Dräger Infinity Series User Manual
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Dräger Infinity Series User Manual

Configured monitoring
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Configured Monitoring Series
Infinity Gamma Series
User's Guide

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  • Page 1 Infinity Configured Monitoring Series Infinity Gamma Series User’s Guide...
  • Page 2 Draeger Medical Systems, Inc. 16 Electronics Avenue Danvers, MA 01923 Authorized EC representative: Dräger Medical AG & Co. KGaA Moislinger Allee 53-55 23558 Lübeck Germany Infinity Gamma Series User’s Guide Software Version VF4 This product is covered by one or more of the following patents: 5,224,484; 5,224,740;...
  • Page 3 What’s New The functionality of the Infinity Gamma Series patient monitor has been improved and expanded to include the following new features in software version VF4: Support of gas monitoring functions in anesthesia and operat- ing room environments. The Gamma XL can now display concentrations of CO O, O and of the anesthetic agents...
  • Page 4 Infinity Gamma Series Software Release Notes Software Version VF4 Wireless network operation requires special configurations of the monitor- ing network and the M (a service function). If ULTI TATION you experience problems with wireless network operations, contact your Service personnel. When moving and assigning a wireless monitor to a different central sta- tion, the original central station may emit a brief network error tone and display an Offline message instead of the message Bed Disconnected.
  • Page 5 Occasionally, the ECG waveform is not displayed in the second waveform channel, when you assign SpO to the first waveform channel. In this case, click on the second waveform channel and select the desired ECG lead again. When admitting a patient at the M , the monitor ULTI TATION...
  • Page 6 Documentation Features Notes, Cautions, Warnings NOTE: A note presents information that helps you operate the equipment or connected devices. CAUTION: A caution provides information or instructions that must be followed to ensure proper operation and performance of the equipment WA RN I N G : A warning contains important information regarding possible danger to you or the patient that is present during normal operation of the equipment.
  • Page 7 Chapter Overview Chapters Overview..................1 Monitor Setup ................2 Network Applications............... 3 Admission, Discharge, Transfer..........4 Alarms and Messages.............. 5 Trends..................6 Recordings................7 ECG and Heart Rate ..............8 Arrhythmia ................9 ST-Segment Analysis ............. 10 Respiration................11 Pulse Oximetry ............... 12 End-Tidal CO2.................

  • Page 8: Table Of Contents

    Table of Contents Overview Important General Safety Considerations ........1-2 Electromagnetic Compatibility ..........1-2 Reducing EMI ................1-3 Site of Operation ...............1-3 Electrical Safety ................1-4 Connections to Peripheral Devices.........1-4 Safety, Inspection, and Maintenance ........1-5 Electrosurgery and Defibrillation Safety ........1-6 Pacemaker Safety ..............1-6 Device Markings................1-7 General Description................1-8 Front Panel ..................1-10 Back Panel..................1-11...
  • Page 9 Starting the Monitor ..............2-10 Main Screen Configuration ............2-11 Waveform Selection..............2-11 Bottom Channel Display............2-12 OR Mode ..................2-15 Show Respiration or etCO2 Parameters .......2-16 Setting Date and Time ..............2-17 Setting the Master Speaker Volume..........2-18 Turning External Alarm Lights ON/OFF ........2-19 Standby..................2-20 Saving Setups ................2-21 Network Applications Overview ..................3-2 Network Configurations ..............3-3...
  • Page 10 Alarms and Messages Alarm Grades ..................5-2 Life-Threatening Alarms............5-2 Serious Alarms................5-3 Advisory Alarms ...............5-4 Alarm Settings.................5-5 Setting Alarm Limits ..............5-6 Turning Parameter Alarms On/Off...........5-8 Turning Alarm Recordings On/Off ..........5-9 External Alarm Lights...............5-9 Alarm Validation................5-10 Silencing Alarms................5-11 Alarm Silence Key..............5-11 All Alarms OFF Key ..............5-12 Assigning Alarm Groups..............5-13 Central Alarms ................5-14 Alarms in OR Mode...............5-15...
  • Page 11 Recording Alarms .................7-13 Stored Recordings................7-14 Event Recall................7-14 Saving, Printing, Deleting Stored Recordings .....7-16 Recording Status Messages ............7-17 ECG and Heart Rate Overview ..................8-2 Patient Preparation .................8-3 Selecting and Preparing the Electrodes .........8-3 Preparing the Patient’s Skin ............8-3 Positioning the Electrodes............8-5 ECG Monitoring Settings ...............8-8 Cable Type .................8-8 Lead Selection and Display Amplitude ........8-9...
  • Page 12 Arrhythmia Overview ..................9-2 Turning Arrhythmia Monitoring ON ..........9-4 Arrhythmia Setup................9-5 Rate and Count .................9-6 Arrhythmia Alarms..............9-6 Arrhythmia Alarm Recordings..........9-7 Relearning a Patient’s ECG............9-7 ST Segment Analysis Overview ..................10-2 ST Monitoring Display ..............10-3 ST Setup ..................10-4 Isoelectric and ST Measuring Points ........10-5 ST Reference Complex............10-7 ST Alarms ..................10-8 Respiration...
  • Page 13 Pulse Oximetry Overview ..................12-2 Sensor Application ...............12-2 SpO2 Safety Considerations............12-4 SpO2 Monitoring Display .............12-5 SpO2 Display Channel............12-5 SpO2 Display Amplitude ............12-6 Cascade Display..............12-7 SpO2 Monitoring Settings ............12-8 Pulse Tone Source..............12-8 Pulse Tone Volume ..............12-9 Signal Strength Bar Graph ...........12-10 Averaging Mode ..............12-11 End-Tidal CO2 Overview ..................13-2 etCO2 Source ................13-3...
  • Page 14 Site of Operation ..............14-6 Installing/Removing the Water Trap........14-7 Connecting Sampling Lines and Power Cord ......14-7 OR Mode ..................14-9 CO2 Display and Setup ............14-11 Multigas Display and Setup ..........14-12 Non-Invasive Blood Pressure Overview ..................15-2 Cuff Selection and Placement .............15-4 NBP Safety Considerations ...........15-5 NBP Measurements ..............15-6 Single Measurements .............15-6 Interval Mode................15-6...
  • Page 15 Options and Accessories Options ................... A-2 MultiMed/NeoMed Pods..............A-2 ECG ....................A-3 Pulse Oximetry (SpO2) ..............A-4 End Tidal CO2 (etCO2) ..............A-6 Multigas ..................A-7 Temperature ................... A-8 Invasive Blood Pressure (IBP)............A-8 Non-invasive Blood Pressure (NBP) .......... A-10 Power Sources ................
  • Page 16 Default Settings and Biomedical Support Default Settings................C-2 Biomedical Support ..............C-12 Startup Tests ................C-13 Checking the NBP Calibration ..........C-14 Biomed Menu ................. C-15 Saving a Patient Setup ............C-16 Locked Options and Demo Mode ......... C-17 Diagnostic Logs ..............C-18 Changing Units of Measure ..........

  • Page 17: Overview

    1 Overview Important General Safety Considerations......1-2 Electromagnetic Compatibility ........1-2 Reducing EMI ..............1-3 Site of Operation .............. 1-3 Electrical Safety ............... 1-4 Connections to Peripheral Devices........ 1-4 Safety, Inspection, and Maintenance ......1-5 Electrosurgery and Defibrillation Safety......1-6 Pacemaker Safety ............

  • Page 18: Important General Safety Considerations

    Important General Safety Considerations CAUTION: Read all operating instructions carefully before using the monitor. Specific warnings and cautions are found throughout the User’s Manual where they apply. CAUTION: These devices are not intended for use in the same room as magnetic resonance equipment. WA RN I N G : Monitor operation is currently not sup- ported in the following environments: magnetic reso- nance imaging (MRI), aircraft, ambulance, home or...

  • Page 19: Reducing Emi

    Overview Reducing EMI To reduce possible problems caused by electromagnetic interfer- ence, we recommend the following: Use only Dräger-approved accessories. Ensure that other products used in areas where patient moni- toring and/or life-support is used comply to accepted emis- sions standards (EN55011). Try to maximize the distance between electromedical devices.

  • Page 20: Electrical Safety

    Electrical Safety CAUTION: Operate the monitor and any connected devices only in a clinical environment where the electrical installation is in accordance with local electric codes. The universal AC adapter, CPS, or IDS should be connected to a fully tested, hospital-grade outlet with proper grounding.

  • Page 21: Safety, Inspection, And Maintenance

    Overview Safety, Inspection, and Maintenance WA RN I N G : Because of the danger of electric shock, never remove the cover of any device while in operation or connected to a power outlet via the AC adapter. In the interest of safety, regular equipment inspection and mainte- nance is required.

  • Page 22: Electrosurgery And Defibrillation Safety

    Electrosurgery and Defibrillation Safety The monitor is protected against high-frequency interference from electrosurgery units and discharges from defibrillators, as well as against 50- and 60-Hertz power line interference. WA RN I N G : The monitor is not protected against high- frequency interference from diathermy equipment.

  • Page 23: Device Markings

    Overview Device Markings Power On/Off, Power standby. Battery operated equipment. Attention, consult the accompanying documents. Type CF, defibrillator-proof equipment. & Direct current. Alternating current. Danger: Risk of explosion if used in presence of flam- mable anesthetics. This device bears the ) label in accordance with the 0123 provisions of the Directive 93/42/EEC of 14June 1993 concerning medical devices.

  • Page 24: General Description

    General Description The Gamma Series monitor is a durable, lightweight, and porta- ble patient monitor that can operate as a stand-alone device or as part of the Dräger Infinity network. The Dräger P ™ ICK AND concept allows the monitor’s quick and easy disconnection from the network, and the monitor can travel with the patient from one clinical station to another —...
  • Page 25 Overview The monitor Gamma has a 6.5”, the monitor Gamma XL an 8” color display. Both monitors have a rechargeable battery. A uni- versal AC adapter is available for connection to a hospital- grade outlet. When used as a stand-alone device, you can connect the follow- ing peripheral equipment to the monitor via the monitor’s inter- face plate: An R50 Series recorder for printing alarm data, waveforms,...

  • Page 26: Front Panel

    Front Panel 1) Alarm Light 2) Fixed Keys 3) Rotary Knob 4) Power ON/OFF Key Page 1-10 Infinity Gamma Series...

  • Page 27: Back Panel

    Overview Back Panel 1) Power Supply Connection 2) Battery Compartment Cover Infinity Gamma Series Page 1-11...

  • Page 28: Left Side Panel

    Left Side Panel 1) NBP Hose Connection 2) M Connection ULTI 3) Invasive Blood Pressure Connection 4) PodPort (optional etCO Pod Connection) Page 1-12 Infinity Gamma Series...

  • Page 29: Right Side Panel

    Overview Right Side Panel 1) Carrying Handle 2) Memory Card Slot 3) QRS Sync. Output Infinity Gamma Series Page 1-13...

  • Page 30: Interface Plate (Optional)

    Interface Plate (optional) 1) X5: External VGA/Scio Multigas Module 2) X7: Alarm Output/R50 Recorder/RS232 Page 1-14 Infinity Gamma Series...

  • Page 31: Alarm Colors

    Overview Gamma/Gamma XL Display Message Waveform Area Channel Waveform Channel 2 Parameter Waveform Boxes Channel 3 Waveform/ Parameter Channel 4 NOTE: The fourth display channel is available as an option for the Gamma monitor, but standard on all monitors Gamma XL. For information on screen configuration, see the chapter Monitor Setup.

  • Page 32: Display Colors

    Display Colors The use of colors on the monitor allows you to identify a parame- ter and its waveform quickly. The following colors are pre- defined and cannot be changed: Heart rate Green PVC/ARR Green ST Segment Analysis* Green /PLS White Respiration Blue...

  • Page 33: Rotary Knob

    Overview Rotary Knob Using the rotary knob, you can: Select a screen area (parameter box or waveform field). Call up a menu and change menu options. Scroll through trend tables and graphs. Scroll through stored events. Switch between trend tables and graphs. STEPS: Calling up a menu 1.

  • Page 34: Fixed Keys

    Fixed Keys The monitor has a Power ON/OFF key and eight fixed keys on the front of the unit. These keys give the user access to various monitoring functions: Press this key to turn the monitor on or off. Power Alarm Silence Press this key to silence an active alarm for one minute.

  • Page 35: Menus

    Overview Menus Menus provide easy access to monitoring functions, including: Initial monitor and system setup. The setting of alarm functions. The setting of monitoring options for each parameter. Menus are displayed in the waveform area. Use the rotary knob or a fixed key to access menus. A complete menu tree is shown at the end of this chapter.

  • Page 36: Power Sources

    Power Sources The monitor can be operated with battery power or connected to line power via an AC adapter or Docking Station. See the chapter Monitor Setup for a description of battery operation and the AC adapter. See the chapter Network Applications for a descrip- tion of the Docking Station and Pick-and-Go transport.
  • Page 37 Overview ULTI For easier cable management, ECG cable sets, the SpO sensor and temperature probes are housed in a M or N ULTI pod. See the Monitor Setup chapter for information on assem- bling the patient cables. 5 Pod and Accessories ULTI 6 Pod and Accessories ULTI...

  • Page 38: Etco2 Pod And Multigas Module

    etCO Pod and Multigas Module An etCO pod for the measurement of end-tidal CO , and a multi- gas module for the measurement of O , CO O and five anes- thetic agents are available as an option. See the chapters End- Tidal CO and Multigas for more information.

  • Page 39: Remote Displays

    Overview Remote Displays The bedside monitor can send data to a larger VGA video display for an enhanced view of the monitoring functions. The VGA dis- play connects directly to the Infinity Docking Station (IDS), interface plate, or the Communication Power Supply (CPS). Use of a Dräger-approved video display is recommended.
  • Page 40 Main Menu Review Trend Graphs Trend Tables Event Recall Admit/Discharge Patient Admit Patient Category Adult Pediatric Neonate Name (dial in) (dial in) Admit Date (current date) Care Unit (select) Bed Label (select) Discharge Discharge Patient? Transfer Care Unit (select) Transfer Bed (select) Start Transfer Confirm...
  • Page 41 Overview Admit/Discharge Copy Data Copy to Monitor Name Start Transfer Monitor Setup Main Screen Bottom Channel Waveform Wave+NBP OR Mode Show Rsp/etCO etCO Screen Brightness Bright Monitor Options Date & Time Date Time Speaker Volume Medium High Alarm Light Trend Setup Channel 1 (select parameter) Channel 2...
  • Page 42 Monitor Setup Trend Setup Channel 3 (select parameter) Recordings Primary Recorder (select) Secondary Recorder (select) Review Event Recall Biomed (password) Alarm Groups 1 - 255 Standby Fast Access Menu Bottom Channel Waveform Wave+NBP Trend Graphs Trend Tables Event Recall Channel Display Menu (1, 2, 3, 4 Channel) Waveform (select param.)
  • Page 43 Overview Alarm Limits Table (Parameter) Upper (dial in) Autoset Lower (dial in) Alarm Record Record Store Str/Rec HR Menu (HR P-Box) Tone Source SpO2 Tone Volume Medium High Pacer Detect QRS Mark Infinity Gamma Series Page 1-27...
  • Page 44 (HR P-box) Arrhythmia Setup Rate (dial in) Count (dial in) Alarm Record Record Store Str/Rec ECG Processing ECG1 ECG1&2 ECG Leads 3, 5, 6 Arrhythmia Basic Full Relearn (last relearn) Page 1-28 Infinity Gamma Series...
  • Page 45 Overview Rsp Menu (Resp P-Box) Resp Mode Manual Auto Resp. Marker Relearn (last relearn) Apnea Time 10 . . . 30 Coincidence Multigas Menu (Agent P-Box) Agent Override Isoflurane Enflurane Halothane Desflurane Sevoflurane Multigas Alarms (alarm table) Autozero Delay Infinity Gamma Series Page 1-29...
  • Page 46 etCO Menu (with POD) NOTE: If Scio rather than the pod is the etCO source, the etCO menu shows only the selection RRc Apnea. (etCO2 P-Box) etCO Source SCIO Averaging Breath 10s, 20s Instant. RRc Apnea 10 . . . 30 Sensor Cal.
  • Page 47 Overview Menu (SpO2 P-Box) Tone Source SpO2 Tone Volume Medium High Bar Graph Averaging Normal Fast Sensor Type (informational only) ST Menu (ST P-Box) (place point) (place point) Save (last save) Infinity Gamma Series Page 1-31...
  • Page 48 NBP Menu (NBP P-Box) Interval Mode 2 . . . 240 Calibration Mode Inflation Mode Adult: 270 Adult: 180 Ped: 180 Ped: 140 Neo: 140 Neo: 90 Measurement Tone IBP Menu (IBP P-Box) Label (select param.) Zero Cal. Factor 80 . . . 120 1 .

