ApexPro™ Telemetry System Operator’s Manual Software Version 3 2001989-134 Revision D
NOTE: The information in this manual only applies to ApexPro Telemetry System software version 3. It does not apply to earlier software versions. Due to continuing product innovation, specifications in this manual are subject to change without notice. Listed below are GE Medical Systems Information Technologies trademarks. All other trademarks contained herein are the property of their respective owners.
CE Marking Information CE Marking Information Compliance The ApexPro telemetry system bears CE mark CE-0459 indicating conformity with the provisions of the Council Directive 93/42/EEC concerning medical devices, and fulfills the essential requirements of Annex I of this directive. The product is radio-interference protection class A in accordance with EN 55011. The country of manufacture can be found on the equipment labeling.
CE Marking Information Exceptions The CIC Pro and ApexPro server is suitable for use in the specified electromagnetic environment. The customer and/or the user of the CIC Pro and ApexPro server should assure that it is used in an electromagnetic environment as described below: CE Exception Table EN60601-1-2 Clause 36 36.202.
CE Marking Information CE Exception Table EN60601-1-2 Clause 36 Exception Electromagnetic Environment Guidance ApexPro and ApexPro CH Transmitters 36.202.2 Immunity: Radiated Fields If operated in the midst of the conditions outlined in EMC standard EN60601-1-2 (Radiated Immunity 3 V/m), fields in excess of 1 V/m may cause waveform distortions and erroneous numeric data at various electromagnetic interference (EMI) frequencies.
CE Marking Information CE Exception Table EN60601-1-2 Clause 36 Exception Electromagnetic Environment Guidance Apex Oximeter 36.202.2 Immunity: Radiated Fields If operated in the midst of the conditions outlined in EMC standard EN60601-1-2 (Radiated Immunity 3 V/m), fields in excess of 0.5 V/m may cause waveform distortions and erroneous numeric data at various electromagnetic interference (EMI) frequencies.
CE Marking Information CE Exception Table EN60601-1-2 Clause 36 Exception Electromagnetic Environment Guidance Accutracker DX NBP Monitor 36.202.1 Immunity: ESD Air — Discharges in excess of ±6 Kv may cause the cuff to deflate and the unit to lock up. By turning the power switch off, then back on (manual reset), the unit will be restored to the user-defined settings and normal operation. The Accutracker DX blood pressure monitor should be kept in the carrying pouch supplied with each unit.
CE Marking Information Restrictions The Radio and Telecommunication Terminal Equipment Directive (R&TTE) states that radio equipment operating in frequency bands for which the use has not been harmonized across the European Community have to be identified by an equipment symbol. ApexPro is classified as Class 2 Equipment and bears the following equipment symbol (also called the Alert Mark): . Not all European member states have approved the frequencies within 433. 25 MHz to 434.
CE Marking Information General Information Revision D This manual is an integral part of the product and describes its intended use. It should always be kept close to the equipment. Observance of the manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety. The symbol documents. Information which refers only to certain versions of the product is accompanied by the model number(s) of the product(s) concerned.
CE Marking Information For your notes CE-8 ApexPro Telemetry System 2001989-134 Revision D
Contents 1 The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 About This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3 Manual Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3 Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3 Revision History . . . . . . . . . . . . . .
3 Equipment Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3 ApexPro Telemetry System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4 Compatibility with Bedside Monitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5 ApexPro Transmitters . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1 Biocompatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3 Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4 Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5 General Cleaning/Disinfecting . .
7 Admit/View a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1 About Admitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3 Switching Transmitters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3 Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3 Admit Instructions . . . . . . . . . . . . . . . . . . .
9 Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1 Initiating a Manual Graph . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3 Automatic Alarm Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3 Transmitter Initiated Graphs (Manual Graphs) . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4 Graph Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Time Focus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-17 Full Disclosure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-18 Full Disclosure Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-19 11 ECG Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1 Introduction . . . . . . . . . . . . . . . . . . . . .
12 SpO2 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-3 SpO2 Probe Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4 Infants and Pulse Oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5 Signal and Data Validity . . . . . . . . . . . . . . . . . . .
Pressures Tab Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-15 Accessing the Pressures Tab Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-15 Auto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-16 Cuff Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-16 Clear Message . . . . . . . . . . .
ApexPro FH Transceiver . . . . . . . . . . . . . . . . . . . . . . . . . .D-1 The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-3 About the ApexPro FH Transceiver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-3 Programming Transceivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .D-4 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For your notes x ApexPro Telemetry System 2001989-134 Revision D
1 Revision D The Basics ApexPro Telemetry System 2001989-134 1-1
For your notes 1-2 ApexPro Telemetry System 2001989-134 Revision D
The Basics: About This Manual About This Manual Manual Purpose This manual contains the instructions necessary to operate the ApexPro telemetry system safely and in accordance with its function and intended use. This manual addresses the operation of the ApexPro telemetry system at the CIC Pro. Be sure to read the entire manual before using the equipment. Intended Audience This manual is geared for clinical professionals.
