Download  Print this page

Philips 50 XM Series Instructions For Use Manual

Fetal/maternal monitors.
Hide thumbs

Advertisement

Series 50 XM (M1350B)
Series 50 XMO (M1350C)
Fetal/Maternal Monitors
I N S T R U C T I O N S F O R U S E
M1350-9001S
Printed in Germany March 2002
Edition 1

Advertisement

Table of Contents

   Also See for Philips 50 XM Series

   Summary of Contents for Philips 50 XM Series

  • Page 1 Series 50 XM (M1350B) Series 50 XMO (M1350C) Fetal/Maternal Monitors I N S T R U C T I O N S F O R U S E M1350-9001S Printed in Germany March 2002 Edition 1...
  • Page 2 Philips makes no warranty of any kind with regard to this material, including, but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Philips shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing, performance or use of this material.
  • Page 3 Intended Use (M1350C) The Series 50 XMO Fetal/Maternal Monitor (M1350C) allows non-invasive or invasive monitoring of an ambulant patient during both antepartum testing and labor and delivery in that the monitoring of the fetal heart rate (FHR) via ultrasound or direct electrocardiogram (DECG), and uterine activity via an external Toco transducer or an internal intrauterine pressure (IUP) transducer is possible, additionally it allows maternal heart rate recording via the MECG transducer.
  • Page 4 US law restricts this device to sale by, or on the order of, a physician.  2002 Philips Medizinsysteme GmbH All rights are reserved. Reproduction in whole or in part is prohibited without the prior...
  • Page 5: Table Of Contents

    Contents 1. Safety ..........1 General Safety Information .
  • Page 6 4. Getting Started ........29 Introduction .
  • Page 7 7. Monitoring Twin FHRs........63 Introduction ............63 Things to Remember During Monitoring .
  • Page 8 Example Trace ............88 Trace Display on External Monitoring Systems .
  • Page 9 Warning Messages ........... . . 107 Acknowledging a Warning Message.
  • Page 10 Alarm (SpO ) ............134 Turning Alarm On and Off.
  • Page 11 19. Troubleshooting ........159 Introduction .
  • Page 12 Ultrasound, External and Internal Toco........179 Recorder .
  • Page 13: Safety

    Safety General Safety Information This symbol indicates that you should consult the Instructions For Use (this guide), and particularly any warning messages. Equipotential Terminal This symbol identifies terminals which are connected together, bringing various equipment or parts of a system to the same potential. This is not necessarily earth potential.
  • Page 14: Electrical Safety

    Electrical Safety ORDINARY EQUIPMENT - Enclosed equipment protected against ingress of water. CONTINUOUS OPERATION - Can be operated continuously. The Series 50 XMO and the Series 50 XM are not “ECG-Monitors”, are not defibrillator-protected, and are not designed for direct cardiac application.
  • Page 15: Maximum Input/output Voltages

    Maximum Input/Output Voltages Maximum Input/Output Voltages The following diagram shows the sockets for peripheral devices. Chapter 1 - Safety...
  • Page 16 Use the grounding cable supplied with the monitor. 3. +5V input socket for the HBSW8200 Barcode Reader. 4. Socket for the Philips M1310A Series 50 T Fetal Telemetry System. +5V input except for: Pins 1, 14, 15 and 16: ± 12V input...
  • Page 17: Service Socket For Upgrade Key

    Service Socket for Upgrade Key Service Socket for Upgrade Key The Service Engineer can connect a compatible PC to this socket (1) to carry out extended configuration and service functions. Maximum voltage of ± 12V. Protective Earth To protect hospital personnel and the patient, the monitor’s casing must be grounded.
  • Page 18: Environment

    Environment Warning Check each time before use that the monitor is in perfect working order and properly grounded. Position the patient cable so that it does not come into contact with any other electrical equipment. The cable connecting the patient to the monitor must be free of electrolyte.
  • Page 19: Spillage

    During the test program the monitor was subjected to international standard and Philips proprietary EMC tests. During most of the testing no anomalies were observed. Some reduced performance was observed with the IEC 801-3 Radiated Immunity and IEC 801-4 Fast Transient/ Bursts Immunity tests.
  • Page 20: System Characteristics

    Electromagnetic Compatibility (EMC) Immunity Parameter Sensor Frequency Range Level M1191A 52 MHz to 70 2.3 V/m M1192A M1194A IEC 801-4 specified that the product is subjected to high speed pulses up to 1000 V applied to the power cord and all I/O cables. During and after most of the test pulses, no anomalies were observed.
  • Page 21: Avoiding Interference

    4. Add external attenuators. If EMI becomes an unusually difficult problem, external devices such as an isolation transformer or a transient suppressor may help. An Philips customer engineer can assist you in determining the need for external devices. ESU, MRI and Defibrillation...
  • Page 22: Leakage Current

    Leakage Current Leakage Current Leakage current can be hazardous to the patient. Warning If the monitor is connected directly to other equipment, such as an additional patient monitor, or a second monitor is to be connected directly to the mother, you must carry out all relevant safety tests in accordance with safety standard IEC 60601-1-1.
  • Page 23: Overview

    Overview About This Guide This guide tells midwives, nurses and other healthcare professionals how to use the Series 50 XMO fetal/maternal monitor and the Series 50 XM fetal/maternal monitor. It discusses and illustrates all possible features and parameters of both monitors. Your monitor may not have every one of these features and may look slightly different to the monitor shown in the illustrations in this guide.
  • Page 24: Major Parts And Keys

    Major Parts and Keys Major Parts and Keys The display panel can be viewed flat in the monitor, or tilted at an angle. 1. Monitor on/off switch 9. Function key 2. Monitor on/off light 10. Telemetry indicator 3. Recorder keys 11.
  • Page 25: Cardio, Toco And Fspo Channels

    Major Parts and Keys Cardio, Toco and FSpO Channels 1. Toco Display shows uterine activity. 2. Fetal SpO display shows fetal pulse indicator, signal quality, alarm status, and cross channel verification plus indicator. 3. Cardio Display shows the FHR. 4. Signal Quality Indicator shows the quality of heart rate signal detected by the transducer: –...
  • Page 26 Major Parts and Keys 7. Fetal SpO display shows current value of FSpO 8. Speaker Lamp shows which heartbeat is heard from the loudspeaker. 9. Volume Keys set the volume and select the channel to which you are listening. Changes current setting of FMP, twins offset, logic, FHR alert and FSpO alarms.
  • Page 27: Maternal Parameters

    Major Parts and Keys Maternal Parameters 1. NBP Transducer Socket for connecting: – NBP cuff interconnect tubing (M1599A) and blood pressure cuff. 2. SpO Transducer Socket for connecting: – SpO transducer (M1940A adapter cable connected to M1191A transducer). 3. Softkeys for setting maternal parameters. –...
  • Page 28 Major Parts and Keys 6. Maternal heart/pulse rate icon indicates measurement source of maternal heart/pulse rate. indicates heart rate value comes from MECG. indicates pulse rate value comes from SpO indicates average pulse rate value comes from NIBP. 7. Maternal Heart Rate shows the current heart/pulse rate. 8.
  • Page 29: Recorder Keys

    Major Parts and Keys Recorder Keys 1. Recorder On/Off Light lights when the recorder is working. Flashes when monitor detects five or fewer pages remaining in the pack, or if the paper runs out. 2. Recorder On/Off Key switches recorder on and off. Also starts NST timer (switch off recorder and press for two seconds).
  • Page 30: Setting Keys

    Major Parts and Keys Setting Keys 1. Time and Date Key for changing the time and date. Press to show the current time in the Cardio 1/Combi and Toco displays, to cycle through the settings to be changed (hours, minutes, day, month and year) and to return to the normal display.
  • Page 31: General Information

    Your monitor may not have all these features. Features The Philips Series 50 XMO fetal/maternal monitor and the Philips Series 50 XM fetal/maternal monitor combine advanced fetal monitoring with integrated maternal non-invasive blood pressure, pulse oximetry and ECG measurement.
  • Page 32: Suspected Fetal Demise

    Suspected Fetal Demise The monitors give you flexible monitoring capability for both high-risk patients and those with normal labor and delivery. Both monitors can measure traditional fetal parameters, including twins. Maternal vital signs - blood pressure, pulse oximetry, and maternal ECG - are monitored non-invasively.
  • Page 33: Fastening A Belt

