D Infinity CentralStation with Infinity TeleSmart Instructions for Use WA R N I NG ! F o r a f u l l u n d e r s ta n d i n g o f t h i s p r o d u c t , t h e u s e r should carefully read this manual before use.
Infinity CentralStation Instructions for Use Manufactured By: Draeger Medical Systems, Inc. 16 Electronics Avenue Danvers, MA 01923 Infinity CentralStation with Infinity TeleSmart Instructions for Use Software VF8 ©Dräger Medical AG & Co. KG 2006. All rights reserved. Printed in the United States of America. This software bears the ! label in accordance with the provisions of the Directive 93/42/EEC of 14 June 1993 concerning medical devices (this label is not applicable for US devices).
Infinity CentralStation Instructions for Use Table of Contents This is a DRAFT document. TOC entries may not be accurate. Software Release Notes VF8 .......................................................................................... iii Documentation Features .............................................................................................. xiv Notes, Cautions, Warnings .................................................................................... xiv Applicability...............
Infinity CentralStation Instructions for Use LED Description ......................................................................................................2-5 Audio Tones ............................................................................................................2-5 Transceiver Self Test ..............................................................................................2-6 Infinity TeleSmart Power.............................................................................
Infinity CentralStation Instructions for Use CHAPTER 3: Infinity CentralStation Setup Accessing the Setup Screens ......................................................................................3-2 Password-Protected Screens ................................................................................3-2 Setup - Central Screen ..................................................................................................3-3 Setup - Recorder Screen.................................................
Infinity CentralStation Instructions for Use CHAPTER 6: Patient Setup - Bed View General Bed View Setup ...............................................................................................6-2 Accessing a Patient’s Bed View Screen......................................................................6-4 Bed View Screen Layout...............................................................................................6-5 Waveform Assignment .........................................................
Infinity CentralStation Instructions for Use Transferring Data to the Infinity CentralStation .................................................7-10 Transferring Data From the Infinity CentralStation ...........................................7-11 Transfer Messages ...............................................................................................7-11 CHAPTER 8: Arrhythmia Overview....................................................................................................................
Infinity CentralStation Instructions for Use CHAPTER 11: Alarms Overview.......................................................................................................................11-2 Alarm Validation....................................................................................................11-2 Alarm Grades ...............................................................................................................11-3 Latching alarms ..................................................
Infinity CentralStation Instructions for Use Shift Report .........................................................................................................12-13 Graphical Trend Report ......................................................................................12-18 Selected Strip Report .........................................................................................12-18 Selected Events Report ......................................................................................
Infinity CentralStation Instructions for Use Full Disclosure ECG Caliper Tool ............................................................................14-21 Caliper Measure Screen ....................................................................................14-22 Caliper Review Screen .......................................................................................14-26 Full/Event Disclosure Reports .................................................................................
Infinity CentralStation Instructions for Use Hamilton Galileo Ventilator ................................................................................15-51 Maquet SV 300/SV 300A/Servoi Ventilator........................................................15-52 Maquet SV 900 Ventilator ...................................................................................15-54 Viasys Bear 1000 Adult Ventilator .....................................................................
Infinity CentralStation Instructions for Use APPENDIX C: Accessories APPENDIX D: Cleaning Cleaning the Infinity CentralStation............................................................................ D-2 Cleaning and Disinfecting Transceivers ................................................................... D-3 Recommended Cleaning Agents .......................................................................... D-3 Patient Cables ........................................................................
Infinity CentralStation Instructions for Use Documentation Features Notes, Cautions, Warnings NOTE: A note provides additional information intended to avoid inconvenience during operation. CAUTION! A caution statement provides important information about a potentially hazardous situation which, if not avoided may result in minor or moderate injury to the user or patient, or in damage to the equipment or other property.
Infinity CentralStation Instructions for Use Introduction Before using all Dräger devices, read all provided documentation carefully. Patient monitoring equipment, however sophisticated, should never be used as a substitute for the care, attention, and critical judgment that only trained health care professionals can provide.
Infinity CentralStation Instructions for Use Intended Use NOTE: Federal Law in the U.S. restricts this device to sale by, or on the order of a physician. WA R N I N G ! D o n o t u s e I N F I N I T Y Tel e S m a r t i n t h e p r e s e n c e o f a flammable anaesthetic mixture with air or with oxygen or nitrous oxide. The INFINITY TeleSmart Telemetry System is indicated for adult and pediatric patient populations in an environment where patient care is provided by Healthcare Professionals.
Infinity CentralStation Instructions for Use Safety Considerations Recommendations Dräger recommends the use of an Uninterruptible Power Manager in conjunction with the Infinity CentralStation at all times. General Precautions WA R N I N G ! B e c a u s e o f t h e d a n g e r o f e l e c t r i c s h o c k , n e v e r r e m o v e t h e c o v e r o f a n y d e v i c e w hi l e i t i s i n o p e r a t i o n o r c o n nected to a power outlet.
Infinity CentralStation Instructions for Use Infinity TeleSmart Precautions WA R N I N G ! ! Under NO circumstances should the Infinity TeleSmart be used without the battery cover securely in place. ! D o n o t u s e t h e I n f i n i t y Te l e S m a r t n e a r e qu ip m e n t t h a t p ro d u c e s s ta t i c o r g r a d i e n t m a g n e t i c f i e l d s . ! D o n o t u s e I n f i n i t y Te l e S m a r t i n M R ( M a g n e t i c R e s o n a n c e ) e n v i r o n m e n ts .
Infinity CentralStation Instructions for Use Pacemaker and TENS Precautions Certain difficulties are inherent to ECG monitoring and require special attention. Use care to not misinterpret ECG waveforms of patients with pacemakers. WA R N I N G ! P a c e m a k e r P e r f o r m a n c e ! I n a r e a s o f u n c e r ta i n p e r f o rm a n c e , t h e m o n i t o r h a s b e e n d e s i g n e d t o e r r i n t he d i r e c t i o n o f f a l s e p os i t i v e rather than false negative alarms.
Infinity CentralStation Instructions for Use For Patients Without a Pacemaker: ! Disable pacer detection. ! Be aware that TENS signals are similar to pacemaker spikes and may be labeled as such. WA R N I N G ! Va l i d Q R S c o m p l e x e s f o l l o w i n g m i s l a b e l e d T E NS s ig na l s c o u l d b e r e j e c t e d , r e s u l t i n g i n f a l s e a s y s t o l e o r l o w h e a r t r a t e a l a rm s . F o l l o w t h e d i r e c t i o n s f o r pa c e m a k e r pa t i e n ts .
Infinity CentralStation Instructions for Use Pulse Oximetry Precautions WA R N I N G ! ! Sp O 2 m e a s u r e m e n ts a r e pa r t i c u l a r l y s e n s i t i v e t o p u l s a t i o n s i n t h e a r t e r y a n d t h e a r t e r i o l e . T he re f o re , m e a s u r e m e n ts m a y n o t b e a c c u r a t e i f a pa t i e nt i s e x p e r i e n c i n g s h o c k , h y p ot h e r m i a , a n e m i a , o r h a s r e c e i v e d m e d i c a t i o n s t h a t r e d u c e a r t e r y b l o od f l o w.
Infinity CentralStation Instructions for Use Maintenance, Modifications, and Repairs WA R N I N G ! D i s p o s a b l e a c c e s s o r i e s ( s u c h a s d i s p o s a b le e l e c t r o d e s ) a re f or s i n g l e - u s e o n l y. D o n o t r e u s e d i s p o s a b l e a c cessories. Safety requires regular equipment inspection and maintenance. Dräger is liable for the safety, reliability, and performance of its equipment.
Infinity CentralStation Instructions for Use Electromagnetic Compatibility The Infinity TeleSmart System has been designed and tested for compliance with current regulatory standards as to its capacity to limit electromagnetic emissions (EMI), and also as to its ability to block the effects of EMI from external sources. The Infinity TeleSmart System is designed to comply with the EMI/EMC standard, EN60601-1-2. For further details see page B-13.