The Basics: About This Manual Revision History Each page of the document has the document part number and revision letter at the bottom of the page. The revision letter changes whenever the document is updated. Revision Date Comments A 25 June 2003 Initial release of this document, corresponding to ApexPro telemetry system software version 3. B 23 October 2003 Updated to support the ApexPro FH Transceiver Added additional CE Exceptions for the ApexPro system.
The Basics: Manual Conventions Manual Conventions This section describes terminology, standards, and other conventions that are used throughout this manual. Product References In this manual: The ApexPro telemetry system is referred to as the ApexPro system, or simply the system. The CIC Pro Clinical Information Center is referred to as the clinical information center, the CIC Pro or the central station.
The Basics: Manual Conventions Messages/Prompts — A message is text that appears on the CIC Pro. It informs you of conditions occurring that are not necessarily part of normal operating conditions. Prompts are text messages that appear, instructing you to perform a specific action. Multiple patient viewer — The multiple patient viewer is the CIC Pro display in its normal state. Bed windows for admitted patients are shown, as well as a menu bar at the bottom of the display.
The Basics: Common Operations Common Operations Some operations are used repetitively at the CIC Pro or the ApexPro telemetry system. Rather than explaining how to perform each operation every time it appears in this manual, these operations are presented below. Please familiarize yourself with the proper procedure for each. “Clicking” the Mouse The term “click” refers to positioning the mouse pointer on a selection and pressing the left mouse button one time.
The Basics: Common Operations Check Boxes To use check box controls, click on the square or the text next to it. When selected, a check mark is shown in this square. To deselect a check box control, click again on the text or in the square. When deselected, no check mark is shown. Check Boxes — indicates active selection. 078B Scroll Bars Use horizontal and vertical scroll bars to move a window’s contents left/ right and up/down.
The Basics: Common Operations Popup Lists Clicking in a text field may produce a down arrow button on the right side of the field. This arrow button is used to open a popup list. A popup list is a list of options available for that particular field. Use the mouse to click on the arrow button, which opens the popup list. Arrow Button — indicates there is a popup list. Popup List 332A Once the popup list is open, use the mouse to click on an option. This selects the option and closes the popup list.
The Basics: Unit Defaults Worksheet Unit Defaults Worksheet This worksheet has been provided as an optional reference tool to record your care unit’s default settings. Fill out the information and keep it in a prominent place to refer to your setup. For your convenience, the factory default settings appears dimmed. Fill in only those settings that differ from the factory default ones. NOTE Before you fill it out, you may want to make additional copies of the worksheet for future use.
The Basics: Unit Defaults Worksheet Telemetry Unit Defaults Graph Setup: ECG: Manual Graph Location Display Lead Alarm Graph Location Arrhythmia Print Window Graph Location Lead Analysis ST Analysis Va Lead Waveforms: Vb Lead ECG 1 Waveform Display Detect Pace Waveform 2 Display Waveform 3 Display Waveform 4 Display Patient Age Transmitter Alarm Pause Alarm Pause Breakthrough Transmitter Graph Event Marker* Alarm Graph On/Off Event Marker Graph On/Off* *The Event Marker Graph and Event Mark
The Basics: Unit Defaults Worksheet For your notes 1-12 ApexPro Telemetry System 2001989-134 Revision D
2 Revision D Safety ApexPro Telemetry System 2001989-134 2-1
For your notes 2-2 ApexPro Telemetry System 2001989-134 Revision D
Safety: For Your Safety For Your Safety Intended Use The ApexPro Telemetry System is intended for use under the direct supervision of a licensed healthcare practitioner. The system is designed to acquire and monitor physiological data for ambulating patients within a defined coverage area. The system processes this physiological data to detect various ECG arrhythmia events and select physiological parameter limit violations.
Safety: For Your Safety System Safety The safety statements presented in this chapter refer to the equipment in general and, in most cases, apply to all aspects of the telemetry system. There are additional safety statements in other chapters that are specific to the information presented in that chapter. The order in which safety statements are presented in no way implies order of importance. Dangers There are no dangers that refer to the equipment in general.
Safety: For Your Safety WARNINGS ALARMS — Do not rely exclusively on the audible alarm system for patient monitoring. Adjustment of alarm volume to a low level or off during patient monitoring may result in a hazard to the patient. Do not rely exclusively on the alarm pause breakthrough feature for alarm notification during an alarm pause. This may result in a hazard to the patient. Only crisis alarms break through an alarm pause.
Safety: For Your Safety WARNINGS CONDUCTIVE CONNECTIONS — Extreme care must be exercised when applying medical electrical equipment. Many parts of the human/machine circuit are conductive, such as the patient, connectors, electrodes, transducers. It is very important that these conductive parts do not come into contact with other grounded, conductive parts when connected to the isolated patient input of the device.
