless Pod is active. The CL Wide Range Pod is activated and trying to connect to the monitor. A base station is connected to the monitor, it is on, and minimum one assigned cableless transducer or cableless Pod is active.
  • Page 97 4 Cableless Monitoring Use Priority When Combining Cableless and Wired Measurements CL Transducers versus wired transducers CL transducers have priority over wired transducers. If an Avalon CL or Avalon CTS base station is connected to the fetal monitor, and both wired and CL transducers are connected to the monitor, all the wired transducers are disabled whenever one CL transducer is active.
  • Page 98 4 Cableless Monitoring CL Transducer Assignment The CL transducers are assigned by simply docking them at the Avalon CL base station connected to the patient’s fetal monitor. Since twins and triplets can be monitored with the Avalon CL base station, it can be delivered with up to six CL transducers: one CL Toco MP, three CL US, and two CL ECG/IUP transducers.
  • Page 99 4 Cableless Monitoring NOTE When a CL transducer is unassigned, all the measurements from this transducer are no longer monitored; e.g. if you unassign a CL Toco MP transducer, the Toco measurement, maternal Pulse, or possibly also MECG or DECG are no longer monitored. CL Pod Assignment The CL Pods are assigned by simply docking them at the Avalon CL base station connected to the patient’s fetal monitor.
  • Page 100: Preparing To Monitor Cablelessly

    4 Cableless Monitoring Preparing to Monitor Cablelessly When monitoring cablelessly with the FM20/30/40/40 monitors, most of the same procedures apply as described in “Preparing to Monitor” on page 48. Additions and deviations applying to cableless devices and existing procedures are described here.
  • Page 101 Remove the cover from the adhesive area under the central area of the patch. (Do not remove the cover from any of the five surrounding electrodes yet). Verify the correct orientation of the patch. The “Philips/Monica” printed top electrode must point to the patient’s chest.
  • Page 102 4 Cableless Monitoring For the last remaining electrode attached to the long flexible cable, identify the small area of skin to prepare, so that the center of this reference electrode will be positioned on the midline, approximately 6 cm (2.4 in) above the rim of the symphysis pubis. For patients with a displaced umbilicus, very obese patients, or patients with a large panniculus: Place the electrode on top of the panniculus approximating to the point 6 cm (2.4 in) vertically...
  • Page 103 4 Cableless Monitoring At the Monitor After you have placed the CL F&M Pod on the electrode patch, the cl F&M Electrode Status window opens at the monitor. In the window, the electrodes and their skin contact status are shown. The skin cl F&M Electrode Status contact status indicates, whether the skin preparation at each electrode site was successful.
  • Page 104 4 Cableless Monitoring Electrode Description What to Do Status Further skin preparation is required. Carefully remove the electrode from the skin. Dry the skin. Repeat the skin preparation procedure. It is not recommended to skip the electrode status check, if bad skin contact quality is persistently indicated for one or more electrodes.
  • Page 105 4 Cableless Monitoring After Monitoring After monitoring is done, remove the CL F&M Pod from the electrode patch. Clean and disinfect the CL F&M Pod, see “Care and Cleaning” on page 261. Dock the CL F&M Pod back at the base station. Gently remove the electrode patch and the electrodes from the abdomen of the patient.
  • Page 106: Battery Lifetime Management

    4 Cableless Monitoring Battery Lifetime Management The lifetime of a Lithium Ion battery depends on the frequency and duration of use. CL Transducers Battery replacement is recommended after 500 charge-discharge cycles, or if the battery is older than 4 years whatever is reached first. If the battery of a cableless transducer has aged and an exchange of the battery is highly recommended, a prompt message is displayed at the fetal monitor for ca.
  • Page 107: Patient Transport Within The Hospital

    4 Cableless Monitoring The date of manufacture and number of charge-discharge cycles can be printed out in a battery report. Patient Transport Within the Hospital During transport, the patient wearing the CL transducers can be transferred from one fetal monitor to another fetal monitor.
  • Page 108: Underwater Monitoring

    4 Cableless Monitoring Underwater Monitoring Only the battery-operated CL transducers of the Avalon CL and Avalon CTS systems can be used to monitor under water. You can use them to monitor patients in a bathtub or shower. This does not apply to the IntelliVue CL SpO , CL NBP, and the CL Wide Range Pod, do not immerse the CL Pods into water.
  • Page 109: Fm20/30 Battery Option

