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Philips IntelliVue MP Series Instructions For Use Manual

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I NS TR UCTI ON S FOR US E
IntelliVue Patient Monitor
MP 40 /50 an d MP 60 / 70/ 90
R e l ea s e B . 0 w i th S of tw a r e R e v i s i o n B . 0 x. x x
P a t i e nt M o n i t o r i n g

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Table of Contents

   Related Manuals for Philips IntelliVue MP Series

   Summary of Contents for Philips IntelliVue MP Series

  • Page 1 I NS TR UCTI ON S FOR US E IntelliVue Patient Monitor MP 40 /50 an d MP 60 / 70/ 90 R e l ea s e B . 0 w i th S of tw a r e R e v i s i o n B . 0 x. x x P a t i e nt M o n i t o r i n g...
  • Page 2 Part Number M8000-9001D Printed in Germany 11/03 Re-order Number: 453563499331 *M8000-9001D*...
  • Page 3: Table Of Contents

    M8000-9001D Table Of Contents 1 Basic Operation Introducing the IntelliVue Family IntelliVue MP40/MP50 MP40/MP50 Major Parts and Keys IntelliVue MP60/MP70 MP60/MP70 Major Parts and Keys MP90 Major Parts and Keys Remote Alarm Device Related Products Flexible Module Server (M8048A) Measurement Modules Multi-Measurement Server (M3001A) M3015A and M3016A Measurement Server Extensions M3012A Hemodynamic Measurement Server Extension...
  • Page 4 What’s New in Release A.2? 3 Alarms Visual Alarm Indicators Audible Alarm Indicators Alarm Tone Configuration Traditional Audible Alarms (HP/Agilent/Philips/Carenet) ISO/IEC Standard 9703-2 Audible Alarms Changing the Alarm Tone Volume Minimum Volume for No Central Monitoring INOP Acknowledging Alarms Acknowledging Disconnect INOPs...
  • Page 5 Changing Alarm Limits About Automatic Alarm Limits (AutoLimits) Documenting Alarm Limits Reviewing Alarms Alarm Messages Window Review Alarms Window Understanding Alarm Messages Latching Alarms Viewing the Alarm Latching Settings Alarm Latching Behavior Silencing Latched Alarms from an Information Center Testing Alarms Alarm Behavior at On/Off 4 Patient Alarms and INOPs Patient Alarm Messages...
  • Page 6 Monitoring Paced Patients Setting the Paced Status (Pace Pulse Rejection) Avoiding Pace Pulse Repolarization Tails Changing the Size of the ECG Wave To Change the Size of an Individual ECG Wave To Change the Size of all the ECG Waves Changing the Volume of the QRS Tone Changing the ECG Filter Settings Choosing EASI or Standard Lead Placement...
  • Page 7 Arrhythmia Relearning Initiating Arrhythmia Relearning Manually Automatic Arrhythmia Relearn Arrhythmia Relearn and Lead Fallback Arrhythmia Alarms Yellow Arrhythmia Alarms Arrhythmia Alarms and Latching Switching Individual Arrhythmia Alarms On and Off Switching All Yellow Arrhythmia Alarms On or Off Adjusting the Arrhythmia Alarm Limits Arrhythmia Alarm Timeout Periods Arrhythmia Alarm Chaining Understanding PVC-Related Alarms...
  • Page 8 Changing the Size of the Respiration Wave Changing the Speed of the Respiration Wave Using Resp Alarms Changing the Apnea Alarm Delay Resp Safety Information 9 Monitoring SpO Selecting an SpO Sensor Applying the Sensor Connecting SpO Cables Measuring SpO Assessing a Suspicious SpO Reading Understanding SpO...
  • Page 9 Using the Zero Hardkey Zeroing All Pressures Simultaneously Troubleshooting the Zero Adjusting the Calibration Factor Displaying a Mean Pressure Value Only Changing the Pressure Wave Scale Optimizing the Waveform Non-Physiological Artifact Suppression Choosing the Pressure Alarm Source Calibrating Reusable Transducer CPJ840J6 Making the Pressure Calibration Troubleshooting the Pressure Calibration Calculating Cerebral Perfusion...
  • Page 10 14 Monitoring Carbon Dioxide Using the Mainstream CO Extension (M3016A) Preparing to Measure Mainstream CO Checking Transducer Accuracy Calibrating the Transducer Attaching and Removing the CO Transducer Using the Microstream CO Extension (M3015A) Preparing to Measure Microstream CO Setting up Microstream CO Measurements Using Microstream Accessories Using the FilterLine and Airway Adapter...
  • Page 11 Inserting the Catheter Performing a Light Intensity Calibration Performing In-Vivo Calibration Setting Up the In-Vivo Calibration Making the In-Vivo Calibration Calculating Oxygen Extraction 17 Using the AGM Understanding the AGM Display AGM Major Parts and Keys Watertrap AGM Rear Panel Understanding the Gas Measurement Connecting AGM Accessories Using the AGM Setup Menus...
  • Page 12 Displaying CSAs Changing EEG Settings Switching EEG Numerics On and Off Changing the Scale of the EEG Waves for Display Changing Filter Frequencies Changing the Speed of the EEG Wave EEG Reports EEG Safety Information EEG and Electrical Interference 19 Monitoring BIS BIS Monitoring Setup BIS Continuous Impedance Check BIS Cyclic Impedance Check...
  • Page 13 Automatic Value Substitution Automatic Unit Conversion BSA Formula Documenting Calculations 22 Event Surveillance Event Groups Event Episode Episode Types Event Triggers Viewing Events Events Pop-Up Keys Event Counter Event Summary View Event Review Window Event Episode Window The Event Counter Counting Combi-Events Counting Neonatal Event Review (NER) Events Levels of Event Surveillance...
  • Page 14 Sample Recording Strip Recording Strip Code Recorded Waveforms Maintaining Recording Strips Reloading Paper Recorder Status Messages 24 Printing Patient Reports Starting Reports Printouts Stopping Reports Printouts Setting Up Reports Setting Up ECG Reports Setting Up Vital Signs and Graphic Trend Reports Setting Up Auto Reports Setting Up Individual Print Jobs Checking Printer Settings...
  • Page 15 28 Care and Cleaning General Points AGM Accessories Cleaning Disinfecting Cleaning Monitoring Accessories Sterilizing Cleaning the Recorder Printhead Cleaning the Batteries and Battery Compartment 29 Using the Batteries Battery Power Indicators Battery LED Battery Status on the Main Screen Battery Status Window Viewing Individual Battery Status Documenting Battery Status Replacing Batteries...
  • Page 16 Reusable Cuff Kits Adult/Pediatric Antimicrobial Coated Reusable cuffs Adult/Pediatric Soft Single Patient Single-Hose Disposable Cuffs Neonatal/Infant Cuffs (Disposable, non-sterile) Invasive Pressure Accessories Accessories Temperature Accessories Cardiac Output (C.O.) Accessories Mainstream CO Accessories Microstream CO Accessories tcGas Accessories EEG Accessories BIS Accessories BIS Sensors Other BIS Accessories AGM Accessories...
  • Page 17 tcGas Anesthetic Gas Module Safety and Performance Tests Electromagnetic Compatibility (EMC) Specifications Accessories Compliant with EMC Standards Electromagnetic Emissions Avoiding Electromagnetic Interference (Resp and BIS) Electromagnetic Immunity Recommended Separation Distance Recommended separation distances from portable and mobile RF communication equipment Electrosurgery Interference/Defibrillation/Electrostatic Discharge Fast Transients/Bursts Restart time...
  • Page 19: Basic Operation

    Basic Operation This Instructions for Use is for clinical professionals using the IntelliVue MP40/50 (M8003A/ M8004A) and MP60/70/90 (M8005A/M8007A/M8010A) patient monitors. Unless otherwise specified, the information here is valid for all the IntelliVue patient monitors. The basic operation section gives you an overview of the monitor and its functions. It tells you how to perform tasks that are common to all measurements (such as entering data, switching a measurement on and off, setting up and adjusting wave speeds, working with profiles).
  • Page 20: Introducing The Intellivue Family

    Introducing the IntelliVue Family Introducing the IntelliVue Family The Philips IntelliVue family of patient monitors offers a monitoring solution optimized for the surgical, cardiac, medical and neonatal care environments. Combining patient surveillance and data management, it allows multi-measurement monitoring by linking separate modules with “plug-and- play”...
  • Page 21: Mp40/mp50 Major Parts And Keys

    Introducing the IntelliVue Family 1 Basic Operation MP40/MP50 Major Parts and Keys MP40/MP50 left side Color-coded alarm lamps Alarms off lamp Model indicator ECG out Navigation Point Part number and serial number Quick-release mounting release Plug-in module slots MP40/MP50 front panel On/Standby switch On/Standby LED Error LED...
  • Page 22: Intellivue Mp60/mp70

    1 Basic Operation Introducing the IntelliVue Family IntelliVue MP60/MP70 The IntelliVue MP60/MP70 (M8005A/M8007A) patient monitors integrate the display unit, with a 15” color LCD display, and the data processing unit into one. Up to eight waves can be shown on the screens, as well as the 12-Lead ECG Screen.
  • Page 23: Mp90 Major Parts And Keys

    Introducing the IntelliVue Family 1 Basic Operation MP90 Major Parts and Keys In the MP90, the display and the processing unit are separate components. It offers both touchscreen and the Remote SpeedPoint as standard input devices. AC Power LED Power on LED Power on Switch Error LED Processing Unit...
  • Page 24: Related Products

    1 Basic Operation Related Products Related Products Related products extend the measurement capabilities of your monitor. None of the related devices have their own power on/standby switches. They take their power from the monitor, and switch on automatically when you turn on the monitor. A green power-on LED indicates when they are drawing power from the monitor.
  • Page 25 Related Products 1 Basic Operation You can plug and unplug modules during monitoring. Insert the module until the lever on the module clicks into place. Remove a module by pressing the lever upwards and pulling the module out. Reconnecting a module to the same monitor restores its label and measurement settings, such as alarms limits.
  • Page 26: Multi-measurement Server (m3001a)

    1 Basic Operation Related Products Multi-Measurement Server (M3001A) The Multi-Measurement Server (MMS) can simultaneously monitor 3-, 5- or 10-lead ECG (including arrhythmia and ST monitoring), respiration, SpO , NBP and either invasive pressure or temperature. Depending on the monitor model, you can connect it to the monitor via a cable or mount it either on the left side of the FMS or on the back of the monitor, as shown here.
  • Page 27: M3015a And M3016a Measurement Server Extensions

    Related Products 1 Basic Operation M3001A Connectors and Symbols White ECG/Resp connector Blue SpO connector Red NBP connector 4 & Combined pressure (red) and temperature (brown) connector - connect either invasive pressure transducer or temperature probe. You might have a version of the MMS that does not have this connector.
  • Page 28: M3012a Hemodynamic Measurement Server Extension

    1 Basic Operation Related Products M3015A Microstream M3016A Mainstream Pressure connector (red) Inlet Microstream connector CO Temperature connector (brown) Mainstream connector CO (optional) Gas sample outlet M3012A Hemodynamic Measurement Server Extension Pressure connectors Connection to MMS The M3012A Hemodynamic (red) Measurement Server Extension (HMSE) can be connected to the M3001A Multi-Measurement Server to...
  • Page 29: Operating And Navigating

    Operating and Navigating 1 Basic Operation Operating and Navigating Everything you need to operate the monitor is contained on its screen. Almost every element on the screen is interactive. Screen elements include measurement numerics, waveforms, screen keys, information fields, alarms fields and menus. The configurability of the monitor means that often you can access the same element in different ways.
  • Page 30: Using The Touchscreen

    1 Basic Operation Operating and Navigating Select a screen element to tell the monitor to carry out the actions linked to the element. For example, select the Patient Identification element to call up the Patient Demographics window, or select the HR numeric to call up the Setup ECG menu. Select the ECG wave segment to call up the ECG lead menu.
  • Page 31: Using The Mp40/mp50 Navigation Point

    Operating and Navigating 1 Basic Operation Using the MP40/MP50 Navigation Point MP40/MP50 only Silence- acknowledges all active alarms by switching off audible alarm indicators and lamps. Exact behavior depends on permanent key configuration Alarms Off/Pause Alarms- pauses alarm indicators. Exact behavior depends on Pause Alarms permanent key configuration Main Screen - closes all open menus and windows and return to the main screen.
  • Page 32: Permanent Keys

    1 Basic Operation Operating and Navigating Permanent Keys A permanent key is a graphical key that remains on the screen all the time to give you fast access to functions. - pauses alarm indicators. Pause duration depends on monitor Pause Alarms configuration.
  • Page 33: Hardkeys

    Operating and Navigating 1 Basic Operation start veni puncture (inflate cuff to start NBP STAT measurement subdiastolic pressure) - start/stop manual NBP measurement - start auto series stop automatic or STAT NBP - stop current automatic measurement measurement and measurement series within series set the NBP repeat time access patient reports...
  • Page 34: Using The On-screen Keyboard

    1 Basic Operation Operating Modes Using the On-Screen Keyboard Use this as you would a conventional keyboard. Enter the information by selecting one character after another. Use the and capital keys to access uppercase letters. Use the Back key to delete Shift Lock single characters, or use the Clr key to delete entire entries.
  • Page 35: Disabling Touchscreen Operation

    Tailoring Your Monitor 1 Basic Operation • Configuration Mode: Passcode protected, this mode is for personnel trained in configuration tasks. These tasks are described in the Configuration Guide. During installation the monitor is configured for use in your environment. This configuration defines the default settings you work with when you switch on, the number of waves you see and so forth.
  • Page 36: Switching To A Different Screen

    1 Basic Operation Tailoring Your Monitor Switching to a Different Screen To switch to a different Screen, select the current Screen name in the monitor info line, or select the Change Screen SmartKey. Choose the new screen from the pop-up list. When you switch from a complex to a less complex screen layout, some measurements may not be visible but are still monitored in the background.
  • Page 37 Tailoring Your Monitor 1 Basic Operation • Measurement Settings – Each profile can have a choice of different predefined measurement settings. These relate directly to individual measurements, for example, measurement on/off, measurement color, alarms limits, NBP alarm source, NBP repeat time, temperature unit ( F or C) pressure unit (mmHg or kPa).
  • Page 38: Swapping A Complete Profile

    1 Basic Operation Changing Measurement Settings Swapping a Complete Profile Select in the monitor info line, or select the Profiles SmartKey. Profiles In the menu, select Profiles Profile Chose a profile from the pop-up list. Confirm your selection. Swapping a Settings Block Select in the monitor info line, or select the Profiles SmartKey.
  • Page 39: Switching A Measurement On And Off

    Using Labels 1 Basic Operation Switching a Measurement On and Off When a measurement is off, its waves and numerics are removed from the monitor’s screen. The monitor stops data acquisition and alarming for this measurement. A measurement automatically switches off if you disconnect its module or measurement server. If you disconnect a transducer, the monitor replaces the measurement numeric with question marks.
  • Page 40: Changing Measurement Labels (e.g. Pressure)