Safety: For Your Safety WARNINGS LEAKAGE CURRENT TEST — When interfacing with other equipment, a test for leakage current must be performed by qualified biomedical engineering personnel before using with patients. NETWORK INTEGRITY — The clinical information center resides on the hospital’s computer network, and it is possible that inadvertent or malicious network activity could adversely affect patient monitoring. The integrity of the computer network is the responsibility of the hospital.
Safety: For Your Safety WARNINGS RATE METERS — Keep pacemaker patients under close observation. Rate meters may continue to count the pacemaker rate during cardiac arrest and some arrhythmias. Therefore, do not rely entirely on rate meter alarms. SITE REQUIREMENTS — For safety reasons, all connectors for patient cables and sensor leads are designed to prevent inadvertent disconnection, should someone pull on them. Do not route cables in a way that they may present a stumbling hazard.
Safety: For Your Safety CAUTIONS BEFORE INSTALLATION — Compatibility is critical to safe and effective use of this device. Please contact your local sales or service representative prior to installation to verify equipment compatibility. DEFIBRILLATOR PRECAUTIONS — Patient signal inputs labeled with the CF and BF symbols with paddles are protected against damage resulting from defibrillation voltages. To ensure proper defibrillator protection, use only the recommended cables and leadwires.
Safety: For Your Safety CAUTIONS EMC — Magnetic and electrical fields are capable of interfering with the proper performance of the device. For this reason make sure that all external devices operated in the vicinity of the monitoring system comply with the relevant EMC requirements. X-ray equipment or MRI devices are a possible source of interference as they may emit higher levels of electromagnetic radiation.
Safety: For Your Safety CAUTIONS OPERATOR — Medical technical equipment such as this monitor/monitoring system must only be used by persons who have received adequate training in the use of such equipment and who are capable of applying it properly. POWER REQUIREMENTS — Before connecting the device to the power line, check that the voltage and frequency ratings of the power line are the same as those indicated on the unit's label.
Safety: For Your Safety Notes Put the system in a location where you can easily see the screen and access the operating controls. This product is not likely to cause abnormal operation of other patient-connected equipment such as cardiac pacemakers or other electrical stimulators. Exceptions are noted in the pacemaker monitoring section, if applicable. This product is protected against the effects of cardiac defibrillator discharges to ensure proper recovery, as required by test standards.
Safety: For Your Safety Classification The telemetry system is classified, according to IEC 60601-1, as: Type of protection against electrical shock Transmitter — Internally powered Receiver system — Class I Degree of protection against electrical shock ApexPro Transmitter — Type B applied part ApexPro *CH Transmitter—Type CF Defibrillation proof applied part Degree of protection against harmful ingress of water ApexPro Transmitter — IPX3 (IEC 60529) ApexPro *CH Transmitter — IPX7 (IEC 60529) Receiver
Safety: For Your Safety FCC Compliance Information Statement NOTE The FCC and the Industry Canada compliance are applicable to the Apexpro CH Transmitter only. The ApexPro CH Transmitter is not for sale outside of the U.S. and Canada. This equipment complies with Part 95 Subpart H of the FCC rules to be used in wireless medical telemetry service. Operation of this equipment requires prior coordination with a frequency coordinator designated by the FCC for the Wireless Medical Telemetry Service.
Safety: For Your Safety Equipment Symbols NOTE Some symbols may not appear on all equipment. ATTENTION: Consult accompanying documents. CAUTION: To reduce the risk of electric shock, do NOT remove cover. Refer servicing to qualified service personnel. TYPE CF APPLIED PART: Isolated (floating) applied part suitable for intentional external and internal application to the patient including direct cardiac application. “Paddles” outside the box indicate the applied part is defibrillator proof.
Safety: For Your Safety Alternating current (AC) Power; I = ON; O = OFF PRESS Indicates where to press to open the door on the 7160 DDW. Silence Alarms keyboard key. Non-ionizing electromagnetic radiation: To indicate elevated, potentially dangerous, levels of non-ionizing radiation. Note - In case of application in a warning sign the rules according to ISO 3864-1 shall be adhered to. IEC 60878 note: See safety sign ISO 7010 - W005 "Warning, non-ionizing radiation".
3 Revision D Equipment Overview ApexPro Telemetry System 2001989-134 3-1
For your notes 3-2 ApexPro Telemetry System 2001989-134 Revision D
Equipment Overview: Introduction Introduction This chapter provides an overview of the equipment used in the ApexPro telemetry system. For battery installation and equipment interconnection instructions, refer to Chapter 4, Connection, in this manual. For detailed installation instructions, refer to the appropriate service manual.
Equipment Overview: ApexPro Telemetry System ApexPro Telemetry System The ApexPro telemetry system consists of the following components: 3-4 ApexPro transmitter (one for each monitored patient) and/or ApexPro CH transmitter (not for sale outside the U.S. and Canada) ApexPro FH transceiver (not for sale outside the U.S.