    The external power supply M8023A (option #E25) allows you to operate the fetal monitor from an AC (alternating current) power source of 100 V to 240 V (±10%) and 50/60 Hz (±5%). If this option is used, then the M8023A (option #E25) power supply is included for FM20/30.
  • Page 110: Using Batteries

    5 FM20/30 Battery Option AC power cord, connected to AC mains socket Measurement Link (MSL) cable, supplies the power to the monitor for operation and for battery charging Power-on LED, the green light is on when the external power supply is connected to the AC...
  • Page 111 5 FM20/30 Battery Option Battery LED The possible battery LED status on the right side of the monitor is described in the table below. Battery LED Colors If the monitor is connected to If the monitor is running on mains power, this means battery power, this means Battery power is >90%...
  • Page 112 5 FM20/30 Battery Option Battery malfunction symbols: Normal battery function is indicated by the battery power gauge, together with the remaining operating time, on the main screen. You are informed of problems or changes in the status of the battery by the battery status/malfunction indicator. This consists of a blank battery gauge containing a "!"...
  • Page 113: Optimizing Battery Performance

    5 FM20/30 Battery Option Symbols indicating critical situations are colored red. Battery Status Symbols Battery Malfunction Symbols Battery is empty (Red) incompatible battery Battery not charging as the (Red) battery malfunction temperature is above or below the specified range Battery requires maintenance...
  • Page 114 5 FM20/30 Battery Option Charging the Battery To charge the battery: Connect the monitor to the external power supply (M8023A). Charge the battery until it is full, the battery LED is green, and the battery power gauge is filled. During high load of the monitor (usage of multiple measurements) the battery may not charge. To remedy this: •...
  • Page 115: Storing The Battery

    Battery Safety Information WARNING Use only Philips batteries part number M4605A. Use of a different battery may present a risk of fire or explosion. Do not open batteries, or dispose of them in fire, or cause them to short circuit. They may ignite, explode, leak, or heat up, causing personal injury.
  • Page 116: Cableless Monitoring With Fm20/30 Battery Option

    The only exception to this is the CL F&M Pod, which can also be charged. The charging time of the CL transducers can take up to 6 hours if they are charged from an FM20/30 with battery option.
  • Page 117: Alarms

    INOPs are cyan by default. The following INOPs can also be configured as red or yellow INOPs to provide a severity indication: • ECG Leads Off • Battery Empty (FM20/30, CL devices) • Cuff Overpress • Cuff NotDeflated • No Pulse...
  • Page 118: Alarm Mode

    6 Alarms • The time between the displayed numerical values exceeding an alarm limit and the alarm indication on the monitor. This delay is the sum of the alarm delay configured for the specific measurement plus the system alarm delay. The system alarm delay is the processing time the system needs for any alarm on the monitor to be indicated after the measurement has triggered the alarm.
  • Page 119: Visual Alarm Indicators

    6 Alarms Visual Alarm Indicators Alarm message: An alarm message appears in the alarm status area on the second line at the top of the screen indicating the source of the alarm. If more than one measurement is in an alarm condition, the message changes every two seconds, and has an arrow at the side.
  • Page 120 6 Alarms Standard Philips Alarms • Red alarms and red INOPs: a high pitched sound is repeated once a second. • Two-star yellow alarms and yellow INOPs: a lower pitched sound is repeated every two seconds. • One-star yellow alarms (short yellow alarms): the audible indicator is the same as for yellow alarms, but of shorter duration.
  • Page 121: Acknowledging Alarms

    Power Loss Tone When power is lost - no power is available from the AC power source or from the battery - a beeper FM20/30 with will sound. The tone can be silenced by pressing the On/Standby button. Battery...
  • Page 122: Alarm Reminder

    6 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 the same as a new alarm).
  • Page 123 Cuff Overpress Battery Empty FM20/30 monitor with battery option. These INOPs switch all alarms back on again, so that an INOP tone can be sounded. You must remove the INOP condition first, before you can switch off or pause the alarms again.
  • Page 124: Alarm Limits