  • Page 49: Monitor Setup

    2 Monitor Setup Getting Started............... 2-2 Using the AC Adapter ............2-2 Using the Battery ............. 2-4 Assembling MultiMed and NeoMed Pods ...... 2-9 Starting the Monitor ............2-10 Main Screen Configuration..........2-11 Waveform Selection............2-11 Bottom Channel Display..........2-12 OR Mode ................. 2-15 Show Respiration or etCO2 Parameters ......

  • Page 50: Getting Started

    Getting Started CAUTIONS: Before monitoring your patient, the battery that is delivered with a new monitor has to be fully charged (see below). Before monitoring your patient, be sure you have read the Important General Safety Considerations in the Overview chapter.
  • Page 51 Monitor Setup STEPS: Connecting the AC Adapter 1. Connect the AC adapter's cable to the DC input on the moni- tor’s back panel. 2. Connect the power cord to the AC adapter. 3. Plug the other end of the power cord into a hospital-grade outlet.

  • Page 52: Using The Battery

    Using the Battery The battery powers the monitor when the monitor is not con- nected to line power via the AC adapter, an IDS Docking Station, or a CPS Communication Power Supply (IDS and CPS are described in the chapter Network Applications). The battery fits into the battery compartment at the back of the monitor.
  • Page 53 Monitor Setup If the battery charge drops below 10 V, monitoring stops, but monitoring settings, trended data, and stored recordings are saved in memory. Screen Brightness To save power, the monitor’s display may automatically dim when you change to battery operation. With a lead acid battery, the display always dims on battery power.
  • Page 54 STEPS: Inserting a Lead Acid Battery into the Monitor NOTE: Before installing the battery, read the cautions and warn- ings in the Important General Safety Considerations section at the beginning of this manual. 1. Turn the monitor so that its rear panel is facing towards you. 2.
  • Page 55 Monitor Setup 4. With the battery pushed into the left side of the battery com- partment, press the right side of the battery into the clip at the right side. 5. Insert the left side of the battery door into the hinges, and swivel the door closed until the locking tab snaps into place.
  • Page 56 STEPS: Charging Lead Acid Batteries with a Battery Charger You can charge up to four additional lead acid batteries with the battery charger available from Dräger. To do so: 1. Place the lead acid batteries on the battery charger. 2. Keep the lead acid batteries in the charger for at least four hours to ensure a full charge.

  • Page 57: Assembling Multimed And Neomed Pods

    Monitor Setup Assembling M and N Pods ULTI Choose a 5-lead or 6-lead M Pod (adult/pediatric appli- ULTI cations) or a N Pod (neonatal applications) for your moni- toring session. Assemble the pods as illustrated prior to connect- ing them to the monitor. (Parameter-specific patient preparation is described in the individual parameter chapters.) 1) SpO sensor 2) ECG lead sets 3) Temperature sensor...

  • Page 58: Starting The Monitor

    Starting the Monitor 1. Press the fixed key. The green light indicator in the Power key lights up. 2. Wait until the main screen appears at the end of the self-tests. NOTES: If an internal failure or error should occur, the monitor’s screen turns blank.

  • Page 59: Main Screen Configuration

    Monitor Setup Main Screen Configuration The monitor has four display channels. The top three channels show waveforms and their corresponding parameter boxes. The bottom channel can be configured to show either parameter boxes, enlarged NBP values, a waveform, or a combination of a waveform and parameter boxes (see illustrations below).

  • Page 60: Bottom Channel Display

    Bottom Channel Display STEPS: Selecting the Bottom Channel Display 1. Press the fixed key. Menu 2. Click on Monitor Setup 3. Click on Main Screen 4. Click on Bottom Channel NOTES: You can also call up the Bottom Channel menu by pressing the Fast Access fixed key.
  • Page 61 Monitor Setup Bottom Channel showing parameter boxes Bottom Channel showing enlarged NBP values Infinity Gamma Series Page 2-13...
  • Page 62 Bottom Channel showing a fourth waveform Bottom Channel showing a waveform and parameter boxes Page 2-14 Infinity Gamma Series...

  • Page 63: Or Mode

    Monitor Setup OR Mode The OR mode allows access to multigas monitoring functions and is available for monitors Gamma XL operating in the adult or pediatric mode. STEPS: Selecting the OR Mode 1. Verify that the adult or pediatric patient category is selected. 2.

  • Page 64: Show Respiration Or Etco2 Parameters

    Show Respiration or etCO2 Parameters STEPS: Selecting Rsp/etCO2 1. Press the fixed key. Menu 2. Click on Monitor Setup 3. Click on Main Screen 4. Click on Show Rsp/etCO 5. Select and click the knob. etCO NOTES: For more information on Respiration or etCO2 monitoring, see the respective parameter chapters.

  • Page 65: Setting Date And Time

    Monitor Setup Setting Date and Time Monitors operating in the Infinity network receive their date and time settings from the network. For a stand-alone monitor, you can set the current date and time as follows: STEPS: Setting Date and Time 1.

  • Page 66: Setting The Master Speaker Volume

    Setting the Master Speaker Volume The setting for the master speaker volume defines the volume for alarm tones, pulse tones, attention and error tones. The available settings are , and Medium High NOTES: For safety reasons, you cannot turn the speaker volume off when the monitor operates as a stand-alone device or if the French-NFC mode has been selected (a Service setting).

  • Page 67: Turning External Alarm Lights On/Off

    Monitor Setup Turning External Alarm Lights ON/OFF A set of alarm lights on top of the monitor blink red for life- threatening alarms and yellow for serious alarms, if the external alarm light function is enabled in the Monitor Setup menu (default setting is ON).

  • Page 68: Standby

    Standby The standby function lets you interrupt and then resume monitor- ing. When you put the monitor into standby, all patient data and monitoring setups are saved in memory until you resume moni- toring. During standby, the monitor displays a Standby banner. If the monitor is part of the Infinity network and its monitoring data is displayed on the central station, the Standby banner appears also on the central display.

  • Page 69: Saving Setups

    Monitor Setup Saving Setups The current monitoring configuration can be saved and used again. A saved configuration is specific to the selected patient category and is automatically restored when a you admit a new patient of the same category (e.g., pediatric). The following monitoring settings are saved: waveform channel assignments and scales, alarm limits and on/off status, NBP inter- val mode, IBP pressure labels, arrhythmia monitoring (adult or...
  • Page 70 Page 2-22 Infinity Gamma Series...

  • Page 71: Network Applications

    3 Network Applications Overview................. 3-2 Network Configurations............3-3 Basic Network Components ........... 3-4 Basic Bedside Setups............3-5 Network Operation ..............3-6 Docking Station..............3-7 Docking and Undocking ..........3-9 Wireless Network Configuration........3-11 Wireless Network Operation ......... 3-13 Network Safety Considerations ......... 3-16 Alarm and Status Messages..........

  • Page 72: Overview

    Overview The Infinity network provides communication links between the bedside monitor and other network devices such as a central sta- tion, other monitors, recorders, and laser printers. The network allows you to monitor your patient at a central location away from the bedside, and to monitor many patients at once.

  • Page 73: Network Configurations

    Network Applications Network Configurations A basic Infinity network includes: Bedside monitors. A central station (M ULTI ORKSTATION Docking stations at the bedside. R50 Series recorders. Infinity network cabling and repeater hubs. A basic Infinity wireless network includes: Bedside monitors. A central station (M ULTI ORKSTATION Wireless LAN PC Cards.

  • Page 74: Basic Network Components

    Basic Network Components Bedside Monitor Central Station Simple Docking Station (mount only) Infinity Docking Station (IDS) IDS Power Supply Communication Power Supply (CPS) Interface Plate R50 Recorder Wireless LAN PC Card Access Points Laser Printer Page 3-4 Infinity Gamma Series...

  • Page 75: Basic Bedside Setups

    Network Applications Basic Bedside Setups Access Point Bedside Setup with IDS Wireless Monitor with Wireless LAN PC Card Monitor with Interface Plate Bedside Setup with CPS Infinity Gamma Series Page 3-5...

  • Page 76: Network Operation

    Network Operation The bedside monitor operates in network mode when it is: Docked at a docking station, Equipped with a wireless PC card in a wireless network Docking stations must be configured for network mode (versus standalone mode) by Dräger personnel during installation. Only Dräger personnel can modify these configurations, which define numerous network functions, including bedside labels, recorder labels, and the availability of remote control functions of the bed-...

  • Page 77: Docking Station

    Network Applications NOTES: The only configurations of the IDS/CPS that you can perform via the monitor’s menus are the assignment of alarm groups and the selection of primary and secondary network recorders (see the chapters Alarms and Messages and Recordings). If central monitoring is disabled at the IDS/CPS, -- you cannot turn the monitor’s master speaker volume off, -- no network offline messages appear at the bedside.
  • Page 78 Multigas Module Power Supply Alarm Output Infinity Network External VGA/RS232 R50 Recorder Infinity Docking Station (back panel) ON/OFF switch Infinity Network Power Cord R50 Recorder External VGA/RS232 Alarm Output Docking Station Mount-only Docking Station and CPS (back panel) Page 3-8 Infinity Gamma Series...

  • Page 79: Docking And Undocking

    Network Applications Docking and Undocking STEPS: Docking the Monitor 1. Hold the monitor firmly by its handle and set it onto the Dock- ing Station. Make sure the mon- itor is securely positioned and clicks into place. The Docking Station’s locking lever does not move unless the monitor is seated properly.
  • Page 80 versus Network Error ICK AND The network can distinguish between a network error and the intentional removal of a bedside monitor from its Docking Sta- tion. If the monitor loses its connection with the network due to a tech- nical problem, the network generates a network error message. When the monitor is removed from its Docking Station for trans- port, the central station displays a network status message (Bed Disconnected).

  • Page 81: Wireless Network Configuration

    Network Applications Wireless Network Configuration The Infinity Gamma Series monitor can operate in a wireless net- work which allows the monitor to establish and maintain contact with the Infinity network and the central station without being docked at a Docking Station. A wireless monitor transmits and receives data with the help of a wireless LAN PC card installed in the Memory Card slot on the monitor’s side panel.
  • Page 82 A wireless network offers the following: Seamless Patient Transport — A wireless monitor contin- ues to communicate with the Infinity network during Pick- and-Go transport situations and its data remains on the cen- tral display after leaving the bedside Docking Station. Seamless Patient Relocation —...

  • Page 83: Wireless Network Operation

    Network Applications Wireless Network Operation Care Unit and Bed Label Assignments A wireless monitor receives care unit and bed label assignments in one of the following ways: Automatically when docking at a Docking Station. By manual entry via the Patient Admit menu. When docking at a Docking Station, a wireless monitor automati- cally accepts the Docking Station’s Care Unit and Bed Label assignments and communicates with the Infinity network via the...
  • Page 84 STEPS: Selecting Care Unit and Bed Label 1. Undock the monitor, if docked. 2. Press the fixed key. Menu 3. Click on Admit/Discharge 4. Click on Patient Admit 5. Click on Care Unit 6. Dial in the desired care unit from the list of available choices and click the knob.
  • Page 85 Network Applications Central Display The central station identifies wireless monitors by a trans- mission icon on the central display. Upon undocking, the bed’s central display channel (viewport) remains assigned to the wireless monitor. If another monitor docks on the same Docking Station which is still associated with the wireless monitor, the new monitor receives the same bed label from the Docking Sta- tion, but does not replace the wireless monitor in the viewport of...

  • Page 86: Network Safety Considerations

    Network Safety Considerations When operating the monitor in a wireless network, please observe the following: Before using the wireless monitoring equipment, read the instructions and safety warnings supplied by the wireless equipment manufacturer. While the unit is transmitting or receiving signals, do not hold the transmitting/receiving unit close to exposed body parts, especially the face or eyes.

  • Page 87: Alarm And Status Messages

    Network Applications Alarm and Status Messages When the monitor is connected to the network, network messages alert you of network operating conditions. Some messages display only once (i.e., Remote Limit Change), while others appear alternately until the condition has been resolved (i.e.
  • Page 88 Page 3-18 Infinity Gamma Series...

  • Page 89: Admission/Discharge/Transfer

    4 Admission/Discharge/ Transfer Overview................. 4-2 Patient Admission ..............4-3 Admit Menu............... 4-4 Patient Category............... 4-5 Name and ID ..............4-6 Admit Date ................4-8 Patient Discharge ..............4-9 Data Transfer ............... 4-10 Transfer Across the Network ........4-11 Transfer with a Data Memory PC Card......4-13...

  • Page 90: Overview

    Overview The Patient Admit menu allows you to enter and edit a patient’s personal data (name, ID, admit date) and select the patient cate- gory. If your monitor is operating in a monitoring network, you can also review or change the monitor’s care unit and bed label assignments.

  • Page 91: Patient Admission

    Admission/Discharge/Transfer Patient Admission When you turn on the monitor or exit the standby mode, the mon- itor displays a New Patient? prompt to assure that previously stored patient data is deleted before you monitor a new patient. To start monitoring a new patient, press the rotary knob and click .

  • Page 92: Admit Menu

    Admit Menu STEPS: Calling up the Patient Admit Menu 1. Press the fixed key. Menu 2. Click on Admit/Discharge 3. Click on Patient Admit NOTE: You cannot enter selections for Care Unit and Bed Label when the monitor is docked at a Docking Station or operating as a stand-alone device.

  • Page 93: Patient Category

    Admission/Discharge/Transfer Patient Category NOTE: The currently selected patient category is indicated between the first and second waveform channels next to the param- eter boxes. STEPS: Selecting the Patient Category 1. Call up the Patient Admit menu (Menu > Admit/Discharge > Patient Admit, see above).