Equipment Overview: ApexPro Telemetry System Compatibility with Bedside Monitors ApexPro telemetry system patient data can be viewed on most GE Medical Systems Information Technologies patient monitors. The monitor must be connected to the Unity network and in the same care unit as the ApexPro telemetry system. The telemetry patient can be viewed on the bedside monitor using the monitor’s split screen view, or when the monitor is set for either Combo or Rover Combo monitoring mode.
Equipment Overview: ApexPro Telemetry System ApexPro Transmitters The ApexPro transmitter sends the patient’s ECG data to the ApexPro receiver subsystem for processing. Data is then transmitted via a dedicated Ethernet interface to the CIC Pro for further processing and viewing. The ApexPro transmitter can send the patient’s SpO2 data when the optional Apex Oximeter is connected to it.
Equipment Overview: ApexPro Telemetry System ApexPro Transmitter Buttons and LEDs When the transmitter is first powered up, all the LEDs will flash rapidly, followed by two slow flashes of the top row of LEDs (RA, LA, LL, Va, Vb, Change Battery). The transmitter will begin functioning after the two slow flashes. When any of the transmitter's buttons are pushed (Verify Leads, Graph, or the Pause Alarm combination), the top row of LEDs will flash twice.
Equipment Overview: ApexPro Telemetry System Graph When the Graph button is pushed, the top row of LEDs will flash twice, indicating the button was pushed. Pressing the Graph button initiates a 20-second graph strip to be printed on the writer or printer. When an IMPACT.wf paging system (version II or later) is also available in the same care unit, pressing the Graph button enables the View on Demand feature (also called the Apex Graph Button Push feature). The IMPACT.
Equipment Overview: ApexPro Telemetry System Reactivating Alarms To reactivate the alarms before the five minute time period has elapsed, press both transmitter buttons simultaneously again. Low Batteries The Change Battery LED flashes when battery power is running low. Change the batteries in the ApexPro transmitter when this LED flashes. Refer to the ApexPro Transmitter Battery Installation section in Chapter 4, Connection, for more information about changing the batteries.
Equipment Overview: ApexPro Telemetry System ApexPro CH Transmitter (not for sale outside of the U.S. and Canada) The Channel Number (CH) is how the ApexPro CH transmitter is identified. During setup, when the TTX ID is entered for a patient at the CIC Pro, the CIC Pro recognizes the transmitter type and translates the information into an alpha-numeric number. The alpha-numeric number of the transmitter is displayed under the ECG parameter window.
Equipment Overview: ApexPro Telemetry System ApexPro FH Transceiver (not for sale outside of the U.S.) Please refer to Appendix D for operator’s instructions on the ApexPro FH Transceiver.
Equipment Overview: ApexPro Telemetry System Apex Oximeter SpO2 Module The Apex Oximeter is an optional module that can be connected to the ApexPro transmitter, allowing telemetry monitoring of a patient’s pulse oximetry data. The Apex Oximeter must be connected to an ApexPro transmitter in order to convey SpO2 data to the CIC Pro. Only digital data is available; no waveforms are generated or transmitted.
Equipment Overview: ApexPro Telemetry System To turn the display on continuously, press and hold the Display On/Off button for 2 seconds. The flashing Power LED turns off to verify that the display has been turned on in continuous mode. To turn the display off at any time, press the Display On/Off button again. NOTE Using the Apex Oximeter with the display on continuously will result in reduced battery life. To turn all power to the Apex Oximeter off, press and hold the Power button for 2 seconds.
Equipment Overview: ApexPro Telemetry System Accutracker DX Noninvasive Blood Pressure (NBP) Monitor NOTE The Accutracker DX noninvasive blood pressure monitor is available in the United States only. This model, available from GE Medical Systems Information Technologies, has been modified by SunTech Medical Instruments to operate with the ApexPro telemetry system.
Equipment Overview: ApexPro Telemetry System Accutracker DX Buttons and Switches An on/off switch and five buttons control the functions of the blood pressure monitor. Their functions are described below. LAST button NO – button 412A 403A On/Off switch NEXT button YES + button START/STOP button The on/off switch, labeled 1/0, is located on the side of the blood pressure monitor. The on position is 1; the off position is 0. It is used to turn the main power on and off.
Equipment Overview: ApexPro Telemetry System DINAMAP® PRO Series Monitors The DINAMAP PRO 100, 200, 300, and 400 series monitors can be connected to the ApexPro telemetry transmitter. They monitor SpO2, NBP, and temperature, depending on the purchased configuration. Parameter data from the PRO 100–400 series monitors is displayed, trended, and stored at the CIC Pro. DINAMAP PRO 400 Series Monitor The DINAMAP PRO 100–400 series monitors alarm limits are not configurable at the CIC Pro.
Equipment Overview: ApexPro Telemetry System Antenna System The antenna system is used for transmission of data from the transmitter to the receiver system. An ApexPro receiver antenna is illustrated below. 417A Receiver System Each receiver in the quad receiver module, located in the receiver subsystem, receives data from the transmitters. This data is processed by the receiver system and then transmitted via the dedicated Ethernet interface to a CIC Pro for further processing and display.