    1 Basic Operation Using Labels Changing Measurement Labels (e.g. Pressure) To change a measurement label of a measurement with multiple labels (invasive pressure, temperature, or SpO Enter the Wave menu of the measurement. Select Label. Choose a label from the list. The monitor automatically applies the scale, color, etc.
  • Page 41: Changing Monitor Settings

    Changing Monitor Settings 1 Basic Operation Changing Monitor Settings ♦ To change monitor settings such as date and time, brightness, or QRS tone volume, select the Main Setup SmartKey and then select the setting you want to change, or select User Interface to enter a submenu where you can change user interface settings.
  • Page 42: Getting Started

    1 Basic Operation Getting Started Getting Started Once you understand the basic operation principles, you can get ready for monitoring. Inspecting the Monitor WARNING Do not use the system for any monitoring procedure on a patient if you suspect the monitor is not working properly, or if it is mechanically damaged.
  • Page 43: Disconnecting From Power

    Using Remote Applications If your monitor is connected to a Philips Application Server, you can access applications hosted remotely on the Application Server and display and operate them on the bedside monitor screen. The Application Server provides portal technology to allow information access through a web browser, terminal emulation, or served applications.
  • Page 44 1 Basic Operation Using Remote Applications...
  • Page 45: What's New

    M1020B, enables dual SpO measurement without the need to use the VueLink module. Two options are available: – Option A01 for use with Philips reusable and disposable sensors and Nellcor “R-Cal” disposable sensors. – Option A02 for use with Nellcor OxiMax sensors, including the MAX-FAST forehead sensor.
  • Page 46: What's New In Release A.2

    2 What’s New? What’s New in Release A.2? What’s New in Release A.2? 12-Lead ECG recordings: 12-Lead ECG waves and numerics can be sent to a connected recorder High-Resolution Trend Report: high-resolution trend report can be sent to a connected printer ST Snippets ST snippets, showing a one second wave segment for each measured ST lead, can be permanently displayed on the Screen or called up as required.
  • Page 47: Alarms

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

    3 Alarms Visual Alarm Indicators Visual Alarm Indicators Alarm message: An alarm message text appears in the alarm status area 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 49: Traditional Audible Alarms (hp/agilent/philips/carenet)

    Audible Alarm Indicators 3 Alarms Traditional Audible Alarms (HP/Agilent/Philips/Carenet) • Red alarms: A high pitched sound is repeated once a second. • Two-star yellow alarms: A lower pitched sound is repeated every two seconds. • One-star yellow alarms (arrhythmia alarms): The audible indicator is the same as for yellow alarms, but of shorter duration.
  • Page 50: Acknowledging Alarms

    3 Alarms Acknowledging Alarms Acknowledging Alarms To acknowledge all active alarms and INOPs, select the Silence permanent key. This switches off the audible alarm indicators and alarm lamps. Alternatively, you can acknowledge alarms by pressing the Silence hardkey on the MMS or Silence on the SpeedPoint.
  • Page 51: To Pause All Alarms

    Pausing or Switching Off Alarms 3 Alarms To Pause All Alarms ♦ Select the Pause Alarms permanent key. If your monitor is configured to infinite pause time, the permanent key is labelled Alarms Off, and selecting it Pause switches alarms off. Alarms ♦...
  • Page 52: Resetting Arrhythmia Alarm Timeouts

    3 Alarms Alarm Limits Resetting Arrhythmia Alarm Timeouts ♦ To reset the arrhythmia alarm timeout period, select the Alarms Off or Pause Alarms permanent key and then reselect it. Extending the Alarm Pause Time If your monitor has extended alarm pause enabled, you can extend the alarm pause time. Use this to prevent alarms being indicated, for example, while you are washing a patient or carrying out a procedure.
  • Page 53: Viewing All Alarm Limits

    Alarm Limits 3 Alarms Viewing All Alarm Limits The Alarm Limits overview window lists the currently set alarm limits for all measurements. If an Apnea alarm delay time is set, this is also shown. The Alarms Off symbol is shown beside the measurement label of any measurement whose alarm switched off.
  • Page 54: Changing Alarm Limits

    3 Alarms Alarm 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. This calls up a list of available values for the alarm limit. Select a value from the list to adjust the alarm limit.
  • Page 55: About Automatic Alarm Limits (autolimits)

    Alarm Limits 3 Alarms About Automatic Alarm Limits (AutoLimits) The monitor can automatically set alarm limits suited to your individual patient, using the Automatic Alarm Limits function. This tells the monitor to adapt the alarm limits of selected measurements to the measured vital signs within a defined safe limit.
  • Page 56: Reviewing Alarms

    3 Alarms Reviewing Alarms Reviewing Alarms To review the currently active alarms and INOPs, select any of the alarm status areas on the monitor screen. The Alarm Messages window pops up. All alarms and INOPs are erased from the monitor’s alarm history when you discharge a patient, or if you change to Demonstration Mode. Alarm Messages Window The Alarm Messages window shows all the currently active alarms and INOPs in chronological order, beginning at the top with the most recent.
  • Page 57: Understanding Alarm Messages

    Understanding Alarm Messages 3 Alarms Understanding Alarm Messages If you do not immediately understand an INOP or alarm message, refer to its help text. ♦ In the Alarm Messages window, select the INOP message. This calls up a help window with an explanation of the INOP message and, where appropriate, a suggested solution for the problem.
  • Page 58: Alarm Latching Behavior

    3 Alarms Testing Alarms Alarm Latching Behavior Red and Yellow Measurement Non-latching Visual and audible Visual latching, Alarms alarms latching audible non-latching Alarm has not been Alarm condition Alarm tone on. Alarm lamp on. Alarm message. Flashing numerics. acknowledged. still present. Alarm condition All audible and visual Alarm tone on.
  • Page 59: Patient Alarms And Inops

    Patient Alarms and INOPs This chapter lists patient alarms and technical alarms (INOPs) alphabetically, irrespective of their priority. INOPs start on page 47. Patient Alarm Messages The measurement labels and abbreviations for pressure, temperature, SpO , and anesthetic agent alarms are explained in the individual chapters. Note that yellow arrhythmia alarms (“short yellow alarms”) may be shown with one or with two stars, depending on the monitor and Information Center revision you are using.
  • Page 60 4 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication Continuous Cardiac Output or CC numeric flashes and low alarm **CCO/CCI LOW Index is below the low alarm limit. limit is highlighted, yellow alarm lamp, alarm tone. The CPP value has exceeded the high numeric flashes and high limit **CPP HIGH...
  • Page 61 Patient Alarm Messages 4 Patient Alarms and INOPs Alarm Message From Condition Indication The inspired agent high alarm limit (3.4 numeric flashes, high limit is **in <Agent label> vol.%) has been exceeded. highlighted, yellow alarm HIGH lamp, alarm tone. The inspired agent value has fallen numeric flashes, low limit is **in <Agent label>...
  • Page 62 4 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication ECG/ A non-ventricular contraction, followed numeric flashes, yellow alarm */**PAIR PVCs Arrhythmia by two ventricular contractions, lamp, short yellow audible followed by a non-ventricular alarm. contraction has been detected. ECG/ No beat detected for a period greater numeric flashes, yellow alarm...
  • Page 63 Patient Alarm Messages 4 Patient Alarms and INOPs Alarm Message From Condition Indication **<SpO2 label> LOW SpO The arterial oxygen saturation has fallen numeric flashes and low limit below the low alarm limit. is highlighted, yellow alarm lamp, alarm tone. ECG/ The ST elevation in lead <n>...
  • Page 64 4 Patient Alarms and INOPs Patient Alarm Messages Alarm Message From Condition Indication A fibrillatory waveform for 4 numeric flashes, red alarm ***VENT FIB/TACH consecutive seconds was detected. lamp, alarm tone. ECG/ A dominant rhythm of adjacent Vs > numeric flashes, yellow alarm */**VENT RHYTHM Arrhythmia vent rhythm limit and ventricular HR <...
  • Page 65: Technical Alarm Messages (inops)

    Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) The measurement labels and abbreviations for pressure, temperature, SpO , anesthetic agent, and VueLink INOP messages are explained in the individual chapters. INOP Message, Indication Source What to do PRESS See <Pressure label>...
  • Page 66 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do There is a problem with the automatic agent identification. To AGT ID MALFUNCTION Numerics replaced by -?-, INOP tone continue monitoring, switch to manual agent selection. The (in Auto mode) Gas Analyzer numeric cannot reliably be derived.
  • Page 67 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do Batteries The monitor requires two batteries but can detect only one BATT 1/BATT 2 MISSING functioning battery. Replace the missing or faulty battery Battery LED flashes immediately.
  • Page 68 If the INOP persists, replace PIC. If INOP persists, contact your service personnel. Unsupported sensor connected or sensor type unknown. BIS SENSOR INCOMPT Replace the sensor, using only Philips supported sensors. INOP tone Malfunction in the sensor hardware, most often caused by BIS SENSOR MALFUNC...
  • Page 69 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do The ST algorithm cannot generate a valid ST value. Possible CANNOT ANALYZE ST causes are large variations in the measured ST values for consecutive beats, or ventricular paced beats. Review the ECG signal quality and the ST measurement points.
  • Page 70 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do Monitor Perform a visual check of the alarm lamp to establish whether CHECK ALARM LAMPS INOP tone. there is a problem. Contact your service personnel to check the internal connections to the alarm lamps.
  • Page 71 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do Currently no calibration is running. Accuracy can be checked CAL MODE numeric displays current CO by placing the transducer on the two cells of the calstick and value for accuracy check starting calibration.
  • Page 72 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do C.O. Plug in the C.O. module. Silencing this INOP switches off the C.O. UNPLUGGED numeric displays -?- measurement. INOP tone. The software in the Measurement Server Extension does not UPDATE FW Numeric is replaced by a - ? - match the software in the MMS.
  • Page 73 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do Excessive line noise has been detected in either channel EEG1 EEG LINE NOISE or EEG2, or in both EEG channels. EEG 1 or 2 LINE NOISE Keep all cables together and away from metallic bodies, other cables &...
  • Page 74 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do Monitor The power consumption of the devices connected to the MSL POWER OVERLOAD INOP tone. Measurement Server Link (MSL) cable is much too high or there has been a short circuit.
  • Page 75 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do The Gas Analyzer currently cannot measure O . If this INOP UNABLE TO MEAS Numerics replaced by -?-. INOP tone persists, contact your service personnel. An O zero calibration failed.
  • Page 76 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do Monitor There is a problem with the connection to the remote alert REM.ALARMDEV.MALF device. Contact your service personnel to check the remote INOP tone alert device and its connections.
  • Page 77 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do Excessive patient movement or electrical interference is causing <SpO label> NOISY SIGN. Numeric is replaced by a -?- irregular pulse patterns. Try to reduce patient movement or to INOP tone.
  • Page 78 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do The SvO Module or Optical Module is faulty. Unplug and EQUIP MALF numeric displays -?-. replug the Optical Module and SvO module. Exchange the INOP tone modules.
  • Page 79 Technical Alarm Messages (INOPs) 4 Patient Alarms and INOPs INOP Message, Indication Source What to do tcGas A calibration failed. Check the cal. unit, gas pressure, and tcpO (or tcpCO or tcGas) tubing connections, then restart the cal. If the cal. has failed CAL FAILED Numeric displays -?- more than once, remembrane the transducer and restart the...
  • Page 80 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs) INOP Message, Indication Source What to do TEMP Make sure the TEMP probe is connected to the MMS or <Temp label> NO module. TRANSDUCER Numeric is displayed with a -?- If you silence this INOP, the measurement will be switched off. INOP tone.
  • Page 81 The VueLink module has not been configured during VueLnk NO CONFIG INOP tone. installation. The installation process should be completed by either your biomedical engineering department or the Philips service engineer. VueLink INOP abbreviations may differ slightly depending on the device category.
  • Page 82 4 Patient Alarms and INOPs Technical Alarm Messages (INOPs)
  • Page 83: Managing Patients

    Managing Patients The monitor displays physiological data and stores it in the trends as soon as a patient is connected. This lets you monitor a patient who is not yet admitted. It is however important to fully admit patients so that you can clearly identify your patient on recordings, reports and networking devices. During admission you enter data that the monitor needs for safe and accurate operation.
  • Page 84: Patient Category And Paced Status

    5 Managing Patients Quick Admitting a Patient – : Enter the patient’s medical record number (MRN), for example 12345678 – : Choose the patient category, either Adult, Pediatric, or Neonatal. Patient Cat – : Choose Yes or No (You must use “Yes” if your patient has a pacemaker). Paced –...
  • Page 85: Editing Patient Information

    Editing Patient Information 5 Managing Patients Editing Patient Information To edit the patient information after a patient has been admitted, select the patient name field on the Main Screen to open the window, and make the required changes. Patient Demographics Discharging a Patient You should perform a discharge even if your previous patient was not admitted.
  • Page 86: Transferring A Patient

    5 Managing Patients Transferring a Patient Transferring a Patient Different sets of patient- and measurement-related data are stored in the monitor and the Multi- Measurement Server. Understanding this will help you to understand what happens to patient data when you transfer patients. Patient Information Stored in Monitor Stored in MMS and extensions...
  • Page 87: Transferring A Patient With An Mms

    Resolving Patient Information Mismatch 5 Managing Patients Transferring a Patient with an MMS To transfer a patient with an MMS, Disconnect the MMS from the original monitor. Silence the resulting MMS UNPLUGGED INOP. Move the patient with the measurement server and connect the MMS at the new monitor. If prompted, re-admit the patient to the new monitor: in the Patient Selection window, select Continue MMS to retain the data in the MMS.
  • Page 88: Patient Mismatch - If One Set Of Patient Data Is Correct

    5 Managing Patients Resolving Patient Information Mismatch Patient Mismatch - If One Set of Patient Data is Correct ♦ If there is a mismatch between an Patient Selection Information Center and a monitor, Central Monitor choose the data set you want to Last name MILLER continue using for this patient,...
  • Page 89: Patient Mismatch - If Both Patient Data Sets Are Correct

    Care Groups 5 Managing Patients Patient Mismatch - If Both Patient Data Sets Are Correct A patient mismatch where both sets of patient data are correct might occur if you admit a new patient at the monitor (or Information Center) before the patient arrives at your unit and then connect the MMS that was used during the patient transport to the monitor.
  • Page 90: Understanding Care Group Symbols

    5 Managing Patients Care Groups Understanding Care Group Symbols The Care Group monitors’ status is shown in symbol form in the Care Group overview bar. Care Group Symbols The highest priority alarm at this monitor is an INOP condition The highest priority alarm at this monitor is a yellow alarm The highest priority alarm at this monitor is a red alarm...
  • Page 91: Viewing The Care Group Overview Bar

    Care Groups 5 Managing Patients Viewing the Care Group Overview Bar In the overview bar, flashing symbols indicate active alarms, symbols that are not flashing indicate alarms that have been acknowledged. The bed label and patient name for any Care Group beds in alarm condition rotate on the right.
  • Page 92: Viewing The Other Patient Window