  • Page 94: Name And Id

    When switching to the neonatal mode, the monitor also: Disables arrhythmia detection and clears all arrhythmia labels from the screen. Disables pacemaker detection. Disables ST Segment analysis (if option is available). Allows viewing of an Oxy-Cardiorespirogram (if option is available). Name and ID STEPS: Entering Name and ID 1.
  • Page 95 Admission/Discharge/Transfer 5. Enter the remaining characters accordingly. The Admit Menu can display up to 9 characters at a time, but you can enter additional characters (up to 25 for the name and up to 12 for the ID) by scrolling past the up arrow ( ↑...

  • Page 96: Admit Date

    Admit Date STEPS: Entering the Admit Date 1. Call up the Patient Admit menu (Menu > Admit/Discharge > Patient Admit, see above). 2. Click on . The monitor automatically enters the Admit Date current date. 3. If necessary, edit the date by clicking on the day, month, or year entry fields and dialing in the desired date.

  • Page 97: Patient Discharge

    Admission/Discharge/Transfer Patient Discharge You can discharge a patient only at the bedside, not at the central station. Upon discharge, the monitor deletes all previously stored monitoring data (such as QRS reference complexes, trends, events, and recordings), and it returns to default or previously stored monitoring settings (see the chapter Default Settings and Biomedical Support).

  • Page 98: Data Transfer

    Data Transfer You can transfer patient data between monitors in the following ways: By sending data to a different monitor over the Infinity net- work. By copying data onto a memory card and then loading it into a different monitor (stand-alone option). The transfer of patient data involves a source monitor and a desti- nation monitor.

  • Page 99: Transfer Across The Network

    Admission/Discharge/Transfer Transfer Across the Network NOTE: Before data transfer can take place over the network, the source monitor must be placed into Standby mode. STEPS: Transfer Across the Network At the source monitor: 1. Place the source monitor into Standby. At the destination monitor: 1.
  • Page 100 NOTES: The Transfer Bed menu displays all networked beds in the selected care unit that are currently in Standby mode. You must click on a bed label, even if there is only one avail- able bed listed in the transfer menu; if you do not select a bed, the transfer cannot take place.

  • Page 101: Transfer With A Data Memory Pc Card

    Admission/Discharge/Transfer Transfer with a Data Memory PC Card The transfer of patient data with a memory card involves copying data from the source monitor onto a card and then from the card into the destination monitor. WA RN I N G : Your monitor may not be equipped with ESD protection for the memory card slot.
  • Page 102 STEPS: Copy to Card CAUTION: Before a copy, the monitor erases all contents of the card. 1. Insert a memory card into the mem- ory card slot on the right side of the source monitor. 2. Press the fixed key. Menu 3.
  • Page 103 Admission/Discharge/Transfer During data transfer, the monitor displays the message ‘Wait’ in the Status field or an error message, if copying cannot be initiated (i.e. card is not fully inserted). If the copy was successful, the monitor time stamps the card and displays the message ’Card data copy complete’;...
  • Page 104 NOTE: The Offset, minutes field shows how many minutes have passed since the patient data was written on the card. The field shows a negative value if the card was written earlier than the cur- rent time on the destination monitor. The field shows a positive value if the time stored on the card is ahead of the time displayed on the destination monitor.
  • Page 105 5 Alarms and Messages Alarm Grades....................5-2 Life-Threatening Alarms ..............5-2 Serious Alarms ..................5-3 Advisory Alarms ..................5-4 Alarm Settings....................5-5 Setting Alarm Limits................5-6 Turning Parameter Alarms On/Off .............5-8 Turning Alarm Recordings On/Off .............5-9 External Alarm Lights ...............5-10 Alarm Validation..................5-11 Silencing Alarms ..................5-12 Alarm Silence Key ................5-12 All Alarms OFF Key ................5-13 Assigning Alarm Groups.................5-14 Central Alarms..................5-15...

  • Page 106: Alarm Grades

    Alarm Grades The monitor annunciates both audible and visual alarms to alert you to significant changes in the patient’s condition and to mal- functions of the equipment that may affect the accuracy of mea- surements. All alarms fall under one of three alarm grades: Life-threatening.

  • Page 107: Serious Alarms

    Alarms and Messages Serious Alarms A serious alarm has the second highest priority. It alerts you to significant changes in the patient’s condition other than life- threatening events as defined in the preceding section. For exam- ple, if a monitored parameter falls below the selected alarm lim- its, the monitor triggers a serious alarm.

  • Page 108: Advisory Alarms

    Advisory Alarms An advisory alarms has the lowest priority. It can result from one of three conditions: When the monitor cannot produce a parameter value due to a technical problem (e.g. a lead-off condition). A patient cable or accessory failure (e.g. a blocked line in the pressure cuff).

  • Page 109: Alarm Settings

    Alarms and Messages Alarm Settings On the Alarm Limits table you can: Set alarm limits. Turn parameter alarms on or off. Turn alarm recordings on or off. To call up the Alarm Limits table, press the fixed Alarm Limits key. The Alarm Limits table has several pages with additional parame- ters.

  • Page 110: Setting Alarm Limits

    Setting Alarm Limits You can set alarm limits for each parameter individually, or you can use the AutoSet function to set alarm limits for all parameters at once based on the current parameter values. STEPS: Setting alarm limits individually 1. Press the fixed key.
  • Page 111 Alarms and Messages NOTES: The AutoSet function sets alarm limits for all parameters at once, even for those not displayed on the current page of the Alarm Limits table. Exception: There is no AutoSet function for PVC. If a parameter value is not currently available (e.g. during a lead-off condition), the monitor does not adjust the alarm limit for that parameter when you click on AutoSet.

  • Page 112: Turning Parameter Alarms On/Off

    Turning Parameter Alarms On/Off The monitor annunciates alarms only for parameters whose alarm is turned on. You can turn alarms on or off for each parameter individually. When you turn a parameter alarm off, the moni- tor displays a crossed bell icon in the corre- sponding parameter box.

  • Page 113: Turning Alarm Recordings On/Off

    Alarms and Messages Turning Alarm Recordings On/Off The monitor prints and/or stores alarm recordings automatically, if the Record and/or Store function is enabled on the Alarm Lim- its table. STEPS: Turning Alarm Recordings/Storage On or Off 1. Press the fixed key. Alarm Limits 2.

  • Page 114: Alarm Validation

    Alarm Validation The alarm validation feature minimizes nuisance alarms for tran- sient conditions. When a parameter value falls below or rises above its current alarm limits, the monitor waits a predetermined time before triggering the alarm. If the parameter value returns to within the upper or lower alarm limit before the end of the alarm validation period, the monitor does not trigger the alarm.

  • Page 115: Silencing Alarms

    Alarms and Messages Silencing Alarms The monitor offers two fixed keys to silence alarms: Alarm Silence All Alarms OFF Alarm Silence Key Press the fixed key to silence active alarms. The Alarm Silence silence period lasts 1 minute unless a new alarm occurs. During the silence period while an alarm condition persists: The parameter box stops blinking but remains highlighted.

  • Page 116: All Alarms Off Key

    If the monitor detects two or more new alarm conditions dur- ing the silence period: The monitor delivers the audible signal for the newest alarm with the highest priority. Both alarming parameter boxes blink. The message for both alarms is displayed alternately in the message area of the screen.

  • Page 117: Assigning Alarm Groups

    Alarms and Messages Assigning Alarm Groups If a monitor is part of the Infinity network, alarm messages from other networked monitors appear in the message area at the bot- tom of the screen (i.e. BED 20: ECG Leads Off). In order to limit the number of messages from remote beds, you can group beds into separate alarm groups so that only messages from monitors within the same alarm group are shared.

  • Page 118: Central Alarms

    Central Alarms If the bed appears on the central station’s display, the central sta- tion announces all bedside alarms. The alarm grade (life-threaten- ing, serious, advisory) is determined by the bedside’s setting. If the central station fails to indicate a bedside alarm within 10 sec- onds, the bedside monitor reports a network alarm error and alarms sound at their highest volume at the bedside.

  • Page 119: Alarms In Or Mode

    Alarms and Messages Alarms in OR Mode When you select the OR mode (see the chapter Multigas), the monitor’s alarm behavior for some alarms changes in order to avoid nuisance alarms during surgical procedures. In OR mode, the following applies: All ECG Lead Off conditions as well as the sensor applica- tion errors SpO2 Transparent and SpO2 Light Blocked cause one-time advisory alarm indications only.

  • Page 120: Messages

    Messages The monitor displays the following types of messages: Alarm messages to alert you to a physiological condition (e.g., Asystole). Status messages to alert you to faults and their causes (e.g., RA Lead Off) or to follow the work-in-progress of your mon- itor (e.g., Alarm Recording Started).
  • Page 121 Alarms and Messages Heart Rate (HR), Arrhythmia (ARR) and ST Segment Analysis (ST) Displayed Message Possible Cause Suggested Action Message: Arrhythmia The monitor is learn- • Wait until the message dis- Relearning ing the patient’s nor- appears from the screen. mal QRS complex to Parameter value: LRN use as reference.
  • Page 122 Heart Rate (HR), Arrhythmia (ARR) and ST Segment Analysis (ST) Message: ECG Artifact Patient’s movement. • Calm the patient. HR parameter value: *** Shivering, tremors. • Check the electrodes. ST<lead1>/ST<lead2> Excessive signal • Apply the electrodes care- parameter value: <blank> noise.
  • Page 123 Alarms and Messages Heart Rate (HR), Arrhythmia (ARR) and ST Segment Analysis (ST) Message: V Fib Detection of a ventric- • Observe the patient and ular fibrillation. The treat if clinically indicated. Parameter value: VF ventricular rhythm is • View each lead on the mon- chaotic.
  • Page 124 Heart Rate (HR), Arrhythmia (ARR) and ST Segment Analysis (ST) Message: TACH N* or more consecu- • Observe the patient and tive normal beats with treat if clinically indicated. Parameter value: TACH a beat-to-beat rate >= the TACH rate Message: PAUS A sequence of two •...
  • Page 125 Alarms and Messages Heart Rate (HR), Arrhythmia (ARR) and ST Segment Analysis (ST) Message: ST > UL The ST rate falls out- • Observe the patient care- side the current upper fully. ST<lead1> and or lower alarm limits. ST<lead2> parameter •...
  • Page 126 Respiration Displayed Message Possible Cause Suggested Action Message: Apnea The monitor is • Check the patient. Treat the detecting an apnea patient, if clinically indicated. Parameter value: Apn event that exceeds • If the absence of impedance the apnea time set in changes is due to the place- the menu.
  • Page 127 Alarms and Messages Respiration (continued) Message: Rsp > <UL The respiration rate • Observe the patient care- value> falls outside the cur- fully. rent upper or lower Message: Rsp < <LL • Apply treatment if clinically alarm limits. value> indicated. The current alarm Parameter value: <value>...
  • Page 128 Respiration (continued) Message: Use ECG II for An ECG lead other • Select Lead II to ensure than lead II is dis- accurate respiration monitor- played while 3 ECG ing. Parameter value: *** lead cable is selected. End Tidal CO (etCO ), Inspired CO (iCO...
  • Page 129 Alarms and Messages End Tidal CO (etCO ), Inspired CO (iCO ), and RRc (continued) Message: RRc > UL RRc is outside alarm limits • Check the patient and because of: treat if necessary. Message: RRc < LL • A physiological condition. •...
  • Page 130 End Tidal CO (etCO ), Inspired CO (iCO ), and RRc (continued) Message: etCO Sensor The sensor temperature is • Wait at least three min- Temp Not Stable unstable following warm- utes for the message to disappear. If the mes- Parameter value: *** sage persists, replace the reusable sensor.
  • Page 131 Alarms and Messages End Tidal CO (etCO ), Inspired CO (iCO ), and RRc (continued) Message: etCO Airway adapter calibration • Informational mes- Calibrating Adapter (zeroing in room air) in sage; no action progress. required. Parameter value: <blank> Message: etCO Cal.
  • Page 132 End Tidal CO (etCO ), Inspired CO (iCO ), and RRc (continued) Message: etCO Tubing Sidestream tubing • Clear the blockage in Blocked obstructed, or filter is the tubing. clogged. Parameter value: *** • Replace the pod. Message: etCO Tubing Sidestream tubing has a •...
  • Page 133 Alarms and Messages Multigas (continued) Message: iO > UL The inspired/expired • Observe the patient; concentrations fall treat, if necessary. Message: iO < LL outside the current • Adjust alarm limits. Parameter value: <value> upper or lower alarm limits. Message: etO >...
  • Page 134 Multigas (continued) Message: Multigas H/W fail- Loss of communica- • Check connections. tion or hardware prob- • Disconnect and recon- lem detected. Parameter value: *** nect the Scio module. • Power-cycle the moni- tor or undock/redock the monitor from the Docking Station.
  • Page 135 Alarms and Messages Multigas (continued) Message: Multigas Check Scio reports a full • Empty/replace water- Watertrap watertrap. trap (see the chapter Multigas). Parameter value: <values> Message: Multigas Fan Fail- Fan port blocked. • Check fan port and remove blockage. Hardware problem. Parameter value: *** •...
  • Page 136 Pulse Oximetry (SpO (continued) Message: SpO Motion The monitor has detected • Move sensor to another motion artifacts in the sig- location. Parameter value: *** nal. The cause can be one • Observe the resulting of the following: waveform on the Message: PLS Motion The patient is moving screen.
  • Page 137 Alarms and Messages Pulse Oximetry (SpO (continued) Message: SpO The sensor’s extension • Verify sensor to exten- Unplugged cable disconnected from sion cable connection. the pod. Message: PLS • Verify extension cable Unplugged The sensor is discon- to pod connection. nected from the extension Parameter value: *** •...
  • Page 138 Temperature (T) Displayed Message Possible Cause Suggested Action Message: T >UL The patient's temperature • Observe the patient. <value> falls outside the current • Change the alarm limits temperature alarm limits. Message: T <LL for this patient. <value> • If you suspect a temper- ature probe failure, check and replace it.
  • Page 139 Alarms and Messages Invasive Blood Pressure (IBP1, IBP2) Displayed Message Possible Cause Suggested Action IBP Low Pulse Systolic and diastolic val- • Check the patient. ues are less than 60% of • Zero and check the trans- the baseline. ducer calibration factor. Elevated heart rate.
  • Page 140 Non-Invasive Blood Pressure (NBP) Displayed Message Possible Cause • Suggested Action Message: NBP Cannot Mea- Faulty equipment. • Check the patient. sure Improper cuff place- • Check the hose and Parameter value: *** ment. cuff. Patient’s pulse too • Move the cuff to a limb low.
  • Page 141 Alarms and Messages Non-Invasive Blood Pressure (NBP) (continued) Message: NBP Mean Only The patient's pulse is • Check the patient. too low for the monitor Parameter Value: • Check proper place- to derive the systolic ment of the cuff. NBP M <value> and diastolic pressure NBP S <***>...
  • Page 142 Non-Invasive Blood Pressure (NBP) (continued) Message: NBP Out of Range NBP values are • Check patient and above/below the NBP treat, if necessary. Parameter value: *** measuring range. • Verify that the inflation mode is appropriate for the patient. Change if necessary.

  • Page 143: Trends

    6 Trends Overview................. 6-2 Trend Setup................6-3 Trend Graphs ................. 6-4 Trend Table ................6-6 Special Conditions and Codes..........6-8...

  • Page 144: Overview

    Overview The monitor can store the last 24 hours of trended data. If there is no alarm, the monitor averages the monitored vital signs every minute and stores the results in its trend memory. You can view the trends in the following formats: As a graph (graphical trends).