    Fastening a Belt Fastening a Belt Arrange the belt around the patient until it is tight but still comfortable. Fasten it by pushing the fixing button through the overlapping section of the belt, with the point facing away from the patient. Ensure that the fixing button and the loose ends of the belt are at the patient’s side.
  • Page 34: Clipping A Transducer To The Belt

    Clipping a Transducer to the Belt Clipping a Transducer to the Belt When you have positioned a transducer satisfactorily, you can clip it to the belt. Alternatively, you can affix a button to the transducer and use this to attach the transducer to the abdominal belt. See the Installation Note that comes with the Transducer Knob Adapter for assembly instructions.
  • Page 35: Attaching A Patient Module To The Belt

    Attaching a Patient Module to the Belt Attaching a Patient Module to the Belt You can attach a patient module to the belt by sliding the patient module under the belt and pushing the fixing knob (1) on the patient module through one of the holes in the belt.
  • Page 36: Signal Quality

    Signal Quality Signal Quality During monitoring, if the signal quality indicator fluctuates between red, yellow and green, it does not necessarily means that the transducer needs repositioning. The fluctuation may be caused by fetal movement. Allow time for the signal to stabilize before deciding whether to reposition the transducer (ultrasound) or apply a new electrode (ECG).
  • Page 37: Input Channels At A Glance

    Input Channels at a Glance Input Channels at a Glance This table indicates which combination of transducers and patient modules you can use in the Cardio input sockets. Cardio1/Combi Cardio 2 Measurements US (M1356A or M1358A) Dual ultrasound. (M1356A) DECG (M1357A or M1364A) Single ultrasound and fetal ECG.
  • Page 38: Example Trace

    Example Trace Example Trace 1. Manufacturer’s logo. 2. Time, date and paper speed. 3. Barcode notes. 4. Fetal movement profile. 5. Fetal blood oxygen saturation level (FSpO ) trace. 6. Uterine activity trace. 7. Maternal heart rate (78 bpm) (either Sp0 or NBP pulse rate).
  • Page 39: Marking An Event

    Marking an Event Marking an Event Use the event marker key or the remote event marker to record significant events on the paper (for example, when pain medication is administered or when the mother changes position). To mark an event on the paper: •...
  • Page 40 Marking an Event Chapter 3 - General Information...
  • Page 41: Getting Started

    Getting Started Introduction This chapter tells you how to prepare your monitor to begin monitoring your first patient. You should: • Ensure that your monitor is set for the correct voltage for your country • Check the time, date, and paper speed •...
  • Page 42: Switching On The Monitor

    Switching On the Monitor To use the monitor with other equipment in an operating room environment, connect the equipotential grounding point (B) to earth potential. Use the grounding cable supplied with the monitor. Switching On the Monitor Connect the power cord to the rear of the monitor. Press Line~ to switch on the monitor.
  • Page 43: Loading Paper

    Loading Paper Loading Paper To load a new pack of paper: a. Switch off the recorder. rep5_bw.hpg b. Push the paper-eject key (1) to unlock the drawer. Make sure that the drawer is fully open (2). c. Push and hold the paper-eject key and lift out any remaining paper.
  • Page 44 Loading Paper f. Position the uterine activity scale on the right. rep6_bw.hpg g. Slide the pack into the tray (3). h. Push the drawer back until it “clicks” closed. Don’t push on the paper when closing the drawer (4). pega73_bw.hpg i.
  • Page 45: Switching On The Recorder

    Switching on the Recorder Caution Using recorder paper that is not approved by Philips can damage the monitor. This type of damage is not covered by warranty. If you have difficulty removing the paper, ensure that you have pushed the paper-eject key twice. The first push releases the paper drawer. The second push engages the paper eject mechanism which pushes the remaining paper up the drawer towards you, making it easy to remove.
  • Page 46: Displaying The Time And Date

    Displaying the Time and Date Displaying the Time and Date The date and time are printed on the trace. You can choose from a variety of standard date and time formats, such as 12 hour format or 24 hour format, US or European date format. If you have a barcode reader you can change the time and date display format by scanning the desired format from the barcode sheet.
  • Page 47: Choosing Paper Speed

    Choosing Paper Speed To set the time and date: 1. Press and release to display the current time. The Cardio 1/ Combi display flashes to show that the hour can be changed. 2. Press to set the hour. Press and hold the keys to change the setting more quickly.
  • Page 48: Setting The Paper Speed

    Setting the Paper Speed Setting the Paper Speed Use the paper speed key to display the current paper speed and to return to the normal display. You also return to the normal display automatically if you don’t press any key for a few seconds. Use the volume keys to change the speed.
  • Page 49: Switching Off After Monitoring

    Switching Off After Monitoring Switching Off After Monitoring 1. Switch off the recorder (1). 2. Press and release the paper advance key (2) to advance the paper automatically to the next fold. 3. While you wait for the paper to advance to the next fold, remove the transducers from the patient.
  • Page 50 Switching Off After Monitoring Chapter 4 - Getting Started...
  • Page 51: Monitoring Fhr And Fmp Using Ultrasound

    Monitoring FHR and FMP Using Ultrasound Introduction This chapter describes how to monitor a single fetal heart rate using ultrasound. Monitoring using ultrasound is recommended from the 25th week of gestation for non-stress or normal routine fetal monitoring. The monitor can also detect fetal movements and display the resulting fetal movement profile (FMP) on the trace.
  • Page 52: Getting Started

    4. Find the fetal heart position by palpation, auscultation or ultrasound imaging. Caution Using ultrasound gel that is not approved by Philips may reduce signal quality and may damage the transducer. This type of damage is not covered by warranty.
  • Page 53 Getting Started 5. Apply a small amount of ultrasound gel in a thin layer to the transducer. 6. Apply the transducer to the patient, working it in a circular motion to ensure the gel layer makes good contact. 7. When you have a good signal, clip the transducer in position on the belt.
  • Page 54: Fetal Movement Profile

    Fetal Movement Profile Fetal Movement Profile The monitor can detect fetal movements via an ultrasound transducer plugged into the Cardio 1/Combi socket. The resulting fetal movement profile (FMP) appears as “activity blocks” (A) along the top of the Toco Scale, the length of each block showing the duration of the activity. FMP Statistics FMP Statistics (B) are printed below the activity blocks every 10 minutes.
  • Page 55: Switching Fmp Off And On

    Fetal Movement Profile Note— The transducer detects gross fetal body movements. Eye movements are not detected and movement of the feet and hands may not be detected. Positioning or repositioning the transducer is recorded as fetal movement. Maternal movement, excessive fetal breathing or fetal hiccups may also be recorded as fetal movement.
  • Page 56: Using Keys

    Fetal Movement Profile Using Keys You must connect an ultrasound transducer to the Cardio 1/Combi socket before you can change the FMP setting. 1. Press repeatedly until the monitor displays The Signal Quality Indicator shows: RED if FMP is OFF. GREEN if FMP is ON.
  • Page 57: Troubleshooting

    Troubleshooting Troubleshooting Problem Possible Causes Solutions Erratic trace. Fetal arrhythmia. None. Erratic display. Obese patient. None. Transducer wrongly positioned. Reposition transducer until signal quality indicator is green. Belt loose. Tighten belt. Too much gel. Remove excess. Very active fetus. None. Maternal movement.
  • Page 58 Troubleshooting Chapter 5 - Monitoring FHR and FMP Using Ultrasound...
  • Page 59: Monitoring Fhr Using Decg

    Monitoring FHR Using DECG Introduction This chapter describes how to monitor a single fetal heart rate using a spiral Fetal Scalp Electrode. Because the tip of the electrode penetrates the fetal epidermis, the possibility of trauma, hemorrhage and infection exists. Use the electrode only under aseptic conditions.
  • Page 60: What You Need

    What You Need What You Need • If you are measuring fetal DECG using the traditional open-wire method with a legplate transducer: – DECG legplate transducer (M1357A) – Transducer leg belt and button – Open-wire Fetal Scalp Electrode (M15133A/M15133C). • If you are measuring fetal DECG using the traditional open-wire method with a patient module: –...
  • Page 61: Getting Started