    5 Managing Patients Care Groups Viewing the Other Patient Window This window shows a subset of the waveform and numeric information from a selected monitor. ♦ To open the window, select the patient name or bed label in the My Care Group window, or select the bed symbol in the Care Group overview bar.
  • Page 93: Ecg, Arrhythmia, And St Monitoring

    CAUTION To protect the monitor from damage during defibrillation, for accurate ECG information and to protect protection against noise and other interference, use only ECG electrodes and cables specified by Philips. Connecting ECG Cables Attach the electrode cable to the patient cable.
  • Page 94: Selecting The Primary And Secondary Ecg Leads

    6 ECG, Arrhythmia, and ST Monitoring Selecting the Primary and Secondary ECG Leads Selecting the Primary and Secondary ECG Leads The monitor uses the primary and secondary lead to compute HR and to analyze and detect cardiac arrhythmias. They are also available for recordings and for display on the Information Center. The secondary lead setting is used only if your monitor is configured for multi-lead (instead of single- lead) arrhythmia analysis.
  • Page 95: Understanding The Ecg Display

    Paced paced signal. Defibrillator synchronization marks: If an HP/Agilent/Philips defibrillator is connected, the synchronization marks (vertical lines on the ECG wave) are shown on the ECG wave. ST numerics in ECG wave: ST numerics can be configured to show underneath the ECG wave on the bottom left.
  • Page 96: Setting The Paced Status (pace Pulse Rejection)

    6 ECG, Arrhythmia, and ST Monitoring Changing the Size of the ECG Wave Setting the Paced Status (Pace Pulse Rejection) ♦ In the menu, select to toggle between Yes and No. Paced Setup ECG Paced You can also change the paced status in the Patient Demographics window. When is set to Paced...
  • Page 97: To Change The Size Of All The Ecg Waves

    Changing the Volume of the QRS Tone 6 ECG, Arrhythmia, and ST Monitoring To Change the Size of all the ECG Waves To change the size of all the ECG waves on the screen by a fixed adjustment factor, In the Setup Lead menu, select Adjust Size Select the required adjustment factor from the line of pop-up keys.
  • Page 98: Choosing Easi Or Standard Lead Placement

    6 ECG, Arrhythmia, and ST Monitoring Choosing EASI or Standard Lead Placement only to the ECG bandwidth requirements for diagnostic electrocardiographic devices as outlined in the ANSI/AAMI standard EC11-1991. Choosing EASI or Standard Lead Placement If EASI™ monitoring is available on your monitor, you must enable either standard lead placement or EASI lead placement.
  • Page 99: Ecg Lead Fallback

    ECG Lead Fallback 6 ECG, Arrhythmia, and ST Monitoring ECG Lead Fallback If fallback is configured on and there is a leads off INOP in the primary lead (and in the secondary lead, if you are using multi-lead monitoring) for longer than 10 seconds, and if another lead is available, this available lead automatically becomes the primary lead.
  • Page 100: Standard 5-lead Placement

    6 ECG, Arrhythmia, and ST Monitoring ECG Lead Placements Standard 5-Lead Placement RA placement: directly below the clavicle and near the right shoulder LA placement: directly below the clavicle and near the left shoulder RL placement: on the right lower abdomen LL placement: on the left lower abdomen V placement: on the chest, the position depends on your required lead selection...
  • Page 101: Chest Electrode Placement

    ECG Lead Placements 6 ECG, Arrhythmia, and ST Monitoring Chest Electrode Placement For accurate chest electrode placement and measurement, it is important to locate the fourth intercostal space. Locate the second intercostal space by first palpating the Angle of Lewis (the little bony protuberance where the body of the sternum joins the manubrium).
  • Page 102: Lead Placement

    6 ECG, Arrhythmia, and ST Monitoring ECG Lead Placements 10-Lead Placement When monitoring 12-leads of ECG, using a 10-Electrode Lead Placement, it is important to correctly place electrodes and to label all 12-lead ECG reports with the correct lead placement. Conventional 12-Lead ECG In conventional 12-Lead ECG using 10 electrodes, an electrode is placed on the right arm, left arm, right leg, and left leg.
  • Page 103: Modified 12-lead Ecg

    ECG Lead Placements 6 ECG, Arrhythmia, and ST Monitoring Modified 12-Lead ECG If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System), place the four limb electrodes close to the shoulders and lower abdomen. The six V electrodes are placed on the chest in the same position as the conventional 12-lead placement.
  • Page 104: Choosing Standard Or Modified Electrode Placement

    6 ECG, Arrhythmia, and ST Monitoring Capture 12-Lead Choosing Standard or Modified Electrode Placement If your institution uses modified 10 Lead ECG electrode placement (the Mason-Likar Lead System), you must switch Mod. Lead Placment to On in the monitor. To do this, ♦...
  • Page 105: Easi Ecg Lead Placement

    EASI ECG Lead Placement 6 ECG, Arrhythmia, and ST Monitoring EASI ECG Lead Placement Using a standard 5-electrode set in EASI lead placement you can monitor up to 12 standard ECG leads simultaneously and continuously at the bedside. EASI-derived 12-lead ECGs and their measurements are approximations to conventional 12-lead ECGs.
  • Page 106: Ecg, Arrhythmia, And St Alarm Overview

    6 ECG, Arrhythmia, and ST Monitoring ECG, Arrhythmia, and ST Alarm Overview ECG, Arrhythmia, and ST Alarm Overview The ECG, arrhythmia, and ST alarms available depend on which measurements are switched on, and the arrhythmia option enabled for your monitor. •...
  • Page 107: Using Ecg Alarms

    Using ECG Alarms 6 ECG, Arrhythmia, and ST Monitoring Using ECG Alarms ECG alarms can be switched on and off and the high and low alarm limits changed just like other measurement alarms, as described in the Alarms section. Special alarm features which apply only to ECG are described here.
  • Page 108 6 ECG, Arrhythmia, and ST Monitoring ECG Safety Information WARNING Defibrillation and Electrosurgery: Do not touch the patient, or table, or instruments, during defibrillation. After defibrillation, the screen display recovers within 10 seconds if the correct electrodes are used and applied in accordance with the manufacturers instructions.
  • Page 109: About Arrhythmia Monitoring

    About Arrhythmia Monitoring 6 ECG, Arrhythmia, and ST Monitoring About Arrhythmia Monitoring Arrhythmia analysis provides information on your patient’s condition, including heart rate, PVC rate, rhythm, and ectopics. The monitor uses the user-selected primary and secondary ECG leads for single- lead or multi-lead arrhythmia analysis.
  • Page 110: Switching Arrhythmia Analysis On And Off

    6 ECG, Arrhythmia, and ST Monitoring Switching Arrhythmia Analysis On and Off Switching Arrhythmia Analysis On and Off In the menu, select to toggle between Setup Arrhythmia Arrhythmia Select the pop-up key which appears at the bottom of the screen. Confirm Be aware that when arrhythmia analysis is switched off, –...
  • Page 111: Intermittent Bundle Branch Block

    Understanding the Arrhythmia Display 6 ECG, Arrhythmia, and ST Monitoring Intermittent Bundle Branch Block Bundle branch and the other fascicular blocks create a challenge for the arrhythmia algorithm. If the QRS during the block changes considerably from the learned normal, the blocked beat may be incorrectly classified as ventricular, causing false PVC alarms.
  • Page 112: Arrhythmia Status Messages

    6 ECG, Arrhythmia, and ST Monitoring Understanding the Arrhythmia Display Arrhythmia Status Messages The monitor displays two types of status messages: • Rhythm Status Messages -- to indicate the patient’s rhythm. • Ectopic Status Messages -- to indicate the presence of ectopic beats. These status messages are shown on the right hand side of the primary ECG wave.
  • Page 113: Ectopic Status Messages

    Arrhythmia Relearning 6 ECG, Arrhythmia, and ST Monitoring Ectopic Status Messages The label B or E indicates basic (B) or enhanced (E) arrhythmia capability. Ectopic Status Message Explanation B or E (No message displayed) No ectopic activity within the last minute More than 2 consecutive PVCs within the last minute RUN PVCs Pair PVCs within the last minute...
  • Page 114: Automatic Arrhythmia Relearn

    6 ECG, Arrhythmia, and ST Monitoring Arrhythmia Alarms Automatic Arrhythmia Relearn Arrhythmia relearning is initiated automatically whenever: • ECG monitoring is switched on • The ECG Lead or Lead Label is changed manually, or when fallback occurs • A INOP condition (that has been active for > 60 seconds) ends. Leads Off If you are monitoring multi-lead arrhythmia and there is a change in one lead only, relearning happens only in the affected lead.
  • Page 115: Yellow Arrhythmia Alarms

    Arrhythmia Alarms 6 ECG, Arrhythmia, and ST Monitoring Yellow Arrhythmia Alarms Yellow arrhythmia alarms are short yellow alarms specific to arrhythmia-related patient conditions. Depending on your monitor and Information Center revision, they may be shown with one or two stars. WARNING When arrhythmia analysis is on, all yellow alarms connected with ECG are short (one-star).
  • Page 116 6 ECG, Arrhythmia, and ST Monitoring Arrhythmia Alarms When a yellow arrhythmia alarm is generated, it triggers visible and audible indicators. It also automatically initiates a timeout, or inhibitory period. During this period, the same alarm condition will not generate another alarm. When the timeout period is over, an alarm will be generated again if the condition still persists.
  • Page 117: Arrhythmia Alarm Chaining

    Arrhythmia Alarms 6 ECG, Arrhythmia, and ST Monitoring Arrhythmia Alarm Chaining When arrhythmia analysis is switched on, multiple alarm conditions may be present. Announcing all of the detected alarm conditions would be confusing, and might hide a more serious condition. For this reason, arrhythmia alarms are prioritized in three alarm “chains”: PVC Alarms;...
  • Page 118: Understanding Pvc-related Alarms

    6 ECG, Arrhythmia, and ST Monitoring Arrhythmia Alarms Understanding PVC-Related Alarms PVC-related alarms are detected on the basis of the current ventricular heart rate and the number of consecutive PVCs counted (referred to as PVC Runs). Changing one alarm limit automatically changes linked alarm limits.
  • Page 119: About St Monitoring

    About ST Monitoring 6 ECG, Arrhythmia, and ST Monitoring About ST Monitoring The monitor performs ST segment analysis on normal and atrially paced beats and calculates ST segment elevations and depressions. This information can be displayed in the form of ST numerics and snippets on the monitor.
  • Page 120: Understanding The St Display

    6 ECG, Arrhythmia, and ST Monitoring Understanding the ST Display Understanding the ST Display Your monitor screen may be configured to look slightly different from the illustrations. Current heart rate Current HR ST Numerics Up to 12 ST numerics plus the alarm limits ST index can be displayed on the monitor screen.
  • Page 121: Updating St Baseline Snippets

    Updating ST Baseline Snippets 6 ECG, Arrhythmia, and ST Monitoring ST label and ST Baseline numeric ST-II Baseline ST numeric -0.8 and difference since baseline was stored ?-2.7 1mV calibration Current snippet ST baseline ST Baseline stored at 14 Feb 03 9:38 Timestamp of most recently stored baseline snippet Updating ST Baseline Snippets ST analysis requires valid samples to measure and store a snippet.
  • Page 122: Adjusting St Measurement Points

    6 ECG, Arrhythmia, and ST Monitoring Adjusting ST Measurement Points Adjusting ST Measurement Points The ST measurement for each beat complex is the vertical difference between two measurement points. The isoelectric point provides the baseline for the measurement and the ST point provides the other measurement point.
  • Page 123 Adjusting ST Measurement Points 6 ECG, Arrhythmia, and ST Monitoring ST label and the ST numeric that would Adjust ST Points apply using the ST-I current points calibration Cursors for adjusting ST points ST Points adjusted at 04 Apr 03 11:38 Timestamp of most recent ST ISO Point -80...
  • Page 124: St Alarms

    6 ECG, Arrhythmia, and ST Monitoring ST Alarms ST Alarms ST alarms are yellow alarms. Each ST lead has its own alarm limit. ST alarms are triggered when an ST value exceeds its alarm limit for more than one minute. Switching ST alarms off switches off alarms for all ST leads.
  • Page 125: Monitoring Pulse Rate

    Monitoring Pulse Rate The pulse numeric counts the arterial pulsations that result from the mechanical activity of the heart in beats per minute (bpm). You can display a pulse from any measured SpO signal (pleth wave) or any arterial pressure (ABP, ART, Ao, PAP, UAP, P: see the pressure section for an explanation of the pressure labels).
  • Page 126: Switching Pulse On And Off

    7 Monitoring Pulse Rate Switching Pulse On and Off Switching Pulse On and Off To switch a particular pulse numeric on or off, enter the Setup Pulse menu via the measurement setup menu or wave menu of the pulse source. For example, to switch an SpO pulse numeric on or off, Enter the Setup Pulse menu by selecting the Pulse numeric or by selecting Pulse in the...
  • Page 127: Alarm Source Selection Disabled

    Using Pulse Alarms 7 Monitoring Pulse Rate Alarm Source Selection Disabled If Alarm Source Selection is disabled, you cannot change the alarm source. If you try to change the source, the monitor displays the message To activate enter Config and enable .
  • Page 128 7 Monitoring Pulse Rate Using Pulse Alarms...
  • Page 129: Lead Placement For Monitoring Resp

    Monitoring Respiration Rate (Resp) For the respiratory measurement (Resp), the monitor measures the thoracic impedance between two ECG electrodes on the patient’s chest. Changes in the impedance due to thoracic movement produce the Resp waveform on the monitor screen. The monitor counts the waveform cycles to calculate the respiration rate (RR).
  • Page 130: Lateral Chest Expansion

    8 Monitoring Respiration Rate (Resp) Understanding the Resp Display Lateral Chest Expansion Some patients, especially neonates, expand their chests laterally. In these cases it is best to place the two respiratory electrodes in the right midaxillary and left lateral chest areas at the patient’s maximum point of breathing movement to optimize the respiratory wave.
  • Page 131: Manual Detection Mode

    Changing the Size of the Respiration Wave 8 Monitoring Respiration Rate (Resp) • breathing is spontaneous, with or without continuous positive airway pressure (CPAP) • patients are ventilated, except patients with Intermittent Mandatory Ventilation (IMV). Manual Detection Mode In Manual Detection Mode you must set the Resp detection level. ♦...
  • Page 132: Using Resp Alarms

    8 Monitoring Respiration Rate (Resp) Using Resp Alarms Using Resp Alarms Resp alarms can be switched on and off and the high and low alarm limits can be changed just like other measurement alarms, as described in the Alarms chapter. Changing the Apnea Alarm Delay The apnea alarm is a high priority red alarm used to detect apneas.
  • Page 133: Monitoring Spo 2

    Monitoring SpO Philips pulse oximetry uses a motion-tolerant signal processing algorithm, based on Fourier artefact suppression technology (FAST). It provides four measurements: • Oxygen saturation of arterial blood (SpO ) - percentage of oxygenated hemoglobin in relation to the sum of oxyhemoglobin and deoxyhemoglobin (functional arterial oxygen saturation).
  • Page 134 If you are measuring SpO with the M3001A Multi-Measurement Server or the SpO measurement module M1020B, Option A01, use Philips reusable and disposable sensors and Nellcor “R-Cal” disposable sensors. If you are measuring SpO with the SpO measurement module M1020B Option A02, use Nellcor OxiMax sensors.
  • Page 135: Applying The Sensor