  • Page 145: Trend Setup

    Trends Trend Setup Select trend parameters for the three top positions on the trend display as follows: STEPS: Selecting Parameters for Trend Channel Display 1. Press the fixed key. Menu 2. Click on Monitor Setup 3. Click on Trend Setup 4.

  • Page 146: Trend Graphs

    Trend Graphs Trend Graphs display up to 12 hours of trended data at a time, sampled and updated every minute. When you first access the graphical trend screen, the monitor shows the most recent trend values plotted against a time grid along the horizontal axis of the graph.
  • Page 147 Trends STEPS: Calling up Trend Graphs 1. Press the fixed key. Menu 2. Click on Review 3. Click on Trend Graphs NOTE: You can also call up the Trend Graphs by pressing the Fast Access fixed key. STEPS: Navigating the Trend Graphs Screen Up and down arrows —...

  • Page 148: Trend Table

    Trend Table The trend table shows up to hour of trended data at a time. When you first access the trend table, the monitor shows the most recent trend values in the right column for the parameters being monitored. The monitor identifies parameter labels by their color. Trend val- ues appear in white or in the color of the alarm grade, if the parameter was in alarm during the one-minute trend sampling interval.
  • Page 149 Trends STEPS: Navigating the Trend Table Up and down arrows — scroll through the available param- eters one page at a time. Left and right single arrows — scroll through older or more recent trend data. Left and right double arrows — view the oldest or the most recent trend data.

  • Page 150: Special Conditions And Codes

    Special Conditions and Codes When a parameter is not monitored during a trend sampling inter- val, the value is blank on the trend display. When alarms are enabled, the monitor stores and displays the first occurrence of the alarm with the highest priority detected during the one-minute trend sampling interval.
  • Page 151 Trends Technical Code Condition – – – Lower measuring range exceeded (IBP, ST) Upper measuring range exceeded (HR, ST, IBP, PLS, etCO , RRc, Rsp, Multigas) Artifact (ECG, Rsp); Multigas Data Invalid Blocked Line, Cuff Leak, Open Line, Overpres- sure (NBP) Fault (SpO , PLS, NBP, Multigas) Lead Off (ECG, Rsp, ST)
  • Page 152 Page 6-10 Infinity Gamma Series...

  • Page 153: Recordings

    7 Recordings Overview................. 7-2 Recorder Preparation............7-3 Assigning Network Recorders ..........7-6 Recording Waveforms ............7-7 Timed Recordings............7-7 Continuous Recordings ..........7-8 Recording Formats ............7-9 Recording Trends..............7-11 Recording Alarms..............7-13 Stored Recordings .............. 7-14 Event Recall..............7-14 Saving, Printing, Deleting Stored Recordings .... 7-16 Recording Status Messages..........

  • Page 154: Overview

    Overview You can connect a Dräger R50 Series 2-channel strip-chart recorder to the monitor in order to print out monitoring data, including trends and alarm data. If your monitor is part of the Infinity network, recordings can also be printed on a centrally located recorder or laser printer assigned to the bedside (see the section Assigning Recorders).

  • Page 155: Recorder Preparation

    Recordings Recorder Preparation Connect the R50 Series recorder to the interface plate at the back of the monitor or to the Infinity Docking Station, if available. CAUTION: Always place recorders and laser printers on a flat and stable surface to prevent them from falling. NOTES: The configuration/installation of a network laser printer is a Service function.
  • Page 156 STEPS: Loading Paper 1. Press and release the top right button to open the paper door of the recorder. 2. Pull out the paper roll from the spool holder and any paper remaining in the printing mechanism. 3. Place a new paper roll into the spool holder. Unroll a few inches of paper from the bottom.
  • Page 157 Recordings 4. Align the paper roll with the paper guides. If not aligned, the paper could jam. 5. Close the paper door. 6. To verify proper connection and paper loading, generate a timed recording. CAUTIONS: Use only the recording paper specified by Dräger. Use of other paper will result in unclear printing and damage to the print- ing head.

  • Page 158: Assigning Network Recorders

    Assigning Network Recorders For monitors connected to the Infinity network, you can choose a primary and secondary recorder/laser printer within the network. The monitor sends a recording request first to the primary record- ing device. If that device is busy or unavailable (i.e. out of paper), the monitor sends the request to the secondary recording device.

  • Page 159: Recording Waveforms

    Recordings Recording Waveforms To print real-time monitoring data, two types of recordings are available: Timed Recordings. Continuous Recordings. For both recording types, the recording speed is 25 mm/s. Timed and continuous recordings include up to two waveforms. If one of the waveforms is hidden by a menu, you can still request a recording.

  • Page 160: Continuous Recordings

    Continuous Recordings Continuous recordings provide an up-to-the-second printout of patient data. This mode is useful when more than 20 seconds of data must be printed during critical, short-term applications. NOTES: You can request a continuous recording during an alarm, timed, trend, and diagnostic log recording.

  • Page 161: Recording Formats

    Recordings Recording Formats A timed or continuous recording consists of a header and two waveforms with proper scales, units of measure and parameter labels. R50 Recording Strip Printout of Laser Printer Infinity Gamma Series Page 7-9...
  • Page 162 The printout is identified by the following: Patient name and ID. Bed label and Care Unit. Date and time of the recording request. Recording delay and speed. Monitored parameters and values. Crossed bell symbol for parameters whose alarm is disabled. Recording mode (timed or continuous).

  • Page 163: Recording Trends

    Recordings Recording Trends Trend printouts are long-term records of heart rate and other patient vital signs. The printouts are snapshots of the tableor graphs as displayed when you press the fixed key on the Record monitor. Trend parameters are printed in the order selected by the user. In addition, parameter trend data is printed only if valid trend data is available for that parameter in the tabular trend columns or in the graphical trend window.
  • Page 164 STEPS: Recording the Trend Table 1. Display the Trend Table. 2. Press the fixed key on the monitor. The illustration Record below shows a typical trend table recording strip. STEPS: Recording Trend Graphs 1. Display the Trend Graph. 2. Press the fixed key on the monitor.

  • Page 165: Recording Alarms

    Recordings Recording Alarms The monitor initiates a timed recording for life-threatening alarms and limit violations provided that: The parameter is being monitored. The parameter alarm is enabled. The parameter alarm recording is enabled. A recorder/printer is available. Turn parameter alarms and alarm recordings on or off on the or the tables (see the chapters Alarm Limits...

  • Page 166: Stored Recordings

    Stored Recordings The monitor can store up to 10 alarm or timed recordings consist- ing of 20 seconds of data each (about 10 seconds of pre-event/ request data and about 10 seconds of post-event/request data.) Recordings are stored when: No recorder/laser printer is available or if the recorder/laser printer is temporarily out of order (i.e.
  • Page 167 Recordings NOTES: You can also access the Event Recall screen via the Fast Access fixed key or by clicking on Monitor Setup > Record- ings > Review in the Main Menu. The Event Recall screen shows only 4 seconds of data for each stored recording, although the monitor has actually stored 20 seconds of data for each stored recording.

  • Page 168: Saving, Printing, Deleting Stored Recordings

    Saving, Printing, Deleting Stored Recordings You can save, print or delete stored recordings via the Event Recall screen. The monitor allows you to permanently save up to 9 stored recordings. A saved recording cannot be deleted and it is marked by a padlock icon. STEPS: Saving a Stored Recording 1.

  • Page 169: Recording Status Messages

    Recordings Recording Status Messages The monitor displays messages during a recording to help you follow the progress of a recording and to alert you to any operational errors. Message Possible Cause Recorder Door Open Close door to obtain recordings. Recorder Failure Recorder error;...
  • Page 170 Page 7-18 Infinity Gamma Series...

  • Page 171: Ecg And Heart Rate

    8 ECG and Heart Rate Overview................. 8-2 Patient Preparation..............8-3 Selecting and Preparing the Electrodes ......8-3 Preparing the Patient’s Skin ........... 8-3 Positioning the Electrodes..........8-5 ECG Monitoring Settings ............8-8 Cable Type ................8-8 Lead Selection and Display Amplitude ......8-9 Cascade Display.............

  • Page 172: Overview

    Overview The monitor can: Display one or two ECG leads. Calculate the average heart rate per minute. Identify a number of arrhythmia events, including asystole, ventricular fibrillation, bradycardia, and ventricular tachycar- dia (see the chapter Arrhythmia). Analyze ST segment deviations for the displayed ECG leads (option -- see the chapter ST-Segment Analysis).

  • Page 173: Patient Preparation

    ECG and Heart Rate Patient Preparation Selecting and Preparing the Electrodes There is a wide selection of reusable and prepackaged, pre-gelled, and disposable electrodes to choose from. Always select the best electrode for your particular monitoring situation. Because of their stability, the use of Ag/AgCl reusable or disposable electrodes is recommended.
  • Page 174 3. Remove the outer epidermal layer as required to reduce skin impedance. Mildly abrade only the electrode contact site with ultrafine sandpaper (220-400 grit). Apply the electrodes one at a time and make sure the electrode gel is in contact with the abraded skin area.

  • Page 175: Positioning The Electrodes

    ECG and Heart Rate Positioning the Electrodes Position the electrodes on the chest at locations that provide the clearest and most informative electrocardiogram for each patient. The following table identifies each lead and its associated color for the IEC 2 (AHA/US) and IEC 1 color schemes. Lead IEC 2 (AHA/US) IEC 1...
  • Page 176 3-Lead MCL1 Configuration NOTE: Select ECG I in the waveform channel for monitoring the MCL1 configuration. 5-Lead Standard Configuration Page 8-6 Infinity Gamma Series...
  • Page 177 ECG and Heart Rate 6-Lead Standard Configuration 3-Lead Configuration for Neonates When monitoring neonates, the use of a 3-lead configuration is recommended. Dräger also recommends use of the N ™ Pod for neonates. Position the right arm (RA), left arm (LA) and left leg (LL) electrodes as illustrated below.

  • Page 178: Ecg Monitoring Settings

    ECG Monitoring Settings Cable Type This option lets you select the number of leads connected to your patient. This is particularly important when monitoring with a 5- or 6-lead cable set to ensure the proper detection and display of augmented leads. NOTE: If an augmented lead was displayed when switching from a 5-lead or 6-lead cable to a 3-lead cable set, the monitor defaults to the display of lead II.

  • Page 179: Lead Selection And Display Amplitude

    ECG and Heart Rate Lead Selection and Display Amplitude Select the lead(s) that provides the clearest and most informative electrocardiogram for your patient. The selection lets you Size modify the amplitude of the displayed ECG for optimum view- ing. The available ECG sizes are: 0.25, 0.5, 1, 2, 4, and 8 mV/cm.

  • Page 180: Cascade Display

    Cascade Display The electrocardiogram displayed in the first channel is about four seconds long. To display eight seconds of the same waveform, select the cascade mode. Cascade mode continues the display of the first waveform channel into the second channel. NOTES: The Cascade is only available in the second waveform channel.

  • Page 181: One- Or Two-Channel Signal Processing

    ECG and Heart Rate One- or Two-Channel Signal Processing The monitor can process one or two ECG leads. If you select two- channel signal processing, ECG and arrhythmia monitoring is less vulnerable to artifact, because the monitor can assign a greater weight to the “cleaner”...

  • Page 182: Pulse Tone Source

    Pulse Tone Source You can select either ECG or SpO as the pulse tone source. With ECG as the pulse tone source, the tone’s pitch is constant (rather than modulated -- see the chapter Pulse Oximetry) and a pulsating ♥ symbol appears in the HR parameter box with each detected heart beat.

  • Page 183: Pulse Tone Volume

    ECG and Heart Rate Pulse Tone Volume When ECG is selected as the pulse tone source, the monitor emits a tone every time it detects a QRS complex. You can adjust this tone volume and choose one of the following settings: High, Medium, Low, and OFF.

  • Page 184: Pacer Detection

    Pacer Detection Pacer detection is used for paced patients in the adult and pediat- ric monitoring modes. The monitor detects paced pulses in the amplitude range of ±5 to ±700 mV. When pacer detection is enabled, the letter “P” is added to the flashing ♥ symbol in the HR parameter box for each paced beat.

  • Page 185: Displaying Sync Marks

    ECG and Heart Rate Displaying Sync Marks The timing of the sync pulse triggered by the QRS complex can vary slightly. You can display sync marks on the R-wave of the electrocardiogram to verify the timing of the pulse. The monitor displays sync marks as a white line during synchro- nization.

  • Page 186: Ecg And Hr Safety Considerations

    ECG and HR Safety Considerations HR Alarm Settings Set HR alarm limits on the Alarm Limits table (see the chapter Alarms and Messages). If you turn the HR alarm off, the monitor displays a crossed bell icon in the HR parameter box and the ban- appears above the first waveform channel.

  • Page 187: Electrosurgery (Esu)

    ECG and Heart Rate Electrosurgery (ESU) The monitor’s ECG function is protected against high-frequency interference from defibrillators and electrosurgical units. The ESU B (optional) enhances the performance of the monitor LOCK during electrosurgery and allows you to use standard ECG leads. It reduces noise on ECG tracings and helps protect the patient from burns.
  • Page 188 WA RN I N G S: Dräger recommends using the ESU block during electrosurgery. If you do not have an ESU block, use only Dräger blue ECG lead wires. They help protect the patient from burns caused by ESU-induced cur- rent flowing through the leads.

  • Page 189: Infusion Pumps

    ECG and Heart Rate Infusion pumps Use of an infusion pump may cause artifact in ECG signals. To determine if the pump is the source of electrical interference in the signal, turn it off, if possible. If the artifact disappears, it was probably caused by the pump.

  • Page 190: Pacemakers

    To obtain the most accurate heart rate count, do the following: Follow the steps outlined for pacemaker patients, selecting the lead with the highest R-wave relative to the T-wave and the P-waves or both. If inaccurate counting continues, reposition the electrodes until you obtain an acceptable waveform.

  • Page 191: Av Sequential Or Ddd Pacemakers

    ECG and Heart Rate AV Sequential or DDD Pacemakers For pacemaker patients, follow these steps: Always attach at least four electrodes to allow for a choice of leads. Turn pacer detection on. Select the lead with the highest R-wave and the least interfer- ence.

  • Page 192: Large Amplitude Pacer Pulses

    Large Amplitude Pacer Pulses WA RN I N G : Some pacemakers, especially external pacemakers, emit pulses with amplitudes far exceeding those shown in the pacer pulse rejection table. The mon- itor may misinterpret such pulses as valid QRS com- plexes and may fail to detect cardiac arrest.
  • Page 193 9 Arrhythmia Overview................. 9-2 Turning Arrhythmia Monitoring ON ........9-4 Arrhythmia Setup ..............9-5 Rate and Count..............9-6 Arrhythmia Alarms............9-6 Arrhythmia Alarm Recordings ........9-7 Relearning a Patient’s ECG ..........9-7 Arrhythmia Classification Expert (ACE) The Infinity Gamma Series monitor uses Dräger’s ACE (Arrhythmia Clas- sification Expert) technology to screen out misleading or erroneous arrhyth- mia information.

  • Page 194: Overview

    Overview Arrhythmia monitoring is available for adult and pediatric patients. The arrhythmia monitoring mode you select (Basic, Full, or OFF) determines which kinds of arrhythmia events the monitor detects (see table below). NOTES: Full arrhythmia monitoring is available as an option and must be enabled by your Biomed.
  • Page 195 Arrhythmia Arrhythmia Monitoring Modes Label Event Description OFF: The monitor detects these events when Arrhythmia = OFF (via ECG) Asystole 4 seconds pass without the detection of a valid QRS complex Ventricular The monitor identifies a sinusoidal waveform Fibrillation with fibrillation characteristics Basic: The monitor detects these additional events when Arrhythmia = Basic Ventricular N* or more consecutive PVCs with a beat-to-...