    Getting Started Getting Started Prepare as you would for a routine sterile vaginal examination. Ensure that the fetus is in a position to be monitored by DECG. Attach the electrode to the fetus as described in the instructions that come with the Fetal Scalp Electrode.
  • Page 62: Using The Traditional Open-wire Method To Monitor Decg

    Using the Traditional Open-wire Method to Monitor DECG Using the Traditional Open-wire Method to Monitor DECG (applicable to Fetal Scalp Electrode 15133A and 15133C) With DECG legplate M1357A To monitor fetal DECG using the traditional open-wire method and a DECG legplate M1357A, follow these instructions. 1.
  • Page 63: With Patient Module M1364a Or M1365a

    Using the Traditional Open-wire Method to Monitor DECG 3. Connect the Fetal Scalp Electrode wires to the DECG transducer. 4. You are now ready to begin monitoring DECG: see the section “Monitoring DECG” for your next step. With Patient Module M1364A or M1365A To monitor fetal DECG using the traditional open-wire method and either an ECG-only patient module (M1364A), or an FSpO /ECG...
  • Page 64 Using the Traditional Open-wire Method to Monitor DECG Ensure that the electrode is correctly positioned to prevent tension in the cable from pulling on the Fetal Scalp Electrode and injuring the fetus. 4. Attach the pink connector (1) on the DECG Cable (M1362A) to the ECG pink connector (1) on the patient module (M1364A/ M1365A).
  • Page 65: Using The Decg Adapter Cable M1362b To Monitor Decg

    Using the DECG Adapter Cable M1362B to Monitor DECG Using the DECG Adapter Cable M1362B to Monitor DECG (Applicable to Fetal Scalp Electrode 15133D/15133E) With DECG Legplate M1357A To monitor fetal DECG using the DECG Adapter Cable (M1362B) and a DECG legplate transducer (M1357A), follow these instructions. 1.
  • Page 66 Using the DECG Adapter Cable M1362B to Monitor DECG 2. Secure the legplate transducer under the abdominal belt or under the leg belt. To get the best signal the transducer must have good contact to the mother’s skin. Do not apply Redux creme or any other conductive gel to the silver plate on the bottom of the DECG transducer.
  • Page 67 Using the DECG Adapter Cable M1362B to Monitor DECG 4. Connect the DECG Adapter Cable (M1362B) to the DECG Adapter (M1347A). M1362B M1357A M1347A 5. Connect the Fetal Scalp Electrode (15133D/15133E) to the DECG Adapter Cable (M1362B). M1349A 15133D or M1362B 15133E 6.
  • Page 68: With Patient Module M1364a Or M1365a

    Using the DECG Adapter Cable M1362B to Monitor DECG With Patient Module M1364A or M1365A To monitor fetal DECG using the DECG Adapter Cable M1362B and either an ECG-only patient module (M1364A) or an FSpO /ECG combined patient module (M1365A), follow these instructions. 1.
  • Page 69 Using the DECG Adapter Cable M1362B to Monitor DECG 4. Attach the pink connector (1) on the DECG Adapter Cable (M1362B) to the ECG pink connector (1) on the patient module (M1364A/M1365A). M1349A M1362B M1364A M1365A 5. Fix the patient module to the patient’s belt using the fixing knob (2).
  • Page 70 Using the DECG Adapter Cable M1362B to Monitor DECG Typical Configuration Showing Fetal Scalp Electrode 15133E/D, DECG Adapter Cable M1362B, and Patient Module M1364A Chapter 6 - Monitoring FHR Using DECG...
  • Page 71: Monitoring Decg

    Monitoring DECG Monitoring DECG 1. Switch on the monitor and the recorder. 2. Connect the legplate, or patient module, to the monitor. To simultaneously measure fetal pulse oximetry and DECG you must connect the patient module to the Cardio 1/Combi socket. If you are measuring DECG only you may use either the Cardio 1/ Combi socket or the Cardio 2 socket.
  • Page 72: Why Use Arrhythmia Logic

    Why use Arrhythmia Logic? Warning Periodically compare the mother’s pulse with the signal coming from the monitor’s loudspeaker to ensure that you are monitoring fetal heart rate. Do not mistake a high maternal heart rate for FHR. When you monitor maternal heart rate simultaneously with FHR, cross-channel verification alerting warns you if maternal and fetal heart rates coincide.
  • Page 73: Troubleshooting

    Troubleshooting Troubleshooting Problem Possible Causes Solutions Erratic trace. No ECG signal. Use a new spiral electrode. Erratic display. Poor contact between the reference electrode and the mother. Patient module is not Attach the patient module to the securely fixed. patient’s belt with the fixing button. Signal quality indicator is red Fetal arrhythmia.
  • Page 74: Heart Rate Out Of Limits

    Heart Rate Out of Limits Heart Rate Out of Limits A questionable heart rate is rare but these are some of the possible causes. Problem Possible Cause Questionable FHR less than 30 bpm heart rate. FHR is not recorded and the signal quality indicator is red.
  • Page 75: Monitoring Twin Fhrs

    Monitoring Twin FHRs Introduction You can monitor twins throughout labor and delivery after rupture of the membranes by monitoring one twin externally using ultrasound and the other internally using DECG. If you want to monitor twins externally, you can use two ultrasound transducers, or one ultrasound transducer and a US/MECG transducer.
  • Page 76: Monitoring Internally

    Monitoring Internally • Monitor maternal heart rate, especially during later stages of labor, to avoid mistaking maternal heart rate for FHR. Cross-channel verification then alerts you if this occurs. Monitoring Internally Monitor one twin using the procedures described in Chapter 5, “Monitoring FHR and FMP Using Ultrasound”. Monitor the second twin using the procedures described in Chapter 6, “Monitoring FHR Using DECG”.
  • Page 77: Separating Twin Fhr Traces

    Separating Twin FHR Traces to distinguish at a glance the Cardio 1/Combi US transducer from the Cardio 2 US transducer. Separating Twin FHR Traces To help interpretation of traces with similar baselines, you can separate the baselines, so that one is displayed on the trace as if it is 20 bpm higher than the other.
  • Page 78: Twins Offset: On

    Separating Twin FHR Traces Using the Barcode Reader Enter “Twins Offset” from the barcode sheet. Twins Offset: On To indicate that Twins Offset is switched on and the Cardio 1/Combi trace is offset: • A dotted line labeled ‘+20’ prints across the FHR scale. •...
  • Page 79: Twins Offset: Off

    Troubleshooting Twins Offset: Off To indicate that Twins Offset is switched off a dotted line labeled “+0” prints across the FHR scale. Switching off the monitor automatically switches off Twins Offset. Troubleshooting The following problem may occur when monitoring twins. Problem Possible Cause Solution...
  • Page 80 Troubleshooting Chapter 7 - Monitoring Twin FHRs...
  • Page 81: Monitoring Uterine Activity

    Monitoring Uterine Activity Introduction You can measure uterine activity externally using a Toco transducer, or internally using an intrauterine catheter. A Toco transducer measures the frequency and duration of contractions but not their intensity. Amplitude and sensitivity depend on various factors such as the position of the transducer, the belt tension and the size of the patient.
  • Page 82: Internal Toco Monitoring (iup Monitoring)

    Internal Toco Monitoring (IUP Monitoring) 4. Place the transducer on the patient’s fundus to ensure the optimum recording of uterine activity. 5. When you have a good signal, clip the transducer in position on the belt. 6. Between contractions, press the Toco Baseline Key .
  • Page 83: Troubleshooting

    Toco its elasticity. and the entire surface of the transducer baseline varies. without causing discomfort. Ensure your are using the correct Philips belt. Adjust it as necessary. Maternal movement. Relax the patient. Fetal movement. None.
  • Page 84: Internal Toco

    Troubleshooting Internal Toco Problem Possible Causes Solutions No trace. Catheter blocked. Flush with sterile solution. No change in pressure during Dry environment or Flush with sterile solution or reposition contraction. possible extra-ovular sensor. placement of sensor tip. Only pressure peaks can be seen Zero adjustment is Zero the system.
  • Page 85: Fetal Pulse Oximetry

