User Manual

ManualsBrandsData Critical ManualsElectronicsPATIENTNET

ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION

PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft 73

All information contained herein is subject to the rights and restrictions on the title page.

ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION

This chapter tells you how to admit and discharge patients to the PatientNet System

and how to enter, view, modify and print patient demographic information.

The settings described in this section are displayed on the Patient Settings screen

(fig. 30). To display this screen, press Setup on the Main screen.

Fig. 30. Patient Settings screen

Admitting a Patient to the System

Admit a patient at the Central Station as follows:

1. Select an available patient channel by clicking on the waveform area. The

presence of the Admit button on the Patient Settings screen indicates that a

channel is available.

2. Press the Admit button.

3. Enter demographic information and clinical setting for this patient as

instructed in the following sections.

If the transceiver is transmitting when you press Admit, the system verifies that the

transceiver or device type matches the configuration for the channel. If the data does

not match, the ?? SOURCE alarm is triggered.

Note: The System Administrator may configure the system to make it mandatory

to enter specific patient demographic data before admitting a patient. The

required fields may include name, nursing unit, room number, physician,

and ID number.

Summary of content (78 pages)

PAGE 1
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION This chapter tells you how to admit and discharge patients to the PatientNet System and how to enter, view, modify and print patient demographic information. The settings described in this section are displayed on the Patient Settings screen (fig. 30). To display this screen, press Setup on the Main screen. Fig. 30.
PAGE 2
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION Entering Patient Information Once a patient is admitted, press the Patient Data button to display the Patient Data Entry screen (fig. 31). Fig. 31. Patient Data Entry screen 1. Highlight Patient Name in the list of items. 2. Press the Keyboard button. 3. Using the on-screen keyboard, type in the patient’s name then press the Enter button. You can also enter information with the external keyboard. 4.
PAGE 3
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION 7. Click the size mm/mv button (this button varies depending on the device type) to select the size of the waveform that is displayed. 8. Click the Next button to select the Primary and Secondary leads for Arrhythmia analysis. Note: For best results, select lead II for your Primary Lead, and lead V or I for your Secondary Lead. Note: The Primary and Secondary Lead selection is a configurable option.
PAGE 4
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION Modifying Patient Information Modify existing patient demographic information on the View Data screen (fig. 32). Fig. 32. View Data screen 1. Press Patient Data on the Patient Settings screen. 2. Press Modify Data on the View Data screen to re-display the Patient Data entry screen. 3. Highlight the information field you wish to change and type in your changes for that field using either the on-screen keyboard or the external keyboard. 4.
PAGE 5
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION Printing Patient Information You may want to maintain a record of patient demographic information as contained in the PatientNet System. To do so, print the Patient Data Report (fig. 33) from the laser printer for the patient’s file. 1. Press Patient Data on the Patient Settings screen to display the Patient Data Entry screen (fig. 31) or the View Patient Data screen. 2. Press Laser to print the Patient Data Report. Fig. 33.
PAGE 6
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION Discharging a Patient From the System Discharging a Patient at the Central Station To discharge a patient at the Central Station: 1. Press Discharge on the Patient Settings screen. If you want to print a discharge report, click Yes on the popup; otherwise click No. The information printed on the Patient Discharge Report is similar to that of the Patient Data Report, except that no ST or alarm configuration data is printed. 2.
PAGE 7
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION Printing a Discharge Report To print a Discharge Report: 1. Select No on the Remote Discharge screen. 2. Click the Setup button on the menu tool bar. 3. Click the Discharge button on the Patient Settings screen. The Discharge Report popup will appear. If you want to print a discharge report, click Yes on the popup; otherwise click No.
PAGE 8
ADMIT, DISCHARGE, AND PATIENT DEMOGRAPHIC INFORMATION This page is intentionally left blank. 80 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 9
PATIENT SETTINGS PATIENT SETTINGS Once a patient is admitted and demographic information is entered into the system, you can tailor the system to the individual patient. This section shows you how to make settings to accommodate patients’ specific monitoring needs. Note: All settings described in this chapter are channel-specific; they apply only to the patient channel selected when you make the settings. To select the patient, click on or touch the desired patient’s waveform.
PAGE 10
PATIENT SETTINGS Setting Device Types Patients are classified as ambulatory, bedside monitored, or ventilator, depending on whether they are connected to an ambulatory transceiver, a bedside monitoring device, or a ventilator. Monitored parameters are different for the three types of patient. When you define the patient’s device, the system determines the set of monitoring options available for the patient. To enter or change the device type that is connected to the selected patient: 1.
PAGE 11
PATIENT SETTINGS Table 7. Device types Device Type Specific Device Ambulatory • 5 wire • 4 wire • 3 wire Bedside Monitor • • • • • • • • • • Ventilator AT w/PRO Passport 2 Exp w/EP Encore Passport Expert MPS PRO-1000 PB 7200 Bird • • • • • • DASH Radical Propaq NK 4000 NK 2300 Agilent PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 12
PATIENT SETTINGS Selecting Monitored Parameters for the Configurable Data Block The configurable block displays up to four monitored parameters at a time. You can change the displayed parameters at any time as a patient’s monitoring needs change. The available parameters for each patient type are shown below. Table 8.
PAGE 13
PATIENT SETTINGS To Select a monitored field: 1. Click one of the four display fields in configurable block to display a popup (fig. 36) listing choices available for the type of patient. Fig. 36. Digital Parameter Popup - Bedside Device 2. Highlight the data option you wish to display in the block and press Post. 3. To display a blank field on the screen, highlight the blank space at the top of the popup screen and press Post. PatientNet Operator’s Manual, v1.
PAGE 14
PATIENT SETTINGS Assigning a Transceiver ID to a Patient Note: This button is configurable in the system administrator screens. If this button is unavailable, then see your system administrator for details. To assign a transceiver to a patient channel: 1. Click the Assign TX button on the Patient Settings screen (see Figure 34 on page 81) to display the Assign Transceiver screen (fig. 37). Fig. 37. Assign Transceiver Screen 2.
PAGE 15
PATIENT SETTINGS Selecting Waveforms for Display on the Main Screen Since more than one waveform is transmitted from the patient to the Central Station, you may select which waveform(s) appear on the Main screen. The monitoring device type of the patient determines the set of choices available for display. Note: Ventilator patients have no waveforms. Ambulatory Patients Ambulatory patients show one waveform on the Main screen. To select the waveform: 1.
PAGE 16
PATIENT SETTINGS 4. Press the Bottom Wave button to select the non-ECG wave. The choices are PLETH, P1, P2, RESP, CO2 and None. 5. Select the size of the bottom wave by pressing Bottom Size. Choices are as follows: • P1 and P2: 1.5, 3, 6, 12 or 24 mm/Hg, where 24 is the smallest and 1.5 the largest. • RESP, CO2 and PLETH: 0.25x (smallest), 0.5x, 1x, 2x, 4x (largest).
PAGE 17
PATIENT SETTINGS Table 9. Waveform labels 3-Wire 5-Wire Bedside I II ECG I P1 Wave 3 N/A I, ML1 I, II, III, ML1, II, ML6 ML6 N/A N/A Augment N/A Yes, No Wave 1 Wave 2 4-Wire No, Yes, N/A V, V1, V2, V3, P2 V4, V5, or V6 N/A Alarms Information on alarms and instructions on how to set and work with alarms are covered in detail in the “Alarm Management” chapter starting on page 105.
PAGE 18
PATIENT SETTINGS Note: If the Pager # button is set to Pre-Admit, then a pager number must be entered before a patient may be admitted. If the Pager # setting is set to PreAdmit and you attempt to admit a patient without a pager number, then a popup will be displayed stating that a pager number must be entered prior to admitting the patient. Implants Press the Implant button on the Patient Settings screen to cycle through the choices for patient implant.
PAGE 19
PATIENT SETTINGS Setting the Pacer Blanking Period Setting a blanking period before and after the pacer spike removes residual pacer artifact from the ECG signal. See “Pacemaker Processing” on page 95 for details. Note: This feature availability is configurable. If the Pacer Filter button is not available, then see your system administrator for details. Arrhythmia Processing Arrhythmia processing can take place at the Central Station or at the bedside patient monitor.
PAGE 20
PATIENT SETTINGS Fig. 39. Transfer popup Network Transfer You can move a patient’s settings and data from one Central Station to another in a network transfer. Setting The Network Transfer Status of a Patient The network transfer status of a patient determines whether or not he or she can be transferred to a different Central Station. To make a patient transferable on the network: 1. Press Transfer on the Patient Settings screen. 2. On the Transfer popup, toggle the Transfer button to Yes.
PAGE 21
PATIENT SETTINGS WARNING: It is possible that you can abort patient a transfer operation. If you abort the transfer, then the patient waveform will revert back to the source channel. The destination channel will not be monitored, and alarms at the source channel must be turned back on manually. System operators must diligently monitor patients undergoing transfers to assure that if an abort does occur, the transfer can be re-initiated.
PAGE 22
PATIENT SETTINGS This page is intentionally left blank. 94 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 23
PACEMAKER PROCESSING PACEMAKER PROCESSING You can select pacemaker processing, ST Analysis, or neither for a patient, but not both. These two processes are mutually exclusive functions. WARNING: Always set Process to Pacer for patients who have working electronic pacemakers. Do not set Process to Pacer for patients who do not have an electronic pacemaker. Press the Process button on the Patient Settings screen to toggle through Pacer, ST, or None.
PAGE 24
PACEMAKER PROCESSING Fig. 41. Three Lead Depiction of Pacemaker Rhythm Pacemakers are electronic devices that stimulate the myocardium with an electrical impulse. The type of pacemaker and its settings determine the frequency of the impulse. Demand pacemakers detect the underlying heart rhythm and send an impulse only when the heart rate falls below a preset level/rate. Fixed-rate pacemakers send an impulse at a specific rate regardless of the intrinsic heart rate.
PAGE 25
PACEMAKER PROCESSING Determining Pacer Filter Blanking Periods WARNING: If the pacer filter is changed from 25 ms, an increased level of surveillance should be instituted. Note: This feature availability is configurable. If the Pacer Filter button is not available, then see your system administrator for details. The pacer filter is enabled when Process is set to Pacer.
PAGE 26
PACEMAKER PROCESSING FALSE ASYSTOLE ALARMS ON FUSED BEATS FILTER TOO HIGH FILTER OK HOW TO VISUALIZE THE EFFECT OF THE PACER FILTER The pacer filter controls how much data is blanked on both sides of a detected pacemaker spike. The blue flag indicates the position where the spike was detected. The red line represents the region of pacer blanking. If there is a fused pacemaker spike on a narrow QRS complex, the blanking may remove the QRS complex.
PAGE 27
PACEMAKER PROCESSING FALSE HIGH RATES DUE TO DETECTION OF BEATS ON PACER ARTIFACT FILTER TOO LOW FILTER OK HOW TO VISUALIZE THE EFFECT OF THE PACER FILTER The pacer filter controls how much data is blanked on both sides of a detected pacemaker spike. The blue flag indicates the position where the spike was detected. The red line represents the region of pacer blanking. WHAT THE USER SEES The displayed and printed data show the unfiltered data. There should be one and only one annotation (N,V,etc.
PAGE 28
PACEMAKER PROCESSING The following procedure is recommended for determining the length of the optional blanking interval: 1. Place the patient on the system. 2. After establishing a stable waveform, store the paced rhythm in the view screen. 3. Inspect the flag and measure the interval from the flag to the physiologic response (P wave or QRS), as shown in fig. 44 and fig. 45. Residual artifacts of the pacer may appear between the flag and the start of the QRS.
PAGE 29
PACEMAKER PROCESSING 4. You can also inspect the flag and artifacts by recording the waveform on a strip or a laser printout. You can use manual calipers for the inspection. Remember the following facts: • Not all monitors position the pacer flag in the same place in the data in relation to the actual pacemaker spike or artifact. The flag may be in the center of the artifact, or it may precede or follow the artifact. Examine the location of the artifact and measure it accordingly.
PAGE 30
PACEMAKER PROCESSING Note the next four figures, where the system is accurately detecting and presenting the pacemaker flag. Fig. 47. Accurate Pacemaker Flag - Atrial-Ventricular Pacing Fig. 48. Accurate Pacemaker Flag - Ventricular Pacing 102 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 31
PACEMAKER PROCESSING Fig. 49. Accurate Pacemaker Flag - Ventricular Pacing Fig. 50. Accurate Pacemaker Flag - Atrial Pacing PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 32
PACEMAKER PROCESSING This page is intentionally left blank. 104 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 33
ALARMS ALARMS Alarms are activated by life-threatening, medical and technical events. WARNING: Because of the large physiologic differences among individuals, we cannot ensure that every life threatening event will trigger an alarm. The PatientNet System cannot replace skilled nursing care and proper surveillance. Any alarm or abnormal indication displayed by this system should be reviewed by skilled clinical staff to determine if the appropriate diagnostic procedure should be initiated.
PAGE 34
ALARMS Visual Alarm Indicators Alarms are indicated visually on the Main screen in the patient information block and on the Full Disclosure screen (fig. 51). Main Screen Patient Information Block Alarm names are displayed in the patient block. Only the active or latched alarm with the highest priority is shown, but if more than one alarm is active, the alarms with the highest priority are displayed in rotation. Full Disclosure Screen Zoomed-Out Mode A line under the waveform indicates an alarm.
PAGE 35
ALARMS Acknowledging Alarms When an alarm is triggered, you can temporarily silence the tone associated with the alarm while you analyze the rhythm and notify the appropriate personnel of the patient’s condition. The Silence button on the Main screen silences alarms for a duration preset by the system administrator. This duration may be 30, 45, 60 seconds, or 3 minutes. During this period, a silence indicator (crossed-out bell) appears in the patient block.
PAGE 36
ALARMS When you turn off all alarms, the alarm text in the patient block reads ALARM OFF in yellow until you click on it. Medical, Level 2 Less urgent than a medical, level 1 alarm (flashing red, single fast tone). 1. Press the Silence button on the Main screen once. 2. Press the View button and select the alarming patient to observe the patient’s real-time rhythm in applicable leads. 3. Notify the appropriate staff according to hospital policy and procedure. 4.
PAGE 37
ALARMS Technical, Level 3 Least urgent of all alarms (solid yellow, single slow tone). 1. Press the Silence button on the Main screen once. 2. Press the View button and select the alarming patient to observe the patient’s real-time rhythm in applicable leads. 3. Notify the appropriate staff according to hospital policy and procedure. 4. If the alarm is configured for paging, analyze the rhythm and select Page or No Page as appropriate. 5. If the alarming rhythm corrects to normal, go to Step 6.
PAGE 38
ALARMS If the bedside monitor permits alarm silencing, the Central Station responds as follows: • Bedside alarm source: the Central Station silences alarms for the specified bed. A crossed-out bell appears in the patient block while the silence remains in effect. Alarms are silenced for a period of time set by your facility’s system administrator. • Central alarm source: the Central Station ignores the silence indicator from the bedside monitor. (See page 115 for alarm source information.
PAGE 39
ALARMS Smart Alarm With Smart Alarm you can remove patients from monitoring temporarily for such purposes as testing or showering without having to re-enter their settings or turn off alarms. 1. Press Alarms on the Patient Settings screen to display the alarms popup. 2. Highlight Smart Alarm, then press Post. This brings up a popup with a list of locations the patient might be while monitoring is suspended. Default locations are shown below; this list can by changed by the system administrator.
PAGE 40
ALARMS Re-learning After Alarm State Transitions Relearning (see “Learn and Relearn Considerations” on page 70) takes place automatically on resumption of monitoring after Smart Alarm and after alarm state transitions as shown in Table 10. Table 10. Relearning after alarm state transitions.
PAGE 41
ALARMS Alarm Configuration Alarm settings are made at the system-wide level and at the patient level. System-wide alarm settings apply to all alarms and are set by the system administrator. Alarm settings are made at the patient level to tailor alarms according to individual patient needs. To configure patient alarms, you must open the Alarm Configuration screen. To open the Alarm Configuration screen: 1. Click on the Setup button in the toolbar 2.
PAGE 42
ALARMS Storing an Alarm Triggered Event You can store an alarmed event automatically by setting the system to capture the event and ten seconds before and after the event that caused the alarm. The event is stored in the patient’s history file. Toggle the Store button to On. Enable Paging for an Alarm Triggered Event If your system has the paging option, you can have the system automatically generate a page when an event triggers an alarm. See “Paging” on page 238. Toggle the Page button On.