  • Page 196: Turning Arrhythmia Monitoring On

    Turning Arrhythmia Monitoring ON STEPS: Turning Arrhythmia Monitoring On/Off 1. Click on the parameter box. 2. Click on More... 3. Click on Arrhythmia 4. Select the desired setting ( ) and click the Basic Full knob. NOTES: If a continuous recording is in progress when you turn arrhyth- mia monitoring on, printing stops and the recording is can- celed.

  • Page 197: Arrhythmia Setup

    Arrhythmia Arrhythmia Setup The Arrhythmia Setup table lets you set Rate and Count limits for certain arrhythmia parameters and turn alarms and alarm record- ings on or off. Call up the Arrhythmia Setup table as follows: 1. Click on the parameter box.

  • Page 198: Rate And Count

    Rate and Count STEPS: Selecting Rate and Count Limits 1. Call up the table (see above). Arrhythmia Setup 2. Click on the limit in the column for the Rate Count desired arrhythmia parameter. 3. Dial in the desired limit and click the knob. NOTE: You can change limits only for VT, BRDY (rate only), SVT, TACH, and PAUS (rate only).

  • Page 199: Arrhythmia Alarm Recordings

    Arrhythmia Arrhythmia Alarm Recordings STEPS: Turning Alarm Recordings On/Off 1. Call up the table (see above). Arrhythmia Setup 2. Click on the recording setting in the column of the Record desired arrhythmia parameter. 3. Dial in the desired setting ( , or Record Store...
  • Page 200 STEPS: Relearning the Patient’s ECG 1. Make sure that the ECG leads are properly connected and that the ECG displayed seems normal for this patient. 2. Click on the parameter box. 3. Click on More... 4. Click on Relearn NOTE: You cannot initiate a relearning, if arrhythmia monitoring is turned off.

  • Page 201: 10 St Segment Analysis

    10 ST Segment Analysis Overview................10-2 ST Monitoring Display............10-3 ST Setup ................10-4 Isoelectric and ST Measuring Points ......10-5 ST Reference Complex ..........10-7 ST Alarms................10-8...

  • Page 202: Overview

    Overview The monitor provides an option for ST segment analysis, avail- able for the adult and pediatric monitoring modes. When acti- vated, this option analyzes the patient’s normal QRS pattern and determines values for ST segment deviation (i.e., how far the ST segment of the QRS complex is above or below the isoelectric line).

  • Page 203: St Monitoring Display

    ST Segment Analysis ST Monitoring Display The monitor performs the ST segment analy- sis on the two leads selected for ECG moni- toring. If the ECG leads monitored are not currently displayed, the monitor processes the signal on the last ECG lead(s) selected. When the ST option is enabled, and the mon- itor is set for adult or pediatric monitoring mode, the ST1 and ST2 values are continuously displayed in the ST parameter box.

  • Page 204: St Setup

    ST Setup Call up the ST Setup menu by clicking on the ST parameter box. For each ST lead selected, the ST Setup menu displays the fol- lowing: ST Segment Waveform — Includes the last averaged QRS complex. The label and scale of the ST waveform appear on the left side of the waveform.

  • Page 205: Isoelectric And St Measuring Points

    ST Segment Analysis Isoelectric and ST Measuring Points ST segment deviations are specified in terms of a displacement above or below the isoelectric level. To calculate this displace- ment, the monitor compares the amplitudes of the signal at two user-selectable measurement points in the patient’s QRS wave- form.
  • Page 206 STEPS: Setting the Isoelectric and ST Measuring Points 1. Click on the parameter box. 2. Click on . Two vertical lines, indicating the location of the ISO and the ST measurement points, appear in the ST waveform channels. 3. With the rotary knob, move the position of the ISO point to the desired location and click the knob.

  • Page 207: St Reference Complex

    ST Segment Analysis ST Reference Complex The averaged ST segment waveform(s) displayed in the ST menu can be saved as reference complexes. The reference waveforms can then be superimposed on the current ST segment waveform to highlight changes in the ST segment since the last save. Upon saving, the reference complex is time-stamped and available for display.

  • Page 208: St Alarms

    ST Alarms Set ST alarm limits on the Alarm Limits table (see the chapter Alarms and Messages). The default ST segment deviation alarm limits are +1.0 mm (or +0.10 mV) for the upper limit and -1.0 mm (or -0.10 mV) for the lower limit. However, adjustments to the upper and lower alarm limit settings must be made based on careful clinical evaluation.
  • Page 209 11 Respiration Monitoring Overview................11-2 Patient Preparation.............. 11-3 Selecting and Preparing the Electrodes ...... 11-3 Preparing the Patient’s Skin ......... 11-3 Electrode Placement for Respiration Monitoring..11-3 Respiration Monitoring Display ......... 11-5 Displaying Respiration Data ......... 11-6 Rsp Display Channel ............. 11-7 Resp Display Amplitude ..........

  • Page 210: Overview

    Overview NOTE: The Rsp parameter box is not displayed when you first enable the ST, IBP2, or the etCO or Multigas locked options. Rsp monitoring can be restored, however, when you select Show Rsp in the Main Screen menu (see below). The monitor measures impedance respiration by passing a harm- less high-frequency current between two ECG electrodes on the patient's chest.

  • Page 211: Patient Preparation

    Respiration Monitoring Patient Preparation Selecting and Preparing the Electrodes Proper selection and preparation of the ECG electrodes is impor- tant for effective respiration monitoring. See the chapter ECG and Heart Rate for information on preparing and placing elec- trodes. Preparing the Patient’s Skin Follow the recommended instructions given in the chapter ECG and Heart Rate.
  • Page 212 NOTE: If you are using this electrode placement for monitoring respiration, lead I and II will be compromised for monitoring ECG. Page 11-4 Infinity Gamma Series...

  • Page 213: Respiration Monitoring Display

    Respiration Monitoring Respiration Monitoring Display You can display the respiration waveform in one of the bottom display channels. NOTES: The monitor has a total of three or, as an option, four waveform display channels. For more information, contact your Dräger representative.

  • Page 214: Displaying Respiration Data

    Displaying Respiration Data If the ST, IBP2, and either the etCO or Multigas locked options are enabled, you can call up the Rsp display from the Main Screen menu as follows: STEPS: Displaying Respiration Data 1. Press the fixed key. Menu 2.

  • Page 215: Rsp Display Channel

    Respiration Monitoring Rsp Display Channel Display the Rsp Waveform in one of the bottom display channels as follows: STEPS: Selecting the Rsp Display Channel 1. Click on the desired waveform channel. 2. Click on Waveform 3. Select and click the knob. Infinity Gamma Series Page 11-7...

  • Page 216: Resp Display Amplitude

    Resp Display Amplitude option lets you increase or decrease the amplitude of the Size respiration waveform. In manual breath detection sensitivity mode (see the section Selecting the Rsp Mode, below), the detec- tion sensitivity is based on the selected waveform amplitude. Available amplitude settings are: 10% to 100%, in increments of 10% (default 50%) WA RN I N G : In Manual Mode, if you set the size of the...

  • Page 217: Respiration Monitoring Settings

    Respiration Monitoring Respiration Monitoring Settings Rsp Mode To enable respiration monitoring, select the Auto or Manual Res- piration Monitoring Mode. In Auto mode, the monitor adjusts the breath detection sensitivity to the strength of the respiration signal, adjusting it over several minutes.

  • Page 218: Resp Markers

    Resp Markers When you turn respiration markers on, the monitor displays a spike on the respiration waveform every time it detects a valid breath. (Respiration markers are not printed.) If breath detection occurs on a clipped portion of the waveform (as when the wave- form exceeds the waveform channel’s selected size), respiration is still detected and marked.

  • Page 219: Apnea Time

    Respiration Monitoring Apnea Time The monitor detects apnea in all monitoring modes provided an apnea time is selected in the menu. Apnea times are: 10 to 30 seconds, in increments of 5. Upon detection of an apnea event and after the selected apnea time has elapsed, the monitor triggers a serious alarm.

  • Page 220: Coincidence Alarm

    Coincidence Alarm The coincidence alarm alerts you when the respiration rate is within 20% of the heart rate over three consecutive breaths. This alarm indicates that the monitor may be counting heart beat arti- facts as respiration signals. The monitor alarms and displays the message Coincidence if the coincidence alarm is turned on.

  • Page 221: Relearning A Patient's Respiration Pattern

    Respiration Monitoring Relearning a Patient’s Respiration Pattern When respiration monitoring is enabled and set to , the mon- Auto itor takes about one minute to automatically learn the patient's respiration pattern. You can initiate a new learning phase at any time.

  • Page 222: Rsp Safety Considerations

    Rsp Safety Considerations WA RN I N G S: Do not rely upon impedance respiration monitoring as the sole method for detecting the cessation of breathing. Patients at risk for respiratory distress should be observed closely and heart rate alarms should be enabled and set appropriately.

  • Page 223: Oxycrg Monitoring (Neonatal Option)

    Respiration Monitoring OxyCRG Monitoring (Neonatal Option) The monitor offers a neonatal Oxycardiorespirogram (OCRG or OxyCRG) provided the option is enabled on your monitor (for more information, see your Dräger representative). Neonatal OxyCRG is a non-invasive procedure to display a beat-to-beat heart rate (bbHR) trend, an SpO trend, and a respiration wave- form simultaneously on a dynamically updated display.
  • Page 224 STEPS: Displaying the OCRG Waveforms 1. Click on the channel. second third waveform 2. Click on Waveform 3. Select and click the knob. OCRG STEPS: Adjusting the OCRG Waveform Size 1. Click on the channel. third waveform 2. Click on Size 3.

  • Page 225: Ocrg Recordings

    Respiration Monitoring OCRG Recordings The monitor can print OCRG alarm and manual recordings, if OCRG waveforms are displayed. OCRG recordings show the second and the third waveform channels (not the first channel). An apnea event triggers an OCRG alarm recording, which includes 108 seconds of pre-apnea OCRG data and 36 seconds of post-apnea OCRG data.
  • Page 226 Page 11-18 Infinity Gamma Series...

  • Page 227: 12 Pulse Oximetry

    12 Pulse Oximetry Overview................12-2 Sensor Application.............. 12-2 SpO2 Safety Considerations ..........12-4 SpO2 Monitoring Display............ 12-5 SpO2 Display Channel........... 12-5 SpO2 Display Amplitude ..........12-6 Cascade Display............. 12-7 SpO2 Monitoring Settings ..........12-8 Pulse Tone Source............12-8 Pulse Tone Volume ............12-9 Signal Strength Bar Graph ..........

  • Page 228: Overview

    Overview Pulse Oximetry monitoring is a non-invasive procedure to deter- mine the functional oxygen saturation of the patient’s arterial blood (SpO ) and an accompanying pulse rate. A sensor is attached to the patient (usually the finger) and mea- sures the absorption of light by the oxyhemoglobin. The light sent through the tissue is transformed into a signal that is processed by the monitor.
  • Page 229 Pulse Oximetry STEPS: Applying the Sensor 1. Select a sensor that is best suited for your patient (type and size, see the list of available sensors in the appendix Options and Accessories). 2. Clean reusable sensors before and after each use. 3.

  • Page 230: Spo2 Safety Considerations

    Safety Considerations WA RN I N G S: During electrosurgery, use only Dräger SpO shielded extension cables with a blue locking mecha- nism to protect from ESU interference. Check sensors periodically (recommended is at least every four hours). Move the sensor if there is any sign of skin irritation or impaired circulation.

  • Page 231: Spo2 Monitoring Display

    Pulse Oximetry Monitoring Display The quality of the pulse waveform and the SpO values are an indication that the sensor is attached to the patient correctly. In most clinical situations, the waveform is displayed in the second or third channel in order to view the electrocardiogram in the first channel during SpO monitoring.

  • Page 232: Spo2 Display Amplitude

    Display Amplitude option lets you modify the amplitude of the displayed Size waveform for optimum viewing. The available sizes are 10% to 100%, in increments of 10% (default 50%). STEPS: Selecting the SpO Display Amplitude 1. Click on the channel. waveform 2.

  • Page 233: Cascade Display

    Pulse Oximetry Cascade Display The pulse waveform is about four seconds long. To display eight seconds of the same waveform, select the Cascade display mode. NOTES: The second channel of a cascaded pulse waveform cannot be printed on recordings. The Cascade display is only available in the second waveform channel.

  • Page 234: Spo2 Monitoring Settings

    Monitoring Settings Pulse Tone Source You can select either ECG or SpO as the source for the pulse tone. When SpO is the pulse tone source, the pitch of the tone is modulated according to O blood saturation levels. A tone occurs with each pulse detected via the SpO signal.

  • Page 235: Pulse Tone Volume

    Pulse Oximetry Pulse Tone Volume When SpO is selected as the tone source, the pulse tone changes with the level of arterial oxygen saturation. Low saturation levels result in low pitched tones; high saturation levels result in high pitched tones. If SpO is selected as the tone source but is not cur- rently being measured, no pulse tones are heard.

  • Page 236: Signal Strength Bar Graph

    Signal Strength Bar Graph The monitor can display a pulsing bar graph. The number of illuminated segments is propor- tional to the pulse amplitude. Proper sensor placement and environmental conditions ensure a strong signal. Refer to the section Sensor Application for details. STEPS: Displaying the Signal Strength Bar Graph 1.

  • Page 237: Averaging Mode

    Pulse Oximetry Averaging Mode The monitor calculates the oxygen saturation of the arterial blood and the derived pulse rate based on the averaging mode you select in the SpO menu. The two modes are Normal and Fast. The Normal averaging mode updates the SpO value and the derived pulse rate in 30 seconds or less.
  • Page 238 Page 12-12 Infinity Gamma Series...

  • Page 239: 13 End-Tidal Co2

    13 End-Tidal CO2 Overview................13-2 etCO2 Source............... 13-3 etCO2 Display ..............13-4 Monitoring Preparations ............. 13-6 Connecting Sensor and etCO2 Pod ......13-6 Attaching the Capnostat and Airway Adapter..... 13-6 Calibrating the Sensor and Adapter......13-10 etCO2 Monitoring Settings ..........13-12 Averaging Mode ............13-12 RRc Apnea Time............

  • Page 240: Overview

    Overview The Infinity Gamma Series monitor measures concentrations of end-tidal CO (etCO ) when this option is enabled and the etCO pod or a Scio multigas module is connected to your monitor. (Ordering information about these options is available from your Dräger representative.) The etCO pod can perform mainstream measurements in all monitoring modes and sidestream measure-...

  • Page 241: Etco2 Source

    End-Tidal CO2 Inspired CO (iCO ) — The level of CO in the airway dur- ing inspiration. Taken as the minimum value during the pre- vious measurement interval. The current value for iCO displayed in the etCO parameter box. Respiration Rate (RRc) — The patient’s respiration rate; derived from the etCO signal by calculating an average rate over the eight most recent breaths.