    6 Alarms Extending the Alarm Pause Time If your monitor has the function 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 125 6 Alarms If your monitor is not configured to show the alarm limits next to the numeric, you can see them in the related measurement setup menu. Select the measurement numeric to enter the menu and check the limits. Changing Alarm Limits To change individual measurement alarm limits using the measurement's setup menu: In the measurement's setup menu, select the alarm limit you want to change.
  • Page 126: Reviewing Alarms

    6 Alarms Reviewing Alarms To review the currently active alarms and INOPs, select any of the alarm status areas on the fetal monitor screen. The window pops up. All alarms and INOPs are erased from the Alarm Messages monitor's alarm history when you discharge a patient, or if you leave the Demonstration Mode. Alarm Messages Window Alarm Messages window shows all the currently active alarms and INOPs in chronological order,...
  • Page 127 6 Alarms Viewing the Alarm Latching Settings To see the alarm latching setting for your monitor: In the monitor's Main Setup menu, select Alarms Select , and see the settings. Alarm Settings Visual Latching Audible Latching This setting can be changed in Configuration Mode. You should be aware of the settings chosen for your unit.
  • Page 128: Testing Alarms

    6 Alarms Testing Alarms When you switch the fetal monitor on, a self test is started. You should hear a single tone. This indicates that the audible alarm indicators are functioning correctly. For further testing of individual measurement alarms, perform the measurement on yourself (for example SpO or NBP) or use a simulator.
  • Page 129: Patient Alarms And Inops

    Patient Alarms and INOPs This chapter lists alarms and technical alarms (INOPs) for the fetal monitors irrespective of their priority. Alarm Messages Fetal alarms are identified by either "FHR", "dFHR", or aFHR. All other alarms without these identifiers refer to maternal parameters. Alarm messages can be configured with the Enhanced setting to give more information.
  • Page 130 7 Patient Alarms and INOPs Alarm Message From Condition Indication The heart rate from the Pulse signal has Numeric flashes, red alarm *** Brady (Pulse) fallen below the bradycardia limit. message, alarm tone. ***Brady/P xxx<yyy xxx denotes the lowest measured value; yyy is the bradycardia limit.
  • Page 131 7 Patient Alarms and INOPs Alarm Message From Condition Indication MECG The maternal heart rate obtained from the Numeric flashes and high ** HR High maternal ECG has risen above the high limit is highlighted, yellow **HR xxx>yyy alarm limit. alarm message, alarm tone.
  • Page 132: Technical Alarm Messages (inops)

    7 Patient Alarms and INOPs Technical Alarm Messages (INOPs) Monitor INOPs INOP Message Indication What to do 2nd Tele Incompatible Monitor: INOP tone One of the connected base stations is not supported by the monitor. Check software revisions. Bus Master Incomp Monitor: INOP tone The Bus Master board or firmware is incompatible and cannot be used with this monitor software revision.
  • Page 133: At The Monitor

    Monitor: INOP tone Perform a visual and functional check of all the monitor User I/F Malfunct input devices. Contact your service personnel. FM20/FM30 Battery INOPs INOP Message Indication What to do Monitor: INOP tone...
  • Page 134 Check that there is no paper jam, that the print drawer is Check Paper properly shut, that the paper is loaded with the grid facing Recorder: printout upwards, and that the correct Philips paper is being used. FetRec Chk Config Monitor: INOP tone Recorder Speed...
  • Page 135: Transducers

    7 Patient Alarms and INOPs Wired Transducer INOPs FHR (Ultrasound) INOP Message Indication What to do FHR1 Equip Malf Monitor: INOP tone There is a problem with the FHR hardware. Contact your service personnel. FHR2 Equip Malf FHR3 Equip Malf Monitor: INOP tone The input signal quality is not sufficient to process the FHR1 Signal Loss...
  • Page 136: Environment

    7 Patient Alarms and INOPs Cableless Transducer INOPs INOP Message Indication What to do Monitor: INOP tone The remaining monitoring time with this transducer is cl US Batt Empty !!cl US Batt Empty (configurable cyan, yellow, below 15 minutes. Charge battery. red) !!!cl US BattEmpty CL transducer: yellow tone...
  • Page 137 7 Patient Alarms and INOPs CL Fetal & Maternal Pod INOPs INOP Message Indication What to do Monitor: INOP tone The input signal quality is not sufficient to process the aFHR1 Signal Loss aFHR2 Signal Loss measurement. Reapply the electrodes of the electrode Numeric is replaced by a -?- patch.
  • Page 138 7 Patient Alarms and INOPs INOP Message Indication What to do Monitor: INOP tone • Not all electrodes have sufficient skin contact: cl F&M Chk Electr. without tone, if no CL F&M Prepare the skin at the application site further with Pod parameter shows -?- the abrasive pad.
  • Page 139 7 Patient Alarms and INOPs CL Wide Range Pod INOPs INOP Message Indication What to do Monitor: INOP tone The remaining time with the CL Wide Range Pod is cl WRP Batt Empty !!cl WRP BattEmpty (configurable cyan, yellow, below 15 minutes. Charge the battery. red) !!!cl WRP BatEmpty CL Wide Range Pod: Display...
  • Page 140 7 Patient Alarms and INOPs DECG and MECG INOPs INOP Message Indication What to do Monitor: INOP tone There is a problem with the DECG hardware. Contact dFHR1 Equip Malf dFHR2 Equip Malf your service personnel. dFHR3 Equip Malf dFHR1 Leads Off Monitor: INOP tone One or more DECG lead is not attached.
  • Page 141 7 Patient Alarms and INOPs NBP INOPs INOP Message Indication What to do Monitor: INOP tone (severe Remove the cuff from the patient. Make sure that the Cuff Not Deflated !! Cuff Not Deflat yellow/red INOP tone) tubing is not kinked or twisted. Try restarting the measurement.
  • Page 142 7 Patient Alarms and INOPs INOP Message Indication What to do Monitor: INOP tone Check the tubing and cuff for leakages or kinks. Check NBP Interrupted that you are using the correct cuff size and placement, Numeric is replaced by a -?- and that the correct patient category is selected.
  • Page 143 7 Patient Alarms and INOPs INOP Message Indication What to do Monitor: INOP tone The temperature of the battery in the CL NBP Pod is cl NBP Batt Temp critically high. Check that the Pod is not covered or CL NBP Pod: display exposed to a heat source.
  • Page 144 7 Patient Alarms and INOPs SpO2 INOPs INOP Message Indication What to do Monitor: INOP tone There is a problem with the SpO hardware. Contact your SpO₂ Equip Malf service personnel. Monitor: INOP tone Check the sensor placement. Try another adapter cable SpO₂...
  • Page 145 7 Patient Alarms and INOPs INOP Message Indication What to do Monitor: display only The SpO measurement is currently in upgrade mode. SpO₂ Upgrade Monitoring is not possible in this mode. Numeric unavailable Monitor: INOP tone There is too much interference caused by a high level of SpO₂Interference ambient light, and/or electrical interference.
  • Page 146 7 Patient Alarms and INOPs INOP Message Indication What to do Monitor: INOP tone If this INOP appears and an INOP tone sounds, check cl SpO₂ Chk Sett the Cableless Measurement Device and patient settings CL SpO Pod: display before you resume making measurements. If the settings message are unexpected, there may be a problem with the Cableless Measurement Device software.
  • Page 147: Admitting And Discharging

    Admitting and Discharging The fetal monitor can store basic patient demographic information used to identify patients. Admit/Discharge on the Monitor This section describes how you admit and discharge patients when using the monitor as a stand-alone device (that is, when not used with an obstetrical information and surveillance system such as OB TraceVue/IntelliSpace Perinatal).
  • Page 148 8 Admitting and Discharging Quick Admitting a Patient Quick Admit to quickly admit a patient using only a limited set of demographic data. Select the Quick Admit SmartKey. Enter the required data (ID fields or last name depending on configuration) with the keyboard or a barcode scanner.
  • Page 149: New Patient Check

    8 Admitting and Discharging New Patient Check The fetal monitor can be configured to ask you in certain situations: • after a specified power-off period • after a specified standby period whether a new patient is now being monitored. The pop-up window is entitled Is this a New Patient? The monitor offers a key, to discharge the previous patient and begin monitoring a new patient,...
  • Page 150 8 Admitting and Discharging OB TraceVue/IntelliSpace Perinatal via RS232 In contrast to a LAN connection, when the monitor is connected to an OB TraceVue/IntelliSpace Perinatal system over an RS232 connection, the OB TraceVue/IntelliSpace Perinatal system does not have full control over the monitor's patient admission and discharge functions. Depending on how OB TraceVue/IntelliSpace Perinatal is configured, either the Last Name First Name...

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