Infinity CentralStation Instructions for Use Device Markings Markings on various Infinity CentralStation hardware components may include the following: " Consult accompanying documents Display ON/OFF button CPU ON/OFF LED IPX7 (Infinity TeleSmart) IPX4 (Infinity TeleSmart connection side of Bedside Charger) IPX0 (Central Charger and back of Bedside Charger) # IC: 267I-ABTU4 $ Observe WEEE (Waste Electrical and Electronic Equipment) disposal requirements (ii).
Infinity CentralStation Instructions for Use " Consult accompanying documents USB Connector xxiv TUV Draft VF8 DRAFT
1 About the Infinity CentralStation General Description.......................................................................................................1-2 System Components .....................................................................................................1-3 Infinity CentralStation ............................................................................................1-4 Infinity CentralStation Central Processing Unit (CPU) ........................................
1: About the Infinity CentralStation General Description The Infinity CentralStation provides centralized monitoring and critical care management for bedside and telemetry monitored patients. From the Infinity CentralStation, clinicians can gain access to patient information for as many as 1024 patients on the Infinity Network.
System Components Infinity CentralStation WA R N I N G ! T h e I n f i n i t y C e n t r a l Sta t i o n C P U m u s t b e p l a c e d s o t h a t i t c a n b e h e a r d e a s i l y i f t h e e x t e r n a l s p e a k e r s b e c om e n on - f u n c t i o n a l . Yo u m u s t k e e p t h e I n f i n i t y C e n t r a l Sta t i o n e x t e r n a l s pe a k e r s c o n n e c t e d a t a l l t i m e s . CAUTION! The Infinity CentralStation CPU and its display(s) must always stay on.
1: About the Infinity CentralStation Infinity CentralStation Central Processing Unit (CPU) 1 2 3 4 5 6 7 USB Ports Mouse Port Serial Port Floppy Disk Drive USB Ports CDRW/DVD Drive Locked Drive Bay 1-4 TUV Draft 8 9 10 11 12 13 14 Parallel Port External Speaker Connector DVI Connector VGA Connector LAN Connectors VGA Connector Keyboard Port Infinity CentralStation VF8 DRAFT
Infinity Network Infinity Network The Infinity® Network is a standards-based network providing connectivity and data access among Infinity devices. Dräger offers a variety of components and supplies permitting network customizing. Network setup and configuration is a Service function performed during installation. Planning, design, and implementation of the Infinity Network is performed by trained Dräger personnel. Network Configuration The Infinity Network can include wired and wireless components.
1: About the Infinity CentralStation Interacting with the Infinity CentralStation Keys To interact with the Infinity CentralStation, you can use a keyboard, a mouse, or a touch screen. When your Infinity CentralStation is configured to use the touch screen display, the keyboard and mouse are still active. This is true even if the touch screen fails. The Infinity CentralStation keyboard uses has the following quick-access keys: ! F1 silences all active alarms at the Infinity CentralStation for 1 minute.
User Interface User Interface User Interface Function/Purpose Remarks/Illustration/Example BUTTONS Action button Executes a function Examples of action buttons are: • Audio Pause, which silences alarms at the Infinity CentralStation (1 minute). • Alarm Pause, which silences the alarms of an individual patient. • Accept Menu button Activates a menu Option button A small rectangle inside the button implies fixed selections. Radio button Available choices are visible.
1: About the Infinity CentralStation User Interface Function/Purpose Remarks/Illustration/Example PASSWORD POPUPS Confirmation popup Safeguards against accidental execution of a function that may have significant consequences For example, when you try to change the time, a confirmation popup appears because the change may affect other devices on the network.
On line Help On line Help The Infinity Central Instructions for Use are available on screen. When active, the Instructions for Use PDF occupies the left side of the screen. Using On Line Help Function Instruction Open • Click on Help in the upper right-hand corner of the Infinity Central menu bar to launch the Infinity Central Instructions for Use. Search • Use Adobe Reader’s Find function to search for the wanted instructions.
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2 Infinity TeleSmart About Infinity TeleSmart ...............................................................................................2-3 User Controls ..........................................................................................................2-4 Parameter/Waveform Color ....................................................................................2-5 LED Description ......................................................................................................
2: Infinity TeleSmart ECG Monitoring.....................................................................................................2-18 SpO2 Monitoring ...................................................................................................2-18 Infinity TeleSmart Messages ......................................................................................2-19 Message Area ........................................................................................................
About Infinity TeleSmart About Infinity TeleSmart Infinity TeleSmart is patient worn device that uses the Infinity CentralStation as the primary patient monitoring display and primary alarm source.
2: Infinity TeleSmart User Controls The Infinity TeleSmart fixed keys give you quick access to a variety of functions. Fixed Key NOTE: Action/Description When you press the Record key: • a timed recording is generated, • a timed or continuous recording is cancelled, or • an event is stored and is recorded at the Infinity CentralStation.
About Infinity TeleSmart Parameter/Waveform Color From the Infinity CentralStation, you can configure each patient waveform and parameter box color (page 6-11). For the default colors of each parameter see page 6-12. LED Description Behavior Description Blinking green (approximately every 5 seconds) Power ON Infinity TeleSmart is being used away from the charger.
2: Infinity TeleSmart Starting up Infinity TeleSmart When you remove an Infinity TeleSmart from the Central Charger, the display turns on automatically and the device generates a verification tone. If no verification tone sounds, do not use the device and contact your Biomed. During a cold start, a startup screen displays the current software version and possible messages. During this operation Infinity TeleSmart also sounds a verification tone.
Infinity TeleSmart Power Infinity TeleSmart Central Charger If you want to charge multiple Infinity TeleSmart devices you can use the Central Charger, which accommodates up to 10 devices. When you put an Infinity TeleSmart into the Central Charger, the device goes through a patient discharge cycle, which includes: erasing data in device’s memory (i.e. trends, demographics) and discharging that patient from the Infinity CentralStation. After performing this, Infinity TeleSmart automatically shuts down.
2: Infinity TeleSmart Parameter Displays Infinity TeleSmart ECG Display 1 2 3 4 The Battery Charge icon appears in the Message Area and illustrates how much battery power is available. Wireless signal strength icon appears in the Message Area Bed Label appears in the Message Area Arrow icons show that you can use the UP Arrow or Down Arrow keys to scroll through available waveforms. 5 Waveform If pacer detection is enabled, pacer spikes are indicated on the waveform.
Parameter Displays ECG/SpO2 Display NOTE: 1 SpO2 does not display unless the parameter is being monitored Message Area (Bed Label and Time become Message Area) When alarms are paused the Alarms Paused Icon appears. Arrow icons show that you can use the UP Arrow or Down Arrow keys to scroll through available waveforms. Waveform Lead being displayed 2 3 4 5 6 Scale next to the waveform is configured at the Infinity CentralStation. 7 Arrhythmias are shown below the parameter label.
2: Infinity TeleSmart Other Displays Start Up Screen The Start Up screen displays while the tranceiver is powering up. A progress bar provides a visual display of the Start up process. New Patient Screen NOTE: To admit a patient to Infinity TeleSmart, use the ADT screen at the Infinity CentralStation. Once Start Up is completed, the New Patient screen will display if a previous patient’s trends and demographics are still in the Infinity TeleSmart memory.
Other Displays Standby Screen Standby mode must be initiated at the Infinity CentralStation. When a telemetry patient’s monitoring is in Standby mode (page 6-8), the Standby banner displays on to exit. the Infinity TeleSmart screen along with the message, Press\hold When Standby mode is selected at the Infinity CentralStation: ! Patient monitoring is suspended, ! The Infinity TeleSmart screen is blank except for a Standby banner.
2: Infinity TeleSmart Electrode Status Screen An Electrode Status screen provides a status of electrode connection. The color of the dot indicates which electrodes are disconnected or connected to the patient. Green represents that electrode is connected; red represents the one that is disconnected. To access the Electrode Status screen press the Views key. This screen allows you to quickly check which electrodes are disconnected without disturbing the patient.
Alarms Alarms Alarm Grade Display Infinity TeleSmart supports three alarm severity grades: life-threatening, serious and advisory. Each grade is accompanied by a different pattern and color-coded display.