    Fetal Pulse Oximetry Introduction Fetal pulse oximetry (FSpO ) gives you a continuous real-time measurement of the percentage of oxygen saturation in the fetal arterial blood. Identifying adequately oxygenated fetuses and those at risk of hypoxia may help clarify whether or not intervention in the case of a non- reassuring fetal heart rate trace is necessary.
  • Page 86: To Begin Monitoring

    To Begin Monitoring To Begin Monitoring 1. Plug the FSpO ECG combined patient module into the Cardio 1/Combi socket. The monitor displays the symbol: 2. Check, and if necessary change, the alarm settings. 3. Connect the sensor to the patient module, maintaining sterility by exposing only the connector when you open the sensor package.
  • Page 87: Understanding The Display

    Understanding the Display 6. Wait until the four-step signal quality indicator shows that it is receiving a medium or good signal (with three or four segments lit). It may take up to a minute after this until the monitor displays the fetal oxygen saturation value. Do not reposition the sensor unless you are certain the monitor is not receiving a signal of acceptable quality.
  • Page 88 Understanding the Display The monitor may not yet be able to calculate a saturation value from the signal it is receiving. If the pulse indicator becomes briefly irregular, and then returns to a regular rhythm, do not reposition the sensor. The irregularity is probably caused by fetal or maternal movement.
  • Page 89: Alarm

    Alarm You should check the fetus and adjust the sensor until you are sure you are recording fetal oxygen saturation. 5. Saturation value This displays the level of oxygen saturation in the fetal blood. Typical fetal values lie within the range 40% to 70%. See Chapter 3, “General Information”...
  • Page 90: Triggering An Alarm

    Alarm Triggering an Alarm For an alarm to trigger: • The FSpO alarm must be switched on and • The percentage saturation must fall below the saturation alarm level for the length of time specified by the time delay. Acknowledging an Alarm Press the acknowledge key on the recorder or the yellow key on the maternal display to acknowledge an FSpO alarm.
  • Page 91: Inop Alarms

    Alarm 5. Press to set the time delay. The Toco display shows indicating that you are changing the time delay. The FSpO display shows the current delay, in minutes. 6. Press to increase or decrease the time delay in increments of 0.5 minutes. Press to return to normal monitor function.
  • Page 92: Troubleshooting

    Troubleshooting Troubleshooting Display Problem Solution Patient module not Plug in patient module. plugged in. Patient module plugged Check connection of in but sensor not sensor to patient attached. module. Replace patient module or sensor if necessary. Patient module and The sensor has lost sensor are both contact with the correctly connected but...
  • Page 93: Loss Of Pulse Signal

    Loss of Pulse Signal Loss of Pulse Signal Temporary loss of pulse signal is normal and the clinical professional must judge whether the trace gives enough information for diagnosis. Loss of pulse signal can occur: • If there is excessive or prolonged fetal or maternal movement •...
  • Page 94 Inaccurate Measurements Chapter 9 - Fetal Pulse Oximetry...
  • Page 95: Monitoring Using External Devices

    Monitoring Using External Devices Introduction This chapter describes how to record maternal non-invasive blood pressure (NIBP), maternal blood oxygen saturation level (SpO maternal temperature and maternal heart rate (MHR) by connecting a supported external device to your monitor. If you have a Series 50 XM ...
  • Page 96: Recording From An External Device

    You can connect: Parameters Maternal Fetal Supported External Devices FSpO NIBP Temp Philips M1165A/1166A/1175A/ 1176A/1167A/1177A CMS Philips 78352C/78354C Compact Configurable Monitor (CCM) Dinamap 1846/8100 NIBP Monitor Press-Mate/Listmini Model BP-8800 Accutorr 3, 4 Accutorr 3SAT, 4SAT Nellcor N-200 SpO Monitor Nellcor N-400 FSpO Monitor 1.
  • Page 97: What You Need

    Recording From an External Device What You Need To connect a supported external device you require: Requirements Model Additional Requirement Option J13 Press-Mate/Listmini Dual Interface COLIN Interface cable Model BP-8800 Board (available from COLIN NIBP Corporation) Dinamap 8100 Dual Interface Model 8801 interface adapter Board (available from General Electric)
  • Page 98 Dual Serial Interface 1. Use socket 1 (9 pin) for connecting: • Philips M1165A/1166A/1175A/1176A/1167A/1177A CMS. • Philips 78352C/78354C Compact Configurable Monitor. • Dinamap 1846/8100 NIBP Monitor. • Press-Mate/Listmini Model BP-8800. • Accutor 3, 4, 3SAT and 4SAT. 2. Use socket 2 (25 pin) for connecting: •...
  • Page 99 Recording From an External Device 3. Use the interface cable to connect the external device to the appropriate socket. 4. Connect the other end of the interface cable to the external device. (See the service documentation supplied with the external device for the correct socket to use for the connection.) If you are monitoring maternal SpO or temperature and the monitor is...
  • Page 100: Example Trace

    Recording From an External Device Example Trace 1. Maternal blood pressure: – Systolic blood pressure is 128 mmHg. – Diastolic blood pressure in 98 mmHg. – Mean arterial pressure is 109 mmHg. 2. Maternal heart rate (78 bpm). 3. Maternal oxygen saturation level of blood (97%). 4.
  • Page 101: Trace Display On External Monitoring Systems

    Trace Display on External Monitoring Systems If you monitor only maternal NIPB, or only SpO , a MHR value obtained from the Philips Series 50 monitor is also automatically printed. If you are using automatic mode with a short repetition interval, not all Automatic measurements can be recorded on the trace.
  • Page 102: Troubleshooting

    Troubleshooting Troubleshooting FSpO If the external Nellcor N-400 FSpO monitor has two power switches (a mains switch at the rear of the unit and a standby switch at the front of the unit), take care to switch them on and off in the correct order, as shown below.
  • Page 103: External Devices

    Troubleshooting FSpO on page 90. The are printed on the trace. battery power symbol should go out. Philips M165A/M1675A/M1676A/M1167A/M1177A No maternal The parameters are switched off. Switch on the parameters in the measurements are Parameters On/Off menu. See the printed on the trace.
  • Page 104 Troubleshooting Chapter 10 - Monitoring Using External Devices...
  • Page 105: Recording Notes

    Recording Notes Introduction The optional barcode reader and sheets of barcodes let you record your most commonly-used notes, and some patient information on the trace. Recording A Note To record a note on the trace: 1. Switch on the recorder. 2.
  • Page 106: Deleting A Barcode Note

    Deleting a Barcode Note 4. Using gentle pressure and constant speed, draw the pen (from right to left, or left to right) over the center of the barcode to the white margin on the other side. Do not let the pen wander from the barcode or stop before it reaches the white margin The monitor “beeps”...
  • Page 107: Recording Several Barcodes As Separate Notes

    Recording Several Barcodes as Separate Notes For example, to record a blood pressure of 150/85 as shown in the picture below: 1. Read the following codes: 2. Read “ENTER”. Recording Several Barcodes as Separate Notes To record several barcodes as separate notes: 1.
  • Page 108: Recording A Patient's Name

    Recording a Patient’s Name Recording a Patient’s Name To record a patient’s name on the paper: 1. Read each letter of the patient’s first name. 2. Read “SPACE”. 3. Read each letter of the patient’s second name. 4. Read “ENTER”. Chapter 11 - Recording Notes...
  • Page 109: Fetal Heart Rate Alerting

    Fetal Heart Rate Alerting Introduction Fetal heart rate alerting can give both audible and visual warning of a non-reassuring fetal condition. Fetal heart rate (FHR) alerting is NOT available for monitors purchased in the USA. Alerts Your monitor must be enabled for alerting, via a service setting, before you can use the alert facilities.
  • Page 110: Turning Alerting On Or Off

    Alerts Turning Alerting ON or OFF 1. You must connect either an ultrasound or a DECG transducer to one of the two Cardio sockets. 2. Press repeatedly until is displayed. The Signal Quality Indicator shows: – RED if fetal alerting is OFF. –...
  • Page 111: Non Stress Test Timer

    Non Stress Test Timer Introduction This chapter explains how to set the non stress test (NST) timer. Setting the NST Timer 1. Ensure the recorder is off. 2. Press the recorder ON/OFF key for 2 seconds. 3. Adjust the timer using the keys.
  • Page 112 Setting the NST Timer Chapter 13 - Non Stress Test Timer...
  • Page 113: Maternal Monitoring - Overview

