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Novametrix Medical Systems CO2SMO User Manual

Etco2/spo2 monitor
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CO
SMO
2
User's Manual
ETCO
/SpO
Monitor
2
2
Model 7100
May 1, 1998
Catalog No. 5758-23-04
Novametrix Medical Systems Inc.
5 Technology Drive, Wallingford, Connecticut, U.S.A. 06492.
Copyright © 1993, 1998. All rights reserved. No part of this manual may be reproduced
without the written permission of Novametrix Medical Systems Inc.

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  • Page 1 May 1, 1998 Catalog No. 5758-23-04 Novametrix Medical Systems Inc. 5 Technology Drive, Wallingford, Connecticut, U.S.A. 06492. Copyright © 1993, 1998. All rights reserved. No part of this manual may be reproduced without the written permission of Novametrix Medical Systems Inc.
  • Page 3 Revision History 23-Jul-93 Revision 00. 27-Apr-93 Revision 01, this manual is based on software version 2.1. 18-Jun-93 Revision 02 (DN-N1247). 21-Sep-94 Revision 03. Includes versions 1.9 and 2.8 software, Disposable Adult Airway Adapter, and CAPNOSTAT III references. 01-May-98 Revision 04. R-N563 Declaration of Conformity with European Union Directive The authorized representative for Novametrix Equipment is: D.R.M.
  • Page 4 [This page intentionally blank.] Operator’s Guide Rev. 04...
  • Page 5 Copyright © 1993, 1998, Novametrix Medical Systems Inc. This document contains information which is proprietary and the property of Novametrix Medical Systems Inc., and may not be reproduced, stored in a retrieval system, translated, transcribed, or transmitted, in any form, or by any means, without prior explicit written permission from Novametrix Medical Systems Inc.
  • Page 6 Service Policy Novametrix Medical Systems Inc. will provide Warranty Service Support to its customers within 48 hours of receiving a telephone request for technical support. This 48 hour period begins once a service request is placed through the Factory Technical Support Department in Wallingford, Connecticut.

  • Page 7: Table Of Contents

    Contents About This Manual ......................1 Acknowledgments ......................... 1 Introduction .........................3 Principles of Operation ......................3 Principles of Operation ......................4 Front Panel Controls and Connectors .................... 5 POWER Keys ......................... 6 AC Mains Operation ....................... 6 Battery Operation ......................6 AUDIO Key ........................
  • Page 8 Sampling Airway Adapter ......................25 Non-Intubated Patients ....................25 Calibration ........................... 27 Sensor Calibration ......................27 Calibration Verification ....................27 Adapter Calibration ...................... 28 Monitoring CO and Respiratory Rate ................29 Carbon Dioxide ........................... 29 End Tidal CO 2 ............................29 Oxygen Compensation ....................
  • Page 9 IABP Mode ..........................56 Making IABP Mode Available ..................56 Turning IABP Mode On/Off ..................57 Using IABP Mode ......................57 Alerts ..........................59 Overview ............................. 59 Limit Alerts ..........................59 Auto Alert Limits ........................60 ETCO2 Auto Alert Limits .................... 61 Respiratory Rate Auto Alert Limits ................
  • Page 10 Capnogram or Plethysmogram Waveform Printout ............. 90 Zoom Trend Printout ....................90 Compressed Trend Printout ..................91 Interpreting Printer Output ......................92 Header ........................... 92 Graphical Data ......................94 Histogram Data ......................94 Tabular Data Format ..................... 94 Capnogram or Plethysmogram Waveform Format ............95 External Devices .......................
  • Page 11 Additional Features ........................116 Accessories ........................117 CO2SMO Capnograph and Pulse Oximeter ................117 Typical Capnogram Waveforms ..................123 Normal Waveform ........................123 Cardiogenic Oscillations ......................123 Hypoventilation ........................124 Hyperventilation ........................124 Muscle Relaxants ........................125 Rebreathing ..........................125 Obstruction in Breathing Circuit or Airway ................126 Endotracheal Tube Kinked .......................
  • Page 12 SMO User’s Manual Rev. 04...

  • Page 13: About This Manual

    Acknowledgments CAPNOSTAT is a registered trademark and , SuperBright, Y-Sensor and Y-Strip are trademarks of Novametrix Medical Systems Inc. Other trademarks and registered trademarks are owned by their respective companies. U.S.A. and foreign patents pending. Rev. 04 SMO User’s Manual...
  • Page 14 Acknowledgments [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 15: Introduction

    Section 1 Introduction The Novametrix ETCO /SpO Monitor, Model 7100, is a lightweight, easy to use, combination capnograph and pulse oximeter monitor designed for use in a variety of clinical settings. It provides reliable measurement, display and alerts for, end tidal carbon dioxide (ETCO ), respiration rate, functional pulsatile oxygen saturation (SpO ) and pulse rate.

  • Page 16: Spo Principles Of Operation

    Section 1 Principles of Operation Principles of Operation measures oxygen saturation and pulse rate with sensors that contain red and infrared light sources, called LEDs. Since oxygen saturated blood absorbs different amounts of light at each wavelength (red and infrared) as compared to unsaturated blood, the amount of light absorbed by the blood in each pulse can be used to calculate oxygen saturation.

  • Page 17: Front Panel Controls And Connectors

    Introduction Front Panel Controls and Connectors Front Panel Controls and Connectors 15 14 Press to turn CO SMO on, or if on, press to turn (Contrast). Press to adjust display contrast for optimum viewing. off ETCO portion of monitor. Press in combination with to turn unit off.

  • Page 18: Power Keys

    Section 1 Front Panel Controls and Connectors POWER Keys To turn on, press either the key. To turn the monitor off, press both the keys. NOTE SMO powers up as a combined ETCO /SpO monitor. If only the capnograph or pulse oximeter portion is going to be used, the unused half can be disabled to avoid nuisance alerts and error messages.