2: Infinity TeleSmart Infinity TeleSmart Modes Telemetry Mode When Infinity TeleSmart is being displayed at the Infinity CentralStation and is not in Standby mode, it is in Telemetry mode. The Infinity CentralStation display is Infinity TeleSmart’s primary user interface.
Setting up Infinity TeleSmart at the Infinity CentralStation Setting up Infinity TeleSmart at the Infinity CentralStation Infinity TeleSmart Setup Screens If you want to . . . Refer to . . .
2: Infinity TeleSmart Programming Infinity TeleSmart The Infinity TeleSmart must be programmed by Dräger Medical installation personnel or the Hospital Biomedical Engineering Dept. Please refer to your service documentation for programming information. Attaching Infinity TeleSmart to the Patient ECG Monitoring 1. Apply electrodes to patient. (Appendix A). 2. Connect the appropriate lead wire set (3-, 5-, or 6-wire) to the Infinity TeleSmart. 3. Attach the lead wires to the electrodes. 4.
Infinity TeleSmart Messages Infinity TeleSmart Messages Message Area The Infinity TeleSmart message area displays alarms, network-generated or locallygenerated messages. If more than one message must display, the messages circulate in a round-robin manner, with each message appearing for 1 second. These messages include: ! Alarm messages, which display in black characters on a background color defined by the alarm grade (page 11-5).
2: Infinity TeleSmart Infinity TeleSmart Status Messages Alarm Message in Message Area Grade Description Action STAFF ALERT SER Check the patient. TeleSmart no signal ADV Telesmart low battery ADV HR Alarms Off SER Alarms Pause: xxx ADV Telesmart Offline SER The Infinity TeleSmart STAFF ALERT key was pressed. This message requires acknowledgement. Check the patient. The Infinity CentralStation cannot detect the Infinity TeleSmart. Contact Biomed.
3 Infinity CentralStation Setup Accessing the Setup Screens ......................................................................................3-2 Password-Protected Screens ................................................................................3-2 Setup - Central Screen ..................................................................................................3-3 Setup - Recorder Screen...............................................................................................
3: Infinity CentralStation Setup Accessing the Setup Screens 1. Click on Setup in the Main Screen menu bar. 2. Click on one of the drop down menu selections. Selection Reference Central... page 3-3 Recorders... page 3-5 Central Layouts... page 3-6 Telemetry Chapter 4 Password-Protected Screens Access to the following setup functions is controlled with assignment of a required password (page 16-4).
Setup - Central Screen Setup - Central Screen To open the Setup - Central screen, refer to page 3-2.
3: Infinity CentralStation Setup Setup - Central Screen Selections Selection Description Available Settings Year Sets current year • 1995 - 2099 Report Trend Order Displays System Trend Order Setup screen, • Enable Auto Scale Disabled which allows selection and sorting of (page 12-18) parameters for a Shift (page 12-13) or Click selection box Graphical Trend Report (page 12-18). to activate. • Trends Per Page Click on 1, 2, 3, 4, 3 To configure Trend Order Setup for a specific or 5.
Setup - Recorder Screen Setup - Recorder Screen To open the Setup - Recorder screen, refer to page 3-2. Setup - Recorder Screen Selections Selection Description Primary Recorder Selects preferred recorder Secondary Recorder Available Settings Default When you click on Assign... in the Assign Recorder popup a list of available Determines recorder to be used when recorders displays. Primary Recorder is unavailable • Click on the desired recorder.
3: Infinity CentralStation Setup Setup - Central Layouts Screen To open the Setup - Central Layouts screen, refer to page 3-2.
4 Telemetry System Setup Overview.........................................................................................................................4-2 Accessing the Telemetry Setup Screens ..............................................................4-2 Changing the System Default Patient Category...................................................4-2 Telemetry System Setup Screen ..................................................................................
4: Telemetry System Setup Overview The Telemetry setup screens allow you to set system defaults for Infinity CentralStation telemetry channels.These defaults are activated at telemetry patient discharge. Accessing the Telemetry Setup Screens ! Select Telemetry from the Setup drop-down menu. Telemetry Submenu Selections Submenu Selection Password Required Category Selection System...
Telemetry System Setup Screen Telemetry System Setup Screen To access the Telemetry System Setup screen, see page 4-2. Table part of screen now supports 32 beds; a toggle button permits selection of beds 116 or 17-32 System Setup Screen Selections Selection Description Settings Default Alarm Pause Time Determines duration of Alarm PauseTime With Disable, the button is ghosted in Bed View. • Disable • 1, 2, 3, 4, 5 min 3 min Alarm Tone Pattern Determines alarm pattern used.
4: Telemetry System Setup System Setup Screen Selections Selection Description Settings Default Remote Silence Enabled Determines whether or not you can silence alarms for telemetry patients from other monitors in the monitoring unit When OFF, the Bed Silence button in Bed View is ghosted and the corresponding icon will not appear in the Main Screen during an alarm.
Patient View Defaults Setup Screen Patient View Defaults Setup Screen The Main Screen Default Patient View Setup screen allows you to define systemwide, default, patient-monitoring settings. It is similar to the Bed View Patient View Setup, which allows you to customize a particular patient’s monitoring (page 6-16). The Default Patient View Setup screen for Telemetry patients provides selections to configure SpO2 and ECG monitoring.
4: Telemetry System Setup Patient View Setup Screen Selections Selection Required Action Available Settings ECG Monitoring Setup QRS Processing Select leads for ECG and ARR monitoring. • ECG1 & ECG2 • ECG1 WA R N I N G ! H i g h a m p l i t u d e ( > 0 . 1 5 m V ) P - a n d T- w a v e s o f l o n g d u r a t i o n m a y r e g i s t e r a s i n t e g r a l Q R S c o m p l e x e s .
Patient View Defaults Setup Screen Patient View Setup Screen Selections Selection Required Action Available Settings TruST 12-lead: Activate/deactivate TruST monitoring (Selection only appears (page 6-20) when ECG Wire Mode setting is 6 wire and TruST locked option is enabled.) • ON • OFF (Default) Set V: Set V+: V1, V2, V3, V4, V5, V6 Set TruST chest lead placement (page 6-21) These selections display when the TruST 12-lead setting is ON and ECG Wire Mode setting is 6 wire.
4: Telemetry System Setup Patient View Setup Screen Selections Selection Required Action Available Settings SpO2 Sensor (grayed out if SpO2 option not available) Determines device sensorelectrode type • Nellcor (Default) • Massimo • Click on Accept to save changes or Undo to keep previous settings. ST Defaults Setup The Default ST Setup screen is similar to the ST Setup screen in Bed View, which allows you to customize a particular patient’s ST monitoring.
Alarm Limits Defaults Screen ST Setup Screen Selections Available Settings Factory Default Selection Description Event Duration Determines how long an ST event has • 15, 30, 45, 60 75, 60 sec to remain outside the set ST alarm limit 90, 105, 120 before an alarm sounds seconds For Infinity TeleSmart this is a Read-Only value set at 60 seconds.
4: Telemetry System Setup Available Functions on the Default Settings - Alarm Limits Screen Button/Function Description Arrhythmia Opens Default Settings - Arrhythmia screen (page 4-12) Parameter alarm limit setup 1.Click on the table row you wish to set up. This activates the configuration mode for that row during which you can set limits within each column. 2.Click on the arrows or toggle button so that the desired setting appears. 3.Click on OK. 4.Repeat steps 1 to 3 for each parameter.
Alarm Limits Defaults Screen Alarm Limits Parameter Settings Parameter Heading Adult Default HR Upper Limit Lower Limit Alarm On On On/Off Alarm Archive Rec/Store Rec/Store Rec, Store, Rec/Store, Off Upper Limit 100% 100% 21 - 100% Lower Limit 90% 90% 20 - 99% Alarm On On On/Off Alarm Archive Off Off Rec, Store, Rec/Store, Off Upper Limit 120 beats/min 150 beats/min 35 - 250 beats/min Lower Limit 45 beats/min 50 beats/min 30 - 245 beats/min Alarm Off Off On/Off Alarm
4: Telemetry System Setup Arrhythmia Defaults Screen This screen allows you to define system-wide default settings for arrhythmia event categories. These defaults are activated at telemetry patient discharge or by clicking Restore System Defaults on a particular patient’s Bed View screen (page 8-4). The patient category is part of the screen title, and event defaults are based on that category (page 4-13).