Equipment Overview: ApexPro Telemetry System CIC Pro Clinical Information Center The CIC Pro is the central station that displays ApexPro telemetry system data sent to it via the dedicated Ethernet interface. The CIC Pro also allows modification of telemetry defaults and setup information, among other telemetry functions.
4 Revision D Connection ApexPro Telemetry System 2001989-134 4-1
For your notes 4-2 ApexPro Telemetry System 2001989-134 Revision D
Connection: ApexPro Transmitter Setup ApexPro Transmitter Setup ApexPro Transmitter Battery Installation CAUTION Never store the transmitter with the batteries inside. Storing the transmitter with the batteries inside may result in damage to the transmitter. Install two new AA alkaline batteries in the transmitter. 1. Locate the battery cover at the bottom of the transmitter. 2. Slide the cover over to open the battery compartment. 3.
Connection: ApexPro Transmitter Setup Battery Functional Life The ApexPro transmitter runs on two AA batteries. Battery life is approximately 40 hours. Battery life for the ApexPro CH transmitter is approximately 120 hours (not for sale outside of the U.S. and Canada). For optimum performance, follow these guidelines: Install two new alkaline batteries each time you begin monitoring a new patient.
Connection: ApexPro Transmitter Setup ApexPro Transmitter Leadwires Installation The ApexPro transmitter can be used with the following Multi-Link leadwire sets: Multi-Link six-leadwire set Multi-Link five-leadwire set Multi-Link three-leadwire set To install a leadwire set into the ApexPro transmitter, align the leadwire pins with the connector on the top of the transmitter, then push the leadwire set firmly into the transmitter.
Connection: ApexPro Transmitter Setup Multi-Link Leadwire Sets To use sets of Multi-Link individual leadwires, firmly press the individual leadwires into their appropriate locations on the combiner. Use the colors on the leadwires to place them in corresponding order with the colors that appear on the back of the ApexPro transmitter. Individual leadwires Combiner 308B Attachment to the Electrodes 1. Attach leadwires to the transmitter by plugging the Multi-Link leadwire set into the transmitter. 2.
Connection: Apex Oximeter Setup Apex Oximeter Setup Apex Oximeter Battery Installation Install two new AA alkaline batteries in the Apex Oximeter: 1. Locate the battery cover at the bottom of the back of the Apex Oximeter. 2. Press the latch tab and lift up to open the battery compartment. 3. Insert the batteries, being careful to follow the polarity signs located within the battery compartment. 4. Close the battery cover.
Connection: Apex Oximeter Setup Apex Oximeter Connections To function correctly, the Apex Oximeter must be connected to a pulse oximetry (SpO2) probe. To transmit data to the CIC Pro, the Apex Oximeter must also be connected to the ApexPro transmitter. SpO2 Probe Connection Connect the SpO2 probe to the Apex Oximeter by plugging the nonsensor end of the probe into the 9-pin connector on the top of the Apex Oximeter. CAUTION Use only Nonin SpO2 probes with the Apex Oximeter.
Connection: Apex Oximeter Setup When properly interconnected, the Apex Oximeter and the ApexPro transmitter should appear similar to the illustration below. Interconnection cable Pu lse Sp O Ra te 2 % Po we r Outside INTFC connector, labeled 1 on the dust cover D Onisp /O lay ff o xi m et er Pe rfu sio n INTFC connector 400B The Apex Oximeter and the ApexPro transmitter can now be attached to the patient. Follow your unit’s protocol for attaching them to the patient.
Connection: Accutracker DX Setup Accutracker DX Setup NOTE The Accutracker DX noninvasive blood pressure monitor is available in the United States only. Tips for Monitoring Use a microphone pad to maintain the best microphone position. Use a cuff anchor to maintain the blood pressure cuff’s position. Advise the patient not to shower or bathe while being monitored. Battery Installation Install four new AA alkaline batteries in the Accutracker DX blood pressure monitor. Follow these steps: 1.
Connection: Accutracker DX Setup Accutracker DX Functional Life IMPORTANT — Store and use the Accutracker DX blood pressure monitor with four good AA batteries installed. The four AA batteries will last for approximately 250 blood pressure readings, taken at an average interval of 15 minutes. Install four new alkaline batteries each time you begin monitoring a patient.
Connection: Accutracker DX Setup Accutracker DX Connections The patient cable, microphone cable, and interconnection cable are attached to one another in one assembly. Refer to the illustration below. 407A Microphone Cable Patient Cable Interconnection Cable NOTE Refer to the Interconnection Cables section in this chapter for information about cable compatibility.
