FULL DISCLOSURE Displaying Data from a Specific Time You can display data taken at any time in the past 24/72 hours. If no trend data is available for the time you select, data closest to this time is displayed. 1. Press Skip To on the Disclosure screen to display the Skip To popup (fig. 73). Fig. 73. Skip To Popup 2. On the popup keypad, enter the desired time: use A/P to set a.m. or p.m. Note: If using a 24-hour time setup, you do not need to specify a.m. or p.m.
FULL DISCLOSURE Displaying Vital Statistics Press the Vitals buttons to display the patient’s vital statistics, as well as the primary and secondary arrhythmia leads and rhythm indicator (page 70), from the first valid sample in the disclosure screen. Fig. 74. Full Disclosure Vitals Popup Viewing the Previous Alarm Press the Prev Alarm button to display the previous alarm. 152 PatientNet Operator’s Manual, v1.
FULL DISCLOSURE Storing a Disclosure Waveform Segment as a History Event To store a 20-second waveform segment in Full Disclosure as a history event: 1. Highlight a wave segment to store. If it is longer than 20 seconds, the center 20-second segment is stored. If the waveform is fully zoomed in, there is no need to highlight a segment. The 7 seconds of zoomed-in data is stored. 1. Press the Options button to display the Options Popup (fig. 75). Fig. 75. Full Disclosure Options Popup 2.
FULL DISCLOSURE Printing Full Disclosure You can print disclosure reports in 1, 2, 4, 8, 12, or 16 hour report, 24/72-hour report, 24/72-hour summary report, zoomed-in report formats, and 24/72-hour quality reports. These reports may be annotated with alarm violations and beat annotations. Note: With the 72-Hour Full Disclosure option enabled, you can also print a 24, 48, and 72-hour report, summary, and quality reports.
FULL DISCLOSURE One Hour Disclosure Report This report prints from 15 minutes to one hour of waveforms to a page, depending on the number of waves selected. • One waveform in the disclosure screen: one hour of data is printed on a page (one minute per line). • Two waveforms in the disclosure screen: 30 minutes of waveforms are printed on a page. • Three waveforms in the disclosure screen: 20 minutes of waveforms are printed on a page.
FULL DISCLOSURE 24/72-Hour Summary Report This report prints summary graphs of all data trended during the last 24/72 hours and the total number of alarm violations. It leaves space for physician signature and notes. The data reported depends on the parameters selected for the past 24/72 hours. The event is listed on the second page if archived, or a report was set. It is printed at the Central Station even if requested at a PatientNet Viewer.
FULL DISCLOSURE All Patients Button The All Patients button prints the summary 24 (72) hour quality report for all patients on the Central Station. Note: This button is not displayed on the PatientNet Viewers.
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TREND DATA TREND DATA The Trend function tracks monitored parameters up to twenty-four hours (or an optional 72 hours) for patients whose alarms are set to ON on the Patient Settings screen. You choose which parameters to trend and then customize the data to be shown on the screen and in printed reports. You can also mark specific events on the trend graph. Trend settings are made on the Trend screen.
TREND DATA Selecting Trend Parameters to View You can display two of the following parameters at a time on the trend graph Table 18.
TREND DATA Device Type Trend Parameter Ventilator Patients • • • • • • • • • • • • • • • * † RR Setting RR Observed Vt Setting Vt Observed Minute Volume Spontaneous Minute Volume PEEP/CPAP Peak Flow Peak Inspiratory Pressure O2 % I:E Ratio MAP (Mean Airway Pressure) Pressure Support Plateau Pressure SpO2 Available only if ST analysis is enabled. Available only if Pacer processing is enabled. To display the parameters you have chosen: 1. Press the Left button on the Trend screen.
TREND DATA Adjusting the Time Span of the Displayed Trend Data The time span of the trend graph can be adjusted from one to 24 (72) hours, and if less than 24 (72) hours, can be moved to a later or earlier time. The time span is shown along the y-axis of the trend graph. To adjust the length of the time span: 1. To lengthen the time span shown in the graph, press Zoom Out repeatedly to a maximum of 24 (72) hours. 2. To shorten the time span, press Zoom In repeatedly to a minimum of one hour.
TREND DATA Trend List For bedside monitored and ambulatory patients you can view and print in list form the same trend information shown in the trend graph screen. Press the List button on the View screen to display the List Trends window (fig. 80), which contains data collected in the past 24/72 hours. Data older than 24/72 hours is automatically deleted. Data older than 12 hours is in red text. Ambulatory patient data is presented in a single column.
TREND DATA Selecting a Time Interval for Trend Data Display Trend data in the list is shown by default at intervals of one minute. To select a different interval, press the Settings button and choose 1, 5, 10, 15 or 30 minutes, or 1, 2, 3 or 4 hours on the popup (fig. 81). CAUTION: All alarms and NIBP measurements are displayed regardless of the time setting. If more than one alarm occurs at the same time, the alarm of highest priority is displayed.
TREND DATA Fig. 82. Report Configuration screen Note: Your report choices can be configured to be kept at the time of discharge. See your system administrator for details. 3. When you are finished making your selections, press Exit. 4. Press the Record or Laser button on the List Trends screen to display the Trend List Output popup (fig. 83). Fig. 83. Trend List Output popup 5.
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ST ANALYSIS ST ANALYSIS PatientNet performs ST analysis on ambulatory and bedside monitored patients as described in this section. Arrhythmia processing and ST Analysis is not performed when the device type is a ventilator. Enabling ST Analysis To enable ST analysis: 1. Press Setup on the Main screen and select the patient. 2. Set Process to ST and make further ST settings as instructed in this section. Process can be set to ST, None or Pacer. See “Pacemaker Processing” on page 95 for pacer information.
ST ANALYSIS The ST Analysis screen shows current and learned ST templates for up to seven leads, including derived leads (III, aVR, aVL, aVF) for central arrhythmia source patients. ST analysis is always performed on augmented leads regardless of whether they are displayed, so you can review augmented lead ST data at a later time. An ST template is the current 16 or 32 beat average of the last 16 or 32 normal beats for the lead. ST templates are updated every time the 16 or 32 beat average is updated.
ST ANALYSIS ST Segment End Point Use the arrow buttons under ST End or move the orange slide bar to adjust the ST end point between 5 and 300 ms past the J point in 5 ms increments. The default is J point plus 80 ms. The ST end point must be greater than the ST start point. System Defaults To revert to system defaults for ST points and the isoelectric point, press Defaults on the ST Configuration screen.
ST ANALYSIS Configuring ST Alarms This section includes ST alarm configuration instructions. For ST alarm information other than configuration, see “Alarm Management” starting on page 105. ST alarm settings are made on the ST Alarm Config screen (fig. 85). Press the ST Config button on the Patient Settings screen then the ST Alarm button on the ST Configuration screen to display this screen. Fig. 85.
ST ANALYSIS Minimum Episode Duration For central arrhythmia source patients you can establish a minimum time the ST condition must exist before it is classified as an episode and triggers an alarm. 1. Press the ST Config button on the Patient Settings screen. 2. Press the ST Alarm Config button on the ST Measurement Configuration screen. 3. Use the arrow buttons under Minimum Episode Duration field to select a minimum time. The range is 30 to 300 seconds in 15-second increments.
ST ANALYSIS Selecting an Average Beat for ST Template Generation To select a rate for the arrhythmia software to generate a new ST template (options are every 16 beats or every 32 beats): 1. Press ST Config on the Patient Settings screen. 2. Press the ST Alarm button. 3. Toggle the Beat Avg button to select 16 or 32. 32 is the default. Reference Level For ST Measurement The ST level can be measured from zero or can be measured relative to the learned ST template (Lrn).
ST ANALYSIS ST Printing Laser Printing ST Analysis Information To print real-time ST analysis information on the laser printer, press Laser on the ST Analysis screen. The patient’s demographic information and ST parameters are printed with the ST analysis data. If grid and/or ST points are selected when you press Laser, they are also printed. If the Cal Pulse is displayed when you press Laser, a one-mv calibration pulse is printed on the left side of the template.
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REMOTE VIEWING STATIONS REMOTE VIEWING STATIONS The RVS (PatientNet Viewer) and IRVS (Interactive-PatientNet Viewer) are monitors that display data on any patient on the network (from up to ten Central Stations simultaneously) on their own Main screens. You can enter information and make changes on the IRVS, but not on the RVS. The RVS is for viewing purposes only.
REMOTE VIEWING STATIONS Network Patient Information PatientNet Viewer and Interactive-PatientNet Viewer operations are performed on the Network Patient Information screen (fig. 86), displayed when you press the Network button on the PatientNet Viewer or Interactive-PatientNet Viewer main screen. Fig. 86. Network Patient Information screen Locating a Patient You can find a patient in window list according to channel number, patient name, room number, physician, or pager number.
REMOTE VIEWING STATIONS Printing the Network Census Report From the Network screen, you can print the Network Census Report, which displays patient information for all channels that are on the network. The report columns are sorted according to the sort settings on the Network Screen.
REMOTE VIEWING STATIONS How Remote Alert Displays an Alarming Patient The system assigns the alarming patient to an empty channel on the PatientNet Viewer (RVS) or Interactive-PatientNet Viewer (IRVS). If there are no empty channels, then the alarming patient replaces the patient who has been displayed longest on the RVS/ IRVS. In a 16 channel Interactive-PatientNet Viewer in split screen mode the alarming patient may be placed in a channel not currently visible.
REMOTE VIEWING STATIONS Central Station and PatientNet Viewers Differences Table 19. Differences between the Central Station and PatientNet Viewers.
REMOTE VIEWING STATIONS Table 20.
USING THE RETROSPECTIVE VIEWER USING THE RETROSPECTIVE VIEWER Note: This function is only available on systems with the Retrospective Viewer option enabled. The Retrospective Viewer allows you to access patient demographics, full disclosure, history, trends, and vital signs once a patient is discharged. The discharged patient files, however, are read-only and cannot be modified. To access the Retrospective Viewer: 1. Click the System button at the top of the screen to display the Passcode screen. 2.
USING THE RETROSPECTIVE VIEWER 5. Click on the Up and Down arrows to highlight and select a patient for viewing. 6. Click the Archived button to toggle between Yes and No. • Selecting Yes will prevent the selected patient data from being deleted from the system. The maximum number of archived files is dependent on the system in use. On 16 channel Central Stations, you can have up to 16 discharged patients in the Retrospective Viewer, with 8 of those patients being saved in the Archive.
WMTS TRANSCEIVERS WMTS TRANSCEIVERS Note: The information in this section is only applicable for Wireless Medical Telemetry Service (WMTS). About Transceivers Wireless Medical Telemetry Services (WMTS) Remote Transceivers provide the link between the patient and the Central Station through the newly approved 608 - 614 MHz Medical Telemetry frequency band. The ambulatory and bedside device transceivers communicate data to the Central Station through the Access Point transceiver.
WMTS TRANSCEIVERS Displaying Transceiver Status You can view transceiver status on the Central Station, but not on the PatientNet Viewers (also known as the IRVS and RVS). 1. Press System on the Main screen. 2. Press OpenNet button on the Passcode screen to display the OpenNet Status screen (fig. 90). Fig. 90. OpenNet Status screen Your System Administrator enables or disables the Assign TX, Program AT, and Program IT buttons. Check with your System Administrator for more information.
WMTS TRANSCEIVERS Impedance Values The DT-4500 Ambulatory Transceivers electrode impedance values, which are displayed on the OpenNet Transceiver Status screen, indicate the quality of the signal connection and are not the actual impedance values that are measured by the system. The electrode impedance values range from 100 to 200 (optimal). The typical values range between 180 and 200. If the electrode’s impedance value is greater than the defined Quality Threshold value, then its LED is illuminated.
WMTS TRANSCEIVERS 7. The DT-7000/DT-7001 is not designed as a patient contact device. Per FCC rules, the DT-7000/DT-7001 must reside more than 20 cm (7.9 inches) from the patient. Cautions 1. Any changes or modifications to the device that are not expressly approved by the party responsible for compliance could void the user’s authority to operate this equipment. 2. Electromagnetic interference or power overload, due to electrosurgical or diathermy instruments, may damage the device. Notes 1.
WMTS TRANSCEIVERS Ambulatory Transceiver (DT-4500) The DT-4500 transceiver is a battery-operated ambulatory transceiver worn by the patient and used with a 3, 4, or 5-wire leadset that is connected to electrodes on the patient. The transceiver is available to patients who are not confined to a bed, but still require constant monitoring of their ECG waveforms. Operating Instructions Push Button Function and Use See Figure 91 on page 190 for an image of the DT-4500 controls and LED indicators.
WMTS TRANSCEIVERS Attendant Present / Procedure Alarm Silence (PAS) Unlock Button The Attendant Present/PAS Unlock Buttons consists of two buttons that are located on either side of the transceiver (See Figure 91 on page 190). The Attendant Present push buttons have three functions. Each function is initiated based on how long the buttons are pressed. 1. Lead Quality Pressing both Attendant Present buttons simultaneously will illuminate the LEDs for each lead that has a minimum level of quality. 2.
WMTS TRANSCEIVERS Procedure Alarm Silence (PAS) Button Depressing the PAS button, while the PAS Status Indicator LED is flashing, informs the clinicians at the Central Station area that the attending nurse will be performing a procedure to the patient that may cause inadvertent false alarms at the Central Station (i.e. changing lead wires, electrodes, etc.) Once the PAS button is pressed, the following events occur at the Central Station. 1.
WMTS TRANSCEIVERS *External Serial Device (I/O) Cable ECG Leadset and connector cover ECG Leadset Connector *External Serial Device (I/O) Connector Attendant Present / Procedure Alarm Silence Unlock buttons Battery Low, RF, and I/O Connector Link Status Indicators Remote Record button Procedure Alarm Silence button Nurse Call button Procedure Alarm Silence Status Indicator Electrode Status Indicators Battery Compartment Fig. 91.
WMTS TRANSCEIVERS LED Indicators Function Upon Power-On, all LED indicators are illuminated for a brief period. After the specified time period, only those LEDs displaying positive (or negative) transceiver functions, as described in each section below, remain illuminated. Procedure Alarm Silence Status Indicator The Procedure Alarm Silence Status Indicator is illuminated when the PAS function is active.
WMTS TRANSCEIVERS The Quality Threshold value has a default setting. If the electrode’s impedance value is greater than the default, then its LED is illuminated. The DT-4500 stores the Quality Threshold value and uses this value to determine whether or not the electrode LED should be illuminated when the Attendant Present buttons are pressed. See “Impedance Values” on page 185 for details.
WMTS TRANSCEIVERS Cleaning This section provides cleaning and maintenance instructions for DT-4500 transceivers. Read and follow all precautions when cleaning transceivers. WARNING: No claims are made concerning the sterility of the DT-4500 Ambulatory Transceivers. CAUTION: Do not sterilize any part of the transceivers. Gas sterilization, autoclaving, liquid immersion, and other sterilization methods can cause serious damage to the devices that may not be obvious to the user.
WMTS TRANSCEIVERS Note: Once a month, or whenever the DT-4500 is submersed or subjected to a stream of liquid, remove the accessory connector cover and remove any moisture that may have collected inside. Cleaning the Battery Compartment CAUTION: When cleaning the battery compartment, use only soap, water, or alcohol. Do not use any other cleaning agents inside the battery compartment as they may damage the battery compartment.
WMTS TRANSCEIVERS Cleaning 1. Wipe the leadset with a solution of soap and water. 2. Use a cloth moistened with distilled water to rinse away the cleaning solution. 3. Dry thoroughly with a lint-free cloth. Disinfecting Use hospital-approved disinfecting procedures such as those recommended by AAMI or AORN. 1. Wipe the leadset with a fresh 10% solution of chlorine bleach and water or a 2% gluteraldehyde solution such as Cidex. 2.
WMTS TRANSCEIVERS Installing and Removing a Battery See “Specifications” on page 247 for acceptable batteries. Note: Battery service life can be substantially improved by using nine-volt lithium batteries. To install a 9V transceiver battery, first open the transceiver battery compartment by placing your thumb and forefinger on the compartment latch and flipping it open.
WMTS TRANSCEIVERS Instrument Transceiver (DT-7000, DT-7001) WARNING: When using a bedside device with the instrument transceiver (DT-7000/7001), the bedside device is the primary monitor and alarm source. Disabling alarms on the bedside device is not safe clinical practice. The DT-7000 and DT-70011 send data and alarm information from bedside monitors and NPB 7200 series ventilators to the Central Station. The transceivers support the bedside monitors shown in the PatientNet Customer Release Notes.
WMTS TRANSCEIVERS Remote Record When depressed, the Remote Record function button will initiate a strip chart recording at the Central Station. Nurse Call When depressed, the Nurse Call function button will initiate a Nurse Call Alarm at the Central Station. Power Button Pressing the Power button either places the transceiver in or out of Standby Mode. Attendant Present / Procedure Alarm Silence (PAS) Unlock Button The Attendant Present push button has two functions.
WMTS TRANSCEIVERS Procedure Alarm Silence (PAS) Button Depressing the PAS button, while the PAS Status Indicator LED is flashing, informs the clinicians at the Central Station area that the attending nurse will be performing a procedure to the patient that may cause inadvertent false alarms at the Central Station (i.e. changing lead wires, electrodes, etc.) Once the PAS button is pressed, the following events occur at the Central Station. 1.
WMTS TRANSCEIVERS External Serial Devices (I/O) Ports 3 and 4* Power Connector Bottom View External Serial Devices (I/O) Ports 1 and 2* Procedure Alarm Silence (PAS) button External Serial Devices (I/O) Ports Status Indicators* Nurse Call button Attendant Present and Power buttons RF, Low Battery, and Power Adapter Indicators PAS Status Indicator Remote Record button Front View Fig. 92.
WMTS TRANSCEIVERS LED Indicators Function Once the transceivers exit Standby Mode, either by pressing the Attendant Present or Power buttons, all LED indicators are illuminated for a brief period. After the specified time period, only those LEDs displaying positive (or negative) transceiver functions, as described in each section below, remain illuminated. Procedure Alarm Silence Status Indicator The Procedure Alarm Silence Status Indicator is illuminated when the PAS function is active.
WMTS TRANSCEIVERS Cleaning This section provides cleaning and maintenance instructions for DT-7000 and DT7001 transceivers. Read and follow all precautions when cleaning transceivers. WARNING: No claims are made concerning the sterility of the DT-7000 and DT-7001 Instrument Transceivers. CAUTION: Do not sterilize any part of the transceivers. Gas sterilization, autoclaving, liquid immersion, and other sterilization methods can cause serious damage to the devices that may not be obvious to the user.
WMTS TRANSCEIVERS Use and Maintenance Connecting to the Bedside Monitor See Figure 92 on page 200 for an image of the DT-7000/DT-7001 controls and LED indicators. Note: Before the transceiver is connected to the bedside monitor, the system administrator must program it with the bedside device specific software module. 1. Attach the transceiver to the bedside monitor by sliding the Device Hook over the Mounting Disk until the transceiver snaps into place.
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