Arrhythmia Defaults Screen Events available for arrhythmia monitoring are determined by the monitoring mode.
4: Telemetry System Setup Arrhythmia Event Settings Parameter Heading Adult Default Setting AIVR Count Not adjustable. Default: ≥ 3 Rate Not adjustable, upper value is VT rate - 1. Default: < 119 Alarm Grade LT, SER, ADV (default), OFF Alarm/Archive Rec, Store, Rec/Store, Off CPT Pediatric Default Setting Not adjustable, upper value is VT rate - 1.
Finding the Infinity TeleSmart Finding the Infinity TeleSmart You can initiate a Find Device tone that will help you locate an Infinity TeleSmart if it is lost. 1. Select Telemetry from the Main Screen Setup drop-down menu. 2. Select Find Device. A drop-down list of configured TeIeSmart IDs displays. 3. Click on the device you wish to locate. NOTE: If the Infinity CentralStation cannot communicate with the selected device, a message displays. Contact your Biomed if this message continues. 4.
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5 Main Screen Overview.........................................................................................................................5-2 Main Screen Layout.......................................................................................................5-2 Split vs. Full Main Screen .............................................................................................5-2 Selecting a Main Screen Layout ............................................................................
5: Main Screen Overview The Infinity CentralStation Main Screen displays waveforms, parameters, status messages, banners, and alarm messages for telemetry and bedside patients on the Infinity Network. It can be configured in various layouts (typically 2 to 8 patient windows per display). With the 9-16 Patient option a single display can fit up to 16 patients. With the Dual Display, monitoring information appears on two displays and each display can fit up to 8 patients.
Split vs. Full Main Screen Selecting a Main Screen Layout 1. Click on View in the Main Screen menu bar. 2. Click on the Central Layout menu selection. A submenu with available Main Screen layout selections appears. 3. Click on the desired layout. A popup window displays. 4. Click on Yes in the popup to select the new layout or on No to exit the menu and keep the current layout.
5: Main Screen Main Screen Setup Menu Bar Selection Allows you to...
Main Screen Setup Infinity CentralStation Patient Window 1 Manual configuration mode, telemetry, or wireless monitor icon (page 5-7) 6 Keys that generate manual Timed or Continuous recordings (page 12-6) 2 Bed Label 7 MIB Ventilator Alarm Icon area 3 Patient Name 8 Area reserved for ventilator alarm messages 4 Bedside alarm, banner, status, standby, or discharge message area 9 Location for the following: • “WAVE PAUSED” message • “STANDBY“ message 5 Icons from bedside monitors 10 Lead La
5: Main Screen Banner and Status Messages Banner Telemetryspecific Monitorspecific Appearance Description Alarm Pause Yes Yes HR Alarms OFF Yes Yes Black text/yellow background Patient’s alarm function is disabled HR Limits OFF Yes Yes HR, ASY, VF OFF Yes Yes Bed Disconnected No Yes Black text/white background Bedside monitor disconnected for patient transport Bedside Offline Yes Yes Yellow text Network communication i interrupted CODE 1 No Yes Black text /red background Cod
Main Screen Setup Icons Icon Location Description Bed Silence Upper right corner of top waveform channel Alarm Pause Next to parameter value Appears when the patient has an active nonsilenced alarm or a latching alarm message (a message corresponding to an alarm whose condition is no longer valid but that has not The icon only appears if the Bed Silence function is enabled yet been acknowledged).
5: Main Screen Stopping Waveforms You can stop all patient waveforms by clicking anywhere in the waveform area. Stopping a patient’s waveforms in Main Screen does not stop them in Bed View. Stopping waveforms has the following effect: ! The banner WAVE(S) PAUSED displays below the topmost waveform. ! The CONT and REC buttons appear ‘ghosted’ in the parameter area and you cannot request a manual recording. You can request a print screen, however.
Main Screen Setup ! monitor/transmitter stopped communicating with network. NOTE: The parameter area does not flash or change color during Offline, Bedside Offline, or Duplicate Address conditions.
5: Main Screen Each parameter field may contain: ! one single-valued primary parameter and up to two secondary parameters, or ! one multi-valued parameter set (e.g. pressures) The Primary Parameter is distinguished by its size. The Primary Parameter value(s) and the label are the color of the associated waveform. If the Primary Parameter has no waveform displayed, the values and the label appear white. Up to two Secondary Parameters, not associated with waveforms, can be displayed per Primary Parameter.
Main Screen Setup Gamma/Gamma XL/Vista monitor parameters are assigned using the top waveform and corresponding parameter as the first primary waveform/parameter at the Infinity CentralStation. The second waveform and associated parameter fill the next Primary/ Secondary fields. The remaining parameters are assigned top-to-bottom, left-to-right, from the bedside parameter boxes to available parameter fields at the Infinity CentralStation.
5: Main Screen Status Area The status area is located along the bottom of the screen. 1 Alarm/Status Messages These messages may originate from the Infinity CentralStation, network recorders, CPSs, or Infinity Network. With Dual Display, the status messages appear on both devices. Some status messages appear only briefly and indicate a one-time occurrence. Others appear for as long as the cause for the message exists.
Manual Waveform Configuration Mode Manual Waveform Configuration Mode With Manual waveform configuration mode you can choose different waveforms (not parameters) for a bedside patient in Main Screen. NOTE: Once you configure a bedside patient’s waveform setup via the manual configuration mode, the new setup remains intact for that channel even if you discharge the patient and admit a different one to that channel. For a new patient you can manually change waveforms again or switch to ‘Automatic’ mode. 1.
5: Main Screen Main Screen Status Area Messages The following table lists possible status messages that may display in the Main Screen status area (shaded rows pertain to telemetry channels only). For recorder-specific status messages, see Chapter 12. Device/Network Status Messages Status Message Tone Description Raid hard drive failure none The Raid drive failed. Central Offline Serious Infinity CentralStation is not communicating with network due to incorrect configuration information.
Main Screen Status Area Messages Device/Network Status Messages Status Message Tone Description stands for the device/host label; yyy stands for the specific setup data file. Infinity TeleSmart Status Area Messages Menu-specific Status Messages Status Message Tone Description Action No Bed Assigned Attention No bed has been assigned to the selected parameter area in Main Screen. Select the correct parameter area or assign a patient to the available slot.
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6 Patient Setup - Bed View This chapter describes both general Bed View configuration for all Infinity CentralStation bedside monitor and telemetry patients. General Bed View Setup ...............................................................................................6-2 Accessing a Patient’s Bed View Screen......................................................................6-4 Bed View Screen Layout ...............................................................................................
6: Patient Setup - Bed View General Bed View Setup In Bed View you can: ! remotely view a patient’s monitor, remotely view a bedside patient’s ventilation data (with VentCentral option), print the Bed View screen,and ! print a simultaneous ECG Report (page 12-12). ! ! The Bed View screen constantly updates patient data, immediately reflecting changes in configuration or signal availability from the patient monitor.
General Bed View Setup Available Infinity CentralStation functions differ depending on whether a patient is within or outside the Infinity CentralStation monitoring unit.
6: Patient Setup - Bed View Accessing a Patient’s Bed View Screen Viewing a Patient Displayed in Main Screen ! Click on the patient’s parameter area in the Main Screen patient window. When the Bed View screen opens, the last viewed screen mode will display. Bed View mode descriptions and selection instructions are on (page 6-13). Viewing a Patient Not Displayed in Main Screen 1. Click on View on the Main Screen menu bar. 2. Click on the Bed... menu selection. A screen with two list boxes appears. 3.
Bed View Screen Layout Bed View Screen Layout A patient’s Bed View screen occupies the left half of the Infinity CentralStation display, leaving patients in the Main Screen still visible. It displays parameters that originate at a bedside monitor or patient worn device. Waveform Assignment Bedside Monitor Patients The Infinity CentralStation Bed View screen can display bedside monitor main screen layouts.