    Maternal Monitoring - Overview Introduction This chapter gives an overview of the following maternal parameters: • Maternal blood pressure • Maternal heart rate • Maternal pulse oximetry Chapter 14 - Maternal Monitoring - Overview...
  • Page 114: Maternal Parameters - Overview

    Maternal Parameters - Overview Maternal Parameters - Overview 1. Non-invasive blood pressure transducer socket. 2. Pulse oximetry transducer socket. 3. Softkeys for setting maternal parameters. They are: – NBP softkey selects the mode and alarm limits for non- invasive blood pressure. –...
  • Page 115: Softkeys

    Maternal Parameters - Overview indicates average heart rate value taken from NIBP measurement. 7. Maternal heart rate shows current heart rate or pulse rate in beats per minute. 8. Systolic value shows the value for the systolic parameter of the most recent non-invasive blood pressure measurement.
  • Page 116: Power On Screen

    Power on Screen Power on Screen When you first switch on, the monitor displays its power on screen, with factory set default alarm limits. To Begin Monitoring Immediately Step 1. Switch the monitor on. Step 2. Apply the blood pressure cuff, MECG transducer and SpO transducer to the patient as required.
  • Page 117 Maternal Main Screen parameters (if any) are currently in an alarm condition. Maternal Main Screen 1. Systolic blood pressure. 2. Diastolic blood pressure. 3. Maternal heart rate (if derived from MECG) or pulse rate (if derived from pulse oximetry). 4. Current oxygen saturation (SpO ) level.
  • Page 118: Returning To The Maternal Main Screen

    Returning to the Maternal Main Screen Returning to the Maternal Main Screen When you are working with the maternal measurements, individual screens replace the maternal main screen. If you need to view the maternal main screen quickly, press the reset key once. The monitor automatically redisplays this screen if there is an interval of approximately 20 seconds between key presses while you are changing any alarm, volume or contrast setting.
  • Page 119: Setting An Alarm

    Warning Messages Setting an Alarm You can find out how to change each maternal alarm in the section relevant to that parameter. When you change alarm settings for an individual patient, the monitor automatically updates the power on screen with the new values. If the monitor’s power is switched off for less than one minute, the monitor remembers any alarm values you have set for a patient.
  • Page 120: Volume And Contrast Control

    Volume and Contrast Control Volume and Contrast Control You can increase, or decrease, the volume of the alarms and the contrast of the display screen. The method is exactly the same for both. Volume and Contrast Control Step 1. Display the maternal main screen. Step 2.
  • Page 121 Volume and Contrast Control Press this to increase the setting. Step 4. Press the reset key to return to the maternal main screen. A single tone at the current volume accompanies each key press when you change the volume. A single click and contrast change accompanies each key press when you change the contrast.
  • Page 122 Volume and Contrast Control Chapter 14 - Maternal Monitoring - Overview...
  • Page 123: Non-invasive Blood Pressure Monitoring

    Non-invasive Blood Pressure Monitoring Introduction When you first switch the monitor on, non-invasive blood pressure measurement is in manual mode. The maternal main screen displays 0 for both systolic and diastolic values. To Begin Monitoring 1. Ensure that the non-invasive blood pressure cuff is applied correctly to the patient and is not on the same arm as an SpO finger transducer.
  • Page 124: Setup Screen

    Setup Screen Setup Screen Use the non-invasive blood pressure setup screen to start measurements, change mode, and enter the alarm setup screen. Press to access the setup screen. NBP Setup Screen (Manual Mode) Start Press this to begin a measurement immediately. If the monitor is in stat mode, this commences a stat cycle.
  • Page 125: Measurement Modes

    Measurement Modes Measurement Modes Three modes of non-invasive blood pressure measurement are available: • Manual The monitor executes a measurement on demand. This is the preferred method. • Automatic The monitor continually repeats measurements. You can adjust the time period between measurements from two to 60 minutes. •...
  • Page 126: Changing Measurement Mode

    Changing Measurement Mode Changing Measurement Mode To change measurement mode, press to enter the non-invasive blood pressure setup screen. Manual 1. Press Mode until Manual is displayed above the mode key. 2. Press Start to make an immediate NBP measurement Auto Press Mode until Auto is displayed above the mode key.
  • Page 127: Pulse Rate

    Pulse Rate Pulse Rate When the monitor takes a NIBP measurement, it can also calculate the average pulse rate. This occurs in either manual or automatic mode, when neither MECG nor SpO is being measured. The value is shown on the screen and printed on the trace. It is an average pulse rate, taken during the most recent NIBP measurement.
  • Page 128: Turning Alarms On And Off

    Alarms Turning Alarms On and Off The following illustration shows an example alarm setting for NIBP. The diastolic low limit is 50, the high limit 90. The systolic low limit is 90, the high limit is 160. NBP alarming is switched off. 1.
  • Page 129: Changing Alarm Limits

    Alarms Changing Alarm Limits Starting from the maternal main screen, to change alarm limits: 1. Press to display the NBP setting screen. 2. Press Alarm to display the alarm setup screen. 3. Press Alarm until the parameter you want to change (either systolic or diastolic) is displayed, with its current values.
  • Page 130: Recording

    Troubleshooting Recording Each new measurement value is recorded only if the previous value printout is finished. The printout shows the mean pressure in brackets. Troubleshooting This section details warning messages, possible measurement problems and limitations associated with measuring non-invasive blood pressure. Warning Messages Audible Warning Message...
  • Page 131: Measuring Problems

    Troubleshooting Measuring Problems Situation Possible Cause Possible Solution Cuff will not inflate. Monitor in service mode. Switch power off, then switch on again. Technical defect. Call service. Cuff tubing not connected. Connect cuff tubing. High or low values measured Contraction occurring. Wait until contraction has finished.
  • Page 132: Limitations

    Troubleshooting Limitations Oscillometric measurement has some limitations according to the patient’s condition. The measurement looks for a regular arterial pressure pulse. If this is difficult to detect the measurement time increases and the measurement itself is unreliable. Measurements will be: •...
  • Page 133: Maternal Ecg, Heart And Pulse Rate

    Maternal ECG, Heart and Pulse Rate Introduction You can monitor maternal ECG, view the waveform on the screen and print it on the trace. You can also set alarms for heart and pulse rate. To Begin Monitoring 1. Connect the transducer to the required monitor socket. See “Input Channels at a Glance”...
  • Page 134: Connecting The Transducer

    To Begin Monitoring Connecting the Transducer When you connect the transducer: 1. The “---” display goes out. 2. The MECG indicator comes on. 3. The monitoring mode (either MECG or US1/MECG) is printed on the paper immediately and then every three to four pages. If a fetal transducer is connected to the Cardio 1/Combi or Cardio 2 channel, then you can change the volume of the maternal heartbeat using the volume keys for the fetal cardio channel.
  • Page 135: Applying The Electrodes

    To Begin Monitoring Applying the Electrodes To obtain a satisfactory maternal ECG waveform you must use the RA to LL 2-lead position of the standard 5-lead ECG. 1. Place RA electrode directly below the clavicle and near the right shoulder. 2.
  • Page 136: Using Mecg Transducer M1359a

    To Begin Monitoring Using MECG transducer M1359A 1. Connect each lead to an electrode and to the transducer. 2. Peel the backing from the electrodes and apply them to the patient. 3. Slide the transducer under the belt or clip the cable to the bed sheet or patient’s clothing.
  • Page 137: Using A Patient Module (m1364a Or M1365a)

    To Begin Monitoring Using a Patient Module (M1364A or M1365A) 1. Connect each lead on the MECG adapter cable to a pre-gelled electrode (4). M1363A 2. Peel the backing from the electrodes and apply them to the patient. M1365A M1364A 3.
  • Page 138: Displaying The Mecg Waveform

    Displaying the MECG Waveform Displaying the MECG Waveform To display the MECG waveform on the maternal display: 1. Press . The display changes to the MECG Alarm/wave selection screen. 2. Press . The display changes to the MECG waveform. Reading from left to right, the figures at the top of the waveform show: 1.
  • Page 139: Changing Display Speed