PAGE 43
ALARMS Configuring the V-TACH Alarm Limits You can set the limits, PVC and HR, for calling a level 1 V-TACH alarm on the VTACH Config screen. Note: The changes made to the V-TACH alarm limits affect only the selected patient. To configure the V-TACH alarm: 1. Click the Alarm Config button to display the Device Alarm Config screen (See Figure 55 on page 115). 2. Use the Up and Down arrows on the Alarm Config screen (fig. 55) to highlight and select the V-TACH alarm. Fig. 55.
PAGE 44
ALARMS Alarm Source Alarm Source may be set to Central for alarm processing at the Central Station or Bedside for alarm processing at the bedside monitor. Alarms for ambulatory patients are always set to central source. Alarms for bedside monitored patients can be set to central alarm source or bedside alarm source. Alarms for ventilator patients are always set to bedside source. To set the alarm source, press Source on the Alarm Config screen to display the alarm Source popup (fig.
PAGE 45
ALARMS Bedside Alarm Source In bedside alarm source, the bedside monitor performs alarm processing on all high/ low limit alarms and the Central Station displays alarms exactly as they occur on the bedside monitor. Alarm settings must be made at the bedside monitor, except for paging, storing, assign to net, and recording, which may be made at the Central Station. The bedside monitor processes DEV LOWBATT, LEAD OFF (ECG), the COMM ERR and NO SIGNAL technical alarms.
PAGE 46
ALARMS Patient-Specific Alarms Monitored parameters differ among bedside monitored, ambulatory and ventilator patients. The tables in this section list patient-specific alarms along with their triggering conditions. Ambulatory Patients Table 11. Ambulatory physiological alarms Alarm Label Alarm Triggering Condition HIGH HR high heart rate heart rate greater than high HR limit LOW HR low heart rate heart rate below the low HR limit ASYSTOLE asystole no QRS detected for 3.0 sec.
PAGE 47
ALARMS Table 12.
PAGE 48
ALARMS 120 Alarm Label Alarm Triggering Condition HI P3 SYS high systolic P3 high limit exceeded for systolic P3 invasive pressure LO P3 SYS low systolic P3 low limit exceeded for systolic P3 invasive pressure HI P3 MN high mean P3 high limit exceeded for mean P3 invasive pressure LO P3 MN low mean P3 low limit exceeded for mean P3 invasive pressure HI P3 DIA high diastolic P3 high limit exceeded for diastolic P3 invasive pressure LO P3 DIA low diastolic P3 low limit exceeded for diast
PAGE 49
ALARMS Alarm Label Alarm Triggering Condition LO EtCO2 low EtCO2 low limit exceeded for the end-tidal carbon dioxide concentration in the expired air (EtCO2) HI InCO2 high InCO2 high limit exceeded for the inspired carbon dioxide concentration in the inspired air (InCO2) HI T1 high T1 high limit exceeded for T1 temperature LO T1 low T1 low limit exceeded for T1 temperature HI T2 high T2 high limit exceeded for T2 temperature LO T2 low T2 low limit exceeded for T2 temperature HI DT hig
PAGE 50
ALARMS Table 14. Bedside arrhythmia alarms (in Bedside Alarm Source Mode) Note: 122 These alarms may be called only on a bedside monitor when the Central Station is set to Bedside Alarm Source Mode. Please refer to the operator’s manual for the specific bedside device for the alarm definitions.
PAGE 51
ALARMS Table 15.
PAGE 52
ALARMS 124 CHECK LEAD check leads One or more of the ECG leads has a poor connection and/or is causing significant baseline wander NO ARR Arrhythmia unable to analyze No good leads are available for analysis CHKSIGNAL check signal intermittent no signal detected CHK BEDSIDE check bedside technical alarm not supported by the Central Station CHKPATIENT check patient medical or technical alarm not supported by the Central Station COMM ERR communication error communications CRC errors between
PAGE 53
ALARMS Ventilator Patients Alarms Alarm Label Alarm Name Triggering Condition HI PRESS high pressure limit see ventilator operator’s manual LO INS PRES low inspiration pressure see ventilator operator’s manual LOW PEEP Low PEEP/CPAP see ventilator operator’s manual LOW EX VT low exhaled tidal volume see ventilator operator’s manual LOW EX MV low exhaled min.
PAGE 54
ALARMS Special Alarm Handling Muscle When muscle artifact is detected, the alarm annotation in the full disclosure one-hour report reads “Muscle” rather than any alarm that may have occurred during the same one-minute interval. This notifies you that any alarm call during this period may have been influenced by muscle artifact. Level 1 Asystole, V-FIB, and V-TACH alarms are set to level 1 priority and cannot be changed. The Low Heart Rate (LOW HR) alarm may be designated a Level 1 alarm, if desired.
PAGE 55
ALARMS Attendant Present The instrument transceiver (DT-7000) and ambulatory transceiver (DT-4500) have the capability of sending an attendant present alarm indicator to the Central Station. Once the Central Station receives the attendant present alarm indicator, the Central Station activates the attendant present alarm and displays the text “ATT PRESENT” in the patient block. The alarm level may be configured to allow the attendant present alarm to rotate with other configured physiological alarms.
PAGE 56
ALARMS • all non-level 1 alarms are ignored while the alarm procedure silence alarm is active • full disclosure is annotated “PA SILENCE” for the duration of the procedure alarm silence period Technical Alarms The following technical alarms do not support Record or Store, and can only be set to Page and Assign: SYS ERR ECG ERR BP ERR P1 ERR P2 ERR SPO2 ERR CO2 ERR P3 ERR NO P3 CHK LEAD 128 LEAD OFF CHKSIGNAL T1 ERR T2 ERR ?? SOURCE LOW BATT MUSCLE P4 ERR NO P4 NO ARR NO SIGNAL WRONG ID EDIT NO SPO2
PAGE 57
VIEWING CURRENT PATIENT STATUS VIEWING CURRENT PATIENT STATUS To observe a patient’s current monitoring information, press the View button on the Main screen to display the View screen and select the patient. The NPB 7200 series ventilator patient View screen is different from that of bedside monitored and ambulatory patients. The View screen also encompasses history and full disclosure, which are covered in their own chapters.
PAGE 58
VIEWING CURRENT PATIENT STATUS 5. Press the Wave button on the View screen to save your selections. Ventilator Patient View Screen Fig. 59. Ventilator Patient View screen The ventilator patient View screen shows real-time patient data/ventilator settings. Real-time values are displayed in blue text; current ventilator settings are displayed in black text. Real-time data are updated every second if values have changed.
PAGE 59
VIEWING CURRENT PATIENT STATUS Clinical Data Available clinical data for each patient type is shown in Table 16. Table 16.
PAGE 60
VIEWING CURRENT PATIENT STATUS Strip Recorder There are three types of recording from the strip recorder: timed, continuous, and trend recording. Timed Recording Timed recordings print trace data starting ten seconds before and ten seconds after the print request (the number of seconds can be changed by the system administrator). When more than one recording requests have been queued, a Now button appears in the upper right corner of the screen.
PAGE 61
VIEWING CURRENT PATIENT STATUS Automatic Alarm Printing You can configure the system to print alarmed events automatically when they occur. To do so, you must enable individual alarms for automatic printing as instructed below. 1. Press Setup on the Main screen and select the patient’s waveform. 2. Press Alarm Config on the Patient Settings screen to display the Alarm Config screen. 3. Highlight the desired alarm and toggle Record to On. This alarm will now trigger automatic printouts. 4.
PAGE 62
VIEWING CURRENT PATIENT STATUS Canceling Printing Laser printer: press the System button and then press Cancel Laser on the Passcode screen. Strip recorder: click on the Strip/Laser button. 134 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 63
HISTORY HISTORY The PatientNet System can store up to 100 history events for each patient. All available data is stored with each history event. For ambulatory patients data includes all transmitted leads and current ST templates for valid ECG leads if ST is enabled when the event is stored.
PAGE 64
HISTORY Storing Events in the History File Some events are stored automatically in a patient’s history file. These include alarms if alarms are set to STORE on the Alarm Config screen, and hourly vital signs of ventilator patients. You can also manually store events for later review and printing. All available data is stored in the history event, including received waves of data, vital statistics, ST templates (if ST is enabled), and derived ECG leads, if available. 1. Press Store on the View screen.
PAGE 65
HISTORY Re-labeling History Events You can change the labels of history entries on the History screen. To re-label an entry: 1. Press Event on the History screen. The right-hand portion of the History screen displays the re-labelling choices (fig. 61). Fig. 61. Labeling History Events 2. Highlight the history event you wish to re-label in the history event blackboard. 3. Highlight the desired label in the event label blackboard. 4. Click the Post button to change the event label.
PAGE 66
HISTORY Customized Labeling for Stored Events You can change labels on the history events with the Chart popup. To change event labels: 1. Click the Review button on the History screen to display the History Event Review screen (fig. 64 on page 139). 2. Click the Chart button on the History Event Review screen to display the Chart popup. 3. The Operator Passcode number pad will appear (fig. 62). Enter your operator passcode to display the Chart popup (fig. 63).