6: Patient Setup - Bed View Bed View Submenu Selections The Bed View submenu selections are below the main menu bar, and differ for Telemetry and bedside patients. NOTE: If any selection appears ghosted, remote control is not possible, or the function is not available for the patient category. Bedside Telemetry Description/Selection • Relearn Relearn ECG initiates a Relearn of the normal ECG waveform template for processing arrhythmias and ST.
Bed View Screen Layout Information Area The information area is directly above the top waveform. It is visible in Bed View so alarm and bedside messages can be seen. NOTE: If the patient category ‘Neonate’ is selected and displayed at the bedside monitor, the category label ‘Neonate’ appears in the center of the information area. Message Type Display Color Description Banners 1 CODE (Delta/Delta XL/Kappa) Black text on red The Code fixed key was pressed at the background bedside monitor.
6: Patient Setup - Bed View Message Type Display Color Description 1 If a code condition is activated at the bedside during an alarm, the banner CODE replaces the alarm message. 2 If an alarm occurs while this banner is displayed, the alarm message replaces the banner for the duration of the alarm. 3 This banner appears if no local bedside messages are displayed. Waveform Area Each waveform in Bed View consists of approximately 4 seconds of data.
Bed View Screen Layout Bedside Monitor Patients Bedside patient monitoring must be put in Standby at the bedside monitor. Telemetry Patients Standby is initiated at the Infinity CentralStation for local telemetry patients or for remote telemetry patients if their Infinity CentralStation server has enabled remote control. For telemetry patients you can select a secondary standby label that indicates a standby status.
6: Patient Setup - Bed View ! Recordings are canceled and the recording function is disabled. ! Save Event, Bed Silence, and Alarm Pause buttons are ghosted. ! Blank spaces are added to the trends for the duration.
Parameter Areas in Bed View Parameter Areas in Bed View Each waveform channel in Bed View has an associated parameter area, which displays information. The amount of information may differ slightly between bedside and telemetry patients. Information Types Bedside Patient Telemetry Patient Parameter values HR, ARR, PVC/min, ST, NBP, SPO2, and PLS Alarm limits Display if available at the bedside Always display monitor Alarm Pause symbol displays when alarms are disabled.
6: Patient Setup - Bed View Parameter Label and Unit Defaults Bedside Telemetry Parameter Labels/Units Color Parameter Labels/Units HR Matching the color of the associated waveform at the bedside monitor HR Green ARR, PVC/min Green STx Green ARR, PVC/min STx SpO2 and PLS SpO2 + PLS NPB NPB Parameter Color White Waveform Color Blue Ventilator Blue Alarm Limits Color Alarm Limits Color HR Gray (provided the limits are displayed at the bed) HR Gray ARR, PVC/min ARR, PVC/min STx
Bed View Screen Modes Bed View Screen Modes The Bed View screen has three different modes: ! Bed View (page 6-14) is a remote view of a bedside patient’s monitor. It is also the monitor screen for a telemetry patient. ! All Leads (page 6-14) displays all available leads of an individual patient (telemetry or bedside). ! Ventilator (page 15-6) displays the ventilation status of an individual bedside patient. Selecting the Bed View Mode 1.
6: Patient Setup - Bed View Bed View Review Screens If applicable options are enabled, the Bed View Review screens allow the following: If you want to... From the patient’s Bed View screen . . . Access Trends 1. Click on Review in the Bed View menu bar. 2. Click on Trend Graphs... or Trend Table... (Chapter 13). Review Full/Event Disclosure Data 1. Click on Review in the Bed View menu bar. 2. Click on Full Disclosure... or Event Disclosure... (Chapter 14) Review Ventilator Settings 1.
ST Points Setup Configuring Alarm Limits For information regarding Alarm Setup, see Chapter 11. Configuring Arrhythmia Setup Refer to Chapter 8 for setup information. ST Points Setup This selection becomes available with the ST option. For telemetry patients refer to ST Points Setup Screen, page 10-6, for detailed information on configuring the ST measuring points. For bedside patients refer to specific monitor documentation.
6: Patient Setup - Bed View Patient View Setup Screen The Bed View Patient View Setup screen for Infinity TeleSmart patients provides selections to configure SpO2 and ECG monitoring settings for an individual patient. When you click on the button labeled SpO2, the setup selections for that parameter display. When you click on the button labeled ECG, the setup selections for that parameter display.
Patient View Setup Screen Patient View Setup Screen Selections Function/ Selection Available Settings Required Action/Information Channel Setup Channel Use the vertical scroll bar to view the desired channel. For devices programmed for 6wire monitoring an eighth channel is available. Parameter Click in the Channel’s Parameter column. HR, ARR, ST, ST cont.
6: Patient Setup - Bed View Function/ Selection Required Action/Information ECG Color Assign color of ECG associated waveforms • Red to telemetry channel for an individual patient. • White • Yellow • Green • Light Blue • Blue • Purple • Orange ECG Wire Mode Select Infinity TeleSmart lead wire mode When you confirm a change to the Infinity TeleSmart wire mode the new information is transmitted to the device. An information popup reports if the change is successful or not.
Patient View Setup Screen Function/ Selection Required Action/Information Available Settings Label V: Label V+ Select lead label Lead V1, Lead V2, Lead V3, Lead V4, Lead V5, Lead V6, Lead V (for 5-wire monitoring), Lead V+ (for 6-wire monitoring) These selections display when the TruST 12-lead setting is OFF. Label V displays when ECG Wire Mode setting is 5 wire; Label V+ is also available when ECG Wire Mode setting is 6 wire.
6: Patient Setup - Bed View Infinity TruST 12-Lead Monitoring Option NOTE: Infinity TruST is intended for 12-lead ECG monitoring with a reduced electrode set. Reconstructed leads are intended for real-time assessment of ST segment changes. Infinity TruST is a 12-lead ECG obtained with only six conventionally placed electrodes. Its function is based on the knowledge that, in general, the signal from a measured lead provides information common to other leads.
Infinity TruST 12-Lead Monitoring Option Recommended Lead Configurations and Respective Correlation Correlation Precordial Lead Placement 0.956 V2, V5 0.953 V2, V6 0.953 V1, V5 0.952 V3, V5 0.950 V1, V6 The performance above is based on a minimum 0.3 mV amplitude and QRS duration < 180 milli-seconds on patients with a body surface area (BSA) of 1.5 – 2.5 m2. Performance on patients outside these ranges may be less.
6: Patient Setup - Bed View Infinity TeleSmart Setup The TeleSmart Setup screen is accessible for local Infinity TeleSmart patients and displays information received from the Infinity TeleSmart. It provides Infinity TeleSmart status information and permits configuration functions.
ST ST NOTE: The ST menu selection is not available for telemetry patients outside the monitoring unit. Refer to Chapter 10 for information on customizing a patient’s ST analysis settings. Special Conditions Condition Infinity CentralStation Behavior Infinity TeleSmart goes offline. The telemetry patient channel for that device is blank. Offline message displays in the Information Area (page 6-7).
6: Patient Setup - Bed View 6-24 TUV Draft Infinity CentralStation VF8 DRAFT
7 Admit/Discharge/Transfer This chapter describes the Infinity CentralStation Admit function. It also includes instructions to discharge patients from the Infinity CentralStation and transfer patient data from one location to another. Overview.........................................................................................................................7-2 Admitting a Patient ........................................................................................................
7: Admit/Discharge/Transfer Overview On the Infinity CentralStation you can view, enter, and edit demographic information for any patient that is advertised on the Infinity Network and located within the Infinity CentralStation monitoring unit. Although entering demographics is not essential for monitoring, this data provides helpful information for easy patient identification.
Admitting a Patient From Main Screen 1. Click on the Bed Label/Patient Name in the patient’s waveform area. 2. Click on Admit. From Bed View 1. Click on ADT in the Bed View menu bar. 2. Click on Admit. Upon successful admission of a telemetry patient to the Infinity CentralStation, the configuration data is transmitted to the Infinity TeleSmart.