  • Page 19: Audio Key

    Introduction Front Panel Controls and Connectors life remain. Note: The battery icon may appear fully charged for the first minute after switching to battery power: wait one minute for the icon to truly reflect battery charge. When approximately 15 minutes of battery life remains, the front panel LOW BAT indicator starts to flash.

  • Page 20: The Menu Softkeys

    Section 1 Front Panel Controls and Connectors The Menu SOFTKEYS The Menu Center display area is located just above the five unmarked “softkeys”. Softkeys perform the action displayed above each key. For example; above the rightmost softkey in the Main (or Base) Menu is a MENU key.

  • Page 21: Contrast Key

    Introduction Front Panel Controls and Connectors waveform to the NOVACARD. Pressing will bring up the patient ID menu. The softkey will ERASE erase the card. Pressing will return to real time display. CONTRAST Key Press the (contrast) key to adjust the display for optimum viewing. WAVEFORM Key Press key to display the capnogram, plethysmogram, or dual waveform.

  • Page 22: Rear Panel Controls And Connectors

    Section 1 Rear Panel Controls and Connectors Rear Panel Controls and Connectors Input Connector The SpO Sensor plugs into this connector. CAUTION Connect only Novametrix SuperBright SpO sensors to the CO SMO SpO Input Connector. Do not use other SpO sensors with CO SMO.

  • Page 23: Patient Safety

    Section 2 Patient Safety Input is electrically isolated. Patient leakage current flowing from the instrument to ground is limited to less than 10 µA at 120 VAC, 60 Hz. Patient isolation is greater than 10 MΩ, 2500 VAC rms at 60 Hz. Indications and Usage ETCO Monitor, Model 7100, is intended to be used for monitoring end tidal CO...

  • Page 24: Cautions

    Section 2 Cautions • is not intended to be used as a primary diagnostic apnea monitor and/or recording device. • Inspect the SpO sensor site often for adequate circulation - at least once every four hours. When applying sensors take note of the patient’s physiological condition. For example, burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate.
  • Page 25 Patient Safety Cautions Do not store the monitor or sensors at temperatures less than 14° F (-10° C) or greater than 131° • F (55° C). Do not operate the monitor or sensors at temperatures less than 50° F (10° C) or greater than 104° •...
  • Page 26 Section 2 Cautions [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 27: Monitor Power Up

    Section 3 Monitor Power Up This section explains how to turn the on and off. It also explains AC Mains and battery power operation. Monitor Power Up Verify CAPNOSTAT CO and SpO Sensor integrity. Ensure sensors and their extension cables are physically intact with no broken, frayed or damaged components.

  • Page 28: Monitor Power Down

    Section 3 Monitor Power Down Monitor Power Down To turn off, press both the keys. To turn off while only one parameter is active, press the power key associated with the active parameter. AC Mains Operation uses AC Mains (line cord) power if available and automatically switches to battery operation if AC Mains power is removed or not present.

  • Page 29: Capnostat Co 2 Sensor

    Section 4 CAPNOSTAT CO Sensor This section explains how to select an airway adapter based on the patient to be monitored, connect the airway adapter to the CAPNOSTAT CO Sensor and to the patient’s airway circuit, and how and when to calibrate the airway adapter and sensor.
  • Page 30 Section 4 Adult Airway Adapter Press message appears. CAL. PLACE ON ADPT IN RM AIR Place the sensor and airway adapter away from all sources of CO (including the patient’s— and your own—exhaled breath, and ventilator exhaust valves). Press START. TIME REMAINING counts down and the Main Menu reappears.

  • Page 31: Single Patient Use Adult Airway Adapter

    CAPNOSTAT CO Sensor Single Patient Use Adult Airway Adapter To secure the sensor cable safely out of the way, attach Sensor Cable Holding Clips to the airway tubing, then connect the sensor cable to the clips (Cat. No. 8751). See “Monitoring CO and Respiratory Rate”...

  • Page 32: Single Patient Use Airway Adapter With Mouthpiece

    Section 4 Single Patient Use Airway Adapter with Mouthpiece Install the CAPNOSTAT CO Sensor/Airway Adapter assembly at the proximal end of the airway circuit between the elbow and the ventilator circuit wye. Shown with CAPNOSTAT Sensor Cat. No. 7167 Ventilator (may also use Cat.

  • Page 33: Neonatal Airway Adapter

    CAPNOSTAT CO Sensor Neonatal Airway Adapter ® Press the CAPNOSTAT Sensor onto the airway adapter. It will click into place when properly seated. The CAPNOSTAT CO Sensor cable should be facing away from the mouthpiece. Direction of sensor cable CAPNOSTAT CO Sensor Mouthpiece Airway adapter...
  • Page 34 Section 4 Neonatal Airway Adapter one Neonatal adapter to another Neonatal adapter. Adapter Calibration should also be performed if the monitor displays ADAPTER CAL? To perform an Adapter Calibration: Press message appears. PLACE ON ADPT IN RM AIR Place the sensor and airway adapter away from all sources of CO (including the patient’s—...

  • Page 35: Single Patient Use Neonatal Airway Adapter

    CAPNOSTAT CO Sensor Single Patient Use Neonatal Airway Adapter The sensor cable should face away from the patient. See “Monitoring CO and Respiratory Rate” on page 29. Single Patient Use Neonatal Airway Adapter The single patient use Neonatal Airway Adapter (Catalog No. 6312) should be used when monitoring ®...
  • Page 36 Section 4 Single Patient Use Neonatal Airway Adapter 3a. Press . “ ” message appears. PLACE ON ADPT IN RM AIR 3b. Place the sensor with airway adapter away from all sources of CO (including the patient’s - and your own - exhaled breath and ventilator exhaust valves.) 3c.