    Displaying the MECG Waveform Changing Display Speed You can increase or decrease the rate at which waveforms move across the screen. Switch between slow and fast display by pressing Freezing and Printing Continue Freezing the Waveform If you want to examine the waveform more closely you can suspend its movement.
  • Page 140: Alarm (mecg And Spo )

    Alarm (MECG and SpO When the MECG transducer is plugged in, an ECG symbol shown to the right of the heart rate on the maternal display. If both MECG and SpO are being monitored, the MECG heart rate value is used because it is more accurate than the pulse rate value.
  • Page 141: Turning Alarms On And Off

    Alarm (MECG and SpO Turning Alarms On and Off 1. Press If the maternal heart rate is derived from SpO measurement the alarm setup screen appears immediately. All screens show the word PULSE . If the maternal heart rate is derived from MECG, an intermediate screen appears (as shown in the previous diagram).
  • Page 142: Changing Alarm Limits

    Alarm (MECG and SpO Changing Alarm Limits Starting from the maternal main screen, to change MHR alarm limits: 1. Press to display the alarm setup screen. Remember, if heartrate is derived from MECG, the monitor displays the intermediate Alarm/Wave selection screen and you must press for a second time to enter the alarm setup screen.
  • Page 143: Troubleshooting

    Troubleshooting Troubleshooting This section details problems that might occur when measuring maternal ECG. Situation Possible Cause Possible Solution Monitor displays Electrodes defective. Check electrodes and replace if necessary. NOP. Bad electrical contact. Check positioning of electrodes. The ultrasound Reposition the prints repeatedly transducer is recording ultrasound...
  • Page 144 Troubleshooting Chapter 16 - Maternal ECG, Heart and Pulse Rate...
  • Page 145: Maternal Pulse Oximetry (spo )

    Maternal Pulse Oximetry (SpO Introduction When you connect a pulse oximetry (SpO ) transducer to the monitor, you can measure the percentage of oxygen saturation in the maternal blood. The monitor gives an average value calculated across four pulses. The value is recorded on the trace: •...
  • Page 146: Alarm (spo )

    Alarm (SpO Alarm (SpO The maternal SpO alarm sounds if the SpO level falls below the alarm value. Turning Alarm On and Off 1. Press to display the pulse oximetry setup screen. 2. Pressing at the alarm setting screen cycles between alarm OFF and ON.
  • Page 147: Alarm (pulse Rate)

    Alarm (Pulse rate) Alarm (Pulse rate) See “Alarm (MECG and SpO2)” on page 128 for how to set the pulse rate alarm. Troubleshooting This section details warning messages, possible measurement problems and limitations associated with maternal pulse oximetry measurement. Warning Messages Parameter Audible Warning Message...
  • Page 148: Limitations

    Troubleshooting Parameter Audible Warning Message Possible Cause What to Do Display Indication Normal Weak signal, SpO less Reposition transducer display. or try a different site. accurate. signal. Wrong transducer Use correct selected transducer. Transducer incorrectly Reapply transducer. applied. Photodetector not Reposition opposite light emitter.
  • Page 149 Troubleshooting – COHb, MetHb, and SulfHb – Dye dilution chemicals or other disfunctional hemoglobins – Intravascular dyes – Venous pulsations. • Severe reduction of pulsatile flow in the arteries can prevent accurate readings. Such a reduction can be caused by: –...
  • Page 150 Troubleshooting Chapter 17 - Maternal Pulse Oximetry (SpO...
  • Page 151: Maintenance And Performance Assurance

    Maintenance and Performance Assurance Preventive Maintenance Where there are national regulations on the qualification of the testing personnel, and suitable measuring and testing facilities, these must be observed. You must perform the following checks every 12 months to ensure that your monitor and accessories are in perfect working order.
  • Page 152: Mechanical Inspection

    Calibration and Electrical Safety Checks Tasks and Tests Carry out a mechanical inspection of the monitor. Check transducers, cables, connectors and other accessories for cracks and defects. Carry out the Quick Test as described on page 151. Carry out the Parameter Test as described on page 152. Mechanical Inspection To carry out a mechanical inspection of the monitor: •...
  • Page 153: Care And Cleaning

    You must refer to these for full care and cleaning information. Always follow the manufacturer’s directions carefully when cleaning any equipment. Damage caused by using cleaning substances not approved by Philips is not covered under warranty. Caution After cleaning, disinfecting, and sterilizing the monitor and accessories, check them carefully.
  • Page 154: Transducers And Patient Modules

    Care of the Fetal Monitoring System Transducers and Patient Modules This applies to the following transducers and patient modules: • FSpO /ECG combined patient module (M1365A) • ECG patient module (M1364A) • Ultrasound transducer (M1356A) • DECG transducer (M1357A) • US/MECG Combi transducer (M1358A) •...
  • Page 155: Adapter Cables

    Cleaning Adapter Cables Clean with lint free cloth, moistened with either warm water (40 F maximum) and soap, a diluted non-caustic detergent or one of the approved cleaning agents listed below. Never immerse or soak the cables. Do not allow the cleaning agent to remain on the cable - remove it immediately by wiping with a cloth dampened with water.
  • Page 156 Wipe the cleaning agent off the surface of the equipment immediately with a damp cloth. Warning 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 information on infection control.
  • Page 157: Disinfecting

    Disinfecting Disinfecting We recommend that you disinfect the fetal monitoring equipment only when necessary as determined by your hospital’s policy, to avoid long term damage. Never immerse or soak any part of the monitoring system. Do not allow the disinfectant to remain on the equipment. Remove it immediately by wiping with a cloth dampened with water.
  • Page 158: Sterilizing

    Sterilizing Caution To avoid damage to the product, observe the following general precautions when disinfecting unless instructed otherwise in the guidelines supplied with a specific product. ® ® ® Do NOT use Povodine , Sagrotan , Mucovit or strong solvents. Do NOT use strong oxidants such as bleach.
  • Page 159: Iup (1290c/cpj840j5)

    Sterilizing recommend that you clean the cables before sterilizing them. The M1362A and M1363A cables have been tested to withstand Ethylene Oxide (Et) gas sterilization. Be sure that all safety precautions regarding aeration after EtO exposure are followed. The cables are tested to withstand autoclaving at 136ºC (277ºF) maximum.
  • Page 160: Belts

    Belts Belts Wash soiled belts with soap and water. Water temperature must not exceed 60 C (140 Reusable SpO Transducers Refer to the instructions that accompany the transducer. Non-invasive Blood Pressure Cuff Refer to instructions that accompany the cuff. Storing Recorder Paper Recorder paper is not intended for long-term archival storage.
  • Page 161 Storing Recorder Paper – Papers that contain organic solvents. This includes papers with tributyl and/or dibutyl phosphates, for example recycled paper. – Carbon paper and carbonless copy paper. – Products containing polyvinyl chlorides or other vinyl chlorides for example (but not exclusively) document holders, envelopes, letter files, divider sheets.
  • Page 162: Self Test

    If a fatal error occurs (for example, if a board is defective): – An error message is displayed for ten seconds – After ten seconds, the monitor tries to restart. If the error occurs again contact your Philips Service Engineer or Response Center. Chapter 18 - Maintenance and Performance Assurance...
  • Page 163: Quick Test

    Quick Test Quick Test The quick test takes approximately 15 seconds and tests the basic electronics of the monitor. To carry out the test: 1. Remove any monitoring equipment plugged into the input sockets. Switch off or disconnect the telemetry receiver and any external devices connected to the monitor.
  • Page 164: Parameter Test

    Parameter Test If any of these fail, contact your Philips Service Engineer or Response Center. If an error occurs: • An error message is displayed for ten seconds. • Err xxx time and date are printed on the trace after ten seconds, and then every ten minutes.
  • Page 165 M1191A with M1940A Pulse 120 displayed on LCD. FSpO 88% displayed. using M1365A If your monitor’s response is different, contact your Philips Service Engineer or Response Center. If an error occurs: • An error message is displayed for ten seconds. •...
  • Page 166: Testing Transducers

    Testing Transducers Testing Transducers If any of the following tests fail, repeat the test using another transducer. If it still fails, contact your Philips Service Engineer or Response Center. Toco To test a Toco transducer: 1. Switch on the monitor and the recorder.
  • Page 167: Iup