7: Admit/Discharge/Transfer Entering Patient Demographics To open the Admit screen see page 7-2. Demographic Data Selections of the Admit Screen Selection Possible Settings Name 1 to 25 characters ID# 1 to 12 characters Birth Date Day-Month-Year selection fields Physician 1 to 12 characters Admit Date Day-Month-Year selection fields Click on the up/down arrow buttons to scroll to the appropriate settings for each category.
Admitting Wireless Monitor Patients Changing Patient Category When you change Category in the ADMIT screen, a popup displays with the message: CAUTION: Alarm settings, arrhythmia settings, and QRS processing will be changed to the defaults for this category . You must press Confirm in the popup to accept the change. Whenever you successfully change a patient category, the following occur. ! Label and QRS-sensitivity settings are changed.
7: Admit/Discharge/Transfer Assigning a Wireless Monitor to a Patient Window If a previously docked bedside monitor is removed from the docking station to begin wireless communication and is configured to keep the CPS/IDS bed label, the Infinity CentralStation patient window remains assigned to the wireless monitor and displays a wireless icon before the bed label. When the wireless monitor returns to the CPS/IDS, the icon disappears from the patient window bed label.
Admitting Under Special Conditions Wireless Transmission Interruption If a wireless monitor loses contact with all APs and wireless transmission is interrupted, the Infinity CentralStation generates an Offline alert. Admitting Under Special Conditions Circumstance Effect on Admit Function Bedside monitor is powering up. Patient admission is not possible. Infinity TeleSmart is offline. Bedside monitor, bedside monitor CPS/IDS, or Infinity TeleSmart cannot communicate with the network.
7: Admit/Discharge/Transfer Discharging a Patient ! Bedside patients must be discharged at the bedside monitor. ! Telemetry patients must be discharged at the Infinity CentralStation where they were originally admitted. Remote discharges are not possible. When you discharge a telemetry patient: ! Demographics are deleted. ! All patient setup data such as alarm limits, arrhythmia setup, etc. are replaced by system defaults.
The Patient Transfer Function The Patient Transfer Function NOTE: ! After a successful transfer, the source monitor automatically discharges the patient. ! If an error occurs during the transfer, the data remains unchanged at the original location. You can transfer a patient’s Trend and demographic data from one location to another.
7: Admit/Discharge/Transfer The source bed for the transfer must be in Standby. Please put this bed in Standby. 7. You must click on Continue to close the popup. A Confirmation popup displays a message similar to the following example: Before proceeding with Transfer ... You have requested to transfer data from Bed_xx to Tel_xx. This action will replace any stored data at Tel_xx with data from Bed_xx. Data stored at Bed_xx will also be deleted once the transfer is complete.
8 Arrhythmia This chapter describes how to customize a patient’s arrhythmia setup. These settings supersede bedside monitor defaults and Infinity CentralStation system defaults (Chapter 4). Overview.........................................................................................................................8-2 Relearning the Template ...............................................................................................8-3 Customizing a Patient’s Arrhythmia Setup .........................
8: Arrhythmia Overview For telemetry patients the Infinity CentralStation is the monitor performing arrhythmia analysis parallel to QRS processing. After each QRS complex a heart rate is computed from the last eight R-R intervals minus the two longest and shortest intervals. A learning period begins when arrhythmia monitoring is first initiated to create a beat classification template.
Relearning the Template Relearning the Template During the Relearn process a beat classification template is created against which each detected beat is compared and classified. An automatic Relearn is initiated in the following conditions: ! Arrhythmia monitoring is enabled for the first time. ! A patient’s monitor (or Infinity CentralStation) comes out of Standby mode. ! The processing mode (ECG1 or ECG 1&2) changes. ! Lead assignment changes. ! TRUST monitoring is enabled.
8: Arrhythmia Customizing a Patient’s Arrhythmia Setup Accessing the Arrhythmia Setup Table 1. Open the patient’s Bed View screen and click on Setup in the Bed View menu bar. 2. Click on Arrhythmia.... Illustration of Setup - Arrhythmia Screen 1 Column heading is ‘Alarm Archive’ for telemetry patients admitted to Event Disclosure and ‘Record’ for telemetry patients not admitted to Event Disclosure..
Customizing a Patient’s Arrhythmia Setup Available Functions on the Arrhythmia Setup Table Heading/Function Description Alarm Grade 1. Click on the ‘Alarm Grade’ column of the • L-T event you wish to configure and scroll to the • SER desired setting. • ADV 2. Click on OK. • OFF Rate Determines when an event call is triggered 1. Click on ‘Rate’ or ‘Count’ column of the event you wish to configure and scroll to the desired setting. 2. Click on OK. See page 8-7.
8: Arrhythmia Heading/Function Description Available Settings Arrhythmia Determines which arrhythmia events are monitored • Basic - ASY, VF, VT, ART • Full - ASY, TACH, BRDY, PAUS, VT, RUN, AIVR, CPT, BGM, ARTF, SVT (‘Full’ arrhythmia capability at the Infinity CentralStation for bedside patients is only active if the bedside monitor has that capability.) • OFF (If you select ‘OFF’, arrhythmia setup table and arrhythmia field in patient’s parameter area are blank.
Available Bedside Event Settings Available Bedside Event Settings For available event settings for Telemetry patients see page 4-13. NOTE: Some arrhythmia settings are based on the Rate and Count settings for other calls (e.g. RUN is dependent on the VT settings).
8: Arrhythmia Settings for Gamma/Gamma XL/Vista Monitors Alarm Setting Store/Record Setting ASY1 Not adjustable Default: LT On, Off Default: On VF Not adjustable Default: LT On, Off Default: On Event Count (bpm) Rate (bpm) VT 3 - 15 Default: ≥ 3 100 - 200 Default: ≥ 100 not adjustable Default: LT On, Off Default: Off BRDY1 not adjustable Default: ≥ 8 30 - 70 Default: ≥ 50 Default: On On, Off Default: On PVC/min 1 - 60 Default: 10 Default: Off Rec, Store, Rec/ Store, Off Default: Off
Arrhythmia Beat Classification Arrhythmia Beat Classification The following available beat classifications appear in priority order. Abbreviations display in the parameter area and identify events. If two or more different events occur simultaneously, the Infinity CentralStation reports the highest priority event.
8: Arrhythmia Arrhythmia Messages Status Messages Message Parameter Value Status Area Description Action Regular or Paced rhythm is detected. Arrhythmia monitoring is OFF. ARR: ARR:LRN ECG RELEARN Arrhythmia system is ‘learning’ the patient’s QRS morphology to build a reference template. Wait until the learning period ends. ARR: CANNOT LEARN Unable to relearn on indicated lead. ARR: CANNOT LEARN Unable to learn on any lead. Note: Attention tone sounds.
Arrhythmia Messages ECG Alarm Messages Alarm Message Default Alarm Grade Description Action Check the patient and administer appropriate treatment. Parameter Area Status/Information Area HR: ASY ASYSTOLE L-T Asystole HR: VF VENTRICULAR FIBRILLATION L-T Ventricular fibrillation HR HR > UL SER HR value exceeds upper alarm limit. Check the patient. Change the limits. HR HR < LL SER HR value is below the lower alarm limit. Check the patient. Change the limits.
8: Arrhythmia 8-12 TUV Draft Infinity CentralStation VF8 DRAFT
9 Telemetry Pulse Oximetry Monitoring This chapter describes Telemetry patient SpO2 monitoring at the Infinity CentralStation. Overview........................................................................................................................9-2 Pulse Oximetry...............................................................................................................9-3 Turning Pulse Oximetry Monitoring On/Off ................................................................
9: Telemetry Pulse Oximetry Monitoring Overview You can use a Pulse Oximeter with the Infinity Telemetry transmitter to transmit SPO2 and PLS values to the Infinity CentralStation. While you are measuring SPO2 and PLS, the Infinity CentralStation screen icons, alarm messages, and acoustic alarms alert you to limit violations, low battery conditions, and sensor malfunctions.