  • Page 37: Sampling Airway Adapter

    CAPNOSTAT CO Sensor Sampling Airway Adapter Sampling Airway Adapter The Sampling Airway Adapter with tubing (Catalog No. 5843) should be used in conjunction with a nasal sampling cannula to monitor non-intubated patients, and to provide sidestream monitoring of pediatric tracheostomy patients. Non-Intubated Patients Verify the windows are clean and dry.
  • Page 38 Section 4 Sampling Airway Adapter Press appears. PUMP SET SAMPLING PUMP Press to turn the sampling pump on (or press to turn the pump off). If necessary, perform an adapter calibration. Otherwise, skip this step. Adapter Calibration is necessary when the pump is first turned on; in order to set the sampling system alert thresholds, and to compensate for the unique optical characteristics of the sampling airway adapter.

  • Page 39: Calibration

    CAPNOSTAT CO Sensor Calibration Calibration Sensor Calibration The CAPNOSTAT CO Sensor does NOT require calibration at each monitor power up. Calibration of a particular CAPNOSTAT CO Sensor is necessary only when (1), the monitor requests calibration, and (2), the first time a particular sensor is connected to a particular monitor—as is the case the first time you power up your and CAPNOSTAT CO Sensor.

  • Page 40: Adapter Calibration

    Section 4 Calibration Within several seconds should appear. Remove the sensor from the cell. The CALIBRATION VERIFIED sensor is ready for use. appears, remove the sensor from the Reference cell and place it on the NOT CALIBRATED Zero cell. Calibration is automatically started and, within 15 seconds later, PLACE ON REF should appear.
  • Page 41 Section 5 Monitoring CO and Respiratory Rate Once the Capnostat CO Sensor and airway adapter are connected to the patient’s airway circuit, displays ETCO , Inspired CO if present, Respiratory Rate and a capnogram. Carbon Dioxide Carbon Dioxide display reflects the maximum concentration of CO detected during SMO’s respiration.

  • Page 42: Nitrous Oxide Compensation

    Section 5 Carbon Dioxide O2 Indicator To turn O Compensation on or off: Press the MENU key. CO2 OPTIONS appears. Press the key. >60% appears. O2 COMPENSATION The current setting flashes. Press as desired. Press to activate O Compensation. The icon is displayed.

  • Page 43: Barometric Pressure Compensation

    Monitoring CO and Respiratory Rate Carbon Dioxide Barometric Pressure Compensation Barometric pressure changes (changes in base altitude from sea level) can affect the CO value. is shipped from the factory with barometric pressure compensation set at 760 mmHg (sea level). If the monitor is used in an area with a different normal barometric pressure, the compensation should be changed to the new pressure value.

  • Page 44: Co 2 Display Units

    Section 5 Carbon Dioxide Press the key. appears. NEXT SYSTEM OPTIONS Press the (averaging) key. AVERAGING SELECTIONS appears. Press the key. appears. SELECT ETCO2 AVERAGING The current setting flashes. Press , or as desired. Press to select breath-by-breath ETCO display. Press to display the highest ETCO value within the most recent 10 seconds.

  • Page 45: Respiratory Rate

    Monitoring CO and Respiratory Rate Respiratory Rate Respiratory Rate Respiratory Rate display is the result of averaging the inverse of the eight most recently SMO’s detected time intervals between CO waveforms. measures Respiratory Rate in the range of 0-150 br/min. The display is accurate to ± 1 br/min. The monitor provides audible and visible high and low limit alerts for Respiratory Rate.

  • Page 46: Selecting The Respiratory Interval Alert Timer Duration

    Section 5 Respiratory Rate If, during a Respiratory Interval Alert, the user presses • The audible alert and Red Alert Bar are reset • indicator continues to flash and the timer remains displayed. NO RESP The Respiratory Interval Alert will not activate until the monitor detects some initial respiration and displays a nonzero Respiratory Rate.

  • Page 47: Capnogram

    Monitoring CO and Respiratory Rate Capnogram Resp. Rate Editor Icon To turn the Respiratory Rate Editor on or off: Press and hold the key for 3-seconds. appears. MENU CO2 SETUP OPTIONS Press the EDIT key. RESP RATE EDITOR appears. The current status of the Respiratory Rate Editor flashes. Press as desired.

  • Page 48: Capnogram Scale

    Section 5 Capnogram Capnogram Scale To change the capnogram’s vertical scale: Press the key. appears. SCALE CAPNOGRAM CONTROLS If necessary, press to display both the capnogram and the SCALE key. Press the key. SCALE The capnogram’s vertical scale toggles from 0-50 to 0-75 to 0-100 mmHg with each keypress. Press to return to the Main Menu.

  • Page 49: Oxysnap Connectors

    Section 6 Sensors This section explains how to select an SpO sensor, how to connect the sensor to the monitor, and how to apply the sensor to that patient. CAUTION Connect only Novametrix saturation sensor extension cables and/or SuperBright SpO sensors to SMO.

  • Page 50: Finger Sensor

    Section 6 Finger Sensor Finger Sensor The Finger Sensor is intended for adult fingers and not designed for neonatal or pediatric applications. To apply the finger sensor to the patient: Gently squeeze the grips at the rear of the sensor (indicated by arrows below). Placement Guide Cable exits above finger Position fingertip against placement guide with fingernail towards the red light.

  • Page 51: Y-Sensor

    SpO2 Sensors Y-Sensor Y-Sensor The reusable Y-Sensor is a flexible sensor designed for use on any patient. The Y-Sensor’s Center Strip is not a functional part of the sensor. Its twofold purpose is to aid in the placement of the sensor into the Y-Strip or other securing system and to limit the distance between the sensor heads to no more than 25 mm.
  • Page 52 Section 6 Y-Sensor Press the “button”, on the back of each sensor head, through a hole in the tape. Press in from the sticky side of the tape. The tape will stretch to fit the sensor button. Liner this side (top) Head Button Y-Strip Tape...

  • Page 53: Non-Adhesive Foam Wrap

    SpO2 Sensors Non-Adhesive Foam Wrap Adult/Pediatric Finger Pediatric Toe Neonatal/Pediatric Foot Neonatal Hand Inspect the site often for adequate circulation—at least once every four hours. Non-Adhesive Foam Wrap Use the non-adhesive foam wrap with Novametrix SpO Y-Sensor’s™ (catalog No. 8793 or 8791). Select a foam wrap based on the patient type: •...
  • Page 54 Section 6 Non-Adhesive Foam Wrap NOTE If using the first and third holes on the foam wrap it may be necessary to cut the middle strip off the Y- sensor. Face the blue side of the wrap toward the skin and wrap around the site (cut excess foam if necessary on ®...

  • Page 55: Adhesive Foam Wraps

    SpO2 Sensors Adhesive Foam Wraps Adhesive Foam Wraps Adhesive foam wraps are for use when applying the Novametrix Y-Sensor™ (catalog No. 8793 or 8791) to adult, pediatric or neonatal patients. Select a foam wrap based on the patient type: • Catalog No.
  • Page 56 Section 6 Adhesive Foam Wraps Face the blue side of the wrap toward the skin and wrap around the site. If using the neonatal/pediatric foam wrap, Velcro tab may be removed and replaced to allow excess foam to be cut as necessary. Secure ®...

  • Page 57: Y-Sensor Application Using Ear Clip

    SpO2 Sensors Y-Sensor Application using Ear Clip Y-Sensor Application using Ear Clip Remove center strip from the Y-Sensor. Sensor Heads Center Strip (remove) Slide each Y-Sensor head into the ear clip‘s receptacles, the heads should face each other. Sensor Head Sensor cable fits in groove on clip Ear Clip Receptacle...

  • Page 58: Y-Sensor Quick Check

    Section 6 Single Patient Use SpO Sensors WARNING Inspect the site often for adequate circulation—at least once every four hours. When applying sensors take note of patient’s physiological condition. For example, burn patients may exhibit more sensitivity to heat and pressure and therefore additional consideration such as more frequent site checks may be appropriate.

  • Page 59: Instructions For Use

    SpO2 Sensors Single Patient Use SpO Sensors CAUTION These SpO sensors are intended for single patient use. The sensors can be reapplied to various sites on the same patient but should not be used on multiple patients. Do not attempt to clean or disinfect the sensor, as system performance will be compromised.
  • Page 60 Section 6 Single Patient Use SpO Sensors Press the white connector on the end of the extension cable into the gray connector on the end of the Single Patient Use sensor. Close the locking clip until it snaps around the sensor cable. DB-9 Connector on extension cable Locking clip...

  • Page 61: Sensor Application

    SpO2 Sensors Single Patient Use SpO Sensors Sensor Application Select the appropriate size sensor based on the patient type. PEDIATRIC/ADULT SENSOR Adult toe Adult finger NEONATAL/PEDIATRIC SENSOR Neonatal hand Neonatal foot Pediatric toe To apply the sensor, place the blue side of the sensor wrap against the skin, wrap it around the site and ®...
  • Page 62 Section 6 Single Patient Use SpO Sensors Ensure that the sensor heads are positioned directly opposite each other through the tissue. The adhesive dots (Catalog No. 8700) which are included with each sensor can be applied to the sensor before patient application for additional adhesion to the site.

  • Page 63: Monitoring Spo 2 And Pulse Rate

    Section 7 Monitoring SpO and Pulse Rate Once an SpO sensor is connected to the monitor and properly applied to the patient, displays , Pulse Rate, a plethysmographic waveform and a bar that gives a qualitative indication of SIGNAL the strength of the pulsatile signal the monitor is receiving (If necessary, press to display the plethysmogram and signal bar).

  • Page 64: Pulse "Beep" Volume

    Section 7 Pulse “Beep” Volume Pulse “Beep” Volume is equipped with an audible pulse beep feature that allows the user to “hear” changes in the patient’s SpO and pulse rate. An audible “beep” occurs with each detected pulse beat. The time between beeps indicates the pulse rate.

  • Page 65: Using The Size Softkey

    Monitoring SpO and Pulse Rate Timers To turn the Plethysmogram Autosize feature on or off: Press and hold the MENU key for 3-seconds. CO2 SETUP OPTIONS appears. Press the key. appears. NEXT SpO2 SETUP OPTIONS Press the SIZE key. PLETH AUTOSIZE appears.

  • Page 66: Special Alert Delay

    Section 7 Timers • ambient Light Interference • Low (pulsatile) Signal Strength The SpO and Pulse Rate displays blank out and display “- - -” if the duration of the invalid data exceeds the Special Alert Delay setting. Once started, the Display Held Timer remains active for as long as invalid data is received from the sensor (After 99 seconds the timer display remains at 99).

  • Page 67: Bad Signal Timer

    Monitoring SpO and Pulse Rate Timers The current setting flashes. Press (seconds) as desired. SPO2 TIMERS reappears. Press to return to the Main Menu. Bad Signal Timer The Bad Signal Timer feature provides audible (unless disabled by the user) and visible alerts in the event the monitor does not receive valid pulse and saturation data from the sensor (i.e., a regular and rhythmic pulsatile signal) for an extended period of time.

  • Page 68: Iabp Mode

    Section 7 IABP Mode IABP Mode uses advanced signal processing algorithms to distinguish valid pulsatile signals from signals generated by motion or other artifact. Motion artifact, very common in all but heavily sedated patients, can swamp the true pulsatile signal or distort it enough to produce significant errors in the SpO and Pulse Rate calculations.

  • Page 69: Turning Iabp Mode On/Off

    Monitoring SpO and Pulse Rate IABP Mode Turning IABP Mode On/Off Once IABP Mode is made available to the Main Menu (refer to the previous section) IABP Mode can be turned on or off as desired. To turn IABP MODE on or off: Press the MENU key.
  • Page 70 Section 7 IABP Mode [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 71: Alerts

    Section 8 Alerts Overview provides several alert options. • Alert limits can be adjusted automatically with the Auto Alerts feature or manually from within the menu system. • Limit alerts require user action to be reset; they can also be configured to automatically reset. •...

  • Page 72: Auto Alert Limits

    Section 8 Auto Alert Limits • (up or down arrow) indicator starts to flash beside the violated parameter’s display. The arrow direction indicates a High or Low Limit Alert. Low SpO Indicator If the parameter returns within its limits before 10 seconds elapse the indicators stop flashing.

  • Page 73: Respiratory Rate Auto Alert Limits

    Alerts Auto Alert Limits WARNING Once the limit values are set, the user should periodically confirm patient status by alternate means and not rely solely on alerts generated when a limit is violated. reappears. Press to return to the Main Menu. SET ALERT LIMITS ETCO Auto Alert Limits...

  • Page 74: Pulse Rate Auto Alert Limits

    Section 8 Setting Alert Limits Manually For example, if the SpO =98% when is pushed, the system will set the upper alert limit to 100 AUTO (98+5=103 with max of 100) and the lower alert limit to 93 (98-5=93). Pulse Rate Auto Alert Limits The pulse rate high auto alert limit is set at 25% more than, and the low auto alert limit is 25% less than, the pulse rate value that was displayed before was selected (maximum = 249 and minimum = 30).

  • Page 75: Alert Volume

    Alerts Alert Volume Press and release the arrow keys to change the limit value up or down by one. Press and hold the arrow keys to make the value change more rapidly. NOTE SMO will not allow a parameter’s high and low alert limits to be set to within 5 digits of each other. For example, using default values, if the lower Respiratory Rate limit is increased to 116, the upper limit will change from 120 to 121 in order to maintain the 5 digit difference between limits.

  • Page 76: Limit Alerts-Latched/Unlatched

    Section 8 Limit Alerts—Latched/Unlatched Press appears. MUTE ALLOW AUDIO OFF The current setting flashes. Press as desired. . The user can use Audio Off to permanently silence audible alerts. . The user cannot use Audio Off. is displayed instead. AUDIO OFF DISABLED NOTE Once the decision to allow or disallow the user to use Audio Off is made, that choice remains in effect, even if the monitor is turned off and on, until changed by the user.

  • Page 77: Limit Alerts-Delayed/Instant

    Alerts Limit Alerts—Delayed/Instant To use Retained or Default alert limit settings at power up: Press and hold the MENU key for 3-seconds. CO2 SETUP OPTIONS is displayed. Repeatedly press the key until appears. NEXT ALERT OPTIONS 1 Press DFLT (default) and RETAIN ALERT LIMITS appears.

  • Page 78: Alert Bar-Latched/Unlatched/Off

    Section 8 Alert Bar—Latched/Unlatched/Off Alert Bar—Latched/Unlatched/Off The Alert Bar to the right of the monitor display can be set to operate in three different modes. The Alert Bar can be Latched, Unlatched, or turned off altogether. A “Latched” Alert Bar starts to flash as soon as a limit alert occurs. If the alerting parameter returns within its limits before 10 seconds elapse, the Alert Bar turns off.

  • Page 79: Trend Memory Display

    Section 9 Trend Memory Display Overview maintains trend information for ETCO , Respiratory Rate, SpO and Pulse Rate. Trend memory is continually and automatically updated. Trend memory can hold up to 24 hours of data. The data is battery-backed, so turning the monitor off and on does not destroy or erase trend memory contents. Trend memory features include: •...

  • Page 80: Dual Trend Displays

    Section 9 Graphical Trend Display New trend data is continually collected. The display is redrawn each time you (exit and) enter the trend display mode. New data enters the graph from the right—pushing older already displayed data towards the left (If less than 12 hours of data have been collected, the graph will be shortened accordingly).

  • Page 81: Etco

    Trend Memory Display Graphical Trend Display ETCO and Respiratory Rate Trend Display Scales The ETCO only and ETCO and Respiratory Rate trend display scales can be changed. To change the ETCO and/or Respiratory Rate graphical trend display scales: Press the TRND key.

  • Page 82: Histogram Trend Display

    Section 9 Histogram Trend Display Histogram Trend Display Histogram displays provide a neatly tabulated and easily interpreted summary of ETCO and Respiratory Rate, or, SpO and Pulse Rate trend memory data. histogram display reflects the currently selected graphical trend type and expansion setting. SMO’s For example, if the graphic trend display is set to an ETCO 12 hour display, the resulting histogram...

  • Page 83: Erase Trend Memory

    Trend Memory Display Erase Trend Memory For Respiratory Rate, SpO , and Pulse Rate, the upper extent of the bar represents the maximum value and the bottom of the bar the minimum value stored during that particular compression period. The value displayed above the graph represents the minimum value stored over the compression period.
  • Page 84 Section 9 Trend and NOVACARD Memory Module [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 85: Miscellaneous Features

    Section 10 Miscellaneous Features Keyclick Volume can respond to each key press with an audible tone, a “keyclick”, assuring the user that the monitor recognized a key was pressed. To alter the keyclick volume; Press and hold the MENU key for 3-seconds. CO2 SETUP OPTIONS appears.

  • Page 86: Setting The Clock/Calendar

    Section 10 Setting the Clock/Calendar Press (display) and the display colors are inverted. DISP The two display modes are: White text on blue background with a blue wave on white background (default), and blue text on a white background with a white wave on a blue background. When the display is as desired, press to return to the Main Menu.

  • Page 87: Menu Tree

    Section 11 Menu Tree The menu flow diagrams of the CO SMO are listed in the following pages, each menu is shown with its associated softkeys. Rev. 04 SMO User’s Manual...
  • Page 88 ALRT TREND SCALE MENU This is the MAIN Menu See page 2 for TREND menu tree SCALE will be displayed if Capnogram or dual waveform is displayed. SET ALERT LIMITS CO2 OPTIONS SYSTEM OPTIONS ↑ SIZE will be displayed if PUMP NEXT AUDIO...
  • Page 89 SYSTEM OPTIONS SYSTEM OPTIONS ALRT TREND SIZE MENU AUDIO LITE CARD AUDIO LITE PRNT SELECT PRINT MODE EXP AND <- -> NEXT NOVACARD MENU ETCO2 12 Hr: TREND PREV STORE ERASE TIME Cursor MAIN MAIN MAIN MAIN Select Time ETCO2 8 Hr: EXP AND <- ->...
  • Page 90 If mains and battery power is removed from When the pump is turned on in the SET SAM- the main board, when power is reapplied and This menu is displayed for approximately 8 Pressing the EVENT key while in the Main PLING PUMP menu CAL CO2 CANNULA will seconds on power-up, if niether key is the monitor is turned on this will appear for 3...
  • Page 91 MENU Hold for 3 seconds SpO2 SETUP OPTIONS SpO2 TIMERS MONITOR OPTIONS 1 MONITOR OPTIONS 2 CO2 SETUP OPTIONS IABP SIZE NEXT HELD SPEC NEXT DISP KCLK VER# NEXT CLOCK NEXT BARO EDIT UNITS NEXT MAIN MAIN MAIN MAIN MAIN Invert CCD DISPLAY HELD TIMER BARO PRESSURE = XXXmmHg...

  • Page 92: Status Messages

    Section 12 Status Messages Certain status messages may appear on the display of the CO SMO ETCO /SpO monitor, Model 7100. These messages are listed in the following table with an explanation of the probable causes. Message Displayed Possible Explanation ETCO2 SECTION Try different sensor.
  • Page 93 Section 12 Message Displayed Possible Explanation A calibration error has been detected, or a new sensor has been PLACE ON ZERO CELL connected. Place the sensor on the zero cell to recalibrate. Error detected during Adapter cal. This will occur if Airway Adapter is not connected or if CO gas is present in the Airway CO2 ADAPTER CAL ERR...
  • Page 94 Status Messages Message Displayed Possible Explanation Insufficient light, where ** is time in seconds (after 99 seconds NO SPO2 UPDATE ** display shows “--”). Possibly caused by motion or poor sensor placement, resulting in poor signal. A non-SuperBright™ sensor is connected. Sensor is faulty. INCOMP SPO2 PROBE Remove sensor from use and contact qualified service personnel.
  • Page 95 Section 12 [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 96: Using A Printer

    Section 13 Using a Printer directly supports specific RS232 serial printers . They include the Seiko DPU-414 and DPU 411 Thermal Printers, and the Hewlett-Packard ThinkJet Printer. The information output by the printers is the same. However, due to printer differences, the format of the printed information will vary slightly between printers.

  • Page 97: Configuring The Seiko Dpu-414 Printer

    Section 13 Selecting a Specific Printer Configuring the Seiko DPU-414 Printer The Seiko DPU-414 Thermal Printer (Cat. No. 9140-00) must be configured to communicate with the . When properly configured, the Seiko printer will retain the settings, even when turned off. Top view Rear view Serial connection...

  • Page 98: Connecting The Seiko Dpu-411 Printer

    Using a Printer Selecting a Specific Printer The DIP switch settings for the Model 7100 are as follows: [ DIP SW settings mode ] Dip SW-1 1 (OFF) : Input = Serial 2 (ON ) : Printing Speed = High 3 (ON ) : Auto Loading = ON 4 (OFF) : Auto LF = OFF 5 (ON ) : Setting Command = Enable...
  • Page 99 Section 13 Selecting a Specific Printer Interface cable Catalog No. 5861-00 is twelve inches long and allows the Seiko DPU-411 printer to be powered from the . The printer’s AC adapter is not needed. Interface cable Catalog No. 6887-00 is a six foot cable that requires the Seiko DPU-411 printer to be powered from its AC adapter.

  • Page 100: Connecting The Hewlett-Packard Thinkjet Printer

    Using a Printer Print Formats Connecting the Hewlett-Packard ThinkJet Printer To connect the Hewlett-Packard ThinkJet Printer to The ThinkJet must be a Hewlett-Packard Model 2225D (RS232 serial interface). Set the dip switches on the rear panel of the ThinkJet as indicated below. 1 2 3 4 5 6 7 8 1 2 3 4 5 Mode switches = 1, 2, 5, 6 up (on) and 3, 4, 7, 8 down (off).

  • Page 101: Tabular Mode Text Printout

    Section 13 Print Formats Press is displayed and printing starts. PRNT PRINTOUT STARTED The user can also press in the histogram display—the printout will be the same. PRNT The printer stops automatically when the printout is complete. is pressed again before the printout finishes, appears.

  • Page 102: Compressed Trend Printout

    Using a Printer Print Formats Press . The START time menu appears. PART Press ↑ or ↓ to select the point (time) in trend memory to start the printout. Press the key. The STOP time menu appears. Or, press to reset the start time to the beginning of trend memory. RESET Press ↑...

  • Page 103: Interpreting Printer Output

    Section 13 Interpreting Printer Output Interpreting Printer Output Header Each printout starts with a header that identifies the monitor ( ETCO /SpO Monitor). The date and time of the printout is furnished by the monitor’s calendar/clock. Space is then provided to enter patient information.
  • Page 104 Using a Printer Interpreting Printer Output Beginning of Histogram Limit Alert Status Histogram Data Average, Min. & Max. Rev. 04 SMO User’s Manual...

  • Page 105: Graphical Data

    Section 13 Interpreting Printer Output Graphical Data A graphical depiction of trend memory is printed after the header for all printouts except the tabular and waveform modes. Column A and B Information: The next two lines refer to Columns A and B in the printout. Column A represents the monitor’s audible alarm status.

  • Page 106: Capnogram Or Plethysmogram Waveform Format

    Using a Printer Interpreting Printer Output where is the hour, minute and seconds (24 hour format) and is the appropriate displayed HH:MM:SS parameter value. Header Time and Parameters (printed every 30 seconds) Capnogram or Plethysmogram Waveform Format If the capnogram or dual waveform display is selected, a capnogram waveform is printed; if the plethysmogram display is selected, a plethysmogram waveform is printed.
  • Page 107 Section 13 Interpreting Printer Output Respiratory Rate and Inspired CO values are also printed. The printed values reflect the monitor’s display at the instant of printing. Header Printout Identification Scale ETCO2 Parameters EVENT key pressed SMO User’s Manual Rev. 04...
  • Page 108 Using a Printer Interpreting Printer Output A Plethysmogram Waveform Printout represents the five seconds of plethysmogram data immediately prior to when the EVENT key was pressed. Graphically, the EVENT key press corresponds to the bottom of the printout; the top of the printout is five seconds before was pressed.
  • Page 109 Section 13 Interpreting Printer Output [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 110: External Devices

    Section 14 External Devices supports, in addition to the printers previously mentioned, specific external RS232 serial devices: computer interface (NOVACOM1), Analog Module, Memory Card (NOVACARD), Telecap, and TeleSat. For information on printers see “Using a Printer” on page 85. NOVACOM1 Interface The NOVACOM1 interface is designed to output data in formats easily read by a computer or data logging device.
  • Page 111 Section 14 NOVACOM1 Interface CAUTION If the ETCO section is turned off while the SpO section remains on the E, R, and I fields will be followed by blanks. Likewise the S and P fields will be followed by blanks if the SpO section is turned off while the ETCO section remains on.

  • Page 112: Mode 4 - Spo2 Waveform

    External Devices NOVACOM1 Interface To enter CO Waveform mode, the computer must send an ASCII “3” character. The will echo the “3” followed by a <cr><lf> and then enable communication. The data format is: ME***R***I**Y**<cr><lf> (sent once a second) c++<cr><lf> (sent 48 times a second) where: M - Event Marker identifier, “M”= event marked, “-”= no event,...

  • Page 113: Mode 5 - Dual Waveform

    Section 14 NOVACOM1 Interface Mode 5 — Dual Waveform In Dual Waveform mode, the end tidal CO , respiratory rate, inspired CO values, saturation values, and respiration rate are continually transmitted at one second intervals. To enter dual waveform mode, the computer must send an ASCII “5” character. The will echo the “5”...
  • Page 114 External Devices NOVACOM1 Interface The Mode 6 data format is: INFO record: byte 0 T**************************************** ****************************************<cr><lf> byte 39 where: T- Trend mode identifier **-INFO byte, starting at byte 0 and ending at byte 39 (see below) byte -0 flag byte = FF for INFO record byte-1 information type (FE-power on, FD-limit change, FC-time stamp)

  • Page 115: Mode D - Date And Time

    Section 14 NOVACOM1 Interface DATA record: byte 0 T**************** **************** **************** **************** ****************<cr><lf> byte 39 T - Trend mode identifier **-DATA byte, starting at byte 0 and ending at byte 39 (see below) byte 0-7 8 byte ETCO2 data, range: units mmHg 0-100, units Kpa 0-133,units % 0-133, 251-no data available over period (pen lift) byte 8-15...

  • Page 116: Mode C - Clear Trends

    External Devices Selecting NOVACOM1 Interface Mode c — Clear Trends Clear Trends mode allows the user to remotely clear the trend memory This action has the same result as the monitor’s Clear Trend function in that trend memory and the Trend Page displays are cleared. Note: Use this remote Clear Trends function with care as there is no way to undo the clear command once issued.

  • Page 117: Connecting The Analog Module

    Section 14 Selecting Analog Module Interface Connecting the Analog Module must be configured for Analog Module Interface to operate with the Analog Output Module. See “Selecting Analog Module Interface” on page 105. Connect the Analog Output Module to the monitor’s rear panel RS232 connector. Tighten the two spring loaded screws that secure the Analog Module to the rear panel.

  • Page 118: The Novacard Memory Module

    External Devices The NOVACARD Memory Module The NOVACARD Memory Module can store patient trend information and waveforms into a memory card through the use of the NOVACARD Memory Module. The NOVACARD Memory Module connects to ’s rear panel RS232 connector, see “Selecting NOVACARD Interface” on page 107.The information stored in the memory card can then be read by a computer using the NOVACARD Reader.

  • Page 119: Selecting Telesat Interface

    Section 14 Selecting TeleSat Interface Press (previous) or to select PREV NEXT TELECAP INTERFACE The Telecap interface is now selected for the Press to return to the Main Menu. Selecting TeleSat Interface To select the TeleSat Interface for the Press and hold the key for 3-seconds.

  • Page 120: Maintenance

    Section 15 Maintenance This section contains monitor and accessory maintenance information. Cleaning and Sterilization Follow the cleaning and sterilization instructions listed below to clean and/or sterilize the monitor and its accessories. Monitor • Turn the monitor off and unplug the line cord from the AC power source before cleaning. •...

  • Page 121: Spo 2 Y-Strip Tapes And Foam Wraps

    Section 15 Cleaning and Sterilization • The Y-Sensor may be immersed—up to, but not including, the connector, in a 2% gluteraldehyde solution, or 10% bleach solution. Refer to manufacturer’s instructions and standard hospital protocols to determine recommended times for disinfection and sterilization. •...

  • Page 122: External Sampling System Components

    Maintenance Cleaning and Sterilization • The Neonatal Airway Adapter (Cat. No. 7053) may be sterilized by ETO (ethylene oxide) gas. Be sure to use appropriate aeration times. • Before reusing the adapter, ensure the windows are dry and residue-free, and that the adapter has not been damaged during handling or by the cleaning/sterilization process.