PAGE 67
HISTORY 7. Click the Report and Archive buttons to tag and/or archive the event (see pages 143 and 144). 8. When you have finished making your selections, press Exit to save your changes and close the popup. Reviewing Stored History Events Bedside Monitored and Ambulatory Patients With an event in the list highlighted, you can make more detailed observations and perform operations on the events. 1. Press the Review button to display the Review screen (fig. 64).
PAGE 68
HISTORY Magnifying History Waveforms To magnify history event waveforms 2.5 times for more detailed examination: 1. Move the brackets on the History Review screen small window to the desired location. 2. Press the Expand button. The magnified segment appears. The first waveform that appears is the ECG waveform, if ECG is present. 3. Select the Wave button to display the other stored waveforms.
PAGE 69
HISTORY Press caliper buttons only after making a measurement with the calipers. Otherwise, the following message box appears. Fig. 65. Caliper message box Printing Caliper-Annotated Waveforms Calipers can be printed from the expanded history mode only. 1. Press Expand on the History Review Screen 2. Set the calipers as instructed in Making Measurements above. 3. Save the measurements as instructed in the Saving Measurements section above. 4. Press the Back button and then the Record or Laser button.
PAGE 70
HISTORY 4. If the history is filling with the same correct alarms (i.e. Bigeminy or Couplet) and your policy guidelines allow, do the following: a. Go to Alarm Config under “Setup” and turn Store OFF for that particular alarm. b. Archive an example of the alarm for your shift before disabling the Store function. c. Remember also that turning “Level” to OFF will disable the audio and visual alarms, but will continue to go into the history as long as Store is still ON.
PAGE 71
HISTORY Tagging Events as Report Candidates You can designate events in a patient’s history file as report candidates. This allows you to print reports of only these events. 1. Highlight the event to be marked as a report candidate. 2. Press the Event button on the History screen and then the Report button. This places an “R” to the right of the event number in the History blackboard. Press Report a second time to cancel the report candidate status. The Report button also appears on Chart popup (fig.
PAGE 72
HISTORY Archiving Events Archived events are events that cannot be erased. You can archive the history events of all patient types. 1. Press the History button on the View screen. 2. Highlight the appropriate event in the history blackboard. 3. Press the Archive button. This places an “A” to the left of the event number in the History blackboard. To remove the “A” and make it possible to delete the event, press Archive again.
PAGE 73
HISTORY Printing History Events Printing To print a history event, press Record or Laser on the History or History review screen. You can also print from the expanded History Review screen. To print tagged events only, see page 143. All events in a patient’s history file can be printed from either the strip chart recorder or the laser printer.
PAGE 74
HISTORY This page is intentionally left blank. 146 PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 75
FULL DISCLOSURE FULL DISCLOSURE The system stores all waveforms and digital data for 24 (or 72) hours with the Full Disclosure feature. You can review and print all or a portion of this data from the Full Disclosure screen (see fig. 69 on page 148), which lets you select the time period and how you want the information displayed and printed. Full Disclosure is available for ambulatory and bedside monitored patients but not for ventilator patients.
PAGE 76
FULL DISCLOSURE zoomed out zoomed in Fig. 69. Full disclosure screens Fig. 69 shows zoomed in and zoomed out versions of waveforms on the Full Disclosure screen. Note: 148 There are two Zoomed Out displays in Full Disclosure. Press the Zoom Out button twice to display each Zoomed Out screen. PatientNet Operator’s Manual, v1.04, 10001001-00X, Draft All information contained herein is subject to the rights and restrictions on the title page.
PAGE 77
FULL DISCLOSURE Zooming In and Out Use the Zoom Out and Zoom In buttons to zoom out or in. Alarms and beat annotations are displayed differently on zoomed in and zoomed out views. Zoomed In Zoomed Out Alarms Alarm text appears in the lower left Alarms are indicated by a line corner of the waveform window. under the waveform. See page 106 for details on alarm indicators. Beat Annotations Available. See the next section. Note: Not available.
PAGE 78
FULL DISCLOSURE 2. Toggle Annotation to Yes on the popup. This following beat calls appear as appropriate. Table 17 1.