    Testing Transducers 4. Holding the transducer in one hand, move your other hand repeatedly towards and then away from the surface. 5. Check that a noise is heard from the loudspeaker. 1. Switch on the monitor and the recorder. 2. Connect the transducer to the Cardio 1/Combi socket. 3.
  • Page 168: Replacing The Batteries

    Replacing the Batteries Replacing the Batteries The monitor’s internal clock is powered by two batteries that are located behind a panel at the rear. The average life span of these batteries is one year. We recommend replacing them during the annual preventative maintenance cycle.
  • Page 169: Replacing The Fuses

    Replacing the Fuses Replacing the Fuses Fuse values are printed on the rear of the monitor: For 100/120V Line Voltage T1A/250V For 220/240V Line Voltage T500mA/250V means “alternating current”) To replace the fuses: 1. Switch off the monitor and disconnect it from the main power supply.
  • Page 170 Replacing the Fuses 3. Lift the fuse holder slightly and pull it out. 4. Remove the fuse from the holder and replace it with another of the correct value. 5. Slide the holder back into place, aligning the arrow on the holder with the arrow on the cover.
  • Page 171: Troubleshooting

    Troubleshooting Introduction Common problems that may occur during monitoring are dealt with in the relevant chapters in this book. More details are given in the Installation and Service Guide for your monitor. Chapter 19 - Troubleshooting...
  • Page 172: Error Messages

    Error Messages Error Messages Error Display Cause Solution Err 1 Cardio 1 Wrong transducer in Cardio 1/ Connect correct transducer. Combi socket. Err 1 Cardio 2 Wrong transducer in Cardio 2 Connect correct transducer. socket. Err 2 Toco Wrong transducer in Toco Connect correct transducer.
  • Page 173 Load paper with 30-240 scale or change the monitor’s paper loaded paper format setting (see the Installation and Service Guide). xxx is between 500 Contact your Philips Service Engineer or Medical Err xxx and 600. This Response Center. indicates a technical failure diagnosed by the monitor’s self test...
  • Page 174 Error Messages Chapter 19 - Troubleshooting...
  • Page 175: Accessories

    This chapter lists the accessories supplied as standard and as options. Items are subject to availability and this chapter is not, therefore, a definitive listing. Do not use accessories that are not approved by Philips. You may damage the equipment and this type of damage is not covered by warranty.
  • Page 176: Maternal Accessories

    • 1 x M1599B NIBP monitor to cuff interconnect tubing (3.0m) • 1 x M1191A reusable adult finger SpO transducer • 1 x M1940A adapter cable for Philips SpO transducers. Documentation • Quick Reference Guide • Pocket Guide to Fetal Monitoring (English language shipments only) •...
  • Page 177 Maternal parameter interface to connect external patient monitor. Use this only if your monitor has no internal maternal parameters installed. The following external devices can be connected: – M1165A/1166A/1175A/1176A Philips CMS. – 78352C/78354C Compact Configurable Monitors. – Dinamap 1846 and 8100 NIBP Monitors. A model 8801 adapter is required from General Electric to connect the Dinamap 8100.
  • Page 178: Paper

    Paper Paper Use only the following types of paper: Product Color Highlighted Country Number Scale of Grid Scale 3cm Lines M1910A USA/Canada 30-240 Orange M1911A Europe/Japan 50-210 Green M1913A Japan 50-120 Green M1913J Japan 50-210 Green 1. Normal bradycardia and tachycardia ranges alarm ranges are yellow; severe bradycardia and tachycardia ranges are red.
  • Page 179: Transducers And Patient Modules

    Transducers and Patient Modules Transducers and Patient Modules All transducers are supplied individually. M1355A Toco Transducer M1356A Ultrasound Transducer M1358A US/MECG Combi transducer for ultrasound or MECG monitoring M1359A MECG Transducer M1365A FSpO /ECG combined patient module M1364A ECG only patient module MECG Electrodes and Cables M1363A Reusable MECG adapter cable for M1364A or M1365A patient module.
  • Page 180: Decg Cables

    DECG Cables DECG Cables M1362A Reusable DECG adapter cable for M1364A or M1365A patient module, for open-wire electrodes. M1362B Reusable DECG adapter cable for M1364A or M1365A patient module, scalp electrodes with a connector. M1349A Pad electrode for fixing M1362B Disposable Scalp Electrodes 15133D Available in Europe only.
  • Page 181: Fetal Oxygen Sensor

    Fetal Oxygen Sensor Fetal Oxygen Sensor Nellcor FS14 Must be ordered directly from the local Tyco Healthcare distributor. IUP Transducers CPJ840J5 IUP pressure transducer, supplied with transducer holder CPJ84046. Use with sterile disposable domes CPJ84022. IUP Catheters M1333A Disposable intrauterine sensor-tip pressure catheter (5 mV/VmmHg ± 2% tolerance).
  • Page 182: Domes

    Domes Domes CPJ84022 Sterile, disposable dome for use with IUP pressure transducer CPJ840J5. • Supplied in packs of 50. • Shelf life: 18 months maximum. IUP Transducer Holder CPJ84046 IUP Transducer holder • For use with IUP pressure transducer CPJ840J5. •...
  • Page 183: Spo Accessories

    Each of the following transducers requires adapter cable M1900B which must be ordered separately. • M1904B (Oxisensor II D-25 adult) • M1903B (Oxisensor II D-20 small adult) Adapter Cables • M1900B connector cable for Philips/NELLCOR transducers • M1940A adapter cable for Philips transducers Chapter 20 - Accessories...
  • Page 184: Belts And Buttons

    Belts and Buttons Belts and Buttons Reusable Abdominal Transducer Belt (M1562A) • Pre-cut. • Width: 50mm • Length: 1.3m • Supplied in packs of 5. Belt Buttons (M1569A) • Supplied in packs of ten. Transducer Knob Adapter (M1356-43201) • Supplied in packs of three. Chapter 20 - Accessories...
  • Page 185: Specifications

    Specifications Introduction The following section gives the manufacturer’s specification for the monitor. Patient Safety The monitor is designed to comply with: • IEC 60601-1/EN 60601-1 • UL 2601-1 • CSA-C22.2 No 601.1-M90 Input Resulting Parameter Connector Isolation IUP, TOCO, NIBP, SpO2 US (M1356A) DECG (M1357A) MECG (M1359A)
  • Page 186: Operating And Environmental

    Operating and Environmental Operating and Environmental Operating Voltage 100 - 120 V (± 10%) Power Requirements 220 - 240 V (±10%) Line Frequency 50 to 60 Hz Power Consumption 60 VA max Environment Operating 0°C to + 55°C Temperature Storage -40°C to +75°C Temperature Relative Humidity...
  • Page 187: Fetal Display

    Fetal Display Fetal Display 50 to 240 bpm Heart Rate Range DECG 30 to 240 bpm 30 to 240 bpm (not displayed) External Toco Range 0 to +127 relative units -99 to +127 mmHg IUP Range 0 - 99% Fetal SpO Range Maternal Non-invasive Blood Pressure 15°C to 25°C...
  • Page 188 Maternal Non-invasive Blood Pressure Cycle Time (Typical at HR over 60 bpm ) Auto/manual 35 seconds Stat 17 seconds Maximum 120 seconds Adjustment 5mmHg steps Limit Alarms Diastolic 10 to 245mmHg Systolic 30 to 270mmHg Overpressure Safety 300 mmHg for more Limit than 2 seconds Measurable within heart rate range of 30 to...
  • Page 189: Maternal Pulse Oximetry

    Maternal Pulse Oximetry Maternal Pulse Oximetry 0 to 100% Percentage Range 30 to 300 bpm BPM Range ± 1% Accuracy 1 bpm Resolution Pulse Rate Limit Range 70% - 90% Alarms Adjustment 1% steps M1191A 70 to 100% ± 2.5% Accuracy at 1 standard deviation M1192A...
  • Page 190: Maternal Display Section

    Maternal Display Section Maternal Display Section Numerical Display Two heart rate displays (orange) and one uterine activity display (green). Type: (10mm) 7 segment LEDs. Maternal Display The maternal display shows: • systolic measurement • diastolic measurement • level • maternal heart rate (if derived from MECG), pulse rate (if derived from pulse oximetry) or average pulse rate (if derived from NIBP) •...
  • Page 191: Ultrasound, External And Internal Toco