Pulse Oximetry Pulse Oximetry A pulse oximeter determines the percentage of functional hemoglobin saturated with oxygen (% SpO2) in the patient’s arterial blood. A light sensor on the patient’s finger measures the absorption levels of red and infrared light. Since oxyhemoglobin and deoxyhemoglobin absorb different amounts of red light, but nearly the same amount of infrared light, the monitor uses the difference between the two measurements to calculate the percentage of saturated hemoglobin.
9: Telemetry Pulse Oximetry Monitoring Turning Pulse Oximetry Monitoring On/Off If pulse oximetry monitoring is enabled as a system default (page 4-7), set it for a telemetry patient as follows: 1. Open the patient’s Bed View screen. 2. Click on Setup in the Bed View menu bar. 3. Click on Telemetry (If selection does not appear, the Telemetry option is not enabled). 4. Click on Patient View. The Patient View Setup screen displays. 5. Click on the SpO2 button. 6.
Alarm Functions Alarm Functions For specific Infinity CentralStation SpO2 and PLS alarm setup instructions, see Chapter 11. Alarm Messages SpO2 Alarm Messages via MicrO2 and Infinity TeleSmart Alarm Message Alarm Grade Description Action PLS > UL SER Parameter value exceeds the upper alarm limit. • Check the patient. PLS: PLS < LL SER Parameter value is below the lower alarm limit. PLS: +++ Pulse rate out of range SER The pulse rate is outside the measuring range.
9: Telemetry Pulse Oximetry Monitoring Alarm Message Alarm Grade Description Action SpO2: *A* PLS: *A* P2 ADV Sensor cannot detect any signals. • Check the patient. • Check sensor and reapply or replace it if necessary. SpO2: *A* PLS: *A* P3 ADV Sensor does not detect any light. • Make sure the LED on the oximeter is not blocked. SpO2: *A* PLS: *A* P4 ADV Motion artifact • Make sure the patient remains as still as possible. • Check sensor; reapply or replace it if necessary.
10 Telemetry ST Analysis Option This chapter describes the Infinity CentralStation ST Analysis option and available setup functions (for telemetry patients). For information on these setup functions for bedside patients, refer to the specific monitor documentation. Overview.......................................................................................................................10-2 ST Segment Morphology ......................................................................................
10: Telemetry ST Analysis Option Overview ST deviation measurements are performed on averaged ECG segments. An averaged ECG segment is 900 ms long and is calculated from a minimum of 4 normal QRS complexes having occurred in the previous 15 seconds. To eliminate the effects of artifact, only normal beats are included in the average (if no normal beats are available, no complex or corresponding parameter box values display).
Overview The value of the ST measurement point is compared to the isoelectric point value, and the difference between the two measurements is the ST deviation. The onset and offset points for the QRS complex are determined by the QRS detection algorithm.
10: Telemetry ST Analysis Option Parameter Display With the ST option the Infinity CentralStation parameter area lists the ECG leads selected by the user as data sources for ST analysis. These data can fill one or two double parameter boxes. The ST values displayed depend on the transmitter lead configuration mode.
Relearning ST Relearning ST The Infinity CentralStation initiates a Relearn automatically under the following circumstances: ! Whenever you enable ST for the first time ! After you change leads ! When the monitor, Infinity TeleSmart, or Infinity CentralStation comes out of Standby mode ! After a device restart Initiating a relearn manually 1. Open the patient’s Bed View screen. 2. Click on Relearn in the Bed View menu bar. 3. Click on Relearn ECG.
10: Telemetry ST Analysis Option ST Points Setup Screen The ST Points Setup screen displays the current averaged complex for each lead with associated deviation measurement values and times. NOTE: Infinity TeleSmart does not support Hexaxial (Cabrera) display. Hexaxial (Cabrera) Lead Support In Cabrera display mode (page 16-4), the aVR lead is presented in inverted polarity as -aVR. The order of the lead presentation in Cabrera is: aVL, I -aVR, II aVF, III V1-V6.
ST Points Setup Screen Accessing the ST Points Setup Screen 1. Open patient’s Bed View screen. 2. Click on Setup in the Bed View menu bar. 3. Click on ST Points.
10: Telemetry ST Analysis Option Display Order of ST Complexes 3-/5-wire 1-/7-lead 6-wire 12-lead I aVF I aVF V3, dV3 II aVL II aVL V4, dV4 III V III V, V1, dV1 V5, dV5 aVR V+, V2, dV2 V6, dV6 aVR The averaged complexes and corresponding ST deviation measurements and times are updated as each new complex is computed. If an averaged complex is not available, the reserved display area appears blank. You can change the gain of the complexes and adjust the measurement points.
ST Points Setup Screen Zoom Mode ! To examine an individual ST complex in greater detail and view the current ST measurement point selections, click on the desired complex in the ST Points Setup screen. l 1 Lead label 2 Reference deviation 3 Current deviation value 4 Lead selection 5 Amplitude NOTE: gain.
10: Telemetry ST Analysis Option Available Functions on ST Points Setup Screen Function Description Available Settings Adjust Display Size • Click on the option button and select from available settings. 0.25, 0.5, 1, 2, 4, and 8 mV/cm Save Ref. Permits comparison of reference ST complex with another, more recent complex • Click on Save Ref. Ref. ON/OFF Allows visual comparison of a stored reference QRS complex to current complex • Click on Ref. On/Off toggle button.
Telemetry ST Setup Screen Telemetry ST Setup Screen The telemetry ST Setup screen allows you to customize a telemetry patient’s ST setup. For bedside patients, please refer to the specific monitor documentation. Accessing the Telemetry ST Setup Screen A patient’s ST Setup Screen differs according to transmitter monitoring mode. 1. Open the patient’s Bed View screen. 2. Click on Setup in the Bed View menu bar. 3. Click on Telemetry. 4. Click on ST.
10: Telemetry ST Analysis Option Special Conditions The following table lists some of the most common non-alarm conditions that may occur during ST segment analysis. Message in information area Parameter area Description Action cannot learn STx: blank Due to artifact or abnormal beats, the algorithm cannot determine the ST value for lead . • Initiate a relearning (see page 10-5). • Reprep the ECG electrodes. ecg signal saturated The ECG signal is saturated. Reprep the ECG electrodes.
ST Alarms ST Alarms An ST alarm occurs when the ST deviation measurement for any lead violates the set alarm limits for the user-selected duration (page 10-11). An ST alarm is cleared if the majority of intervals following the alarm are within the specified limits. ST alarms are subject to the same alarm guidelines as any other parameter. Refer to Chapter 11 for information on setting up the various alarm functions.
10: Telemetry ST Analysis Option 10-14 TUV Draft Infinity CentralStation VF8 DRAFT
11 Alarms Overview.......................................................................................................................11-2 Alarm Validation ....................................................................................................11-2 Alarm Grades ...............................................................................................................11-3 Latching alarms.....................................................................................................
11: Alarms Overview The Infinity CentralStation is the primary alarm annunciator for telemetry patients; for bedside patients the bedside monitor is the primary alarm annunciator.
Alarm Grades Alarm Grades All alarms are classified according to three alarm grades: ! Life-threatening ! Serious ! Advisory Each alarm grade has its own unique tone and color scheme (page 11-5). Depending on the seriousness of the alarm condition, alarms are either Latching or Non-latching. NOTE: If several alarms are simultaneously active for a single patient, the Infinity CentralStation reports the highest grade active alarm (alarm that has not been silenced and whose condition remains valid).
11: Alarms Visual and audible Alarm Signals Life-threatening (e.g. asystole, ventricular fibrillation) first or highest priority Serious (limit violation) second priority Advisory (e.g. network events, bedside events such as lead-off) third or lowest priority Alarm Indication in Main Screen Entire parameter area flashes red. Entire parameter area flashes yellow. Entire parameter area flashes white. Alarm Indication in Bed View Parameter area of respective parameter flashes red.
The Surveillance Feature The Surveillance Feature This feature provides alarm messages for life-threatening and serious alarms to bedside monitors that are not currently assigned to the Infinity CentralStation Main Screen but are located within the same monitoring unit. This function cannot be turned on or off. Display of Surveillance Alarm Messages All surveillance alarm messages overwrite the date/time field of the Main Screen status area.