Connection: Accutracker DX Setup If the patient cable/microphone cable/interconnection cable assembly is not already connected to the Accutracker DX noninvasive blood pressure monitor, follow this procedure to connect it: 1. Attach the brass end of the patient cable to the blood pressure monitor by screwing it onto the brass air hose connector on the side of the blood pressure monitor. 2.
Connection: Accutracker DX Setup 3. Secure the cable by screwing on the metal cable cap, then insert the blood pressure monitor into the nylon pouch. When the patient cable assembly is connected, the blood pressure monitor will look similar to the following photograph.
Connection: Accutracker DX Setup 4. Attach the blood pressure cuff hose to the patient cable already attached to the blood pressure monitor. Insert the cuff hose into the white plastic fitting on the patient cable. Turn the fitting to the right approximately one quarter turn. Some connector models will click when they are connected, otherwise, be sure that it is securely tightened. Then plug the 3-pin microphone connector into 3-pin connector on the microphone cable.
Connection: DINALink™ Serial Cable DINALink™ Serial Cable The DINALink serial cable is used to connect the ApexPro transmitter to the PRO 100–400 series monitors. The interconnect cable connects to either of the interface ports on the ApexPro transmitter.
Connection: Interconnection Cables Interconnection Cables The interconnection cables used to connect the ApexPro transmitter with the Apex Oximeter and/or the Accutracker DX blood pressure monitor are not the same as those used with the Apex S transmitter (CD Telemetry-LAN monitoring system). NOTE The Accutracker DX noninvasive blood pressure monitor is available in the United States only. The connector ends that are plugged into the telemetry transmitters are different and are not interchangeable.
Connection: Interconnection Cables For your notes 4-18 ApexPro Telemetry System 2001989-134 Revision D
5 Revision D Maintenance ApexPro Telemetry System 2001989-134 5-1
For your notes 5-2 ApexPro Telemetry System 2001989-134 Revision D
Maintenance: Biocompatibility Biocompatibility When used as intended, the parts of the product described in this operator manual, including accessories that come in contact with the patient during the intended use, fulfill the biocompatibility requirements of the applicable standards. If you have questions about this matter, please contact GE Medical Systems Information Technologies or its representatives.
Maintenance: Inspection Inspection An effective maintenance schedule should be established for your monitoring equipment and reusable supplies. This should include inspection as well as general cleaning on a regular basis. The maintenance schedule must comply with the policies of your institution’s infection control unit and/or biomedical department.
Maintenance: Cleaning Cleaning General Cleaning/Disinfecting WARNING Disconnect AC-powered equipment from the power line before cleaning or disinfecting its surface. Turn off the power to battery-powered equipment before cleaning or disinfecting its surface. The equipment should be cleaned on a regular basis. (Comply with the policies of your institution’s infection control unit and/or biomed department.
Maintenance: Cleaning Never use these cleaning agents: abrasive cleaners or solvents of any kind, acetone, ketone, quaternary ammonium solutions alcohol-based cleaning agents, or Betadine CAUTION Failure to follow these rules may melt, distort, or dull the finish of the case, blur lettering on the labels, or cause equipment failures.
Maintenance: Cleaning Transmitter Cleaning Process Follow these steps to properly clean your transmitter. CAUTIONS Do not autoclave or steam clean the transmitters. Do not submerse the transmitters. 1. Always remove batteries and disconnect leadwires from the transmitter before cleaning. 2. For general cleaning, wipe with a lint-free cloth dampened with the recommended diluted bleach solution (refer to “General Cleaning/ Disinfecting” on page 5-5). 3.
Maintenance: Cleaning Leadwire Cleaning Process Follow these step for proper cleaning of your leadwires. CAUTIONS Do not use acetone or ketone solvents for cleaning; do not use an autoclave or steam cleaner. Do not submerse the telemetry leadwires. 1. Always disconnect the ECG cable from the transmitter before cleaning. 2. For general cleaning, wipe with a lint-free cloth dampened with the recommended diluted bleach solution (refer to “General Cleaning/ Disinfecting” on page 5-5). 3.
Maintenance: Cleaning More Intensive Disinfecting or Sterilization CAUTION The decision to sterilize must be made per your institution’s requirements with an awareness of the effect on the integrity of the transmitter and leadwire. Cleaning the Oximeter and Accutracker DX To clean the Apex Oximeter, the Nonin Xpod Oximeter, or the Accutracker DX blood pressure monitor, follow the instructions in “General Cleaning/Disinfecting” on page 5-5. CAUTION Do not autoclave or steam-clean the equipment.
Maintenance: Transmitter and Leadwire Storage Transmitter and Leadwire Storage Storage Guidelines Always remove batteries when the transmitter is not in use, even for short periods of time. Store transmitters in a dry environment. The preferred method of storage is to hang the transmitter in the transmitter holder. If leadwires are attached, they should hang straight.
Maintenance: Technical Maintenance Technical Maintenance Schematic diagrams and other relevant technical information can be found in the service manuals supplied with this equipment. Comply with the policies of your institution’s biomedical department, or the recommendations made within the Preventive Maintenance section of the product’s service manual. Technical Specifications Technical specifications are located in the service manuals.