    Ultrasound, External and Internal Toco Ultrasound, External and Internal Toco System Pulsed Doppler oscillator Ultrasound Mode Frequency 998.4kHz Repetition Rate 3.2kHz Ultrasound Intensity 1.5mW/cm average for each of the seven active surfaces (using M1356A transducer) Signal Range 0 to 100 units External Labor Offset Compensation ±200 units...
  • Page 192: Fhr (cardio) Scales

    Recorder FHR (Cardio) Scales Uterine Scale A Scale B Activity (Toco) Scale Vertical Scale Size 4 cm Vertical Scale Sensitivity 30 bpm/cm 20 bpm/cm 25 units/cm Range 30 to 240 bpm 50 to 210 bpm 0 to 100 units Z-fold paper with numbered pages Recording times per pack: 8h 20min at 3cm/min.
  • Page 193: Declaration

    Devices Directive (93/42/EEC) concerning medical devices. This product is classified as Class IIb in accordance with Annex IX of the Medical Devices Directive (93/42/EEC). Manufactured by: Philips Medizinsysteme Boeblingen GmbH Hewlett-Packard Str. 2, Boeblingen, Germany Product Name: Fetal Monitor Series 50 XM and 50 XMO...
  • Page 194 Declaration Chapter 21 - Specifications...
  • Page 195: Warranty

    Warranty Manufacturer’s Responsibility Philips only considers itself responsible for any effects on safety, reliability and performance of the equipment if: • Assembly operations, extensions, re-adjustments, modifications or repairs are carried out by persons authorized by Philips, and • The electrical installation of the relevant room complies with national standards, and •...
  • Page 196 Warranty If Philips is unable, within a reasonable time, to repair or replace any product to a condition as warranted, Customer shall be entitled to a refund of the purchase price upon return of the product to Philips. 1. Duration and Commencement of Warranty Period The warranty period for each product is one year, depending upon the warranty classification code of the product at time of order.
  • Page 197 Warranty Export price). Service outside the country of initial purchase is subject to the conditions regarding Philips service travel areas and initial installation point described above. 3. Limitation of Warranty The foregoing warranty shall not apply to defects resulting from: a.
  • Page 198 Warranty Chapter 22 - Warranty...
  • Page 199: Training Evaluation

    Training Evaluation M1350 XM, XMO Fetal Monitoring Lab Evaluation Competency Statement The Student will be able to perform the basic monitoring functions. Performance Objectives The following objectives provides evidence of minimum achievement of the above competency. The student will explain or demonstrate how to: 1.
  • Page 200: Maternal Parameters

    M1350 XM, XMO Fetal Monitoring Lab Evaluation 14. Turn off and on the arrhythmia logic feature. 15. Identify the symbol for cross channel verification that is printed on the recorder paper. 16. Mark an event on the fetal tracing. Maternal Parameters 17.
  • Page 201: Fetal Monitor Lab Evaluation

    M1350 XM, XMO Fetal Monitoring Lab Evaluation Fetal Monitor Lab Evaluation 1. Identify each of the following components and describe its function: A. ___________________ Function: _____________________________ B. ___________________ Function: _____________________________ C. ___________________ Function: _____________________________ D. ___________________ Function: _____________________________ E. ___________________ Function: _____________________________ F.
  • Page 202 M1350 XM, XMO Fetal Monitoring Lab Evaluation 2. Identify each of the following items: A. _________________________ B. _____________________________ C. _________________________ D. _____________________________ 3. Load paper in the recorder. 4. a. Perform a Monitor Quick Test. b. What displays in the Cardio 1/ Combi, Cardio 2 and Toco digital display windows? __________________________________________ c.
  • Page 203 M1350 XM, XMO Fetal Monitoring Lab Evaluation 6. a. How can you check the US and Toco transducers to ensure they are working properly? __________________________________________ _________________________________________________________ b. List two possible causes of transducer damage in the clinical setting _________________________________________________________ 7. a. With the recorder on, mark an event. b.
  • Page 204: Maternal Parameters

    M1350 XM, XMO Fetal Monitoring Lab Evaluation b. What action should you take when cross channel verification has been detected? ________________________________________________ c. You should periodically compare the mother’s pulse with the signal coming from the fetal monitor’s loudspeaker to ensure you are detecting the fetal heart rate.
  • Page 205: Fetal Spo2

    M1350 XM, XMO Fetal Monitoring Lab Evaluation C. Hypothermia. D. Uterine contraction during the blood pressure measurement time. 21. Adjust the alarms for the NBP to alert for a high systolic pressure of 180 mmHg or a low systolic pressure of 90 mmHg. 22.
  • Page 206: Fetal Telemetry

    M1350 XM, XMO Fetal Monitoring Lab Evaluation C. FSpO is below the low limit longer then the configured delay time. D. FSpO is above the high limit longer then the configured delay time. Fetal Telemetry 27. The Fetal telemetry system is made up of a _____________________, a ____________________ and the patient cables.
  • Page 207 M1350 XM, XMO Fetal Monitoring Lab Evaluation d. On/off key 3. With the recorder off, push the paper eject button. With the drawer fully open, push and hold the eject button then lift out the remaining paper. Place the new paper in the tray with the bottom side down. Unfold the top page of the pack.
  • Page 208 M1350 XM, XMO Fetal Monitoring Lab Evaluation 7. a. Press the event marker key or press the button on the remote event marker. b. A small arrow prints on the FHR scale at the exact time the button or key was pressed.
  • Page 209 M1350 XM, XMO Fetal Monitoring Lab Evaluation 13. a. When monitoring twins, the FHR offset is helpful because you can separate the similar baselines for easier interpretation of the recorded trace. The FHR value displayed on the fetal monitor is the correct value. b.
  • Page 210: Maternal Parameters

    M1350 XM, XMO Fetal Monitoring Lab Evaluation Maternal Parameters 20. a. Ensure that the cuff is completely deflated. Place the ARTERIA marking on the cuff over the appropriate artery. Check that the edge of the cuff falls within the white range marked by the arrows (<-->), (on disposable cuffs this is a blue line without arrows).
  • Page 211: Fetal Spo2

    M1350 XM, XMO Fetal Monitoring Lab Evaluation Fetal SpO 25. A. Alarm status indicator: when the crossed bell is lit the alarms are off. B. Signal Quality indicator lights: reflects the strength of the signal being received by the monitor. C.
  • Page 212 M1350 XM, XMO Fetal Monitoring Lab Evaluation Chapter 23 - Training Evaluation...
  • Page 213 Index recommended Connecting power Accessories Barcode Connecting transducers optional deleting an entry Contrast control standard recording a note Cross-channel Acknowledging a warning Barcode reader verification message switching FMP on and twins Acknowledging an Cross-channel verification alarm twins offset plus ACOG technical bulletin Baselines After monitoring separating...
  • Page 214 statistics IUP transducer switching on and off testing ECG patient module FSpO IUP transducer adapter monitoring MECG alarm criteria cable Elecromagnetic applying the sensor cleaning compatibility changing alarm limits Electrical safety check inaccurate measurements Electrical surgery inop alarm Environment introduction Lead position for maternal Error messages pulse indicator...
  • Page 215 returning to alarm correct type Maternal parameters, alarm setup removing overview alarms tearing off a trace Maternal SpO automatic mode types changing the alarm average pulse rate paper limit calibration check storing cleaning the transducer cancelling a Paper speed measurement measurement changing limitations...
  • Page 216 Recording a note Switching on the maternal heart rate Redux creme recorder measurement Remote event marker problems Remote event marker Maternal SpO NIBP Replacing batteries Testing noninvasive blood Replacing fuses IUP transducer pressure Reset quick test Toco Reset key self test twins monitoring acknowledging a warning Time, setting...
  • Page 217 NIBP Waveform Warning message Zeroing the monitor changing speed acknowledging See Toco freezing Warning messages maternal ECG acknowledging printing maternal SpO Index...

This manual is also suitable for:

50 xmo seriesM1350cM1350b

Comments to this Manuals

Symbols: 0
Latest comments: