SVM7500 - EnglishUG - NIHON KOHDEN
SVM7500 - EnglishUG - NIHON KOHDEN
SVM7500 - EnglishUG - NIHON KOHDEN
Bedside Monitor
SVM-7501
SVM-7521
SVM-7503
SVM-7523
SVM-7500 Series
0614-907644B
About This Manual
In order to use this product safely and fully understand all its functions, read this manual before using the
product. Keep this manual near the instrument or in the reach of the operator and refer to it whenever the
operation is unclear.
Accompanying Documentation
The product comes with the following manuals. Refer to the manual depending on your needs.
Operator’s Manual
Describes the operation and settings of the product. Read this manual before use.
Administrator’s Guide
For administrators. Describes how to install the product. Read the Operator’s Manual together with this
guide.
Service Manual
For qualified service personnel. Describes information on servicing the product. Only qualified service
personnel can service the bedside monitor.
User’s Guide
Gives supplemental information on the operation of the product.
Copyright Notice
The entire contents of this manual are copyrighted by Shanghai Kohden Medical Electronic Instrument
Corp., hereinafter referred to as “Shanghai Kohden” or “SKC”. All rights are reserved. No part of this
document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical,
photocopied, recorded, or otherwise) without the prior written permission of Shanghai Kohden.
This product stores personal patient information. Manage the information appropriately.
Patient names on the screen shots and recording examples in this manual are fictional and any resemblance to
any person living or dead is purely coincidental.
The contents of this manual are subject to change without notice. If you have any comments or suggestions
on this manual, please contact us at: https://www.nihonkohden.com/
1
Contents
2
GENERAL HANDLING PRECAUTIONS...................... I
WARRANTY POLICY.................................................. II 5 Alarm Function 3
EMC RELATED CAUTION......................................... III Overview of Alarms.................................................. 5-4
Conventions Used in this Manual and Device.............V Alarm Types.............................................................. 5-8 4
Explanations of Symbols............................................VI Alarm Indications.................................................... 5-13
Related Documentation............................................VIII Silencing/Suspending/Resetting Alarms................. 5-22 5
Safety Standards......................................................VIII Turing Automatic Alarm Recording On/Off............. 5-28
Safety Information....................................................VIII Setting Alarms........................................................ 5-29 6
Interbed Alarm........................................................ 5-37
1 General 7
Introduction............................................................... 1-2 6 Review Window
Features................................................................... 1-3 General..................................................................... 6-3 8
Composition............................................................. 1-4 Time Bar................................................................... 6-4
Panel Description..................................................... 1-5 TREND GRAPH Window.......................................... 6-5 9
Basic Operating Concepts ....................................... 1-8 TREND TABLE Window......................................... 6-11
Guide Window........................................................ 1-16 NIBP TABLE Window............................................. 6-15 10
HL7......................................................................... 1-17 RECALL Window.................................................... 6-18
Alarm History Window............................................ 6-23 11
2 Preparation OCRG Window....................................................... 6-26
Full Disclosure Window.......................................... 6-30
Preparation Flowchart.............................................. 2-2
12
Installation Conditions.............................................. 2-3
Installing the Battery Pack........................................ 2-5 7 Interbed Window 13
Preparing the Optional Recorder............................ 2-10 Registering Interbed Beds........................................ 7-3
Power..................................................................... 2-15 Displaying the Numeric Data of All Interbed Beds.... 7-4 14
Displaying the Interbed Bed Data............................. 7-5
4 Home Screen
Safety Precautions for Monitoring............................ 4-3 9 ECG Monitoring
Overview.................................................................. 4-4 General..................................................................... 9-3
Home Screen........................................................... 4-5 Preparing for ECG Monitoring.................................. 9-4
Freezing Waveforms................................................ 4-9 Monitoring ECG........................................................ 9-9
Using Sleep Mode.................................................. 4-10 Monitoring Arrhythmia............................................ 9-13
Displaying the LARGE NUMERICS Screen........... 4-12 Changing ECG Settings......................................... 9-20
12 SpO 2 Monitoring
General................................................................... 12-2
Preparing for SpO2 Monitoring................................ 12-5
Monitoring SpO2.................................................... 12-7
Changing SpO2 Settings......................................... 12-8
13 NIBP Monitoring
General................................................................... 13-2
Preparing for NIBP Measurement.......................... 13-3
Measuring and Monitoring NIBP............................. 13-8
Changing NIBP Settings....................................... 13-19
Using Venous Puncture Mode.............................. 13-22
14 IBP Monitoring
General................................................................... 14-2
Preparing for Blood Pressure Monitoring............... 14-2
Monitoring IBP........................................................ 14-8
Changing IBP Settings........................................... 14-9
15 Temperature Monitoring
General................................................................... 15-2
Preparing for Temperature Monitoring.................... 15-3
Monitoring Temperature.......................................... 15-6
Changing Temperature Settings............................. 15-7
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
3. Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is combined with other instruments to avoid misdiagnosis or other
problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient's safety.
(3) Avoid direct contact between the instrument housing and the patient.
(4) The operator must not touch patients and the input/output interface of the equipment simultaneously, this may
cause electric shock.
6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is
not functioning properly, it should be clearly marked to avoid operation while it is out of order.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or
location of electrodes and/or transducers to avoid possible burn to the patient.
10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator
discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.
WARRANTY POLICY
Shanghai Kohden Corparation (SKC) shall warrant its products against all defects in materials and workmanship for one
year from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded
from the warranty.
SKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period,
provided these products are used as prescribed by the operating instructions given in the operator's and service manuals.
No other party is authorized to make any warranty or assume liability for SKC's products. SKC will not recognize any other
warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by
someone other than SKC or its authorized agents without prior consent of SKC may be cause for voiding this warranty.
Defective products or parts must be returned to SKC or its authorized agents, along with an explanation of the failure.
Shipping costs must be pre-paid.
This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Shanghai
Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism,
water or other casualty, improper installation or application, or on which the original identification marks have been
removed.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station
or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source such as cellular
phone away from the equipment and/or system, or turn off the cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of the equipment
and/or system:
Identify the cause of this interference and if possible remove this interference source. If this is not
possible, use a different power supply.
Make sure all users and patients in contact with the equipment and/or system are free from direct or
indirect electrostatic energy before using it. A humid room can help lessen this problem.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or
system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is installed, it may induce
an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord
from the equipment and/or system and operate the equipment and/or system by battery power, or use
an uninterruptible power supply.
When the equipment and/or system is adjacent to or stacked with other equipment, the equipment
and/or system may affect the other equipment. Before use, check that the equipment and/or system
operates normally with the other equipment.
When an unspecified accessory, transducer and/or cable is connected to this equipment and/or
system, it may cause increased electromagnetic emission or decreased electromagnetic immunity.
The specified configuration of this equipment and/or system complies with the electromagnetic
requirements with the specified configuration. Only use this equipment and/or system with the
specified configuration.
When the equipment and/or system is used with the unspecified system configuration different than
the configuration of EMC testing, it may cause increased electromagnetic emission or decreased
electromagnetic immunity. Only use this equipment and/or system with the specified configuration.
The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If
the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic
interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the
surrounding electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden
representative for additional suggestions.
For EMC compliance, refer to "Specification - Electromagnetic Compatibility" in the Reference section.
NOTE about Waste Electrical and Electronic Equipment (WEEE) Directive 2002/96/EC
For the member states of the European Union only:
The purpose of WEEE directive 2002/96/EC is, as a first priority, the prevention of waste electrical and
electronic equipment (WEEE), and in addition, the reuse, recycling and other forms of recovery of such
wastes so as to reduce the disposal of waste.
Contact your Nihon Kohden representative for disposal.
In IEC 60601-1-2 Medical Electronic Equipment, Part 1: General Requirements of Safety, 2. Collateral
Standard: Electromagnetic compatibility-Requirements and test. Section 6.2.3 Radiated radio-frequency
electromagnetic fields, PATIENT COUPLED EQUIPMENT and/or SYSTEMS applicable IMMUNITY test
methods are under consideration at SC62A/WG13. The 3 V/m IMMUNITY level may be inappropriate
especially when measuring SpO2 because physiological signals can be much smaller than those induced
by a 3 V/m electromagnetic field.
When measuring SpO2, various interference may produce false waveforms which look like pulse
waveforms. SpO2 value and pulse rate may be measured from these waveforms, causing the alarm to
function improperly.
When installing the monitor, avoid locations where the monitor may receive strong electromagnetic
interference such as radio or TV stations, cellular phone or mobile two-way radios.
WARNING
Interaction between Minute Ventilation Rate-Adaptive Pacemakers and Cardiac Monitoring and Diagnostic
Equipment*
The bioelectric impedance measurement sensor of a minute ventilation rate-adaptive implantable pacemaker
may be affected by cardiac monitoring and diagnostic equipment which is connected to the same patient. If
this occurs, the pacemaker may pace at its maximum rate and give incorrect data to the monitor or
diagnostic equipment. If this occurs, disconnect the monitor or diagnostic equipment from the patient or
change the setting on the pacemaker by referring to the pacemaker’s manual. For more details, contact your
pacemaker representative or Nihon Kohden representative.
WARNING: A warning alerts the user to possible injury or death associated with the use or misuse of the instrument.
CAUTION: A caution alerts the user to possible injury or problems with the instrument associated with its use or misuse
such as instrument malfunction, instrument failure, damage to the instrument, or damage to other property.
Note: A note provides specific information, in the form of recommendations, prerequirements, alternative methods
or supplemental information.
On screen
The CE mark is a protected conformity mark of the Products marked with this symbol comply with the
European Community. European WEEE directive 2012/19/EU and require
separate waste collection. For Shanghai Kohden
products marked with this symbol, contact your
Date of manufacture
Nihon Kohden representative for disposal.
Safety Standards
The safety standard of this bedside monitor is classified as follows:
Safety Information
This User’s Guide only contains safety information related to operation. Full information is in the SVM-7500 Series
Bedside Monitor Operator’s Manual (code number: 0614-907564*).
General
Introduction......................................................................1-2
Features..........................................................................1-3
Composition....................................................................1-4
Panel Description............................................................1-5
Front Panel.....................................................................................1-5
Left Side Panel...............................................................................1-6
Right Side Panel.............................................................................1-7
Rear Panel.....................................................................................1-7
Guide Window...............................................................1-16
HL7................................................................................1-17
1. GENERAL
Introduction
SVM-7501/7521 hardwired bedside monitors have several connectors for ECG,
impedance method respiration, SpO2, NIBP and temperature monitoring. SVM-
7503/7523 bedside monitors can also monitor CO2 and IBP. Its easy operation
and compact lightweight design let you use this bedside monitor in the OR,
recovery room, general ward, ICU, CCU, HCU, NICU and ER. For portability, it
can operate on battery power as well as AC power.
NOTE: Only use Shanghai Kohden parts and accessories to assure
maximum performance from your instrument.
1
Features
1 Hardwired system
With the dedicated sockets on the monitor, ECG, impedance method
respiration, SpO2, NIBP and temperature can be monitored. On SVM-
7503/7523, CO2 and IBP can also be monitored.
2 AC or battery operation
The monitor can operate on AC power or battery.
7 Function keys
There are three function keys at the upper left corner of the screen. A
function can be assigned to each key, for example, freezing waveforms or
displaying the MENU window.
Composition
PVM-2701/PVM-2703 Bedside
PVM-2701/PVM-2703 Monitor
Bedside Monitor
Battery Pack
Battery Pack Recorder
Recorder Module Module Interface
Interface
SB-201P SB-201P
WS-201PWS-201P QI-201PQI-201P
InterfaceInterface Transmitter
Transmitter Other Other
ZS-900PG/PK
ZS-900PG/PK DI-270PDI-270P
Adapter Adapter
KC-600PKC-
Ca
QI-202P QI-202P
DH-270P Adapter
DH-270P Adapter KC-013PKC
C
1
Panel Description
Front Panel
1 Touch screen 2 Alarm indicator
1 Touch screen
Display monitoring data. Touching a key or data on the screen changes the
displayed screen and setting.
2 Alarm indicator
Red or yellow lamp blinks, or yellow lamp lights according to the alarm
settings. Green lamp blinks in synchronization with the patient’s QRS or
pulse.
3 Power key
Press to turn the monitor power on. When turning the monitor power off, press
and hold for more than one second.
4 Power lamp
Lights when the monitor power is turned on.
5 AC power lamp
Lights when the power cord is connected between the AC SOURCE socket
and AC outlet.
6 Battery lamp
Indicate the status of the battery pack.
1 Handle
3 TEMP sockets
5 NIBP socket
7 SpO2 socket*
1 Handle
For carrying the monitor.
2 ECG/RESP socket
Connects to the ECG PATIENT CABLE.
3 TEMP sockets
Connects to the temperature probe cables.
4 CO2 socket*
For SVM-7503 and SVM-7523. Connects to the CO2 connection cord.
5 NIBP socket
Connects to the air hose.
6 PRESS sockets*
For SVM-7503 and SVM-7523. Connects to the IBP connection cord.
7 SpO2 socket*
Connects to the SpO2 connection cord.
* NOTE: When inserting the CO2, PRESS or SpO2 connector, make
sure the color of the connector sleeve is the same color as the
socket.
Rear Panel
5 Battery
1 Network socket pack
holder
2 USB socket
1 Network socket
Connects to monitor network system by a network cable.
2 USB socket
For USB memory.
3 Equipotential grounding terminal
For an equipotential grounding lead.
4 AC POWER SOURCE socket
For the AC power cord.
5 Battery pack holder
For installing a battery pack.
Screen Displays
The followings are the screens and windows available on the bedside monitor.
For details about the individual screens and windows, see the appropriate section.
The shadow of the previous screen may remain for a few minutes after changing
the screen.
Normally, the home screen is displayed. All screens, except for the LARGE
NUMERICS screen and SYSTEM CONFIGURATION screen, return to the
home screen when there is no key operation for about 3 minutes.
Home Screen
1 The home screen can be displayed anytime by touching the [HOME] key on
the screen.
3 Touch the patient name to display the ADMIT window for entering patient
name.
MENU Window 1
The MENU window can be displayed anytime by touching the [MENU] key on
the screen. From the MENU window, you can display any window except the
home screen.
SLEEP window is for turning sleep mode on. The SLEEP window is only
available when the bedside monitor is connected to the central monitor network.
Review Windows 1
NIBP TABLE window displays vital signs data with NIBP measurements.
ALARM HISTORY window displays vital sign data at past alarm occurrences.
OCRG window displays OCRG trendgraph. Only available when the patient type
is NEONATE.
ADMIT Window
ADMIT window is for entering a patient’s information.
Interbed Window
Displays interbed beds when the monitor is connected to a network.
Setup Windows
1 DATE window
DATE window is for changing date and time.
2 DISPLAY/SOUND window
DISPLAY/SOUND window is for changing alarm and sync sound volume,
waveform sweep speed, and respiration waveform sweep speed.
3 RECORD window
RECORD window is for setting recording parameters.
4 SYSTEM window
SYSTEM window is for checking assigned functions.
Scroll key
Scroll bar
Scroll key
Cursor
Section 14*2
Section 15
Section 5
Section 4
Section 3 Section 4
Section 9
Section 7
Administrator's
Section 5 Guide Section 1
Section 8 Section 16
Guide Window
The guide window explains how to attach electrodes or cuff with illustration. The
window also shows the countermeasure for the technical alarms.
When a technical alarm occurs during monitoring, the [GUIDE] key appears at
the top of the screen. Touch the [GUIDE] key to display the guide window for
that alarm.
Guide key
You can open the Guide window by touching the [GUIDE] key on the MENU
window.
GUIDE key
Abbreviations
The ITEMS tab in the Guide window shows abbreviations for parameters,
arrhythmias and icons.
1
HL7
You can set LS-NET or HL7 on SYSTEM CONFIG window.
Setting Item Setting Range (Default) Description
Use ORU ON, OFF Selects whether or not to output the ORU (current numeric) data.
Sets the port number to use for ORU data output. Touch [ ]
ORU Port No. 1024 to 65535 of the port number and enter the number.
ORU (ORU/ACK-R01) (Default: 7998) After entering the port number, touch [OK] to close the
window.
1 min, 5 min, 10 min, 30 Sets the interval to output the ORU data. Touch [ORU
ORU SAMPLING
min, 60 min SAMPLING] and select the time.
Use ORF ON, OFF Selects whether or not to output the ORF (old numeric) data.
Sets the port number to use for ORF data output. Touch [ ]
ORF ORF Port No. 1024 to 65535 of the port number and enter the number.
(QRY^R02/
ORF^R04) (Default: 9004) After entering the port number, touch [OK] to close the
window.
Use QRY ON, OFF Selects whether or not to request patient information.
Preparation
Preparation Flowchart.....................................................2-2
Installation Conditions.....................................................2-3
Power............................................................................2-15
Connecting the Power Cord and Grounding the Monitor.............2-15
Connecting the Power Cord..................................................... 2-15
Grounding the Monitor.............................................................2-16
Turning the Power On..................................................................2-16
Check Before Turning On the Power.......................................2-16
Turning the Power On.............................................................. 2-17
ADMIT MODE Setting.............................................................. 2-18
Check After Turning On the Power and During Monitoring...... 2-19
Power and Battery Status Indications..........................................2-20
When the “BATTERY WEAK” Message Appears....................2-20
Charging the Battery................................................................2-21
Charging...................................................................................2-21
Monitor Status on Power Interruption...........................................2-22
Turning the Power Off..................................................................2-22
Check When Turning the Power Off........................................2-22
2. PREPARATION
Preparation Flowchart
You may not need to do all of these.
Installation Conditions
2
Put the monitor on a stable and flat stand where the screen is easy to see and does
not reflect light. Follow the cautions below.
The monitor must be installed by qualified personnel. Details are in the
Administrator’s Guide.
WARNING
Never use the monitor in the presence of any flammable anesthetic
gas or high concentration oxygen atmosphere. Failure to follow this
warning may cause explosion or fire.
WARNING
Connect only the specified instrument to the monitor and follow the
specified procedure. Failure to follow this warning may result in
electrical shock or injury to the patient and operator, and cause fire
or instrument malfunction.
CAUTION
The display screen is made of glass. Strong impact may damage it.
CAUTION
Avoid a location where the monitor is sprinkled with liquids. Avoid
direct sprinkling, spray or moist air from a nebulizer or a humidifier.
CAUTION
Avoid collision when moving the monitor. Strong impact may damage
the monitor.
CAUTION
Avoid locations where the monitor may receive strong
electromagnetic interference such as radio or TV stations, cellular
phones or mobile two-way radios.
CAUTION
If fluids are accidentally spilled on the monitor, take the monitor out
of service and check for damage.
CAUTION
Avoid exposing the monitor to direct sunlight.
CAUTION
Do not place the monitor in a dusty area.
CAUTION
Do not place blankets or cloth over the monitor. It may affect
monitoring.
CAUTION
Do not use the monitor in an ambulance. The monitor may not
function properly in a moving vehicle.
CAUTION
Do not place the monitor in an MRI examination room. The monitor
may not function properly, or noise from the monitor may interfere
with the MRI.
CAUTION
Connect the power cord to an AC outlet which can supply enough
AC current to the monitor. The monitor cannot function properly with
low current.
CAUTION
Do not use an electrical blanket. It may affect monitoring.
CAUTION
Avoid placing the monitor near a heater or humidifier.
CAUTION
When there is any problem on the monitor, turn off the power
immediately and disconnect the power cord from the AC outlet. Take
the monitor out of service and check for damage.
CAUTION
Make sure that there is more than 5 cm of space between the
monitor and the wall for adequate ventilation. When the monitor is
surrounded, make sure that there is about 10 cm of space above the
monitor for ventilation so that the operating temperature does not
exceed 40 °C (104 °F).
10 cm
↕ 5 cm Rear
↔ ↔
5 cm 5 cm 5 cm 5 cm
↔ ↔
Side
Safety Information
WARNING
If the battery pack is damaged and the substance inside the battery
contacts the eyes, skin or clothes, wash immediately and thoroughly
with water and see a physician. Never rub your eyes, because you
may lose your eyesight.
WARNING
• Do not immerse the battery pack in water. The battery may heat
up and rust and the substance inside the battery may leak.
• Do not leave the battery unused for more than about two years.
The battery may leak.
WARNING
Do not do the following to the battery pack. It may cause leakage,
overheating, explosion and fire.
• Short-circuit the + and - terminals on the battery.
• Put the battery pack into fire or heat the battery.
• Disassemble or alter the battery.
• Give strong impact to or deform the battery.
• Use the battery on unspecified instruments.
• Charge the battery on unspecified instruments.
• Install the battery with the wrong polarity.
• Leave the battery in the reach of patients.
• Connect the wire or cable in a wrong way.
WARNING
Do not use a deformed battery. It may cause overheating, rupture or
fire.
CAUTION
Do not leave the battery pack near the patient or in reach of children.
CAUTION
Use the battery pack between 10°C (50°F) and 40°C (104°F).
Temperatures out of this range affect the working of the battery.
CAUTION
Do not expose the battery pack to direct sunlight or leave in a high
temperature place. The lifetime of the battery pack may be
shortened, the performance of the battery pack may be degraded
and the battery may leak.
CAUTION
Do not subject the battery pack to a strong mechanical impact.
CAUTION
Before disposing of the battery, check with your local solid waste
officials for details in your area for recycling options or proper
disposal. The battery is recyclable. At the end of its useful life, under
various state and local laws, it may be illegal to dispose of this
battery into the municipal waste stream.
CAUTION
Do not use a battery which is past the expiration date written on the
label.
CAUTION
Do not use a battery pack with a damaged cover because this may
cause electric hazard and malfunction.
CAUTION
Be careful when handling the fully charged battery pack. The battery
pack heats up to about 60ºC (140°F). The operator may be surprised
and drop the battery pack, causing injury to the operator.
2 Remove the battery cover by holding the tape which sticks to the cover.
CAUTION
Do not pull out the battery connector forcibly. Otherwise, the battery
connector may break and the battery pack cannot be used.
4 Insert the battery connection cable into the connector until it is locked. Insert
the battery pack into the battery pack holder by following the instructions as
shown in the picture.
CAUTION
The battery connection cable must be on the right side. Do not insert
the battery pack in the wrong direction.
5 Push the battery pack into the holder by pressing the sponge pad until the
battery pack is inserted into the bottom of the holder.
2
6 Tear off the tape and close the battery cover with a screwdriver.
3 Insert the connection cable of the recorder into the connector inside the
monitor as shown in the picture.
CAUTION
When connecting the connection cable to a socket, insert it straightly
2
without bending or tilting it and connect it slowly and firmly without
too much force. If you tilt the connector when inserting it, the
connector pin may break and units cannot communicate with each
other.
4 Put the recorder into the recorder magazine as shown in the picture.
6 Push the recorder into the recorder magazine by pressing the two tabs in the
top of the recorder.
NOTE: Press the two tabs slightly downward, then push the recorder into
the recorder magazine.
7 Slightly lift up the tabs at the bottom of the recorder and push it into the
recorder magazine.
8 Push the recorder into the recorder magazine by pressing the lower part.
When a click sound is heard, the installation is complete.
NOTE: If the recorder is not parallel to the monitor case, the recorder
may get stuck in the recorder magazine. If it gets stuck, press
the release lever of recorder with a strong force as shown in the
picture to take out the recorder, and then reinstall it.
CAUTION
Do not touch the thermal head inside the recorder module. The
thermal head may be damaged by static electricity or become dirty
and cause printing failure.
1 Move the door release lever in the direction of the arrow ( ) to release the
lock.
2 Open the recorder door and set the recording paper (RQW50-2SK) according
to the picture as shown on the recorder cover.
Set the recording paper as
shown in the picture.
4 Close the recorder door by pressing the middle of the door. If the “CLOSE
PAPER MAGAZINE” message and icon are still displayed, the recorder
door is not closed properly.
The middle part. Press
this part to close the
recorder door.
Power
2
The monitor can operate on either battery or AC power.
When the power cord is plugged into an AC outlet and the power switch on the
front panel is turned on, the monitor operates on AC power.
When a SB-752P battery pack is installed in the monitor and the power cord
is disconnected or there is a sudden power failure, the monitor automatically
switches to battery power.
When there is no battery pack in the monitor and there is a sudden power failure,
the stored data remains in memory for about 30 minutes after the power is shut
down.
The battery is charged when the power cord is plugged into an AC outlet and
the AC current is supplied to the monitor. The battery is also charged during
monitoring.
When the monitor is operated on battery power, the brightness of the screen can
be reduced to save battery power.
The monitor can operate for about 6 hours with a new fully charged battery pack
when:
• Used in normal temperature.
• Optional recorder module is not installed.
• No alarm occurs.
• Only monitoring ECG.
• <POWER SAVING MODE> on the SYSTEM SETUP window is set to ON.
• NIBP is not measured.
WARNING
Only use the provided power cord. Using other power cords may
result in electrical shock or injury to the patient and operator.
Connect the provided power cord to the AC SOURCE socket on the rear panel of
the monitor and plug the cord into a 3-prong AC outlet.
When the AC power is supplied to the monitor, the AC power lamp on the front
panel lights.
NOTE: If the AC power lamp does not light, check the power cord
connection.
WARNING
When several medical instruments are used together, ground all
instruments to the same one-point ground. Any potential difference
between instruments may cause electrical shock to the patient and
operator.
When more than one electrical instrument is used, there may be electrical
potential difference between the instruments. Potential difference between
instruments may cause current to flow to the patient connected to the
instruments, resulting in electrical shock (micro shock). Never use any medical
equipment in patient treatment without proper grounding.
Always perform equipotential grounding when required. It can be used in the
OR, recovery room, general ward, ICU, CCU, HCU, NICU and ER. Consult
with a biomedical engineer to determine if equipotential grounding is required.
When equipotential grounding is required, connect the equipotential ground
terminal on the instrument to the equipotential ground terminal on the wall
(equipotential grounding system) with the equipotential grounding lead (potential
equalization conductor).
CAUTION 2
When the monitor is turned on, check that one “bong” sounds and
the red, yellow and green alarm indicator lamps blink once to show
that the alarm functions properly.
NOTE • It takes a few minutes for the LCD screen to reach full
brightness.
• The shadow of the previous screen may remain for a few
minutes after changing screens.
• There may be some dots on the LCD screen which are always
on or always off, but it does not affect monitoring. This is normal
for all LCD screens.
• The patient data and settings are deleted when the monitor
power is off for more than 30 minutes and <SHOW ADMIT
CONFIRMATION WINDOW> is not checked in the SYSTEM
SETUP screen. When <SHOW ADMIT CONFIRMATION
WINDOW> is checked, the message appears asking whether
monitoring a new patient or not.
When <ADMIT MODE> is set to AUTO When <ADMIT MODE> is set to MANUAL
Press the [POWER] key on the front panel to turn the power on. The power lamp
and the AC power lamp light and self check starts. When the check is complete,
the home screen appears.
If the power lamp does not light, check the power cord connection.
When the monitor power is turned on, alarms are suspended while the monitor is
waiting for the electrodes and probe to be attached to the patient. The monitoring
starts when the connection cord is connected to the socket on the monitor and the
electrodes or probe are attached to the patient. The alarm activates when one of
the following occurs:
When <ADMIT MODE> is set to AUTO When <ADMIT MODE> is set to MANUAL
Less
Power and battery status are indicated by three lamps on the bedside monitor. A
discharged battery is also indicated by battery marks, screen message and alarm.
NOTE: When charging the battery pack with the monitor power turned off,
check that the power lamp and battery lamp light. If the lamps do
not light even when the power cord is connected and the battery
pack is inserted, turn the power key on, check that the battery
lamp is blinking or lit, then turn the power key off.
CAUTION
When charging the battery pack, keep the ambient temperature at
approximately 20 °C to maintain the optimal battery operation time. If
the battery pack is charged at less than 10 °C (50 °F) or more than
30 °C (86 °F), the maximum battery operation time will be 20 % to
30 % less than the optimal operation time.
Charging
During AC operation, the battery pack is automatically charged without
interrupting monitoring. It takes approximately 4 hours of continuous charging to
fully charge a battery pack.
After continuous charging to full charge, charging stops and the battery voltage
is continuously checked. The monitor controls charging to keep the battery pack
fully charged.
NOTE: Do not disconnect the power cord from the monitor during battery
charging.
CAUTION
Follow the specified procedure to turn off the bedside monitor.
Otherwise, patient data will be deleted and the storage device and
data in the storage device may be damaged.
Press the [POWER] key on the front panel for more than 1 second to turn the
power off. The screen becomes dark and the power lamp on the front panel turns
off.
NOTE • Press and hold the [POWER] key for more than 1 second to
turn the power off.
• Do not disconnect the power cord while the monitor power is
on. The data may be lost.
Admitting.........................................................................3-8
Displaying the ADMIT Window.......................................................3-8
Closing the ADMIT Window............................................................3-9
Entering the Patient Name.............................................................3-9
Entering the Patient Name by Using the Keyboard................... 3-9
Entering the Patient Name by Using Free Function.................3-10
Entering the Patient ID.................................................................3-11
Changing the Patient Type...........................................................3-12
Enter the HEIGHT/WEIGHT.........................................................3-13
Set the Gender.............................................................................3-13
Discharging...................................................................3-14
Suspended Alarms...................................................................3-15
Save Data.................................................................................3-15
3. NECESSARY SETTINGS BEFORE MONITORING
Or,
Touch the date and time at the upper right corner on the home screen.
5 Touch the [SET] key. The [SET] key must be touched to save the settings,
otherwise the settings change back to the previous settings.
When the set date is incorrect, the “OUT OF RANGE” message appears on
the screen. Enter the correct date.
Slider
3 Change settings.
• To change the alarm sound volume, touch the or key to adjust
the setting or drag the slider to the desired level on the setting bar in the
ALARM VOLUME window. You cannot set the volume to 1 which is no
sound.
• Select ON or OFF in the SYNC SOUND VOLUME window to set sync
sound on or off.
• To change the sync sound volume, touch the or key, or drag
the slider to the desired level on the setting bar in the SYNC SOUND
VOLUME window. At the lowest volume setting, the sync sound is not
audible.
Cursor
3 Touch the desired place on the setting bar in the BRIGHTNESS window.
Use the or key, or drag the slider to the desired level on the setting
bar to adjust the setting.
2 Touch the [SWEEP SPEED] key to change sweep speed for ECG and pulse
waveforms or [RESP SWEEP SPEED] or [RESP/CO2 SWEEP SPEED]
key to change sweep speed for respiration waveform. The SWEEP SPEED,
RESP SWEEP SPEED or RESP/CO2 SWEEP SPEED window opens.
3 Select the sweep speed in the SWEEP SPEED window for waveforms other
than respiration waveform.
Select the sweep speed in the RESP SWEEP SPEED or RESP/CO2 SWEEP
SPEED window for the respiration waveform.
Admitting
Before entering the name of a new patient, you must first delete all data of the
previous patient.
WARNING
When admitting a new patient, check the alarm settings. The alarm
settings return to the alarm master settings on the SYSTEM SETUP
window when either of the following occurs:
• A patient is discharged and all data is deleted on the ADMIT
window.
• <ADMIT MODE> in the SYSTEM SETUP window is set to AUTO
and 30 minutes elapse after monitor power off.
• “PATIENT TYPE” is changed on the ADMIT window.
CAUTION
When admitting a new patient, first delete all data of the previous
patient. Otherwise, the data of the previous patient and new patient
will be mixed together.
NOTE • After turning the monitor on and when admitting a patient on the
monitor, make sure that the time displayed at the upper right of
the screen is correct. When the date or time is changed during
monitoring, the date and time of all stored data is also changed
and may not match the date and time on the printout.
• When admitting a new patient, check the alarm settings.
The ADMIT window can also be displayed by touching the patient name area at
the upper part of the home screen.
1 Touch the [NAME] key on the ADMIT window, and then touch NAME tab,
the PATIENT NAME input window with keyboard appears.
Cursor
3 Touch the [ENT] key. The patient name appears in the patient name area on
the home screen.
1 Touch the [NAME] key on the ADMIT window, and then touch NAME
(FREE) tab, the NAME window with free writing area appears.
2 Write the patient name with your finger in the free writing area. You can
enter any character by drawing it.
Scroll the writing area left
or right. The displayed
writing area is 1/4 of the
total available writing area. Erase all characters.
3 Touch the [SET] key. The patient name appears in the patient name area on
the home screen.
1 Touch the [PATIENT ID] key on the ADMIT window. The PATIENT ID 3
window with keyboard appears.
Enter patient ID.
Cursor
Delete the
character after
the cursor.
Delete the character
before the cursor.
Touch the
desired Touch to enter the
character. patient name. The
The cursor registered patient
moves to name appears on
the right. the patient name
Touch to enter Enter space. Moves the cursor area on the home
capital letters. one block (one screen.
character).
3 Touch [YES] key to change patient type. Touch [NO] key to cancel the
change.
2 Enter the height and weight using the keyboard on the screen.
Touch to enter
height/weight. The
registered height/
weight appears
on the height and
weight box.
1 Touch the [GENDER] key on the ADMIT window. The setting window
opens.
Discharging
CAUTION
When admitting a new patient, first delete all data of the previous
patient. Otherwise, the data of the previous patient and new patient
will be mixed together.
3 Touch [YES] key to delete the data. Touch [NO] key to not to delete the data.
4 The home screen appears. Check the following items to confirm that all data
are deleted.
• Patient name on the home screen is deleted.
• “ALARMS SUSPENDED” message appears and alarms are suspended on
3
the monitor.
"ALARMS SUSPENDED" message appears.
Patient name is deleted.
Suspended Alarms
All alarms are suspended during discharging, admitting or when preparing for
monitoring. Alarm function resumes when the [SUSPEND ALARMS] key is
touched or the following monitoring conditions are continuously met.
Setting of <ALARM
ACTIVATION DELAY>
Condition
on the SYSTEM
SETUP Window
Alarm function activates when ECG or SpO2 is monitored
or NIBP* is measured and a value is displayed.
AUTO * When SYS, DIA or MAP value is measured.
The alarm function is also recovered when the heart rate is
0.
When one of the following requirements is met.
1 min ECG, SpO2 or IBP is continuously monitored for the
2 mins selected time.
Save Data
The patient data can be saved to USB memory.
NOTE: This is for maintenance. Only the service personnel specified by
Shanghai Kohden or authorized agents are allowed to perform the
maintenance. Please contact your Nihon Kohden representative
for more details.
Overview.........................................................................4-4
Home Screen.................................................................................4-4
Review Windows............................................................................4-4
Sync Sound....................................................................................4-4
Adjusting the Sync and Alarm Sound Volume................................4-4
Changing Settings and Performing Other Tasks during
Monitoring.......................................................................................4-4
Recording on the Home Screen.....................................................4-4
Home Screen..................................................................4-5
Settings for the Home Screen........................................................4-7
Waveform Sweep Speed............................................................4-7
Parameter Colors.......................................................................4-7
Waveform Sensitivity..................................................................4-7
Numeric Parameter Display Area (On the DISPLAY Window of
the SYSTEM SETUP Window)...................................................4-7
Displaying Other Windows from the Home Screen........................4-8
Freezing Waveforms.......................................................4-9
This section explains how to monitor the patient’s waveforms and data.
Before monitoring the patient:
• Prepare the patient and equipment according to the Administrator’s Guide and
Sections 1, 2, 3, 5, 6, and 9 to 16 of this User’s Guide. When using the optional
recorder module, also see Section 8.
• Before monitoring a new patient, follow the flowchart in Section 2.
• Read the safety precautions in “Safety Precautions for Monitoring” in this
section.
In this section:
• “Overview” gives general information for all monitoring.
• “Freezing Waveforms” explains how to freeze waveforms.
• “Displaying LARGE NUMERICS Screen” explains about displaying large
numeric data.
• “Using Sleep Mode” explains how to use sleep mode.
WARNING
Electrosurgical units (ESU) emit a lot of RF interference. If the
monitor is used with an ESU, RF interference may affect the monitor
operation.
WARNING
Locate the monitor as far as possible from the ESU. Locate them on
opposite sides of the operating table, if possible.
WARNING
Connect the monitor and ESU to different AC outlets located as far
as possible from each other.
WARNING
When the monitor is used with an ESU, firmly attach the entire area
of the ESU return plate. Otherwise, the current from the ESU flows
into the electrodes of the monitor, causing electrical burn where the
electrodes are attached. For details, refer to the ESU manual.
Using a Defibrillator
WARNING
Before defibrillation, all persons must keep clear of the bed and must
not touch the patient or any equipment connected to the patient.
Failure to follow this warning may cause electrical shock or injury.
If the ECG waveform on the screen is too unstable to synchronize with the
patient’s heart beat because of the following reason(s), remove the cause(s)
of an alarm, message, or unstable ECG, and then use a stable ECG lead for
synchronization.
• ECG electrode is detached or broken. Lead wire is detached or broken.
• Lead wire moves. AC interference, EMG noise or noise from ESU is
superimposed.
• Connection cable is broken or has a short circuit. Connector has poor contact.
Overview
Home Screen
When you first begin monitoring, the home screen appears. The home screen
displays waveforms and numeric data for ECG and other parameters. Any time
you touch the [HOME] key, the home screen appears.
The parameters on the home screen depend on the measured parameters.
When the monitor power is turned on, alarms are suspended while the monitor is
waiting for the electrodes and probe to be attached to the patient. The monitoring
starts when the connection cord is connected to the socket on the monitor and
electrodes or probe is attached to the patient.
NOTE: When <ADMIT MODE> in the SYSTEM SETUP window is set to
AUTO and the monitor power is turned on more than 30 minutes
after turning power off, the stored data in the monitor is deleted.
Review Windows
The trend, arrhythmia recall, alarm history, full disclosure and OCRG windows
display the stored data. For details about the review windows, refer to Section 6.
Sync Sound
During monitoring, a continuous “pip” sounds in synchronization with either the
QRS or pulse. QRS is the default setting. Refer to “Changing the Sync Sound
Source” in the User’s Guide Section 9, 13 or 15 to change the source of the sync
sound.
Home Screen
When you first begin monitoring, the home screen appears. To return to the home
screen from another window or screen, touch the [HOME] key.
When a window is displayed and there is no operation for about 3 minutes, the
screen automatically returns to the home screen.
4
The home screen is automatically laid out according to the measured parameters.
The layout changes when a measuring parameter changes.
The settings for monitoring parameters can be changed individually on the
parameter window. For details about individual parameters, see Sections 9 to 16.
33 32 31 30 29 28 27 26
25
24
1
23
22
2
3 21
4
5 20
6
19
7
18
17
16
8
10 11 12 13 14 15
1 Heart rate
When SpO2 is selected for the <SYNC SOURCE>, the pulse rate can be
displayed to the left of the heart rate on the screen.
2 ST level
3 VPC
4 Cuff type
5 NIBP values
Systolic, diastolic (MAP)
6 NIBP measurement mode
7 PRESS values
PRESS1 and PRESS2 (for SVM-7503 and SVM-7523)
8 Temperature values
TEMP1 and TEMP2
9 Respiration rate
15 Record key
16 Menu key
17 Pulse waveform
20 PRESS waveforms
23 ECG sensitivity
24 ECG lead
26 Battery status
It is displayed when SB-752P battery pack is installed.
27 ECG waveform
29 Patient type
30 Patient name
31 Bed ID
32 Function keys
You can “freeze” (stop sweeping) the waveforms on the home screen. By
freezing the waveforms, you can observe one part of a waveform in detail. The
numerical data on the screen are not frozen. For details, refer to the “Freezing
Waveforms” section.
You can use sleep mode when the monitor is connected to the central monitor
network. In sleep mode, the screen is darkened and sync sound is turned off to
prevent the monitor from disturbing the patient, such as during sleep. For details,
refer to “Using Sleep Mode” later in this section.
Parameter Colors
The parameter colors are set on the COLOR window of the SYSTEM SETUP
window. Refer to “COLOR Window” in the Administrator’s Guide, Section 3.
Waveform Sensitivity
Waveform sensitivity can be changed on the parameter window. Refer to
Sections 10 to 16.
Numeric Parameter Display Area (On the DISPLAY Window of the SYSTEM
SETUP Window)
You can change the layout of the home screen. Refer to “LAYOUT Page” in
Section 3 of the Administrator’s Guide.
NUMERIC PARAMETER AREA – LEFT SIDE NUMBERIC PARAMETER AREA – SIDE + SMALL BOTTOM
Freezing Waveforms
Normally, the waveforms continuously sweep across the screen. You can also
“freeze” (stop sweeping) the waveforms. By freezing the waveforms, you can
observe one part of a waveform in detail. The numerical data on the screen are
not frozen.
To freeze waveforms, the freeze function must be assigned to one of the function 4
keys in the upper left corner of the screen. Refer to “KEYS Window” in the
Administrator’s Guide, Section 3.
When the freeze function is assigned to a function key, waveforms on the home
screen can be frozen any time by touching the [FREEZE] key. The waveforms
are frozen for 3 minutes or until they are unfrozen.
When the waveforms are frozen, the “FREEZE” message appears with the frozen
time.
To unfreeze the waveforms, touch any key or any place on the screen, or touch
the FREEZE function key again, or wait for 3 minutes until they are unfrozen.
When the time is set in <SLEEP MODE WILL END AT> box on the SLEEP
window of the SYSTEM SETUP window, the monitor exits the sleep mode on
the set clock time.
Refer to the Administrator’s Guide, Section 3.
WARNING
When the <EXIT SLEEP MODE ON CRISIS ALARM> check box on
the ALARM page of the SYSTEM SETUP window is OFF, the
bedside monitor alarm cannot be seen or heard on the bedside
monitor during sleep mode. In this case, monitor the bedside monitor
alarms on the central monitor. Otherwise, the bedside monitor
alarms may be overlooked.
NOTE • After turning the monitor on and when admitting a patient on the
monitor, make sure that the time displayed at the upper right of
the screen is correct. When the date or time is changed during
monitoring, the date and time of all stored data is also changed
and may not match the date and time on the printout.
• When admitting a new patient, check the alarm settings.
PRESS1
Heart rate
SQI (Signal
Quality Index)
PRESS2
SpO2
3 To return to the standard home screen, touch the [MENU] key, and then
touch the [HOME] key.
Overview of Alarms.........................................................5-4
5
What is an Alarm............................................................................5-4
Alarm Level....................................................................................5-4
Alarm Priority..................................................................................5-5
Silencing/Suspending Alarms.........................................................5-5
Resetting Alarms............................................................................5-5
Alarm Master..................................................................................5-6
Automatic Recording......................................................................5-6
Alarm Setting..................................................................................5-6
Canceling the Technical Alarm.......................................................5-6
Adjusting Alarm Sound Volume......................................................5-6
Alarm Activation after Power On....................................................5-7
ALARM HISTORY Window............................................................5-7
Alarm Escalation............................................................................5-7
Alarm Types.....................................................................5-8
Vital Signs Alarms..........................................................................5-8
Arrhythmia Alarms..........................................................................5-8
Technical Alarms............................................................................5-9
ECG Related Alarms................................................................. 5-9
CO2 Related Alarms (SVM-7503 and SVM-7523)..................... 5-9
SpO2 Related Alarms................................................................ 5-9
NIBP Related Alarms................................................................ 5-9
IBP Related Alarms (SVM-7503 and SVM-7523).....................5-10
Temperature Related Alarms...................................................5-10
Other Alarms............................................................................5-10
Interbed Alarms........................................................................5-10
Messages.....................................................................................5-11
ECG Related Messages...........................................................5-11
Respiration Related Messages................................................5-11
CO2 Related Messages (SVM-7503 and SVM-7523)...............5-11
SpO2 Related Messages..........................................................5-11
NIBP Related Messages..........................................................5-12
IBP Related Messages (SVM-7503 and SVM-7523)...............5-12
Other Messages.......................................................................5-12
Alarm Indications...........................................................5-13
Overview......................................................................................5-13
Individual Alarm Indications..........................................................5-13
Vital Signs Alarms....................................................................5-14
Arrhythmia Alarms...................................................................5-16
Technical Alarms......................................................................5-17
Other Alarms........................................................................... 5-20
Alarm Control Marks.....................................................................5-20
Individual Vital Signs Alarm Off Marks.................................... 5-20
Flow of Alarm Function.................................................................5-21
Silencing/Suspending/Resetting Alarms........................5-22
Overview......................................................................................5-22
Silencing an Alarm.................................................................. 5-22
Suspending Alarms................................................................. 5-22
Silencing Alarms after Alarm Occurrence.....................................5-25
Silencing Alarms..................................................................... 5-25
Canceling Alarm Silence......................................................... 5-25
Suspending Alarms Before Alarm Occurrence.............................5-25
Suspending Alarms................................................................. 5-25
Suspending All Alarms Indefinitely.......................................... 5-26
Setting Alarms...............................................................5-29
Overview......................................................................................5-29
Alarm Limits Ranges....................................................................5-29
Vital Signs Alarms................................................................... 5-30
Arrhythmia Alarms.................................................................. 5-32
Setting Vital Signs Alarms Individually.........................................5-32
Automatically Setting All Upper and Lower Alarm Limits (Including
ST)................................................................................................5-33
Setting All Vital Signs Alarm Limits to a Preset Pattern (Alarm
Master).........................................................................................5-35
Checking Arrhythmia Alarm Settings............................................5-36
Interbed Alarm...............................................................5-37
5. ALARM FUNCTION
Overview of Alarms
What is an Alarm
When the monitor detects an abnormal patient condition, it can generate an alarm
sound, screen indication and alarm lamp indication. When the optional recorder
module is installed in the monitor, ECG waveforms and data can be recorded at
an alarm occurrence. You can set each individual alarm condition. There are four
types of alarms: vital signs, arrhythmias, technical alarms and interbed alarms,
and three levels of alarm: crisis, warning and advisory. The different alarm types
are fully explained in the “Alarm Types” section and different alarm levels are
explained in the “Alarm Indications” section.
WARNING
Check the alarm settings when admitting a new patient and
whenever the patient condition changes and change the alarm
settings if necessary. The alarm settings return to the alarm master
settings on the SYSTEM SETUP window when:
• A patient is discharged and all data is deleted on the ADMIT
window.
• “PATIENT TYPE” is changed on the ADMIT window.
• <ADMIT MODE> in the SYSTEM SETUP window is set to AUTO
and 30 mins elapse after monitor power off.
Highlighted
numeric data
Alarm sound
Alarm Level
There are three alarm levels: CRISIS, WARNING and ADVISORY.
* Onset of potential HARM refers to when an injury occurs and not to when it is
manifested.
The priority and monitor action are different for each level.
Alarm Priority
When several alarms occur at the same time, the alarm with the highest alarm
level is indicated.
Silencing/Suspending Alarms
You can temporarily silence current alarm sounds and indications for a 1-minute,
2-minute or 3-minute period. See the “Silencing/Suspending/Resetting Alarms”
section.
WARNING
During alarm suspension (“SUSPEND ALARMS”, “ALL ALARMS
OFF” or “ALARM RESET” message displayed), all alarms are turned
off. Be careful when you suspend the alarm.
Resetting Alarms
When an alarm occurs, you can reset the alarm by touching the [ALARM
RESET] key. While the key is touched, the "ALARM RESET" message appears,
the alarm value is highlighted and the alarm sound is deactivated. The alarm
reoccurs when an alarm different from the reset one occurs, or cause of alarm
was eliminated temporarily.
Alarm Master
For fast and easy alarm setup, a group of alarm items can be set all together
at one time. For example, there may be typical alarm settings at your hospital,
or you may have certain alarm settings for certain patients. There is one alarm
master for vital signs and one alarm master for arrhythmias. The alarm masters
are set by the administrator on the MASTER window of the SYSTEM SETUP
window.
Even when alarms are set by an alarm master, individual alarm settings can still
be changed on the ALARM LIMITS and ARRHYTH ALARMS windows or
the alarm setting window of each parameter window. See the “Setting Alarm”
section.
Automatic Recording
When the optional recorder module is installed in the monitor, you can set the
monitor to automatically record ECG waveforms and data when an alarm occurs.
See the “Turning Automatic Alarm Recording On/Off” section.
If a higher level alarm occurs during another alarm recording, the present alarm
recording is canceled and the higher level alarm is recorded.
Alarm Setting
Usually, alarms are set before monitoring, but alarms can be set or changed
anytime without interrupting monitoring.
If you turn the bedside monitor power off and 30 minutes elapses when <ADMIT
MODE> is set to AUTO or change the PATIENT TYPE setting, all alarm settings
return to the alarm master settings of the SYSTEM SETUP window.
To set a parameter alarm to off, set the upper and lower limits to OFF.
CAUTION
After the monitor power is turned on, parameter-related alarms do
not function until the parameters are monitored.
When the monitor power is turned on, alarms are suspended while the monitor is
waiting for the electrodes and probe to be attached to the patient. The monitoring
starts when the connection cord is connected to the socket on the monitor and the 5
electrodes or probe are attached to the patient. The alarm activates when one of
the following occurs:
• ECG or SpO2 is monitored or NIBP is measured and a value is displayed
(when AUTO is selected for <ALARM ACTIVATION DELAY> on the
ALARM window of the SYSTEM SETUP window)
• ECG, SpO2 or IBP is continuously monitored for the selected time (when 1
min, 2 min or 3 min is selected for <ALARM ACTIVATION DELAY>)
• NIBP is measured (when 1 min, 2 min or 3 min is selected for <ALARM
ACTIVATION DELAY>)
Alarm Escalation
If the APNEA, SpO2, CHECK ELECTRODES, ECG CANNOT ANALYZE or
SpO2 CHECK PROBE alarm occurs and no action is taken for a selected time,
the alarm level can be escalated. For details, refer to “ALARM Window” in
Section 3 of the Administrator’s Guide.
Alarm Types
Alarms are divided into 4 categories: vital signs, arrhythmia, technical and
interbed alarms. The alarm name is displayed on the screen when an alarm
occurs. For the vital signs and arrhythmia alarms, waveforms and data can be
recorded in automatic alarm recording when the optional recorder module is
installed in the monitor.
For the alarm types which are not classified into alarm levels, only the message
is displayed.
Arrhythmia Alarms
Arrhythmia Name Description
ASYSTOLE Longer than 3 to 10 seconds (selectable) with no QRS complex.
VF Ventricular fibrillation longer than 4 seconds.
VT Ventricular tachycardia. 9 or more consecutive VPCs when
heart rate is exceeding 100 beats/min.
VPC RUN VPC short run. 3 to 8 (selectable) consecutive VPCs.
TACHYCARDIA Heart rate above the upper heart rate limit.
BRADYCARDIA Heart rate below the lower heart rate limit.
COUPLET VPC couplet (paired VPCs). 2 consecutive VPCs.
EARLY VPC Early VPC including R-on-T type. VPC with a time interval
from the preceding normal QRS complex of less than
approximately one-third of the normal R-R interval, at heart
rate dropping below 120* beats/min.
BIGEMINY Ventricular bigeminy. 3 or more consecutive pairs of VPC and
normal QRS. A dominant rhythm of N-V-N-V-N-V (N = normal
beat, V = ventricular beat)
FREQ VPC Frequent VPCs. VPC rate (VPCs/min) reaching or exceeding
the preset limit of 1 to 99 VPCs/min (selectable).
VPC Ventricular premature contraction.
* 120 beats/min when <PATIENT TYPE> is set to ADULT, 150 beats/min when
<PATIENT TYPE> is set to CHILD or NEONATE.
Technical Alarms
You can see the detailed information of the technical alarms by touching the
[GUIDE] key on the upper right of the screen. For details, refer to “Guide
Window” in Section 1.
Other Alarms
Alarm Name Description
– – – ALARM Alarm concerning the – – – (parameter name)
occurred.
BATTERY ERROR Battery problems.
BATTERY WEAK Battery pack is nearly discharged.
CLOCK IC FAILURE The clock IC is damaged.
MPU MODULE ERROR MPU circuit malfunction.
PARAMETER NOT AVAILABLE Connected cord or cable of the parameter is not
available on the monitor.
COMMUNICATION LOSS The network cable of the CNS is disconnected
from the monitor.
Interbed Alarms
When an alarm occurs on an interbed bed, the interbed alarm occurs on this
bedside monitor. For details, refer to “Interbed Alarm” later in this section.
Messages
The following messages are monitoring information and are not considered
alarms.
* When this message is displayed for more than 30 seconds, the message
changes to the “CANNOT DETECT PULSE” alarm.
Other Messages
Message Description
ALARM SILENCED Alarm is silenced.
ALARM SUSPENDED/ The [SUSPEND MONITORING] key was touched.
SUSPENDED MONITORING
ALARMS SUSPENDED: X min The [SUSPEND ALARMS] key was touched.
Remaining suspended time is indicated.
ALL ALARMS OFF The [ALL ALARMS OFF] key was touched to turn
all alarms OFF.
ALARM RESET The [ALARM RESET] key was touched to reset
all alarms.
CLOSE PAPER MAGAZINE Recorder door is open.
FREEZE Waveforms are frozen.
INSERT REC PAPER No recording paper.
Bed name INTERBED ALARM Alarm occurred on an interbed bed of the bed
name.
MONITOR OFF Monitor cannot access to interbed bed.
SIMULATED DATA The displayed data is simulated data.
UPDATING DATA Changing the parameter on the trend window.
Alarm Indications
Overview
The monitor can indicate alarms both visually and audibly:
• Alarm sound
• Alarm message or highlighted numeric data on the screen
5
• Alarm indicator: red blinking, yellow blinking or yellow lit LED
Alarm control marks indicating that various alarm functions are turned off are
also displayed.
The same color is set for all parameters. When an alarm occurs, the alarmed
parameter color changes according to the alarm level set on the SYSTEM
SETUP window. Refer to the Administrator’s Guide, Section 3.
CRISIS: red
WARNING: yellow
ADVISORY: yellow
The alarm indicator on the monitor indicates three alarm levels: crisis, warning
and advisory. The lamp blinks or lights according to the alarm level. The colors
are set on the SYSTEM SETUP window.
CRISIS: Blinking red
WARNING: Blinking yellow
ADVISORY: Lights in yellow
Sound/Display Alarm
Alarm Alarm Level Alarm Sound Alarm Display
Duration Indicator LED
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “RR Blinking red
IEC standard (ceg-gC) ALARM” message
NK1 (Continuous bing bong Highlighted numeric
RR WARNING sound), NK2 (Continuous ding data and “RR During detection Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 and NK2 (Single beep every Highlighted numeric
ADVISORY 20 s) or IEC standard (ec every data and “RR Lights in yellow
20 s) ALARM” message
NK1 (Continuous pip sound), Highlighted 5
CRISIS NK2 (Continuous ping sound) or “APNEA ALARM” Blinking red
IEC standard (ceg-gC) message
NK1 (Continuous bing bong Highlighted
APNEA WARNING sound), NK2 (Continuous ding “APNEA ALARM” During detection Blinking yellow
ding sound) or IEC standard (ceg) message
NK1 and NK2 (Single beep every Highlighted
ADVISORY 20 s) or IEC standard (ec every “APNEA ALARM” Lights in yellow
20 s) message
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “SpO2 Blinking red
IEC standard (ceg-gC) ALARM” message
SpO2 During detection
NK1 (Continuous bing bong Highlighted numeric
WARNING sound), NK2 (Continuous ding data and “SpO2 Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “NIBP Blinking red
IEC standard (ceg-gC) ALARM” message
NK1 (Continuous bing bong Highlighted numeric
NIBP WARNING sound), NK2 (Continuous ding data and “NIBP During detection Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 and NK2 (Single beep every Highlighted numeric
ADVISORY 20 s) or IEC standard (ec every data and “NIBP Lights in yellow
20 s) ALARM” message
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “PRESS Blinking red
IEC standard (ceg-gC) ALARM” message
NK1 (Continuous bing bong Highlighted numeric
PRESS* WARNING sound), NK2 (Continuous ding data and “PRESS During detection Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 and NK2 (Single beep every Highlighted numeric
ADVISORY 20 s) or IEC standard (ec every data and “PRESS Lights in yellow
20 s) ALARM” message
Sound/Display Alarm
Alarm Alarm Level Alarm Sound Alarm Display
Duration Indicator LED
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “TEMP Blinking red
IEC standard (ceg-gC) ALARM” message
NK1 (Continuous bing bong Highlighted numeric
TEMP WARNING sound), NK2 (Continuous ding data and “TEMP During detection Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 and NK2 (Single beep every Highlighted numeric
ADVISORY 20 s) or IEC standard (ec every data and “TEMP Lights in yellow
20 s) ALARM” message
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “CO2 (E) Blinking red
IEC standard (ceg-gC) ALARM” message
CO2(E)* During detection
NK1 (Continuous bing bong Highlighted numeric
WARNING sound), NK2 (Continuous ding data and “CO2 (E) Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
NK1 (Continuous pip sound), Highlighted numeric
CRISIS NK2 (Continuous ping sound) or data and “CO2 (I) Blinking red
IEC standard (ceg-gC) ALARM” message
CO2(I)* During detection
NK1 (Continuous bing bong Highlighted numeric
WARNING sound), NK2 (Continuous ding data and “CO2 (I) Blinking yellow
ding sound) or IEC standard (ceg) ALARM” message
Arrhythmia Alarms
Sound/Display Alarm
Alarm Alarm Level Alarm Sound Alarm Display
Duration Indicator LED
ASYSTOLE
NK1 (Continuous pip sound),
VF CRISIS NK2 (Continuous ping sound) or Highlighted message During detection Blinking red
IEC standard (ceg-gC)
VT
NK1 (Continuous pip sound),
CRISIS NK2 (Continuous ping sound) or Highlighted message Blinking red
VPC RUN, IEC standard (ceg-gC)
Technical Alarms
ECG related alarms
Sound/Display Alarm
Alarm Alarm Level Alarm Sound Alarm Display
Duration Indicator LED
CHECK NK1 (Continuous bing bong Highlighted
ELECTRODES WARNING sound), NK2 (Continuous ding numeric data and Blinking yellow
ding sound) or IEC standard (ceg) message
CHECK
ELECTRODE
–– 5
(electrode lead
name) During detection
NK1 and NK2 (Single beep every
Highlighted
ADVISORY 20 s) or IEC standard (ec every Lights in yellow
message
20 s)
CANNOT
ANALYSIS
MODULE
ERROR
CO2 CHANGE
ADAPTER NK1 and NK2
(Single beep
ADVISORY every 20 s) or Highlighted message During detection Lights in yellow
CO2 CHECK IEC standard (ec
SENSOR every 20 s)
CO2 SENSOR
ERROR
CHECK PROBE
SITE
NK1 and NK2
CONNECTOR (Single beep
OFF Lights in
ADVISORY every 20 s) or Highlighted message During detection
yellow
IEC standard (ec
every 20 s)
LIGHT
INTERFERENCE
MODULE
ERROR
NK1 (Continuous
bing bong sound),
NK2 (Continuous Blinking
WARNING
ding ding sound) yellow
or IEC standard
CHECK PROBE (ceg) Highlighted message During detection
NK1 and NK2
(Single beep
Lights in
ADVISORY every 20 s) or
yellow
IEC standard (ec
every 20 s)
CANNOT DETECT
PULSE
CHECK INTERVAL
SETTING
5
CHECK PATIENT
NK1 and NK2
TYPE
(Single beep
Lights in
ADVISORY every 20 s) or Highlighted message During detection
yellow
IEC standard (ec
CONNECTOR OFF
every 20 s)
MEAS TIME-OUT
MODULE ERROR
SYSTOLIC OVER
Other Alarms
Alarm
Alarm Sound/Display
Alarm Alarm Sound Alarm Display Indicator
Level Duration
LED
MPU MODULE
ERROR
TRANSMITTER
CONNECTOR OFF
CHECK ALARM
OUT CABLE
Alarms are suspended infinitely or vital sign alarm limit is set to off.
LIMIT DISPLAY set to MARK BRIGHT LIMIT DISPLAY set to MARK DIM LIMIT DISPLAY set to VALUES
Startmonitoring
Start monitoring
Suspend all
Suspend
Suspend all alarms by touching the ALL ALARMS
ALARMS
OFF
OFF key
key on the MENU window
The “ALL ALARMS
The “ALL ALARMSOFF” OFF”message
message with
with all all alarms
alarms off
off mark
all alarms
appears
mark at the top
appears of the
at the topscreen.
of the screen. Suspend
Suspend all
all alarms
alarms by
by touching
touching the SUSPEND
alarms indefinitely
Suspend
No alarms
alarms are
aregenerated
generateduntil the alarm function is is MONITORING key
MONITORING key on
on the
the MENU
MENU window
window
Suspend all
No until the alarm function
re-activated.
re-activated. The
The “SUSPEND MONITORING” and “ALARMS SUSPENDED”
5
indefinitely
messagewith
message withalarm
alarm suspended
suspended mark
mark alternately
alternately appears
appears at top
at the the
topthe
of of screen.
the screen. No alarms
No alarms are generated
are generated untiluntil the system
the system resumes
resumes
Suspend alarms by
Suspend all alarms bytouching
touchingthe
theSUSPEND
SUSPEND
ALARMS key
ALARMS key onon the
theMENU
MENUwindow
window
The
The “ALARMS
“ALARMS SUSPEND
SUSPENDED -- min” message
--- min” appears
message at the
appears at top
the
top
of of screen.
the the screen. No alarms
No alarms are generated
are generated for afor
seta period.
set period.
Arrhythmia
Arrhythmia Technical
Technical Interbed
Interbed
Vital sign
Vital sign alarm
alarm
alarm
alarm alarm
alarm alarm
alarm
window
Not
Not connected
connected
Off
Arrhythmia is
Arrhythmia is No
No interbed
interbed
setting and
On not Connected
Connected operation
operation
not analyzed
analyzed
and alarm
Set
Set alarm
alarm on
on or
or off
off for
for each
each Set interbed alarm on or off
arrhythmia and
arrhythmia and alarm
alarm threshold
threshold
alarm behaviors
generated
generated
On
On Off
Off Off
Off
No
No alarms
alarms generated
generated No
Noalarms
alarms
On even
even if arrhythmia
arrhythmia isis On
On generated
generated
detected
detected.
An
An alarm
alarm is
is generated
generated when
when An alarm is generated An
Analarm
alarmisisgenerated
generated AnAnalarm
alarmisisgenerated
generatedwhen
the
the alarm
alarm setting
setting value
value is when an arrhythmia is when
whena atechnical
technicalalarm
alarmis anwhen
alarmanisalarm
detected on an
is detected
exceeded.
is exceeded. detected. detected.
is detected. interbed bed.
on an interbed bed.
Silence
Silence Alarms
Alarms
Identify
Identifythe
thecause
causeofofthe
thegenerated
generatedalarm
alarmand
andsilence
silencethe
thealarm
alarm Identify
Identifythe
thecause
causeofofthe
the
Silence an alarm
by
bypressing
pressingthe
theSilence
[SilenceAlarms key
Alarms] key generated
generatedalarm
alarmand
and
silence
silencethe
thealarm
alarmbyby
The
The“ALARMS SILENCED -----min”
“ALARM SILENCED min”message
message and thethe
and period in which
period the
in which touching
alarm is silenced appearappear
at the top of the touchingthetheSILENCE
SILENCE
the alarm is silenced at the topscreen.
of the screen. ALARM
ALARMkey keyononthe
the
INTERBED
INTERBEDwindowwindow
Silencing/Suspending/Resetting Alarms
Overview
Silencing an Alarm
When an alarm occurs, you can silence the alarm sound and indications for
1, 2 or 3 minutes by touching the [Silence Alarms] key on the screen. When a
vital signs alarm or arrhythmia alarm is silenced, the alarm resumes after the
alarm silence ends. When a technical alarm other than the following alarms is
silenced, the alarm indication does not resume after the alarm silence ends. If the
following alarms are silenced, the alarm resumes after the alarm silence ends.
• BATTERY ERROR
• BATTERY WEAK
• ECG CANNOT ANALYZE
• NIBP CUFF OCCLUSION
• NIBP SAFETY CIRCUIT RUNNING
• SpO2 CHANGE PROBE
When several alarms occur together and the [Silence Alarms] key is touched,
all alarms are silenced. To cancel vital sign or arrhythmia alarm silence, touch
the [Silence Alarms] key <SILENCE ALARMS TIME> is set on the ALARM
window of the SYSTEM SETUP window. Refer to the Administrator’s Guide,
Section 3.
When [Silence Alarms] key is touched, technical alarms can be reset, or alarms
can be silenced. You can select on <SILENCE KEY FUNCTION> of SYSTEM
SETUP window.
SILENCE KEY FUNCTION:
• RESET TECHNICAL ALARMS When this function is selected and a technical
alarm occurs, touch [Silence Alarms] key to reset
the technical alarm. When the key is touched, the
alarm sound is silenced and the alarm message is
disappeared.
• SILENCE ONLY When this function is selected and a technical alarm
occurs, touch [Silence Alarms] key to silence the
technical alarm. When the key is touched, the alarm
sound is silenced, but the alarm message is still
displayed on the screen.
Suspending Alarms
All alarms can also be suspended before they occur. During alarm suspension, all
alarms are off. This monitor has two types of alarm suspension according to the
settings of the SILENCE/SUSPEND page of the ALARM window.
SUSPEND ALARMS
Silencing Alarms
Touch the [Silence Alarms] key. The “ALARMS SILENCED” message and the
time remaining in the alarm silence are displayed on the screen.
Suspending Alarms
By touching the [SUSPEND ALARMS] key, all alarms for the patient are
suspended for 1 min, 2 min or 3 min. The alarm suspend time can be set to 1
min, 2 min or 3 min at <SUSPEND ALARMS TIME> on the ALARM window
of the SYSTEM SETUP window. Refer to the Administrator’s Guide, Section 3.
The default setting is 2 minutes.
WARNING
Do not turn all alarms off with the [ALL ALARMS OFF] key or
[ALARM RESET] key when there is no medical staff around the
patient or when the patient is connected to a ventilator.
2 Touch the [ALL ALARMS OFF] key. The following window appears for
confirmation.
3 Touch the [YES] key. If you wish to cancel, touch the [NO] key.
The “ALL ALARMS OFF” message appears on the screen.
5
Resuming Alarms
To resume alarms, touch the [ALL ALARMS OFF] key again. Alarms can only
resume by touching the [ALL ALARMS OFF] key. Or, alarms resume when a
new alarm occurs.
Suspending All Alarms and NIBP STAT and Auto Measurement Indefinitely
You can suspend all alarms and NIBP STAT/SIM and auto measurements for an
indefinite time by touching the [SUSPEND MONITORING] key.
The [SUSPEND MONITORING] key is displayed on the MENU window when
the SUSPEND ALARMS is selected at <ALARM INACTIVATION> on the
ALARM window of the SYSTEM SETUP window. Refer to the Administrator’s
Guide, Section 3.
Resuming Alarms
To resume alarms, touch the [SUSPEND MONITORING] key again. Alarms
also resume when the <ALARM ACTIVATION DELAY> condition is met.
To resume NIBP measurement in STAT or Auto mode, touch the [NIBP Start/
Stop] key. Refer to Section 15.
Setting Alarms
Overview
There are three ways to set alarm limits and on/off settings:
• Set all alarm limits at the same time on one window.
• Set a group of alarm items all together to a preset pattern using an alarm
master. 5
• Set the alarms for individual parameters separately from the ECG, RESP/CO2,
SpO2, NIBP, PRESS and TEMP windows. See Sections 9 to 15.
Vital signs alarm limits can be set on two different windows: the ALARM
LIMITS window and the alarm setting page for the individual parameter
window. When you change an alarm setting on one window, the same setting on
the other window is also automatically changed.
Arrhythmia alarm limits can be set on MAIN tab - ECG page - PARAMETERS
window of the SYSTEM SETUP window.
When the ADMIT MODE in the SYSTEM SETUP window is set to AUTO, the
setting remains in memory even when the power is turned off. After 30 minutes,
the setting returns to the master settings. When the ADMIT MODE in the
SYSTEM SETUP window is set to MANUAL, you can select whether to save or
initialize the master settings.
To set NIBP alarm limits for neonate or child, the patient type on ADMIT
window must be changed to NEONATE or CHILD.
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Be careful when you set the alarm limit to OFF.
OFF, 1 to 98 mmHg 1
Lower OFF
OFF, 0.1 to 12.9 kPa 0.1
ALARM LIMITS
Arrhythmia Alarms
Window Setting Items Settings Range Step Default Setting
ON fixed
ASYSTOLE 1 ON (5 s)
3 to 10 s
ARRHYTH ALARMS
VF ON fixed – ON
VT ON fixed – ON
ON, OFF
VPC RUN 1 ON (3 beats)
3 to 8 beats
COUPLET ON, OFF – OFF
EARLY VPC ON, OFF – OFF
BIGEMINY ON, OFF – OFF
Selected parameter
Parameter
keys
Upper limit
2 Touch the parameter key for the limit you want to change.
3 Touch and drag the sliders to the desired level on the setting bar. Use the
or to adjust the setting.
If the upper limit is set to a value above the maximum or the lower limit is
set to a value below the minimum, the alarm is set to OFF.
Automatically Setting All Upper and Lower Alarm Limits (Including ST)
You can automatically set all upper and lower alarm limits (including ST) with
respect to the current measuring values. This function allows you to suitably set
alarm limits according to a patient.
NOTE: You cannot automatically set any parameters not currently
measured or assigned with invalid values.
* Not automatically set (the upper limit value is greater than the lower limit
value).
ii) Touch the [YES] key. All upper and lower alarm limits (including ST) are
replaced by the values according to current measurements.
Setting All Vital Signs Alarm Limits to a Preset Pattern (Alarm Master)
For fast and easy alarm setup, a group of alarm items can be set all together to
one group of preset settings. This is called an alarm master. This is useful, for
example, if there are typical alarm settings at your hospital, or you have certain
alarm settings for certain patients.
You can also change individual alarm settings, as described in previous pages,
after setting all alarms with an alarm master.
The alarm masters are set by the administrator on the MASTER window of the
SYSTEM SETUP window.
5
1 Display the ALARM LIMITS window.
Touch the [MENU] key → [ALARM LIMITS] key.
3 Touch the [YES] key to change all settings to the values set on the MAIN
ALARMS page - MATER window - SYSTEM SETUP window.
Touch the [NO] key to cancel changing the alarm settings to the alarm
master settings.
WARNING
For arrhythmia monitoring, set <ARRHYTHMIA ANALYSIS> on the
PARAMETERS window of the SYSTEM SETUP window to ON.
Otherwise, there is no sound or indication for arrhythmia alarms.
CAUTION
When the alarm is turned OFF for an arrhythmia, there will be no
alarm for that arrhythmia type. There is no message or mark to
indicate that a certain arrhythmia alarm is turned off. Therefore, be
careful when you turn off an arrhythmia alarm.
Interbed Alarm
When an interbed alarm occurs, the monitor acts as follows.
NOTE: Parameters which cannot be measured on this monitor are
displayed as “ALARM”.
The monitor action depends on the INTERBED ALARM setting. For details,
refer to the “INTERBED Window” section.
INTERBED ALARM Setting ON OFF
5
Alarm Indicator Off
Three continuous ping sounds (only No sound
Alarm Sound
when the alarm is detected)
The bed ID of interbed alarm The bed ID is highlighted.* The bed ID is displayed in white.
bed is displayed in the upper
right corner. When two or
more alarms are detected, the
Home Screen bed IDs alternate.
Vital sign and arrhythmia alarm: remain Vital sign and arrhythmia alarm: remain
After the alarm is highlighted in white font
Bed ID
silenced.
Technical alarm: Bed ID disappears
The bed ID and interbed alarm message is highlighted.*
* When the alarm of crisis or warning level occurs, the message blinks.
General...........................................................................6-3
6
Review Recording..........................................................................6-3
Time Bar.........................................................................6-4
Scrolling the Time Bar....................................................................6-4
RECALL Window.........................................................6-18
General.........................................................................................6-18
Arrhythmia List.........................................................................6-18
Displaying the RECALL Window..................................................6-19
Scrolling the Arrhythmia Recall Files.......................................6-19
Selecting the Arrhythmia Types to be Saved as a Recall File......6-20
Displaying the Actual Size Waveform of the Selected Arrhythmia
Recall File.....................................................................................6-20
Arrhythmia Waveform Annotation........................................... 6-20
Recording the Arrhythmia Recall Waveform.................................6-21
Recording on the ARRHYTH HISTORY Window....................6-21
Recording on the Actual Size ECG Waveform Window.......... 6-22
OCRG Window.............................................................6-26
Displaying the OCRG Window.....................................................6-26
Changing the OCRG Display Setting...........................................6-27
Changing the Trendgraph Scale for Heart Rate and SpO2 and
Sensitivity for Respiration.............................................................6-28
Recording the OCRG Trend.........................................................6-29
General
You can review saved data on the following review windows. All windows and
pages can display the data of past 120 hours.
• TREND TABLE window: Displays vital sign data of past 120 hours.
• NIBP TABLE window: Displays vital sign data at the NIBP measurement of past
120 hours.
• TREND GRAPH window: Displays trendgraphs of the past 120 hours.
• RECALL window: Displays arrhythmia waveforms from 4 seconds before to
4 seconds after the arrhythmia detection. Up to 120 hours
of files can be saved.
• FULL DISC window: Displays up to 120 hours of compressed and expanded
6
ECG waveforms.
• ALARM HISTORY Displays a table of vital sign alarms and arrhythmia
window: alarms. Up to 120 hours of files can be saved.
• OCRG window: Displays the heart rate, SpO2 and impedance respiration
trendgraphs of the past 120 hours. OCRG window is
available when the patient type setting is NEONATE.
NOTE • When changing the review window, the data at the cursor on
the original window is also displayed on the second window. For
example, if the FULL DISC window is centered on 14:30, and
the window is changed, the ALARM HISTORY window will be
centered on 14:30.
• When <ADMIT MODE> in the SYSTEM SETUP window is set
to AUTO and the monitor power is turned on after the power
has been off for more than 30 minutes, the stored data for the
previous patient (patient information, trend table, NIBP table,
arrhythmia recall, full disclosure, trendgraph and alarm history)
is deleted. Even if <ADMIT MODE> is set to MANUAL, data
(patient information, trend table, NIBP table, arrhythmia recall,
full disclosure, trendgraph and alarm history) is deleted if the
monitor is off for more than 24 hours.
• The oldest file is deleted when the maximum number of files are
saved.
• Do not disconnect the power cord while the monitor power is
on. The data may be lost.
Review Recording
You can record review data. For details of recording, refer to the Section 8
“Recording”.
Time Bar
The time bar is displayed at the lower part of the review window. You can
display the trendgraph, table, NIBP table, recall event, alarm history and full
disclosure of the time by touching the desired time on the time bar.
Overview
There are 2 trendgraphs on the TREND GRAPH window. You can select
common or separate scales for each trendgraph. Common scale trendgraph can
display trendgraphs for up to 3 selected parameters and separate scale trendgraph
can display trendgraphs for up to 2 selected parameters of the past 120 hours.
You can record trendgraphs on the optional recorder.
The maximum, mean and minimum values of all monitoring parameters are
automatically acquired every 1 minute for the trendgraph. The acquired values 6
are 1-minute averaged data. The frequency of data display depends on the
selected trend time.
1 or 2 h: 1 min
4 h: 2 min
8, 24 h: 4 min
120 h: 15 min
2 Touch the [TREND GRAPH] key. The TREND GRAPH window appears.
When TREND GRAPH is assigned to one of the function keys at the upper
left of the screen, the trendgraph window can be displayed by touching
the TREND GRAPH function key. Refer to “KEYS Window” in the
Administrator’s Guide, Section 3 to assign a function to the function key.
You can change time bar time interval by touching the or key above the
time bar. When the key is touched, the interval changes 120 h → 24 h → 8 h
→ 4 h → 2 h → 1 h. When the key is touched, the interval changes 1 h → 2 h
→ 4 h → 8 h → 24 h → 120 h. The time bar can be scrolled by touching the
or key on the time bar.
You can select the trendgraph parameters and the display format on the
PARAMETER SETUP window, and the scale on the SCALE SETUP window.
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, touch the [HOME] key.
Selectable
parameters
Unselect the
parameters
Trendgraph Keys for displaying
display position other parameters
5 Select the parameter by touching the desired parameter key. Use the [NONE]
key to deselect the parameter.
1 Touch the [SCALE] key on the TREND GRAPH window. The SCALE
SETUP window appears.
Trendgraph
parameter
Upper limit slider
Setting bar
3 Touch and drag the sliders to the desired level on the setting bar.
AVERAGE
6
1 Touch the [SETUP] key on the TREND GRAPH window. The
PARAMETER SETUP window appears.
1 Display the trendgraph you want to record on the TREND TABLE window.
Recording example
Overview
The TREND TABLE window displays monitoring parameter data of up to 15
selected parameters as a table and you can change the display interval. One page
shows 6 files. Each file appears in a separate column. Up to 120 hours of files
of periodic vital signs can be created. The table can be recorded on the optional
recorder module.
NOTE: When <ADMIT MODE> in the SYSTEM SETUP window is set to
AUTO and the monitor power is turned on more than 30 minutes 6
after turning power off, the stored data in the monitor is deleted.
Even if <ADMIT MODE> is set to MANUAL, data is deleted when
the monitor is turned off for more than 24 hours.
2 Touch the [TREND TABLE] key. The TREND TABLE window appears.
When TREND TABLE is assigned to one of the function keys at the
upper left of the screen, the TREND TABLE window can be displayed by
touching the TREND TABLE function key. Refer to “KEYS Window” in the
Administrator’s Guide, Section 3 to assign a function to the function key.
Display other review windows
Selected file
Scroll to display
Display the parameters other parameter
selected in the SETUP data
window
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, touch the [HOME] key.
2 Select the display position from the left column. Select the parameter from
the right column. The selected parameter appears in the display order on the
left column.
Selected parameters in the display order.
Up to 15 parameters can be selected.
Selectable
parameters
Unselect the
parameter
Keys for displaying other parameters
2 Select the interval for the trend table on the INTERVAL window.
1 Display the trend table you want to record on the TREND TABLE window.
3 Set the RECORD START TIME and RECORD END TIME with the
and key.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
Recording example
Overview
The NIBP TABLE window displays monitoring parameter data of up to 15
selected parameters with NIBP as a table. Data for all parameters is automatically
entered into the table every time NIBP is measured. The table can be recorded on
the optional recorder module.
One page shows 6 measurements. Each measurement appears in a separate
column. Up to 120 hours of data can be registered to the NIBP trend table. If
more than 120 hours past, the oldest measurement data is deleted. 6
NOTE: When <ADMIT MODE> in the SYSTEM SETUP window is set to
AUTO and the monitor power is turned on more than 30 minutes
after turning power off, the stored data in the monitor is deleted.
Even if <ADMIT MODE> is set to MANUAL, data is deleted when
the monitor is turned off for more than 24 hours.
2 Touch the [NIBP TABLE] key. The NIBP TABLE window appears.
When NIBP TABLE is assigned to one of the function keys at the
upper left of the screen, the NIBP TABLE window can be displayed by
touching the NIBP TABLE function key. Refer to “KEYS Window” in the
Administrator’s Guide, Section 3 to assign a function to the function key.
Selected file
Scroll to display
Display the parameters other parameter
selected in the SETUP data
window
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, touch the [HOME] key.
1 Touch the [SETUP] key on the NIBP TABLE window. The PARAMETER
SETUP window appears.
2 Select the display position from the left column. Select the parameter from
the right column. The selected parameter appears in the display order on the
left column.
Selected parameters in the display order.
Up to 15 parameters can be selected.
Selectable
parameters
Unselect the
parameter
Keys for displaying other parameters
1 Display the NIBP trend table you want to record on the NIBP TABLE
window.
3 Set the RECORD START TIME and RECORD END TIME with the
and key.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
4 Confirm the RECORD PAGES and touch the [RECORD] key. Recording
starts.
To stop recording, touch the Record key .
Recording example
RECALL Window
General
An ECG waveform of 4 seconds before and 4 seconds after the arrhythmia
detection is saved as an arrhythmia recall file. Up to 120 hours of files can
be created. When more than 120 hours of files are created, the oldest file is
automatically deleted.
To create arrhythmia recall files:
• <ARRHYTHMIA ANALYSIS> on the SYSTEM SETUP window must be set
to ON. Refer to “ARRHYTH Page” in Section 3 of the Administrator’s Guide.
• The type of arrhythmias you want to save as files must be selected on the
ARRHYTHMIA EVENT SETUP window. Refer to “Selecting the Arrhythmia
Types to be Saved as a Recall File” section.
NOTE: When <ADMIT MODE> in the SYSTEM SETUP window is set to
AUTO and the monitor power is turned on more than 30 minutes
after turning power off, the stored data in the monitor is deleted.
Even if <ADMIT MODE> is set to MANUAL, data is deleted when
the monitor is turned off for more than 24 hours.
The arrhythmia recall window displays the recall files. Up to 8 files can be
displayed on one page. The actual size arrhythmia waveform can be displayed by
touching a recall file.
Arrhythmia List
The arrhythmias are listed in the priority of highest to lowest. When several
arrhythmias occur at the same time, only the arrhythmia of the highest priority is
saved as the recall file.
Arrhythmia Name Description
ASYSTOLE Longer than 3 to 10 seconds (selectable) with no QRS complex.
VF Ventricular fibrillation longer than 4 seconds.
VT Ventricular tachycardia. 9 or more consecutive VPCs when
heart rate exceeding 100 beats/min.
VPC RUN VPC short run. 3 to 8 (selectable) consecutive VPCs.
TACHYCARDIA Heart rate above the upper heart rate limit.
BRADYCARDIA Heart rate below the lower heart rate limit.
COUPLET VPC couplet (paired VPCs). 2 consecutive VPCs.
EARLY VPC Early VPC including R-on-T type. VPC with a time interval
from the preceding normal QRS complex of less than
approximately one-third of the normal R-R interval, at heart
rate dropping below 120* beats/min.
BIGEMINY Ventricular bigeminy. 3 or more consecutive pairs of VPC
and normal QRS. A dominant rhythm of N-V-N-V-N-V (N =
normal beat, V = ventricular beat)
FREQ VPC Frequent VPCs. VPC rate (VPCs/min) reaching or exceeding
the preset limit of 1 to 99 VPCs/min (selectable).
VPC Ventricular premature contraction.
Scroll to display
other parameter
recall files
Displaying the Actual Size Waveform of the Selected Arrhythmia Recall File
The RECALL window displays the actual size ECG of the selected recall file.
1 Touch the or key to display the recall file of the arrhythmia recall
waveform which you want to display in actual size.
2 Touch the center of the recall file. The arrhythmia waveform is displayed in
the actual size.
Display other review windows
Arrhythmia type
QSR annotation
3 Set the RECORD START TIME and RECORD END TIME with the
and key.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
4 Confirm the RECORD PAGE and touch the [RECORD] key. Recording
starts.
To stop recording, touch the Record key .
Recording example
3 Check the RECORD PAGE and touch the [RECORD] key. Recording starts.
To stop recording the table, touch the Record key .
Recording example
Selected file
Scroll files
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, touch the [HOME] key.
3 Set the RECORD START TIME and RECORD END TIME with the
and key.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
Recording example
OCRG Window
The OCRG window displays heart rate and SpO2 acquired every 1 minute for the
trendgraph and compressed respiration waveform of the past 120 hours.
NOTE • When <ADMIT MODE> in the SYSTEM SETUP window is
set to AUTO and the monitor power is turned on more than 30
minutes after turning power off, the stored data in the monitor
is deleted. Even if <ADMIT MODE> is set to MANUAL, data is
deleted when the monitor is turned off for more than 24 hours.
• The OCRG window is available only when PATIENT TYPE
is NEONATE. For details, refer to “Selecting Patient Type” in
Section 3.
The following table shows the available trend parameters, screen displays and
scales.
Parameter Description Vertical Range
HR Heart rate (beats/min) 210 - 60, 160 - 80, 220 - 100
Saturated oxygen from pulse oximeter
SpO2 100 - 60, 100 - 80
(%SpO2)
Respiration measured by impedance
RESP × 1/4, × 1/2, × 1, × 2, × 4
method
Displays other
review windows.
Scale
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, press the [Home] key.
Changing the Trendgraph Scale for Heart Rate and SpO2 and
Sensitivity for Respiration
1 Touch the [SCALE] key on the OCRG window to display the SCALE
SETUP window.
2 Touch the [HR], [SpO2] or [RESP(IMP)] key on the left and select the
desired scale or sensitivity on the right.
1 Display the OCRG trend you want to record on the OCRG window.
3 Set the RECORD START TIME and RECORD END TIME with the or
key or time slider.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
4 Confirm the NUMBER OF PAGES and touch the RECORD key. Recording
starts.
To stop recording, touch the Record key.
Recording example
2 Touch the [FULL DISC] key to display the FULL DISC window.
When FULL DISC is assigned to one of the function keys at the upper
left of the screen, the FULL DISC page can be displayed by touching the
FULL DISC function key. Refer to “KEYS Window” in Section 3 of the
Administrator’s Guide to assign a function to the function key.
Display other review windows
When 5 second
Displayed is selected, the
time range waveform is
actual size.
Time
60-second ECG lead
full disclosure
waveform
Scroll time
Vital signs
numeric values
at the cursor
For details on the time bar, refer to the “Time Bar” section.
To return to the home screen, touch the [HOME] key.
Displayed
time range
Time ECG sensitivity
5-second full QRS annotation
disclosure
waveform ECG lead
When the ECG measurement is set to OFF, the SpO2 waveform is displayed. For
turning ECG measurement off, refer to Section 9.
3 Set the RECORD START TIME and RECORD END TIME with the
and key.
The initial RECORD START TIME and RECORD END TIME depend on
the REVIEW setting on the RECORDER page of the SYSTEM SETUP
window. For details, refer to “RECORDER page” in Section 3 of the
Administrator’s Guide.
Recording example
1 Display the enlarged waveform you want to record by touching the part of
the waveform.
Recording example
Interbed Alarm.................................................................7-6
Settings Related to Interbed Alarm.................................................7-7
7. INTERBED WINDOW
WARNING
Do not monitor a patient’s vital signs only by the interbed function.
The patient must be monitored on the interbed bed or central
monitor.
Registered
beds 7
Group key
2 In the <SELECTED BEDS> box, select the position to register the interbed
bed.
3 Touch the [GROUP] key to select the group to which the desired bed
belongs and select the bed from the bed list. The beds which are already
registered as interbed beds cannot be selected.
4 Check that the selected bed appears in the <SELECTED BEDS> box.
Numeric display
area
2 Touch the desired bed on the Multiple Beds window to display the individual
bed window.
To change beds, touch the key to close the window and select the desired
bed.
Interbed Alarm
When an alarm occurs on an interbed bed, a highlighted bed name appears
at the top right corner of the home screen. This interbed alarm message does
not indicate the type of alarm. The VIEW OTHER BEDS window can be
automatically displayed when an alarm occurs and <AUTO INTERBED
DISPLAY> is set to ON.
NOTE: When the alarm function is turned off by “all alarms off” or “alarm
suspended” on the interbed bed, the interbed alarm does not
occur on this bedside monitor.
Only one interbed ID can be displayed at a time on the home screen. When more
than one interbed alarm occurs, the alarm message appears and the alarming
interbed IDs are alternately displayed one at a time.
On the INTERBED window, the bed ID and patient name of the alarmed bed is
highlighted.
NOTE: The interbed alarm for another bed is lower level than any other
alarm for this bed. Therefore, the interbed alarm might not be
indicated during an alarm for this bed.
The interbed alarm can be set to on or off. When set to ON, the highlighted
bed name in the alarm level color is displayed on the upper right corner of the
home screen when an interbed alarm occurs. When set to OFF, only the non-
highlighted message is displayed.
You can also silence the interbed alarm by touching the key on the individual
bed window of the INTERBED window. Silencing the interbed alarm on this
monitor also silences the alarm on the alarmed bed itself. The alarm silence
indication on the alarmed bed depends on the alarmed bed specifications. The
alarm silence time depends on the setting on the alarmed bed.
For the monitor action when the interbed alarm is silenced, refer to “Interbed
Alarm” in Section 5.
NOTE: When several interbed alarms occur, all interbed alarms are
silenced by touching the key on the individual bed window of
the INTERBED window.
The interbed alarm can only be suspended on the alarmed bed.
CAUTION
The interbed window only appears on the home screen when an
interbed alarm occurs and <AUTO INTERBED DISPLAY> is set to
ON.
Overview of Recording....................................................8-2
Recording Modes...........................................................................8-3
8
Manual Waveform Recording/Printing...................................... 8-4
Recording on the Review Windows.......................................... 8-4
Periodic Recording.................................................................... 8-5
Alarm Recording....................................................................... 8-5
Recording Mode Annotations.................................................... 8-6
Recording Priority...........................................................................8-7
Recording Sensitivity......................................................................8-7
Recording Speed............................................................................8-7
Recording Related Message..........................................................8-7
Recorded Data...............................................................................8-7
Overview of Recording
A variety of waveforms and data can be recorded by the optional recorder
module.
This section provides an overview of recording.
The “Changing the Recording Pattern” section explains how to change the
recording pattern for all recordings except for the review data recordings.
The “Manually Recording Waveforms” section explains how to manually record
waveforms at any time.
The “Setting Periodic Recording” section explains necessary settings for
performing automatic periodic recording.
Some recording procedures are explained in other sections.
• To record trendgraphs and table, see Section 6.
• To record arrhythmia recall files, see Section 6
• To record alarm history, see Section 6.
• To record full disclosure, see Section 6.
• To record OCRG trend graph, see Section 6.
• For alarm recording, see Section 5.
To load recording paper, see “Loading Recording Paper” in Section 2.
Recording Modes
The following recording modes are available.
Recording Length/Time of Recorded Operations/Conditions/ Recorded
Recorded Data
Mode Data Settings for Recording Annotation
Periodic Recording
Up to three waveforms selected on the RECORD window and vital signs data are
recorded automatically at the set interval.
Set the following items on the RECORD window. The time interval is set on the
SYSTEM SETUP window. Refer to Section 3 of the Administrator’s Guide.
• Select ON for periodic recording. When OFF is selected, periodic recording is
turned off.
• Recording pattern
Recording example
Alarm Recording
When a vital sign alarm or arrhythmia alarm occurs, up to three waveforms
selected on the RECORD window and vital sign data are automatically recorded.
The recorded waveforms are from 8 seconds before to 12 seconds after the alarm
occurrence.
Set alarm recording on or off on the RECORD window. For details, refer to
Section 5.
CAUTION
Alarm recording is not performed when:
• Alarm is suspended.
• Alarm recording is set to OFF.
Recording example
Recording Priority
If more than one recording mode is activated at the same time, only the highest
priority mode is used.
Manually stopping recording Manual recording Alarm recording Periodic recording
by the Record key Recording on NIBP measurement
During alarm recording, if a higher priority alarm occurs, the current recording is
canceled and the higher priority alarm is recorded for 20 seconds.
During any type of recording, if a lower or equal priority alarm recording or
any other type of recording occurs, the lower or equal priority recording is not
performed; only the current recording is performed.
Recording Sensitivity
The sensitivity of the waveforms recorded on the recording paper is the same as 8
the sensitivity of the waveforms displayed on the screen.
To change the sensitivity, change the sensitivity setting on the parameter setting
window as described in Sections 9 to 16.
Recording Speed
The recording speed can be set at <RECORDING SPEED> on the RECORD
window. Refer to “Changing the Recording Speed” in this section.
Recorded Data
The following data can be printed.
Printed Items Example
Patient name John Smith
Bed ID BED-001
Date and time 2015/04/09 14:19
Reason for recording TIMER, ALARM, etc.
Sensitivity ×2
Paper speed 25 mm/s
ECG related message MONITOR*1
Pacing detect ON
3 Select the parameter by touching the parameter key. Select the [NONE] key
to not assign any parameter.
2 Touch the [PERIODIC REC] key. The PERIODIC REC window opens.
General............................................................................9-3
Monitoring ECG...............................................................9-9
ECG Information on the Home Screen.........................................9-10
ECG Data Display........................................................................9-10
Measuring ST Level.....................................................................9-10
Detached Electrode Detection and Display..................................9-11
AC Interference and Display........................................................9-12
Monitoring Arrhythmia...................................................9-13
General.........................................................................................9-13
Arrhythmia Analysis Data Display............................................9-14
Changing Arrhythmia Monitoring Settings....................................9-14
Turning Arrhythmia Analysis On or Off....................................9-15
Selecting the Patient Type for QRS Detection.........................9-15
Learning the ECG Waveform for Arrhythmia Detection (VPC
Learning)..................................................................................9-16
Checking the Dominant QRS...................................................9-18
Changing ECG Settings................................................9-20
Changing the Monitoring Lead.....................................................9-21
Optimum Lead..........................................................................9-21
Changing a Lead..................................................................... 9-22
Changing the ECG Sensitivity......................................................9-23
Changing the Heart Rate/Pulse Rate, VPC and ST Alarm Limits.9-24
Checking Arrhythmia Alarm Settings............................................9-25
Turning ECG Measurement On or Off..........................................9-27
Turning Pacing Spike Detection On or Off...................................9-28
Changing the Number of Electrodes............................................9-30
Selecting the Filter Type...............................................................9-31
Changing the Sync Sound Source...............................................9-32
General
To monitor ECG, attach disposable electrodes to the patient and connect them
to the ECG/RESP socket on the monitor. Two leads can be monitored with
arrhythmia analysis and ST level measurement.
WARNING
Interaction Between Minute Ventilation Rate-Adaptive Pacemakers
and Cardiac Monitoring and Diagnostic Equipment*
The bioelectric impedance measurement sensor of a minute
ventilation rate-adaptive implantable pacemaker may be affected by
cardiac monitoring and diagnostic equipment which is connected to
the same patient. If this occurs, the pacemaker may pace at its
maximum rate and give incorrect data to the monitor or diagnostic
equipment. In this case, set the <IMPEDANCE MEASUREMENT>
on the RESP window to OFF on the bedside monitor.
Preparation Flowchart
1 Select the electrode lead and electrodes.
2 Connect the electrode lead to the ECG patient cable and connect the ECG
patient cable to the ECG/RESP socket on the left side panel of the monitor.
3 Attach the disposable electrodes to the patient and attach the electrode lead
to the electrodes.
Electrode Position
3 Electrode Leads
Electrode Position
Symbol Lead Color (Clip Color) Electrode Position
R Red (Red-beige)
Right infraclavicular fossa
RA White (White-beige)
L Yellow (Yellow-beige)
Left infraclavicular fossa
LA Black (Black-beige)
F Green (Green-beige)
Lowest rib on the left anterior axillary line
LL Red (Red-beige)
Lead Connection
5 Electrode Leads
Electrode Position
The 5-electrode method with lead II and lead V5 is effective for monitoring
myocardial ischemia. You can improve monitoring accuracy considerably
C/V by adding lead V4 to this combination. Ca (Va) can be at any position of the
standard 12 leads C1 to C6 (V1 to V6).
Symbol Lead Color (Clip Color) Electrode Position
R Red (Red-beige)
Right infraclavicular fossa
RA White (White-beige)
L Yellow (Yellow-beige)
Left infraclavicular fossa
LA Black (Black-beige)
F Green (Green-beige)
Lowest rib on the left anterior axillary line
LL Red (Red-beige)
N (RF) Black (Black-beige) Right anterior axillary line at the same level
N (RL) Green (Green-beige) as F.
Lead Position 9
Standard limb leads
Lead I Lead II Lead III
R/RA L/LA
F/LL
N (RF/RL)
3 If step 2 was not effective, move the R/RA and F/LL electrodes closer
together.
If the pacemaker pulse is still not detected, the pacing pulse on the body
surface may be too small. The sensitivity performance is limited.
WARNING
When using a defibrillator together with the monitor, use Ag/AgCl
electrodes. Other types of electrodes, stainless steel in particular,
will adversely affect the ECG waveform by slowing the baseline
recovery on the monitor and result in no monitoring immediately
following defibrillation.
CAUTION
Only use Shanghai Kohden products and specified parts and
accessories. When other electrodes are used, the “CHECK
ELECTRODES” message may appear and monitoring may stop.
CAUTION
At the start of ECG monitoring, check that the dominant QRS is
appropriate. Otherwise arrhythmia monitoring may be inaccurate. 9
3
Vitrode L-150, L-150X
(I, II, III)
5
(I, II, III, aVR, aVL, Vitrode L-150, L-150X
aVF, V1 to V6)
WARNING
After attaching the electrode to the patient and connecting the cable
to the monitor, check that electrodes are attached to the patient and
check that the cable is connected to the monitor properly. When the
electrodes are removed from the patient, do not touch the metal part
of the electrode with bare hands or let the metal part of the electrode
contact the metal part of the bed or any other conductive parts.
Failure to follow this warning may cause electrical shock or injury to
the patient by discharged energy.
CAUTION
Do not reuse disposable electrodes.
Monitoring ECG
When electrodes are attached to the patient and cables are connected properly,
ECG and heart rate appear on the screen. The monitor automatically learns the
patient’s dominant ECG.
One lead appears on the home screen. Up to two leads can be displayed on the
home screen when monitoring with five electrodes.
CAUTION
When the “CHECK ELECTRODE” message is displayed, ECG is not
monitored properly and the ECG alarm does not function. Check the
electrode, electrode leads and connection cord, and if necessary,
replace with new ones.
CAUTION
When the “NOISE” or “CANNOT ANALYZE” message is displayed,
ECG data and alarm are not reliable. Remove the cause by checking
the electrodes, electrode leads, patient’s body movement, EMG and
9
peripheral instruments grounding. Also make sure that an electric
blanket is not used.
CAUTION
During NIBP cuff inflation, heart rate counting accuracy is not
guaranteed by noise interference.
NOTE • After adjusting the sensitivity of the ECG on the screen and
changing necessary settings, check that the dominant QRS is
appropriate.
• The maximum heart rate range is 300 beats/min. “300” is
displayed on the screen even when the patient’s heart rate is
above 300.
ST level
Sensitivity
VPC
Measuring ST Level
9-10 User’s Guide SVM-7500 Series
9. ECG MONITORING
The ST level is the amplitude between the baseline and ST wave. The ECG
waveform is averaged for 15 seconds to remove artifacts. The baseline and the
ST wave are detected from the averaged ECG, and the ST level is measured.
Baseline NOTE • If there are too many arrhythmias, there is noise on the ECG, or
ST level
the heart rate is below 32, ST level might not be measured and
ST wave ST level is not displayed on the screen.
• Although the ST algorithm has been tested for accuracy of the
ST analysis result, the significance of the ST level changes
need to be determined only by a physician.
CAUTION
When the “CHECK ELECTRODE” message is displayed, ECG is not
monitored properly and the ECG alarm does not function. Check the
electrode, electrode leads and connection cord, and if necessary,
replace with new ones.
Monitoring Arrhythmia
General
The following functions are available for arrhythmia monitoring.
• Arrhythmia alarm indication (alarm sound, screen message and alarm indicator
lamp). Refer to the Operator’s Manual or Section 5 of the User’s Guide.
• Arrhythmia waveform storage (Arrhythmia recall files). Refer to the
Operator’s Manual or Section 6 of the User’s Guide.
• Arrhythmia waveform recording. Refer to the Operator’s Manual or Section 8
of the User’s Guide.
• VPC display and trendgraph. Refer to the Operator’s Manual or Sections 4 and
6 of the User’s Guide.
WARNING
For arrhythmia monitoring, set <ARRHYTHMIA ANALYSIS> on the
SYSTEM SETUP window to ON. Otherwise, there is no sound or
indication for arrhythmia alarms (except for ASYSTOLE). 9
CAUTION
At the start of ECG monitoring, check that the dominant QRS is
appropriate. Otherwise arrhythmia monitoring may be inaccurate.
When the QRS wave or RR interval changes too frequently, it becomes difficult
for the monitor to distinguish between the normal ECG and arrhythmia. To solve
this problem, the monitor uses pattern matching and multi template matching for
analyzing arrhythmia. However, when the patient’s QRS changes rapidly, check
that the appropriate dominant QRS is used for arrhythmia analysis.
* 120 beats/min when <PATIENT TYPE> is set to ADULT, 150 beats/min when
<PATIENT TYPE> is set to CHILD or NEONATE.
The QRS is annotated as follows.
QRS Annotation Description
N Normal QRS complex
P Paced QRS
V Ventricular premature contraction
? Impossible to classify or during learning.
– Impossible to classify due to noise interference.
WARNING
For arrhythmia monitoring, set <ARRHYTHMIA ANALYSIS> on the
SYSTEM SETUP window to ON. Otherwise, there is no sound or
indication for arrhythmia alarms (except for ASYSTOLE).
You can turn the arrhythmia analysis on or off on the ECG page of the
PARAMETERS window of the SYSTEM SETUP window. When arrhythmia
monitoring is necessary, select ON. For details, refer to Section 3 of the
Administrator’s Guide.
CAUTION
At the start of ECG monitoring, check that the correct patient type is
set for <PATIENT TYPE> on the ADMIT window. If an inappropriate
patient type is set, heart rate cannot be counted accurately and
noise or P waves may be counted as QRS and cardiac arrest may 9
be overlooked.
Select the monitoring patient type. The selected patient type is displayed on the
home screen.
When “SHOW ADMIT CONFIRMATION WINDOW” is set to ON on
the DISPLAY window of the SYSTEM SETUP window, a confirmation
window of “NEW PATIENT?” appears. When [YES] key is touched, the
patient data including this patient type setting returns to the master setting
on the ARRHYTH page of the MASTER window. When “SHOW ADMIT
CONFIRMATION WINDOW” is set to OFF on the DISPLAY window of the
SYSTEM SETUP window, and 30 minutes elapse after monitor power off, the
patient data including this patient type setting also returns to the master setting
on the ARRHYTH page of the MASTER window. Refer to Section 3 of the
Administrator’s Guide.
The QRS settings depend on the patient type. You can set the patient type on the
ADMIT window. Refer to “Change the Patient Type” in Section 3.
PATIENT TYPE Setting
Items
ADULT CHILD NEONATE
Detect narrow QRS Not Not available Available
available
QRS detection Automatic Same as the Automatic sensitivity
sensitivity sensitivity <SENSITIVITY> setting
CAUTION
If there is any doubt about the arrhythmia analysis, make the monitor
relearn the patient’s ECG and check that the dominant QRS is
appropriate. Otherwise, an important arrhythmia may be overlooked.
3 Touch the [LEARN] key. The monitor learns the reference ECG waveform
and the dominant QRS is refreshed.
Dominant QRS
If there is any doubt about the arrhythmia analysis, make the monitor relearn the
patient’s ECG and check the dominant QRS.
3 The dominant QRS and ECG of the first trace is displayed on the ECG1
LEAD/SENSITIVITY FILTERS/LEARN window.
QRS annotation
Dominant QRS
When monitoring with 5 electrodes, the lead of the first trace can be
automatically changed to a stable lead when there is an electrode detachment or
the “CHECK ELECTRODES” message is displayed for more than 5 seconds.
Refer to the “Auto Lead Change On or Off” section of the Administrator’s
Guide.
Optimum Lead
NOTE: Follow the physician’s instructions for lead position when
available.
It is generally considered that Lead II and Lead V1 are suitable for arrhythmia
monitoring and that Lead V4 and Lead V5 are suitable for myocardial ischemia
monitoring.
9
Some types of ECGs are difficult for automatic analysis, and heart rate or
arrhythmia detection level is not accurate for some patients. In these cases, use
the following procedure to find the appropriate lead for automatic analysis.
1 Measure the patient’s ECG with the standard 12 ECG leads using an ECG
instrument.
QRS1
P T1 T2
QRS2
Changing a Lead
You can change the lead of traces on the home screen.
NOTE: When the <ELECTRODES> setting is changed, the lead setting
automatically changes to II. Change the number of electrodes
setting before changing the lead.
3 Select the lead from the <LEAD> box at the bottom of the window. The first
trace changes to the selected lead.
To change the lead for the second trace on the home screen, touch the [ECG2
LEAD/SENSITIVITY] key on the ECG window and select the lead for the
second trace.
To change the sensitivity for the second trace, display the ECG2 LEAD/
SENSITIVITY window and select the sensitivity for the second trace.
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Depending on the setting, the alarm off mark might not be
displayed on the screen. Be careful when you set the alarm limit to
OFF.
You can set the upper and lower heart rate/pulse rate, VPC and ST level of the
first trace alarm limits on the ECG window. You can set all alarms, including the
upper and lower heart rate alarm limits, on the ALARM LIMITS window (See
the Operator’s Manual or Section 5 of the User’s Guide).
Setting Range
NOTE: VPC alarm limit can only be set when <ARRHYTHMIA
ANALYSIS> on the SYSTEM SETUP window is ON.
HR/PR: Upper limit: When <SYNC SOURCE> is set to ECG:
16 to 300 beats/min in 1 beat/min steps, OFF
When <SYNC SOURCE> is set to PRESS1 or SpO2:
31 to 300 beats/min in 1 beat/min steps, OFF
(default setting: ADULT-140, CHILD-170, NEONATE-200)
Lower limit: When <SYNC SOURCE> is set to ECG:
OFF, 15 to 299 beats/min in 1 beat/min steps
When <SYNC SOURCE> is set to PRESS1 or SpO2:
OFF, 30 to 299 beats/min in 1 beat/min steps
(default setting: ADULT-50, CHILD-75, NEONATE-100)
VPC: Upper limit: 1 to 99 beats/min in 1 beats/min steps, OFF
(default setting: OFF)
ST: Upper limit: –1.99 to +2.00 mV in 0.01 mV steps (–19.9 to +20.0 mm in 0.1
mm steps), OFF (default setting: OFF)
Lower limit: OFF, –2.00 to +1.99 mV in 0.01 mV steps (–20.0 to +19.9 mm
in 0.1 mm steps) (default setting: OFF)
2 Touch the [HR/PR] key to change the heart rate/pulse rate alarm limits.
Touch the [VPC] key to change the VPC alarm limit.
Touch the [ST] key to change the ST level of the first trace alarm limits.
Selected parameter
Upper limit
Upper limit
slider
Current measured Setting bar
value
9
Lower limit slider Lower limit
3 Touch and drag the sliders to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
WARNING
For arrhythmia monitoring, set <ARRHYTHMIA ANALYSIS> on the
SYSTEM SETUP window to ON. Otherwise, there is no sound or
indication for arrhythmia alarms (except for ASYSTOLE).
CAUTION
When the alarm is turned to OFF for an arrhythmia, there will be no
alarm for that arrhythmia type. There is no message or mark to
indicate that a certain arrhythmia alarm is turned off. Therefore, be
careful when you turn off an arrhythmia alarm.
Alarm ON/OFF
Parameter Detection Condition (Default Setting)
Setting
ASYSTOLE 3 to 10 seconds (5) ON fixed
VF – ON fixed
9 or more consecutive VPCs when heart rate
VT exceeding 100 beats/min. ON fixed
(ADULT, CHILD: 100, NEONATE: 140)
VPC RUN 3 to 8 VPCs (3) ON fixed
COUPLET – ON/OFF (OFF)
EARLY VPC – ON/OFF (OFF)
BIGEMINY – ON/OFF (OFF)
Select the arrhythmia type in the SYSTEM SETUP window. Refer to the
Administrator’s guide, Section 3.
Threshold setting
ON/OFF setting
3 Check the arrhythmia alarm settings. An administrator can change the setting
by touching the [SETUP] key. Refer to “ARRHYTH Page” in Section 3 of
the Administrator’s Guide.
CAUTION
When the ECG measurement is OFF, ECG alarms do not occur
even if each ECG alarm item is set to ON.
NOTE • You cannot turn off the ECG measurement when ECG is
monitored.
• When ECG data is received, the ECG measurement is
automatically set to ON. If the ECG measurement does not
start, set ECG measurement to ON manually.
When ECG measurement is turned off, other parameters are enlarged on the
home screen.
When the ECG measurement is turned off, HR, VPC and ST on the TREND
TABLE, NIBP TABLE and TREND GRAPH window is not displayed. The ECG
full disclosure waveform is not displayed on the FULL DISC window.
WARNING
Turn the pacing pulse detection* to ON when monitoring a
pacemaker patient. Otherwise the pacemaker pulse is not rejected.
However, even when the pacing pulse detection is set to ON, the
pacemaker pulse might not be rejected. When the pacemaker pulse
is not rejected, the pacemaker pulse is detected as QRS and false
heart rate may be indicated or critical arrhythmia such as asystole
may be overlooked. Keep pacemaker patients under close
observation.
WARNING
Even when the pacing pulse detection is set to ON, the pacemaker
pulse can be overlooked or detected as QRS. You cannot confirm
the pacemaker operation only from the detected pacemaker pulse.
2 Touch the [SYNC SOURCE] key. The SYNC SOURCE window opens.
WARNING
When the monitor is used with an electrosurgical unit (ESU), firmly
attach the entire area of the ESU return plate. Otherwise, the current
from the ESU flows into the electrodes of the monitor, causing
electrical burn where the electrodes are attached. For details, refer
to the ESU manual.
WARNING
When using the monitor with an ESU, locate the monitor and ESU
and ground the instruments properly. Check the ECG and value on
the monitor. Otherwise noise from the ESU may interfere with the
ECG and the heart rate and arrhythmia analysis may be incorrect.
• Arrangement
Install the monitor as far from the ESU as possible. If possible, locate them on
opposite sides of the operating table.
• Power supply
Noise from the ESU may interfere with the ECG signal through the AC power
line. Supply power to the monitor and ESU from different outlets located as far
from each other as possible. Do the equipotential grounding properly.
3 electrodes
Return plate
Incision
Make small
General..........................................................................10-2
Impedance Method.......................................................................10-2
Monitoring Respiration..................................................10-5
Respiration Information on the Home Screen..............................10-5
General
On this monitor, respiration can be measured by impedance method.
Impedance Method
In the impedance method, respiration is measured and monitored by attaching the
ECG electrodes to the patient and connecting them to the ECG/RESP socket on
the monitor. This method measures changes in impedance between the R and F
(RA and LL) ECG electrodes.
WARNING
Interaction Between Minute Ventilation Rate-Adaptive Pacemakers
and Cardiac Monitoring and Diagnostic Equipment*
The bioelectric impedance measurement sensor of a minute
ventilation rate-adaptive implantable pacemaker may be affected by
cardiac monitoring and diagnostic equipment which is connected to
the same patient. If this occurs, the pacemaker may pace at its
maximum rate and give incorrect data to the monitor or diagnostic
equipment. In this case, set the <IMPEDANCE MEASUREMENT>
on the RESP window to OFF on the bedside monitor.
Preparation Flowchart
The electrode lead is fixed on R-F.
1 Connect the electrode lead to the ECG patient cable and connect the ECG
patient cable to the ECG/RESP socket on the left side panel of the monitor.
3 Attach the disposable electrodes to the patient and attach the electrode lead
to the electrodes.
L/LA
Electrode Position
R/RA
1
F/LL
Electrode lead and position 162 cm 47 kg female 153 cm 45 kg female
Standard R-F/RA-LL
R/RA L/LA
R/RA L/LA
1
2
F/LL
F/LL
Standard R-F/RA-LL
R-L/RA-LA
R/RA
R/RA L/LA
L/LA
2
3
2
F/LL
F/LL
R-F/RA-LL withR-L/RA-LA
higher F/LL position
R/RA L/LA
3
F/LL
Electrode Position
R or RA F or LL L or LA
Lowest rib on the left anterior
1 Right infraclavicular fossa —
axillary line
Fifth intercostal space on the
2 Right infraclavicular fossa —
left midaxillary line
Amplitude
170 cm 60 kg male 179 cm 94 kg male 160 cm 50 kg male
1 Respiration measurement is influenced by movement of the chest and abdomen.
The amplitude of the waveform changes greatly according to slight change of the F
(LL) electrode position. It also differs considerably between different patients.
2 Respiration amplitude is large, and therefore, detection rate is good. The electrode
position is similar to lead II of the ECG. This position is highly recommended.
Monitoring Respiration
When preparation is done properly, the respiration waveform appears on the
screen.
In impedance method, the respiration data do not appear on the screen when
respiration monitoring in impedance method is set to OFF (the “RESP OFF”
message appears). When using an ESU, noise is superimposed on the waveform
and the respiration measurement cannot be monitored accurately.
10
10
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Depending on the setting, the alarm off mark might not be
display on the screen. Be careful when you set the alarm limit to
OFF.
You can set the upper and lower respiration rate and apnea alarm limits on the
RESP or RESP/CO2 window. You can set all alarms, including the upper and
lower respiration rate and apnea alarm limits, on the ALARM LIMITS window
(See the Operator’s Manual or Section 5 of the User’s Guide).
Setting Range
Respiration rate upper limit: 2 to 150 counts/min in 2 counts/min steps, OFF
(default setting: OFF)
Respiration rate lower limit: OFF, 0 to 148 counts/min in 2 counts/min steps
(default setting: OFF)
Apnea upper limit: 5 to 40 seconds in 5-second steps, OFF (default setting: 20)
10
2 Touch the [RR] key to change the respiration rate alarm setting.
Touch the [APNEA] key to change the apnea alarm setting.
Selected parameter
Upper limit
slider
Upper limit
Setting bar
Current measured
value
3 Touch and drag the sliders to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
2 Touch the [RESP SWEEP SPEED] or [RESP/CO2 SWEEP SPEED] key. The
RESP SWEEP SPEED or RESP/CO2 SWEEP SPEED window opens.
General.......................................................................... 11-2
Mainstream Method......................................................................11-2
Measurement Error with the TG-901T4/TG-921T4 CO2 Sensor
Kit.................................................................................................11-2
Use with Volatile Anesthetic Agents.............................................11-4
General
On this monitor, CO2 can be measured by mainstream method.
To monitor CO2 by the mainstream method, connect the TG-901T4, TG-921T4,
TG-971T4 or TG-981T4 CO2 sensor kit to the patient’s respiration circuit or
directly to the patient and connect the CO2 sensor kit to the CO2 socket on the
monitor.
Mainstream Method
In the mainstream method, the sensor is located directly in the respiration circuit.
There are two types of sensors for different calculation methods.
Semi-quantitative method using the TG-901T4/TG-921T4 CO2 sensor kit
Measurements are based on the assumption of no CO2 gas in the inspiration.
The CO2 concentration in the respiration is calculated by taking the CO2
concentration in the inspiration as 0 mmHg (0 kPa).
Quantitative method using the TG-971T4/TG-981T4 CO2 sensor kit
The CO2 partial pressure in both inspiration and expiration is measured.
The mainstream CO2 measurement method has the following merits and limits
compared to the sidestream method. Understand these points when performing
measurements.
Merits
• No delay in the measurement time.
• Measurement is stable over a long period of time.
• Few measurement troubles due to mixture of water droplets.
Limits
• TG-901T4 CO2 sensor kit cannot be used on non-intubated patients.
• Due to the weight of the TG-901T4 CO2 sensor kit, load is easily imposed on
the tracheal tube.
• The dead space volume is relatively large.
WARNING
With the TG-901T4/TG-921T4 CO2 sensor kit, measurements are
based on the assumption of no CO2 gas in the inspiration. The CO2
concentration in the respiration is calculated by taking the CO2
concentration in the inspiration as 0 mmHg. Therefore, measuring
CO2 by connecting the CO2 sensor kit to a Jackson Rees circuit,
Mapleson D circuit or any other respiration circuit where CO2 gas
may be present during inspiration may result in the acquired data
being lower than the actual value.
WARNING
The CO2 sensor kit cannot correctly measure the ETCO2 value and
respiration rate during high frequency oscillation (HFO). Do not
diagnose the patient from the ETCO2 Value and respiration rate.
CAUTION
With the TG-921T4 CO2 sensor kit, measurements are based on the
assumption of no CO2 gas in the inspiration. The CO2 concentration
in the respiration is calculated by taking the CO2 concentration in the
inspiration as 0 mmHg. Therefore, measuring CO2 of a patient with
an oxygen mask where CO2 gas may be present in the inspiration
gas may result in the acquired data being lower than the actual
value.
11
0 0
5
(0.7 kPa)
0
Error (mmHg)
5
( 0.7 kPa)
10
( 1.3 kPa)
15
( 2.0 kPa)
20
( 2.7 kPa)
25
( 3.3 kPa)
CO2 mixed in inspired air
1 mmHg (0.1 kPa)
2 mmHg (0.3 kPa)
4 mmHg (0.5 kPa)
8 mmHg (1.1 kPa)
CAUTION
The TG-901T4 and TG-921T4 CO2 sensor kits do not adjust the
measurement value to compensate for different atmospheric
pressure. Be careful when reading the value when using the CO2
sensor kit at high altitudes because the measurement value may be
inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for 5.33 kPa (40 mmHg) CO2
gas when an atmospheric pressure drops 3.3 kPa.
CAUTION
The measured value may be incorrect when the operating
temperature changes greatly or there is excess condensation in the
airway adapter or nasal adapter.
CAUTION
When using an anesthetic instrument with a volatile anesthetic
agent, the CO2 measurement may be inaccurate.
Volatile anesthetic agents affect the CO2 value. Be aware of this when using
volatile anesthetic agent.
Example: At 1 atmospheric pressure, 5 % (38 mmHg, 5.07 kPa) CO2 and N2
mixture gas, no condensation
Difference
Anesthetic Gas Concentration TG-901T4 TG-921T4 TG-971T4/
TG-981T4
+0.9 mmHg +0.9 mmHg +0.3 mmHg
Halothane 4%
(+0.12 kPa) (+0.12 kPa) (+0.04 kPa)
+1.5 mmHg +1.5 mmHg +0.9 mmHg
Enflurane 5%
(+0.20 kPa) (+0.20 kPa) (+0.12 kPa)
+1.8 mmHg +1.8 mmHg +1.7 mmHg
Isoflurane 5%
(+0.24 kPa) (+0.24 kPa) (+0.22 kPa)
+2.8 mmHg +2.8 mmHg +2.1 mmHg
Sevoflurane 6%
(+0.37 kPa) (+0.37 kPa) (+0.28 kPa)
+7.0 mmHg +6.6 mmHg -
24 %
(+0.93 kPa) (+0.88 kPa)
Desflurane
+6.6 mmHg +5.4 mmHg +2.9 mmHg
15 %
(+0.88 kPa) (+0.72 kPa) (+0.39 kPa)
Preparation Flowchart
Mainstream Method
2 Connect the CO2 sensor kit to the CO2 socket on the monitor.
4 Connect the CO2 sensor to the respiration circuit or attach the CO2 sensor to
the patient.
WARNING
Select the airway adapter or nasal adapter taking the patient weight
and ventilation volume into consideration. If an inappropriate airway
adapter or nasal adapter is used, the resistance in the respiration
circuit increases or the measurement value is incorrect.
WARNING
When using the airway adapter or nasal adapter on a patient with
low ventilatory volume, the CO2 may mix in the inspiration due to the
airway adapter’s dead space volume, resulting in inaccurate
measured values or difficulty in detecting apnea. Perform ventilation
taking into consideration the dead space volume.
CAUTION
The CO2 data may be inaccurate when monitoring a patient with an
extremely high respiration rate or irregular respiration. Read the
measured values carefully.
CAUTION
When monitoring CO2, make sure that the gas composition is
entered. Otherwise the measurement result may be inaccurate.
CAUTION
When using an anesthetic instrument with a volatile anesthetic
agent, the CO2 measurement may be inaccurate.
CAUTION
The airway adapter/nasal adapter is non-sterilized and disposable.
Use only for a single patient and single use. Failure to follow this
instruction causes cross infection.
Holder for
oxygen cannula
Clip Mouth guide
Mouth guide
11
Dead Space
Type of Adapter Model Weight Code No.
Volume
Airway adapter YG-111T 7 kg or more 4 mL R804
YG-120T V921
Nasal adapter YG-121T 10 kg or more 1.2 mL V922
YG-122T V923
WARNING
The only oxygen cannula that can be used with YG-122T is
manufactured by HUDSON RCI®. Do not use any other oxygen
cannula. Other oxygen cannulas cannot be attached and oxygen
cannot be delivered to the patient through the nostrils.
WARNING
Check that the oxygen cannula tube is not bent, broken, or blocked
by the nasal tube. If the ends of the oxygen cannula tube turn too far
up or down, it causes insufficient O2 supply or the CO2 value may be
incorrect.
WARNING
• When you use YG-122T together with an oxygen cannula, check
that the oxygen cannula is correctly attached on the patient
by referring to other parameters and by observing the patient
periodically.
• If arterial oxygen partial pressure does not increase, immediately
stop using the oxygen cannula with the CO2 sensor kit and select
another way to supply oxygen.
CAUTION
When using the YG-121T/YG-122T nasal adapter on a patient with
bleeding disorder, poor general medical condition or malnutrition,
observe the patient condition all the time. The mouth guide touches
the mouth and may cause pressure sores.
CAUTION
The TG-971T4/TG-981T4 CO2 sensor kit cannot correctly measure
the ETCO2 value and respiration rate during high frequency
oscillation (HFO). Do not diagnose the patient from the ETCO2 Value
and respiration rate.
CAUTION
With the TG-971T4/TG-981T4 CO2 sensor kit, measured value may
be incorrect when the operating temperature changes greatly. In this
case, wait for about 30 minutes to acquire correct measurement.
For non-intubated patient: With cap-One mask For intubated patient: With airway adapter
YG-232T YG-242T The airway adapter can be selected from the following
3 types depending on the patient weight and respiratory
volume.
YG-272T YG-227T
YG-282T
Dead Space
Optional Item Model Patient Weight Code No.
Volume
11
Performing Zero Calibration when Using a TG-971T4/TG-981T4
CO2 Sensor Kit
When using the TG-971T4/TG-981T4 CO2 sensor kit, perform zero calibration
in the following conditions.
• When the airway adapter is replaced with a new one.
• When a different type of airway adapter is used.
• When the operating temperature changes.
• When the measurement room is changed.
• Whenever necessary.
Zero calibration can be performed in two ways: calibration with air and
calibration with N2 gas. Both methods are performed on the RESP/CO2 window.
• Calibration with air
Expose the airway adapter to air. Calibrates with about 0.2 mmHg (0.03 kPa)
CO2 in the air.
• Calibration with N2 gas
Flow N2 gas into the airway adapter.
NOTE: The calibrated value is saved in memory in the connector of the
CO2 sensor kit. Once calibrated, you don’t need to calibrate again
when connecting the CO2 sensor kit to the different socket of a
different unit.
Calibrating by Air
1 Display the CO2 ZERO CAL window. The TG-971T4/TG-981T4 CO2 sensor
kit must be connected to the monitor for the CO2 ZERO CAL window to be
displayed.
Touch [MENU] key → [RESP/CO2] key → [CO2 ZERO CAL] key.
3 Expose the airway adapter to air and touch the [YES] key to start calibration.
2 Display the CO2 ZERO CAL window. The TG-971T4/TG-981T4 CO2 sensor
kit must be connected to the monitor for the CO2 ZERO CAL window to be
displayed.
Touch [MENU] key → [RESP/CO2] key → [CO2 ZERO CAL] key.
4 Open the N2 gas cylinder so that the N2 gas flows into the airway adapter and
11
touch the [YES] key to start calibration.
Monitoring CO2
After completing the preparation, CO2 data and waveform appear on the screen.
CAUTION
When the “CHANGE ADAPTER” or “SENSOR ERROR” message is
displayed, check the CO2 sensor kit and replace it if necessary. CO2
cannot be monitored while the message is displayed.
CAUTION
When using an anesthetic instrument with a volatile anesthetic
agent, the CO2 measurement may be inaccurate.
Respiration sync I
11
mark
2 Select the scale by touching the desired scale key. You can adjust the scale
using the scale slider.
Scale slider
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Depending on the setting, the alarm off mark might not be
displayed on the screen. Be careful when you set the alarm limit to
OFF.
You can set the upper and lower CO2, respiration rate and apnea alarm limits on
the RESP/CO2 window. You can set all alarms, including the upper and lower
CO2, respiration rate and apnea alarm limits, on the ALARM LIMITS window
(See the Operator’s Manual or Section 5 of the User’s Guide).
Setting Range
CO2 (E) upper limit: 2 to 99 mmHg in 1 mmHg steps (0.2 to 13.0 kPa in 0.1 kPa
steps), OFF (default setting: OFF)
CO2 (E) lower limit: OFF, 1 to 98 mmHg in 1 mmHg steps (0.1 to 12.9 kPa in
0.1 kPa steps) (default setting: OFF)
CO2 (I) upper limit*: 1 to 99 mmHg in 1 mmHg steps (0.1 to 13.0 kPa in 0.1 kPa
steps), OFF (default setting: ADULT, NEONATE: OFF,
CHILD: 3 mmHg (0.4 kPa))
Respiration rate upper limit: 2 to 150 counts/min in 2 counts/min steps, OFF (default
setting: OFF)
Respiration rate lower limit: OFF, 0 to 148 counts/min in 2 counts/min steps (default
setting: OFF) 11
Apnea upper limit: 5 to 40 seconds in 5-second steps, OFF (default setting: 20)
* CO2 (I) alarm upper limit can be set when using a TG-971T4/TG-981T4 CO2
sensor kit.
2 Touch the [CO2 (E)] key to change the end tidal CO2 alarm setting.
Touch the [CO2 (I)] key to change the inspired CO2 alarm setting. This
setting is only available when CO2 is monitored with TG-971T4/TG-981T4
CO2 sensor kit.
Touch the [RR] key to change the respiration rate alarm setting.
Touch the [APNEA] key to change the apnea alarm setting.
Selected parameter
Upper limit
Setting bar
Current measured
value
3 Touch and drag the sliders to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
CAUTION
When monitoring CO2, make sure that the gas composition is
entered. Otherwise the measurement result may be inaccurate.
CAUTION
When using an anesthetic instrument with a volatile anesthetic
agent, the CO2 measurement may be inaccurate.
11
Settings
OFF: The maximum value is updated each breath
10 s: The maximum value for latest 10 seconds (default setting)
20 s: The maximum value for latest 20 seconds
OFF
ETCO2 value 60
46
[mmHg] 40 40
35
30 31
20
10 10
Time
10 s
ETCO2 value 60
46
[mmHg] 40 40
35
30
31
20
10 10 10
Time
10 s
10 s
10 s
10 s
10 s
10 s
20 s
ETCO2 value 60
46
[mmHg] 40 40
30 35
31
20
10 10 10
Time
20 s
20 s
20 s
20 s
20 s
20 s
CAUTION
Follow the CAUTION label on the CO2 gas cylinder.
Check the measurement accuracy every half year and whenever you suspect
the monitor is not reading correctly. This procedure does not calibrate the CO2
sensor. It only checks the measurement accuracy. If the measurement accuracy is 11
not appropriate, contact your Nihon Kohden representative.
For details, refer to the Service Manual.
General..........................................................................12-2
Monitoring SpO2............................................................12-7
12
SpO2 Information on the Home Screen........................................12-7
General
To monitor SpO2, attach a probe to the patient and connect it to the SpO2 socket
on the left side panel of the monitor.
* If the SQI bar graph shows 1 or 2 bars, the “LOW QUALITY SIGNAL”
message appears in the screen.
WARNING
SpO2 measurement may be incorrect in the following cases.
• When the patient’s carboxyhemoglobin or methemoglobin
increases abnormally.
• When dye is injected in the blood.
• When using an electrosurgical unit.
• During CPR.
• When measuring at a site with venous pulse.
• When there is body movement.
• When the pulse wave is small (insufficient peripheral circulation).
WARNING
When not monitoring SpO2, disconnect the SpO2 connection cord
from the SpO2 socket. Otherwise, noise from the probe sensor may
interfere and incorrect data is displayed on the screen.
WARNING
Check the circulation condition by observing the skin color at the
measurement site and pulse waveform. Change the measurement
site every 8 hours for disposable probes and every 4 hours for
reusable probes. The skin temperature may increase at the attached
site by 2 or 3 °C (4 or 5 °F) and cause a burn or pressure necrosis.
When using the probe on the following patients, take extreme care
and change the measurement site more frequently according to
symptoms and degree.
• Patient with a fever
• Patient with insufficient peripheral circulation
• Neonate or low birth weight infant with delicate skin
WARNING
• When using the TL-201T finger probe, do not fasten the probe and
cable to the finger by wrapping with tape. This may cause burn,
congestion or pressure necrosis from poor blood circulation.
• When using probes other than the TL-201T finger probe, to avoid
poor circulation, do not wrap the tape too tight. Check the blood
circulation condition by observing the skin color and congestion at
the skin peripheral to the probe attachment site. Even for short-
term monitoring, there may be burn or pressure necrosis from
poor blood circulation, especially on neonates or low birth weight
infants whose skin is delicate. Accurate measurement cannot be
performed on a site with poor peripheral circulation.
12
WARNING
When monitoring SpO2 of a patient who is receiving photodynamic
therapy, the light from the finger probe sensor may cause a burn.
Photodynamic therapy uses a photosensitizing agent that has a side
effect of photosensitivity.
The SpO2 probe manufactured by Nihon Kohden have two wavelengths with
peaks in the range of 650 and 950 nm. The maximum light intensity is less than 5.5
mW/sr.
CAUTION
Turn off the power of mobile phones, small wireless devices and
other devices which produce strong electromagnetic interference
around a patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as mobile phones or
small wireless devices may be mistaken as pulse waves and the
displayed data may be incorrect.
CAUTION
If the attachment site is dirty with blood or bodily fluids, clean the
attachment site before attaching the probe. If there is nail polish on
the attachment site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value may be incorrect or
measurement cannot be performed.
CAUTION
Normal external light does not affect monitoring but strong light such
as a surgical light or sunlight may affect monitoring. If affected, cover
the measuring site with a blanket.
CAUTION
While a patient is on medication which causes vasodilation, the
pulse waveform may change and in rare cases the SpO2 value might
not be displayed.
CAUTION
When monitoring SpO2 only (without ECG monitoring), turn on both
the upper and lower limit alarms for PR and SpO2. If the patient’s
pulse is not detected during asystole or other condition, a “CANNOT
DETECT PULSE” or “CHECK PROBE” alarm occurs instead of an
SpO2limit alarm.
Furthermore,if the patient has no pulse, noise from probe movement
could be misjudged as a pulse and cause an incorrect PR or SpO2
value to be displayed.
CAUTION
When monitoring SpO2 only, detection of arrhythmia and asystole is
not available and arrhythmia alarms such as ASYSTOLE, VF or VT
are not available. If the patient requires ECG monitoring, monitor the
ECG.
NOTE: Do not attach the probe to the same limb that is used for NIBP
measurement. The SpO2 measurement may be incorrect.
Preparation Flowchart
1 Select the probe.
2 Connect the probe to the SpO2 connection cord and connect the SpO2
connection cord to the SpO2 socket on the monitor.
Selecting a Probe
Select the appropriate probe according to the purpose.
CAUTION
Only use the specified probes. Otherwise, SpO2 cannot be
monitored.
CAUTION
Do not use a probe which is deteriorated by aging. Accurate
measurement cannot be performed.
12
Reusable Probes
Model Patient (Weight) Attachment Site SpO2 Connection Cord
Finger Probe TL-201T Adults, children Finger SpO2 Connection Cord
(Weight more than 20 kg) JL-701P
1 Open the stopper of the SpO2 connection cord and connect the probe
connector firmly.
SpO2 connection cord 3 Connect the SpO2 connection cord to the SpO2 socket on the monitor.
Monitoring SpO2
When the preparation is done properly, the SpO2 value and pulse waveform
appear on the screen.
CAUTION
When the probe is attached on an appropriate site with sufficient
circulation and an error message about probe attachment repeatedly
appears, the probe may be deteriorated. Replace it with a new one.
CAUTION
When a message indicates a faulty probe or faulty SpO2 connection
cord, stop monitoring and replace the probe or SpO2 connection cord
with a new one.
SpO2 sensitivity
SpO2 pulse waveform
SpO2
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Be careful when you set the alarm limit to OFF.
You can set the upper and lower SpO2 and heart rate/pulse rate alarm limits on
the SpO2 window. You can set all alarms, including the upper and lower SpO2
and heart rate/pulse rate alarm limits, on the ALARM LIMITS window (See the 12
Operator’s Manual or Section 5 of the User’s Guide). The heart rate/pulse rate
alarm limits can also be changed on the ECG window.
Setting Range
SpO2 upper limit: 51 to 100 %SpO2 in 1 %SpO2 steps, OFF
(default setting: ADULT, CHILD - OFF; NEONATE - 95 %SpO2)
SpO2 lower limit: OFF, 50 to 99 %SpO2 in 1 %SpO2 steps
(default setting: ADULT, CHILD - 90 %SpO2; NEONATE - 85
%SpO2)
HR/PR upper limit: When <SYNC SOURCE> is set to ECG:
16 to 300 beats/min in 1 beat/min steps, OFF
When <SYNC SOURCE> is set to PRESS1 or SpO2:
31 to 300 beats/min in 1 beat/min steps, OFF
(default setting: ADULT - 140, CHILD - 170, NEONATE - 200)
HR/PR lower limit: When <SYNC SOURCE> is set to ECG:
OFF, 15 to 299 beats/min in 1 beat/min steps
When <SYNC SOURCE> is set to PRESS1 or SpO2:
OFF, 30 to 299 beats/min in 1 beat/min steps
(default setting: ADULT - 50, CHILD - 75, NEONATE - 100)
Setting bar
Lower limit
3 Touch and drag the sliders to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
12
2 Touch the [SYNC SOURCE] key. The SYNC SOURCE window opens.
2 Touch the [SYNC PITCH] key. The SYNC PITCH window opens.
12
NOTE: When "MAX" is selected, a waveform and numeric value for SpO2
may appear even when the probe is detached from the patient.
When not monitoring SpO2, disconnect the SpO2 connection cord
from the unit.
General..........................................................................13-2
General
Non-invasive blood pressure is measured by the oscillometric method in which
the cuff is wrapped on the patient arm (or thigh) and connected to the NIBP
socket on the monitor.
Oscillometric method
The NIBP is measured from the change in amplitude pattern of pulsatile
oscillation in cuff pressure as the cuff pressure is reduced from above systolic
to below diastolic pressure. The occlusive-oscillometry method uses this to
determine the systolic, diastolic, and mean arterial pressure.
The systolic pressure is the pressure at which the pulsatile oscillation suddenly
increases, and the diastolic pressure is the pressure at which the pulsatile
oscillation suddenly decreases. The mean arterial pressure is the point where
maximum pulsatile oscillation occurs.
This monitor has four NIBP measurement modes.
• Manual measurement: Measurement is performed once.
• Automatic measurement: Measurement is performed automatically at preset time
intervals. The time interval can be selected.
Automatic measurement can also be performed with vital
sign alarm occurrence.
• STAT measurement: Measurement is performed for 10 minutes (maximum)
continuously.
• SIM mode measurement: Measurement is performed in Staged Interval Mode (SIM).
WARNING
Be careful when measuring NIBP on a patient with known bleeding
disorders or coagulation. After NIBP measurement, there may be dot
hemorrhage, or circulatory disorder by thrombus where the cuff is
attached.
WARNING
NIBP measurement cannot be used with pregnant, including pre-
eclamptic patients. NIBP measurement may be incorrect in the
following cases.
• When using an electrosurgical unit
• When there is body movement
• When the pulse wave is small (insufficient peripheral circulation)
• Too many arrhythmias
• When there is vibration
• When there is a rapid blood pressure change
• During CPR
• When the pulse is too late
• When blood pressure is too low
• When the cuff is wrapped too tight or too loose
• When the size of the cuff is not proper
• When the cuff is wrapped over thick cloth
• When the cuff is deteriorated
• When using with pregnant, including pre-eclamptic patients
Preparation Flowchart
1 Select the cuff.
2 Connect the cuff to the air hose and connect the air hose to the NIBP socket
on the monitor.
5 Start measurements.
15 Adults large
Adults standard
10 Adults small
Childern standard
5 Infants
0 10 20 30 40 50 60
Arm circumference (cm)
Disposable cuffs
Cuff Width and Arm Circumference Circumference range
applicable to AHA standards
5 Neonates (YP-824S)
Neonates (YP-823S)
Neonates (YP-822S)
Neonates (YP-821S)
Neonates (YP-820S)
0 10 20 30 40 50 60
Arm circumference (cm)
Types of Cuffs
Width
For thigh YP-715T 19 45 to 55
CAUTION
The YP-710T/711T/712T/715T reusable cuffs contain natural rubber
latex which may cause allergic reactions.
Natural rubber may cause allergic reaction with symptoms such as
itching, redness, urticaria, swelling, fever, dyspnea, symptoms
similar to asthma, reduced blood pressure and shock. If the patient
shows any of the above symptoms, immediately stop using the cuff
and perform appropriate medical treatment.
CAUTION
Firmly connect the air hose to the NIBP socket on the monitor until it
clicks. If not connected properly, the cuff type cannot be identified. At
the start of NIBP measurement, check if the cuff type corresponds to
the type displayed on the monitoring screen.
NOTE: Firmly connect the air hose to the cuff and the monitor. The air
leakage will cause incorrect NIBP data or no data.
The monitor automatically identifies the type of air hose (adult/child or neonate)
when the air hose is connected to the NIBP socket. The cuff inflation pressure is
automatically changed according to the identified air hose type. The air hose type
is displayed on the home screen.
NOTE: The alarm settings are not automatically changed according to
the air hose type. The alarm settings which are appropriate for the
13
patient must be manually set.
Joint
Joint
2 Connect the air hose to the NIBP socket on the monitor, and then select
the right patient type in the ADMIT window. For detailed settings, refer to
“Change the Patient Type” in Section 3 of this manual.
3 Check that the home screen displays the correct cuff type.
Cuff type
WARNING
Be careful when measuring NIBP on a patient with known bleeding
disorders or coagulation. After NIBP measurement, there may be dot
hemorrhage, or circulatory disorder by thrombus where the cuff is
attached.
CAUTION
Do not wrap the cuff on an arm or thigh which is used for injection.
NIBP measurement on an arm or thigh which is used for injection
may cause reflux of blood and stop injection.
CAUTION
Do not wrap the cuff too tight. It may cause poor blood circulation
and congestion. If the cuff is wrapped too loosely, the NIBP value
may increase.
Wrap the cuff on the patient arm or thigh by referring to the manual provided
with the cuff. When wrapping the cuff around the upper arm, observe the
following points.
Stretcher (bed)
CAUTION
When too much pressure is applied to the cuff, or the hose is bent or
squeezed, the "NIBP SAFETY CIRCUIT RUNNING" message
appears on the screen and NIBP monitoring may be stopped. 13
Remove the cause, wait 40 seconds, check that the message
disappears, then measure again.
CAUTION
Do not wrap the cuff too tight. It may cause poor blood circulation
and congestion. If the cuff is wrapped too loosely, the NIBP value
may increase.
WARNING
When performing long term measurement at intervals less than 2.5
mins, perform measurements while observing the state of the
patient, blood vessels and limb to ensure adequate circulation.
Congestion may occur at the measurement site. When performing
periodic measurement for a long time, periodically check the
circulation condition.
CAUTION
When too much pressure is applied to the cuff, or the hose is bent or
squeezed, the "NIBP SAFETY CIRCUIT RUNNING" message
appears on the screen and NIBP monitoring may be stopped.
Remove the cause, wait 40 seconds, check that the message
disappears, then measure again.
CAUTION
Before starting STAT or SIM mode measurement, check the
measurement setting (measurement intervals).
NOTE • When measuring patients who are conscious, help the patient
to relax. Measurement may not be accurate if the patient’s arm
is tense or if the patient talks.
• The data for measurement on the thigh tends to be higher than
measurement on the arm.
• Do not apply pressure to the cuff or air hose. NIBP might not be
measured correctly because of the noise or NIBP measurement
may stop due to the NIBP safety circuit running.
• Do not measure NIBP on a patient on whom an IABP is used.
Accurate NIBP measurement cannot be performed due to pulse
waves from the IABP mixing with the patient’s pulse waves.
Manual Measurement
NIBP is measured once whenever the [NIBP Start/Stop] key on the screen is
touched. Manual measurement cannot be performed during the first stage of the
STAT or SIM mode measurement.
Auto Measurement
When <START TIME> on the MAIN tab - NIBP page - PARAMETERS
window is set to CLOCK.
The first NIBP measurement is performed when the [NIBP Start/Stop] key on the
screen is touched and auto mode on the home screen is highlighted. The second
measurement is performed when the current time (minutes) in the monitor
reaches the nearest time interval selected.
The second periodic measurement time begins from the next even clock interval.
Example: When the interval is set to 5 minutes
8:02 First measurement (start measurement)
8:05 Second measurement
8:10 Third measurement
STAT Measurement
Measurements are performed continuously according to the measurement
program set for STAT measurement on the SYSTEM SETUP window. The
program is divided into two stages. In the first stage, NIBP is measured
continuously or at 1-minute interval for 5 or 10 minutes. In the second stage,
NIBP is measured at a different interval (manual or 1, 2, 2.5, 5, 10, 15, 30
minutes, usually, longer interval than the first stage). Manual measurement
cannot be performed during first stage measurement. The settings on the
SYSTEM SETUP window can only be set by the administrator who has the
password to enter the page.