    Applying the Sensor 9 Monitoring SpO Applying the Sensor Follow the SpO sensor’s instructions for use, adhering to all warnings and cautions. Remove colored nail polish from the application site. Apply the sensor to the patient. The application site should match the sensor size so that the sensor can neither fall off, nor apply excessive pressure.
  • Page 136: Measuring Spo 2

    9 Monitoring SpO Measuring SpO Measuring SpO Select the correct patient category setting (adult/pediatric and neonatal), as this is used to optimize the calculation of the SpO and pulse numerics. During measurement, ensure that the application site: – has a pulsatile flow, ideally with a perfusion indicator value above 1.0. –...
  • Page 137: Adjusting The Alarm Limits

    Understanding SpO Alarms 9 Monitoring SpO Understanding SpO Alarms This refers to SpO specific alarms. See the Alarms section for general alarm information. SpO offers high and low limit alarms, and a high priority desat alarm. You cannot set the low alarm limit below the desat alarm limit.
  • Page 138: Perfusion (pleth) Indicator

    9 Monitoring SpO Perfusion (Pleth) Indicator Perfusion (Pleth) Indicator The perfusion indicator gives a numerical value for the pulsatile portion of the measured signal caused by the pulsating arterial blood flow. As pulse oximetry is based on the pulsatile nature of the signal, you can also use the perfusion indicator as a quality indicator for the SpO measurement.
  • Page 139: Monitoring Nbp

    Monitoring NBP This monitor uses the oscillometric method for measuring NBP. In adult and pediatric mode, the blood pressure measurements determined with this device comply with the American National Standard for Electronic or Automated Sphygmomanometers (ANSI/AAMI SP10-1992) in relation to mean error and standard deviation, when compared to intra-arterial or auscultatory measurements (depending on the configuration) in a representative patient population.
  • Page 140: Measurement Limitations

    10 Monitoring NBP Preparing to Measure NBP CAUTION If you spill liquid onto the equipment or accessories particularly if there is a chance that it can get inside the tubing or the MMS, contact your service personnel. Measurement Limitations Measurements are impossible with heart rate extremes of less than 40 bpm or greater than 300 bpm, or if the patient is on a heart-lung machine.
  • Page 141: Correcting The Measurement If Limb Is Not At Heart Level

    Preparing to Measure NBP 10 Monitoring NBP Make sure that you are using a Philips-approved correct sized cuff and that the bladder inside the cover is not folded or twisted. A wrong cuff size, and a folded or twisted bladder, can cause inaccurate measurements. The width of the cuff should be in the range from 37% to 47% of the limb circumference.
  • Page 142: Starting And Stopping Measurements

    10 Monitoring NBP Starting and Stopping Measurements Starting and Stopping Measurements Use the Setup menu, SmartKeys or the MMS hardkey to start and stop measurements. Action to be performed NBP Setup menu SmartKeys MMS hardkey Start/Stop Start/Stop Start/Stop manual measurement Start Auto series Stop current automatic measurement...
  • Page 143: Choosing Nbp Alarm Source

    Choosing NBP Alarm Source 10 Monitoring NBP Choosing NBP Alarm Source You can monitor for alarm conditions in systolic, diastolic and mean pressure, either singly or in parallel. Only one alarm is given, with the priority of mean, systolic, diastolic. In the Setup NBP menu, select and choose from:...
  • Page 144 10 Monitoring NBP Calibrating NBP...
  • Page 145: Monitoring Temperature

    Monitoring Temperature You can measure temperature using the MMS, one of the measurement server extensions, or the temperature plug-in module. You cannot measure invasive pressure and temperature simultaneously in one MMS or server extension. Temp measurement automatically switches on when you connect a probe.
  • Page 146: Calculating Temp Difference

    11 Monitoring Temperature Calculating Temp Difference Calculating Temp Difference The monitor can calculate the difference between two temperature values by subtracting the second value from the first. The difference is labeled with the first letters of the first measurement and the first letters of the second.
  • Page 147: Monitoring Invasive Pressure

    Monitoring Invasive Pressure You can measure pressure using the Multi-Measurement Server (MMS), one of the measurement server extensions or the pressure plug-in module. You cannot measure invasive pressure and temperature simultaneously in one MMS or server extension. WARNING Make sure that the applied parts never come into contact with other conductive parts, or with earth. Setting up the Pressure Measurement Plug in the pressure cable.
  • Page 148: Selecting A Pressure For Monitoring

    12 Monitoring Invasive Pressure Selecting a Pressure for Monitoring Position the transducer so that it is level with the heart, approximately at the level of the midaxillary line. WARNING If measuring intracranial pressure (ICP) with a sitting patient, level the transducer with the top of the patient’s ear.
  • Page 149: Determining A Pressure's Most Recent Zero

    Zeroing the Pressure Transducer 12 Monitoring Invasive Pressure WARNING If you select the label ICP, the measurement device uses the most recently stored zero. Therefore, make sure you zeroed the transducer correctly in accordance with the transducer manufacturer’s instructions and your hospital policy. When you use a transducer that you cannot rezero after placement, ensure that you keep the measuring device with the patient so that you are certain you have the correct zero data for this patient.
  • Page 150: Troubleshooting The Zero

    12 Monitoring Invasive Pressure Adjusting the Calibration Factor Troubleshooting the Zero The status line lists the probable cause of an unsuccessful zero: Message Corrective Action The hardware is faulty. Contact your service personnel. unable to zero - equipment malfunction Make sure the transducer is vented to air and try again. If this fails, the hardware unable to zero - may be faulty.
  • Page 151: Optimizing The Waveform

    Optimizing the Waveform 12 Monitoring Invasive Pressure Optimizing the Waveform ♦ In the menu, select to let the monitor select the best Setup <Press> Optimum Scale minimum and maximum scales for the current wave. Non-Physiological Artifact Suppression Some clinical procedures may affect blood pressure, for example, a flush procedure or a blood sample. Your monitor may be configured to suppress these non-physiological artifacts for a specified duration (Artifact Suppression is configured to 30, 60, or 90 seconds).
  • Page 152: Calibrating Reusable Transducer Cpj840j6

    12 Monitoring Invasive Pressure Calibrating Reusable Transducer CPJ840J6 Calibrating Reusable Transducer CPJ840J6 Depending on your monitor’s configuration, you may be able to perform a calibration in monitoring mode. Perform a mercury calibration when you use a new transducer, and at regular intervals according to your hospital policy.
  • Page 153: Troubleshooting The Pressure Calibration

    Calculating Cerebral Perfusion 12 Monitoring Invasive Pressure Select the calibration pressure from the list, for example 200 mmHg. Select to recalculate the calibration factor using the applied pressure. Confirm When the monitor displays < , remove Press> calibration done at <date and time> the manometer tubing, syringe and extra stopcock.
  • Page 154: Measuring Pulmonary Artery Wedge Pressure

    12 Monitoring Invasive Pressure Measuring Pulmonary Artery Wedge Pressure Measuring Pulmonary Artery Wedge Pressure Pulmonary Artery Wedge Pressure (PAWP) values, used to assess cardiac function, are affected by: • Fluid status • Myocardial contractility • Valve and pulmonary circulation integrity Obtain the measurement by introducing a balloon-tipped pulmonary artery flotation catheter into the pulmonary artery.
  • Page 155: Editing The Wedge

    Editing the Wedge 12 Monitoring Invasive Pressure Editing the Wedge Select the pop-up key to see the stored waveforms. Edit Wedge The monitor displays a cursor in the waveform at the PAWP mean value. It also displays any previously stored value and the time it was stored. Move the cursors up, down, right and left to set them on the correct wedge position.
  • Page 156 12 Monitoring Invasive Pressure Identifying the Pressure Analog Output Connector...
  • Page 157: Monitoring Cardiac Output

    Monitoring Cardiac Output The Cardiac Output (C.O.) measurement invasively measures cardiac output and other hemodynamic parameters using a technique called thermodilution. This can be used to determine the flow rate of a system by introducing a cold solution into the system and measuring the resulting drop in temperature at a downstream site.
  • Page 158: Hemodynamic Parameters

    13 Monitoring Cardiac Output Hemodynamic Parameters Hemodynamic Parameters This table illustrates the hemodynamic parameters available with each method, whether they are measured continuously, and whether they can be shown on the monitor’s resting display or in the HemoCalc Window. PiCCO Method (Transpulmonary Thermodilution) Right Heart Thermodilution...
  • Page 159: Using The C.o. Procedure Window

    Using the C.O. Procedure Window 13 Monitoring Cardiac Output Using the C.O. Procedure Window The C.O. procedure window displays up to six trials (measurement curves) with the trial number and the C.O. value under the thermodilution curve. When you open the window, a line of pop-up keys automatically appears to let you carry out C.O.-related tasks.
  • Page 160: Accessing The Setup C.o. And Setup Cco Menus

    13 Monitoring Cardiac Output Accessing the Setup C.O. and Setup CCO Menus Accessing the Setup C.O. and Setup CCO Menus C.O. settings can be changed in the menu. To access this menu, Setup C.O. ♦ press the C.O. hard key on the C.O. module ♦...
  • Page 161: Setting Up The Picco C.o. Measurement

    Measuring C. O. Using the PiCCO Method 13 Monitoring Cardiac Output Setting Up the PiCCO C.O. Measurement C.O. Module Press Module Set up the arterial line using the arterial catheter (transpulmonary catheter) and the transducer kit from Pulsion Medical Systems. It must be placed in one of the C.O.
  • Page 162: Performing Picco C.o. Measurements

    13 Monitoring Cardiac Output Measuring C. O. Using the PiCCO Method Check that the correct arterial catheter constant is selected. If the catheter is recognized by the monitor, the catheter constant is automatically displayed and cannot be changed manually. If it is not recognized, in the C.O. procedure window, select CathCt and use the pop-up keypad to enter the correct value.
  • Page 163: Saving And Calibrating Picco C.o. Measurements

    Measuring C.O. Using the Right Heart Thermodilution Method 13 Monitoring Cardiac Output accepted and rejected. The background of rejected trials is red and the background of accepted trials is green. The monitor recalculates the average values after you reject trials. Saving and Calibrating PiCCO C.O.
  • Page 164: Setting Up Rh C.o. Measurements

    13 Monitoring Cardiac Output Measuring C.O. Using the Right Heart Thermodilution Method Setting up RH C.O. Measurements C.O. Module Set up the PA line using a PA catheter. Attach the injectate temperature probe housing to the PA line. C.O. Interface Cable Plug the C.O.
  • Page 165: Performing Rh C.o. Measurements

    Documenting C.O. Measurements 13 Monitoring Cardiac Output Performing RH C.O. Measurements Enter the C.O. procedure window. When you see the message , select the pop-up key ...Ready for new measurement Start C.O. When you hear a ready tone and see the message , inject the solution into the ...Inject now! right atrial port of the Swan-Ganz catheter.
  • Page 166: C.o. Injectate Guidelines

    13 Monitoring Cardiac Output C.O. Injectate Guidelines C.O. Injectate Guidelines The greater the injectate volume and the colder the temperature, the more accurate the measurement. Reduced injectate volume or higher injectate temperature may reduce the specified accuracy. For adult patients, to ensure the greatest measurement accuracy, use a cold injectate of 10 ml volume, if not contra-indicated by the patient's condition.
  • Page 167: Injectate For Patients With High Etvi Values (picco Only)

    C.O./CCO Curve Alert Messages 13 Monitoring Cardiac Output Injectate for Patients with High ETVI Values (PiCCO Only) The dilution of injectate is also influenced by the extravascular tissue. The accuracy of the PiCCO method may be reduced in patients with high extra-vascular thermal volume index (ETVI) values. You should use a higher injectate volume and/or colder injectate in these patients, based on this table.
  • Page 168: C.o./cco Prompt Messages

    13 Monitoring Cardiac Output C.O./CCO Prompt Messages C.O./CCO Curve Alert Messages Possible Causes The injection should be performed quickly and with a steady Disturbed Injection pressure. Shaking or unsteady pressure may cause this message to appear. The recorded Tinj signal is uncharacteristic for the M1646 injectate Check Injectate temperature probe.
  • Page 169: C.o./cco Warning Messages

    C.O./CCO Warning Messages 13 Monitoring Cardiac Output C.O./CCO Warning Messages Warning messages contain important information about the C.O. measurement. C.O./CCO Warning Messages Possible Causes Six curves are stored, this is the maximum possible. If another Next measurement erases measurement is stored, the oldest thermodilution curve will be erased. older curve A C.O.
  • Page 170 13 Monitoring Cardiac Output C.O./CCO Safety Information CAUTION During the cardiac output measurement procedure the blood temperature alarms are inactive. This is indicated by a crossed-out alarm symbol next to the temperature numeric. Making alarms inactive during this procedure prevents false alarms. The alarms are automatically reactivated when you have completed the measurement procedure.
  • Page 171: Monitoring Carbon Dioxide

    CO sensor built into the measurement system. Philips uses the advanced Microstream method of sidestream CO measurement which is available in the M3015A Microstream CO Extension to the M3001A Multi-Measurement Server.
  • Page 172: Preparing To Measure Mainstream Co 2

    14 Monitoring Carbon Dioxide Using the Mainstream CO Extension (M3016A) WARNING Correlation: The etCO readings do not always correlate closely with blood gas values, especially in neonatal patients and patients with pulmonary disease, pulmonary embolism or inappropriate ventilation. Pharmaceuticals in aerosols: Do not measure CO in the presence of pharmaceuticals in aerosols.
  • Page 173: Calibrating The Transducer

    Using the Mainstream CO Extension (M3016A) 14 Monitoring Carbon Dioxide Calibrating the Transducer Check that the windows on the calstick are clean and clear. Place the transducer on one of the calstick cells and select Start Cal 1. Enter the calibration value printed on the calstick then press to start calibration.
  • Page 174: Preparing To Measure Microstream Co 2

    14 Monitoring Carbon Dioxide Using the Microstream CO Extension (M3015A) WARNING To prevent stress on the endotrachial tube, support the transducer and airway adapter. To avoid infection, use only sterilized airway adapters. Using the Microstream CO Extension (M3015A) The M3015A Microstream CO Extension measures the partial pressure of carbon dioxide in a patient’s expired gas using Microstream technology.
  • Page 175: Using The Filterline And Airway Adapter

    Using the Microstream CO Extension (M3015A) 14 Monitoring Carbon Dioxide Using the FilterLine and Airway Adapter Attach the female Luer connector to the CO inlet connector on the measurement extension by pushing the socket cover down and screwing the connector into place. inlet connector cover outlet connector Check that the FilterLine is not kinked.
  • Page 176: Setting Up Mainstream And Microstream

    14 Monitoring Carbon Dioxide Setting up Mainstream and Microstream Setting up Mainstream and Microstream These tasks are common to both mainstream and Microstream (sidestream) measurements. Adjusting the CO Wave Scale In the menu or the Setup CO menu, select Wave Scale Choose a suitable scale range from the pop-up list.
  • Page 177: Changing The Apnea Alarm Delay

    Setting up Mainstream and Microstream 14 Monitoring Carbon Dioxide Changing the Apnea Alarm Delay This determines the time limit after which the monitor alarms if the patient stops breathing. In the menu, select awRR. Setup CO menu, select Apnea Time. Setup awRR Choose the apnea alarm delay time.
  • Page 178 14 Monitoring Carbon Dioxide Setting up Mainstream and Microstream...
  • Page 179: Monitoring Tcgas

    Monitoring tcGas The tcGas module measures the partial pressure of the oxygen and carbon dioxide that diffuses through the skin, thereby providing a measure of these gases in the capillary blood. The monitor’s settings for altitude and barometric pressure influence the measurement. The tcpO tcpCO measurement is valid for an infant patient not under gas anesthesia.
  • Page 180: Setting The Tcgas Sensor Temperature

    15 Monitoring tcGas Setting the tcGas Sensor Temperature Setting the tcGas Sensor Temperature In the menu, select Setup tcGas Transducer Temp Choose a temperature value appropriate for your patient’s age, weight and physical condition in accordance with your hospital policy. Usually, a higher transducer temperature gives a better correlation and a quicker response time.
  • Page 181: Restarting The Tcgas Sitetimer

    Setting the tcGas Barometric Pressure 15 Monitoring tcGas Restarting the tcGas SiteTimer To restart the site timer without recalibration (for example, after the site time has elapsed): In the menu, select Setup tcGas Site Time Enter and confirm your desired time. Disabling the tcGas Site Timer Depending on your monitor’s configuration, you might be able to disable the site timer.
  • Page 182: New/dried Out Transducers

    15 Monitoring tcGas Remembraning the tcGas Transducer Unscrew the protection cap from the transducer and hook the O-ring remover under both O-rings to remove them. Remove both of the clear plastic membranes using your fingers. Clean the transducer head, including the groove and rim, with absorbent paper to remove all old electrolyte (old electrolyte causes incorrect values) and apply approximately two drops of electrolyte solution to the...
  • Page 183: Calibrating The Tcgas Transducer

    15 Monitoring tcGas Calibrating the tcGas Transducer You can use either a Philips (15210B) or a Radiometer TCC3 calibration unit and a gas cylinder whose pressure indicator is above the ‘out-of-gas’ zone (black on 15210B, red on TCC3). To maintain accuracy, it is recommended to calibrate the transducer every four hours, even if the monitor does not prompt you to do so.
  • Page 184: Calibration Failure

    15 Monitoring tcGas Calibrating the tcGas Transducer Press CAL on the module until the light above the key comes on and wait (three - 20 minutes) for the “calibration complete” message to appear on the monitor. Alternatively, in the Setup tcGas menu, select .
  • Page 185: Applying The Tcgas Transducer

    Applying the tcGas Transducer 15 Monitoring tcGas Applying the tcGas Transducer Peel protection film from fixation ring. Using a finger, press the sticky side of the ring on to clean, dry skin. Press around the outside to ensure a good seal. Apply three to five drops of contact fluid in the ring’s center.
  • Page 186: Selecting The Tcgas Heatpowerdisplay Mode

    15 Monitoring tcGas Finishing tcGas Monitoring Selecting the tcGas HeatPowerDisplay Mode The heat power display gives an indication of the skin’s perfusion below the transducer and of the transducer’s contact with the skin. If the transducer loses contact, the heat power value drops significantly.
  • Page 187: Monitoring Svo 2

    Monitoring SvO The SvO module measures the percentage of mixed venous oxygen saturation continuously and MP60/70/90 invasively using the Abbott Laboratories OptiCath family of catheters routed via the right side of the monitors heart into the pulmonary artery. Can be used only with the MP60/MP70/MP90 monitors. only WARNING Injected dyes, such as methylene blue, or intravascular dyshemoglobin may lead to inaccurate measurements.
  • Page 188: Preparing To Monitor Svo 2

    16 Monitoring SvO Preparing to Monitor SvO Preparing to Monitor SvO In addition to an SvO module, you need an Abbott Laboratories OptiCath catheter, and 50131-04 Optical Module. Use only the Abbott accessories listed in the Accessories section. optical module balloon inflation stopcock...
  • Page 189: Inserting The Catheter

    Inserting the Catheter 16 Monitoring SvO Place the optical connector into the optical module (with the label “TOP” facing upwards) and close the lid. In the menu, select . Ensure that the tip of the catheter is still Setup SvO2 Start Pre-InsCal in the optical reference.
  • Page 190: Performing In-vivo Calibration

    16 Monitoring SvO Performing In-Vivo Calibration Performing In-Vivo Calibration Perform an in-vivo calibration: • if you place the catheter in a patient without performing a pre-insertion calibration. • if the catheter was disconnected from the optical module. • when the catheter has been in the patient for 24 hours. •...
  • Page 191: Using The Agm

    Using the AGM The M1026A Anesthetic Gas Module (AGM) measures patients’ anesthetic and respiratory gases. It can measure and display waves and numerics for 3 respiratory gases, and it can automatically identify 5 anesthetic agents and display waves and numerics for one of these. The module measures the Airway Respiration Rate (awRR) and provides end tidal (et) and inspired (in) values for the following gases: Respiratory Gases...
  • Page 192: Agm Major Parts And Keys

    17 Using the AGM AGM Major Parts and Keys AGM Major Parts and Keys Airway Gases LED Airway Gases Key Power On/Off Airway Gases switch Power LED Watertrap The setup airway gases LED lights when the menu is open, when the module Setup Gas Analyzer is first switched on (for 5 - 10 seconds), and if there is a problem with the communication between the AGM and the monitor.
  • Page 193: Understanding The Gas Measurement

    Connect the other end of the gas sample tubing to the patient via the airway adapter. CAUTION Airway Adapter: Use a Philips Airway Adapter and position it so that the part connecting to the gas sample tube is pointing upwards. This prevents condensed water from passing into the gas sample tube and causing an occlusion.
  • Page 194: Using The Agm Setup Menus

    17 Using the AGM Using the AGM Setup Menus Using the AGM Setup Menus Many AGM settings can be changed just like other measurement settings. These are described in the chapter on Basic Operation, only AGM-specific settings are described here. To change settings for individual gases, enter the setup menu for the individual gas: ♦...
  • Page 195: Changing The Apnea Alarm Delay

    Changing the Apnea Alarm Delay 17 Using the AGM Changing the Apnea Alarm Delay The apnea alarm delay time determines the time limit after which the monitor alarms if the patient stops breathing. In the menu, select awRR. Setup CO2 In the menu, select Apnea Time.
  • Page 196: Agent Identification

    17 Using the AGM Agent Identification Agent Identification Setting the agent identification mode to lets you choose the anesthetic agent Agent Id: Manual manually. If you choose the setting , the AGM automatically identifies the Agent Id: Auto predominant anesthetic agent in the breathing circuit. ♦...
  • Page 197: Removing Gas From The Circuit

    Removing Gas from the Circuit 17 Using the AGM Removing Gas from the Circuit If inhalation anesthetics are used during anesthesia, pollution of the operating room should be prevented by either returning the filtered gas sample to the breathing circuit or by disposing of the gas sample.
  • Page 198: Zero Calibration

    17 Using the AGM Zero Calibration Zero Calibration The AGM zero calibration maintains the accuracy of the AGM gas measurements by sampling and analyzing room air. It takes about 10 to 15 seconds to complete and may not be interrupted. If a zero calibration fails, a second zero calibration is performed automatically.
  • Page 199: Agm Safety Information

    AGM Safety Information 17 Using the AGM AGM Safety Information To avoid condensed water collecting in the gas sample tube, position the AGM at or above the patient level. Do not set up the AGM in a position where liquid could spill onto it. WARNING Detecting leaks: Any leak in the tubing and connections from the patient to the AGM may result in dilution of the gas mixture with ambient air.
  • Page 200 17 Using the AGM AGM Safety Information...
  • Page 201: Monitoring Eeg

    Monitoring EEG The Electroencephalograph (EEG) module monitors the patient’s cerebral function by measuring the electrical activity of the brain. It provides the monitor with two channels of realtime EEG waves, EEG trend information in the form of Compressed Spectral Arrays (CSA), and up to eight of the following numerics: Spectral Edge Frequency (SEF): The SEF is the frequency below which a defined percentage of the Total Power lies.
  • Page 202: Eeg Monitoring Setup

    18 Monitoring EEG EEG Monitoring Setup EEG Monitoring Setup Plug the trunk cable into the EEG module in the Flexible Module Server. Prepare the patient’s skin prior to placing the electrodes. Good electrode-to-skin contact is important for a good EEG signal, as the skin is a poor conductor of electricity. –...
  • Page 203: Choosing An Eeg Electrode Montage

    Using the EEG Impedance/Montage Window 18 Monitoring EEG Choosing an EEG Electrode Montage To activate one of the five pre-configured electrode montages, select the arrow beside the label in the EEG Impedance/Montage window and choose a montage from the list. Attach the electrodes as illustrated in the EEG Impedance/Montage window.
  • Page 204: About Electrode-to-skin Impedance

    18 Monitoring EEG Using the EEG Impedance/Montage Window About Electrode-to-Skin Impedance Electrode-to-skin impedance is the main quality indicator for the measured EEG signal. During normal EEG monitoring, electrode-to-skin impedance is measured continuously and disconnected electrodes are detected. The impedance value for each single, independent signal electrode is displayed in the EEG Impedance/Montage window.
  • Page 205: About Compressed Spectral Arrays (csa)

    About Compressed Spectral Arrays (CSA) 18 Monitoring EEG About Compressed Spectral Arrays (CSA) The continuous EEG signal is sampled periodically and this value is stored in a frame. Each frame is processed using Fast Fourier Transformation (FFT) to provide a frequency spectrum displayed as a compressed spectral array (CSA).
  • Page 206: Displaying Csas

    18 Monitoring EEG Changing EEG Settings Displaying CSAs To show the CSAs on the resting display (if your monitor has a Screen preconfigured to do this), Select the SmartKey to call up a list of available preconfigured screens. Change Screen From this list, select the screen configured by your unit to show CSAs.
  • Page 207: Changing Filter Frequencies

    Changing the Speed of the EEG Wave 18 Monitoring EEG Changing Filter Frequencies The low and high pass filters screen out undesirable interference from the raw EEG wave display. The current EEG filter frequency settings are shown in the header of the CSA. Changing filter settings affects the EEG wave and all the EEG numerics.
  • Page 208: Eeg Safety Information

    18 Monitoring EEG EEG Safety Information EEG Safety Information EEG Configuration and Monitor Upgrades The A.2 monitor release (software revision A.20.xx) introduced a new feature that lets you rename EEG montages. It is not possible to clone EEG settings between montages with different names, therefore all EEG settings are reset to factory defaults during any upgrade/downgrade/cloning actions that mix releases/software revisions/configurations before A.2/ A.20.xx with subsequent versions.
  • Page 209: Monitoring Bis

    Monitoring BIS Bispectral Index monitoring helps to monitor the level of consciousness of a patient under general anesthesia or sedation in the OR and ICU. The BIS sensor is placed on the patient’s forehead to capture electroencephalographic (EEG) signals from which several numerics are derived, including a single BIS value representing the level of consciousness.
  • Page 210: Bis Monitoring Setup

    19 Monitoring BIS BIS Monitoring Setup BIS Monitoring Setup BIS Engine Digital Signal Interface Converter Module Patient Interface Cable Engine Cable BIS Sensor Connect the BIS Engine to the BIS Interface Module using the BIS Engine Cable. Connect the digital signal converter (DSC) to the digital signal converter port on the rear of the BIS Engine.
  • Page 211: Bis Continuous Impedance Check

    BIS Continuous Impedance Check 19 Monitoring BIS BIS Continuous Impedance Check This checks: • the combined impedance of the signal electrodes plus the reference electrode. This is done continuously and does not affect the EEG wave. As long as the impedances are within the valid range, there is no notification of this check or its results.
  • Page 212: Bis Impedance Check Window

    19 Monitoring BIS BIS Impedance Check Window BIS Impedance Check Window ♦ To open the BIS Impedance Check Window, in the menu, select Setup BIS Show Sensor. The graphic in the BIS Impedance Check Window automatically adapts to show the type of sensor you are using, showing three or four electrodes as required.
  • Page 213: Changing The Bis Smoothing Rate

    Changing the BIS Smoothing Rate 19 Monitoring BIS Changing the BIS Smoothing Rate The smoothing rate defines how the monitor averages the BIS value. ♦ To change the smoothing rate, in the menu, select then Setup BIS BIS Smoothing Rate choose either: –...
  • Page 214: Bis Safety Information

    19 Monitoring BIS BIS Safety Information BIS Safety Information Due to limited clinical experience in the following applications, BIS values should be interpreted cautiously in patients with know neurological disorders, those taking psychoactive medications, and in children below the age of 1. WARNING Conductive Parts The conductive parts of sensors and connectors should not contact other conductive parts, including earth.
  • Page 215: Trends

    Trends Trends are patient data collected over time and displayed in graphic or tabular form to give you a picture of how your patient’s condition is developing. Viewing Trends ♦ To open the tabular trends window, select the Vitals Trend SmartKey. ♦...
  • Page 216: Viewing Vital Signs Trends

    20 Trends Viewing Trends Viewing Vital Signs Trends The Vital Signs window shows measurement values and the time of measurement in a table. Vital Signs: All PAPs PAPd PAPm etCO2 awRR 9 Apr Vital Signs Select Select Graph Print/ Interval Group Trends Record...
  • Page 217: Setting Up Trends

    Setting Up Trends 20 Trends Pop-Up Keys Selecting this pop-up key lets you..jump to the beginning or the end of the trends database to see the most recent or oldest trend information stored. scroll up and down the screen to see measurement trends that do not fit in the current view.
  • Page 218: Changing Parameter Scales

    20 Trends Setting Up Trends In the menu, select Main Setup Trends Select Trend Groups Select the pop-up key and choose a group from the list of available groups that have been defined in Configuration Mode. Select to save your changes. Store Changing Parameter Scales You can set separate scale settings for adult, pediatric, and neonatal patient trend information to define...
  • Page 219: Documenting Trends

    Documenting Trends 20 Trends Documenting Trends To print a Vital Signs or Graphical Trends report, ♦ in the Vitals Trend or Graph Trends window, select the pop-up key to print a Print report for the trend group currently on the monitor screen. Reports include the most recent information and extend backwards in time according to the configuration.
  • Page 220: Screen Trends

    20 Trends Screen Trends Screen Trends Trends configured to display permanently on special monitor Screens are called screen trends. Each screen trend shows graphic trend information for one measurement, rather than for a trend group. All continuously-monitored measurements can be displayed as screen trends. ♦...
  • Page 221: Changing The Selection Of Screen Trends Displayed

    Screen Trends 20 Trends Changing the Selection of Screen Trends Displayed Grouped screen trends If a measurement wave, numeric, and screen trend are configured to form a group, changing one automatically changes the others. Grouped elements often have the same color. To change the selection of grouped screen trends on the Screen, ♦...
  • Page 222 20 Trends Screen Trends...
  • Page 223: Calculations

    Calculations Calculations are patient data that is not directly measured but calculated by the monitor when you provide it with the appropriate information. Your monitor can perform the following hemodynamic, oxygenation, and ventilation calculations. Hemodynamic Oxygenation Ventilation Cardiac Index (C.I.) Arterial Oxygen Content (CaO Minute Volume (MINVOL) Stroke Volume (SV)
  • Page 224: Calculations Windows

    21 Calculations Viewing Calculations Calculations Windows This example calculations window shows the hemodynamic calculations window. The ventilation and oxygenation windows are similar. Calculations Indexed Output Calculation type input values calculation values values Calculations C.O. Hemodynamic ABPs C.I. ABPd ABPm SVRI PAPs PVRI PAPd...
  • Page 225: Reviewing Calculations

    Reviewing Calculations 21 Calculations Pop-Up Keys Selecting this pop-up key lets you..open the hemodynamic calculations review window. Hemo Review open the ventilation calculations review window. Ventil Review open the oxygenation calculations review window. Review access more calculations pop-up keys, if available. Reviewing Calculations ♦...
  • Page 226: Entering Values For Calculations

    21 Calculations Entering Values for Calculations Entering Values for Calculations The monitor automatically enters any available values for calculations. For aperiodically-measured values such as NBP or C.O., the monitor will re-use the most recent value in the calculation database until a new value becomes available. ♦...
  • Page 227: Documenting Calculations

    Documenting Calculations 21 Calculations Documenting Calculations ♦ To send a Calculations recording to a connected recorder, in the Calculations window, select the Print/Record pop-up key, then select the Record Calc pop-up key. Calculations recordings print the patient demographic information and the content of the current Calculations window on the recorder strip.
  • Page 228 21 Calculations Documenting Calculations...
  • Page 229: Event Surveillance

    Event Surveillance Events are electronic records of episodes in your patient’s condition. You can trigger them manually, or set them to trigger automatically during pre-defined clinical situations. The information the monitor stores for each event episode includes: • waveforms for up to four measurements of your choice •...
  • Page 230: Event Episode

    22 Event Surveillance Event Episode Event Episode When an event occurs, information for a predefined duration is stored. This is Event trigger Event time the event episode. It can start from the trigger moment or include information from a defined period before the Event pre- Event post-time trigger, called the event pre-time.
  • Page 231: Viewing Events

    Viewing Events 22 Event Surveillance If you set user-defined event triggers, you can define event triggers that are independent of alarm limits. You must set a threshold value and a threshold time for the trigger. If you set the trigger threshold to 12 seconds, the monitor triggers an event if the threshold is violated for more than 12 seconds.
  • Page 232: Event Counter

    22 Event Surveillance Event Counter Pop-Up Keys Selecting this pop-up key lets you..jump to the first or last event in the event database. toggle between a tabular and graphic version of the Event Episode Vitals Graphic window currently viewed. View View toggle between a tabular and graphic version of the Event Review...
  • Page 233: Event Review Window

    Event Review Window 22 Event Surveillance Event Review Window ♦ To enter the Event Review window, select the graphic event summary, if available, or select the events pop-up key Show Review. ♦ When you open the Event Review window, it automatically shows the event group with the most recent event.
  • Page 234: Event Episode Window

    22 Event Surveillance Event Episode Window Event Episode Window ♦ To enter the Event Episode window, select the pop-up key Show Episode Depending on the event group settings, the Event Episode window shows either 20 minutes of average trend event information, four minutes of high-resolution event information, or 15 seconds of realtime wave information.
  • Page 235: Counting Neonatal Event Review (ner) Events

    Levels of Event Surveillance 22 Event Surveillance Counting Neonatal Event Review (NER) Events For neonatal events (NER; formerly “OxyCRG”), apnea events ( ), bradycardia events ( ), and combinations of these events are counted and classified by the event counter in the Event Summary. If they are associated with a Desaturation ( ), this is also marked.
  • Page 236: Setting Up Events

    22 Event Surveillance Setting Up and Using Event Surveillance Setting Up Events Set the active event group. In the menu, select the name of the Trigger Group and Event Setup then select the required group from the pop-up list. The trigger symbol marks the active group. The measurements and trigger condition for the group automatically change to reflect the new event group.
  • Page 237: Annotating Events

    The Event Database 22 Event Surveillance Annotating Events To annotate an event, in the Event Episode window, select the pop-up key Select Annotation Select the required annotation from the pop-up list of available annotations for the currently active event group. Up to 20 annotations can be configured to let you add commonly-used clinical notes to event episodes for documentation purposes.
  • Page 238: Event Recordings

    22 Event Surveillance Documenting Events Event Recordings Event recordings can be sent to a locally-connected M1116B recorder module. Event Review Recordings Each event review Patient Event information Recording total per recording strip and medical strip event Event types record no. code group begins with a...
  • Page 239: Event Episode Recordings

    Documenting Events 22 Event Surveillance Event Episode Recordings Event episode recordings are divided into four sections. The first section shows the patient information and the event group of the episode with the event values for the group 91MIN Green, Sarah 37549201 23 Jan 02 10:43 ICU 3...
  • Page 240: Event Review Reports

    22 Event Surveillance Documenting Events Event Review Reports The event review report documents all the events stored in the event database.
  • Page 241: Event Episode Reports

    Documenting Events 22 Event Surveillance Event Episode Reports The event episode report documents the patient information from the currently-selected event. See the section on event recordings for an explanation of the report elements.
  • Page 242 22 Event Surveillance Documenting Events...
  • Page 243: Recording

    Recording The M1116B plug-in recorder records numerics for all active measurements and up to three waveforms. You can use it for local recording mounted either in the monitor’s FMS or in the Integrated Module Slot. For central recording from the bedside, your monitor must be connected via a network to an Information Center.
  • Page 244: Starting And Stopping Recordings

    23 Recording Starting and Stopping Recordings Starting and Stopping Recordings The recordings pop-up keys let you start and stop recordings. Select the Realtime Record SmartKey to call up the line of pop-up keys. Scroll right or left to see any pop-up keys not displayed. Start Start Start...
  • Page 245: Overview Of Recording Types

    Overview of Recording Types 23 Recording Overview of Recording Types is always shown “grayed out” in the menu. This table Recording Type Setup Recording details settings for local recordings. Procedure or Delayed Alarm Realtime (RT) ECG Capt HiResTrnd Context manual automatic, manual manual...
  • Page 246: Creating And Changing Recordings Templates

    23 Recording Creating and Changing Recordings Templates Creating and Changing Recordings Templates To save you defining recording settings each time you start a recording, you can create templates for commonly-used types of recordings in the menu. You can create templates for Setup Recording one delayed recording, one alarm recording, three realtime recordings, and one high resolution recording.
  • Page 247: Recording Priorities

    Recording Priorities 23 Recording Recording Priorities Manually-started recordings have priority over automatically-started recordings. If an automatically- triggered alarm recording is running, and a realtime or delayed recording is manually started, the alarm recording is stopped and the manually-requested recording is started. More recent manually-started recordings have priority over older manually-started recordings.
  • Page 248: Recording Strip Code

    23 Recording Sample Recording Strip Recording Strip Code The recording strip code printed in the first line of the initial annotation has up to seven characters, specifying recording type, operating mode, application area, patient category, and delay time, if applicable. Code Meaning Recording type...
  • Page 249: Reloading Paper

    Reloading Paper 23 Recording Reloading Paper Use the latch on the right side of the recorder door to pull the door open. Remove the empty core. Insert a new roll so that it fits snugly into its housing and the paper end is feeding from the top.
  • Page 250 23 Recording Recorder Status Messages...
  • Page 251: Printing Patient Reports

    Printing Patient Reports Starting Reports Printouts Most patient reports can be printed by selecting Main Setup - > Reports (or the Reports SmartKey) and then selecting the report name in the top half of the Reports menu. Report names are shown only for reports that have been correctly set up. Data from the time of the print request is printed, even if the print job is delayed in the printer queue.
  • Page 252: Stopping Reports Printouts

    24 Printing Patient Reports Stopping Reports Printouts Stopping Reports Printouts ♦ To stop Reports printing, in the menu, select Reports – to stop the current print job Stop Report – to cancel all queued report printouts Stop All Reports – to toggle to and switch off scheduled reports.
  • Page 253: Setting Up Vital Signs And Graphic Trend Reports

    Setting Up Reports 24 Printing Patient Reports Setting Up Vital Signs and Graphic Trend Reports The procedure for setting up Vital Signs and Graphic Trend reports is identical. The settings you choose in the menus apply for all Setup Vital Signs Report Graphical Trend Report Vital Signs and Graphic Trend reports printed.
  • Page 254: Setting Up Auto Reports

    24 Printing Patient Reports Setting Up Reports Setting Up Auto Reports Using Auto Reports you can set up to four individual reports to print automatically when a specified trigger occurs. There are two types of Auto Report: • Scheduled reports can be set up to print at predefined intervals, starting at a predefined time of day.
  • Page 255: Setting Up Individual Print Jobs

    Setting Up Individual Print Jobs 24 Printing Patient Reports Setting Up Individual Print Jobs To adjust the appearance of individual print jobs, in the menu, select Reports Setup Reports enter the menu, and then select the appropriate settings. Setup Reports The menu items Report Type, Report Size, and Orientation may be inactive (“grayed- out”) in this menu for reports that can only be started in a special window.
  • Page 256: Checking Printer Settings

    24 Printing Patient Reports Checking Printer Settings Checking Printer Settings The printer settings for your monitor are defined in Configuration Mode. The printer settings Paper , and for the active printer are visible but Size Resolution Color Support Duplex Option inactive (“grayed-out”) in the menu.
  • Page 257: Unavailable Printer: Re-routing Reports

    Unavailable Printer: Re-routing Reports 24 Printing Patient Reports Unavailable Printer: Re-routing Reports If you send a report to be printed on a printer that is not available, for example, because it has run out of paper, this print job is suspended and stored in the monitor’s memory. If the target device of this print job was set to Unspecified, the monitor will periodically try to resend the print job to the first printer listed in the Setup Printers menu under Printer that is set to Enabled and that has paper of the correct size.
  • Page 258: Alarm Limits Report

    24 Printing Patient Reports Sample Report Printouts The monitor may be configured to leave a space on the top left or right of the report printout to enable you to stick a patient address label on it. This setting is called the Addressograph and it can only be changed in the monitor’s Configuration Mode.
  • Page 259: Realtime Report

    Sample Report Printouts 24 Printing Patient Reports Realtime Report Patient demographic information, time stamp Active Alarms and INOPs, followed by vital signs Measurement waves section, including HiRes waves...
  • Page 260: Cardiac Output Report

    24 Printing Patient Reports Sample Report Printouts Cardiac Output Report Patient information Numbered trial curves Trial information in tabular form...
  • Page 261: Ecg Reports

    Sample Report Printouts 24 Printing Patient Reports ECG Reports Patient information Numeric block Wave area Below the header on ECG Reports, the numeric block shows the current HR, PVC, and ST values. The wave area shows the printed waves for all available ECG leads. A 1 mV calibration bar is printed at the beginning of each wave.
  • Page 262 24 Printing Patient Reports Sample Report Printouts...
  • Page 263: Using The Drug Calculator

    Using the Drug Calculator Drug mixtures for intravenous (IV) drug infusions combine information on drug dose, rate, amount, volume, concentration, and standardized rate. The Drug Calculator helps you to manage infusions by calculating one of these values at a time. Term Definition Units...
  • Page 264: Performing Drug Calculations

    25 Using the Drug Calculator Performing Drug Calculations Performing Drug Calculations To access the Drug Calculator, select Main Setup -> Calculations -> Drug Calculator, or select the Drug Calculator SmartKey. Enter three of these four values: dose, amount, volume, Drug Calculator and rate of the infusion solution.
  • Page 265: Charting Drip Progress

    Performing Drug Calculations 25 Using the Drug Calculator Charting Drip Progress Drip Table The Drip Table shows you at a glance how much of the Amount Volume Drip Time Any Drug infusion has been administered to your patient and how much time is left. Dose 3.88 mcg/min...
  • Page 266 25 Using the Drug Calculator Performing Drug Calculations...
  • Page 267: Vuelink Modules

    VueLink Modules A VueLink module transmits information from a connected external device to your monitor. Each module can be connected to up to three external devices, and supports alarms from the external device. Although the external device may transmit more information, the number of waves and numerics you can view simultaneously on your monitor’s main screen depends on the module type.
  • Page 268: Connecting An External Device

    26 VueLink Modules Connecting an External Device Connecting an External Device Insert the module into the FMS or integrated module slot. Check that the device selection LED (c) lights to show that it has correctly identified the external device. If not, select Main Setup -> Measurements -> <VueLink Device Name> to enter the setup menu for the connected device, headed Setup <VueLink Device Name>...
  • Page 269: Using Vuelink Screens

    Using VueLink Screens 26 VueLink Modules Using VueLink Screens Your monitor may be configured to show VueLink device data permanently on the Screens. Select the device data window to display the VueLink pop-up keys that let you access the setup menu and carry out VueLink tasks. Switching VueLink On and Off ♦...
  • Page 270: Language Conflict With External Device Drivers

    26 VueLink Modules Language Conflict with External Device Drivers Language Conflict with External Device Drivers You should avoid language conflicts between the VueLink module device driver and the monitor. Be aware that if you connect a VueLink module with a different operating language to the monitor, the monitor will show: •...
  • Page 271: Respiratory Loops

    Respiratory Loops Using a VueLink module connected to a ventilator, you can measure and store graphic representations of realtime respiratory loops to help you recognize changes in your patient’s lung function over time. Respiratory loops can help in early detection of patient airway changes, and they can also indicate a fault in the airway tubing (the respiratory loop does not close).
  • Page 272: Using The Loops Window

    27 Respiratory Loops Using the Loops Window Using the Loops Window Select a loop on the Screen or the Loops SmartKey, if configured, to open the Loops window and its associated pop-up keys. Loops: Ohmeda 7900 Loop capture in progress..Loops Change Capture...
  • Page 273: Care And Cleaning

    Warranty does not cover damage caused by using unapproved substances or methods. Philips makes no claims regarding the efficacy of the listed chemicals or methods as a means for controlling infection. Consult your hospital’s Infection Control Officer or Epidemiologist. For comprehensive details on cleaning agents and their efficacy refer to “Guidelines for Prevention of...
  • Page 274: Agm Accessories

    28 Care and Cleaning AGM Accessories AGM Accessories Do not clean or disinfect the gas sample tube (M1658A), airway adapter (13902A or M1612A), or gas exhaust return filter (M1656A). Cleaning Clean with a lint-free cloth, moistened with warm water (40°C/104°F maximum) and soap, a diluted non-caustic detergent, tenside, ammonia- or alcohol-based cleaning agent.
  • Page 275: Cleaning Monitoring Accessories

    Cleaning Monitoring Accessories 28 Care and Cleaning Cleaning Monitoring Accessories To clean, disinfect and sterilize reusable transducers, sensors, cables, leads, the AGM watertrap (M1657B), and so forth, refer to the instructions delivered with the accessory. Sterilizing Sterilization is not recommended for this monitor, related products, accessories or supplies unless otherwise indicated in the Instructions for Use that accompany the accessories and supplies.
  • Page 276 28 Care and Cleaning Cleaning the Batteries and Battery Compartment...
  • Page 277: Using The Batteries

    Using the Batteries IntelliVue MP40/MP50 To use the MP40/MP50 only monitor with battery power, two Philips M4605A rechargeable Lithium Ion batteries must be inserted into the battery compartment at the rear of the monitor. The MP60/MP70/MP90 monitors cannot be powered by battery.
  • Page 278: Battery Led

    29 Using the Batteries Battery Power Indicators Battery LED The battery LED on the front panel of the monitor is indicated by a battery symbol. Battery LED Battery LED Colors If the monitor is connected to If the monitor is running on mains power, this means battery power, this means batteries full...
  • Page 279: Battery Status Window

    Battery Power Indicators 29 Using the Batteries Battery Status Window ♦ To access the Battery Status window and its associated pop-up keys, select the battery status information on the Screen, or select Main Setup -> Battery. Battery Status Battery 1 Battery 2 Capacity full charge:...
  • Page 280: Replacing Batteries

    29 Using the Batteries Replacing Batteries Replacing Batteries You can replace batteries without switching off the monitor, if you replace them one at a time and if the remaining battery has sufficient power. The Battery Missing INOP is suppressed for 30 seconds while you exchange each battery.
  • Page 281: Checking Battery Charge

    Batteries can be charged in monitors used to monitor patients. Charging is quicker in unused monitors. Contact your local Philips representative for information on external battery chargers. Insert the batteries into a monitor connected to mains power. The battery LED will light yellow to indicate that charging is in process.
  • Page 282: Battery Safety Information

    29 Using the Batteries Battery Safety Information Battery Safety Information WARNING 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. ° ° CAUTION Do not disassemble, heat above 212 F (100 C) or incinerate the batteries, to avoid the risk of fire and...
  • Page 283: Inspecting The Equipment And Accessories

    Examine all system cables, the power plug and cord for damage. Make sure that the prongs of the plug do not move in the casing. If damaged, replace it with an appropriate Philips power cord. Inspect the Measurement Server Link cable and ensure that it makes good connection with the MMS and the FMS.
  • Page 284: Maintenance And Troubleshooting

    Carry out the tasks as indicated by the monitor’s maintenance schedule, or as specified by local laws. Contact a Philips-qualified service provider if your monitor needs a safety or performance test. Clean and disinfect equipment to decontaminate it before testing or maintaining it.
  • Page 285: Troubleshooting

    Troubleshooting 30 Maintenance and Troubleshooting Troubleshooting If you suspect a problem with an individual measurement, read the Instructions for Use and doublecheck that you have set up the measurement correctly. If you suspect an intermittent, system-wide problem call your service personnel. You may be asked for information from the status log.
  • Page 286 30 Maintenance and Troubleshooting Disposing of Empty Calibration Gas Cylinders...
  • Page 287: Accessories

    Accessories You can order parts and accessories from Philips supplies at www.medical.philips.com or consult your local Philips representative for details. WARNING Reuse: Never reuse disposable transducers, sensors, accessories and so forth that are intended for single use, or single patient use only.
  • Page 288: Electrode Cable Sets

    31 Accessories ECG/Resp Accessories Description Length AAMI Part No. IEC Part No. ICU Grabber shielded 1.0m M1603A M1613A ICU snap shielded 1.0m M1605A M1615A ICU Clip non-shielded 0.45m M1608A M1618A ICU Clip non-shielded 0.7m M1609A M1619A 5-Electrode Cable Sets Description Length AAMI Part No.
  • Page 289: Set Combiners And Organizers

    NBP Accessories 31 Accessories Set Combiners and Organizers Set combiners and organizers Part No. Set combiner 3-electrode M1501A 5-electrode M1502A Set organizer Shielded 3-electrode M1503A Shielded 5-electrode M1504A Bedsheet clip M1509A NBP Accessories These cuffs and tubings are designed to have special protection against electric shocks (particularly regarding allowable leakage currents), and are defibrillator proof.
  • Page 290: Adult/pediatric Antimicrobial Coated Reusable Cuffs

    31 Accessories NBP Accessories Adult/Pediatric Antimicrobial Coated Reusable cuffs Patient Category (color) Limb Bladder Width Part No. Tubing Circumference (cm) Adult Thigh (grey) 45 - 56.5 21.0 cm M1598B M4559A (1.5m) or Large Adult X-Long (burgundy) 35.5 - 46.0 17.0 cm M4558A M1599B (3m) Large Adult (burgundy)
  • Page 291: Invasive Pressure Accessories

    OxiCliq sensors and adapter cables directly from Tyco Healthcare. Do not use more than one extension cable with any sensors or adapter cables. Do not use an extension cable with Philips reusable sensors or adapter cables with part numbers ending in -L (indicates “Long” version).
  • Page 292 M1195A Infant finger sensor. Cable length Cable: polyurethane; 1.5 m. sensor housing: silicone. Philips disposable sensors. Not available in the USA. M1904B Identical to OxiMax MAX-A Standard: Use adapter cable M1943A or M1903B Identical to OxiMax MAX-P M1943AL.
  • Page 293 Needs M1943NL OXI-A/N adapter cable. Oxiband Pediatric / infant sensor OXI-P/I Durasensor Adult finger clip sensor DS100A Dura-Y D-YS Y-sensor Extension / Adapter Cables M1941A Extension cable For use with Philips reusable sensors and adapter cables. Cable: polyurethane, 2 m.
  • Page 294: Temperature Accessories

    Adapter cable for Philips/Nellcor M1943AL Adapter cable (3 m cable) disposable sensors. M1943NL OxiMax adapter cable (3 m cable) Adapter cable for Philips disposable/ Nellcor disposable and reusable sensors. OC 3 Adapter Cable for OxiCliq sensors Available from Nellcor only. Temperature Accessories Temperature Probes Part No.
  • Page 295 Mainstream CO Accessories 31 Accessories Description Part No Common Accessories Accessories Set of ice buckets 14455A Remote handswitch 15244A PiCCO inline temperature probe for Latex free M1646A warmer injectate Right Heart Thermodilution C. O. Interface Cables 2.7 meter cable (right heart only) M1642A 2.4 m + 2.4 m cable M1643A...
  • Page 296 31 Accessories Microstream CO Accessories • “Single purpose” means CO measurement only, “dual purpose” means CO measurement and O delivery. Ventilation Environment Patient Description Quantity Part No. Weight ≥ Intubated Non- 2 kg Airway Adapter Adult/Pediatric M1990A* humidified FilterLine M1925A* FilterLine OR Set Adult/ M1922A* Pediatric...
  • Page 297: Tcgas Accessories

    The patient interface cable has an estimated lifetime of one year. Do not scrap it when disposing of the BIS sensor. BIS Sensors To re-order sensors outside North America, contact your nearest Philips sales office and quote the Philips ordering number. In North America, contact Aspect Medical Systems.
  • Page 298: Other Bis Accessories

    M1998A 186-0110 BIS Sensor Extend 186-0160 Other BIS Accessories Order the following parts from your nearest Philips sales office and quote the Philips ordering number Description Philips Ordering No BIS Engine Cable - Short (0.8 m) M1034-61610 BIS Engine Cable - Long (2.0 m)
  • Page 299: Recorder Accessories

    Recorder Accessories 31 Accessories Description Abbott Part No. Opticath Fiber-optic Catheters P575-EH P575-EH10CM P7110-E P7110-EH P7110-EP-H P7110-EP8 P7110-EP8-H P7110-PZ8-H P575-EH P575-EH10CM U440 Recorder Accessories Description Part No. 10 rolls of paper 40477A 80 rolls of paper 40477B...
  • Page 300 31 Accessories Recorder Accessories...
  • Page 301: Installation And Specifications

    Installation and Specifications The specifications in this section apply to the MP40, MP50, MP60, MP70, and MP90 patient monitors, unless otherwise stated. The monitors are not user installable. They must be installed by qualified service personnel. Intended Use The monitor is intended to be used for monitoring, recording, and alarming of multiple physiological parameters of adults, pediatrics, and neonates in health care facilities.
  • Page 302: Manufacturer's Information

    The information contained in this document is subject to change without notice. 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 303: Symbols

    Symbols 32 Installation and Specifications Symbols These symbols appear on the monitor and its associated equipment. Symbols Refer to accompanying Protective earth RS232 connector documents RS-232 Standby Equipotential Identifies year 2002- grounding and month of manufacture Connection direction Alternating current Connection direction indicator indicator...
  • Page 304: Installation Safety Information

    LAN connection server link connection, for indicator for connection connection to wireless connection to a wired indicator device network Philips Analog interface Digital interface remote indicator for indicator for device connection to any connection to any (SpeedPoint or Alarm Device)
  • Page 305: Mp40/mp50

    Installation Safety Information 32 Installation and Specifications MP40/MP50 MP40/MP50 Rear of monitor Space for optional interface boards, e.g. serial/MIB (RS232) connectors, or optional parallel printer connection Equipotential grounding Protective earth AC power inlet Wired network connector Remote alarm connector Analog video out connector Wireless network connector...
  • Page 306: Mp60/mp70

    32 Installation and Specifications Installation Safety Information MP60/MP70 Right side of monitor (MP60/70) Serial/MIB (RS232) connectors (optional), type RJ45 Parallel printer connector Keyboard connector Mouse/trackball connector Main measurement server link (MSL) Wired network connector Wireless network connector Analog video out connector Equipotential ground connector AC power input Protective earth screw hole...
  • Page 307: Mp90

    Installation Safety Information 32 Installation and Specifications MP90 MP 90 (rear of processing unit) Serial/MIB (RS232) connectors, type RJ45 ECG Sync out Serial/MIB (RS232) connectors, type RJ45 Wired network connector Independent display - remote alarm device connector 14 Wireless network connector Keyboard connector Primary measurement server link Independent display - remote SpeedPoint connector...
  • Page 308: Altitude And Barometric Pressure

    32 Installation and Specifications Altitude and Barometric Pressure MP 90 (front of processing unit) AC Power LED Power supply Error LED AC power input Power on LED Protective earth screw hole Power on switch Equipotential grounding point Altitude and Barometric Pressure Altitude and barometric pressure affect tcGas and CO measurements.
  • Page 309: Physical Specifications

    Monitor Safety Specifications 32 Installation and Specifications WARNING To minimize the risk of causing severe burns during MR imaging, ensure that transducers, sensors and cables are positioned so that no inductive loops are formed. If the measurement does not appear to be operating properly, remove all transducers, sensors and cables immediately from the patient.
  • Page 310: Environmental Specifications

    32 Installation and Specifications Monitor Safety Specifications Product Max Weight W x H x D Comments M1018A 350 g (11.3 oz) 72.5 x 99.6 x 97.5 mm, Transcutaneous Gas Module 2.9 x 3.9 x 3.8 in M1020B < 250 g 36 x 99.6 x 97.5 mm Module 1.4 x 3.9 x 3.8 in...
  • Page 311 Monitor Safety Specifications 32 Installation and Specifications Measurement Server M3001A, Measurement Server Extensions M3015A, M3016A, M3012A, Measurement Modules, and Flexible Module Server M8048A Item Condition Range Temperature Range Operating 0 to 45 C (32 to 113 Non-operating -40 to 70 C (-40 to 158 Humidity Range Operating...
  • Page 312: M4605a Battery Specifications

    32 Installation and Specifications M4605A Battery Specifications Remote SpeedPoint M8026A Item Condition Range 95 %RH max. at 40 °C (100 °F) Humidity range Operating 85 %RH max. at 50 °C (120 °F) Storage Altitude range Operating -500 … 4.600 m (-1600 ... 15000 ft) Storage -500 …...
  • Page 313 Monitor Performance Specifications 32 Installation and Specifications MP40/50, MP60/70/90 Battery Specifications Operating Time Basic monitoring configuration: 5 hours MP40/MP50 (with 2 new, fully (Brightness set to Optimum, MMS connected, NBP charged batteries) measurement every 15 minutes) Extended monitoring configuration: 4 hours (Brightness set to Optimum, MMS and measurement server extension connected, NBP every 15 minutes, Recorder, Pressure, Temperature modules connected)
  • Page 314 32 Installation and Specifications Monitor Performance Specifications MP40/50, MP60/70/90 Real Time Clock Range from: January 1, 1997, 00:00 to: December 31, 2080, 23:59 Accuracy < 2 seconds per day (typically) Hold Time infinite if powered by AC; otherwise at least 48 hours (typical: >...
  • Page 315 (Independent Computing Architecture) Support client, Tunneling Control Engine (TCE) Capabilities a monitor connected to a Philips Application Server can show a Windows NT application on the monitor display. The application can be controlled by the monitor user input devices. Display Specifications...
  • Page 316: Measurement Specifications

    32 Installation and Specifications Measurement Specifications Display Specifications Video Interface MP40/ Specifications must be the same as the integrated display 50, MP60/70 Video Interface SVGA Horizontal Frequency 37.5 kHz MP40/MP50 Video Signals Connector 15 pin D-SUB Video Interface MP90 Horizontal Frequency 48.4 kHz or 60.0 kHz or 64.0 kHz SXGA (MP90 only), Video Signals...
  • Page 317 Measurement Specifications 32 Installation and Specifications ECG/Arrhythmia/ST Performance Specifications PVC Rate Range 0 to 300 bpm Resolution 1 bpm ST Numeric Range -20 to +20 mm Accuracy ±0.5 mm or 15%, whichever is greater Resolution 0.1 mm Sinus and SV Rhythm Brady Adult: 15 to 60 bpm Ranges...
  • Page 318 32 Installation and Specifications Measurement Specifications ECG/Arrhythmia/ST Alarm Specifications Range Adjustment Vent Tach Run 3 to 99 PVCs/minute 1 PVC Vent Rhythm Run 2 to 99 PVCs/minute 1 PVC SVT HR 120 to 300 bpm 5 bpm SVT Run 3 to 99 SV beats 1 SV beat ST High -19.8 to +20 mm...
  • Page 319: Respiration