  • Page 242: Etco2 Display

    etCO Display The etCO parameter box displays the current values for etCO , iCO and RRc. A lung icon appears next to the RRc parameter label and blinks every time a breath is detected. If the Scio module is the signal source, the parameter labels are marked with an asterisk (*).
  • Page 243 End-Tidal CO2 Display Channel and Waveform Amplitude You can display the etCO waveform in one of the lower wave- form channels. The option lets you modify the display Size amplitude of the etCO waveform for optimum viewing. The available sizes are: 40, 60, 80, 100 mmHg (5, 8, 10, 12, kPa or %) STEPS: Selecting the etCO Display Channel and...

  • Page 244: Monitoring Preparations

    Monitoring Preparations Connecting Sensor and etCO 1. Connect the Capnostat sensor to the etCO2 pod as shown. 2. Connect the etCO2 pod to the monitor as shown. NOTE: For mainstream measurements, the Capnostat snaps over an adapter inserted into the patient’s airway. For sidestream mea- surements, the Capnostat snaps on the nasal sampling cannula tub- ing (see below).
  • Page 245 End-Tidal CO2 Mainstream Monitoring In mainstream monitoring mode, the patient is intubated with an endotracheal tube that is connected to a ventilator (see below). STEPS: Mainstream Monitoring Setup 1. Select a mainstream airway adapter. Make sure the windows are clean and dry. Clean or replace the adapter if necessary. 2.
  • Page 246 Sidestream Monitoring (Adult and Pediatric Modes Only) Sidestream monitoring is appropriate for non-intubated patients or for intubated patients who are breathing spontaneously. A pump in the etCO pod draws air through the Capnostat, which samples the patient’s inspired and expired air as it passes a nasal sampling cannula.
  • Page 247 End-Tidal CO2 NOTE: Dehumidification and cannula tubing can affect the cali- bration of the airway adapter. If you change to different combina- tions or lengths of cannula and dehumidification tubing, perform an adapter calibration. 5. Snap the sensor into the airway adapter. Align the mark on the bottom of the adapter with the mark on the bottom of the sen- sor.

  • Page 248: Calibrating The Sensor And Adapter

    Calibrating the Sensor and Adapter Before etCO monitoring, you need to calibrate the Capnostat sensor and airway adapter so that the etCO pod can compensate for the specific characteristics of sensor and adapter. Sensor Calibration In most cases, you need to calibrate the Capnostat sensor only when you connect it to a particular etCO pod for the first time.
  • Page 249 End-Tidal CO2 You can now use the sensor. If the verification fails, the monitor again displays the message etCO Place Sensor on Zero Cell. Adapter Calibration Perform an adapter calibration every time you switch adapter types (e.g., mainstream to sidestream or adult to neonatal). You do not normally have to calibrate an adapter if you are replacing it with another of the same type.

  • Page 250: Etco2 Monitoring Settings

    etCO Monitoring Settings Averaging Mode The monitor displays the highest etCO measurement calculated during a specified interval. enables you to set this Averaging interval to Instantaneous, Breath, 10 seconds, or 20 seconds. The default is 10 seconds. Choose (i.e., one etCO measure- Breath ment for each breath) for patients whose breathing patterns are...

  • Page 251: Rrc Apnea Time

    End-Tidal CO2 RRc Apnea Time The monitor can detect apnea in all monitoring modes based on changes in exhaled CO values. Apnea times are: 10 to 30 seconds in increments of 5 or OFF NOTE: In neonatal monitoring mode, the Apnea alarm is on by default.

  • Page 252: Balance

    Balance The monitor assumes a default oxygen concentration of 21% (the percentage of oxygen in ambient air) for all etCO measurements. If the patient is receiving supplemental oxygen or an anesthetic agent, you must select the gas being administered (available set- tings are N , >60% O , and Heliox).

  • Page 253: Measuring Mode

    End-Tidal CO2 Measuring Mode Configure the etCO pod for mainstream or sidestream monitor- ing as follows. STEPS: Selecting the Measuring Mode 1. Click on the parameter box. etCO 2. Click on More... 3. Click on Meas. Mode 4. Select the desired measurement mode ( ) and Main Side...
  • Page 254 STEPS: Setting Anesthetic Agent Compensation 1. Click on the parameter box. etCO 2. Click on Exp. Agent Insp. Agent 3. Select the desired compensation and click the knob. Page 13-16 Infinity Gamma Series...

  • Page 255: Atmospheric Pressure Compensation

    End-Tidal CO2 Atmospheric Pressure Compensation The monitor can automatically detect the ambient barometric pressure and compensate for it during etCO measurements. Alternatively, you can enter atmospheric pressure values manu- ally. Current barometric pressure values appear next to the Atm. selection in the etCO parameter box.
  • Page 256 STEPS: Entering Atmospheric Pressure Values Manually 1. Click on the parameter box. etCO 2. Click on More... 3. Click on Atm. Pressure 4. Dial in the current barometric pressure value. NOTE: Atmospheric pressure values can be read from a barometer or obtained by calling the closest weather station.

  • Page 257: Etco2 Alarms

    End-Tidal CO2 etCO2 Alarms The monitor alarms for the following etCO parameters: etCO alarm (critical levels of CO saturation in the exhaled breath). alarm (critical levels of CO saturation in the inhaled breath, or rebreathing). RRc alarm (significant changes in the respiratory rate, derived from the capnogram waveform).
  • Page 258 Page 13-20 Infinity Gamma Series...
  • Page 259 14 Multigas Overview................14-2 Connections................. 14-3 Gamma XL with Scio............14-3 The Scio Module ..............14-4 Warm-Up ................. 14-6 Site of Operation ............14-6 Installing/Removing the Water Trap......14-7 Connecting Sampling Lines and Power Cord ..... 14-7 OR Mode................14-9 CO2 Display and Setup..........

  • Page 260: Overview

    Overview NOTES: Multigas monitoring is only available for the monitor Gamma XL (not for the monitor Gamma). Multigas monitor- ing is a locked option and restricted to those clinical sites that have the corresponding gas monitoring capabilities and deliv- ery systems in place. Multigas monitoring is only available in the Adult and Pediat- ric monitoring modes.

  • Page 261: Connections

    Multigas Connections Gamma XL with Scio Standalone Monitor Connect the intermediate cable’s 15-pin serial connector to con- nector X2 on the back of the Scio module. Connect the cable’s other end to connector X5 on the monitor’s rear-panel interface plate. NOTE: When the Scio module is connected to the monitor’s inter- face plate, data collection via the export protocol is not available.

  • Page 262: The Scio Module

    The Scio Module The Scio module is a free-standing unit that samples breathing gases from adult and pediatric patients in non-, partial- and total rebreathing systems at a sample flow rate of 150 ±20 ml/min. The module measures inspiratory and expiratory gases and communi- cates both real-time and derived gas information to the monitor.
  • Page 263 Multigas Scio Module: Front and Rear Panels Water Trap External Power Indicator Fan Filter Exhaust Port Connector for External Power Supply NOTES: The presence of organic cleaning solutions or gases containing freon may adversely impact the accuracy of the Scio module. Mechanical shocks during the measurement or the presence of other paramagnetic agents can distort measured values of oxy- gen concentration.

  • Page 264: Warm-Up

    Warm-Up Upon start-up, the Scio module passes through an initialization and warm-up period. During this time, concentrations for certain gases may not be available and the anesthetic agent may not be identified. Scio achieves full accuracy after a warm-up period of about 5 minutes.

  • Page 265: Installing/Removing The Water Trap

    Multigas The Gamma XL and the Scio module must both be con- nected to a hospital outlet (USA: hospital-grade outlet) within the same medically used room. When the Gamma XL is used with the Scio module, it meets the Class A limits of CISPR11. The system is not intended for connection to public mains.
  • Page 266 NOTES: Sampling lines and T-connectors to the patient’s airway are not reusable. They must be replaced under the following condi- tions: -- A new patient is connected to the module. -- The cleanliness of the tubing/connector is suspect. Use only Dräger-approved sidestream sampling lines. Dräger does not assume responsibility for the reliability and safety of Scio measurements, if non-approved tubing is used.

  • Page 267: Or Mode

    Multigas OR Mode NOTE: Multigas monitoring is available only for monitors Gamma XL in the OR mode. The OR mode is available only for the adult and pediatric patient categories. STEPS: Selecting the OR Mode 1. Verify that the adult or pediatric patient category is selected. 2.
  • Page 268 NOTES: The following display/monitoring restrictions apply in the OR mode: The ST parameter box is not available and deviations in the ST segment are neither monitored nor saved in the trend storage. The NBP parameter box is only available when two ECG waveforms occupy the top two waveform channels.

  • Page 269: Co2 Display And Setup

    Multigas CO2 Display and Setup The CO parameter box displays the inspired and expired values for CO in Vol%. If CO alarms are disabled, crossed-bell icons appear next to the corresponding parameter values. In OR mode, the etCO waveform is always displayed in the bottom waveform channel.

  • Page 270: Multigas Display And Setup

    Multigas Display and Setup The multigas parameter box displays the inspired and expired values in Vol% for O O, and for one of the anesthetic agents hal- othane (HAL), isoflurane (ISO), enflurane (ENF), sevoflurane (SEV), or desflurane (DES), if present. The multigas parameter box does not show alarm limits, but shows an alert icon next to the O...
  • Page 271 Multigas Agent Override The Multigas Setup menu allows you to select a specific agent for display, thereby overriding the automatic agent detection. How- ever, if Scio cannot detect the specified agent, the monitor blanks the agent values in the parameter box. If Scio detects a different agent, the monitor also displays a status message indicating the detected agent.
  • Page 272 Autozero Delay The Scio module is self-zeroing. It automatically initiates zeroing of its gas sensors against room air about every 2 hours. During zeroing, the monitor does not update the displayed Scio parame- ter values on the screen. If zeroing cannot be completed within 25 seconds, the monitor blanks the Scio parameter values and dis- plays an error message (see the chapter Alarms and Messages).

  • Page 273: Non-Invasive Blood Pressure

    15 Non-Invasive Blood Pressure Overview................15-2 Cuff Selection and Placement ..........15-4 NBP Safety Considerations........... 15-5 NBP Measurements............. 15-6 Single Measurements ............ 15-6 Interval Mode ..............15-6 Inflation Mode..............15-8 Measurement Tone ............15-10 NBP Measurements in OR Mode........15-11 NPB Alarms................ 15-12...

  • Page 274: Overview

    Overview WA RN I N G S: Before non-invasive blood pressure moni- toring, please read the safety information in the section NBP Safety Considerations, below. WA RN I N G S: Before monitoring neonates and infants: Select the correct cuff size for your patient. Select the neonatal or pediatric patient category in the Patient Admit menu.
  • Page 275 Non-Invasive Blood Pressure If the pulse signal is poor due to patient movements, improper cuff placement or noise in the signal, the cuff deflates and the monitor attempts a second measurement. For causes and possible remedies for a poor pulse signal see the alarm message tables in the chapter Alarms and Messages.

  • Page 276: Cuff Selection And Placement

    Cuff Selection and Placement The quality of NBP monitoring depends largely on the quality of the signals received by the monitor. For this reason, it is impor- tant to select the correct cuff size for your patient. Cuff sizes are clearly marked on the cuff.

  • Page 277: Nbp Safety Considerations

    Non-Invasive Blood Pressure NBP Safety Considerations WA RN I N G S: Changes in the cuff position relative to the heart level affect measurements. If the cuff is not placed at heart level, add +1.4 mmHg for each 2 cm above the heart and subtract -1.4 mmHg for each 2 cm below the heart.

  • Page 278: Nbp Measurements

    NBP Measurements Single Measurements The monitor gives you two options for taking NBP measure- ments: Taking single NBP measurements. Selecting the Interval Mode to take NBP measurements auto- matically at specific time intervals. NOTE: After an NBP measurement, the valves are opened to ensure that all residual pressure is released from the cuff.
  • Page 279 Non-Invasive Blood Pressure STEPS: Taking NBP Interval Measurements 1. Press and hold the key, NBP Start/Stop 1. Click on the parameter box. 2. Click on Interval Mode 3. Select the desired interval and click the knob. NOTES: When you press and hold the NBP Start/Stop key to turn the Interval Mode on, the interval time is the one that was previ- ously selected.

  • Page 280: Inflation Mode

    As soon as you turn the interval mode on, the monitor starts an NBP measurement. A bar graph appears in the NBP parameter box to indicate the time left until the start of the next measurement. In addition to measurements in the automatic cycle, you can take a single measurement at any time.
  • Page 281 Non-Invasive Blood Pressure STEPS: Selecting the Inflation Mode 1. Click on the parameter box. 2. Click on Inflation Mode 3. Select the desired inflation mode and click the knob. WA RN I N G : In neonatal monitoring mode, a blood pres- sure higher than the inflation range may activate the “NBP Cannot Measure”, “NBP No Pulsation”, or “NBP Mean Only”...

  • Page 282: Measurement Tone

    Measurement Tone The end of an NBP measurement can be indicated by an end-of- measurement tone (2 beeps). The loudness of the tone depends on the setting for the monitor’s speaker volume. If the volume is turned off, the tone does not sound. STEPS: Turning the Measurement Tone ON/OFF 1.

  • Page 283: Nbp Measurements In Or Mode

    Non-Invasive Blood Pressure NBP Measurements in OR Mode In the OR mode (see the chapter Multigas), the NBP parameter box only appears on the screen when two ECG waveforms occupy the top two waveform channels. If the NBP parameter box is not displayed, you cannot take NBP measurements. STEPS: Displaying NBP in the OR mode 1.

  • Page 284: Npb Alarms

    NPB Alarms Turn NBP alarms on or off and set alarm limits on the Alarm Limits table (see the chapter Alarms and Messages). If alarms are on, the monitor alarms for limit violations as well as patient movements, improper placement of the cuff and overpressure conditions.

  • Page 285: 16 Invasive Blood Pressure

    16 Invasive Blood Pressure Overview................16-2 Invasive Pressure Labels............ 16-3 IBP Display................16-4 Display Channel and Waveform Amplitude....16-4 Selecting and Preparing the Transducer ......16-6 Zeroing and Calibration Check ........16-7 Zero and Calibration Check Troubleshooting ..... 16-9 Calibrating Reusable Transducers......16-10...

  • Page 286: Overview

    Overview During invasive blood pressure monitoring (IBP), the monitor measures arterial and venous blood pressures and Displays one or two pressure waveforms continuously (the monitoring of two invasive pressure parameters is available as an option). Calculates systolic, mean, and diastolic invasive blood pres- sures values.

  • Page 287: Invasive Pressure Labels

    Invasive Blood Pressure Invasive Pressure Labels STEPS: Selecting the Invasive Pressure Label 1. Click on the IBP1 parameter box. 2. Click on Label 3. Select the appropriate pressure label for your monitoring ses- sion and click the knob. Infinity Gamma Series Page 16-3...

  • Page 288: Ibp Display

    IBP Display The monitor measures pressure in millimeters of mercury (mmHg) or kilo pascals (kPa), and can display up to two pressure waveforms in the lower display channels. The pressure parameter boxes show the following information: Parameter label (e.g., ART). Systolic pressure value (e.g., 125).
  • Page 289 Invasive Blood Pressure STEPS: Selecting the IBP Display Channel and Waveform Amplitude 1. Click on the desired waveform channel. 2. Click on Waveform 3. Select the desired pressure parameter and click the knob. 4. Click on Size 5. Select the desired display amplitude and click the knob. NOTE: The Channel setup menu makes only those pressure labels available which have been selected for the monitoring session in the IBP setup menu (or the default GP1/GP2).