CAUTION
Before starting STAT or SIM mode measurement, check the
measurement setting (measurement intervals).
CAUTION
For safety during lumbar anesthesia, NIBP SIM mode measurement
is recommended by medical policy in Japan and the factory default
settings are the recommended settings. When changing these initial
settings, make sure that the changed setting is appropriate for the
patient by referring to the manual of the anesthetic agent.
SIM mode program is for monitoring blood pressure during regional anesthesia,
such as lumbar block, subarachnoid block and epidual anesthesia.
Measurements are performed continuously according to the measurement
program set for SIM measurement on the SYSTEM SETUP window. The
program is divided into two stages. In the first stage, NIBP is measured at
1-minute, 2-minute or 2.5-minute interval for 5, 10 or 15 minutes. In the second
stage, NIBP is measured at a different interval (2, 2.5 or 5 minutes, usually
longer interval than the first stage). Manual measurement cannot be performed
during first stage measurement. The settings on the SYSTEM SETUP window
can only be set by the administrator who has the password to enter the page.
Cuff type
Measurement
mode/interval
13
Manual Measurement
Measurement
mode “MANUAL”
Auto Measurement
WARNING
When performing long term measurement at intervals less than 2.5
mins, perform measurements while observing the state of the
patient, blood vessels and limb to ensure adequate circulation.
Congestion may occur at the measurement site. When performing
periodic measurement for a long time, periodically check the
circulation condition.
Measurement interval
STAT Measurement
WARNING
When performing long term measurement at intervals less than 2.5
mins, perform measurements while observing the state of the
patient, blood vessels and limb to ensure adequate circulation.
Congestion may occur at the measurement site. When performing
periodic measurement for a long time, periodically check the
circulation condition.
CAUTION
Before starting STAT or SIM mode measurement, check the
measurement setting (measurement intervals).
1 Before STAT measurement, check the measurement setting on the STAT tab
- NIBP page - PARAMETERS window - SYSTEM SETUP window.
For details, refer to Section 3 of the Administrator’s Guide.
13
Or,
Touch the [MEASUREMENT INTERVAL] key on the NIBP window to
open the MEASUREMENT INTERVAL window and change the interval to
“STAT”.
3 Touch the [NIBP Start/Stop] key to start measurement in the first stage.
During measurement, the cuff inflation pressure appears.
When measurement is complete, the measured data appears on the screen
and another measurement starts.
When <COMPLETION SOUND> in the SYSTEM SETUP window is set
to NK1 or NK2, a sound is generated when NIBP measurement is complete.
For details on the completion sound, refer to Section 3 of the Administrator’s
Guide.
Manual measurement is not available during the first stage of STAT
measurement.
4 When the first stage is completed, measurement in the second stage starts.
To stop STAT measurement in the first stage, touch the [NIBP Start/Stop] key.
The cuff is deflated.
To stop STAT measurement in the second stage, change the measurement mode
to “MANUAL”.
The periodic measurement can be stopped by touching the [NIBP Interval] key to
display the NIBP INTERVAL window and touching the [OFF] key on the NIBP
INTERVAL window during measurement.
To perform a manual measurement between auto measurements in the second
stage, touch the [NIBP Start/Stop] key.
WARNING
When performing long term measurement at intervals less than 2.5
mins, perform measurements while observing the state of the
patient, blood vessels and limb to ensure adequate circulation.
Congestion may occur at the measurement site. When performing
periodic measurement for a long time, periodically check the
circulation condition.
CAUTION
Before starting STAT or SIM mode measurement, check the
measurement setting (measurement intervals).
1 Before SIM measurement, check the measurement setting on the SIM tab -
NIBP page - PARAMETERS window - SYSTEM SETUP window.
For details, refer to the Administrator’s Guide.
13
2 Touch the [NIBP Interval] key to open the NIBP INTERVALS window to
change the interval to “SIM”.
Or,
Touch the [MEASUREMENT INTERVAL] key on the NIBP window to
open the MEASUREMENT INTERVAL window and change the interval to
“SIM”.
3 Touch the [NIBP Start/Stop] key to start measurement in the first stage.
During measurement, the cuff inflation pressure appears.
When measurement is complete, the measured data appears on the screen
and another measurement starts.
When <COMPLETION SOUND> in the SYSTEM SETUP window is set
to NK1 or NK2, a sound is generated when NIBP measurement is complete.
For details on the completion sound, refer to Section 3 of the Administrator’s
Guide.
Manual measurement is not available during the first stage of SIM mode
measurement.
4 When the first stage is completed, measurement in the second stage starts.
To stop SIM measurement in the first stage, touch the [NIBP Start/Stop] key. The
cuff is deflated.
To stop SIM measurement in the second stage, change the measurement mode to
“MANUAL”.
The periodic measurement can be stopped by touching the [NIBP Interval] key to
display the NIBP INTERVAL window and touching the [OFF] key on the NIBP
INTERVAL window during measurement.
To perform a manual measurement between auto measurements in the second
stage, touch the [NIBP Start/Stop] key.
Setting Range
Patient Type Default Setting
(5 mmHg/step, 1 kPa/step)
ADULT 100 to 280 mmHg, 13.0 to 37.0 kPa 180 mmHg, 24.0 kPa
CHILD 100 to 280 mmHg, 13.0 to 37.0 kPa 140 mmHg, 18.5 kPa
NEONATE 70 to 145 mmHg, 9.00 to 19.0 kPa 100 mmHg, 13.5 kPa
2 Select the patient type on the INITIAL CUFF PRESSURE TYPE window.
Refer to the previous procedure.
Slider
Patient type
Cuff inflation
pressure
Setting bar
4 Touch and drag the slider to the desired level on the setting bar. Use the
or key to adjust the setting.
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Be careful when you set the alarm limit to OFF.
You can set the upper and lower systolic, diastolic and MAP NIBP alarm limits
on the NIBP window. You can set all alarms, including the upper and lower NIBP
alarm limits, on the ALARM LIMITS window (See the Operator’s Manual or
Section 5 of the User’s Guide).
Setting Range
Upper limit: 15 to 260 mmHg in 5 mmHg steps (2.0 to 34.5 kPa in 0.5 kPa steps), OFF
(default setting: Systolic: ADULT - 180 mmHg (24.0 kPa), CHILD - 140
mmHg (18.5 kPa), NEONATE - 100 mmHg (13.5 kPa)), Diastolic: OFF,
MAP: OFF
Lower limit: OFF, 10 to 255 mmHg in 5 mmHg steps (1.5 to 34.0 kPa in 0.5 kPa steps)
(default setting: Systolic: ADULT - 80 mmHg (10.5 kPa), CHILD - 65
mmHg (8.5 kPa), NEONATE - 50 mmHg (6.5 kPa)), Diastolic: OFF, MAP:
OFF
Upper limit
Upper limit slider
Current value
of the selected
parameter Lower limit
3 Touch and drag the slider to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
CAUTION
Do not perform a venous puncture on the same arm where NIBP is
measured. This may cause an infusion backflow or internal
hemorrhage at the puncture.
3 Touch the [START] key on the VENOUS PUNCTURE window. The cuff
starts inflating and the remaining time until cuff deflation is shown in the
<REMAINING TIME> box.
The cuff inflation can be stopped at any time by touching the [STOP] key on
the VENOUS PUNCTURE window or by displaying another window.
4 When using the venous puncture mode is finished, touch the [HOME] key to
return to the home screen.
13
General..........................................................................14-2
Monitoring IBP...............................................................14-8
IBP Information on the Home Screen...........................................14-8
14
Changing IBP Settings..................................................14-9
Changing the IBP and Pulse Rate Alarm Limits...........................14-9
Changing the Scale....................................................................14-11
Changing the Sync Sound Source.............................................14-12
Selecting Sync Sound Pitch.......................................................14-13
Adjusting Zero Balance..............................................................14-15
Selecting the Data Display Mode on the Home Screen.............14-16
14. IBP MONITORING
General
Invasive blood pressure and intracranial pressure (ICP) are measured and
monitored by connecting the blood pressure measuring device to the units.
Preparation Flowchart
1 Select the blood pressure measuring device.
2 Install the blood pressure measuring device, connect the blood pressure
transducer to the IBP connection cord, and connect the IBP connection cord
to the PRESS socket on the monitor. For details, refer to the instruction
manual provided with the blood pressure transducer and measuring kit.
WARNING
All parts, except for transducers, must be non conductive. Otherwise,
the discharged energy may cause electrical shock to the operator
during defibrillation.
CAUTION
Check that there are no scratches on the catheter balloon before
use.
CAUTION
Do not reuse disposable parts and accessories.
JP-752P JP-753P
Roller clamp
2 Connect the IBP connection cord to the PRESS socket on the monitor.
NOTE: When connecting the IBP connection cord to the monitor after
assembling the transducer and filling the tubes with saline
solutions, make sure that the connector is not wet.
2 Insert the needle at the tip of the micro-drip into the hole on the
physiological saline pack.
3 Pressurize the physiological saline pack with your hand by pressing the flush
cap to remove air from the pack.
4 When the solution in the micro-drip chamber is about 1/3 full (the stainless
needle is in the solution), turn the physiological saline pack upside down and
mix the physiological saline solution and heparin.
5 Place the saline pack in the pressure bag and hang the pressure bag on the
stand.
6 Press the flush cap to completely fill the tube with saline solution.
NOTE: Tap the bottom part of the micro-drip to remove air bubbles from
under the filter.
7 Fill in the transducer with the saline solution. Remove air bubbles by
pressing the flush cap at above the saline pack, then bringing the flush cap
down.
If the air bubbles cannot be removed from the transducer:
i) Hold the transducer higher than the saline pack to flow the saline solution
back into the saline pack and fill the transducer again.
ii) Tap the transducer lightly and flush the transducer slowly. Do not tap too
hard because the air bubbles may break into small bubbles which are
difficult to remove.
14
iii) Check that there are no air bubbles in the transducer, tubes and 3-way
stopcocks.
8 Replace the white aerated caps with the yellow sealing caps.
9 Pressurize the pressure bag to 300 mmHg (40.0 kPa). The solution in the
micro-chip chamber is about a third to half full.
At this pressure, the drip rate should be 2 to 4 drops/min.
2 Touch the [YES] key to adjust zero balance. When the [YES] key is touched,
ZERO CALIBRATION window appears. Adjust zero balance by doing the
following steps.
When the [NO] key is touched, the monitor starts monitoring IBP by using
the zero balance value memorized in the connector of the IBP connection
cord and the “ZERO IMBALANCE” messages disappear. The IBP values
appear on the screen. If necessary, adjust zero balance by doing the
following steps.
3 Move the dome up or down so that the 3-way stopcock on the transducer is
at the level of the right atrium of the patient and open the air release opening
of the 3-way stopcock to air.
Heart
When measuring the intracranial pressure, adjust the 3-way stopcock of the
catheter to the level of the ventricle and open the air release opening of the
3-way stopcock to air.
14
Monitoring IBP
When the 3-way stopcock is closed after zero balance, you can start IBP
monitoring.
IBP values
Systolic/Diastolic
Scale for IBP
(Mean) or Mean
waveforms
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Depending on the setting, the alarm off mark might not be
displayed on the screen. Be careful when you set the alarm limit to
OFF.
You can set the upper and lower systolic, diastolic and mean IBP alarm limits
and pulse rate alarm limits of the blood pressure on the PRESS window. You 14
can set all alarms, including the upper and lower IBP alarm limits and pulse rate
alarm limits, on the ALARM LIMITS window (See the Operator’s Manual or
Section 5 of the User’s Guide). The pulse rate alarm limits can also be changed
on the SpO2 window.
Setting Range
IBP upper limit: –48 to 300 mmHg in 2 mmHg steps (–6.0 to 40.0 kPa in 0.5
kPa steps), OFF
(default setting: SYS: OFF
DIA: OFF
MEAN: OFF)
IBP lower limit: OFF, –50 to 298 mmHg in 2 mmHg steps (–6.5 to 39.5 kPa in
0.5 kPa steps)
(default setting: SYS: OFF
DIA: OFF
MEAN: OFF)
Upper limit
Current value
of the selected
parameter
Lower limit
3 Touch and drag the slider to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
2 Select the scale by touching the desired scale key. Use the sliders to adjust
the scale.
Or, touch the [ADJUST] key to automatically select to the appropriate scale
for the displayed waveform.
14
14
General..........................................................................15-2
Monitoring Temperature.................................................15-6
Temperature Information on the Home Screen............................15-6
General
To monitor temperature, attach the probe to the patient and connect the probe to
the TEMP socket on the monitor.
NOTE: The monitor simulates the temperature signal of 27 °C and 37 °C
inside the monitor. Monitoring this simulated signal periodically,
the monitor self-diagnoses the temperature signal processor part
of the monitor. When the monitor could not cover the 0 to 45°C
measurement range, a "MPU MODULE ERROR" message is
displayed.
Preparation Flowchart
1 Select the probe.
CAUTION
Select the appropriate probe for the patient. Using adult probes on
premature infants and children may injure the mucous membrane.
CAUTION
The insulation pad may irritate the skin. In long term monitoring,
change the attachment site to prevent irritation.
Reusable Probes
Thermistor Probe Purpose
401J*
402J*
409J*
* These thermistor probes are available direct ** These parts have not been
from YSI, Yellow Springs Instrument Inc., checked for compliance with the
Yellow Springs Ohio 45387, USA; Phone +1 MDD (Medical Device Directive).
937-767- 7241. For EC member countries,
Shanghai Kohden recommends
the use of parts that comply with
MDD.
Disposable Probes
The following probes can be used on this monitor. To use the disposable probes,
the 5-15801 extension cable is required.
The disposable probes and the extension cable are available direct from Kendall
Healthcare Products Company (www.kendallhq.com) or their suppliers.
CAUTION
Do not reuse disposable probes on other patients.
When connecting the 409J reusable probe for the body surface
CAUTION
Select the appropriate probe for the patient. Using adult probes on
premature infants and children may injure the mucous membrane.
15
Monitoring Temperature
After completing the preparation, temperature data appears on the screen.
Temperatures
CAUTION
When the alarm limit is set to OFF, there will be no alarm for that
limit. Be careful when you set the alarm limit to OFF.
You can set the upper and lower temperature alarm limits on the TEMP window.
You can set all alarms, including the upper and lower temperature alarm limits,
on the ALARM LIMITS window (See the Operator’s Manual or Section 5 of the
User’s Guide).
Setting Range
You can set different limits for TEMP1 and TEMP 2.
TEMP1/TEMP2 upper limit: 0.1 to 45.0 °C in 0.1 °C steps (33 to 113 °F in 1 °F steps),
OFF (default setting: 38.0 °C (100 °F))
TEMP1/TEMP2 lower limit: OFF, 0.0 to 44.9 °C in 0.1 °C steps (32 to 112 °F in 1 °F
steps) (default setting: OFF)
Lower limit
3 Touch and drag the slider to the desired level on the setting bar. Use the
or key to adjust the setting.
If the upper limit is set to a value above the maximum, the upper limit alarm
is set to OFF. If the lower limit is set to a value below the minimum, the
lower limit alarm is set to OFF.
General..........................................................................16-2
Preparation....................................................................16-3
Preparation Flowchart..................................................................16-3
and Weight.................................................................................16-11
Changing the Dose Step............................................................16-12
Unit and Setting Range..............................................................16-12
16
16. Drug
General
On the DRUG window, you can calculate the flow rates and dosages for
medication titrations. The flow rate is calculated from the following equation.
The dosage can also be calculated when the flow rate is known.
Dosage x Patient Weight x Solution Amount
Flow rate =
Drug Amount
Preparation
Preparation Flowchart
There are three windows for the drug calculation. On the DOSE window, you can
see the table of the selected drug titration. The drug name and unit are selected
on the DRUG window. On the SETTING window, you can change drug amount
(AMOUNT), solution amount (VOLUME), dosage (DOSE), flow rate (SAMPLE
RATE), patient weight and dose step. The settings on the DRUG and SETTING
windows are used for the drug calculation and you can see the calculation result
on the DOSE window. The dosage and flow rate calculated from the setting on
the SETTING window are highlighted in blue.
Drug name
selected on
the DRUG Titration
window table
Set on the
SETTING
window
Value calculated from the Select the dose step
settings on the SETTING
window
NOTE • When using the DRUG window for the first time after shipment
or after settings are initialized, you must set the drug names
and other settings.
• When the patient weight is changed on the ADMIT page of the
ADMIT window, the titration is automatically recalculated with
the new weight.
17 drugs and drug amount, solution amount, dosage and dose step for each drug 16
are preset on the monitor. The dosage and flow rate are calculated from the
equations listed in the “Flow Rate Equations” section. You can set four other
drugs on the DRUG window and change the settings on the EDIT window.
BRETYLIUM
Dosage (mg/min) x Solution amount (mL) x 60
mg/min LIDOCAINE Flow rate (mL/h) =
Drug amount (mg)
PROCAINAMIDE
EPINEPHRINE
ISOPROTERENOL Dosage (μg/min) x Solution amount (mL) x 60
μg/min Flow rate (mL/h) =
NOREPINEPHRINE Drug amount (mg) x 1000
PHENYLEPHRINE
AMRINONE
DOPAMINE
μg/kg/min DOBUTAMINE Dosage (μg/kg/min) x Weight (kg) x Solution amount (mL) x 60
Flow rate (mL/h) =
Drug amount (mg) x 1000
NITROGLYCERINE
NITROPRUSSIDE
HEPARIN Dosage (units/h) x Solution amount (mL)
units/h Flow rate (mL/h) =
INSULIN Drug amount (units)
Dosage (IU/h) x Solution amount (mL)
IU/h STREPTOKINASE Flow rate (mL/h) =
Drug amount (IU)
For DRUG A to D, when using the same dosage unit as above, the same equation
is used. When using other units, refer to the table below.
Dosage Unit Equation
Dosage (mg/kg/min) x Weight (kg) x Solution amount (mL) x 60
mg/kg/min Flow rate (mL/h) =
Drug amount (mg)
16
Select a drug.
Display EDIT window for entering drug name and dose unit.
16
Selected drug
name.
2 Select the drug by touching the drug name key. When the drug is selected,
drug amount, solution amount (BASE VOLUME), dosage (DOSE) and step
(DOSE STEP) set for that drug and concentration and flow rate (SAMPLE
RATE) which are automatically calculated appear on the window.
NOTE • DOPAMINE, DOBUTAMINE, NITROGLYCERIN and
NITROPRUSSIDE need patient weight to calculate the flow
rate. For these drugs, enter the patient weight on the ADMIT
page of the ADMIT window or the SETTINGS window of the
DRUG window.
• For the DRUG A to D, assign the drug name and set the unit on
the DRUG window and set the drug amount, solution amount,
dosage and step on the SETTINGS window.
When using a drug other than the 17 preset drugs, you can assign a drug name
and dosage unit to DRUG A to D. when the dosage unit is set, the flow rate
unit is automatically set. When using this function, you must also set the drug
amount, solution amount (BASE VOLUME), dosage (DOSE) and step (DOSE
STEP) so that the dosage and flow rate (SAMPLE RATE) can be calculated.
3 Touch the [EDIT] key. The keyboard for entering drug name appears.
Cursor
16
Delete key
Alphanumeric
ENT key
Moves cursor
Space key
5 Select the unit. When the dosage unit is set, the flow rate unit is
automatically set as follows.
Dosage Unit Drug Amount Unit
mg/h
mg/min
mg/kg/h
mg/kg/min
mg
μg/h
μg/min
μg/kg/h
μg/kg/min
units/h units
IU/h IU
16
2 Select the item you want to change the setting for by touching the item name
key.
μg/min
0.01 to 1500000 0.01 to 1500000
μg/kg/h
μg/kg/min
units/h
units 10, 50, 100, 500
units/kg/h
IU/h
IU 5000, 10000, 50000
IU/kg/h
16
Clock Accuracy..............................................................17-2
17
17. Reference
Clock Accuracy
At an operating temperature of 25 °C, the accuracy of the clock IC of this
monitor is about ± 3 minutes 30 seconds per month.
At storage temperatures between –20 and +60 °C, the accuracy of the clock IC of
this monitor is about ± 6 minutes per month.
Periodically check that the time in the upper right corner of the monitor screen is
correct.
To change the time setting, refer to “Changing Date and Time” in Section 3.
NOTE: When the date or time is changed during monitoring, the date and
time of all stored data is also changed and may not match the
date and time on the printout.