  • Page 123: Maintenance Schedules

    Section 15 Maintenance Schedules Remove the syringe from the unit. Do not connect the Sampling Inlet tubing. Connect the line cord and turn the monitor on. Allow the sampling pump to operate for several minutes. This will help to remove any trapped water.

  • Page 124: Mains Voltage Configuration

    Maintenance Mains Voltage Configuration If the battery requires replacement refer to the CO SMO Service Manual (Catalog No. 5758-90) for instructions. Have this procedure performed by qualified service personnel only, there are no user serviceable parts inside the monitor. Mains Voltage Configuration The rear panel power entry module indicates the mains voltage setting for the monitor.
  • Page 125 Section 15 Mains Voltage Configuration Pry the fuse housing out from the power entry module. Fuse housing NOTE: 5 mm X 20 mm fuses are installed toward the “back” of the fuse housing as shown 3AG type 5 X 20mm type Replace the blown fuse(s) with the proper type and rating.

  • Page 126: Specifications

    Section 16 Specifications General Specifications for the Novametrix ETCO /SpO Monitor, Model 7100, are listed for informational purposes only, and are subject to change without notice. Capnograph • Principle of Operation: Non-Dispersive Infrared (NDIR) absorption, dual wavelength ratiometric- True Single Beam Optics •...

  • Page 127: Oximeter

    Section 16 Oximeter Oximeter • Oxygen Saturation Range: 0-100% Accuracy: 80-100% ± 2%, 0-79% unspecified (Approximately 68% of the observations are within the accuracy claim.) Display Resolution: 1% Averaging Time: Menu selectable 2 or 8 seconds • Pulse Rate Range: 30-250 beats per minute (bpm) Accuracy: ±...

  • Page 128: Accessories

    Section 17 Accessories SMO Capnograph and Pulse Oximeter Catalog No. Description SMO is a combined Capnograph and Pulse Oximeter Monitor. It provides reliable mainstream measurement and display of end tidal carbon dioxide (ETCO ) and respiratory rate. The CAPNOSTAT® CO Sensor features rugged solid-state construction and is small and lightweight.
  • Page 129 Section 17 CO2SMO Capnograph and Pulse Oximeter Catalog No. Description 6421-25 Pediatric/Adult Single Patient Use Airway Adapters with mouthpiece (25 per box) 6312-00 Neonatal/Pediatric Single Patient Use Airway Adapters (10 per box) 6312-25 Neonatal/Pediatric Single Patient Use Airway Adapters (25 per box)
  • Page 130 Accessories CO2SMO Capnograph and Pulse Oximeter Catalog No. Description 8793-12 Y-12 Plan The Plan warranty is 12 months. Includes 3 boxes (your choice) of any Y-Strip Taping Systems 8793-24 Y-24 Plan The Plan warranty is 24 months. Includes 6 boxes (your choice) of any Y-Strip Taping Systems 8793-36 Y-36 Plan The Plan warranty is 36 months.
  • Page 131 Section 17 CO2SMO Capnograph and Pulse Oximeter Catalog No. Description 9086-00 Cable to Seiko DPU-414 Printer, 9 to 9 pin, (Model 610) 5331 Cable to Hewlett-Packard ThinkJet Printer 300013 Hewlett-Packard ThinkJet Printer Ink Cartridge 300014 Hewlett-Packard ThinkJet Printer Paper (2500 sheets Z-fold)
  • Page 132 Accessories CO2SMO Capnograph and Pulse Oximeter Catalog No. Description MO U NT IN G S Y S T E M S 140030 Wall Mount 140031 Wall Mount (less Wall Channel) 140032 Pivot Block Mount 140033 Transport Mount (without swivel head)
  • Page 133 Section 17 CO2SMO Capnograph and Pulse Oximeter [This page intentionally blank.] SMO User’s Manual Rev. 04...

  • Page 134: Typical Capnogram Waveforms

    Section 18 Typical Capnogram Waveforms Normal Waveform The “normal” capnogram provides a waveform of changing levels of expired CO mmHg Waveform evaluation: • A-B: Ascending limb, expiratory portion, mixed deadspace and alveolar air with increasing concentration of CO . Normally starts at a baseline of zero. •...

  • Page 135: Hypoventilation

    Section 18 Hypoventilation Hypoventilation An increase in the level of the End Tidal CO from previous levels. Hypoventilation Possible Causes: • Decrease in respiratory rate • Decrease in tidal volume • Increase in metabolic rate • Rapid rise in body temperature (malignant hyperthermia) Hyperventilation An decrease in the level of the End Tidal CO from previous levels.

  • Page 136: Muscle Relaxants

    Typical Capnogram Waveforms Muscle Relaxants Muscle Relaxants Clefts are seen in the final third portion of the alveolar plateau. They appear when the action of the muscle relaxants are affected by spontaneous ventilation. E.C.G. Characteristics: • Depth of the cleft is inversely proportional to the degree of drug activity •...

  • Page 137: Obstruction In Breathing Circuit Or Airway

    Section 18 Obstruction in Breathing Circuit or Airway Obstruction in Breathing Circuit or Airway An obstruction to the expiratory gas flow noted as a change in the slope of the ascending limb of the capnogram. The expiratory portion may diminish without a plateau. Possible Causes: •...

  • Page 138: Inadequate Seal Around Endothracheal Tube

    Typical Capnogram Waveforms Inadequate Seal Around Endothracheal Tube Inadequate Seal Around Endothracheal Tube A capnogram in which the downward slope of the plateau blends in with the descending limb. Possible Causes: • A leaky or deflated endotracheal or tracheostomy cuff •...
  • Page 139 Section 18 Faulty Ventilator Circuit Valve [This page intentionally blank.] SMO User’s Manual Rev. 04...

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