  • Page 290: Selecting And Preparing The Transducer

    Selecting and Preparing the Transducer WA RN I N G S: Never re-use a single-use (disposable) transducer. Dräger approved transducers provide protection for the patient against burns during electrosurgery or defibrillation. Use of non-approved transducers may compromise this protection. The quality of pressure monitoring depends on the quality of the signals received by the monitor.

  • Page 291: Zeroing And Calibration Check

    Invasive Blood Pressure Zeroing and Calibration Check field in the IBP setup menu: Zero Displays the date and time of the last zeroing procedure. Allows you to zero the pressure transducer before entering a calibration factor. NOTE: Before zeroing, make sure the transducer is at heart level. It is necessary to zero the transducer immediately after the intro- duction of the catheter in the patient’s vascular system and before monitoring.
  • Page 292 STEPS: Zeroing and Entering a Cal. Factor 1. Click on the IBP1 parameter box. 2. Re-align the transducer to the patient’s heart level. 3. Close the transducer stopcock to the patient. 4. Open the venting stopcock to air (atmosphere). The monitor displays a flat waveform and a static IBP condition for the systolic (S) value.

  • Page 293: Zero And Calibration Check Troubleshooting

    Invasive Blood Pressure Zero and Calibration Check Troubleshooting Screen Message Possible Cause Suggested Action IBP Cannot Zero, • The transducer offset is • Verify the pressure cable con- outside the zero balance nection to the monitor. IBP Zero Time-out range of +/- 190 mmHg •...

  • Page 294: Calibrating Reusable Transducers

    Calibrating Reusable Transducers You must calibrate reusable invasive blood pressure transducers with the mercury manometer within five minutes after zeroing. Note: This procedure is for reusable transducers only. STEPS: Calibrating the IBP Transducer 1. Zero the pressure transducer via the IPB setup menu. 2.
  • Page 295 17 Temperature Overview................17-2 Temperature Probes............17-3 Placing the Probe............17-3...

  • Page 296: Overview

    Overview The monitor supports the use of temperature probes for oral, rec- tal and axillary applications. The monitor accepts one probe at a time and displays absolute temperature values in degrees Celsius C) or in degrees Fahrenheit ( NOTES: Selecting the unit of measure is a password-protected function. See your Biomed for details.

  • Page 297: Temperature Probes

    Temperature Temperature Probes A wide selection of reusable and disposable thermistor probes is available. Use only Dräger-approved probes (see the appendix Options and Accessories); other probes are not recommended and may produce inaccurate measurement results. Placing the Probe Rectal Probes To place the probe, follow the clinical techniques of your hospi- tal.
  • Page 298 Page 17-4 Infinity Gamma Series...
  • Page 299 A Options and Accessories This appendix lists Dräger-approved options and accessories for use with the Infinity Gamma Series monitors. To place an order, please contact your local Dräger representative. Monitoring in the wireless network requires series access points and wireless LAN PC cards.

  • Page 300: Options

    Options ST Segment Analysis ......55 94 978 E533U Second Invasive Blood Pressure Parameter (IBP2) ..55 86 578 E533U Neonatal OxyCardiorespirogram (OCRG) .

  • Page 301: Ecg

    Options and Accessories 6™ pod ....... . 51 91 221 E530U ULTI accommodates: ECG 3- 5-, and 6-lead patient cables...

  • Page 302: Pulse Oximetry (Spo2

    Miscellaneous ECG ECG electrodes, Neonatal, disposable, 300 pcs..51 95 024 E530U ECG electrodes, disp., 50 pcs......45 27 750 EH405 ECG adhesive rings, large, 500 pcs.
  • Page 303 Options and Accessories MASIMO LNOP-DCIP, pediatric ..... . 72 70 304 E530U pediatric sensor for finger or toe application Patient weight 10-50 kg (22-110 lb.) MASIMO LNOP-YI, adult/pediatric/neonatal .

  • Page 304: End Tidal Co2 (Etco2

    MASIMO LNOPNEO SS, neonatal....74 96 966 E530U neonatal sensor for sensitive skin application Patient weight < 10 kg (22 lb.) Extension Cables Nellcor extension cable, shielded, blue latch, 1 m .

  • Page 305: Multigas

    Options and Accessories Mainstream Accessories etCO Capnostat III sensor, 2.4 m cable....43 22 975 E530U etCO airway adapter, adult Calibration and Reference Cell Cable clip, 5 each etCO Airway Adapter, adult .

  • Page 306: Temperature

    Temperature Adapter Cable Temp adapter cable ....... 51 98 333 E530U WA RN I N G : Temperature probe protective covers con- tain latex.
  • Page 307 Options and Accessories IBP transducer, OHMEDA, dispos., 5 pcs....45 28 741 EH407 IBP intermediate cable, OHMEDA ....33 75 933 E530U 3.7m pressure intermediate cable to connect reusable/ disposable OHMEDA transducers to monitor...

  • Page 308: Non-Invasive Blood Pressure (Nbp

    Non-invasive Blood Pressure (NBP) Reusable Cuffs NP cuff, child 12-19 cm ......28 66 676 EH50U NP cuff, small adult, 17-25 cm .
  • Page 309 Options and Accessories Power Cords Power Cord Cont. Europe, CEE7 ..... 43 21 712 E530U Power Cord North America, 5-15R ....43 21 720 E530U Power Cord Australia, China and New Zealand, AS 3112 .

  • Page 310: Displays And Display Components

    Displays and Display Components Planar Video Display 15-inch Planar D6015TM......59 55 567 E531U A 15-inch Flat Panel display that replicates the screen of the bedside monitor Adapter Cable, 3 m .

  • Page 311: Recorder

    Options and Accessories Wall Mount ........47 20 152 E530U Mount for 15-inch Remote Display;...

  • Page 312: Miscellaneous

    IDS/CPS Power Supply Rollstand Bracket....47 20 103 E530U Docking Station Wall Mount ......‘ 47 20 111 E530U Docking Station Clamp Mount .
  • Page 313 B Cleaning, Disinfecting, Sterilizing Cleaning, Disinfecting and Sterilizing ........ B-2 Monitor ................B-2 Patient Cables ..............B-3 Reusable ECG Electrodes ..........B-3 Reusable SpO2 Sensor........... B-4 NBP Cuff ................B-4 Temperature probes and cables........B-4 Reusable Pressure Transducers and Cables ....B-5 Cleaning etCO2 Pod and Accessories .......

  • Page 314: Cleaning, Disinfecting And Sterilizing

    Cleaning, Disinfecting and Sterilizing Clean the monitor and all accessories after each patient or daily according to your hospital’s standard procedures. We recommend the following cleaning solutions and procedures. CAUTION: Do not use disinfectants that contain phenol as they can spot plastics. Do not autoclave or clean accessories with strong aromatic, chlorinated, ketone, ether, or ester solvents.

  • Page 315: Patient Cables

    Cleaning, Disinfecting, Sterilizing Patient Cables Clean the patient cables with a gauze pad moistened with a soap solution. Dry thoroughly with a lint-free cloth. To disinfect patient cables, wipe the cables with a gauze moistened with diluted alcohol or a gluteraldehyde-based dis- infectant.

  • Page 316: Reusable Spo2 Sensor

    Reusable SpO Sensor See the cleaning instructions and recommendations provided with the sensor. NBP Cuff Wipe the NPB cuff with a cloth moistened with soap and water or a solution based on household bleach (1:10), gluteraldehyde, alcohol, or phenol. CAUTION: The NBP cuff can be immersed in cleaning solution, but do not allow the solution to enter the NBP hose.

  • Page 317: Reusable Pressure Transducers And Cables

    Cleaning, Disinfecting, Sterilizing CAUTION: Never boil or autoclave the cable. Vinyl withstands temperatures up to 100 °C but begins to soften at around 90 °C. Handle gently when hot and wipe away from the tip toward the cable. Reusable Pressure Transducers and Cables CAUTION: Observe the following precautions when cleaning or sterilizing all pressure accessories.
  • Page 318 STEPS: Sterilizing with Ethylene Oxide 1. Clean the transducer and dome. 2. Loosely coil the cable before packaging it. 3. Sterilize at a temperature not exceeding 45°C following your hospital procedures. 4. After sterilization, follow standard degassing procedure and aerate the probe for 24 hours. STEPS: Sterilizing with Fluid 1.

  • Page 319: Capnostat Sensor

    Cleaning, Disinfecting, Sterilizing Cleaning etCO Pod and Accessories There are several accessories used with the etCO pod, each with its own cleaning requirements. Capnostat Sensor Clean the sensor surfaces, including the sensor windows, with a damp cloth. Dry with a clean, lint-free cloth, making sure the sen- sor windows are clean and dry.
  • Page 320 Preparatory Steps The following fluids are acceptable for cleaning/sterilization: Isopropyl alcohol. A 5.25% water solution (by weight) of sodium hypochlorite (bleach). A locally approved sterilant. In addition, you need the following items: A 60 cc catheter-tip syringe. A 2-foot section of 1/8- or 3/16-inch tubing to drain off fluid after it passes through the etCO pump.
  • Page 321 Cleaning, Disinfecting, Sterilizing Cleaning/Sterilizing Procedure To clean and sterilize the sidestream pump: 1. Fill the 60cc catheter-tip syringe with cleaning/sterilizing fluid, and fix it to the sidestream input connector on the etCO pod. 2. Flush the fluid slowly through the pumping system and out through the tubing connected to the exhaust port.
  • Page 322 3. Block the sidestream input port with your finger for several seconds and then unblock it. Repeat at least ten times. 4. Move your finger to the sidestream output port and block the port with your finger for several seconds and then unblock it. Repeat at least ten times.

  • Page 323: Scio Module And Accessories

    Cleaning, Disinfecting, Sterilizing Scio Module and Accessories WA RN I N G S: Occupational safety hazared: Used sampling tubing, T-connectors, and water traps could be contaminated and must be handled and disposed of with care. Infection hazard may be present. Dispose of these items in accordance with local regulations.

  • Page 324: Cleaning/Replacing The Fan Filter

    Cleaning/Replacing the Fan Filter The fan filter should be cleaned once per month and replaced at least once a year. STEPS: Cleaning/Replacing the Fan Filter 1. Grasp the fan filter and remove it from its holding slots on the back of the module. Fan Filter 2.
  • Page 325 C Default Settings and Biomedical Support Default Settings ..............C-2 Biomedical Support............C-12 Startup Tests ..............C-13 Checking the NBP Calibration ........C-14 Biomed Menu..............C-15 Saving a Patient Setup ..........C-16 Locked Options and Demo Mode ........ C-17 Diagnostic Logs ............C-18 Changing Units of Measure..........

  • Page 326: Default Settings

    Default Settings The first section of this appendix list the default settings for the monitor. These settings are programmed into the monitor as you receive it from the factory, and are used by the monitor until the user changes them. The first three columns in the following table show these settings for adult, pediatric, and neonatal monitoring modes.
  • Page 327 Default Settings and Biomedical Support After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Alarm Saved Setup Alarm Limits 120/45 150/50 180/80 Saved Setup (upper/lower) Alarm Recording Previous Patient Tone Source Previous Patient Tone Volume Medium Medium Medium Previous Patient...
  • Page 328 After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? ST Segment Analysis* ST Measurement Beat offset Beat offset Factory Point +80ms +80ms ST Isoelectric Beat onset Beat onset Factory Point -28ms -28ms ST Alarm Saved Setup Alarm Limits +1.0mm/ +1.0mm/ Saved Setup...
  • Page 329 Default Settings and Biomedical Support After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Insp. Agent Previous Patient Exp. Agent Previous Patient Balance Previous Patient Averaging Previous Patient Meas. Mode Main Main Main Saved Setup RRc Apnea 15 seconds 15 seconds Saved Setup...
  • Page 330 After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Multigas Alarm Saved Setup Alarm Recording Saved Setup Alarm Limits Saved Setup in vol% 18/100 18/100 (upper/lower) 10/100 10/100 i/etHal, i/etHal, i/etISO, i/etISO, i/etENF: i/etENF: i/etSEV: i/etSEV: i/etDES: i/etDES: 0/20 0/20...
  • Page 331 Default Settings and Biomedical Support After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? PLS Alarm Limits 120/45 150/50 170/80 Saved Setup (upper/lower) Temperature Alarm Saved Setup Alarm Limits 39/34 °C 39/34 °C 39/34 °C Saved Setup (upper/lower) 102.0/93.2 102.0/93.2...
  • Page 332 After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? IBP1, IBP2 Alarm Saved Setup Alarm Limits Saved Setup (upper/lower) • Systolic • 160/90 • 160/90 • 120/50 • Mean • 125/60 • 125/60 • 85/40 • Diastolic •...
  • Page 333 Default Settings and Biomedical Support After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Channel 1 Waveform ECG II ECG II ECG II Saved Setup Size ECG: 1mV/ ECG: 1mV/ ECG: 1mV/ Saved Setup : 50% : 50% : 50% Channel 2 Waveform...
  • Page 334 After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Channel 4* Display Parameter Parameter Parameter Saved Setup Boxes Boxes Boxes OR Mode Dis- etCO etCO play* waveform waveform plus CO plus CO and Multigas and Multigas parameter parameter boxes boxes...
  • Page 335 Default Settings and Biomedical Support After patient Adult Pediatric Neonatal discharge, Settings Settings settings Settings return to...? Biomed (password-protected settings) Units Previous Patient • T • °C • °C • °C • etCO • mmHg • mmHg • mmHg • etCO in OR •...

  • Page 336: Biomedical Support

    Biomedical Support This section of the appendix is designed for the Biomedical per- sonnel of your hospital. It includes an overview of the Biomed menu, basic setup, saving setups, diagnostic functions, and cali- bration check procedures for NBP. This appendix is not a substi- tute for the Infinity Gamma Series Service Manual that is available from Dräger.

  • Page 337: Startup Tests

    Default Settings and Biomedical Support Startup Tests The monitor runs internal tests continuously and upon power up to check various functions, as well as the integrity of both ROM and RAM memories. If any of the tests fail, the monitor resets and displays a message (see the following table).

  • Page 338: Checking The Nbp Calibration

    Checking the NBP Calibration parameter box gives you access to the NBP Calibration mode. These checks must be performed in Adult Mode only. STEPS: NBP Calibration 1. Click on the parameter box. 2. Click on Calibration Mode 3. Select and click the knob. 4.

  • Page 339: Biomed Menu

    Default Settings and Biomedical Support Biomed Menu The Biomed menu gives you access to basic setup and mainte- nance tasks. The Biomed and the Service menus are password- protected. The Biomed menu gives you access to the following functions: — to save the current configuration of alarm Save Setups limits and display options.

  • Page 340: Saving A Patient Setup

    Saving a Patient Setup You can save and re-use the current monitoring configuration. This saved configuration is automatically restored when a new patient of the same category (e.g., pediatric) is admitted. The monitor saves the following settings: Waveform channel assignments and scales, alarm limits and on/off status, IBP pres- sure labels, arrhythmia monitoring settings (adult or pediatric mode only), respiration mode and markers, apnea time, coinci- dence alarm, etCO...

  • Page 341: Locked Options And Demo Mode

    Default Settings and Biomedical Support Locked Options and Demo Mode The Locked Options menu gives you access to the Demo mode and to a number of monitoring options that are available for pur- chase. These options and their order numbers are listed in the appendix Options and Accessories.