    Measurement Specifications 32 Installation and Specifications Respiration Respiration Performance Specifications Respiration Rate Range Adult/pedi: 0 to 120 rpm Neo: 0 to 170 rpm Accuracy at 0 to 120 rpm ±1 rpm at 120 to 170 rpm ±2 rpm Resolution 1 rpm Bandwidth 0.3 to 2.5Hz (–6dB) Noise...
  • Page 320 M1020B M1191A, M1192A1SD = ±2.5% (70% to 100%) Option #A01 M1193A, M1194A, M1195A1SD = ±3% (70% to 100%) Accuracy Philips Disposable Sensors with M1943A(L): SD = Standard M1901B, M1902B, M1903B, M1904B 1SD = ±3% (70% to 100%) Deviation ® NellcorPB...
  • Page 321 Measurement Specifications 32 Installation and Specifications NBP Performance Specifications Measurement Ranges Systolic Adult: 30 to 270 mmHg (4 to 36 kPa) Pedi: 30 to 180 mmHg (4 to 24 kPa) Neo: 30 to 130 mmHg (4 to 17 kPa) Diastolic Adult: 10 to 245 mmHg (1.5 to 32 kPa) Pedi: 10 to 150 mmHg (1.5 to 20 kPa) Neo: 10 to 100 mmHg (1.5 to 13 kPa)
  • Page 322: Invasive Pressure And Pulse

    32 Installation and Specifications Measurement Specifications NBP Alarm Specifications Range Adjustment Systolic Adult: 30 to 270 mmHg (4 to 36 kPa) 10 to 30 mmHg: 2 mmHg (0.5 kPa) > 30 mmHg: 5 mmHg (1kPa) Pedi: 30 to 180 mmHg (4 to 24 kPa) Neo: 30 to 130 mmHg (4 to 17 kPa) Diastolic Adult: 10 to 245 mmHg (1.5 to 32 kPa)
  • Page 323: Temp

    Measurement Specifications 32 Installation and Specifications Invasive Pressure Performance Specifications Analog Output Range -0.4 V to 3.6 V available only with Level 1 V / 100 mmHg M1006B #C01 (@ Accuracy ± 3% full scale CAL 200 mmHg) Offset ± 30 mV Resolution 8 Bit (@ 5 V range) Signal delay...
  • Page 324 32 Installation and Specifications Measurement Specifications Complies with EN864/ISO9918 M3015A Microstream CO Performance Specifications Range 0 to 98mmHg (0 to 13 kPa), or 13% CO , whichever is lower Accuracy after 4 minutes warmup: ±4 mmHg or 12%, whichever is greater after 20 minutes warmup: 0 to 40 mmHg (0 to 5.3 kPa):±2.2 mmHg (±0.3 kPa) Above 40 mmHg (5.3 kPa):±(5.5% + (0.08%/mmHg above 40 mmHg)) of...
  • Page 325 Measurement Specifications 32 Installation and Specifications M3016A Mainstream CO Performance Specifications Range –4 to 150 mmHg (-0.5 to 20.0 kPa) Accuracy after 20 minutes warmup and calibration: For values between 0 and 40 mmHg:±2.2 mmHg (±0.29 kPa) For values between 40 and 76 mmHg:±5.5% of reading The specifications are valid for 45% O and N or N...
  • Page 326: Cardiac Output / Continuous Cardiac Output

    32 Installation and Specifications Measurement Specifications Cardiac Output / Continuous Cardiac Output C.O./CCO Performance Specifications C.O. (right heart) Range 0.1 to 20.0 l/min Accuracy Instrument Specification (electrical):+ 3% or 0.1 l/min System Specification:+ 5%.or 0.2 l/min Repeatability Instrument Specification (electrical):+ 2% or 0.1 l/min System Specification:+ 3%.or 0.1 l/min C.O.
  • Page 327 Measurement Specifications 32 Installation and Specifications tcGas Performance Specifications tcpO Drift, including transducer < 1 mmHg / h @ 10% O tcpO response time, including transducer < 30 s tcpCO Range 5 to 200 mmHg (0.7 to 26.7 kPa) Accuracy 1.0% (1 + digit) Resolution 1 mmHg (0.1 kPa)
  • Page 328 32 Installation and Specifications Measurement Specifications Alarm Specifications Range Adjustment Delay 10% to 100% max. 15+4 seconds after value goes beyond the low/high alarm limit settings Complies with IEC 60601-2-26:1994/EN60601-2-26:1994. EEG Performance Specifications <=10 µA @ 110V Leakage Current Input Signal Range 1 mV Differential Input Impedance >15 MΩ...
  • Page 329: Anesthetic Gas Module

    Measurement Specifications 32 Installation and Specifications BIS Performance Specifications High Pass Filters 0.25 Hz, 1 Hz, 2 Hz (-3dB) Low Pass Filters 30 Hz, 50 Hz, 70 Hz, 100 Hz (-3dB) Notch Filters (for line frequency) 50 Hz, 60 Hz Impedance Measurement Range 0 to 999 kΩ...
  • Page 330 32 Installation and Specifications Measurement Specifications AGM Performance Specifications awRR Range 0 to 60 rpm Accuracy + 2 rpm Resolution 1 rpm Detection Criteria 6 mmHg variation in CO Agent ID Response Time 15 s Agent Thresholds HAL, ISO, ENF 0.20 vol% 0.24 vol% 0.30 vol%...
  • Page 331: Safety And Performance Tests

    Safety and Performance Tests 32 Installation and Specifications AGM Alarm Specifications Range Adjustment Delay etCO High 20 to 76 mmHg (2.7 to 10.1 kPa) 1 mmHg (0.1 kPa) less than 18 seconds etCO 10 to 75 mmHg (1.3 to 10.0 kPa) imCO High 2 to 20 mmHg (0.3 to 2.7 kPa)
  • Page 332: Electromagnetic Emissions

    1Vrms for conducted disturbances induced by RF fields. Electromagnetic fields with field strengths above 1 V/m and conducted disturbances above 1Vrms may cause erroneous measurements. Therefore Philips recommends that you avoid using electrically radiating equipment in the close proximity of these measurements.
  • Page 333: Electromagnetic Immunity

    Safety and Performance Tests 32 Installation and Specifications Electromagnetic Immunity The monitor is suitable for use in the specified electromagnetic environment. The user must ensure that it is used in the appropriate environment as described below. IEC 60601-1-2 Electromagnetic environment Immunity test test level Compliance level...
  • Page 334: Recommended Separation Distances From Portable And Mobile Rf Communication Equipment

    32 Installation and Specifications Safety and Performance Tests Interference may occur in the vicinity of equipment marked with this symbol: IEC 60601-1-2 Immunity test test level Compliance level Electromagnetic environment guidance Conducted RF Recommended separation distance: IEC 61000-4-6 150 kHz to 80 Mhz (1 V for respiration 1 2 P...
  • Page 335: Electrosurgery Interference/defibrillation/electrostatic Discharge

    Safety and Performance Tests 32 Installation and Specifications Frequency of transmitter 150 kHz to 80 MHz 150 kHz to 800 MHz 800 MHz to 2,5 GHz 1 2 P 1 2 P 2 3 P for respiration and BIS: for respiration and BIS: for respiration and BIS: Equation 3 5 P...
  • Page 336 32 Installation and Specifications Safety and Performance Tests...
  • Page 337: Default Settings Appendix

    Default Settings Appendix This appendix documents the most important default settings of your monitor as it is delivered from the factory. For a comprehensive list and explanation of default settings, see the Configuration Guide supplied with your monitor. The monitor’s default settings can be permanently changed in Configuration Mode.
  • Page 338: Alarm Default Settings

    33 Default Settings Appendix Alarm Default Settings Alarm Default Settings Alarm Settings Factory Default Alarm Volume Alarms Off 3 min. Pause Al. 5min Enabled Pause Al. 10min Enabled Auto Alarms Off Alarm Off Reminder Visual Latching Red & Yell (for Anesthesia configurations (option H30) Visual Latching: Red) Audible Latching Red &...
  • Page 339 ECG, Arrhythmia, and ST Default Settings 33 Default Settings Appendix ECG Settings Factory Adult Factory Pedi Factory Neo Secondary Lead Analysis Mode Multi-lead Lead Placement Standard Mod. Lead Placment Filter Monitor Speed 25mm/s Auto Filter Default ECG Size Color Green Asystole Thresh 4.0 sec 3.0 sec...
  • Page 340 33 Default Settings Appendix ECG, Arrhythmia, and ST Default Settings Arrhythmia Settings Factory Adult Factory Pedi Factory Neo Arrhythmia On (for Anesthesia (H30) options Arrhythmia: Off.) Pause Threshold 2.0 sec 1.5 sec VTach HR VTach Run Vent Rhythm SVT HR SVT Run PVCs/min Non-Sustain...
  • Page 341: Pulse Default Settings

    Pulse Default Settings 33 Default Settings Appendix Lead I, II, III, V, aVR, aVL, aVF, V1-6, Factory Adult Factory Pedi Factory Neo MCL Settings (Label) For Alarm Mode = Single-ST High +2.0 mm (Label) -2.0 mm (Label) For Alarm Mode = Multi-ST High +1.0 mm (Label)
  • Page 342: Respiration Default Settings

    33 Default Settings Appendix Respiration Default Settings Respiration Default Settings Resp Settings Factory Adult Factory Pedi Factory Neo High Limit 30 rpm 100 rpm Low Limit 8 rpm 30 rpm Apnea Time 20 sec Alarms Resp On (for Anesthesia configurations (option H30): Resp Off ) Auto/Manual Auto (Trigger Mode) Resp Speed...
  • Page 343: Nbp Default Settings

    NBP Default Settings 33 Default Settings Appendix Alarm Default Settings Setting adult pediatric neonatal Pulse Low Limit 50 bpm 75 bpm 100 bpm ∆ Extr Brady 20 bpm 20 bpm 20 bpm Brady Clamp 40 bpm 40 bpm 50 bpm ∆...
  • Page 344: Invasive Pressure Default Settings

    33 Default Settings Appendix Invasive Pressure Default Settings Invasive Pressure Default Settings ABP, ART, Ao, UAP, P Settings CVP, RAP, LAP, UVP Settings Invasive Pressure Settings Factory Adult Factory Pedi Factory Neo Factory Adult Factory Pedi Factory Neo Alarms from Sys.
  • Page 345 Default Settings 33 Default Settings Appendix C.O. Settings Factory Adult Factory Pedi Factory Neo Tblood Low Limit 36.0 ºC Tblood Alarm On/Off Temperature Unit Color Green CCO/CCI Settings Factory Adult Factory Pedi Factory Neo Settings common to CCO and CCI Alarms from CCO from Color...
  • Page 346: Tcgas Default Settings

    33 Default Settings Appendix tcGas Default Settings tcGas Default Settings tcGas Settings Factory Adult Factory Pedi Factory Neo tcpO High 80 mmHg tcpO 50 mmHg tcpO Alarms tcpCO High 50 mmHg tcpCO 30 mmHg tcpCO Alarms Site Time 4.0 hours Disable Timer Not Allowed Heat Switch Off (i.e., after Site Timer...
  • Page 347: Eeg Default Settings

    EEG Default Settings 33 Default Settings Appendix AGM Settings Adult/Pedi/Neo: 18 % High Adult/Pedi/Neo: 100 % et + in O High 80 % Agent Channel et + in etHAL Low Adult/Pedi/Neo: 0 % etHAL High Adult/Pedi/Neo: 1.6 % inHAL Low Adult/Pedi/Neo: 0 % in HAL High Adult/Pedi/Neo: 2 %...
  • Page 348: Vuelink Default Settings

    33 Default Settings Appendix VueLink Default Settings BIS Settings Factory Adult Factory Pedi Factory Neo Speed 25 mm/s Filters Low Filter 2 Hz High Filter 70 Hz Notch Filter High Alarm Limit Low Alarm Limit Alarms Smoothing Rate 30 sec Color Yellow VueLink Default Settings...
  • Page 349 ISO/IEC standard 9703-2 SpO2 watertrap limit, SpO2 Nellcor adhesive sensors wave scale, adjusting NBP source (disposable) zero calibration patient messages Philips sensors (disposable) airway adapter pausing Philips sensors (reusable) CO2, microstream accessory physiological SvO2 pleth as source alarm tcpO2/tcpCO2 suspended symbol...
  • Page 350 reviewing messages initiating basic event surveillance reviewing window arrhythmia learning, initiating battery selftest and display brightness arrhythmia monitoring SpO2 high and low limits battery compartment location aberrantly conducted beats SpO2 specific charge status and defibrillation malfunction symbols atrial fibrillation and flutter SvO2, behavior during power gauge intermittent bundle branch block...
  • Page 351 how the measurement works measuring microstream method, mainstream cardiac output report C.I. method, microstream cardiac overlay C.O. method, sidestream and Resp detection modes accessories microstream accessories when measuring Resp calibrating measurements (PiCCO) microstream extension cardiotach alarms curve alert messages removing exhaust gases catheter documenting measurements transducer, calibrating...
  • Page 352 CO2, N2O display brightness ECG output counting events disposal ECG primary lead gas cylinder choosing CPAP (RESP) parts and accessories ECG report CSA (Compressed Spectral Arrays) documenting events lead layout cuff dPmax ECG reports pressure, NBP setup selection, NBP DSC (BIS) software revision ECG safety information curve alert messages (C.O.)
  • Page 353 conventional 12-lead EVLW/EVLWI help modified 12-lead INOPS exchanging anesthetic agents electrode placement (Resp) hemodynamic calculations exclamation mark symbol with abdominal breathing hemodynamic parameters exhaust gases, removing with lateral chest expansion high filter (EEG) extension cable for SpO2 electrode-to-skin impedance (BIS) high pass filter (BIS) extensions electrode-to-skin impedance (EEG)
  • Page 354 cords maintenance, calibration measurements, schedule maintenance, performance test keyboard connection symbol microstream CO2 measuring keys microstream CO2, calibration mismatch hardkeys microstream CO2, performance patient data, resolving test pop-up schedule SmartKeys connecting to FMS visual inspection connecting to monitor major parts and keys MMS patient cable connector MP40 MP50 label conflict resolution...
  • Page 355 (disposable) pf loops OxyCRG event episodes numeric Philips contact information oxygen extraction numerics physiological alarms oscillometric method oxygenation calculations PIC cable (BIS) pediatric cuffs securing preparing to measure...
  • Page 356 wedge setup menu wedge, editing starting and stopping QRS tone zeroing the transducer types changing volume wave overlap pressure accessories QRS tone pitch, SpO2 wave scale pressure analog output waveforms recorded QRS volume, changing pressure artifact suppression wedge quick admit pressure of NBP cuff with the plug-in recorder Quick Link connector...
  • Page 357 (disposable) serial LAN interface (C.O.) perfusion indicator serial/MIB connector symbol rs-232 interface symbol Philips sensors (disposable) service mode runtime Philips sensors (reusable) set combiners setting recording runtime pleth as alarm source setting the arterial catheter constant...
  • Page 358 multi-lead measurement settings CO2, calibrating monitor pressure, zeroing st alarms monitor settings tcGas, calibrating ST display predefined screens tcGas, remembraning ST measurement points profiles transducer connector adjusting profiles, measurement settings transferring a patient standard 10-lead placement settings transport brightness setting standard 3-lead placement profiles, monitoring settings trend time...
  • Page 359 module module options module setup visible waves and numerics warnings watertrap (AGM) wave adjusting changing speed scale (AGM) scale (CO2) scale (pressure) size (AGM) size (CO2) size (pressure) wave scale (EEG) changing wave size Resp wave size (ECG) changing wave speed (EEG) wave speed (Resp) wedge balloon inflation...

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