Maintenance: Technical Maintenance For your notes 5-12 ApexPro Telemetry System 2001989-134 Revision D
6 Revision D Telemetry Setup ApexPro Telemetry System 2001989-134 6-1
For your notes 6-2 ApexPro Telemetry System 2001989-134 Revision D
Telemetry Setup: Introduction Introduction The Setup CIC button, located in the CIC Pro’s main menu at the bottom of the display, opens the CIC Setup window. The CIC Setup window contains the tab sheets used for customizing the CIC Pro. The Telemetry Unit Defaults, CIC Defaults, Current Telemetry Listings, Full Disclosure Defaults, and Service Password tab sheets are discussed in this chapter. The Telemetry Alarm Control Defaults tab sheet is discussed in Chapter 8, Alarm Control.
Telemetry Setup: Telemetry Factory Default Settings Telemetry Factory Default Settings These factory defaults are in effect, depending upon the patient’s age, unless they have been modified through Telemetry Unit Defaults.
Telemetry Setup: Service Password Service Password The Service Password tab sheet contains a field for entering the password to access the CIC Pro’s service mode. To open the Service Password tab sheet, follow these steps. 1. Use the mouse to click on Setup CIC in the main menu. 2. Click on the Service Password tab to bring it to the front.
Telemetry Setup: Service Password CAUTION The service mode is intended for use only by qualified personnel with training and experience in its use. The consequences of misuse include loss of alarm configuration, loss of patient data, corruption of the CIC Pro operating system software, or disruption of the entire Unity network. 3. To change from the user mode to the service mode, use the keyboard to enter the service password, then click Apply. The Current Permission entry changes from User to Service.
Telemetry Setup: Telemetry Unit Defaults Telemetry Unit Defaults Unit defaults are saved settings for various features and alarm levels that apply to telemetry monitoring at the CIC Pro. Unit defaults can be set only in service mode, and once they are set, they remain in effect and are automatically applied each time a new telemetry patient is admitted to the CIC Pro.
Telemetry Setup: Telemetry Unit Defaults Telemetry unit defaults can be set for the following features: Manual, alarm, and print window graph locations ECG 1, and Waveforms 2, 3, and 4 Transmitter graph Alarm graph on/off Event marker graph on/off (not applicable to all transmitters) Display lead Arrhythmia Lead analysis ST analysis Va and Vb leads Detect pace PDS server Patient age Transmitter alarm pause Alarm pause breakthrough Event marker (
Telemetry Setup: Telemetry Unit Defaults Waveforms The ECG 1 popup list is used to set the unit default for the waveform that will print in the first position on a graph. Lead II is the default. The Waveform 2, 3, and 4 options are used to set the unit defaults for the waveforms that will be printed in the second, third, and fourth positions on the graph. The options found in these popup lists are: I II III V (This option will indicate the V lead being monitored, e.g., V2.
Telemetry Setup: Telemetry Unit Defaults Event Marker Graph The Event Marker Graph option allows you to select whether a graph will be printed when a patient’s event is marked using the Event Marker button on the transmitter (refer to “Event Marker” on page 3-10). The choices are: Off (factory default selection) On This feature is not applicable to all transmitters.
Telemetry Setup: Telemetry Unit Defaults Va and Vb Lead Use the Va Lead and Vb Lead options to set the defaults for the V leads that will be monitored in these positions. A 6-lead cable is required for dual V-lead monitoring. The options are: V1 (recommended for arrhythmia detection*) V2 V3 V4 V5 (recommended for ST depression monitoring*) V6 * Barbara J. Drew, RN, PhD, FAAN (2000).
Telemetry Setup: Telemetry Unit Defaults Patient Age The options found in the pull-down list for the Patient Age field are: 0-2 years 3-10 years 11-13 years Adult (factory default selection) The patient age setting chosen in the Telemetry Unit Defaults tab sheet affects the alarm settings. Refer to the example below. Example 1.
Telemetry Setup: Telemetry Unit Defaults Transmitter Alarm Pause NOTE Refer to Chapter 8, Alarm Control, for important information about Transmitter Alarm Pause. The options found in the popup list for the Transmitter Alarm Pause field are: Disabled (factory default selection) Enabled Off This option sets the unit default for all telemetry patients admitted to the CIC Pro.
Telemetry Setup: CIC Defaults CIC Defaults You can view the current CIC Pro default settings by clicking on the CIC Setup button, but defaults can only be modified when in the service mode. Unless you are in the service mode, you will not be able to see all available options, you will not be able to highlight the options, and the current settings will appear dimmed. Refer to the Service Password section in this chapter. To open the CIC Defaults tab sheet, follow these steps. 1.