  • Page 342: Diagnostic Logs

    To disable the Demo Mode, turn the monitor off and on again or enter the Standby mode and discharge the patient upon resuming monitoring. NOTES: Patient data transfer across the network of simulated data is not possible. If the monitor is connected to the network, disabling the demo mode at the bedside clears all data at the MultiView Worksta- tion.

  • Page 343: Changing Units Of Measure

    Default Settings and Biomedical Support 5. Click on Diagnostic Logs 6. The monitor displays the diagnostic log. Turn the rotary knob clockwise to scroll back to previous messages. Turn the knob counterclockwise to scroll forward to current messages. Changing Units of Measure You can change the units of measure for the following parame- ters: Temperature —...
  • Page 344 6. Change the units for the desired parameter and click the knob. 7. Click on New Patient? Yes Page C-20 Infinity Gamma Series...
  • Page 345 D Technical Data Overview................D-2 Regulatory Compliance ..........D-2 Basic System Components..........D-3 Monitoring Accessories ..........D-9 Monitoring Specifications ..........D-12...

  • Page 346: Overview

    Overview This appendix contains technical specifications for the physical and functional aspects of the Infinity Gamma Series patient mon- itor and its monitoring accessories. Upon request, Dräger makes technical information required for maintenance and/or calibration of serviceable items available to qualified technical personnel. For specifications of wireless monitoring accessories such as wireless LAN PC cards and access points, please refer to the doc- umentation of the wireless component’s manufacturer, Cisco Sys-...

  • Page 347: Basic System Components

    Technical Data Basic System Components Monitor — Base Unit Dimensions Gamma: 196 mm height (7.7 in) 249 mm width (9.8 in) 134 mm depth (5.3 in) Gamma XL: 196 mm height (7.7 in) 267 mm width (10.5 in) 147 mm depth (5.8 in) Weight Gamma: 3.42 kg (7.54 lb) with lead acid battery...
  • Page 348 Patient Leakage Current < 10µA @ 110 V and 60 Hz < 10µA @ 220 V and 50 Hz QRS Sync. Output Output will go high for 100 ms every time a QRS is detected. QRS detected: +12 V ±5%, 5.1 KΩ source impedance. Output low (no QRS): <...
  • Page 349 Technical Data Environmental requirements (Base Unit and AC Power Adapter) Cooling Convection and cooling chimney (no fan) Operating: 0 °C to +40 °C (without recorder) Temperature Storage: –20 °C to 50 °C Relative Humidity Operating: > 30% and < 95%, non-condensing Storage: >...
  • Page 350 Infinity Docking Station (IDS) Power Requirements 0.7 A @12 V with no devices attached Mains Frequency Mode of Operation Continuous Protection Class Dimensions 228 mm (w) x 210 mm (d) x 102 mm (h) (9” x 8.25” x 4”) Weight 2 kg (4.5 lbs) Environmental Require- Temperature:...
  • Page 351 Technical Data Infinity Docking Station (IDS) Power Supply 59 55 393 E530U CAUTION: This Power Supply has a switch used to select nominal line operating voltage. Make sure that the switch is in the correct position for your nominal voltage as indicated on the power supply itself.
  • Page 352 Infinity Docking Station (IDS) Power Supply (55 84 912 E530U and 59 49 271 E530U) Connections AC Power Connector, DC Power Cable/Connector, Potential Equalization Conductor Cooling Convection Dimensions 135 mm (w) x 111 mm (d) x 270 mm (h) (5.3” x 4.4” x 10.6”) Without mounting bracket the depth is 71 mm (2.8”).

  • Page 353: Monitoring Accessories

    Technical Data Monitoring Accessories etCO2 Pod Size (H x W x D) Pod: approx. 140 x 140 x 51 mm (5.5 x 5.5 x 2 in) Capnostat III Sensor (without cable) 33 x 42 x 22 mm (1.3 x 1.7 x 0.9 in.) Weight Pod: 1.1 lb or .5 kg Capnostat...
  • Page 354 Scio Multigas Module Size (H x W x D) 122 x 222 x 300 mm (4.8 x 8.7 x 11.7 in.) with watertrap Weight 3.0 kg (6.6 lbs) Cooling Mains Frequency 50/60 Hz Power Requirement < 0.8 A at 100-120 Vac; <0.4 A at 200-240 Vac ≤...
  • Page 355 Technical Data R50 N Network Recorder Dimensions 180 x 120 x 222 mm (7.1 x 4.72 x 8.74 in.) Weight 1.64 kg (3.6 lb) Connections AC Power Connector, Infinity Network, R50 Recorder, Potential Equalization Connector. Cooling Convection Input voltage range 100-240 VRMS Mains frequency 50/60 Hz...

  • Page 356: Monitoring Specifications

    Monitoring Specifications Accessories 3-,5-, and 6-Lead patient cable Input Connector 2-pin connector to MultiMed pod Input Parameters 3-Lead (RA, RL, LA and LL electrodes) 5-Lead (RA, RL, LA, LL and CHEST electrodes) 6-Lead (RA, RL, LA, LL and 2 CHEST electrodes) Number of Channels Sweep Speed 25 mm/s...
  • Page 357 Technical Data Degree of Protection Against Electric Shock Pacer Pulse Detection On active ECG lead Pacer Pulse Detection Amplitude: ± 5 to ± 700 mV Level Width: 0.1 to 2.0 ms Separation between pulses: ≥30 ms Recharge time constant: 4 to 100 ms Over/Undershoot: 0.025 a 2 mV maximum Lead Off Sensing Cur-...
  • Page 358 Respiration Method Impedance Pneumography Sensing Electrodes RA and LL (Lead II) Number of Channels Sweep Speed 6.25 mm/s Resolution 1 breath per minute Measurement Range 0 to 155 breaths per minute Measurement Accuracy ± 1 breath per minute, or ± 2%, whichever is greater Response Time After a step change in respiration rate, it takes 36 sec- onds to stabilize to a new respiration rate of 10 breaths...
  • Page 359 Technical Data etCO (continued) Measurement Range etCO : 0-100 mmHg : 0-10 mmHg RRc: 5-145 bpm Accuracy etCO : ±2 mmHg for 0-40 mmHg ±5% reading for 41-70 mmHg ±8% reading for 71-100 mmHg : ±2 mmHg RRc: 1 bpm Stable over 24 hours, over full range of readings at atmospheric pressure.
  • Page 360 etCO (continued) Degree of Protection Against Electric Shock Defibrillation Protection In accordance with IEC 601-1A2 Multigas Parameter Labels CO2, O2, N2O, HAL, ISO, ENF, SEV, DES Agents Monitored Halothane, Isoflurane, Enflurane, Sevoflurane, Des- flurane Measuring Methods CO2, N2O, Agents: Infrared Paramagnetic Sensor Display Inspired and expired concentrations (%) and...
  • Page 361 Technical Data Due to the response time of the sensors and the gas sample flow rate, the stated accuracy of O , CO O and the anesthetic agents is limited by the respiratory rate and by the inspiratory to expiratory ratio (I:E) as follows: For O measurements, accuracy is maintained up to a respiratory rate of 60 breaths/min.
  • Page 362 (1, 2, 3, 4) Measuring accuracy, Neonatal mode 0 to 69% not specified 70 to 100% sensor-specific as follows: Nellcor: N-25 ......................±3 Masimo: LNOPNEO, LNOPNEO SS, LNOP-YI............±3 Pulse Rate: ..........±3 beats/min or ±3% (whichever is less) Notes: 1) SpO accuracies are expressed as ±...
  • Page 363 Technical Data Temperature Input Connector 7-pin connector on MultiMed pod 0 °C to +50 °C (32 °F to 122 °F) Measurement Range Measurement Accuracy ±0.1 °C for a range of 0 °C to 50 °C Probe Accuracy ±0.1 °C for a range of 0 °C to 50 °C Total System Accuracy ±0.2 °C for a range of 0 °C to 50 °C Average Response Time...
  • Page 364 Measuring Range Heart rate: 30 - 240 bpm (Adult - 270mmHg) Systolic NBP: 30 - 250 mmHg Mean NBP: 20 - 230 mmHg Diastolic NBP: 10 - 210 mmHg Measuring Range Heart rate: 30 - 240 bpm (Adult - 180mmHg) Systolic NBP: 30 - 170 mmHg Mean NBP:...
  • Page 365 Technical Data Minimum Inflation Adult (270): 110 mmHg ±5 mmHg Pressure Adult (180): 90 mmHg ±5 mmHg Pediatric (180): 90 mmHg ±5 mmHg Pediatric (140): 70 mmHg ±5 mmHg Neonatal (both): 70 mmHg ±5 mmHg Maximum Measurement Adult (both): 2 min ±1 sec Time Pediatric (both): 2 min ±1 sec...
  • Page 366 Measurement Accuracy ±2 mmHg or ±3% (whichever is greater) after suc- cessful zero and calibration (exclusive of trans- ducer). Resolution 1 mmHg or 0.1 kPa ≤35 s (to reach 90% of the change of the lowest Response Time pulse rate of 25 1/min. Zero Balance Range ±190 mmHg Zero Resolution...

  • Page 367: Glossary

    Glossary The following list explains terms and abbreviations you may encounter while reading this guide. Alternating Current Arrhythmia Arterial Pressure Asystole Foot augmented lead Left arm augmented lead Right arm augmented lead Battery-backed memory The circuits inside the monitor that retain information after turning off the monitor.
  • Page 368 Gravity force Global recorder A recorder shared by many devices on the network. GP1, GP2 Generic Pressure1, Generic Pressure 2 Hour Hertz Intra Cranial Pressure Intensive Care Unit Infinity Docking Station Inches Infinity™ Docking Station A hardware component that provides the functional- (IDS) ity of both the CPS and the Docking Station.
  • Page 369 Glossary Minute millimeter mm/s Millimeter per second mmHg Millimeters of mercury Monitoring Unit Group of devices sharing patient data in a network installation. Millisecond Multigas Monitoring Monitoring of O , CO O, and of the anesthetic agents halothane, isoflurane, enflurane, sevoflurane, and desflurane with the a multigas module.
  • Page 370 PVC/min Premature Ventricular Contractions per minute R50 Series Recorder Recorder used to print a paper copy of patient data (alarms and waveforms). The R50 Series recorder connects to the bedside monitors via the interface plate, the CPS, or IDS. Right arm Right leg S or Sys Systolic pressure...
  • Page 371 INDEX life-threatening 15-12 1-20 AC adapter 5-8, 5-11 On/Off Accessories serious 5-11 silencing 13-10 Adapter, Airway 10-8 Admission 2-18 volume date Alarms menu 5-12 All Alarms Off name and ID Alternate Speed Key patient category Amplitude Adults Advisory Alarms 13-5 etCO2 13-15 Agent Compensation, etCO2...
  • Page 372 Calibration 13-10 etCO2 16-7 1-11 Back Panel C-14 13-14 Balance, etCO2 13-8 Cannula, etCO2 Bar Graph cleaning 15-8 13-4 Capnogram 12-10 SpO2 13-2, 13-6 Capnostat 1-20, 2-4 Battery cleaning charging 4-14 Card gauge 4-13 for transfer inserting into monitor 4-14, 4-15 Card Copy lead acid 3-12...
  • Page 373 14-2 Display 11-12 Coincidence Alarms screen brightness 1-15, 1-16 Colors Discharge of electrodes Disinfecting Communication Power Supply cables Compensation electrodes 13-15 agent monitor 13-17 atmospheric pressure sidestream pump Components, of network temperature probes 13-14 1-15 Composition Values, etCO2 Display Conductive Parts battery gauge 2-12 Configuration, see Setup...
  • Page 374 14-2 Enflurane ESU, see electrosurgery etCO2 accessories arrhythmia functions 13-10 adapter cables 13-15 agent compensation 8-10 cascade 13-6 airway adapter display amplitude 13-14 airway gases electrode colors 13-19 alarms electrode placement 13-12 averaging mode functions 13-14, 13-15 balance 8-8, A-3 leads 13-4 capnogram...
  • Page 375 Inspection, monitor 13-3 Inspired CO2 13-2 Instantaneous CO2 1-26 Fast Access Menu 1-14, 7-3 Interface Plate 1-18 Fixed Keys, monitor operation 15-6 Interval Mode, NBP 1-10 Front Panel Invasive Blood Pressure, see IBP 10-5 Isoelectric Point, ST 14-2 Isoflurane 16-2 GP1, pressure 16-2 GP2, pressure...
  • Page 376 1-12 Masimo left side panel C-12 sensors and cables line frequency MCL1 ECG Config. maintenance 1-19, 1-24 Mean Pressure menus 16-4 2-10 On/Off 15-2 peripherals 13-15 1-21 Measurement Mode,etCO2 pods 15-10 1-20 Measurement Tone, NBP power sources 10-5 Measuring Point, ST regulatory compliance A-14 1-13...
  • Page 377 15-4 connector 15-4 15-8 cuff placement mode 15-4 cuff selection 15-8 inflation limit 15-6 interval mode 14-2 15-10 measurement tone 1-18, 2-10 On/Off 15-6 measurements A-1, C-17 Options 1-32 menu 14-9 OR Mode 15-2 neonatal monitoring 1-24 Overview, menus 15-5 safety 11-15 OxyCRG...
  • Page 378 Patient Setup C-16 saving 2-20 Patient Setup, saving QRS Amplitude 4-10 Patient Transfer 8-15 QRS Sync Marks 3-15 wireless 8-13 QRS Tone Volume Pediatric Patients 1-4, 1-9 Peripheral Equipment 3-10 Pick and Go 1-22 R50 Recorder A-12 Planar Video Display A-13 Rails Rate, Arrhythmia...
  • Page 379 1-23 15-2 Remote Displays NBP (neonates) 8-16 Respiration neonatal ECG 11-11 8-19 apnea time P/T-Waves 11-12 1-6, 8-20, 8-21 coincidence pacemakers 11-6 display peripheral devices 11-3 11-14 electrode placement respiration 11-2 functions site of operation 11-10 12-4 markers SpO2 1-29 17-3 menu temperature probes...
  • Page 380 10-5 recordings isoelectric point 2-20, C-16 10-5 saving measuring point 10-4 1-31 menu 10-7 trend reference complex 3-11 10-4 wireless network setup 14-2 C-19 Sevoflurane units 11-6 Show Rsp ST Segment Analysis, see ST Sidestream Accessories Standards 2-19 Sidestream Pump, cleaning Standby 13-8, 13-15 2-10...
  • Page 381 Tone 15-10 NBP tone 12-8 pulse tone source 1-23 VGA displays 12-9 pulse tone volume 2-18, 8-13 Volume 8-12 Tone Source 12-9 pulse tone 2-18 Tone Volume Transducer types of A-13 Wall Mount 16-6 Transducer, IBP 2-11 Waveform Configuration 16-10 calibrating 3-12 Wireless Card...
  • Page 382 Index-12 Infinity Gamma Series...
  • Page 384 In the United States: Draeger Medical Systems, Inc. 16 Electronics Avenue Danvers, MA 01923-1079 Tel: (978) 907-7500 Fax: (978) 907-3398 In all other countries: Dräger Medical AG & Co. KGaA Moislinger Allee 53-55 23558 Lübeck Germany Tel: +49 18 05 3 72 34 37 11/2003 / KR Printed in the United States of America Dräger Medical reserves the right to make modifications to equipment without prior notice.

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