11: Alarms Silencing Surveillance Alarms A surveillance alarm continues until it is either acknowledged or the alarm condition ceases.You can silence the audible alarm signal of a surveillance alarm locally by clicking on Alarm Silence in the Main Screen menu bar or by pressing F1. Special Surveillance Alarm Conditions Condition Effect on surveillance alarm Bedside CPS/IDS goes offline or fails while a surveillance alarm for that bed is reported at the Infinity CentralStation.
MIB Ventilator Alarms MIB Ventilator Alarms For MIB-connected ventilator events, the Infinity CentralStation provides alarm messages which are accompanied by a serious alarm tone. However, not all ventilator messages are reported at the Infinity CentralStation. MIB ventilator alarms are described in detail in Chapter 15. The most recent MIB ventilator alarm message appears in the patient’s top waveform channel in orange on the Main Screen.
11: Alarms Silencing Alarms The Alarm Pause function clears all audible and visual alarm indicators for lifethreatening and serious latched alarms (page 11-3). This function also suspends audible signals for life-threatening and serious alarms associated with conditions that are still valid for one minute. There are two ways to silence alarms. Local Alarm Pause • Silences active alarms for all local patients at the Infinity CentralStation or 1-minute.
Silencing Alarms ! The orange ventilator MIB Alarm Tone icon remains displayed (for an MIB alarm). ! The Alarm Pause button remains selected. After the Alarm Silence period expires, the alarm tone resumes if the alarm condition is still valid. In contrast to a local Alarm Silence, which silences all active alarms at the Infinity CentralStation only, a Bed Silence silences all alarms for an individual patient at the Infinity CentralStation and for bedside patients at the bedside monitor.
11: Alarms Configuring a Patient’s Alarm Setup The Setup - Alarm Limits screen appearance varies for telemetry patient screens depending on whether the patient is admitted to Event Disclosure. To adjust alarm tone see page 3-3.
Opening the Alarm Limits Setup Screen Opening the Alarm Limits Setup Screen 1. Open the patient’s Bed View screen. 2. Click on Setup in the Bed View menu bar. 3. Click on Alarm Limits... Pausing Alarms Telemetry Patient 1. Open the patient’s Bed View screen. 2. Click on Alarm Pause in the Bed View menu bar. NOTE: If the Alarm Pause button is ghosted, remote control is not enabled for the remote patient.
11: Alarms 3. Click on the up/down arrows in the Upper Limit and Lower Limit columns to set limits. 4. Click on OK. 5. Repeat steps 2 through 4 for each parameter.
Opening the Alarm Limits Setup Screen Initiating an AutoSet As soon as you click on Auto Set, the alarm limits for all monitored parameters are replaced. There is no confirmation process. 1. Open patient’s Alarm Limits Setup screen (page 11-11). 2. Click on Auto Set. NOTE: If a parameter value is outside the limit range during the Auto Set, alarm limits are not changed for that parameter. The automatically calculated alarm limits can be manually replaced at any time (page 11-11).
11: Alarms Turning Event Storage On/Off When a parameter’s storage and alarm functions are turned on, waveforms are stored automatically at the bedside for each validated alarm condition. 1. Open patient’s Alarm Limits Setup screen (page 11-11). 2. Click on the table row of the parameter whose alarm recording function you wish to set up. The parameter row changes to Configuration mode. 3. Click on the arrow buttons in the Alarm Archive column and scroll to STORE. 4. Click on the OK button. 5.
Alarm Messages Alarm Messages The Infinity CentralStation displays device- or parameter-specific alarm messages. For description of these messages see the following references.
11: Alarms 11-16 TUV Draft Infinity CentralStation VF8 DRAFT
12 Recordings / Reports This chapter describes the various types of recordings and reports that can be generated at the Infinity CentralStation. Overview ......................................................................................................................12-2 Processing of Strip Recordings .................................................................................12-3 Active Recordings.................................................................................................
12: Recordings / Reports Overview WA R N I N G : I f y o u r e q u i r e a d i a g n os t i c q u a l i t y r e c o r d i n g y o u m u s t u s e a R e s t E C G R e p o r t ( pa g e 1 6 - 8 ) .
Processing of Strip Recordings Processing of Strip Recordings A recording request can generate an active or pending recording. Active Recordings If a recorder is available and no pending recordings of higher priority exist, the recording begins printing immediately. If a recording is interrupted and another recorder is available, the complete recording is rerouted and printed at the available recorder.
12: Recordings / Reports Recorder Setup The R 50 and R 50-N recorders have two buttons: ! The mm/s button on the recorder’s front panel (Alternate Speed on older recorders) The Alternate Speed button allows you to change the recording speed while a recording is in progress. The recorder stops briefly and then restarts automatically at the new recording speed. ! The Stop button stops a recording in progress. Replacing the Recorder Paper 1.
Laser Printers Laser Printers A laser printer can print Infinity CentralStation screens and reports. Refer to the manufacturer’s operating instructions for specific information regarding the use of your particular type of laser printer.
12: Recordings / Reports Recording Types Recording Type Priority Description Alarm recording override Continuous recording 1 A strip recording that runs until interrupted manually (generated from Infinity TeleSmart, or Infinity CentralStation). A continuous recording request will cancel any alarm recording in progress. Alarm recording 2 A timed recording generated automatically in response to a limit violation for a parameter whose recording function is enabled.
Recording Types Timed Recordings Timed recordings are strip recordings of a specified duration. They contain delay data originating before the recording is initiated and real-time data acquired after the recording started. NOTE: If the patient was monitored for less time than the specified delay, the amount of delay data is adjusted accordingly. If no delay data is available at the recording request time, that part of the printed waveform is blank. Timed recordings consist of up to two waveforms.
12: Recordings / Reports Timed recording with header 1 Patient Name 8 Recorder label 2 Patient ID 9 Recording type: CENTRAL TIMED, CENTRAL CONT.
Recording Types Diagnostic Code Digit Possible Values Description 1 Lead processed for VF and pacer pulse rejection 2 ECG filter 3 Pacemaker detection 4 QRS/ARR processing 5 Patient category/QRS classification 6 Leads available for processing 7 VT count 8 VT rate 0-A 9 SVT count 3-A 10 SVT rate 0-A VF8 X 1 2 3 S T U V + a b c d e f A B C D E F M D E C c 2 1 1 2 B n 0 1 2 3 5-F Definition None I II III aVR aVL aVF V V+ V1 V2 V3 V4 V5 V6 dV1 dV2 dV3 dV4 dV5 dV6 Monitor Off
12: Recordings / Reports Possible Values Digit Description 11 TACH count 5-F 12 TACH rate 0-A 13 BRDY rate 0-F 14 PAUS rate 0-5 15 HR source 16 RESP mode 17 RESP size E P S O M A 1-K 18 Minutes since breath detector initialization 20 21 Not used Monitor model 00-99 A B I J K T xxxxx (ASCII) 22 - 26 Software version Definition value = TACH count (where A-F corresponds to 10-15) value = (TACH rate - 100)/10 (where A corresponds to 10) value = (BRDY rate - 30)/5 (where A-F
Reports Reports Depending on the activated options and configuration of your Infinity CentralStation, the following reports can be generated. Simultaneous ECG Report ! Full Disclosure (Strip, Hour, 24-Hour, Shift, Selected Strip, Graphical Trend, Patient Status, and Caliper Reports) ! Event Disclosure (Strip, Graphical Trend, Shift, and Selected Events Reports) ! VentCentral Reports Reports are processed and printed even if you leave the respective application.
12: Recordings / Reports Full Disclosure Strip Report The Full Disclosure strip report prints the screen-displayed waveforms. A report page may contain a 2-channel strip, each twenty seconds long with data centered around the cursor time. To request a Full Disclosure strip report, see page 12-23. Full Disclosure Hour Report The Hour Report consists of up to three user-selectable waveforms in a compressed format of one minute per row. There are 60 minutes of data per page.
Reports Shift Report You can request a 2, 4, 8, 12, or 24 hour shift report from Full or Event Disclosure. From either application the cursor time represents the report ‘stop time’. The report ‘start time’ equals ‘stop time’ minus the selected report length.