Telemetry Setup: CIC Defaults The following features of the CIC Defaults tab sheet can be modified in the service mode. Name: Central—allows you to enter the name for this CIC Pro. Unit—allows you to enter the care unit name for use on the Unity IS network. Waveforms: ECG 1—this is defined by the ECG source. Waveform 2 – 4—allows you to define multiple patient viewer waveforms. Mirror Central Display—allows double-monitoring of patients from remote, or secondary, central stations.
Telemetry Setup: CIC Defaults Adjusting Alarm Volume The default alarm volume can be adjusted without entering the service mode when the alarm level is set above 40%. Follow these steps. 1. Click on the Alarm Volume field. The Alarm Volume popup menu opens. 367B 2. Click on the desired volume level. The volume can be set between 40% and 100%. To set the volume below 40%, you must enter the service mode. When the alarm level is set below 40%, the Alarm Volume field is disabled for the user. 3.
Telemetry Setup: Current Telemetry Listings Current Telemetry Listings You can view the Current Telemetry Listings by clicking on the Setup CIC button, but defaults can only be modified when in the service mode. Refer to the Service Password section in this chapter. The Current Telemetry Listings tab sheet allows you to view characteristics of telemetry settings. To open the Current Telemetry Listings tab sheet, follow these steps. 1. Click on the Setup CIC button at the bottom of the display.
Telemetry Setup: Current Telemetry Listings Admitted Telemetry Patients NOTE This overview covers the controls in a row. Each row contains information for one telemetry patient. The second line of an entry shows the current software level for the patient bed in question. Tower—indicates which telemetry receiver system this telemetry patient is communicating with. Receiver—indicates the receiver inside the telemetry receiver system with which this telemetry transmitter is communicating.
Telemetry Setup: Full Disclosure Defaults Full Disclosure Defaults The Full Disclosure Defaults tab sheet is used to set up the defaults for full disclosure monitoring. You must enter the service mode to make any modifications to this tab sheet. Refer to the Service Password section in this chapter for more information about entering the service mode. Below is an illustration of the Full Disclosure Defaults tab sheet.
Telemetry Setup: Full Disclosure Defaults For your notes 6-20 ApexPro Telemetry System 2001989-134 Revision D
7 Revision D Admit/View a Patient ApexPro Telemetry System 2001989-134 7-1
For your notes 7-2 ApexPro Telemetry System 2001989-134 Revision D
Admit/View a Patient: About Admitting About Admitting Switching Transmitters If you wish to switch to an ApexPro transmitter from a CD TelemetryLAN transmitter (Apex S, Apex 5, Apex 3, or CD Telemetry transmitter) or vice versa while a patient is admitted, you must follow this procedure: Discharge the patient (losing stored data). Switch transmitters. Re-admit the patient. Monitoring will stop if you switch transmitters while a patient is admitted.
Admit/View a Patient: About Admitting Combo Monitoring This application provides the option to acquire ECG data from either the monitor or from a telemetry receiver system. This ECG data acquisition capability enhances basic telemetry monitoring by providing additional access to all of the available parameters from the monitor. A Unity network connection is required.
Admit/View a Patient: Admit Instructions Admit Instructions Admitting a telemetry patient is a simple, yet important procedure. After you have prepared the patient’s skin, properly placed the electrodes, verified lead quality and electrode status, and set up the transmitter, the patient can be admitted. Refer to “Patient Preparation” on page 11-4 for information on patient skin preparation, proper electrode placement and verifying lead quality and electrode status.
Admit/View a Patient: Admit Instructions 2. Use the mouse to click on the Admit button. The single patient viewer appears at the bottom of the display, with the Admit tab in front. 342D 3. Select the desired bed number by using the mouse to click on the down arrow that appears to the right of the Bed field. A popup list of beds in the unit appears. Click on your choice to select it. The bed number selection will not change if the bed number is locked.
Admit/View a Patient: Admit Instructions 6. You can enter patient information by clicking in the various patient information fields, typing in the information, and then tabbing into or clicking in the next field. The patient information that should be entered is: Last Name, First Name, Patient ID, and Age. You do not have to enter this information in order to admit a patient. However, it is recommended that you enter it. Last Name, First Name, and Patient ID are entered using the keyboard.
Admit/View a Patient: Discharge Instructions Discharge Instructions To discharge a patient, follow this procedure: 1. At the CIC Pro, click on the bed window of the patient you wish to discharge. The display rearranges to accommodate the single patient viewer at the bottom of the display. 2. Click on the Admit tab to bring the tab sheet to the front. 342D 3. Click on the Discharge button in the lower right corner of the tab sheet. A dialog box similar to the one below appears on the display. 344A 4.
Admit/View a Patient: Discharge Instructions New Patient Button This option is only available for Telemetry Beds and Tele Combo type patients. It is located on the Admit tab sheet on the CIC Pro. It allows the user to discharge a patient and admit a new patient, while keeping the same bed number and transmitter ID number. To discharge then admit a patient, follow this procedure: 1. At the CIC Pro, click on the bed window of the patient you wish to discharge.
